HomeMy WebLinkAboutContract 50174?TEXAS
OIC' TARRANT
This contract ("Contract") is made and entered into by and between the City of Fort Worth
(hereafter "City") and Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity
(hereafter "Agency"). City and Agency may be referred to individually as a "Party" and jointly as
"the Parties".
The Parties state as follows:
WHEREAS, City receives grant monies from the United States Department of Housing
and Urban Development through the Community Development Block Grant ("CDBG") Program,
Program No. B -17 -MC -48-0010, Catalog of Federal Domestic Assistance No. 14.218;
WHEREAS, a national objective of the CDBG program is to benefit low and moderate
income citizens in accordance with 24 CFR Part 570, as amended from time to time;
WHEREAS, Agency submitted a proposal to use CDBG funds for a program to serve
individuals and families, 1.00% of whom must be low and moderate income;
WHEREAS, City citizens, the Community Development Council, and the City Council
have determined that CDBG programs are needed by the City's citizens.
NOW, THEREFORE, the Parties understand and agree as follows:
1. INCORPORATION OF RECITALS.
City and Agency hereby agree that the recitals set forth above are true and correct and form
the basis upon which the Parties have entered into this Contract.
2. DEFINITIONS.
In addition to terms defined in the body of this Contract, the terms set forth below shall
have the definitions ascribed to them as follows:
Area Median Income or AMI means the median family income for the Fort Worth -Arlington
metropolitan statistical area as established annually by HUD. The 2017 income limits are
attached hereto as EXIIIBIT "A-1" — 2017 HUD Income Limits.
Business Diversity Enterprise Ordinance or BDE means the City's Business Diversity
Ordinance, Ordinance No. 20020-12-2011.
CDBG means Community Development Block Grant,
Complete Documentation means the following documentation as applicable:
• Attachments I, II, and III, with supporting documentation including:
OFFICIAL RECORD
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Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humat ity FT. WORTH, TX Rev. 12.21.2017
o Proof of expense: copies of timesheets, invoices, leases, service or
construction/vendor contracts or other documentation showing that payment
is due byAgency._
o Proof of payment: cancelled checks, bank statements, or wire transfers
necessary to demonstrate that amounts due by Agency were actually paid by
Agency.
o Proof of client eligibility: Source Documentation for all clients participating
in the Program.
• Complete Documentation shall meet the standards described in the attached
EXHIBIT "F" = Standards for Complete Documentation.
• Any other document or record reasonably necessaryto verify costs spent and client
eligibility for the Program.
CDBG Funds means the CDBG grant funds supplied by City to Agency under the terms of this
Contract.
CDBG Regulations means regulations found at 24 CFR Part 570 et seq.
DBE means disadvantaged business enterprise in accordance with 49 CFR Part 26.
Director means the Director of the Neighborhood Services Department.
Effective Date means October 15, 2017:
HUD means the United States Department of Housing and Urban Development.
IDIS means Integrated Disbursement Information System, HUD's project tracking system.
Income Eligible Client means a client whose annual income adjusted for family size does not
exceed 50% of AMI using the most current HUD Income Guidelines and Technical Guidance for
Determining Income and Allowances: The definition of annual ineome to determine client income
eligibility shall b., the definition contained in 24 CFR Part 5.609, as amended from time to time.
National Objective means an activity that benefits low and moderate income persons..For the
purposes of this Contract, 100% of the clients served by the Program must be Income Eligible
Clients.
Neighborhood Services Department means the City's Neighborhood: Services. Department.
OMB means the Office of Management and Budget.
Program means the services described in EXHIBIT "A" — Program Summary.
Reimbursement Request means all reports and other documentation described in Section 9.
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Source Documentation means documentation of full household income of any type described
under the definition of annual income in 24 CFR Part 5.609, including but not limited to copies of
paychecks, Social Security and disability verification letters, interest or rental income statements,
retirement income statements, child support and alimony verification, unemployment benefit
letters, and the like.
Unduplicated Clients means a count of all clients served by the Program at least once in the
Contract Term. Clients served by the Program more than once in the Contract Term will only be
counted the first time they are served when determining the total count of Unduplicated Clients.
3. TERM.
The tern of this Contract begins on the Effective Date and terminates on December 31,
2018 unless earlier terminated as provided in this Contract.
4. DUTIES AND RESPONSIBILITIES OF CITY.
4.1 Provide CDBG Funds.
City shall provide up to $285,000.00 of CDBG Funds under the terms and conditions of
this Contract for Agency's Cowtown Brushup Program.
4.2 Monitor.
City will monitor the activities and performance of Agency and any of its contractors,
subcontractors or vendors as necessary, but no less than annually. Monitoring by City will include
determining whether Agency is meeting the National Objective during the term of this Contract.
5. DUTIES AND RESPONSIBILITIES OF AGENCY.
5.1 Required Services.
Agency shall perform the services described in EXHIBIT "A" — Program Summary in
accordance with the terms and conditions of this Contract.
5.2 Use of CDBG Funds.
5.2.1. Compliance with CDBG Regulations and Contract.
Agency shall be reimbursed for eligible Program costs with CDBG Funds only if City
determines in its sole discretion that:
5.2.1.1 Costs are eligible expenditures in accordance with CDBG Regulations.
5.2.1.2 Costs are in compliance with this Contract and are reasonable and
consistent with industry norms.
5.2.1.3 Complete Documentation, as applicable, is submitted to City by
Agency.
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5.2.2 Budget.
5.2.2.1 The CDBG Funds will be paid on a reimbursement basis in accordance
with EXHIBIT `B" - Budget.
5.2.2.2 During the term of this Contract, Agency may submit written requests
to increase or decrease line -item amounts in the Budget, including an
explanation of why such increases or decreases are necessary. All
requests shall be approved_ by Director in writing, with such approval
being in the Director's sole discretion. If Director approves the
Agency's proposed Budget amendment (as approved, the "Amended
Budget"), then the Amended Budget will take effect on the first day of
the month following the month in which .it was approved by Director,
unless otherwise specified in the amendment. All requests for Budget
amendments must be submitted by June 1, 2018.
5.2.3 Change in Program Budget.
5,2.3,1 Agency will notify City promptly of any additional funds it receives for
operation of the Program, and City reserves the right to amend this
Contract in such instances to ensure compliance with HUD regulations
governing cost allocation.
5.2.3.2 Agency agrees to utilize the CDBG Funds to supplement rather than
supplant funds otherwise available for the Program.
5.2.4 Payment of CDBG Funds to Agency.
CDBG Funds will be disbursed to Agency upon City's approval of Reimbursement
Requests including submission of Complete Documentation to City in compliance with Section 9.
IfAgency expends all funds budgeted for the Program prior to December 31, 2018, City may hold
back a small amount of the CDBG Funds until the end of the term. During this interim period,
Agency must continue to submit Attachment. III -- Client Data Report in EXHIBIT "D" —
Reimbursement Forms monthly. It is expressly agreed by the Parties that any CDBG Funds not
spent or approved for reimbursement to Agency shall remain with City.
5.3 Program Performance Milestones.
5.3.1 Agency represents that the Program will achieve the following milestones in
accordance with EXHIBIT "A" — Program Summary and the table below:
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EXHIBIT
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; ISA",—Program
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25% 25%
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50% 50%
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75% 75%
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12 1 100% 1 100%
5.3.2 Failure of Agency to meet these milestones or a material deviation from them as
outlined in this Section 5.3 is a breach of this Contract. For the purpose of this Section, "material
deviation" shall mean more than 10% lower than the specified goal. In the event of such breach,
City reserves the right in its sole option to (i) delay or withhold payment of Reimbursement
Requests, (ii) lower Agency's allocation of CDBG Funds, or (iii) terminate this Contract.
5.3.3 Failure to meet at least 80% of its performance milestones or serve 70 Unduplicated
Clients under this contract may, in City's sole discretion, disqualify Agency for consideration
under the City's Request for Proposals for the 2018-2019 Program Year for federal grant funds.
5.3.4 Amendments to performance milestones regarding CDBG funds must be approved
by the Director in writing, with such approval being in the Director's sole discretion. If Director
approves the Agency's proposed amended performance milestones (as approved, the "Amended
Performance Milestones"), then the Amended Performance Milestones will take effect on the
first day of the month following the month in which it was approved by Director, unless otherwise
specified in the amendment. All requests for amendments to performance milestones must be
submitted by June 1, 2018. Notwithstanding the above, any amendments to this Contract shall
not reduce the number of Unduplicated Clients stated in Section 5.3.3 and in EXHIBIT "A" -
Program Summary.
5.4 Identify Program Expenses Paid with CDBG Funds.
Agency will keep accounts and records in such a manner that City may readily identify and
account for Program expenses reimbursed with CDBG Funds. These records shall be made
available to City for audit purposes and shall be retained as required hereunder.
5.5 Meet National Ob.iective.
Agency shall ensure that the activities carried out in the Program will meet the National
Objective.
5.6 Program Subcontracts.
Agency shall not enter into a subcontract with another agency, contractor, or vendor to
provide a service to clients for any part of the Program that will be paid with CDBG Funds without
City's written consent.
6. CLIENT ELIGIBILITY VERIFICATION.
6.1 Client Eligibility.
Agency will document client eligibility as follows:
6.1.1 Agency Clients.
Agency must verify all new clients' income with Source Documentation. Agency must
use the annual income definition in 24 CFR Part 5.609 to establish client income and must use the
most current HUD Income Guidelines. The income of all Program clients must be documented
and 100% of them must be Income Eligible Clients.
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6.1.1.1 All Program clients must be reported on EXHIBIT "D" —
Reimbursement Forms, Attachment III. Any Agency clients for
which the appropriate Source Documentation is not obtained shall be
presumed ineligible.
6.2 Submission of Complete Documentation.
Agency must submit copies of documentation of client eligibility described in Section 6.1
with Attachment III with each month's Reimbursement Request for all Unduplicated Clients.
6.3 Maintain Documentation.
Agency must maintain copies of all documentation required by this Section 6 for 5 years
following the expiration of the Contract term. This Section shall survive the earlier termination
or expiration of this Contract.
7. ADDITIONAL CDBG REQUIREMENTS.
Agency agrees to comply with all requirements of the CDBG Program as stated in the
CDBG Regulations, including but not limited to the following;
7.1 Environmental Review.
CDBG Funds will not be paid, and costs cannot be incurred on a given site until City has
conducted an environmental review and completed an Environmental Review Record for that site
as required by 24 CFR Part 58. The individual environmental reviews may result in a decision to
proceed with, modify, or cancel the funding for the Program. Further, Agency will not undertake
or commit any funds to physical or choice limiting actions as described in any applicable federal
regulations. Any violation of this provision will (i) cause this Contract to terminate immediately,
and (ii) require Agency to repay City the CDBG Funds it has already received and forfeit any
future payments of CDBG Funds.
7.1.2 Environmental Mitigation.
If applicable, Agency must take the mitigation actions outlined in EXHIBIT "A-2" —
Environmental Mitigation Actions. Failure to complete the required mitigation action is an
event of default under this Contract.
7.2 Contract Not Constituting Commitment of Funds.
Notwithstanding any provision of this Contract, the Parties agree and acknowledge that
this Contract does not constitute a commitment of funds, and that such commitment of funds or
approval may occur only upon (i) satisfactory completion of an environmental review and receipt
by City of an authorization to use grant funds from HUD under 24 CFR Part 58, (ii) approval of
City's 2017-2018 Action Plan, and (iii) receipt by City of a grant agreement from HUD.
7.3 Monitoring.
7.3.1 Agency understands and agrees that it will be subject to monitoring by City for
compliance with terms and provisions of this Contract and the CDBG Regulations for the term of
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this Contract. Agency is subject to such monitoring during the term of this Contract and for 5
years after the Contract term ends. Agency will provide reports and access to Program files as
requested by City during this 5 year period. For purposes of this Contract, this 5 year period for
monitoring is deemed to begin on October 15, 2017 and end on December 31, 2023 regardless of
whether or not this Contract is earlier terminated.
7.3.2 Representatives of City, HUD, HUD Office of Inspector General, and the United
States Comptroller General shall have access during regular business hours, upon 48 hours prior
notice, to Agency's offices and records pertaining to the use of the CDBG Funds, and to Agency's
officers, directors, agents, employees, contractors, subcontractors and vendors for the purpose of
such monitoring.
7.3.3 In addition to other provisions of this Contract regarding frequency of monitoring,
City reserves the right to perform desk reviews or on-site monitoring of Agency's compliance with
the terms and conditions of this Contract. City shall provide Agency with a written report of the
monitor's findings after each monitoring visit. If the monitoring report notes deficiencies in
Agency's performance, the report shall include requirements for the timely correction of said
deficiencies by Agency. Failure by Agency to take the action specified in the monitoring report
may be cause for suspension or termination of this Contract as provided herein.
7.3.4 Subsections 7.3.1 through 7.3.3 shall be applicable for the Contract term and for 5
years thereafter and shall survive the earlier termination or expiration of this Contract.
7.3.5 Agency shall provide City annually the results of any state or federal monitoring
of any of its programs and single audits. Such results shall be submitted within 60 days of
receipt of such state or federal monitoring report, or with the January Reimbursement Request,
whichever is earlier.
7.4 Ay-ency Procurement Standards.
Agency shall comply with all applicable federal, state and local laws, regulations, and
ordinances for making procurements under this Contract. In addition to the conflict of interest
provisions in Section 14.13.3, Agency shall establish written procurement procedures to ensure
that materials and services are obtained in a cost effective manner and that provide for full and
open competition. Agency shall provide a copy of such procurement procedures to City before the
first payment for construction services is processed. When procuring materials and services for
this Contract, Agency shall comply at a minimum with the procurement standards in 2 CFR Part
200.317 through Part 200.326.
7.4.1 Contracts in excess of $10,000.00 made by Agency using CDBG Funds must
include provisions governing termination for cause and convenience including the manner by
which such termination shall be effected and the basis for settlement of the terminated contract, if
any, as required by Appendix 11(B), 2 CFR Part 200.
7.4.2 Agency shall not make any contract with parties listed on the government wide
System for Award Management, www.sarn.gov ("SAM"). Agency must confirm by search of
SAM that all contractors paid with CDBG Funds are not listed by SAM as being debarred, both
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prior to contract execution and prior to submitting a Reimbursement Request which includes
invoices from any such contractor. Failure to submit such proofs of search shall be an event
of default.
7.5 Cost Principles/Cost Reasonableness.
Agency shall administer its use of CDBG Funds in compliance with 2 CFR Part 200, as
applicable. The eligibility of costs incurred for performance rendered shall be determined in
accordance with 2 CFR Part 200.400 through 2 CFR Part 200.475.
7.6 Financial Management Standards.
Agency agrees to comply with 2 CFR Part 200, as applicable. Agency also agrees to adhere
to the accounting principles and procedures required therein, utilize adequate internal controls, and
maintain necessary supporting and back-up documentation for all costs incurred in accordance
with 2 CFR Part 200.302 and Part 200.303.
7.7 Uniform Administrative Requirements, Cost Principles, and Audit
Requirements.
Agency will comply with the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards in 2 CFR Part 200, as applicable, or any reasonably
equivalent procedures and requirements that City may require.
7.8 Terms Applicable to Contractors, Subcontractors and Vendors.
Agency understands and agrees that all terms of this Contract, whether regulatory or
otherwise, shall apply to any and all contractors, subcontractors and vendors of Agency which are
in any way paid with CDBG Funds or who perform any work in connection with the Program.
