DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF
SERVICE PROVIDER AGREEMENT
This SERVICE PROVIDER AGREEMENT (Agreement") is entered into this day of , 2022 ("Effective Date"), by and between the CITY OF ALAMEDA, a municipal corporation ("the City"), and ABT ASSOCIATES INC., a Massachusetts corporation, whose address is 6130 EXECUTIVE BOULEVARD, ROCKVILLE, MD 20852 ("Provider"), in reference to the following facts and circumstances:
RECITALS
The City is a municipal corporation duly organized and validly existing under the laws of the State of California with the power to carry on its business as it is now being conducted under the statutes of the State of California and the Charter of the City.
B. The City is in need of the following services: Research Partner for the City's Guaranteed Income Pilot Program. City staff issued an RFP on August 8, 2022 and after a submittal period of 30 days received four (4) timely submitted proposals. Staff reviewed the proposals, interviewed qualified firms and selected the service provider that best meets the City's needs.
C. Provider possesses the skill, experience, ability, background, certification and knowledge to provide the services described in this Agreement on the terms and conditions described herein.
D. The City and Provider desire to enter into an agreement for Abt Associates (Abt) to serve as the Research Partner for the City of Alameda's Guaranteed Income Pilot Program, upon the terms and conditions herein.
AGREEMENT
NOW, THEREFORE, in consideration of the forgoing, which are incorporated herein by reference, and for good and valuable consideration, the receipt and adequacy of which are hereby acknowledged, the City and Provider agree as follows:
1. TERM
The term of this Agreement shall commence on the _day of 20 and shall terminate on the day of 2026, unless terminated earlier as set forth herein.
The parties may agree to extend the term of this Agreement on a month-by-month basis, for up to one additional year. Any extension shall be documented in a signed amendment. In the event that the parties agree to extend the Agreement, all provisions of the Agreement shall remain unchanged.
2. SERVICES TO BE PERFORMED:
Provider agrees to do all necessary work at its own cost and expense, to furnish all labor, tools, equipment, materials, except as otherwise specified, and to do all necessary work included in Exhibit A as requested. Provider acknowledges that the work plan included in Exhibit A is tentative and does not commit the City to request Provider to perform all tasks included therein.
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3. COMPENSATION TO PROVIDER:
a. By the 7" day of each month, Provider shall submit to the City an invoice for the total amount of work done the previous month. These requests shall be prepared by Provider with supporting documentation.
b. City shall approve payment requests not to exceed the total funding amount of three hundred and ten thousand dollars (S309,940) as described in the itemized budget included in Exhibit B. Substantial changes to line items within the budget included in Exhibit B will require written approval from the Community Development Director or their designee within five (5) business days to ensure project continuity. The City, through the Community Development Director or their designee, retains sole and complete discretion to determine whether a change to a line item within the budget is "substantial."
In compliance with the American Rescue Plan Act funding requirements, all funds must be encumbered by the end of 2024 and spent by the end of 2026.
4. TIME IS OF THE ESSENCE:
Provider and the City agree that time is of the essence regarding the performance of this Agreement.
5. STANDARD OF CARE:
Provider agrees to perform all services hereunder in a manner commensurate with the prevailing standards of like professionals or service providers, as applicable, in the San Francisco Bay Area and agrees that all services shall be performed by qualified and experienced personnel who are not employed by the City.
6. INDEPENDENT PARTIES:
Provider hereby declares that Provider is engaged as an independent business and Provider agrees to perform the services as an independent contractor. The manner and means of conducting the services and tasks are under the control of Provider except to the extent they are limited by statute, rule or regulation and the express terms of this Agreement. No civil service status or other right of employment will be acquired by virtue of Provider's services. None of the benefits provided by the City to its employees, including but not limited to unemployment insurance, workers' compensation plans, vacation and sick leave, are available from the City to Provider, its employees or agents. Deductions shall not be made for any state or federal taxes, FICA payments, PERS payments, or other purposes normally associated with an employer-employee relationship from any compensation due to Provider. Payments of the above items, if required, are the responsibility of Provider.
IMMIGRATION REFORM AND CONTROL ACT (IRCA):
Provider assumes any and all responsibility for verifying the identity and employment authorization of all of its employees performing work hereunder, pursuant to all applicable IRCA or other federal, or state rules and regulations. Provider shall indemnify, defend, and hold the City harmless from and against any loss, damage, liability, costs or expenses arising from any noncompliance of this provision by Provider.
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8. NON-DISCRIMINATION:
Consistent with the City's policy and state and federal law that harassment and discrimination are unacceptable conduct, Provider and its employees, contractors, and agents shall not harass or discriminate against any job applicant, City employee, or any other person on the basis of any kind of any statutorily (federal, state or local) protected class, including but not limited to: race, religious creed, color, national origin, ancestry, disability (both mental and physical) including HIV and AIDS, medical condition (e.g. cancer), genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, pregnancy, political affiliation, military and veteran status or legitimate union activities. Provider agrees that any violation of this provision shall constitute a material breach of this Agreement.
9. HOLD HARMLESS:
a. To the fullest extent permitted by law, Provider shall indemnify, defend (with counsel acceptable to the City) and hold harmless the City, its City Council, boards, commissions, officials, employees, agents and volunteers (Indemnitees") from and against any and all loss, damages, liability, obligations, claims, suits, judgments, costs and expenses whatsoever, including reasonable attorney's fees and costs of litigation (Claims"), arising from or in any manner connected to Provider's performance of its obligations under this Agreement or out of the operations conducted by Provider even if the City is found to have been negligent. If the Claims filed against Indemnitees allege negligence, recklessness or willful misconduct on the part of Provider, Provider shall have no right of reimbursement against Indemnitees for the costs of defense even if negligence, recklessness or willful misconduct is not found on the part of Provider.
Provider shall not have any obligations to indemnify Indemnitees if the loss or damage is found to have resulted solely from the negligence or the willful misconduct of the City. The defense and indemnification obligations of this Agreement are undertaken in addition to, and shall not in any way be limited by, the insurance obligations contained in this Agreement. b. As to Claims for professional liability only, Provider's obligation to defend Indemnitees (as set forth above) is limited as provided in California Civil Code Section 2782.8.
Provider's obligation to indemnify, defend and hold harmless Indemnities shall expressly survive the expiration or early termination of this Agreement.
10. INSURANCE:
On or before the commencement of the terms of this Agreement, Provider shall Comere be cive fates Ma dies vie piration of shoring cheng, mompilace of pections.
10.b. (I) through (5) Such certificates, which do not limit Provider's indemnification, shall also contain substantially the following statement:
"Should any of the above insurance covered by this certificate be canceled or coverage reduced before the expiration date thereof, the insurer affording coverage shall provide thirty (30) days' advance written notice to the City of Alameda. Attention: Risk Manager." Abt Associates 3 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Provider shall maintain in force at all times during the performance of this Agreement all appropriate coverage of insurance required by this Agreement with an insurance company licensed to offer insurance business in the State of California with a current A.M. Best's rating of no less than A: VII or Standard & Poor's Rating (if rated) of at least BBB unless otherwise acceptable to the City. Provider shall deliver updated insurance certificates to the City at the address described in Section 17.f. prior to the expiration of the existing insurance certificate for the duration of the term of Agreement. Endorsements naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers as additional insured shall be submitted with the insurance certificates.
