HomeMy WebLinkAboutContract 52981 -
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CSC No.52981
RECEIVED
OCT 2 8 2019
CIE{OF FORT WORTH
MYSECRETARY VENDOR AGREEMENT
COMPREHENSIVE ENERGY ASSISTANCE PROGRAM
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The purpose of the Comprehensive Energy Assistance Program ("CEAP")funded from the Low-
Income Home Energy Assistance Program ("LIHEAP") grant is to maintain an energy supply to ,.
heat and cool the residences of eligible low-income clients.
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The Energy Services provider, (or"Vendor,") agrees to honor the purpose of the CEAP grant and
to accept pledges of payment from CEAP agencies only for certified customers to whom Vendor
continues to provide energy services. The Energy Assistance Provider, (or"Agency",) agrees to
make payments only for eligible low-income clients.
This vendor agreement is by and between: !
City of Fort Worth and
Energy Assistance P vider(Agency)
(Vendor)
Vendor and Agency agree to assist customers in the following counties: Tarrant County -
This agreement shall be effective from the day ofti for a period not to
exceed two years from the effective date. Either party may terminate this agreement by written
notice. Such written notice of termination shall not affect any obligation by either party incurred
prior to the receipt of such notice. Notice shall be sent via certified mail with return receipt
requested.
(Vendor Name)
(Vendor Mailing Address)
City of Fort Worth; Neighborhood Services Department
(Agency Name)
200 Texas Street Fort Worth TX 76102
(Agency Mailing Address)
OFFICIAL RECORD
dQ.TX UMTARY
FT. WORTH,TX
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The Agency named above represents and warrantsboVendor it is a subrecipient of the Texas
Department ofHousing and Community Affairs ("TDH[A7) and as such is authorized and has
received funding from theTOHCA to provide bill payment assistance service for eligible low-
income households. �
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The Vendor named above represents and warrants that it wilil apply any payments received from '
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Agency to the account of the customer that the Agency has determined to be eligible under the i
CEAP guidelines and suchio a "Certified Cumtoner'. |
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Vendor will, with reference tmaCertified Customer: '
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° Extend the CEAP applicant's energy service for up to five business days while the Agency .
determines whether the CEAP applicant is eligible purbuant to the CEAP guidelines.
= Upon accepting pledge from Agency for Certified Cuutomer, continue or restore energy
service to Certified Customer with no increases in chmqgom, service charges or other
charges affecting the total coat of the biU, except as allowed by the stated tariff cost
registered vWith the Public Utility Commission"pUC^ and/or Texas Railroad Commission.
° In the event the full past due balance is not paid by the Agency, the Certified Customer
must pay the remaining balance on or before the disconnect date stated in the customer's
Disconnect Notice required by PUC regulations in order to avoid disconnection or be
eligible for reconnection. Nothing in this agreement requires the Vendor to reconnect the
customer upon receipt of a pledge that does not cover the full past due balance or if the
customer has already been disconnected bV the time the pledge is received by the
Vendor.
° Invoice the Certified Customer in accordance with Vendor's normal billing practices.
° Upon verbal or written request from Agency, provide atno cost bothe Agency the Certified
Customer's billing and usage history for previous twelvo nmonthm, or available history |uo
monthly estimates if \oma than bwa|va months of bU\iMb history and usage is available.
Vendor will transmit such billing history via electronic nnsi| or fsnairni|a as soon as
possible, but no later than forty-eight hours following the request.
° VVodv with Agency and Certified Customer to explore the feasibility of offering flexible
payment arrangements that may include, without limitation, waiving security deposits,
reconnect fees, application fees, and all other fees whenever possible.
° Not discriminate against Certified Customer in phoa or services, including the availability
of deferred payment plans, \ovo\ or average payment plans, diomourd, budgot, advance
payment or other credit plans.
° Not refuse to provide energy oan//oe or otherwise discriminate in the marketing and
provision of energy service to any Certified Customer because ofrace, oneed, oo|or,
national origin, anoaotry, sax, marital status, lawful source of /nomnnw, level of income,
disability,financial status, location of customer in an economically distressed geographic
area, or qualification for low-income or energy-efficiency services.