Agency shall cause all applicable provisions of this Contract to be included in and made a part of
any contract or subcontract executed in the performance of its obligations hereunder including its
obligations regarding the CDBG Regulations. Agency shall monitor the services and work
performed by its contractors, subcontractors and vendors on a regular basis for compliance with
the CDBG Regulations and Contract provisions. Agency must cure all violations of the CDBG
Regulations committed by its contractors, subcontractors or vendors. City maintains the right to
insist on Agency's full compliance with the terms of this Contract and the CDBG Regulations and
Agency is responsible for such compliance regardless of whether actions taken to fulfill the
requirements of this Contract are taken by Agency or by Agency's contractors, subcontractors or
vendors. Agency acknowledges that the provisions of this Section shall survive the earlier
termination or expiration of this Contract and shall be applicable for 5 years after the Contract term
ends.
7.9 Copyright and Patent Rights.
No reports, maps, or other documents produced in whole or in part under this Contract shall
be the subject of an application for copyright by or on behalf of Agency. HUD and City shall
possess all rights to invention or discovery, as well as rights in data, which may arise as a result of
Agency's performance under this Contract.
7.10 Conflict of Interest Disclosure.
In accordance with the requirements of Section 14.13.2.1 and 14.13.4, Agency shall
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establish conflict of interest policies for federal awards. Agency shall disclose to City in writing
any potential conflict of interest. Additionally, all applicants for Agency services shall be required
to complete the attached conflict of interest form incorporated herein as Exhibit "K"—Conflict
of Interest Form and disclose any potential conflict of interest to both Agency and City. If the
applicant checks "yes" to any items on the form, Agency must submit the form to its designated
Contract Administrator. City Compliance Specialist(s) will review information to determine
whether CDBG Conflict of Interest requirements will apply. The Contract Administrator will
notify Agency of appropriate next steps at that time.
7.11 Compliance with FFATA and Whistleblower Protections.
Agency shall comply with the requirements of 2 CFR 300(b), including provisions of the
Federal Funding Accountability and Transparency Act ("FFATA") governing requirements on
executive compensation and provisions governing whistleblower protections contained in 10
U.S.C. 2409,41 U.S.C. 4712, 10 U.S.C. 2324,41 U.S.C. 4304 and 41 U.S.C. 4310.
7.11.1 Agency shall provide City with its DUNS number.
7.12 Internal Controls.
In compliance with the requirements of 2 CFR Part 200.303, Agency shall:
7.12.1 Establish and maintain effective internal control over the CDBG Funds that
provides reasonable assurance that Agency is managing the CDBG Funds in compliance with
federal statutes, regulations, and the terms and conditions of this Contract. These internal controls
shall be in compliance with guidance in "Standards for Internal Control in the Federal
Government" issued by the Comptroller General of the United States or the "Internal Control
Integrated Framework" issued by the Committee of Sponsoring Organizations of the Treadway
Commission ("COSO");
7.12.2 Comply with federal statutes, regulations, and the terms and conditions of this
Contract;
7.12.3 Evaluate and monitor Agency's compliance with statutes, regulations and the terms
and conditions of this Contract;
7.12.4 Take prompt action when instances of noncompliance are identified including
noncompliance identified in audit findings; and
7.12.5 Take reasonable measures to safeguard protected personally identifiable
information and other information that HUD or City designates as sensitive or Agency considers
sensitive consistent with applicable federal, state, local and tribal laws regarding privacy and
obligations of confidentiality.
7.13 Lead Safe Housing Rule.
Agency will ensure compliance with the Lead Safe Housing Rule at 24 CFR Part 35, as
applicable. This includes but is not limited to Provision of Lead Hazard Information pamphlet,
use of Lead Certified contractors, use of Lead -Safe work practices, and clearance of the work site,
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as applicable to the age of the housing unit and the extent of rehabilitation. Agency shall certify
that work affects only "de minimus" areas as appropriate to specific sites. "de minimus" thresholds
as defined by HUD are as follows: 20 square feet (2 square meters) on exterior surfaces; 2 square
feet (0.2 square meters) in any one interior room; or 10 percent of the total surface area on an
interior or exterior type of component with a small surface area (such as window sills, baseboards,
and trim).Agency shall submit EXHIBIT "J" — Lead Safe Hazard Certification to City when
appropriate.
8. RECORD KEEPING; REPORTING AND DOCUMENTATION
REQUIREMENTS; AUDIT.
8.1 Record Keeping.
Agency shall maintain a record-keeping system as part of its performance of this Contract
and shall promptly provide City with copies of any document City deems necessary for the
effective fulfillment of City's monitoring and evaluation responsibilities. Specifically, Agency
will keep or cause to be kept an accurate record of all actions taken and all funds spent, with
supporting and back-up documentation. Agency will maintain all records and documentation
related to this Contract for 5 years after the Contract term ends. If any claim, litigation, or audit is
initiated before the expiration of the 5 year period, the relevant records and documentation must
be retained until all such claims, litigation or audits have been resolved. For purposes of this
Contract, this 5 year period for record retention is deemed to begin on October 15, 2017 and end
on December 31, 2023 regardless of whether or not this Contract is earlier terminated.
8.2 Access to Records.
Representatives of City, HUD and any duly authorized officials of the federal government
will have full access to, and the right to examine, audit, copy, excerpt and/or transcribe any of
Agency's records pertaining to all matters covered by this Contract for 5 years after the Contract
term ends. Such access shall be during regular business hours and upon at least 48 hours prior
notice. For purposes of this Contract, this 5 year period for access to records is deemed to begin
on October 15, 2017 and end on December 31, 2023 regardless of whether or not this Contract is
earlier terminated.
8.3 Reports.
Agency will submit to City all reports and documentation described in this Contract in such
form as City may prescribe. Agency may also be required to submit a final performance and/or
final financial report if required by City at the termination of this Contract in such form and within
such times as City may prescribe. Failure to submit to City any report or documentation described
in this Contract shall be an event of default of this Contract and City may exercise all of its
remedies for default under this Contract.
8.3.1 Additional Information.
Agency shall provide City with additional information as may be required by state or
federal agencies to substantiate Program activities and/or expenditure eligibility.
8.4 Change in Reporting Requirements and Forms.
City retains the right to change reporting requirements and forms at its discretion. City
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will notify Agency in writing at least 15 days prior to the effective date of such change, and the
Parties shall execute an amendment to the Contract reflecting such change if necessary.
8.5 Audit.
8.5.1 Entities that Expend $750,000 or more in Federal Funds Per Year.
All non-federal entities that expend $750,000 or more in federal funds within 1 year,
regardless of the source of the federal award, must submit to City an annual audit prepared in
accordance with specific reference to 2 CFR Part 200.501 through Part 200.521. The audit shall
cover the Agency's fiscal years during which this Contract is in force. The audit must be prepared
by an independent certified public accountant, be completed within 6 months following the end of
the period being audited and be submitted to City within 30 days of its completion. Agency's audit
certification is attached hereto as EXHIBIT "C" — "Audit Certification Form" and "Audit
Requirements". The Audit Certification Form must be submitted to City prior to or with the
first Reimbursement Request. Entities that expend less than $750,000 a year in federal funds are
exempt from federal audit requirements for that year, but records must be available for review or
audit by appropriate officials of the federal agency, City, and General Accounting Office.
8.5.2 City Reserves the Right to Audit.
City reserves the right to perform an audit of Agency's Program operations and finances at
any time during the term of this Contract and for 5 years after the Contract term ends if City
determines that such audit is necessary for City's compliance with the CDBG Regulations or other
City policies. Agency agrees to allow access to all pertinent materials as described herein for such
audit. For purposes of this Contract, this 5 year period for City audit is deemed to begin on
October 15, 2017 and end on December 31, 2023 regardless of whether or not this Contract is
earlier terminated. If such audit reveals a questioned practice or expenditure, such questions must
be resolved within 15 business days after notice to Agency of such questioned practice or
expenditure. If questions are not resolved within this period, City reserves the right to withhold
further funding under this Contract and/or any other contracts with Agency. IF AS A RESULT
OF ANY AUDIT IT IS DETERMINED THAT AGENCY HAS FALSIFIED ANY
DOCUMENTATION OR MISUSED, MISAPPLIED OR MISAPPROPRIATED CDBG
FUNDS OR SPENT CDBG FUNDS ON ANY INELIGIBLE ACTIVITIES, AGENCY
AGREES TO REIMBURSE CITY THE AMOUNT OF SUCH MONIES PLUS THE
AMOUNT OF ANY SANCTIONS, PENALTY OR OTHER CHARGE LEVIED AGAINST
CITY BY HUD BECAUSE OF SUCH ACTIONS.
9. REIMBURSEMENT REQUIREMENTS.
9.1 Deadline for Submitting Reimbursement Requests.
9.1.1 Reimbursement Requests shall be submitted monthly to the City and must be
received by the City on or before the 15th day of the month following the month expenses were
paid by Agency. For example, the Reimbursement Request for June expenses must be received
by July 15. In the event the 15th falls on a weekend or City holiday, Reimbursement Requests
shall be due the next day that the City is open for business. Failure to submit a Reimbursement
Request in a timely fashion will result in City taking the actions outlined in Section 10.1.
NOTWITHSTANDING ANYTHING ABOVE, THE REIMBURSEMENT REQUEST FOR
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EXPENSES INCURRED FOR SEPTEMBER 2018 AND ALL SUPPORTING
DOCUMENTATION MUST BE RECEIVED BY OCTOBER 15, 2018. FAILURE TO
SUBMIT A FINAL REIMBURSEMENT REQUEST WITH COMPLETE
DOCUMENTATION BY OCTOBER 15, 2018 WILL RESULT IN AUTOMATIC
FORFEITURE OF PAYMENT OF THE SEPTEMBER REIMBURSEMENT REQUEST.
9.1.2 City will notify Agency by e-mail within 20 calendar days if a Reimbursement
Request is lacking Complete Documentation or corrections are needed. Agency will have 10
business days from the date of the e-mail notice to submit any requested information or missing
documentation. Agency may be penalized, at City's sole discretion, in the City's HUD Grant
Request for Proposal or Notice of Funding Availability (NOFA) process for the 2018-2019
Program Year for any notifications received under this Section. If Agency fails to submit all the
required information or missing documentation within 30 calendar days from the first e-mail,
Agency shall forfeit any payments otherwise due that month and failure to submit any requested
information will be considered an event of default as outlined in Section 10.1.2.
9.2 Submission of Reimbursement Requests.
Agency shall provide City with Complete Documentation and the following reports
as shown in EXHIBIT "D" Reimbursement Forms with each Reimbursement Request:
9.2.1 Attachment I — Invoice.
This report shall contain the amount requested for reimbursement each month, the
cumulative reimbursement requested to date (inclusive of that month's request).
9.2.2 Attachment II — Expenditure Worksheet.
This report shall itemize each expense requested for reimbursement by Agency and shall
include the Account corresponding the expense to a Budget line item. In order for this report to
be complete the following must be submitted:
9.2.2.1 For payroll expenses, timesheets signed by employees and approved by
supervisor for all payroll expenses listed. Timesheets must distinguish
between CDBG-funded time and non-CDBG funded time and reflect
actual time spent on CDBG-funded activities. Agency may not submit
payroll expenses dated 60 calendar days prior to the date of the
Reimbursement Request.
9.2.2.2 For non -payroll expenses, invoices for each expense listed with an
explanation as to how the invoiced expense pertains to the Program.
Agency may not submit invoices dated 60 calendar days prior to the date
of the Reimbursement Request.
9.2.2.3 Proof that each expense was paid by Agency, which proof can be
satisfied by cancelled checks, wire transfer documentation, paid receipts
or other appropriate banking documentation.
9.2.3 Attachment III — Client Data Report.
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This report shall list each Unduplicated Client served during the month along with his or
her demographic information. The Client Data Report must maintain a list of all clients served
during the Contract term. In order for this report to be complete, the following must be submitted:
9.2.3.1 Source Documentation of income verification for each Unduplicated
Client the first time the client is served by the Program
9.2.4 Delivery of Reimbursement Request.
Reimbursement Requests can be mailed or delivered in person to Neighborhood Services
Department, 908 Monroe Street, Fort Worth, Texas 76102. In addition, Agency can submit
Reimbursement Requests via email to psa@fortworthtexas.gov or to the Agency's designated City
contract administrator.
9.3 Withholding Payment.
CITY SHALL HAVE NO OBLIGATION TO PAY ANY REIMBURSEMENT
REQUEST THAT IS NOT RECEIVED BY THE DUE DATE. Failure to timely submit
Reimbursement Requests and Complete Documentation along with any required reports
shall be an event of default.
10. DEFAULT AND TERMINATION.
10.1 Failure to Submit Reimbursement Request or Required Documentation.
10.1.1 If Agency fails to submit a Reimbursement Request in accordance with Section
9, Agency shall be in default of this Contract. City will notify Agency in writing of such default
and the Agency will have 10 business days from the date of the written notice to submit such
Reimbursement Request to cure the default. If Agency fails to cure the default within such time,
Agency shall forfeit any payments otherwise due that month.
10.1.2 If Agency fails to submit requested information or missing documentation as
set forth in Section 9.1.2, then Agency shall forfeit payment due that month and the failure to
submit shall be considered an event of default that shall not be cured.
10.1.3 NOTWITHSTANDING THE PROVISIONS OF SECTION 10.1.1 OR
10.1.2, IF AGENCY FAILS TO SUBMIT THE REIMBURSEMENT REQUEST DUE
OCTOBER 15, 2018, OR IF THE SUBMITTED REIMBURSEMENT REQUEST FOR
OCTOBER 15, 2018 IS LATE, INCOMPLETE OR OTHERWISE NOT IN COMPLIANCE
WITH THIS CONTRACT OR THE CDBG REGULATIONS AS DETERMINED BY CITY
IN ITS SOLE DISCRETION, THERE WILL BE NO CURE PERIOD AND ANY
REIMBURSEMENT WILL BE FORFEITED.
10.1.4 In the event of (i) an uncured default under Section 10.1.1 or an event of default
under 10.1.2 or (ii) more than 2 instances of default, cured or uncured, under these Sections, City
reserves the right at its sole option to terminate this Contract effective immediately upon written
notice of such intent with no penalty or liability to City.
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10.1.5 Notwithstanding anything to the contrary herein, City will not be required to
pay any CDBG Funds to Agency during the period that any Reimbursement Request, report or
documentation is past due or is not in compliance with this Contract or the CDBG Regulations, or
during any period during which Agency is in default of this Contract.
10.1.6 In the event of termination under this Section 10. 1, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no fbither right to such funds.
10.2 Failure to Maintain Records or Submit Reports and Documentation.
If Agency fails to maintain all records and documentation as required in Section 8, or if the
maintained or submitted report or documentation is not in compliance with this Contract or the
CDBG Regulations as determined by City in its sole discretion, City will notify Agency in writing
and Agency will have 30 calendar days from the date of the written request to obtain or recreate
the missing records and documentation or submit or resubmit any such report or documentation to
City. If Agency fails to maintain the required reports or documentation, or fails to submit or
resubmit any such report or documentation within such time, City shall have the right to terminate
this Contract effective immediately upon written notice of such intent with no penalty or liability
to City.
10.2.1 In the event of termination under this Section 10.2, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds, and any CDBG Funds paid to Agency must be repaid to City
within 30 days of termination. If such CDBG Funds are not repaid to City within the 30 day
period, City shall exercise all legal remedies available under this Contract.
10.3 In General.
10.3.1 Subject to Section 10.2, and unless specifically provided otherwise in this
Contract, Agency shall be in default under this Contract if Agency breaches any term or condition
of this Contract. In the event that such a breach remains uncured after 30 calendar days following
written notice by City (or such other notice period as may be specified herein) or, if Agency has
diligently and continuously attempted to cure following receipt of such written notice but
reasonably requires more than 30 calendar days to cure, as determined by both Parties mutually
and in good faith, City shall have the right to elect in City's sole discretion to (i) extend Agency's
time to cure, (ii) terminate this Contract effective immediately upon written notice of such intent
to Agency, or (iii) pursue any other legal remedies available to City under this Contract.