MBA
Provider Initials
b. COVERAGE REQUIREMENTS:
Provider shall maintain insurance coverage and limits at least as broad as:
(1) Workers' Compensation:
Statutory coverage as required by the State of California. (2) Liability:
Commercial general liability coverage in the following minimum limits:
Bodily Injury: $1,000,000 each occurrence
$2,000,000 aggregate - all other
Property Damage: $1,000,000 each occurrence
S2,000,000 aggregate
If submitted, combined single limit policy with per occurrence limits in the amounts of $2,000,000 and aggregate limits in the amounts of $4,000,000 will be considered equivalent to the required minimum limits shown above. Additional Insured Endorsement naming the City, its City Council, boards, commissions, officials, employees, agents, and volunteers is required. (3) Professional Liability:
Professional liability insurance which includes coverage appropriate for the professional acts, errors and omissions of Provider's profession and work hereunder, including, but not limited to, technology professional liability errors and omissions if the services being provided are technology-based, in the following minimum limits:
$2,000,000 each occurrence
Technology professional liability errors and omissions shall include, or be endorsed to include, property damage liability coverage for damage to, alteration of, loss of, or destruction of electronic data and/or information "property" of the City in the care, custody, or control of Provider. If not covered under Provider's liability policy, such "property" coverage of the City may be endorsed onto Abt Associates 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Provider's Cyber Liability Policy as covered property as follows: cyber liability coverage in an amount sufficient to cover the full replacement value of damage to, alteration of, loss of, or destruction of electronic data and/or information "property" of the City that will be in the care, custody, or control of Provider.
As to commercial general liability and automobile liability insurance, such insurance will provide that it constitutes primary insurance with respect to claims insured by such policy, and, is mate it sei is toughis, shat insurance is is apartional te of insuredanst whary claim insurance carried by or for the benefit of the City.
SUBROGATION WAIVER:
Provider hereby agrees to waive rights of subrogation that any insurer of Provider may acquire from Provider by virtue of the payment of any loss. Provider agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. The Workers" Compensation policy shall be endorsed with a waiver of subrogation in favor of the City for all work performed by Provider, its employees, agents and subcontractors.
FAILURE TO SECURE:
If Provider at any time during the term hereof should fail to secure or maintain the foregoing insurance, the City shall be permitted to obtain such insurance in Provider's name or as an agent of Provider and shall be compensated by Provider for the costs of the insurance premiums at the maximum rate permitted by law and computed from the date written notice is received that the premiums have not been paid.
e. ADDITIONAL INSUREDS:
The City, its City Council, boards, commissions, officials, employees, agents, and volunteers shall be named as additional insured(s) under all insurance coverages, except workers" compensation and professional liability insurance. The naming of an additional insured shall not affect any recovery to which such additional insured would be entitled under this policy if not named as such additional insured. An additional insured named herein shall not be held liable for any premium, deductible portion of any loss, or expense of any nature on this policy or any extension thereof. Any other insurance held by an additional insured shall not be required to contribute anything toward any loss or expense covered by the insurance provided by this policy.
Additional Insured coverage under Provider's policy shall be primary and non-contributory and will not seek contribution from the City's insurance or self-insurance. Any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be available to the additional insured(s). f. SUFFICIENCY OF INSURANCE:
The insurance limits required by the City are not represented as being sufficient to protect Provider. Provider is advised to consult Provider's insurance broker to determine adequate coverage for Provider. The coverage and limits shall be (1) the minimum coverage and limits Abt Associates 5 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF specified in this Agreement; or (2) the broader coverage and maximum limits of the coverage carried by or available to Provider; whichever is greater.
11. CONFLICT OF INTEREST:
Provider warrants that it is not a conflict of interest for Provider to perform the services required by this Agreement. Provider may be required to fill out a conflict of interest form if the services provided under this Agreement require Provider to make certain governmental decisions or serve in a staff capacity as defined in Title 2, Division 6, Section 18700 of the California Code of Regulations.
12. PROHIBITION AGAINST TRANSFERS:
a. Provider shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of the City Manager. Provider shall submit a written request for consent to transfer to the City Manager at least thirty (30) days in advance of the desired transfer. The City Manager or their designee may consent or reject such request in their sole and absolute discretion. Any attempt to do so without said consent shall be null and void, and any assignee, sublessee, hypothecate or transferee shall acquire no right or interest by reason of such attempted assignment, hypothecation or transfer. However, claims for money against the City under this Agreement may be assigned by Provider to a bank, trust company or other financial institution without prior written consent.
The sale, assignment, transfer or other disposition of any of the issued and outstanding capital stock, membership interest, partnership interest, or the equivalent, which shall result in changing the control of Provider, shall be construed as an assignment of this Agreement.
Control means fifty percent or more of the voting power of Provider.
13. APPROVAL OF SUB-PROVIDERS:
a. Only those persons and/or businesses whose names and resumés are attached to this Agreement shall be used in the performance of this Agreement. However, if after the start of this Agreement, Provider wishes to use sub-providers, at no additional costs to the City, then Provider shall submit a written request for consent to add sub-providers including the names of the sub- providers and the reasons for the request to the City Manager or Community Development Director at least five (5) days in advance. The City Manager or Community Development Director may consent or reject such requests in their sole and absolute discretion. b Each sub-provider shall be required to furnish proof of workers' compensation insurance and shall also be required to carry general, automobile and professional liability insurance (as applicable) in reasonable conformity to the insurance carried by Provider.
In addition, any tasks or services performed by sub-providers shall be subject to each provision of this Agreement. Provider shall include the following language in their agreement with any sub-provider: "Sub-providers hired by Provider agree to be bound to Provider and the City in the same manner and to the same extent as Provider is bound to the City." d. The requirements in this Section 13 shall not apply to persons who are merely providing materials, supplies, data or information that Provider then analyzes and incorporates into Abt Associates 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF its work product.
14. PERMITS AND LICENSES:
Provider, at its sole expense, shall obtain and maintain during the term of this Agreement, all appropriate permits, certificates and licenses, including a City business license that may be required in connection with the performance of the services and tasks hereunder.
15. REPORTS:
a. Each and every report, draft, work product, map, record and other document produced, prepared or caused to be prepared by Provider as part of its services to the City pursuant this Agreement shall be the exclusive property of the City. b. No report, information or other data given to or prepared or assembled by Provider pursuant to this Agreement shall be made available to any individual or organization by Provider without prior approval of the City Manager or their designee. Notwithstanding this requirement, Provider is authorized to use the information and data it gathers as part of its work performed pursuant to this Agreement to prepare reports, policy briefs, and other written materials that do not fall within the scope of its services to the City pursuant to this Agreement. Provider is further authorized to publish such written materials without obtaining the prior approval of the City Manager or their designee. However, under no circumstances may Provider publish any private information or data regarding individual participants in the projects) funded or authorized pursuant to this Agreement, including but not limited to individual participants" names, addresses, phone numbers, email addresses, health or medical information, place(s) of work, Social Security or other identification numbers, bank account numbers or other personally identifying financial information, or social media handles.
C. Provider shall, at such time and in such form as City Manager or their designee may require, furnish reports concerning the status of services and tasks required under this Agreement. d. In addition to the reporting provisions included herein, Provider shall comply with applicable law, guidance (including the Compliance and Reporting Guidance for State and Local Fiscal Recovery Funds issued by the Department of the Treasury), and other requirements imposed by the relevant funding source, as may be amended from time to time.