Revised August aozy
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• Allow Agency forty-five days from the date of the pledge to forward payment to the
Vendor. Vendor agrees not to consider the portion of the Certified Customer's account to
be paid by the Agency delinquent if said payment is received within the above mentioned
forty-five day period and Vendor is provided with a verbal or signed pledge from the
Agency within forty-five days of identifying a Certified Customer.
• Not interrupt service if Certified Customer is eligible under PUC regulations, or other
state agency regulations(as applicable), and enters into an agreement with the Vendor
concerning how the Certified Customer will pay the balance owed Vendor and the
Certified Customer is meeting the obligation under such agreement.
• If the Agency has paid for an initial deposit or similar refundable instrument, upon the
termination of service to the Certified Customer, the Vendor shall return funds including
interest (after any balance owed) to the Agency in accordance with PUC regulations or
other state agency regulations (as applicable).
The Agency will:
• Obtain written permission for Agency to request and have access to customer information,
including confidential or personal account information, credit and payment history, from
customers seeking Agency's assistance. Social Security numbers are not required for the
CEAP program and may not be disclosed to Agency.
• Provide to Vendor, at Vendor's request, customer's written permission for Agency's
access to customer information as stated above.
• Not provide pledges on behalf of a Certified Customer to Vendor without having adequate
funds to pay such pledge.
• Pay pledges within forty-five days of making pledge to Vendor.
• Determine if a customer is a Certified Customer within five days of contacting Vendor.
• Provide Vendor a list of names, telephone numbers and e-mail addresses of Agency staff
designated to make pledges on behalf of the Agency and Certified Clients, if requested
from Vendor.
The terms of any confidential transaction under this agreement or any other information
exchanged by the Agency and Vendor relating to any transaction shall not be disclosed to any
person not employed or retained by the Agency or Vendor, their affiliates, or brokers, except to
the extent disclosure is 1) required by law; 2)necessary to disclose to the other party in connection
with a dispute between the parties; 3) otherwise permitted by written consent of the other party;
4)required by guarantors to be disclosed; 5) information which must be disclosed to a third party
to transmit energy; 6) to meet reliability council, regulatory, administrative, judicial, governmental,
or regulated commodity exchange requirements where necessary; or 7) of information which was
or is hereafter in the public domain.(except by breach of this Agreement).
Revised August 2019
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If Vendor has fewer than 10 employees or the Agreement is for less than$100,000,this section does
not apply. Vendor acknowledges that in accordance with Chapter 2270 of the Texas Government
Code, City is prohibited from entering into a contract with a company for goods or services unless
the contract contains a written verification from the company that it: (1) does not boycott Israel; and
(2) will not boycott Israel during the term of the contract. The terms 'boycott Israel" and "company"
shall have the meanings ascribed to those terms in Section 808-001 of the Texas Government Code.
By signing this Vendor Agreement, Vendor certifies that Vendor's signature provides written
verification to City that Vendor: (1) does not boycott Israel; and (2) will not boycott Israel
during the term of the Agreement.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under the
Agreement, have access to and the right to examine any directly pertinent books, documents, papers
and records of Vendor involving transactions relating to the Agreement. Vendor agrees that City shall
have access during normal working hours to all necessary Vendor facilities and shall be provided
adequate an'd appropriate workspace in order to conduct audits tin compliance with the provisions of
this section. City shall give Vendor reasonable advance notice of intended audits,
[Signature page follows]
is
Revised August 2019
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2Z
Authbrir-2-ed Vendor Signature Date
6) A176 Wb 15
Typed Naine of Authorized Signature Title 0
Vendor(Area Code)Telephone Number Date
Vend Email Address
CITY OF FORT WORTH, TEXAS:
"j;,740_
Fernando Costa(Oct 23,2019) Oct 23,2019
Fernando Costa Date
Assistant City Manager
RECOMMENDED:
-YA4�
Marie Francis
Human Services Manager
APPROVED AS TO FORM AND LEGALITY:
Matthew Murray
O
Assistant City Attorney I - RT
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ATTEST:
Lax-T Ku
By: Mary J.Kayser(Oct-27,2019)
Mary J. Kayser N
City Secretary TEX
Contract Authorization: OFFICIAL RECORD'
M&C: N/A CITY SECRETARY
Date Approved: NIA FT WORTM; TX
L-Revised August 2019
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CONTRACT COMPLIANCE MANAGER:
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By signing below, I acknowledge that I am the person responsible for the monitoring and
administration of this contract, including ensuring all performance and reporting requirements.