10.3.2 City's remedies may include:
10.3.2.1 Direct Agency to prepare and follow a schedule of actions for
carrying out the affected activities, consisting of schedules,
timetables and milestones necessary to implement the affected
activities.
10.3.2.2 Direct Agency to establish and follow a management plan that
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assigns responsibilities for carrying out the remedial activities.
10.3.2.3 Reprogram CDBG Funds that have not yet been expended from
affected activities to other eligible activities or withhold CDBG
Funds,
10.3.2.4 Any other appropriate action including but not limited to any
remedial action legally available such as declaratory judgment,
specific performance, damages, temporary or permanent
injunctions, termination of this Contract or any other contracts with
Agency, and any other available remedies.
10.3.3 In the event of termination under this Section 10.3, all CDBG Funds awarded
but unpaid to Agency pursuant to this Contract shall be immediately forfeited and Agency shall
have no further right to such funds, and any CDBG Funds already paid to Agency must be repaid
to City within 30 days of the termination. Failure to repay such CDBG Funds within the 30 day
period will result in City exercising all legal remedies available under this Contract.
10.4 No Funds Disbursed while in Breach.
Agency understands and agrees that no CDBG Funds will be paid to Agency until all
defaults are cured to City's satisfaction.
10.5 No Compensation After Date of Termination.
Agency shall not receive any compensation for work undertaken after the date of the
termination.
10.6 Rights of City Not Affected.
Termination shall not affect or terminate any of the existing rights of City against Agency,
or which may thereafter accrue because of Agency's default and this provision shall be in addition
to any and all other rights and remedies available to City under the law. Such termination does
not terminate any provisions of this Contract that have been expressly noted as surviving the term
or termination of the Contract. No delay or omission by City in exercising any right or remedy
available to it under this Contract shall impair any such right or remedy or constitute a waiver or
acquiescence in any Agency default.
10.7 Waiver of Breach Not Waiver of Subsequent Breach.
The waiver of a default or breach of any term, covenant, or condition of this Contract shall
not operate as a waiver of any subsequent default or breach of the same or any other term, covenant
or condition hereof.
10.8 Civil Criminal and Administrative Penalties.
Failure to perform all the Contract terms may result in civil, criminal or administrative
penalties, including, but not limited to those set out in this Contract.
10.9 Termination for Cause.
10.9.1 City may terminate this Contract in the event of Agency's default, inability, or
failure to perform subject to notice, grace and cure periods. In the event City terminates this
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Contract for cause, all CDBG Funds awarded but unpaid to Agency pursuant to this Contract shall
be immediately rescinded and Agency shall have no further right to such funds and any CDBG
Funds already paid to Agency must be repaid to City within 30 days of termination. Failure to
repay such CDBG Funds within 30 days will result in City exercising all legal remedies available
to City under this Contract. AGENCY ACKNOWLEDGES AND AGREES THAT IF CITY
TERMINATES THIS CONTRACT FOR CAUSE, AGENCY OR ANY AFFILIATES OF
AGENCY SHALL NOT BE CONSIDERED FOR ANY OTHER CITY CONTRACT FOR
CDBG FUNDS FOR A MINIMUM OF 5 YEARS FROM THE DATE OF TERMINATION.
10.9.2 Agency may terminate this Contract if City does not provide the CDBG Funds
substantially in accordance with this Contract.
10.10 Termination for Convenience.
In terminating in accordance with 2 CFR Part 200, Appendix H, this Contract may be
terminated in whole or in part only as follows:
10.10.1 By City with the consent of Agency in which case the Parties shall agree upon
the termination conditions, including the effective date and in the case of partial termination, the
portion to be terminated; or
10.10.2 By Agency upon at least 30 days written notification to City, setting forth the
reasons for such termination, the effective date, and in the case of partial termination, the portion
to be terminated. In the case of a partial termination, City may terminate the Contract in its entirety
if City determines in its sole discretion that the remaining portion of the Contract to be performed
or CDBG Funds to be spent will not accomplish the purposes for which the Contract was made.
10.11 Dissolution of Agency Terminates Contract.
This Contract shall terminate in the event Agency is dissolved or ceases to exist. In the
event of termination under this Section, all CDBG Funds are subject to repayment and/or City may
exercise all of its remedies under this Contract.
10.12 Reversion of Assets.
In the event this Contract is terminated with or without cause, all assets acquired by Agency
with the CDBG Funds including cash, interest payments from loans or otherwvise, all outstanding
notes, mortgages or other security instruments, any accounts receivable attributable to the use of
the CDBG Funds, and any real or personal property owned by Agency that was improved with the
CDBG Funds shall automatically transfer to City or to such assignee as City may designate.
11. REPAYMENT OF CDBG FUNDS.
All CDBG Funds are subject to repayment in the event the Program does not meet the
requirements of this Contract or in the CDBG Regulations. If Agency takes any action that
results in the City being required to repay all or any portion of the CDBG Funds to HUD,
Agency agrees it will reimburse City for such repayment. If Agency takes any action that
results in City receiving a finding from HUD about the Program, whether or not repayment
of all or any portion of the CDBG Funds is required of City, Agency agrees City may require
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that 10% of the CDBG Funds be repaid to City as liquidated damages. The Parties agree that
City's damages in the event of either repayment to HUD being required or receiving a finding
from HUD are uncertain and would be difficult to ascertain and may include an impact on City's
CDBG grant or other federal grant funds, in addition to the finding by HUD or a required
repayment of funds to HUD by City. Therefore, the Parties agree that payment under this Section
of 10% of the CDBG Funds by Agency to City is liquidated damages and not a penalty.
12. CHANGE IN NON-PROFIT STATUS.
Agency must provide City with written notification of any changes to its non-profit status
within 15 calendar days of being notified of the change. Regardless of notice by Agency, if the
non-profit status of Agency changes after the date of this Contract, City may but is not obligated
to, terminate this Contract. In the event of termination under this Section 12, all CDBG Funds
awarded but not yet paid to Agency pursuant to this Contract shall be immediately rescinded and
Agency shall have no further right to such funds. City, in its sole discretion, may require that any
CDBG Funds already paid to Agency must be repaid to City within 30 calendar days of termination
under this Section.
13. SURVIVAL.
Any provision of this Contract that pertains to auditing, monitoring, client income
eligibility, record keeping and reports, City ordinances, or applicable CDBG requirements, and
any default and enforcement provisions necessary to enforce such provisions, shall survive the
termination of this Contract for 5 years after the Contract term ends and shall be enforceable by
City against Agency. For purposes of this Contract, this 5 year period for survival of certain
Contract provisions is deemed to begin on October 15, 2017 and end on December 31, 2023
regardless of whether or not this Contract is earlier terminated.
14. GENERAL PROVISIONS.
14.1 Agency an Independent Contractor.
Agency shall operate hereunder as an independent contractor and not as an officer, agent,
servant or employee of City. Agency shall have exclusive control of, and the exclusive right to
control, the details of the work and services performed hereunder, and all persons performing
same, and shall be solely responsible for the acts and omissions of its officers, members, agents,
servants, employees, contractors, subcontractors, vendors, clients, licensees or invitees.
14.2 Doctrine of Respondeat Superior.
The doctrine of respondeat superior shall not apply as between City and Agency, or its
officers, members, agents, servants, employees, contractors, subcontractors, vendors, clients,
licensees or invitees, and nothing herein shall be construed as creating a partnership or joint
enterprise between City and Agency. City does not have the legal right to control the details of
the tasks performed hereunder by Agency, its officers, members, agents, employees, contractors,
subcontractors, vendors, clients, licensees or invitees.
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14.3 Agency Property.
City shall under no circumstances be responsible for any property belonging to Agency, or
its officers, members, agents, employees, contractors, subcontractors, vendors, clients, licensees
or invitees that may be lost, stolen or destroyed or in any way damaged and AGENCY HEREBY
INDEMNIFIES AND HOLDS HARMLESS CITY AND ITS OFFICERS, AGENTS, AND
EMPLOYEES FROM ANY AND ALL CLAIMS OR SUITS PERTAINING TO OR
CONNECTED WITH SUCH PROPERTY.
14.5 Religious Organization.
Agency shall comply with all applicable requirements as more particularly described in 24
CFR Part 5.109. No portion of the CDBG Funds shall be used in support of any sectarian or
religious activity. In addition, there must be no religious or membership criteria for clients of a
CDBG-funded service.
14.5.1. Separation of Explicitly Religious Activities.
Agency retains its independence and may continue to carry out its mission, including the
definition, development practice, and expression of its religious beliefs, provided that it does not
use CDBG Funds to support or engage in any explicitly religious activities (including activities
that involve overt religious content such as worship, religious instruction, or proselytization), or
in any other manner prohibited by law.
14.5.2 Explicitly Religious Activities.
If Agency engages in explicitly religious activities (including activities that involve overt
religious content such as worship, religious instruction, or proselytization), the explicitly religious
activities must be offered separately, in time or location, from the programs or activities supported
by CDBG Funds and participation must be voluntary for clients of a CDBG-funded service.
14.5.3 Required Notices.
If Agency constitutes a Faith -based organization under 24 CFR Part 5.109, Agency must
provide all clients of a CDBG-funded service with a Notice of Beneficiary Rights, available upon
request from City staff. Such notice shall be provided to the client prior to enrollment in any
CDBG-funded program or activity. In addition, if a client or prospective client of a CDBG-funded
service objects to the religious character of Agency, then Agency must promptly undertake
reasonable efforts to identify and refer the client or prospective client to an alternate provider to
which the client or prospective client has no such objection, as more particularly described in 24
CFR Part 5.109.
14.6 Venue.
Venue shall lie in Tarrant County, Texas for any action, whether real or asserted, at law
or in equity, arising out of the execution, performance, attempted performance or
non-performance of this Contract.
14.7 Governing Law.
This Contract shall be governed by and construed in accordance with the laws of the State
of Texas. If any action, whether real or asserted, at law or in equity, arises out of the execution,
performance or non-performance of this Contract or on the basis of any provision herein, for any
issue not governed by federal law, the choice of law shall be the laws of the State of Texas.
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14.8 Severability.
The provisions of this Contract are severable, and if for any reason a clause, sentence,
paragraph or other part of this Contract shall be determined to be invalid by a court or federal or
state agency, board or commission having jurisdiction over the subject matter thereof, such
invalidity shall not affect other provisions which can be given effect without the invalid provision.
14.9 Written Agreement Entire Contract.
This written instrument and the Exhibits, Attachments, and Addendums attached hereto,
which are incorporated by reference and made a part of this Contract for all purposes, constitute
the entire agreement by the Parties concerning the work and services to be performed under this
Contract. Any prior or contemporaneous oral or written agreement which purports to vary the
terms of this Contract shall be void. Any amendments to the terms of this Contract must be in
writing and executed by the Parties.
14.10 Paragraph Headings for Reference Only, No Legal Significance; Number
and Gender.
The paragraph headings contained herein are for convenience in reference to this Contract
and are not intended to define or to limit the scope of any provision of this Contract. When context
requires, singular nouns and pronouns include the plural and the masculine gender shall be deemed
to include the feminine or neuter and the neuter gender to include the masculine and feminine.
The words "include" and "including" whenever used herein shall be deemed to be followed by the
words "without limitation".
14.11 Compliance With All Applicable Laws and Regulations.
Agency agrees to comply fully with all applicable laws and regulations that are currently
in effect or that are hereafter amended during the performance of this Contract. Those laws
include, but are not limited to:
➢ CDBG Regulations found in 24 CFR Part 570
➢ Title I of the Housing and Community Development Act of 1974, as amended, (42
USC 5301)
➢ Title VI of the Civil Rights Act of 1964 (42 U.S.C. Sections 2000d et seq.) including
provisions requiring recipients of federal assistance to ensure meaningful access by
persons of limited English proficiency
➢ The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. Sections
3601 et seq.)
➢ Executive Orders 11063, 11246 as amended by 11375 and 12086 and as supplemented
by Department of Labor regulations 41 CFR Part 60
➢ The Age Discrimination in Employment Act of 1967
➢ The Age Discrimination Act of 1975 (42 U.S.C. Sections 6101 et seq.)
➢ The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970
(42 U.S.C. Sections 4601 et seq. and 49 CFR Part 24) ("URA")
➢ Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. Sections 794 et seq.) and 24
CFR Part 8 where applicable
➢ National Environmental Policy Act of 1969, as amended, 42 U.S.C. Sections 4321 et
seq. ("NEPA") and the related authorities listed in 24 CFR Part 58.
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➢ The Clean Air Act, as amended, (42 U.S.C. Sections 1251 et seq.) and the Clean Water
Act of 1977, as amended (33 U.S.C. Sections 1251 et seq.) and the related Executive
Order 11738. In no event shall any amount of the assistance provided under this
Contract be utilized with respect to a facility that has given rise to a conviction under
the Clean Air Act or the Clean Water Act.
➢ Immigration Reform and Control Act of 1986 (8 U.S.C. Sections 1101 et seq.)
specifically including the provisions requiring employer verifications of legal status of
its employees
➢ The Americans with Disabilities Act of 1990 (42 U.S.C. Sections 12101 et seq.), the
Architectural Barriers Act of 1968 as amended (42 U.S.C. Sections 4151 et seq.) and
the Uniform Federal Accessibility Standards, 24 CFR Part 40, Appendix A
➢ Regulations at 24 CFR Part 87 related to lobbying, including the requirement that
certifications and disclosures be obtained fiom all covered persons
➢ Drug Free Workplace Act of 1988 (41 U.S.C. Sections 701 et seq.) and 24 CFR Part
23, Subpart F
➢ Executive Order 12549 and 24 CFR Part 5.105(c) pertaining to restrictions on
participation by ineligible, debarred or suspended persons or entities
➢ Section 6002 of the Solid Waste Disposal Act, as amended by the Resource
Conservation and Recovery Act
➢ Guidelines of the Environmental Protection Agency at 40 CFR Part 247
➢ For contracts and subgrants for construction or repair, Copeland "Anti -Kickback" act
(18 U.S.C. 874) as supplemented in 29 CFR Part 5
➢ For construction contracts awarded by Agency in excess of $2,000 that are not for
single family, owner -occupied, home rehabilitation, and in excess of $2,500 for other
contracts which involve the employment of mechanics or laborers, Sections 103 and
107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327A 300) as
supplemented by 29 CFR Part 5
➢ Lead -Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et seq.), as amended by
the Residential Lead -Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851 et
seq.) and implementing regulations at 24 CFR Part 35, subparts A, B, M, and R
➢ 2 CFR Part 200 et seq.
➢ Federal Funding Accountability and Transparency Act of 2006 ("FFATA") (Pub.L.
109-282, as amended by Section 6205(a) of Pub.L. 110-252 and Section 3 of Pub.L.
113-101)
➢ Federal Whistleblower Regulations, as contained in 10 U.S.C. 2409, 41 U.S.C. 4712,
10 U.S.C. 2324, 41 U.S.C. 4304 and 41 U.S.C. 4310.
14.12 HUD -Assisted Projects and Employment and other Economic Opportunities;
Section 3 Requirements.
14.12.1 Requirement that Law Be Quoted in Covered Contracts. — Certain
Regpirements Pertaining to Section 3 of the Housing and Urban
Development Act of 1968 as Amended (12 U.S.C. Sections 1701 et seq.) and
its Related Regulations at 24 CFR Part 135.
If the Program results in the creation of new employment, training, or contracting
opportunities on a contractor or subcontractor level resulting from the expenditure of the CDBG
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Funds, Agency shall comply with the following and will ensure that its contractors also comply.