16. RECORDS:
a. Provider shall maintain complete and accurate records with respect to the services, tasks, work, documents and data in sufficient detail to permit an evaluation of Provider's performance under the Agreement, as well as maintain books and records related to sales, costs, expenses, receipts and other such information required by the City that relate to the performance of the services and tasks under this Agreement (collectively the "Records"). b All Records shall be maintained in accordance with generally accepted accounting principles and shall be clearly identified and readily accessible. Provider shall provide free access to the Records to the representatives of the City or its designees during regular business hours upon reasonable prior notice. The City has the right to examine and audit the Records, and to make copies or transcripts therefrom as necessary, and to allow inspection of all proceedings and Abt Associates 7 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF activities related to this Agreement. Such Records, together with supporting documents, shall be kept separate from other documents and records and shall be maintained by Provider for a period of three (3) years after receipt of final payment.
If supplemental examination or audit of the Records is necessary due to concerns raised by the City's preliminary examination or audit of records, and the City's supplemental examination or audit of the records discloses a failure to adhere to appropriate internal financial controls, or other breach of this Agreement or failure to act in good faith, then Provider shall reimburse the City for all reasonable costs and expenses associated with the supplemental examination or audit.
17. NOTICES:
a. All notices shall be delivered via electronic mail with confirmation of receipt OR in writing and: (i) by hand; or (ii) sent by registered, express, or certified mail, with return receipt requested or with delivery confirmation requested from the U.S. postal service; or (il) sent by overnight or same day courier service at the party's respective address listed in this Section. b. Each notice shall be deemed to have been received on the earlier to occur of: (x) actual delivery or the date on which delivery is refused; or (y) three (3) days after notice is deposited in the U.S. mail or with a courier service in the manner described above (Sundays and City holidays excepted).
Either party may, at any time, change its notice address (other than to a post office box address) by giving the other party three (3) days prior written notice of the new address. d. All notices, demands, requests, or approvals from Provider to the City shall be addressed to the City at:
City of Alameda
Community Development Department
950 West Mall Square, Suite 205
Alameda, CA 94501
ATTENTION: Community Development Director:
Ph: 510.747.6897 / Email: [email protected]
e. All notices, demands, requests, or approvals from the City to Provider shall be addressed to Provider at:
Abt Associates
6130 Executive Boulevard
Rockville, MD 20852
ATTENTION: Kathleen Aguilar, Contracts Manager
Ph: 301.347. 5093/ Email: [email protected] Abt Associates 8 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF f. All updated insurance certificates from Provider to the City shall be addressed to the City at:
City of Alameda
Community Development Department
950 West Mall Square, Suite 205
Alameda, CA 94501
ATTENTION: Annie Cox
Ph: 510.747.6893 / Email: acox @ alamedaca. gov
18. SAFETY:
a. Provider will be solely and completely responsible for conditions of all vehicles owned or operated by Provider, including the safety of all persons and property during performance of the services and tasks under this Agreement. This requirement will apply continuously and not be limited to normal working hours. In addition, Provider will comply with all safety provisions in conformance with U.S. Department of Labor Occupational Safety and Health Act, any equivalent state law, and all other applicable federal, state, county and local laws, ordinances, codes, and any regulations that may be detailed in other parts of the Agreement. Where any of these are in conflict, the more stringent requirements will be followed. Provider's failure to thoroughly familiarize itself with the aforementioned safety provisions will not relieve it from compliance with the obligations and penalties set forth herein. b. Provider will immediately notify the City within 24 hours of any incident of death, serious personal injury or substantial property damage that occurs in connection with the performance of this Agreement. Provider will promptly submit to the City a written report of all incidents that occur in connection with this Agreement. This report must include the following information: (i) name and address of injured or deceased persons: (ii) name and address of Provider's employee(s) involved in the incident; (iii) name and address of Provider's liability insurance carrier; (iv) a detailed description of the incident; and (v) a police report.
19. TERMINATION:
a. In the event Provider fails or refuses to perform any of the provisions hereof at the time and in the manner required hereunder, Provider shall be deemed in default in the performance of this Agreement. If such default is not cured within two (2) business days after receipt by Provider from the City of written notice of default, specifying the nature of such default and the steps necessary to cure such default, the City may thereafter immediately terminate the Agreement forthwith by giving to Provider written notice thereof. b. The foregoing notwithstanding, the City shall have the option, at its sole discretion and without cause, of terminating this Agreement by giving seven (7) days' prior written notice to Provider as provided herein.
C. Upon termination of this Agreement either for cause or for convenience, each party shall pay to the other party that portion of compensation specified in this Agreement that is earned and unpaid prior to the effective date of termination. The obligation of the parties under this Section 19.c. shall survive the expiration or early termination of this Agreement.
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20. ATTORNEYS' FEES:
In the event of any litigation, including administrative proceedings, relating to this Agreement, including but not limited to any action or suit by any party, assignee or beneficiary against any other party, beneficiary or assignee, to enforce, interpret or seek relief from any provision or obligation arising out of this Agreement, the parties and litigants shall bear their own attorney's fees and costs. No party of litigant shall be entitled to recover any attorneys' fees or costs from any other party or litigant, regardless of which party or litigant might prevail.
21. HEALTH AND SAFETY REQUIREMENTS.
Provider acknowledges that the City shall have the right to impose, at the City's sole discretion, requirements that it deems are necessary to protect the health and safety of the City employees, residents, and visitors. Provider agrees to comply with all such requirements, including, but not limited to, mandatory vaccinations, the use of personal protective equipment (e.g. masks), physical distancing, and health screenings. Provider also agrees to make available to the City, at the City's request, records to demonstrate Provider's compliance with this Section. [See Certification of Compliance attached.]
22. COMPLIANCE WITH ALL APPLICABLE LAWS:
During the term of this Agreement, Provider shall keep fully informed of all existing and future state and federal laws and all municipal ordinances and regulations of the City of Alameda which affect the manner in which the scrvices or tasks are to be performed by Provider, as well as all such orders and decrees of bodies or tribunals having any jurisdiction or authority over the same. Provider shall comply with all applicable laws, state and federal and all ordinances, rules and regulations enacted or issued by the City.
23. CONFLICT OF LAW:
This Agreement shall be interpreted under, and enforced by the laws of the State of California without regard to any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities). Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Alameda, State of California.
24. WAIVER:
A waiver by the City of any breach of any term, covenant, or condition contained herein shall not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained herein, whether of the same or a different character.
25. INTEGRATED CONTRACT:
Subject to the language of Section 30, the Recitals and exhibits are a material part of this Agreement and are expressly incorporated herein. This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all preliminary negotiations and agreements of whatsoever kind or nature are merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any Abt Associates 10 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF modification of this Agreement will be effective only by written execution signed by both the City and Provider.
26. CAPTIONS:
The captions in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit or amplify the terms or provisions of this Agreement.
27. COUNTERPARTS:
Docusign, or there ray be executed i any resort duned an originaline yor hich shall constitute one and the same instrument.
28. SIGNATORY:
By signing this Agreement, signatory warrants and represents that they executed this Agreement in their authorized capacity and that by their signature on this Agreement, they or the entity upon behalf of which they acted, executed this Agreement.
29. CONTROLLING AGREEMENT:
In the event of a conflict between the terms and conditions of this Agreement (as amended, supplemented, restated or otherwise modified from time to time) and any other terms and conditions wherever contained, including, without limitation, terms and conditions included within exhibits, the terms and conditions of this Agreement shall control and be primary.