Marie Francis(Oct 23,2019)
Marie Francis
Human Services Manager
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Revised August 2019
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7135371335 NRG 08:37:11 10-22-2019 717
Form
w-9 Request for Taxpayer Give Form to the
(Rev-Decernber 2014) requester.Do not
Department of the Treasury Identification Number and Certification send to the IRS.
Internal Revenue Service
I Name(as shown on your Income tax return).Name is required on this line;do not leave this fine blank.
NRG Energy,INC
cl; 2 Business name/disregarded entity name,It different from above
US Retailers;LLC dba DISCOUNT POWER
cL 3 Check appropriate box for federal tax classification,check only one of the following seven boxes: 4 Exemptions(codes apply only to
C certain entities,not Individuals;see
0 E]Indivicluallsole proprieforor C corporation El S Corporation El Partnership Trsvestate Instructions on page 3j:
0
C single-member LLC
0 E]Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=parinersNp)0- Exempt payee code fit any)
1 :0
0 Note.For a single-member LLC that Is disregarded,do not check LLC;check the appropriate box In the line above for Exemption from FATCA reporting
ye the tax classification of the single,-marnber owner- code(if any)
El Other(see Instructions)11- *cw-1sm&ftfmd a,nlao.0.u.s.)
!E 5 Acidress,(number,street,and apt.or suite no.) Requester's name and address(optional)
0
0 P.O box 3587 cL
a) City of Fort Worth
,V 6 City,state.and ZIP code 200 Texas Street
CD Houston,TX 77253-3587 Fort Worth,TX 76102
7 List account number(s)here(optional)
NUMU Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(ISSN).However,fora
resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other
entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a m -LL 11 _1
TIN on page 3. or
Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for Employer Identification number
guidelines on whose number to enter.
Certification
Under penalties of perjury,I certify that:
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3. 1 am a U.S.citizen or other U.S.person(defined below):and
4.The FATCA code(s)entered on this form(it any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all Interest and dividends on your tax return,For real estate transactions,Item 2 does not apply.For mortgage
interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and
generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
Instructions on page 3.
Sign Signature Of
Here. U.S.personli� Data ll� t6
12142611
IV
General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T
(tuition)
Section references are to the Internal Revenue Code unless otherwise noted. -Form 1099-C(canceled debt)
Future developments.Inforrnatlon about developments affecting Form W-9(such -Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release-it)is at www.J?s.gov1Av9.
Use Form W-9 only if you are a U.S.person(Including a resident Wien),to
Purpose of Form provide your correct TIN.
An individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a 77N,you might he subject
return with the IRS must obtain your correct taxpayer identification number(TIN to backup withholding.See Mat is backup withhokfing?on page 2.
which may be your social security number(SSN),Individual taxpayer Identification By signing the filled-out form,you:
number(ITIM,adoption taxpayer Identification number(ATIN),or employer 1.Certify that the TIN you Eire giving Is correct(or you are waking for a number
Identification number(EIN),to report on an information return the amount paid to to be issued),
you,or other amount reportable on an information return.Examples of information
returns Include,but are not limited to,the following: 2 Certify that you are not subject to-backup withholding,or
•Form 1099-INT(interest earned or paid) 3-Claim exemption from backup withholding It you are a U.S.exempt payee.If
•Form 1099-DIV(dividends,Including those from stocks or mutual funds) applicable,you are also certifying that as a U.S.person,your allocable share of
any partnership Income tom a U.S.Made or business Is not subject to the
•Form 1 099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and
•Form 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form Pf any)indicating that you are
brokers) exempt from the FATCA reporting,is correct See Mist is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further Inton-nation.
•Form 1099-K(merchant card and third party network transactions)
Cat.No.10231X Fore W-9(qw.12-2014)