If the work performed under this Contract is on a proj ect assisted under a program providing direct
federal financial assistance from HUD, Section 3 of 24 CFR Part 135.38 ("Section 3") requires
that the following clause, shown in italics, be inserted in all covered contracts ("Section 3
Clause"):
Section to be quoted in covered contracts begins:
"A. The work to be performed under this contract is subject to the requirements
of Section 3 of Housing and Urban Development Act of 1968, as amended, 12
U.S.C. section 170]u (Section 3). The purpose of Section 3 is to ensure that
employment and other economic opportunities generated by HUD assisted or
HUD -assisted programs covered by Section 3, shall to the greatest extent feasible,
be directed to low- and very -low income persons, particularly persons who are
recipients of HUD assistance for housing.
A The parties to this contract agree to comply with HUD's regulations in 24
CFR Part 135, which implement Section 3. As evidenced by their execution of this
contract, the parties to this contract certify that they are under no contractual or
other impediment that would prevent them from complying with the Part 135
regulations.
C. The contractor agrees to send to each labor organization or representative
of workers with which it has a collective bargaining agreement or other
understanding, if any, a notice advising the labor organization or workers'
representatives of the contractor's commitments under this Section 3 clause and
will post copies of the notice in conspicuous places at the work site where both
employees and applicants for training and employmentpositions can see the notice.
The notice shall describe the Section 3 preference, shall set forth minimum number
and job titles subject to hire, availability of apprentice and training positions, the
qualifications for each; and the name and location of the person(s) taking
applications for each ofthe positions; and the anticipated date the workshall begin.
D. The contractor agrees that it will include this Section 3 clause in every
subcontract to comply with regulation in 24 CFR Part 135, and agrees to take
appropriate action, as provided in an applicable provision of the subcontract or in
this Section 3 clause, upon finding that the subcontractor is in violation of the
regulations in 24 CFR Part 135. The contractor will not subcontract with any
subcontractor where it has notice or knowledge that the subcontractor has been
found in violation of regulations in 24 CFR Part 135.
E. The contractor will certify that any vacant employment positions, including
training positions that are filed.• (1) after the contractor is selected but before the
contract is executed, and (2) with persons other than those to whom the regulations
of 24 CFR Part 135. The contractor will not subcontract with any subcontractor
where it has notice or knowledge that the subcontractor has been found in violation
of regulations in 24 CFR Part 135.
F. Noncompliance with HUD's regulation in 24 CFR Part 135 may result in
sanctions, termination of this contract for default, and debarment or suspension
from future HUD assisted contracts.
G. With respect to workperformed in connection with Section 3 covered Indian
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housing assistance, section 7(b) of the Indian Self -Determination and Education
Assistance Act (25 U.S.C. Section 450(e) also applies to the work to be performed
under this Contract. Section 7(b) requires that to the greatest extent feasible (z)
preference and opportunities for training and employment shall be given to Indians,
and (ii) preference in the award of contracts and subcontracts shall be given to
Indian organizations and Indian -owned Economic Enterprises. Parties to this
contract that are subject to the provisions of Section 3 and Section 7(b) agree to
comply with Section 3 to the maximum extent feasible, but not in derogation of
compliance with Section 7(b). "
Section to be quoted in covered contracts ends.
14.12.2 Ay_ency Responsibilities for Section 3 Requirements.
City and Agency understand and agree that compliance with the provisions of Section 3,
the regulations set forth in 24 CFR Part 135, and all applicable rules and orders of HUD shall be a
condition of the federal financial assistance provided to the Program binding upon City and
Agency and their respective successors, assigns, contractors and subcontractors. Failure to fulfill
these requirements shall subject Agency and its contractors and subcontractors and their respective
successors and assigns to those sanctions specified by the grant agreement through which federal
assistance is provided and to such sanctions as are specified by 24 CFR Part 135. Agency's
responsibilities include:
14.12.2.1 Implementing procedures to notify Section 3 residents and business
concerns about training, employment, and contracting opportunities
generated by Section 3 covered assistance;
14.12.2.2 Notifying potential contractors working on Section 3 covered
projects of their responsibilities;
14.12.2.3 Facilitating the training and employment of Section 3 residents and
the award of contracts to Section 3 business concerns;
14.12.2.4 Assisting and actively cooperating with the HED Department in
making contractors and subcontractors comply;
14.12.2.5 Refraining from entering into contracts with contractors that are in
violation of Section 3 regulations;
14.12.2.6 Documenting actions taken to comply with Section 3; and
14.12.2.7 Submitting Section 3 Annual Summary Reports (Form HUD -
60002) in accordance with 24 CFR Part 135.90.
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14.12.3 Section 3 Reporting Requirements.
In order to comply with the Section 3 requirements, Agency must submit the forms attached
hereto as EXHIBIT "G" - Section 3 Reporting Forms,
14.12.3.1 Report to the City on a quarterly basis all applicants for
employment, and all applicants for employment by contractor and
subcontractor. This shall include name, address, zip code, date of
application, and status (hired/not hired) as of the date of the report.
14.12.3.2 Advertise available positions to the public for open competition, and
provide documentation to City with the quarterly report that
demonstrates such open advertisement in the form of printout of
Texas Workforce Commission posting, copy of newspaper
advertisement, copy of flyers and listing of locations where flyers
were distributed, and the like.
14.12.3.3 Report to the City on a quarterly basis all contracts awarded by
contractor and subcontractor. This shall include name of contractor
and/or subcontractor, address, zip code, and amount of award as of
the date of the report.
14.13 Prohibition Against Discrimination.
14.13.1 General Statement.
Agency shall comply in the execution, performance or attempted performance of this
Contract, with all non-discrimination requirements of 24 CFR Part 570.607 and Chapter 17, Article
III, Division 4 — Fair Housing of the City Code. Agency may not discriminate against any person
because of race, color, sex, gender, religion, national origin, familial status, disability or perceived
disability, sexual orientation, gender identity, gender expression, or transgender, nor will Agency
permit its officers, members, agents, employees, or clients to engage in such discrimination.
This Contract is made and entered into with reference specifically to Chapter 17, Article
III, Division 3 - Employment Practices of the City Code, and Agency hereby covenants and agrees
that Agency, its officers, members, agents, employees and contractors, have fully complied with
all provisions of same and that no employee, or applicant for employment has been discriminated
against under the terms of such ordinances by either or its officers, members, agents, employees
or contractors.
14.13.2 No Discrimination in EmMovment during the Performance of This
Contract.
During the performance of this Contract Agency agrees to the following provision, and
will require that its contractors and subcontractors also comply with such provision by including
it in all contracts with its contractors:
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Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity Rev. 12.21.2017
[Contractor's Subcontractor's or Vendor's name] will not unlawfully discriminate against
any employee or applicants for employment because of race, color, sex, gender, religion, national
origin, familial status, disability or perceived disability, sexual orientation, gender identity, gender
expression or transgender. [Contractor's Subcontractor's or Vendor's name] will take affirmative
action to ensure that applicants are hired without regard to race, color, sex, gender, religion,
national origin, familial status, disability or perceived disability, sexual orientation, gender
identity, gender expression or transgender and that employees are treated fairly during employment
without regard to their race, color, sex, gender, religion, national origin, familial status, disability
or perceived disability, sexual orientation, gender identity, gender expression or transgender. 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 pay or other forms
of compensation, and selection for training, including apprenticeship. [Contractor's.
Subcontractor's or Vendor's name] agrees to post in conspicuous places, available to employees
and applicants for employment, notices setting forth the provisions of this nondiscrimination
clause.
[Contractor's. Subcontractor's or Vendor's name] will, in all solicitations or
advertisements for employees placed by or on behalf of [Contractor's Subcontractor's or
Vendor's name], state that all qualified applicants will receive consideration for employment
without regard to race, color, sex, gender, religion, national origin, familial status, disability or
perceived disability, sexual orientation, gender identity, gender expression or transgender.
[Contractor's Subcontractor's or Vendor's name] covenants that neither it nor any of its
officers, members, agents, employees, or contractors, while engaged in performing this Contract,
shall, in connection with the employment, advancement or discharge of employees or in
connection with the terms, conditions or privileges of their employment, discriminate against
persons because of their age or because of any disability or perceived disability, except on the
basis of a bona fide occupational qualification, retirement plan or statutory requirement.
[Contractor's Subcontractor's or Vendor's name] further covenants that neither it nor its
officers, members, agents, employees, contractors, or persons acting on their behalf, shall specify,
in solicitations or advertisements for employees to work on this Contract, a maximum age limit
for such employment unless the specified maximum age limit is based upon a bona fide
occupational qualification, retirement plan or statutory requirement.
14.13.3 Agency's Contractors and the ADA.
In accordance with the provisions of the Americans With Disabilities Act of 1990
("ADA"), Agency warrants that it and any of its contractors will not unlawfully discriminate on
the basis of disability in the provision of services to the general public, nor in the availability, terms
and/or conditions of employment for applicants for employment with, or employees of, Agency or
any of its contractors. AGENCY WARRANTS IT WILL FULLY COMPLY WITH THE
ADA'S PROVISIONS AND ANY OTHER APPLICABLE FEDERAL, STATE AND
LOCAL LAWS CONCERNING DISABILITY AND WILL DEFEND, INDEMNIFY AND
HOLD CITY HARMLESS AGAINST ANY CLAIMS OR ALLEGATIONS ASSERTED BY
THIRD PARTIES, CONTRACTORS SUBCONTRACTORS, VENDORS OR AGENTS
AGAINST CITY ARISING OUT OF AGENCY'S AND/OR ITS CONTRACTORS',
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SUBCONTRACTORS', VENDORS' OR AGENTS' OR THEIR RESPECTIVE
EMPLOYEES' ALLEGED FAILURE TO COMPLY WITH THE ABOVE -REFERENCED
LAWS CONCERNING DISABILITY DISCRIMINATION IN THE PERFORMANCE OF
THIS CONTRACT.
14.14. Conflicts of Interest and Violations of Criminal Law.
14.14.1 Agenev Safeguards.
Agency shall establish safeguards to prohibit its employees, board members, advisors and
agents from using positions for a purpose that is or gives the appearance of being motivated by a
desire for private gain for themselves or others, particularly those with whom they have family,
business or other ties. Agency shall disclose to City any such conflict of interest or potential
conflict of interest, immediately upon discovery of such.
14.14.2 General Prohibitions Against Conflicts of Interest.
No employees, agents, consultants, officers or elected officials or appointed officials of
City or of Agency who exercise or have exercised any functions or responsibilities with respect to
activities assisted with CDBG funds or who are in a position to participate in a decision-making
process or gain inside information with regard to these activities may utilize CDBG services, may
obtain a financial interest or benefit from a CDBG-assisted activity, or have an interest in any
contract, subcontract or agreement with respect thereto, or the proceeds thereunder, either for
themselves or those with whom they have family or business ties, during their tenure or for 1 year
thereafter.
14.14.2.1 Agency shall establish conflict of interest policies for
federal awards including the CDBG Funds and shall disclose in
writing potential conflicts of interest to City as authorized by 2 CFR
Part 200.112.
14.14.3 Conflicts of Interest Involving Procurement.
The conflict of interest provisions of 2 CFR Part 200.3 1, shall apply in the procurement of
property and services by Agency. In all cases not governed by this Section, the provisions of 24
CFR Part 570.611 of the CDBG Regulations shall apply.
14.14.3.1 As more particularly described in 2 CFR Part 200.318, Agency shall
maintain and submit to City written standards of conduct covering
conflicts of interest and governing the performance of its employees
engaged in the selection, award, and administration of contracts. No
employee, officer, or agent may participate in the selection, award,
or administration of a contract supported by a federal award if he or
she has a real or apparent conflict of interest. The standards of
conduct must provide for disciplinary actions to be applied for
violations of such standards by officers, employees, or agents of
Agency.
14.14.3.2 The officers, employees, and agents of Agcncy shall neither solicit
nor accept gratuities, favors, or anything of monetary value from
contractors or parties to subcontracts.
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14.14.3.3 Notwithstanding the prohibition contained in Section 14.13.3.2,
Agency may set standards of conduct for situations in which the
financial interest is not substantial or the gift is an unsolicited item
of nominal value. Such standards of conduct must provide for
disciplinary actions to be applied for violations of such standards by
Agency's officers, employees or agents.
14.14.3.4 Agency shall maintain written standards of conduct covering
organizational conflicts of interest. Organizational conflicts of
interest means that because of relationships with a parent company,
affiliate, or subsidiary organization, Agency is unable or appears to
be unable to be impartial in conducting a procurement action
involving a related organization.
14.14.3.5 Agency must maintain records sufficient to detail the history of
procurement. These records will include, but are not necessarily
limited to the following: rationale for the method of procurement,
selection of contract type, contractor selection or rejection, and the
basis for the contract price.
14.14.4 Disclosure of Conflicts of Interest.
In compliance with 2 CFR Part 200.112, Agency is required to timely disclose to City in
writing any potential conflict of interest.
14.14.5 Disclosure of Texas Penal Code Violations.
Agency affirms that it will adhere to the provisions of the Texas Penal Code which prohibit
bribery and gifts to public servants.
14.14.6 Disclosure of Federal Criminal Law Violations.
In compliance with 2 CFR Part 200.113, Agency is required to timely disclose to City all
violations of federal criminal law involving fraud, bribery or gratuity violations potentially
affecting the Agency.
14.15 Subcontracting with Small and Minority Firms, Women's Business
Enterprises and Labor Surplus Areas.
14.15.1 For procurement contracts $50,000.00 or larger that are paid for, in part or in
full, with the CDBG Funds, Agency agrees to abide by City's policy to involve Minority Business
Enterprises and Small Business Enterprises and to provide them equal opportunity to compete for
contracts for construction, provision of professional services, purchase of equipment and supplies
and provision of other services required by City. Agency agrees to incorporate the City's BDE
Ordinance, and all amendments or successor policies or ordinances thereto, into all contracts and
subcontracts for procurement larger than $50,000.00 or larger that are paid for, in part or in full,
with the CDBG Faulds and will further require all persons or entities with which it so contracts to
comply with said ordinance.
14.15.2 It is national policy to award a fair share of contracts to disadvantaged business
enterprises ("DBEs'), small business enterprises ("SBEs"), minority business enterprises
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("MBEs"), and women's business enterprises ("WBEs"). Accordingly, affirmative steps must be
taken to assure that DBEs, SBEs, MBEs, and WBEs are utilized when possible as sources of
supplies, equipment, construction and services.
14.15.2.1 In order to comply with federal reporting requirements as described
in 24 CFR Part 570.506 (g)(6), Agency must submit the form
attached hereto as EXHIBIT "I" — MBE Reporting Form for each
contract or subcontract with a value of $10,000.00 or more paid or
to be paid with the CDBG Funds. Agency shall submit this form by
the date specified in EXHIBIT "I" — MBE Reporting Form.
14.16 Other Laws.
The failure to list any federal, state or City ordinance, law or regulation that is applicable
to Agency does not excuse or relieve Agency from the requirements or responsibilities in regard
to following the law, nor from the consequences or penalties for Agency's failure to follow the
law, if applicable.
14.17 Assignment.
Agency shall not assign all or any part of its rights, privileges, or duties under this Contract
without the prior written approval of City. Any attempted assignment of same without approval
shall be void, and shall constitute a breach of this Contract.
14.18. Right to Inspect Agency Contracts.
It is agreed that City has the right to inspect and approve in writing any proposed contracts
between Agency and any contractor or vendor engaged in any activity in conjunction with this
CDBG-funded Program prior to any charges being incurred.