30. NONDISCRIMINATION - FEDERAL REQUIREMENTS:
a. Provider certifies and agrees that it will not discriminate against any employee or applicant for employment because of race, color, religion, national origin, ancestry, sex, age, or condition or physical or mental handicap (as defined in 41 C.F.R. Section 60-741, et seq.), in accordance with requirement of state or federal law. Provider shall take affirmative action to ensure that qualified applicants are employed and that employees are treated during employment without regard to race, color, religion, national origin, ancestry, sex, age, or condition of physical or mental handicap in accordance with requirements of state and federal law. Such shall include, but not be limited to, the following:
A. Employment upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation.
B. Selection for training, including interns and apprentices. (i) Provider agrees to post in conspicuous places in each of Provider's facilities providing services hereunder, available and open to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF (ii) Provider shall, in all solicitations or advertisements for employees placed by or on behalf of Provider, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, age, or condition of physical or mental handicap, in accordance with requirements of state and federal law. (ili) Provider shall send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding a notice advising the labor union or workers" representative of Provider's commitments under this paragraph.
(iv) Provider certifies and agrees that it will deal with its subcontractors. bidders, or vendors without regard to race, color, religion, national origin, ancestry, sex, age, or condition of physical or mental handicap, in accordance with requirement of state and federal law. (v) In accordance with applicable state and federal law, Provider shall allow duly authorized county, state and federal representatives access to its employment records during regular business hours in order to verify compliance with the anti-discrimination provisions of this paragraph. Provider shall provide such other information and records as such representatives may require in order to verify compliance with the anti-discrimination provisions of this paragraph.
If the City finds that any of the provisions of this paragraph have been violated, the same shall constitute a material breach of Agreement upon which the City may determine to cancel, terminate, or suspend this Agreement. The City reserves the right to determine independently that the anti-discrimination provisions of this Agreement have been violated. In addition, a determination by the California Fair Employment Practices Commission or the Federal Equal Employment Opportunity Commission that Provider has violated state and federal anti- discrimination laws shall constitute a finding by the City that Provider has violated the anti- discrimination provisions of Agreement.
The parties agree that in the event Provider violates any of the anti-discrimination provisions of this paragraph, the City shall be entitled, at its option, to the sum of $500.00 pursuant to California Civil Code Section 1671 as liquidated damages in lieu of canceling, terminating, or suspending this Agreement.
d. Provider hereby agrees that it will comply with Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. Section 794), all requirements imposed by the applicable regulations, and all guidelines and interpretations issued pursuant thereto, to the end that no qualified handicapped person shall, on the basis of handicap, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity of Provider receiving Federal Financial Assistance. In addition, Provider shall comply with the Uniform Federal Accessibility Standards, and Provider, Engineer, or Architect responsible for any design, construction or alteration shall certify compliance with those Standards.
Provider's attention is directed to laws, including but not limited to:
A. CIVIL RIGHTS/EQUAL OPPORTUNITY
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF (1) Civil Rights Act of 1964. Under Title VIl of the Civil Rights Act of 1964, no person shall, on the grounds of race, sex, religion, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. (ii) Section 109 of the Housing and Community Development Act of 1974. No person in the United States shall, on the grounds of race, color, national origin, or sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with funds made available under this title. (iii) Section 109 of the Act further provides that any prohibition against discrimination on the basis of age under the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.) or with respect to an otherwise qualified handicapped individual as provided in Section 504 of the Rehabilitation Act of 1973(29 U.S.C. 794) shall also apply to any program or activity funded in whole or in part with funds made available pursuant to the Act.
B. PROGRAM ACCESSIBILITY FOR INDIVIDUALS WITH
DISABILITIES
This Agreement is subject to laws and regulations concerning the rights of otherwise qualified individuals with handicaps for equal participation in, and benefit from federally assisted programs and activities, including but not limited to:
(i) Americans with Disabilities Act of 1990 (ADA) (28 C.F.R. 35).
Title II, Subpart A of the Americans with Disabilities Act of 1990 applies to all publicly funded activities and programs. Provider shall also comply with the public accommodations requirements of Title III of the ADA, as applicable.
(ii) Nondiscrimination on the Basis of Handicap (24 C.F.R. 8). These regulations, which implement Section 504 of the Rehabilitation Act of 1973, as amended, and as cited in Section 109 of the Housing and Community Development Act, apply to all federally assisted activities and programs and are implemented through the regulations at 24 C.F.R. 8. (iii) Architectural Barrier Act of 1968. Any building or facility, excluding privately owned residential structures, designed, constructed, or altered with federal funds, shall comply with the Uniform Federal Accessibility Standards, 1984 (41 C.F.R. 3) and the Handicapped Accessibility Requirements of the State of California Title 24. The Consultant, Engineer or Architect responsible for such design, construction or alteration shall certify compliance with the above standards.
(iv) In resolving any conflict between the accessibility standards cited in paragraphs (i), (ii) and (iii) above, the more stringent standard shall apply.
31. RESTRICTIONS ON LOBBYING - FEDERAL REQUIREMENT:
This Agreement is subject to 24 C.F.R. 87 which prohibits the payment of Federal funds to any person for influencing or attempting to influence, any public officer or employee in Abt Associates 13 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF connection with the award, making, entering into, extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or agreement.
32. FEDERAL CONDITIONS:
As set forth in Attachment D to this Agreement (Subrecipient Monitoring and Management Requirements), the City has made the disclosures required under 2 CFR Section 200.331 to Provider (as a subrecipient of federal funds).
[REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]
Abt Associates 14 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF IN WITNESS WHEREOF, the parties have each caused this Agreement to be duly executed on its behalf as of the Effective Date.
Abt Associates Ine., CITY OF ALAMEDA.
a Massachusetts corporation a municipal corporation
Melissa B. Digitally signed by
Melissa B. Ashcraft
Ashcraft Date: 2022.10.28
08:13:44-0400
Melissa B. Ashcraft Erin Smith
Vice President, Contracts and
Procurement City Manager
RECOMMENDED FOR APPROVAL
Leonard Hicks
Chief Financial Officer - DocuSigned by:
Lisa Maxwell
Community Development Director
APPROVED AS TO FORM:
City Attorney
- DocuSigned by:
Len Astanian
Lena desper....
Assistant City Attorney
Abt Associates 15 10-13-2022
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Exhibit A
Scope of Work
16 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Section 1: Work Plan, Fee Proposal, and Schedule
1.1 Evaluation Work Plan
Abt Associates offers the City of Alameda a quantitative evaluation of their GI pilot that leverages Abt's existing Abt's Evaluation Advantages work with eight other cities connected to the Mayors for a • Collaborative approach to working with City Guaranteed Income (MGI) coalition. Abt's proposed of Alameda stakeholders to design and approach is a randomized controlled trial (RCT) of 150 implement a rigorous impact evaluation Alameda recipients and 180 control group members. The • Ability to benchmark Alameda findings to procedures and protocols-existing survey instrument, and national MG portfolio pilot application phase-tested by Abt and honed in eight Some limited support in application to state MGI cities will build the efficiency and strength of the benefits waivers for participants Alameda evaluation. Through data comparability and Abt's RCT with 150 treatment group members existing data-sharing agreements, the Abt team can and 180 control group members benchmark the City of Alameda's results against MGI's An online program application survey Follow-up surveys at 12 and 24 months after
national portfolio of over 30 other pilots. Throughout the first Gl disbursement evaluation, the Abt team will follow At's guiding
Evaluation guided by Institutional Review
principles for equitable evaluation. Board
Part of our core approach to equitable evaluation is staffing Final brief and community partner this project with demographically diverse researchers and briefing/presentation others who bring a range of lived experiences.
Exhibit 2 shows a graphical overview of key activities in Abt's approach across the period of performance (October 1, 2022 to October, 2025). impact study design.
Principles of equitable evaluation Exhibit 2. Base Contract Workplan infuse our approach to the evaluation
of Alameda's GI pilot. We
incorporate equitable practices in Base Contract Workplan Overview evaluation' as outlined in the
hyperlinked brief. Specifically in our YEAR 1 YEAR 2 YEAR 3 approach for the City of Alameda,
we will work with the Advisory Baseline 18-month
QUANTITATIVE survey 12-month tracking
Board to design the research STUDY survey 24-month
6-month
questions, and staff the research with tracking survey
Abt staff with lived experience.
Additionally our proposed team has Analysis
extensive experience working with Brief report
ANALYSIS AND
vulnerable populations whom we on findings
DELIVERABLES
expect to participate in Alameda's GI Community
pilot. Briefing
The description of the proposed
research design balances these considerations alongside a need to keep within a prescribed timeline and budget.
Task 1: Program Design and Participant Selection
The key elements that MGI cities typically need to engage with in program design include: (1) determining the eligibility of the pilot participants; (2) deciding how the money will be disbursed; (3) designing and conducting benefits counseling; and (4) in the case of some states such as California, establishing a process for benefits exemption. Following our approach with other MGI cities, Abt will work to inform City of Alameda staff and stakeholders in decisions about these four different elements. Our typical approach is to let City staff and 'https://www.abtassociates.com/insights/publications/report/embedding-equity-focus-in-evaluation Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-1 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
stakeholders guide program eligibility, while informing stakeholders about the trade-offs in the eligibility requirements under consideration. Our team brings experiences from other cities that we have worked with, providing concrete examples of those trade-offs, as well as a wealth of experience in conducting RCTs with historically marginalized and vulnerable populations.
Once the eligibility criteria are set, we recommend that the City of Alameda work with MGI on the specifics of program implementation including navigating disbursement, how to conduct benefits counseling, and any other program elements the City wishes to include, for example a story-telling cohort. The evaluation team limits our involvement in program design and implementation so that we can remain impartial and independent as a third- party evaluator, offering the strongest possible standing for the results of the evaluation.
The City's implementation partner will be responsible for conducting outreach and marketing about the GI pilot to the target population. The Abt team and Abt IRB will review those outreach and marketing materials to ensure information about the evaluation is clearly and accurately described. In other cities, outreach and marketing typically includes a City-hosted GI pilot website with information about the program eligibility and a link to bring applicants to the Abt-hosted GI pilot application. The Abt-hosted application includes an eligibility screen and the baseline survey. After the application is complete, the Abt team runs basic eligibility checks from the self- reported survey data, and then using code, randomizes participants into active treatment, and active control. Abt shares the list of active treatment group members with the City onboarding team, who then onboards participants and conducts benefits counseling with them. We usually provide randomly selected treatment group replacements for the participants who decline to participate in the program, are unreachable, or reveal they are not actually eligible for the program.
The team has projected that the launch of Alameda's GI program's application occurs within five months of Abt's contract start date. We have also projected two months for Alameda's implementation partner to conduct onboarding and benefits counseling to treatment group participants. The first cash disbursements would occur on the 8i' month from Abt's start of the contract. This is to allow for the 24 month survey to occur within the third year of period of performance that Abt has planned for the study. Deviations from this timeline would require an increase to the contract's period of performance, and the city would incur additional costs to extend the timeline.
Specific Abt activities in Task 1 include working with the Advisory Board and City staff to design program eligibility requirements, securing IRB approval and securing state benefits waivers.
1. Support in designing eligibility requirements: Abt will work closely with City staff and the City Advisory Board in determining eligibility requirements for the program. Abt will offer suggestions and advice where requested, based on best practice observed in other MGI cities.
Securing IRB approval: Abt hosts an internal Institutional Review Board which provides helpful guidance and oversight of all our research studies. The Abt team will work with the IRB and the City of Alameda to gain IRB approval through the streamlined process established for other MGI cities.
3. Securing state benefits waivers: The City of Alameda will spearhead efforts to secure state benefits waivers.
Abt staff will provide needed documentation to assist the City of Alameda with these efforts, such as providing IRB approval documentation.
Task 2: Research Design and Methodology
The research design phase of the study will focus on development of the research City of Alameda Research questions in collaboration with the Advisory Board and writing the research Focus Areas design document. In working collaboratively to develop the research questions • Mental stress and the Abt Team will seek to balance the City of Alameda's desire to benchmark anxiety their pilot data against other MGI cities, and the goal of incorporating City of Alameda community collaborator priorities. The City of Alameda has articulated : Housing security Food security their interest in the following topics: participant mental health, public health, Financial security overall well-being including food, housing and financial security.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-2 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
To achieve this goal, we will integrate the core research questions being used for other MGI evaluations with additional community developed research questions. For example, given the context of intense housing pressure for lower-income renters in the City of Alameda, the City may wish to incorporate research questions about the impact of GI on participants' housing. Working with the City, we will incorporate additional validated survey questions that will answer the final research questions, while ensuring that the survey does not become unwieldy for respondents.? We will review the proposed methodological approach (described below) to ensure that we can answer the identified research questions.
Task 3: Data Collection
In order to leverage the advantages of cross-site analysis and benchmarking with other MGI cities, the Abt team proposes conducting the standard MGI city methodological approach in the evaluation of the City of Alameda. As requested by the City of Alameda, we have removed qualitative interviews from the base approach and have included that as an option if the City of Alameda were to secure extra funding. The base design includes: a randomized controlled trial with the standardized MGI city survey. In addition to leveraging analytic advantages, the standard MGI city evaluation builds in key efficiencies in conducting the evaluation. These include:
• Use of an existing validated survey to measure core domains of interest already translated into three of the six languages of interest to Alameda (Spanish, Cantonese, Mandarin, Tagalog, Korean and Vietnamese) • Additional survey modules to supplement the core survey allowing customization of the survey while still allowing comparison with other cities' outcomes interested in the same set of research questions • Streamlined IRB process based on experience with 8 prior cities • Established research processes and procedures, for example secure data transfer, existing field data collection safety guides
• Existing excellent working relationships with MGI and their partners The key components of the standard MGI evaluation are described below, noting the qualitative component as an optional task that the City of Alameda can exercise if it were to secure further funding.
Quantitative Study: The primary goal of the quantitative study will be to assess the impact of GI on recipients inancial, physical, and emotional well-being. 4 Our proposed approach, which is both rigorous and cost-effective. builds on the model we are currently using to evaluate MGI-affiliated pilots in other cities.
We propose to conduct an RCT of Alameda's guaranteed income pilot. Eligible individuals will be randomly assigned to active treatment, and active control. We have budgeted for an active treatment group of n=150 participants and an active control group of n=180 participants. If desired, we can incorporate sample weights so that the sample is reflective of a broader population of interest.
Abt will host the web-based City of Alameda application. The application will incorporate a baseline survey developed by our partner CGIR that covers core domains including: financial well-being, autonomy and agency, physical health, mental health, and a limited set of economic behaviors. Additional survey domains may also be added based on the decisions made in the research design process e.g. child related outcomes, social capital outcomes, or community engagement outcomes.
Research Questions: 1. How does GI impact income volatility for participants? 2. What is the relationship between income volatility and financial well-being, psychological distress, and physical functioning of participants? 3. What is the relationship between GI and individual agency of participants? Other MGI cities have a bank of survey questions on alternative topics. Abt will work with the City to source survey questions already in use in other MGI cities so that Alameda can benchmark results. 4 We have not included analysis of disbursement data since we believe that the MGI partner, Stanford Basic Income (SBI) Lab, is better positioned to present spending data on their dashboard website. This would allow the City of Alameda data to be benchmarked with other MGI cities and take advantage of their existing infrastructure. 5 The web survey is accessible on both computers and mobile devices.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-3 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Drawing on our experience conducting other MGI city surveys, we have proposed an approach that we believe would be the best use of the City of Alameda's budgeted resources for their 24-month pilot. This differs slightly from the approach proposed in the RFP.