14.19 Force Maieure
If Agency becomes unable, either in whole or part, to fulfill its obligations under this
Contract due to acts of God, strikes, lockouts, or other industrial disturbances, acts of public
enemies, wars, blockades, insurrections, riots, epidemics, earthquakes, fires, floods, restraints or
prohibitions by any court, board, department, commission or agency of the United States or of any
States, civil disturbances, or explosions, or some other reason beyond Agency's control
(collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event
will be suspended only during the continuance of such event. Agency will give City written notice
of the existence, extent and nature of the Force Majeure Event as soon as reasonably possible after
the occurrence of the event. Failure to give notice will result in the continuance of Agency's
obligation regardless of the extent of any existing Force Majeure Event. Agency will use
commercially reasonable efforts to remedy its inability to perform as soon as possible.
14.20 IMMIGRATION NATIONALITY ACT.
City actively supports the Immigration & Nationality Act (INA) which includes provisions
addressing employment eligibility, employment verification, and nondiscrimination. Agency shall
verify the identity and employment eligibility of all employees, contractors, and subcontractors
who perform work under this Agreement. Agency shall complete the Employment Eligibility
Verification Form (I-9), maintain photocopies of all supporting employment eligibility and identity
documentation for all employees, and upon request, provide City with copies of all 1-9 forms and
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supporting eligibility documentation for each employee who performs work under this Agreement.
Agency shall establish appropriate procedures and controls so that no services will be performed
by any employee who is not legally eligible to perform such services. Agency shall provide City
with a certification letter that it has complied with the verification requirements required by this
Agreement. Agency shall indemnify City from any penalties or liabilities due to violations of this
provision. City shall have the right to immediately terminate this Agreement for violations of this
provision by Agency.
15. INDEMNIFICATION AND RELEASE.
AGENCY COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS
AND DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS,
SERVANTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR
SUITS FOR PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY,
INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER HIND OR
CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN
CONNECTION WITH THE EXECUTION, PERFORMANCE, ATTEMPTED
PERFORMANCE OR NONPERFORMANCE OF THIS CONTRACT AND/OR THE
OPERATIONS, ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED
HEREIN, WHETHER OR NOT CAUSED IN WHOLE OR IN PART, BY ALLEGED
NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS
OR SUBCONTRACTORS OF CITY; AND AGENCY HEREBY ASSUMES ALL
LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS, AGENTS,
SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS FOR
PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH,
TO ANY AND ALL PERSONS, OF WHATSOEVER KINDS OR CHARACTER,
WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH
THE EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR
NONPERFORMANCE OF THIS CONTRACT AND/OR THE OPERATIONS,
ACTIVITIES AND SERVICES OF THE PROGRAM DESCRIBED HEREIN, WHETHER
OR NOT CAUSED IN WHOLE OR IN PART BY ALLEGED NEGLIGENCE OF
OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS OR
SUBCONTRACTORS OF CITY. AGENCY LIKEWISE COVENANTS AND AGREES TO
AND DOES HEREBY INDEMNIFY AND HOLD HARMLESS CITY FROM AND
AGAINST ANY AND ALL INJURY, DAMAGE OR DESTRUCTION OF PROPERTY OF
CITY, ARISING OUT OF OR IN CONNECTION WITH ALL ACTS OR OMISSIONS OF
AGENCY, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES, CONTRACTORS,
SUBCONTRACTORS, INVITEES, LICENSEES, OR CLIENTS, OR CAUSED, IN
WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS,
SERVANTS, EMPLOYEES, CONTRACTORS OR SUBCONTRACTORS OF CITY.
IT IS THE EXPRESS INTENTION OF THE PARTIES, BOTH AGENCY AND
CITY, THAT THE INDEMNITY PROVIDED FOR THIS SECTION INCLUDES
INDEMNITY BY AGENCY TO INDEMNIFY AND PROTECT CITY FROM THE
CONSEQUENCES OF CITY'S OWN NEGLIGENCE, WHETHER THAT NEGLIGENCE
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IS ALLEGED TO BE THE SOLE OR CONCURRING CAUSE OF THE INJURY,
DAMAGE OR DEATH.
AGENCY AGREES TO AND SHALL RELEASE CITY, ITS AGENTS,
EMPLOYEES, OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY
FOR INJURY, DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY
SUSTAINED IN CONNECTION WITH OR INCIDENTAL TO PERFORMANCE UNDER
THIS CONTRACT, EVEN IF THE INJURY, DEATH, DAMAGE OR LOSS IS CAUSED
BY CITY'S SOLE OR CONCURRENT NEGLIGENCE.
AGENCY SHALL REQUIRE ALL OF ITS CONTRACTORS AND
SUBCONTRACTORS TO INCLUDE IN THEIR CONTRACTS AND SUBCONTRACTS
A RELEASE AND INDEMNITY IN FAVOR OF CITY IN SUBSTANTIALLY THE SAME
FORM AS ABOVE.
16. WAIVER OF IMMUNITY BY AGENCY.
If Agency, as a charitable or nonprofit organization, has or claims an immunity or
exemption (statutory or otherwise) from and against liability for damages or injury, including
death, to persons or property, Agency hereby expressly waives its rights to plead defensively such
immunity or exemption as against City. This Section shall not be construed to affect a
governmental entity's immunities under constitutional, statutory or common law.
17. INSURANCE AND BONDING.
Agency will maintain coverage in the form of insurance or bond in the amount of
$100,000.00 to insure against loss from the fraud, theft or dishonesty of any of Agency's officers,
agents, trustees, directors or employees. The proceeds of such insurance or bond shall be used to
reimburse City for any and all loss of CDBG Funds occasioned by such misconduct. To effectuate
such reimbursement, such fidelity coverage shall include a rider stating that reimbursement for
any loss or losses shall name the City as a Loss Payee.
Agency shall furnish to City in a timely manner, but not later than the Effective Date,
certificates of insurance as proof that it has secured and paid for policies of commercial insurance
as specified herein. If City has not received such certificates by the Effective Date, Agency shall
be in default of the Contract and City may, at its option, terminate the Contract.
Such insurance shall cover all insurable risks incident to or in connection with the
execution, performance, attempted performance or nonperformance of this Contract. Agency shall
maintain the following insurance coverage and limits:
Commercial General Liability (CGL) Insurance
$ 500,000 each occurrence
$1,000,000 aggregate limit
Non -Profit Organization Liability or Directors & Officers Liability
$1,000,000 Each Occurrence
$1,000,000 Annual Aggregate Limit
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Business Automobile Liability Insurance
$1,000,000 each accident on a combined single -limit basis, or
$ 250,000 Property Damage
$ 500,000 Bodily Injury per person per occurrence
$2,000,000 Aggregate
Insurance policy shall be endorsed to cover "Any Auto", defined as autos owned, hired,
and non -owned. Pending availability of the above coverage and at the discretion of
City, the policy shall be the primary responding insurance policy versus a personal
auto insurance policy if or when in the course of Agency's business as contracted
herein.
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Workers' Compensation Insurance
Part A: Statutory Limits
Part B: Employer's Liability
$100,000 each accident
$100,000 disease -each employee
$500,000 disease -policy limit
Note: Such insurance shall cover employees performing work on any and all projects
including but not limited to construction, demolition, and rehabilitation. Agency or its
contractors shall maintain coverages, if applicable, In the event the respective contractors
do not maintain coverage, Agency shall maintain the coverage on such contractor, if
applicable, for each applicable contract.
Additional Requirements
Such insurance amounts shall be revised upward at City's reasonable option and no more
frequently than once every 12 months, and Agency shall revise such amounts within 30 days
following notice to Contractor of such requirements.
Agency will submit to City documentation that it has obtained insurance coverage and has
executed bonds as required in this Contract prior to payment of any monies provided hereunder.
Where applicable, insurance policies required herein shall be endorsed to include City as an
additional insured as its interest may appear. Additional insured parties shall include employees,
officers, agents, and volunteers of City.
Any failure on part of City to request certificate(s) of insurance shall not be construed as a waiver
of such requirement or as a waiver of the insurance requirements themselves.
Insurers of Agency's insurance policies shall be licensed to do business in the state of Texas by
the Department of Insurance or be otherwise eligible and authorized to do business in the state of
Texas. Insurers shall be acceptable to City insofar as their financial strength and solvency and
each such company shall have a current minimum A.M. Best Key Rating Guide rating of A-: VII
or other equivalent insurance industry standard rating otherwise approved by City.
Deductible limits on insurance policies shall not exceed $5,000 per occurrence unless otherwise
approved by City.
In the event there are any local, federal or other regulatory insurance or bonding requirements for
the Program, and such requirements exceed those specified herein, the former shall prevail.
Agency shall require its contractors to maintain applicable insurance coverages, limits, and other
requirements as those specified herein; and Agency shall require its contractors to provide Agency
with certificate(s) of insurance documenting such coverage. Also, Agency shall require its
contractors to have City and Agency endorsed as additional insureds (as their interest may appear)
on their respective insurance policies.
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Directors and Officers Liability coverage shall be in force and may be provided on a claims -made
basis. This coverage may also be referred to as Management Liability, and shall protect the insured
against claims arising out of alleged errors in judgment, breaches of duty and wrongful acts arising
out of their organizational duties. Coverage shall protect not only the entity, but all past, present
and future directors, officers, trustees, employees, volunteers and committee members.
Notwithstanding any provision in this Contract to the contrary, when applicable, Agency
shall comply with the requirements of 2 CFR 200.310 and shall, at a minimum, provide the
equivalent insurance coverage for real property and equipment acquired or improved with
CDBG Funds as provided to property owned by Agency.
18. CERTIFICATION REGARDING LOBBYING.
The undersigned representative of Agency hereby certifies, to the best of his or her
knowledge and belief, that:
No federal appropriated funds have been paid or will be paid, by or on behalf of Agency,
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 in connection with the
awarding of any federal contract, the making of any federal grant, the malting 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.
If any funds other than federally appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency,
member of Congress in connection with this federal contract, grant, loan or cooperative
agreement, Agency shall complete and submit Standard Form -LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions.
This certification is a material representation of fact upon which reliance was placed when
this Contract was made or entered into. Submission of this certificate is a prerequisite for
making or entering into this Contract imposed by 31 U.S.C. Section 1352. Any person
who fails to file the required certification shall be subject to a civil penalty of not less than
$10,000.00 and not more than $100,000.00 for each such failure.
Agency shall require that the language of this certification be included in all subcontracts or
agreements involving the expenditure of federal funds.
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19. LITIGATION AND CLAIMS.
Agency shall give City immediate notice in writing of any action, including any proceeding
before an administrative agency, filed against Agency in conjunction with this Contract or the
Program. Agency shall furnish immediately to City copies of all pertinent papers received by
Agency with respect to such action or claim. Agency shall provide a notice to City within 10 days
upon filing under any bankruptcy or financial insolvency provision of law.
20. NOTICE.
All notices required or permitted by this Contract must be in writing and are deemed
delivered on the earlier date of the date actually received or the third day following deposit in a
United States Postal Service post office or receptacle; with proper postage, certified mail return
receipt requested; and addressed to the other Party at the address set out below or at such other
address as the receiving Party designates by proper notice to the sending Parry.
City:
City Attorney's Office
200 Texas Street
Fort Worth, TX 76102
Telephone: 817-392-7600
Copy to:
Neighborhood Services Department
200 Texas Street
Fort Worth, TX 76102
Attention: Assistant Director
Telephone: 817-392-7540
Copy to:
Neighborhood Services Department
200 Texas Street
Fort Worth, TX 76102
Attention: Management Analyst lI
Telephone: 817-392-7369
Agency:
Fort Worth Area Habitat for Humanity, d/b/a Trinity Habitat for Humanity
Gage Yager, Executive Director,
9333 N. Normandale St.
Fort Worth, TX 76116
Telephone: 817-926-9219
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Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity Rev.12.21.2017
21. AGENCY HAS LEGAL AUTHORITY TO ENTER INTO CONTRACT.
Agency represents that it possesses the legal authority, pursuant to any proper, appropriate
and official motion, resolution or action passed or taken, to enter into this Contract and to perform
the responsibilities herein required.
22. COUNTERPARTS.
This Contract may be executed in multiple counterparts, each of which shall be considered
an original, but all of which shall constitute one instrument which may be sufficiently evidenced
by one counterpart.
23. PROGRAM INCOME
Parties agree that no program income as defined by HUD shall be earned as a result of this
contract.
[SIGNATURES APPEAR ON NEXT PAGE]
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Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity Rev. 12.21.2017
IN WITNESS WHEREOF, the Parties hereto have executed 4 duplicate originals of this
Contract in Fort Worth, Tarrant County, Texas.
ATTEST:
M&C: C 0459
1295 Certification No. 2017
Date: September 27, 2017
APPROVED AS TO FORM
WEPS
�' & �- I
Paige Mebai' , Assistant City Attorney
CITY OF FORT WORTH
Costa, Assistant City Manager
CONRACT COMPLIANCE MANAGER:
By signing, I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensurin all p form ce and reporting requirements
Barbar sbury
Compliance and Plannin M ager
Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity
By: ��----
Gage Yager,
Executive Direc r
CDBG REHABILITATION CONTRACT 2017-2018 Page 35
Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity Rev. 12.21.2017
EXHIBITS:
EXHIBIT "A" —Program Summary
EXHIBIT "A-1" — 2017 HUD Income Limits
EXHIBIT "A-2" — Environmental Review Procedures
EXHIBIT "B" — Budget
EXHIBIT "C" — Audit Certification Form
EXHIBIT "D" — Reimbursement Forms
EXHIBIT "E" — Income Certification Form
EXHIBIT "F" — Standards for Complete Documentation
EXHIBIT "G" — Section 3 Reporting Forms
EXHIBIT "H" — Certification of Severe Disability
EXHIBIT "I" — MBE Reporting Form
EXHIBIT "J" — Lead Safe Hazard Certification
EXHIBIT "K" — Conflict of Interest Form
CDBG REHABILITATION CONTRACT 2017-2018 Page 36
Fort Worth Area Habitat for Humanity d/b/a Trinity Habitat for Humanity Rev.12.21.2017
Fort Worth Area Habitat for Humanity, dba EXHIBIT "A"
Trinity Habitat for Humanity
Cowtown Brushup Program PROGRAM SUMMARY
PROGRAM SUMMARY
(CDBG)
October 15, 2017 to December 31, 2018 $285,000.00
PERIOD AMOUNT
Capitalized terms not defined herein shall have meanings assigned them in the Contract.
PROGRAM:
This program is a volunteer effort supported with Community Development Block Grant (CDBG)
funds that assists very low income homeowners by painting the exterior of their houses.
Agency shall identify income -eligible clients and facilitate all necessary prep -work for income
eligible hornes identified through screening, while also recruiting volunteers and soliciting
donations of paint and supplies. At the completion of each project, Agency shall conduct a final
inspection to ensure quality control.
Agency is responsible for submitting any applications for City permits or approvals.
These approvals may include but are not limited to Historic & Cultural Landmarks
Commission, Board of Adjustment, Zoning approvals, and building inspections. Cost for
permits or approvals are reimbursable under this Contract,
Agency shall coordinate with City to ensure compliance with the Lead Safe Housing Rule.
CDBG Funds will be used to pay for materials, building permits, contractor labor for the
home repairs, and project delivery costs in the form of salaries and FICA insurance for staff
directly dealing with clients.
Agency is located at 9333 N. Normandale St, Fort Worth, TX 76116, with operating hours of
8:30 a.m, to 5:30 p.m., Monday through Thursday and 8:30 a.m. to 4:00 p.m. on Fridays.
REGULATORY CLASSIFICATION:
IDIS Matrix Code(s) and Service Category: 14A Rehab: Single -Unit Residential
National Objective Citation: LMH Low/Mod Housing Benefit 24 CFR 570.208(a)( 3)
Regulatory Citation(s): 24 CFR 570.202(b)(11)
CDBG REHABILITATION PSA CONTRACT 2017-2018—1;XHIBIT "A" —PROGRAM SUMMARY Pagel
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Agency will maintain documentation that verifies that 100% of clients served by the Program are
Income Eligible Clients.