We propose prioritizing the full MGI city survey at 12 months and 24 months after the first disbursement of the guaranteed income payment. We propose also conducting a short web-based tracking survey at 6 months and 18 months after disbursement to update participant contact information, and to ask basic questions about monthly income.® This approach works well for two reasons. Firstly, it reduces participant burden relative to the suggested approach in the Alameda RFP, but still allows us to capture important information about income volatility every six months—income is best captured frequently, allowing us to observe changes every six months. Secondly, we are still able to track longitudinal changes in well-being and agency over time at the pilot mid-point, and end point. We will conduct all surveys in English along with additional languages.? We have developed several processes to keep participants engaged and maintain survey response rates over the course of the pilot. Prior to each survey administration, we will contact study participants by email and/or text message with a link to the survey, as well as sending a letter with a link to the survey approximately one week prior to administration. During the survey window, our survey platform sends email and text reminders. We can also work with the implementation team so they can send out reminders to study participants. Respondents will receive $50 incentives (as electronic gift cards) for completing the survey.
Optional 30-month survey. We can also administer an additional survey 6 months after the end of the pilot to capture outcomes for participants after the pilot has ended. Alameda may wish to consider this since it will allow policy makers to understand whether participants are able to maintain gains made while receiving the guaranteed income. This would be an optional task that the City of Alameda could exercise if it were to secure extra funding.
Optional Qualitative Study: An option for the city of Alameda to consider is conducting a qualitative study of participant experiences. Should the City exercise this option, we would follow the model of Abt's MGI evaluations and conduct between 30 and 40 one-time semi-structured interviews (est. 60-90 minutes) with treatment group members shortly after the 12-month survey is completed and analyzed. These interviews would be conducted in English and Spanish.? Interviews would be tailored to the research questions and appropriateness for Alameda's target population. All interviews would be audio recorded (with participant consent) and transcribed.
We would develop our specific research and interview protocol questions in relation to: the city's target population and goals; questions emerging from the 12-month RCT survey responses; emerging findings from the ethnographic study; and our learning agenda to address gaps in the overall body of knowledge about GI. We would establish the most appropriate sampling strategy based on the final research questions and in conversation with City stakeholders.
6 Respondents receive a $5 incentive for completing the tracking survey.
We can conduct surveys in languages which have already been translated and programmed: Spanish, Mandarin, Vietnamese. We can also program three additional languages, such as Korean, Cantonese and Tagalog. Abt would be responsible for the costs of programming any translated surveys. Alameda staff are responsible getting the surveys translated in the desired three languages and for pre-testing the translated surveys to ensure they work smoothly.
All surveys include informed consent statements, eligibility questions, and then the core survey questions. Abt is responsible for translating the core survey questions. For all surveys, the City of Alameda will be responsible for the costs of translating their specific eligibility requirements and consent language into the languages the survey is conducted in for both the baseline survey and follow-up surveys.
In our MGI evaluations, these interviews take place between the 6- and 12-month surveys on what are typically 12-month pilots. We would alter the timing of interviews for the City of Alameda because we are proposing the first comprehensive survey be 12 months after baseline.
9 To conduct interviews in additional languages beyond English and Spanish would incur additional costs related to translation of protocols into the preferred language; costs of adding staff fluent in desired languages; translation of interview transcripts into English for purposes of analysis. We have not included these costs in our current design.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-4 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
The Abt staff local to Alameda, seasoned qualitative interviewers, would conduct all the English language interviews working with the research fellows. Bi-lingual Spanish speaking staff would conduct the Spanish language interviews on a site visit supported by a research fellow. Interviewees would receive a $60 incentive for completing the interview.
Community Engaged Research: Our research approach seeks to engage community members where possible within anticipated resources. Abt staff can attend two advisory board meetings and engage with any questions the advisory board may have regarding the pilot.
A central part of our community-engaged approach, refined during our MGI evaluations, includes working with one or more community-based research fellows at each pilot site. Should the City of Alameda have sufficient funding, we propose working with the City of Alameda team to hire up to two research fellows, based on GI's standard research fellow job description. '° Among other core duties, research fellows will assist in conducting interviews and observations with treatment group members and in managing logistical aspects of the survey. Abt project leaders will mentor research fellows to provide them with opportunities to learn about conducting policy evaluations." Research fellows will participate in project-specific trainings and monthly professional development seminars coordinated by both Abt and MGI for the overall cohort of MGI research fellows. '2 If the city of Alameda opts out of this approach, our survey team can send reminder emails and texts for follow-up survey reminders. We can also work with the city of Alameda and the IRB to determine other cost-effective solutions in lieu of the research fellow model, but it will likely result in lower response rates.
Task 4: Data Analysis and Reporting
We will conduct quantitative analysis after each wave of survey data collection. In large part we follow the SEED design and pre-analysis plan 3 (Martin-West et al., 2019) to ensure that the City of Alameda data will be comparable to data from all MGI-funded cities.
Abt will prepare a final brief in 2025 to summarize findings from across the full Period of Performance and conduct a final virtual presentation to the City. The final brief will be written in accessible language for a wide readership.
The Abt team has the capacity to develop additional deliverables to share key findings and lessons learned targeted for a policy audience. For example, we regularly conduct webinars and write blogs that have a wide distribution. We would be happy to modify the contract should the City wish to add to the existing scope of work to leverage the learning from the evaluation in this way.
Task 5: Project and Risk Management
To ensure Abt produces high-quality results in line with our clients' expectations, we collaboratively develop research approaches to align with their objectives, budgets, timelines, and desired degree of involvement (from hands-off to highly involved). Our objectives for project management are to ensure timely, within budget, high- quality deliverables, and to ensure that the City of Alameda is satisfied with both the products and the process of this contract. Expectations and requirements will be detailed up front and maintained through frequent communication with the Project Director, Dr. Haisheng Yang.
All Abt projects undergo two types of ongoing quality assurance review: corporate monitoring and project quality review. These systems ensure the project team has the resources it needs to do its work effectively and efficiently.
They also help anticipate problems and implement solutions so that the work can be completed on time and to the 10 MGI research fellows are normally paid $20,000 for an 18-20-month engagement, which is the amount we recommend.
To engage research fellows for the full 24 month pilot and to help with the 30 month survey, Abt recommends paying each research fellow a stipend of $40,000.
" The cost of the research fellow is not included in the Abt budget. We do include costs for Abt to train, supervise, and mentor the research fellow.
12 These activities include a series of monthly seminars and trainings that cover topics such as career development, contract research, equity in evaluation, and training on research methods. 13 https://staticl.squarespace.com/static/6039d612b17d055cac14070f/t/605029f652a6b53e3dd39044/1615866358804/SEE D+Pre-analysis+Plan.pdf
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-5 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
quality standards that our clients expect. More detail is provided about the specific staff fulfilling these functions and their roles in the Staffing Tab.
Specific to fielding a guaranteed income RCT, the City of Alameda evaluation faces various different risks methodologically and in implementing the project. Our experience conducting impact evaluations of the MGI portfolio and being in conversation with other evaluators working with MGI cities gives us a valuable advantage in assessing possible risks for the City of Alameda evaluation. For example, a risk that we will need to prepare for is maintaining comparable response rates within both the treatment and control groups. Our experiences addressing this risk in other MGI cities will enable us to bring best practices honed in those cities to working with the research fellows and survey team to ensure the highest response rates possible.