PROGRAM GOALS:
Minimum Number of Clients to be Served: The Program must serve a minimum of 70
Unduplicated Clients as shown by the monthly reports on Attachment III.
CDBG REHABILITATION PSA CONTRACT 2016-2017 — EXHIBIT "A" —PROGRAM SUMMARY Page]
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "A-1"
2017 HUD INCOME LIMITS
2017 Median Family Income - Fort Worth/Arlington, TX*
1 Person
2 Persons
3 Persons
4 Persons
1 5 Persons
6 Persons
7 Persons
8 Persons
30% AMI
$15,000
$17,150
$19,300
$21,400
$23,150
$24,850
$26,550
$28,250
50% AMI
$25,000
$28,600
$32,150
$35,700
$38,600
$41,450
$44,300
$47,150
80% AMI
$40,000
$45,700
$51,400
$57,I00
$61,700
$66,250
$70,850
$75,400
*Income limits are published at least annually by HUD.
CDBG REHABILITATION CONTRACT 2017-2018 --EXHIBIT "A-1" — 2017 HUD INCOME LMTS Pagel
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "A-2"
ENVIRONMENTAL REVIEW PROCEDURES
Items to be performed by Agency:
Before Environmental Review
• Intake and application process
• Client qualification
o Client is an Income Eligible client as defined by contract
o Client is a Fort Worth resident
o Client owns property or has permission from owner(s) to perform work
o Client is up to date On all property taxes
• Contractor/inspector assessment of client needs and assessment of work to be done
o Take photos of the following:
■ front of the property
■ left and right side view of property
■ house to the left and right
■ house across the street
■ left street view with neighboring homes
■ right street view with neighboring homes
• Preparation of ER request form and attachments
o Full description of work to be performed using City's request form
o Photos as described above
• Submit to City contract administrator for review and approval.
After Environmental Review
• Following notification of approval of work from City, Agency issues Notices to Proceed
to contractor
• Agency performs work as described in the environmental request
• Agency inspects work to verify work is consistent with environmental request description
• Agency requests reimbursement
CDBG REHABILITATION CONTRACT 2017-2018 -EXHIBIT "A-2" - ENVIRONMENTAL REVIEW PROCEDURES Page I
Fort Worth Area Habitat for Ilumatiity, dba Trinity I iabitat for Humanity
Items to be performed by City:
Before Environmental Review
NOTE: If any of the reviewers in the process described below have questions or need additional
information, City's contract administrator will contact Agency to request the additional
information.
• Compliance Division reviews client qualification information to verify eligibility
• City's contract administrator finalizes Environmental request, sends to Environmental
Coordinator and requests contamination checklist from Housing Rehabilitation
Technician
• Environmental Coordinator reviews request and attachments for accuracy and
completeness
• If no environmental impact is anticipated, Environmental Coordinator will sign and send
environmental review to Compliance and Planning Manager for signature
• Compliance and Planning Manager will sign and inform Contract administrator when
environmental review is ready
• City Contract administrator will send Agency a Notice to Proceed and will include the
environmental review and all attachments
After Environmental Review
Agency inspects work to verify work is consistent with environmental request
description
• City reimburses once inspection is complete
CDBGR&HAMuTATIONCONTRACT 2017-2018—EXHIBIT"A-2"— ENVIRONMENTAL REVIEW PROCEDURES Page 1
Port Worth Area Habitat for Humanity, dba Trinity Habitat for .Humanity
Cowtown Brush Up Budget
Salaries
1001 $ 30,000.00
$ 30,000.00
FICA
1002 $ 5,000.00
$ 5;000.00
Life/Disability insurance
1003
$ -
Health/Dental Insurance
1004
$
Unemployment -State
1005
Worker's Compensation
1006
Retirement
1007
Office/Program Supplies
2001
Postage
2002
$
Printing
2003
$
Othero
2004
FE $NR "n"gg i -F
MMM
Construction/Buil ding Materials
3001 $ 125,000.00
$ 125,000.00
Contract Labor/Permitting (City
needs copy of contract before
expenses can be reimbursed)
3002 $ 125,000.00
$ 125,000.00
Food Supplies
3003
$ -
Teaching Aids
3004
$
Craft Supplies
3005
$ -
Field Trip Expenses
3006
$
Mileage
3007
-
Other()
3008
Otheil)
3009
.. ... . . . RNR'gg
I -N 0.1
Telephone
4001
Electric
4002
Gas
4003
Water and Wastewater
4004
Solid Waste Disposal
4005
Rent (City needs copy of lease
before expenses can be
reimbursed)
4006
Cleaning Supplies
4007
Other
4008
gg
Fidelity Bond or Equivalent
5001
Directors and Officers
5002
General Commercial Liability
5003
Other
5004
5
Other(}
6001
BUDGET TOTAL
S 285,000.00 $ $
285,000.00
Page I
EXHIBIT "C"
AUDIT CERTIFICATION FORM
CDBG REHABILITATION CONTRACT 2017-2018 –EXHIBIT "C"— AUDIT CERTIFICATION FORM
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
AUDIT CERTIFICATION FORM AND AUDIT REQUIREMENTS
Agency: Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Fiscal Year Ending: September 30, 2018
❑ During the fiscal year in which funds will be received, we will exceed the federal expenditure
threshold of $750,000. We will have our Single Audit or Program Specific Audit completed
and will submit the audit report described in 2 CFR Part 200 within 7 months after- the end
of the audited fiscal year or 30 days within its cornpletion, whichever is the earlier date.
[] During the fiscal year in which funds will be received, we will not exceed the $750,000 federal
expenditure threshold required for a Single Audit or a Program Specific Audit to be performed
this fiscal year. (Fill out schedule below)
i' HCl L r'i�
- – - Fcticrsrl i�;xl+t:�r+tiiui'r. 1)is�eln;sur°c .
rVIEST be ]1cd oij rl Siau,le, Audit or 1''cti r-rrirl ,ALLdit N N'0 fCUL1ilL;d
11;I l ill?I j h I PtV,,41',L ll ,1111,- t1". t] lr!'iil;C-
a! �lrt{]l;14 ;4,l.dllurc,7
?iait[nr, : 1 IM �,rrrl� °w Ctl?711,:x I I A
Total Federal Expenditures for this Fiscal Year:
Signatory and Title
Date
Failure to submit this or a similar statement or failure to submit a completed single audit package,..
as described in the federally required audit requirements described in 2 CFR Part 200, as
applicable, by the required due date may result in suspension of funding and may affect eligibility
for future funding. Notwithstanding the above, this certification acknowledges the agency's
commitment to meet all other financial reporting, financial statements, and other audit
requirements as may be set forth in the Contract.
CDBG REHABILITATION CONTRACT 2017-2018 –EXHIBIT "C" — AUDIT CERTIFICATION FORM
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "D"
REPORTING FORMS
CUBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "D" — REPORTING FORMS Page I
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
ATTACHMENT I
Invoice
Attachment I
aul
Anion(
Tbis ll>`volee
timuhth-re to Date
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "D" — REPORTING FORMS Page 2
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
ATTACHMENT II
Expenditure Worksheet
A11'ACHNIENT 11
City pfFo,t Wailil
:
Neighburhood Services Department
Elpenditure Warl(sheet
Agency:: .. _ ...... _
.. Program: .. i
Ylest RrOut) lNe account torics.
s' r * Acqua(
Ve�
1
kltOCtLllliYAi,SONNN7;�� - ?-.�, °:.
2
Salaries I00i
3
FICA 1(X)2
4
Life/Uisabilits Insurance 1(X73
5
HealthfDanlnl Imulance IW4
6
Unc lopn>znt-Stale IW5
7
SYod:cr's Co ensulion I(46
8
Retirement IW7
9
STIPkI�ANIISFICVJ(2FS`� .�;�, �_.
Ill
office/pro ram Sup plies I 21X)1 ji
II
Postage 2002
12
Printinu 2003
(3
()lhel) 201A
14
l5
Contract Labor 31X)1
16
Food Su lies 3002
17
Teaching Aids 3(X13
18
Craft Supplies 3(X)4
19
Field Trip f cruses 3005
20
Mileage 3()(X
21
01hero 3(X17
22
011le) 3008
23
ItA(RII17S'-AiVU.IYI'1LfY1FS -~
24
Tele hone 4001
25
Electric 4002
26
Q. 40113
27
Water:uld Wastcnvstcr 4004
28
Solid Wole W osal 4005
29
Rent 4006
30 1
Ckaning Supplies 4007
31 1
orher 4008
32
�-'F3Ni1,�iiC ANDINSUMNC'B:^*.
33
Fidelity bond orF uiv-a(ent 5001
34
Director and Officers 5002
35
General Convriarciai l3abilih, 5003
36
Olh SWl
37
DIIiL+GIf$Sffi7'ANCk :: .x><;,.;;%z<
38
Me) 6W1
39
i. _. __..... ` .... '
i
i .... 1
.i . ..... .:.......
_.._. _.. �. .._.......,.
j
i .. .__ :.... _....,:
i. - _. ......
..
i
40
41
42
43
44
45
46
47
48 .{..
49
51)
52
53
54
55
56
57
58
59 -
..
56.(X7
*For Salaries, state enTloyce's title under Desclipiiynpub Tilk. Rernnnstidmfjf tenant
CDBG REHABILITATION CONTRACT 2017-2018 --- EXHIBIT "D" REPORTING FORMS Page 3
Fort Worth Arca Habitat for Humanity, dba Trinity Habitat for Humanity
ATTACHMENT III exercise
Client Data Report
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "D" — REPORTING FORMS Page 4
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "E"
INCOME CERTIFICATION FORMS
CABG REHABILITATION CONTRACT 2017-2018 —EXHIBIT "I," —FORM OF INCOME CERTIFICATION Page I
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
City of Fort Worth
CERTIFICATION OF INCOME STATEMENT
Applicant Name:
Current Address: _ Phone #:
City and Zip:
Household Members and Income
(Including app licant)
Last Name First Name Age Monthly Source of Income
Income $$
TOTAL NUMBER OF FAMILY MEMBERS
Total Gross Annual Household Income:
(Include Yourself, Spouse, Children, etc.)
PERSONAL INFORMATION: (Check one in each item. This Information is Required for Federal Reporting Purposes)
a. ❑ MALE b. ❑ WHITE ❑ BLACK/AFRICAN AMERICAN ❑ BLACIUAFRICAN AMERICAN & WHITE
❑ FEMALE ❑ AMERICAN INDIAN/ALASKAN NATIVE ❑ ASIAN
❑ AMERICAN INDIAN/ALASKAN NATIVE & WHITE ❑ ASIAN & WHITE
❑ NATIVE HAWAIIAN/OTHER PACirIC ISLANDER ❑ BALANCE/OTHER
❑ AMERICAN INDIAN/ALASKAN NATIVE & BLACK/AFRICAN AMERICAN
c. ETI-INICITY d. DISABLED e. IS HEAD OF HOUSEHOLD FEMALE?
❑ HISPANIC ❑ YES ❑ YES
❑ NON -HISPANIC ❑ NO ❑ NO
Certification: I certify that the information I am providing is true and could be subject to verification at any
time by a third party. I also acknowledge that the provision of false information could leave me subject to the
penalties of Federal, State and local law.
Signature of Applicant
Date
WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY
FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OF
THE UNITED STATES GOVERNMENT.
------------------tor use b
Household Size: Gross Annual Income:
Applicable Income Limit: Is Applicant Eligible?
Check if Applicant refused to provide demographic information: O
Staff Assessment of Demographics:
Person Making Determination: Date:
NOTE: A(idress, i'neome amounts and sources forALL household members are
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "E" — FORM OF INCOME CERTIFICATION Page 2
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Ciudad de Fort Worth
CERTIFICACION DE DECLARAC16N DE INGRESOS
Nombre del Solicitante:
Direction de Actualidad:
Ciudad y Codigo Postal:
Telefono:
Miembros Del IIo ag Ie Ingresos
(Inclu endo el/la Solicitante)
Apellido Nombre Edad Ingreso Origen de Ingresos
Mensual
" TOTAL NOMERO DE MIEMBROS DEL HOGAR
(IncMyase Usted.)
Total Anual de Ingresos del hogar:
"INFORMACION PERSONAL: (Seleccione uno en cads articulo. Esta information es requerida por el Gobiemo federal.)
a. ❑ MASCULINO b. ❑ BLANCO ❑ NEGRO/AFRICANO AMERICANO ❑ NEGRO/AFRICANO AMERICANO & BLANCO
❑ FEMININO ❑ INDIO AMERICANO/NAI'IVO DE ALASKA ❑ ASIA11CO
❑ INDIO AMERICANO/NATIVO DE ALASKA & BLANCO ❑ ASiATICO & BLANCO
❑ NATIVO HAWAIANO/OTRO DE LAS ISLAS PACIFICAS ❑ BALANCE/O RO
❑ INDIO AMERICANO / NATIVO DE ALASKA & NEGRO/AFRICANO AMERICANO
c. ETHNICIDAD d. INCAPACITADO c. LES LA CABEZA DEL HOGAR MUJER?
❑ MSPANO ❑ SI ❑ S1
❑ NO-WSPANO ❑ NO ❑ NO
Certifieaeion: Yo certifico que la information que yo estoy proporcionando es verdadera y puedo ser sujeto a
veriflcaci6n a cualquiera hora por tercera parte. Yo tambidn reconozco que la provision de informacion falsa
puede dejaime sujeto a penalidades Federales, Estatales, y a ley local.
Firma del Solicitante
Fecha
ADVERTENCIA: TITULO 18, SECCION 1001 DEL CODIGO DE LOS ESTADOS UNIDOS INDICA QUE UNA
PERSONA ES CULPABLE DE UN DELITO POR SABER Y VOLUNTARIAMEN`I'E HACER DECLARACIONES FALSOS O
FRAUDULENTAS A CUALQUIER DEPARTAMENTO DE GOBIERNO DE LOS ESTADOS UNIDOS.
_---------------- use de empleados de to
# De Miembros de Familia: Ingreso Anual:
Limite de Ingreso: ZEs solicitante elegible? :
Compruebe si el solicitante se nego a dar su informacion personal: O
Evaluation del empleado sobre informacion personal:
Persona haciendo la determination:
Node: La direction cle la casa y los in,
SUS
Fecha:
lodos miembros del
son requeridos
CDBG REHABILITATION CONTRACT 2017-2019— EXHIBIT "E"— FORM OF INCOME CERTIFICATION Page 3
Fort Worth Area Habitat .for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "F"
STANDARDS OF DOCUMENTATION
CDBG REHABILITATION CONTRACT 2017-2018 -- EXHIBIT "F" —STANDARDS OF DOCUMENTATION Page I
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
2097-2018 Documentation Standards for
CDBG Public Service Contract Expenses
NoteslOther
Items
.,a.a:CI--�a".*..^ 'y�e.^?',M�"'".`".w"'.w✓`-+:+-k S %F.
andene{1tS g4perce�ftage ofp gQipipypg s Syho work direcflY yrli2 C[iBG �ur)fiedMEroyram s
xp)pyggr)gs y,li�vrtlloitiyerrhurse
I'sicsn e� vir I e oast al ocatee andieteitxrtri ri3�tQ the e` scut ort afthe t DBU` Cnnf at? errcte reues►lli the relriahurl;emanto`f
1 may.. to Q_;,.F::.:�>,. -:>P 9 q_,. 9 r any Y Inpoyee,-
: � W.Mk.,.. :. ,N ;
uV111 ragtjtce prior Crrya ,pfoVfil 19t flet muskslloytircatp>tla�fEor�Earr d. wthe p�S p4Gtloat ofp. Rt4YpQa]arlga ah+rengrits;era calculate(1 c Q�� ntl mit '}�e'Cb6G
i
CO► C� i t a r yF jr z . z�C .