Our team has also managed varied challenges that the City of Alameda may face in their GI pilot including:
• Ensuring survey translations meet local dialect needs • Balancing the desire to collect critical data with the length of time to complete the survey • Building application interface and designing geographic eligibility criteria that enable unhoused populations to participate in the pilot
With a resourced organization supporting our direct City of Alameda evaluation team, we are able to draw on best practices to ensure sound data security practices, data collection safety for the research team and study participants.
1.2 Schedule
Exhibit 3 provides detail about the schedule of activities during the period of performance. The schedule is based on our experiences working with other MGI cities.
Exhibit 1: Schedule of Activities for Proposed Evaluation of City of Alameda Guaranteed Income Pilot
N D JFMAMJJASOND JFMAMJJASOND JFMAMJJASOND JEMAMJJASOND Base Contract Activities
Kick Off meeting
Research Design
Community advisory board
engagement
IRB approval
Secure benefits waiver
Survey programming and
testing
Application launch
****Onboarding participants
and benefits counseling (Abt
provides replacements)
***Disbursement of first
payment
6 month tracker survey
12 month survey
Interviews
Analysis
18 month tracker survey
Year 3
24 month survey
Analysis
Short Report
Option: Qualitative Interviews
CAB findings presentation/
engagement
Option: Year 4
30 month survey
Analysis
Brief
CAB findings presentation/
engagement
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-6 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Exhibit B
Budget
17 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Section 1: Work Plan, Fee Proposal, and Schedule
1.1 Fee Proposal
Proposal Cover Sheet
Research Partner for Guaranteed Income Pilot Program
Initial Submission
October 17, 2022
Name, Address, and Contact Numbers of the Offeror
Abt Associates Inc.
6130 Executive Blvd.
Rockville, MD 20852
301-347-5000
DUNS, UEI, and TIN Numbers
DUNS: 05-859-5539
UBI: C9SINLQ67626
TIN: 04-2347643
Name and Telephone Number of Point of Contact for Negotiation Melissa B. Ashcraft
Vice President, Contracts and Procurement
301-347-5915
Lisa [email protected]
Remittance Address
Abt Associates Inc.
P.O. Box 84-5586
Boston, MA 02284-5586
Send wire to:
Citizens Bank Bos
SWIFT # CTZIUS33; ACCT# 110780-048-7
Or ACH to:
Citizens Bank Bos
ABA# 211070175; ACCT# 110780-048-7; Lockbox MF250
Name, Address, and Telephone Number of Cognizant Audit Agency (DCAA) Defense Contract Audit Agency
New England Branch Office
59 Lowes Way, Suite 300
Lowell, MA 01851
Telephone 571-448-2026
Email: [email protected]
DODAAC code: HAA621
Branch Manager/Point of Contact: Ms. Jaclyn Parziale
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-1 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Name and Contact Information of Person Authorized to Sign the Proposal Meryl Finkel
Social Science Economics Principal Associate
10 Fawcett Street
Cambridge, MA 02138-1175
617-349-2380
Agreement of Terms
Abt Associates Inc. agrees with all terms, conditions, and provisions included in the solicitation and agrees to furnish any or all items upon which prices are offered at the price set opposite each item. Our proposal is firm for a period of 180 days from the date of submission of this proposal.
Aht Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-2 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Introduction to Fee Proposal
Abt Associates is pleased to submit this proposal in response to the Research Partner for Guaranteed Income Pilot Program. This section contains budget, supporting cost information, and other administrative data. All prices are firm for a period of 180 days from the date of receipt by the government.
Contact for Questions
Questions relating to this business proposal should be addressed to the following individuals:
Melissa B. Ashcraft Krista Pages
VP, Contracts and Procurement Senior Director Contracts 6130 Executive Blvd. 6130 Executive Blvd.
Or Rockville, MD 20852-4907
Rockville, MD 20852-4907
301-347-5915 (301) 347-5829 voice
[email protected] [email protected]
Organization of This Fee Proposal
Section 2 of this business proposal contains complete budget and cost data. Section 2.1 contains Abt's payment schedule in addition to budgets for Abt Associates by year and task that are supported by person hour charts.
Administrative data are located in Section 3.
Budget Data
Abt Associates
Payment Schedule
Below is the Payment Schedule for the Firm Fixed Price contract proposed by Abt Associates for the Base Period of this Project. Please note this amount ($309,940) is solely for the Base Period of the Contract.
Please note the Optional 30 Month Survey would cost approximately $97,796 and the Optional Qualitative Study would cost approximately $168,152 for a total price (Base plus 2 Options) of $575,888.
PROPOSED PAYMENT SCHEDULE
Deliverable Payment Amount
1. Launch Survey
$ 103,313
2. Completion of the 12-Month Survey
$ 103,313
3. Final Brief
$ 103,313
Total Firm Fixed Price Payments $ 309,940
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-3 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Below are tables for the Detailed Total Budget (Base Plus Options) by Task and Year.
Total Budget by Task
* Abt Associates
Research Partner for Guaranteed
Income Pilot Program
City of Alameda
PoP: 11-01-22 to 10-31-26
Task 1; Program
Design and Task 2: Research Task 3: Data Task 4: Analysis Task 5: Project Total Base Task 6: Optional 30 Task 7: Optional Total Base Plus Collection Contract Month Survey Qualitative Study
NAMF PRO.IFCT ROI F/TITI F Participant Methodology and Reporting Management (Tasks 1-5) Options Selection
Hours Price Hours Price Hours Price Hours Price Hours Price Price Hours Price ] Hours Price Hours Price Sarah Prenovitz, Social Science
Economics Senior Associate 38 15 3 78 45 25 203
I lannah Thomas, Social Science
Research Monitoring Eval Senior 145 145
Associate
Jasmine Harmon, Science and
20 182 202
Research Analyst
Haisheng Yang, Social Science
Research Monitoring Eval Senior 116 10 55
Analyst
Zoe Greenwood, Science and
37 100
Kesearch Associate Analyst
Hannah Betesh, Social Science
Kesearch Monitoring Eval Senior
Associate
Tresa Kappil, Social Science 37
10 Research Monitoring Eval Associate
Randall Juras, Social Science
Economics Senior Associate
Meryl Finkel, Social Science
Economica Principal Aasociate
Michelle Kahmann, Social Science
172
Research Survey Associate
Wyatt Bush, Social Science Survey 286
Research Analyst
Terrence Ceranski, Application 96
Developer 4
Christopher Miller, Application
40 Developer 4
Laurie Cottrell, Data Analytics 4 60
Kevin McMahon, Lata Preparation
Manager 20
Patrick Flaherty, Data Preparation 47
Lead
Marissa Cuellar, Sulence and
Research Analyst
AshLee Smith, Social Science
Research Monitoring Eval Senior 30 30