If an employee works on both a CDBG eligible and non-CDBG eligible program(s), the City will only reimburse for a reasonable portion
of the employee's salary. Prior to the execution of the CDBG Contract, the Agency will priovide the City with a written statement on how
each employee's time will be allocated. If an employee works 100% of their time directly with the CDBG-funded Program, then 100% of
the employee's salary may be eligible for reimbursement. Agency must submit a written statement that 100% of the employee's time is
spent working directly with the CDBG-funded Program. Statements must be signed by a person authorized to sign on behalf of the
Agency and will be submitted with the October invoice.
Salaries
X x •
Reimbursement requests must include a timesheet and work log that reflects the hours worked by the employee(s) working directly on
the CDBG-funded Program. For employees who are paid with multiple funding sources, timesheets must reflect all funding sources. If
separate timesheets are kept for each funding source, all such timesheets must be submitted to City. Timesheets must be signed by
employee and supervisor. Agency must show a calculation and documentation of how the employee's salary was calculated and
invoiced to City.
'If employees are paid by direct deposit rather than check, then the agency must submit both the direct deposit payment company's
report (such as an ADT report) and a bank statement or check showing payment to the direct deposit company.
FICA/Medicare X
XIX
If the City pays gross salary, this is already included, If the City pays the employer portion, the Agency must provide proof that the
Life Insurance X
x X
Health
X
Insurance
x x
employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and
must provide documentation showing payment. Invoice and proof of payment are only required with the first reimbursement request and
Disability
X
Insurance
x x
at any time there are changes to amounts, enrollments, disenrollments, etc.
Unemployment
x
Insurance
x x
If the City pays gross salary, this is already included. If the City pays the employer portion, the Agency must provide proof that the
employee is enrolled in the benefit plan, must show a calculation and documentation of how the invoiced amount was calculated, and
Retirement x
X X
must provide documentation showing payment. Invoice and proof of payment are only required with the first reimbursement request and
at any time there are changes to amounts, enrollments, disenrollments, etc.
i fe Is?E u n� GaAda�a Y i S"?^-: r W II o ye)m U or die eosf I xa d e' cgnt'g a asi"Rip.et it su Q , -of toe GL] G Jpn dPra raM ' c1" "r 5
!€?I r 9.iunp ��,pi)- -- J ?>aY - .. 4.
1i>tursgmnfortheeemslYiilyrayitp:^pt1of�tl!proEiaf,A„yam tsfldwc,�let7oWaho fheGDBG➢t ionaY esee anaesrGe4ecalaulatgd
pl�tl� port f h
reg:.J
YPJ �,... Y.IlF.li �64i.., ... �,:� Tw3 -�...wZ. �<.,,. u...:..a iN�e �:'=3:�.��...:'£4S.,,yLkY�i ,.FX�.�Y.r ..,...,.:11a ....^i .. L✓:.{ .ax.....-. s'g".. .��»'/�"tY 2.._....�_� ... ........ SK J'.-..: ....lMpgi
Office Supplies
X X
X
rnrr�e
Equipment
X X
X
X X
Rental
Postage
X X
X
Printing
X X
X
Construction &
Building
X X
X
X
This category is only available for the REACH Program and Habitat for Humanity.
Materials
Sport and
Recreation
X X
X
Equipment
Cleaning
X X
X
Supplies
Teaching Aids
X X
X
Craft Supplies
X X
X
Food Supplies
X X1 I
X
This category is only available to the Program provided by Meals on Wheels.
Ren' t)ulmes,`and NJaI'pienanee ��lt�7 (£till ot��y payfora jaafigrc : fthesepxpenses 'fha portran.of those a�peg3gs'X+Ftll J2@ rle�eintnad bylhe,squ Ye fQQta�e attr borsht£ to ,
tt�$f;Q �.fttl?d�$l'195r$irLan,Slslt;�ll a k-�Ilay�.�etJ;;ip;�cGgrddnggWlt)1�tttp� pp4unt,Q>•s�a u¢Bd�a�DBGfur�'c�edPr¢�raRlu�ftfesee�tpetts�slnaynrt�)fherris�tS�rPol'
ofth[3HG f�pdada' _rogrtgf'' '�ptte�7srsfed be)nvtkagSt)1� ptt rCrty rava and�ha �c "fs�e rimed fo Lde�fJfss���iyfiiinfiirl source that pa' s fpr the- »rti n o the
oho e�DB
e��t a `"�' t� dwtth�4 Gftlntls A erlbies p howcalcula ow' ter. i ohlanAfthes x enaes' ie a4ul"'�' s s` t1',t�` "`pD
z �y
�- .,1- ar'' ,.�J c ..rw ✓ .,� r r :y a r- 3" �� � -n- � .r� a� r
Corraat .Nn, l it . ?f. t 5 ✓,.. yu 1: J ., f, , <..:: ,. . 4.5 .. % . , f. }', y '{
o
Telephone X X
Gas X X
WaterlWaslew X X
ater
Electric X X
Sol€d Waste X X
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "F” —STANDARDS OF DOCUML,NTATION Page 2
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
*Proof of payment effective October 1, 2013: payments or Expenses must be documented in the following manner:
A) Image of the check AND bank statement showing the check cleared the bank; OR,
B) Image of the cancelled check (ex. At end of bank statement); OR,
C) Payroll Check Stub, "Advice", or Statement AND Bank Statement indicating payroll; OR,
D) For wire or e -transfers: Reclept or statement from payee/vendor OR bank statement.
Rol as 909,2612017 DC
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "F" –STANDARDS OF DOCUMENTATION Page 3 ,
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Facility
Maintenance
X X
X
X
This item requires approval by the City prior to the execution of the CDBG Contract. Repairs may be categorized as major/minor
and Repairs
rehabilitation projects and must be approved through the full HUD Environmelal Review.
Rent
X
X
X
City will pay for a portion of the rent for the Program facility so long as its in proportion to the square footage attributable to the CDBG-
funded program.
MIAV
Al
This item requires prior approval by the City. Prior to the execution of the CDBG Contract, the Agency must submit a written statement
Contracted
that lists the contracted services to be used during the Contract term. Agency will submit a memo related to the procurement of such
Services
X X
X
X
X
services and will forward any information pertaining to the procurement process to City. This requirement applies to, but is not limited to,
services retained for security services, legal, accounting, transportation providers, educational facilitators, custodial services,
rehabilitation services, home repair, and like items. Agencies may not use the contract services of any City of Fort Worth Department.
City-requiredX
X
City will only pay for a percentage of the City -required insurance so long as it's in proportion to the square footage attributable 10 the
Insurance
CDBG-funded program.
City requires that the agency submit its fee schedule or formula on how the Agency calculates the childcare scholarship amount. The
fee schedulelformula should demonstrate a breakout of income levels, and for each income level the schedule should demonstrate
Childcare
X X
which portion of the expense is to be paid by the family and which portion of the expense is to be reimbursed by the City. A fee
Scholarships
scheduleltormula must be submitted to the City prior to the first payment. Agency must submit documentation supporting that the client
is income eligible and that the household is being charged in conformance with the fee schedule. If the fee schedule(formula changes at
any time during the contract term, the Agency must immediately notify City on the dale the new fee scheduleltormula takes into effect.
If an audit is required because federal funds exceed $750,000, then the cost should be split evenly by all grant funding sources. Agency
Audit Services
X X
X
X
must show calculation on how the CDBG portion of the accounting services were calculated. For example, if the CDBG grant is 10% of
your Agency's budget, then invoice shall not exceed 10% of the overall cost. Agency must show a calculation and documentation of
how the invoiced amount was calculated, and must provide documentation showing payment.
*Proof of payment effective October 1, 2013: payments or Expenses must be documented in the following manner:
A) Image of the check AND bank statement showing the check cleared the bank; OR,
B) Image of the cancelled check (ex. At end of bank statement); OR,
C) Payroll Check Stub, "Advice", or Statement AND Bank Statement indicating payroll; OR,
D) For wire or e -transfers: Reclept or statement from payee/vendor OR bank statement.
Rol as 909,2612017 DC
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "F" –STANDARDS OF DOCUMENTATION Page 3 ,
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "G"
SECTION 3 REPORTING FORMS
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "G" ---SECTION 3 REPORTING FORMS Page 1
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Section 3 Summary Report U.S. Department of Housing
Economic Opportunities for and Urban Development
Low — and Very Low -Income Persons Office of Fair Housing
And Equal Opportunity
Section back of page for Public Reporting Burden statement
stale,
4. Contact Person
no.)
EXHIBIT "G"
OMB Approval No: 2529-0043
(exp. 11/3012010)
HUD Field Office:
area
Total j
' Program Codes 3 = PubliclIndian Housing 4 = Homeless Assistance 8 = CDBG State Administered
1 = Hemble Subsidy A= Development, 5 = HOME 9 = Other CD Programs
2 = Section 2021811 B = Operation 6 = HOME State Administered 10 = Other Housing Programs
C = Modernization 7 = CDBG Entitlement
Page 1 of 2 form HUD 60002 (612001)
Ref 24 CFR 135
Part It: Contracts Awarded
1. Construction Contracts:
A. Total dollar amount of all contracts awarded on the project $
B. Total dollar amount of contracts awarded to Sector) 3 businesses $
C. Percentage of the total dollar amount that was awarded to Section 3 businesses
D. Total number of Section 3 businesses receiving contracts
2. Non -Construction Contracts:
A. Total dollar amount all non -construction contracts awarded on the projectlactivity $
B. Total dollar amount of non -construction contracts awarded to Section 3 businesses $
C. Percentage of the total dollar amount that was awarded to Section 3 businesses %
D. Total number of Section 3 businesses receiving non -construction contracts
Part 111: Summary
Indicate the efforts made to direct the employment and other economic opportunities generated by HUD financial assistance for housing
and community development programs, to the greatest extent feasible, toward low -and very low-income persons, particularly those who
are recipients of government assistance for housing. (Check all that apply.)
Attempted to recruit low-income residents through: local advertising media, signs prominently displayed at the project site,
contracts with the community organizations and public or private agencies operating within the metropolitan area (or
nonmetropolitan county) in which the Section 3 covered program or project is located, or similar methods.
Participated in a HUD program or other program which promotes the training or employment of Section 3 residents.
Participated in a HUD program or other program which promotes the award of contracts to business concerns which meet the
definition of Section 3 business concerns.
Coordinated with Youthbuild Programs administered in the metropolitan area in which the Section 3 covered project is located.
Other; describe below.
Public reporting for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
This agency may not collect this Information, and you are not required to complete this form, unless it displays a currently valid OMB
number.
Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701 u, mandates that the Department ensures that
employment and other economic opportunities generated by its housing and community development assistance programs are directed
toward low- and very -low income persons, particularly those who are recipients of government assistance housing, The regulations are
found at 24 CFR Part 135. The information will be used by the Department to monitor program recipients' compliance with Section 3, to
assess the results of the Department's efforts to meet the statutory objectives of Section 3, to prepare reports to Congress, and by
recipients as self-monitoring tool. The data is entered into a database and will be analyzed and distributed. The collection of information
involves recipients receiving Federal financial assistance for housing and community development programs covered by Section 3. The
Information will be collected annually to assist HUD In meeting its reporting requirements under Section 808(e)(6) of the Fair Housing Act
and Section 916 of the HCDA of 1992. An assurance of confidentiality is not applicable to this form. The Privacy Act of 1974 and OMB
Circular A-108 are not applicable. The reporting requirements do not contain sensitive questions. Data is cumulative; personal identifying
information is not included.
Page 2 of 2 form HUD 60002 (11/2010)
Ref 24 CFR 135
Form HUD -60002, Section 3 Summary Report, Economic Opportunities for Low- and Very Low-income Persons.
Instructions: This form is to be used to report annual
accomplishments regarding employment and other economic
opportunities provided to low- and very low-income persons under
Section 3 of the Housing and Urban Development Act of 1968. The
Section 3 regulations apply to any public and Indian housing
programs that receive: (1) development assistance pursuant to
Section 5 of the U.S. Housing Act of 1937; (2) operating assistance
pursuant to Section 9 of the U.S, Housing Act of 1937; or (3)
modernization grants pursuant to Section 14 of the U.S. Housing Act
of 1937 and to recipients of housing and community development
assistance in excess of $200,000 expended for: (1) housing
rehabilitation (including reduction and abatement of lead-based paint
hazards); (2) housing construction; or (3) other public construction
projects; and to contracts and subcontracts in excess of$100,000
awarded in connection with the Section -3 -covered activity.
Form HUD -60002 has three parts, which are to be completed for
all programs covered by Section 3. Part I relates to employment
and training. The recipient has the option to determine numerical
employment/training goals either on the basis of the number of hours
worked by new hires (columns B, D, E and F). Part 11 of the form
relates to contracting, and Part III summarizes recipients' efforts to
comply with Section 3.
Recipients or contractors subject to Section 3 requirements must
maintain appropriate documentation to establish that HUD financial
assistance for housing and community development programs were
directed toward low- and very low-income persons.' A recipient of
Section 3 covered assistance shall submit one copy of this report to
HUD Headquarters, Office of Fair Housing and Equal Opportunity.
Where the program providing assistance requires an annual
performance report, this Section 3 report is to be submitted at the
same time the program performance report is submitted. Where an
annual performance report is not required, this Section 3 report is to be
submitted by January 10 and, if the project ends before December 31,
within 10 days of project completion. Only Prime Recipients are
required to report to HUD. The report must include
accomplishments of all recipients and their Section 3 covered
contractors and subcontractors,
HUD Field Office: Enter the Field Office name .
1. Recipient: Enter the name and address of the recipient
submitting this report.
2. Federal Identification: Enter the number that appears on the
award form (with dashes). The award may be a grant,
cooperative agreement or contract.
3. Dollar Amount of Award: Enter the dollar amount, rounded to the
nearest dollar, received by the recipient.
4&5. Contact Person/Phone: Enter the name and telephone number
of the person with knowledge of the award and the recipient's
implementation of Section 3.
6. Reporting Period: Indicate the time period (months and year)
this report covers.
7. Date Report Submitted: Enter the appropriate date.
Submit one (1) copy of this report to the HUD Headquarters Office of
Fair Housing and Equal Opportunity, at the same time the
performance report is submitted to the program office. The Section 3
report is submitted by January 10. include only contracts executed
during the period specified In Item 8. PHAsfIHAs are to report all
co n tra ctsisu bco ntracts.
' The terms "low-income persons' and very low-income persons' have
the same meanings given the terms in section 3 (b) (2) of the United
States Housing Act of 1937. Low-income persons mean families
(including single persons) whose incomes do not exceed 80 percent of
the median income for the area, as determined by the Secretary, with
adjustments for smaller and larger families, except that
Pagel
a. Program Code: Enter the appropriate program code as listed at
the bottom of the page.
9. Program Name: Enter the name of HUD Program corresponding
with the "Program Code" in number 8.
Part[: Employment and Training Opportunities
Column A: Contains various job categories. Professionals are
defined as people who have special knowledge of an occupation (i.e.
supervisors, architects, surveyors, planners, and computer
programmers). For construction positions, list each trade and provide
data in columns B through F for each trade where persons were
employed. The category of 'Other' includes occupations such as
service workers.
Column B: (Mandatory Field) Enter the number of new hires for
each category of workers identified in Column A in connection with
this award. New hire refers to a person who is not on the contractor's
or recipient's payroll for employment at the time of selection for the
Section 3 covered award or at the time of receipt of Section 3 covered
assistance.
Column C: (Mandatory Field) Enter the number of Section 3 new
hires for each category of workers identified in Column A in
connection with this award. Section 3 new hire refers to a Section 3
resident who is not on the contractor's or recipient's payroll for
employment at the time of selection for the Section 3 covered award or
at the time of receipt of Section 3 covered assistance.
Column D: Enter the percentage of all the staff hours of new hires
(Section 3 residents) in connection with this award,
Column E: Enter the percentage of the total staff hours worked for
Section 3 employees and trainees (Including new hires) connected
with this award. Include staff hours for part-time and full-time
positions.
Column F: (Mandatory Field) Enter the number of Section 3
residents that were trained in connection with this award.
Part N: Contract Opportunities
Block 1: Construction Contracts
Item A: Enter the total dollar amount of all contracts awarded on the
projectiprogram.
Item B: Enter the total dollar amount of contracts connected with this
project/program that were awarded to Section 3 businesses.
Item C: Enter the percentage of the total dollar amount of contracts
connected with this project/program awarded to Section 3 businesses.
Item D: Enter the number of Section 3 businesses receiving awards.
Block 2: Non-Cons(ruction Contracts
Item A: Enter the total dollar amount of all contracts awarded on the
project/program.
Item B: Enter the total dollar amount of contracts connected with this
project awarded to Section 3 businesses.
Item C: Enter the percentage of the total dollar amount of contracts
connected with this project/program awarded to Section 3 businesses.
Item D: Enter the number of Section 3 businesses receiving awards.
Part III: Summary of Efforts — Self -explanatory
The Secretary may establish income ceilings higher or lower than ao percent
of the median for the area on the basis of the Secretary's findings such that
variations are necessary because of prevailing levels of construction costs
or unusually high- or low-income families. Very low-income persons mean
low-income families (including single persons) whose incomes do not
exceed 50 percent of the median family income area, as determined by the
Secretary with adjustments or smaller and larger families, except that the
Secretary may establish income ceilings higher or tower than 50 percent of
the median for the area on the basis of the Secretary's findings that such
variations are necessary because of unusually high or low family incomes.
form HUD 60002 (1112010)
Ref 24 CFR 135
EXHIBIT "H"
CERTIFICATION OF SEVERE DISABILITY
CDBG REHABILITATION CONTRACT' 2017-2018 — EXHIBIT "H" – SEVERELY DISABLED
CERTIFICATION FORM Page i
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Fort Worth Area Habitat for Humanity, dba Trinity .Habitat for Humanity
CERTIFICATION FORM
DOCUMENTING CLIENT STATUS AS "SEVERELY DISABLED ADULT"
Client Mame:
Address:
City, State, Zip
Client Identification No.
W
LE
0
CHECK ALL THAT APPLY
Has used a wheelchair, a walker, cane , crutches or other special aid for six
months or longer
Has been diagnosed with one of the following conditions: Alzheimer's
disease, mental retardation or other developmental disability, senility or
dementia, cerebral palsy, or autism; or has another mental or emotional
condition that seriously interferes with everyday tasks.
Is unable to perform one or more of the following "Functional Activities":
seeing, hearing, speaking and having one's speech understood, lifting or
carrying, using stairs, grasping small objects, or walking.
Is unable to perform or needs assistance to perform one or more of the
following Activities of Daily Living (ADL): getting around inside the home,
getting in or out of bed or a chair, bathing, dressing, eating, and toileting.
Is unable to perform or needs assistance to perform one or more of the
following instrumental Activities of Daily Living (iADL): going outside the
home, keeping track of money and bills, preparing meals, doing light
housework, taking prescription medications in the right amount and at the right
time, and using the telephone.
Has a condition that prevents them from working at a job or doing housework.
The undersigned Agency representative conducted a visual assessment of the client identified on
this form and certifies that the client meets at least one of the conditions indicated above, which
determines that he/ she meets the definition of "severely disabled" according to the U.S. Census
Bureau.
Certified by:
Signature/Title:
Date:
CDBG REHABILITATION CONTRACT 2017-2018 -- EXHIBIT "H" — SEVERELY DISABLED
CERTIFICATION FORM Page 2
Fort North Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "I"
MBE REPORTING FORM
CDBG REHABILITATION CONTRACT 2017-2018 -- EXWBIT "I" — MBE REPORTING FORM Page I
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
EXHIBIT "J"
LEAD SAFE HAZARD CERTIFICATION
CDBG REHABILITATION CONTRACT 2017-2018 --- EX.HIBIT "J" —LEAD SAFE HAZARD
CERTIFICATION Page I
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
CERTIFICATION REGARDING COMPLIANCE WITH LEAD -SAFE HOUSING RULE
FOR
MINOR REHABILITATION PROGRAMS UNDER$5000
ADDRESS OF PROPERTY TO BE REPAIRED:
YEAR BUILT:
SCOPE OF REPAIR/REHABILITATION:
Painted Surfaces: Will be disturbed
Will NOT be disturbed.
If Painted surfaces will not be disturbed, explain:
For Painted Surfaces that will be disturbed: (attach photos of worksite)
Work Area is Interior and is Not Larger than 2 Square Feet:
- Work Area is Interior and is Larger than 2 Square Feet:
- Work Area is Exterior and is Not larger than 20 Square Feet:
Work Area is Exterior and is Larger than 20 Square Feet:
Housing unit is occupied by Elderly Person and/or Disabled Person: Yes No
Children Under 6 Years of Age Reside at / Regularly Visit this Housing Unit: Yes No
Lead Based Paint Information Pamphlet Provided to Homeowner/Resident: Yes No
Date Pamphlet Provided
In housing built before 1978, for Work Areas Exceeding the above 2 Square Foot / 20 Square Foot De-Minimis Levels,
and where children under 6 are expected to 'Reside/Regularly Visit the housing unit, Lead -Certified Contractors must
be used, Lead Safe Work Practices must be performed and Dust Wipes/Tests must be performed following completion
of the rehabilitation work.
Housing units constructed after 1978, and Pre -1978 Housing Units designated for Elderly or Disabled Persons where
children are not expected to reside/visit regularly, are Exempt from the Lead Safe Housing Rule in accordance with 24
CFR 35.110, Definition of Target Housing.
I certify that the information provided above is true and correct
Certification by Agency Staff:
Printed Name and Title:
CDBG REHABILITATION CONTRACT 2017-2018 -- EXHIBIT "J" —LEAD SAFE HAZARD
CERTIFICATION Page 2
Fort Worth Area Habitat for Hmnanity, dba Trinity Habitat for Humanity
EXHIBIT "K"
CONFLICT OF INTEREST DISCLOSURE FORM
CDBG REHABILITATION CONTRACT 2017-2018 -- EXHIBIT "K" — CONFLICT OF INTEREST
DISCLOSURE FORM Page 1
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
FORTWORTH
CONFLICT OF INTEREST DISCLOSURE:
The assistance you are applying for is funded using Housing and Urban Development (HUD) funds and because of this
our office is requesting the following information in order to comply with the funding requirements. Please complete
this form to the best of your ability, sign it, and return it to this Agency at your earliest convenience.
NAME:
ADDRESS:
TELEPHONE: E-MAIL ADDRESS (if applicable)
I. Are you employed by the City of Fort Worth? ❑ YES ❑ NO
Ia. If yes, by which Department and Division:
2. Were you employed by the City of Fort Worth within the most recent 12 -month period? ❑ YES ❑ NO
2a, if yes, by which Department and Division:
3. Are any members of your immediate family currently employed by the City of Fort Worth?
(" hwnediale Family" includes 6dietlter by blood or adoplion): the spouse, parew (including a slepparern),
child (inchiding a stepchild), brother, sister (inchiding a stepbrother or stepsislei), grandparent, grandchild,
and in-Imrs)
El YES
❑ NO
3a. If yes, please provide relative's name(s), Department(s), and Division(s):
4. If No, were any members of your immediate family employed by the City of Fort Worth
within the most recent 12 -month period?
],S❑
NO
4a. if yes, please provide relative's name(s), previous Department(s), and Division(s):
5. Are you an elected or appointed official, or agent or consultant, of the City of Fort Worth? I ❑ YES ❑ NO
5a. If yes, by which Department and Division:
6. Are any immediate family members an elected or appointed official, or agent or consultant
of the City of Fort Worth?
IS
❑ NO
6a. If yes, please provide relative's name(s), Department(s), and Division(s):
Certification: I understand and agree that the City may/will contact the City of Fort Worth department including all supervisors
in order to determine whether any of these persons' employment or official functions are or were related to the City's use of
federal grant funds and whether federal funds can be provided, I certify that the information 1 am providing is true and
could be subject to verification at any time by a third party. I also aclmowledge that the provision of false information
could leave me subject to the penalties of Federal, State and local law.
WARNING: TITLE 18, SECTION 1001 OF THE U.S. CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND
WILLINGLY NIAKING FALSE OR FRAUDULENT SI ATENIENTS TO ANY DEPARTiVIENT OF THE UNITED STATES GOVERNMENT.
Applicant/Prospective Applicant Signature Date
For City Staff Only: Once this form is completed and if "Yes" is marked on any of the above questions, please
return it to your Compliance Specialist as soon as possible for processing. If you have any questions, please contact
Barbara Asbury, Grants Manager, Compliance Division, at 817-392-7331, or Charletta Moaning, Sr. Contract
Compliance Specialist, at 817-392-7333 or at charletta,moaning@fortwolthgov.oig.
CDBG REHABILITATION CONTRACT 2017-2018 — EXHIBIT "K" – CONFLICT OF INTEREST
DISCLOSURE FORM page 2
Fort Worth Area Habitat for Humanity, dba Trinity Habitat for Humanity
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
101`1
Complete Nos. l - 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1
Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2017-266100
Fort Worth Area Habitat for Humanity, Inc.
Fort Worth, TX United States
Date Filed:
09/27/2017
2
Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Fort Worth
Date Acknowledged:
3
Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract,
00000000
Cowtown Brush Up Program - project that includes house prep, trim & siding repair as needed, and painting, Limited to
homeowners with incomes below 50% AMI.
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
5
Check only if there is NO Interested Party.
X
6
AFF, ID IT y_ _ _ _ _ _ _ _ 1 swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
1;�-.y ALISA MAPLES
!' �¢ ; Notary Public, State of Texas
'•• •= Notary ID # 12541753-8 i
My Commission Expires ( F�
august a, 2021v r' "' -K
Vb
Signature of authorized agent of "contracting busine entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said Pk t ' t - � ��( , this the I day of
20 1 'fi to certify which, witness my hand and seal of office.
ce.ma,Y1xt t.' C.:v
Signature of officer ad inistering oath Printed name of officer adn inistering oath Title of officer administeringJoath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337
City of Fort Worth, Texas
Mayor and Council Communication
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize the City Manager or his designee to execute a contract with Fort Worth Area Habitat for
Humanity d/b/a Trinity Habitat for Humanity for Community Development Block Grant funds in the amount
of $285,000.00 to operate the Cowtown Brush Up Program for a 16 month term beginning on the date of
execution of the contract;
2. Authorize the City Manager or his designee to extend the contract for two additional 12 month terms if
such extension is necessary to achieve program goals;
3. Authorize the City Manager or his designee to amend the contract if necessary to achieve program
goals provided that the amendment is within the scope of the program and in compliance with City policies
and applicable laws and regulations governing the use of federal grant funds; and
4. Authorize the City Manager or his designee to substitute funding years as needed in order to meet
United States Department of Housing and Urban Development expenditure deadlines and reporting
requirements for CDBG funds.
DISCUSSION:
The City of Fort Worth has operated the Cowtown Brush Up program for over 20 years, twice a year on a
weekend in April and October. This program is a volunteer effort supported with Community Development
Block Grant (CDBG) funds that assists very low income homeowners by painting the exterior of their
houses. Since 2009, the City has partnered with Fort Worth Area Habitat for Humanity d/b/a Trinity Area
Habitat for Humanity (Habitat) in operating the program, with Habitat recruiting volunteers and soliciting
donations of paint and supplies and the City identifying income -eligible clients and hiring a contractor to
prepare the houses for painting. The City conducts final inspections to ensure quality control. The program
paints approximately 88 houses annually.
The City's 2017-18 Action Plan included an allocation of $285,000.00 in CDBG funds for the Cowtown
Brush Up program, including $30,000.00 for program delivery expenses and $255,000.00 for direct project
costs.
Logname: 19NS HABITAT COWTOWN BRUSHUP 2018 Page 1 of 2
In order to increase efficiency and support Habitat's neighborhood revitalization programs, staff
recommends that the total operation of the program be contracted out to Habitat. Operating the Cowtown
Brush Up Program will allow Habitat to leverage its close relationships with community and neighborhood
organizations to expand outreach for the program and increase its impact in City neighborhoods. This will
allow staff to focus on integration and enhancement of other housing rehabilitation programs such as the
Priority Repair Program, the Weatherization program, and the Lead Safe program.
Habitat has extensive experience in income qualification and documentation for HUD -funded programs,
construction management expertise, and a history of successful partnerships with the City on a number of
projects.
This project is located in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that funds are available in the current operating budget, as appropriated,
of the Grants Fund. Prior to an expenditure being made, the participating department has the
responsibility to validate the availability of funds. This is a reimbursement grant.
FUND IDENTIFIERS (FIDs):
TO
Fund
Department
ccoun
Project
Project
ctiivltyl
Budget
Reference #
mount
moun
ID
ID
JProgram
ID
I Year
(Chartfield 2
Year
FROM
CERTIFICATIONS:
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Aubrey Thagard (8187)
Eric Vodicka (7583)
Additional Information Contact: Barbara Asbury (7331)
ATTACHMENTS
1. 101217 CDBG 17-18- Project Budget Summary.pdf (CFW Internal)
2. Certificate of Interested Parties - Cowtown Brush Up.pdf (Public)
3. Cowtown Brush Up Budget. pd (CFW Internal)
4. MC FID Sheet CTBU.pdf (CFW Internal)
5. SAM Search Results.pdf (CFW Internal)
Logname: 19NS HABITAT COWTOWN BRUSHUP 2018 Page 2 of 2
Fund
Department
ccountl
Project
IlPrograttivityl
Budget
Reference #
moun
ID
ID
Year
(Chartfield 2)
CERTIFICATIONS:
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Aubrey Thagard (8187)
Eric Vodicka (7583)
Additional Information Contact: Barbara Asbury (7331)
ATTACHMENTS
1. 101217 CDBG 17-18- Project Budget Summary.pdf (CFW Internal)
2. Certificate of Interested Parties - Cowtown Brush Up.pdf (Public)
3. Cowtown Brush Up Budget. pd (CFW Internal)
4. MC FID Sheet CTBU.pdf (CFW Internal)
5. SAM Search Results.pdf (CFW Internal)
Logname: 19NS HABITAT COWTOWN BRUSHUP 2018 Page 2 of 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
10f 1
Complete Nos.1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
12017-266100
1
Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Fort Worth Area Habitat for Humanity, Inc.
Fort Worth, TX United States
Date Filed:
09/27/2017
2
Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Fort Worth
edged:
Date Acknowlldl-�
yt' I
3
Provide the identification number used by the governmental entity or state agency to track or Identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
00000000
Cowtown Brush Up Program - project that includes house prep, trim & siding repair as needed, and painting. Limited to
homeowners with incomes below 50% AMI.
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I intermediary
5
Check only if there is NO Interested Party.
X
6
AFFID IT — — i swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
ALISA MAPLES
1 .7 1. Notary Public, State of Texas
:•'s Notary ID fl 12541753-8
"!' "•+:" My Commission Expires
August 4, 2021
Signature of authorized agent o ontracting busine entity
AFFIX NOTARY STAMP / SEAL ABOVE
►� AA /'^ DD I �( +n In ` , J
Swom to and subscribed before me, by the said 1V � � 1 k ` �.� 'G z + r e, this the _ _ day of cit "Y
20_A_:I__, to certify which, witness my hand and seal of office. ?—
Signature of officer adrhnistering oath Printed name of officer adnifnistering oath Title of officer administers ath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337