Analyst
Project Financial Analyst
Production/Graphics
LABOR TOTAL 232 $38,405 35 $6,793 934 S131,037 S63 $37 3278 $149 3511 Business Registration $O SO. $627
Knack 560
DialPad 50 5720
Interview Incentives $o SO $2
IT Rental (Tobieta) =0 3200 8 8188885
30 Misc. Printing and Shibbina Costs for $300
Research Fellow 30
Translation Cost of Qual. Interview sO 50 5062
Into Spanith 30
Transcription Costs 50 $10,050 $10,050
Printing and Mailing 388 $652 $652 $156 $808
Incentives 88388 $27,300 $27,390 $12,870 sn $40,260
Postage $1,516 $1,516 5347 51,862
Abt Travel SO SO $5.755 $5,755
ODC TOTAL $31.464 331,464 $14,221 518,947 S64,633
TOTAL PRICE $38,405 $6,793 [S163.401 $63.416 S37,926 $309,940 $97,796 $168.152| $575,888 Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-4 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Year 1 by Task Detail
• Abt Associates
Research Partner for Guaranteed Income Pilot Proqram
City of Alameda
PoP: 11-01-22 to 10-31-23 3
Task 1: Program
Task 2: Total Base Task 6: Optional Task 7: Optional
Design and Task 3: Data Task 4: Analysis Task 5: Project Total Base Plus Research Contract
Participant Collection and Reporting Managerent (Tasks 1-5) 30 Month Survey Qualitative Study Options Methodology
NAME, PROJECT ROLE/TITLE Selection
Hours Price Hours Price Hours Price Hours Price Hours Price Price Hours | Price Hours Price Hours Price Saran Prenovizz, Social Science Economics 15 0 5
38 60
Senior Associate
Hannah Thomas, Social Science Research • 25 25
Monitoring Eval Senior Associate
Jamin Harmon, Ecience and Rescarch
6 6
Asheng Yang, Social Science Research
Monitoring Eval Enior Analyst 116 10 20 30 0. 213
Zoe Greenwood, Science and Research
37 50 10 97
Associate Analyst
Hannan Betesn, Social Science Research
Monitoring Eval Senior Associato
Tresa Kappi, Social Science Research 37 5 • 8 8
10 Monitoring Eval Associate
Randall Juras, Social Science Economics
4 Senior Associate
Meryl Finkel, Social Science Economics
3 Principal Associate
Michelle Kahmann, Social Science Research
100 100
Curvey Associate
Wyatt Bush, Social Science Survey
114 114
Research Analyst
Terrence Ceranski, Application Developer 4 72
Christopher Miller, Application Developer 4 20
Laurie Cottrell, Data Analytics 4 30 • 00 •
Kevin McMahon. Data Preparation Manager 6
Patrick Flaherty. Data Preparation Lead 14 0 14
Marissa Cellar, Science and Research
63 63
Analyst
Project Financial Analyst 60
LABOR TOTAL 232 $38.405 35 $6.793 434 $62 $15 $25 970
Business Registration S0
Printing and Maling 50
Incentives SO SO $825 288888 598888
Postage sO SO $411
ODC TOTAL SO SO $1,615
TOTAL PRICE $38,405 $6,793 $15 $124,619 $25 49
Aht Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-5 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Year 2 by Task Detail
* Abt Associates
Research Partner for Guaranteed
Income Pilot Program
City of Alameda
PoP: 11-01-23 to 10-31-24
Task 1: Program Total Base
Design and Task 2: Research Task 3: Data Task 4: Analysis Task 5: Project Contract Task 6: Optional Task 7: Optional Total Base Plus NAME, PROJECT ROLE/TITLE Participant Methodology Collection and Reporting Management (Tasks 1- 30 Month Survey Qualitative Study Options Selection 5)
Hours Price Hours Price Hours Price Hours Price Hours Price Price Hours Price Hours Price Hours Price Sarah Prenovitz, Social Science
10 20 30
Economics Senior Associate
Hannah Thomas, Social Science
Research Monitoring Eval Senior 120 120
Associate
Jasmino Harmon, Soionao and
Research Analyst 176 176
Haisheng Yang, Social Science
Research Monitoring Eval Senior 10 20 32 107 169
Analyst
Zoe Greenwood, Science and 80
Research Ascociate Analyst 20 60
Hannah Betesh, Social Science
Research Monitoring Fval Senior 126
Associate
Tresa Kappil, Social Science
Research Monitoring Eval Associate
Randall Juras, Social Science
Economics Senior Assuriate
Meryl Finkel, Social Science
Fconomics Principal Associate
Michelle Kahmann, Social Science
Research Survey Associate 42
Wyatt Bush, Social Science Survey 116
Kesearch Analyst
Terrence Ceranski, Application
0 0 20 20
Developer 4
Christopher Miller, Application
12 Developer 4
Laurie Coltrell, Data Analytics 4 22
Kevin McMahon, Data Preparation
Manager 10
Patrick Flaherty, Data Preparation 24
Lead 24
Marissa Cuellar, Science and 0 220
220
Research Analyst
AshLee Smith, Social Science
Research Monitoring Eval Senior 12 12
Analyst
Project Financial Analyst 30 60
Production/Graphics 0 0 30 60
LABOR TOTAL SO. 539. 484 $16,886 65 829 $123. 1306
Business Registration 88
Knack
DialPad 58888 $360
Interview Incentives so $0 $2,480
IT Rontal (Tablote) $100 S100 $100
Misc. Printina and Shippina Costs for
Research Fellow 30 30 $150 30 $150 50 30 3100
Transistion Cost of Qual Interview intol SO SO so SO $662 $662 Spanish
Transerption Costs SO $0 $10,050 $10,050
Printing and Mating $326 $326 $326
Incentives 8 8889 13.608 $13,605 813,605
8 83888 $758 S758 $758
Postage
Abt Travel so $o $5,755 $5,755
ODG TO TAL 50 15.0 50 30 $15,028 $18,947 334,575
TOTAL PRICE Sol 555.1 $16.886 $10,673 S82,670 SO $142.929| 5225.600 Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-6 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Year 3 by Task Detail
• Abt Associates
Research Partner for Guaranteed Income Pilot Program
City of Alameda
PoP: 11-01-24 to 10-31-25
Task 1: Program Total Base Task 7: Optional
Dosign and Task 2: Research Task 3: Data Tack 4: Analysie Tack 5: Projoct Task 6: Optional Total Baso Plus Contract Qualitative
NAME, PROJECT ROLE/TITLE Participant Methodology Collection and Reporting Management 30 Month Survey Options (Taaka 1-5) Ctudy
Selection
Hours Price Hours Price Hours Price Hours Price Hours Price Price Hours Price Hours Price Hours Price Sarah Prenovitz, Social Science Economics
68 0 68
Senior Associate
Haisheng Yang. Social Science Research
15 88 37 110
Monitoring Eval Senior Analyst
Zoc Greenwood, Science and Rescarch
20 92 0 112
Associate Analyst
Tresa Kappi, Social Science Research
12 12
Monitoring Eval Associate
Randall Juras, Social Science Economics Senior
9 9
Accociate
Mervi Finkel, Social Science Economics
Principal Associate 3
Michelle Kahmann, Social Science Research 30
30 Survey Associate
Wyatt Bush, Social Science Survey Research 56
56 Analyst
Terrence Ceranski, Application Devcloper 4
Christopher Miller, Application Developer 4 •• • 000
Laurie Cottrell, Data Analytics 4 ∞ = ∞0+ 00000 • • •00 10 = 0000+ Kevin McMahon, Data Preparation Manager
Patrick Flaherty, Data Preparation Lead
AshLee Smith, Social Science Research 12 12
Monitoring Eval Senior Analyst
Project Financial Analyst
Production/Graphics •o c
LABOR TOTAL SO 166 $23 .875 274 $46.530 510
Business Registration $0 $209
Knack 50 $30 18: 2 3888E
50 30 5300
IT Rental (Tahlate) sn sn S100
Misc. Printing and Shipping Costs for Research $150 2858888 Fellow SO
Printing and Maling SU $156
Incantive sO 50 $12,870 16x5a a
Postage SO 10:3a
ODC TOTAL SO
TULAL PRICE 546,53U 511,813
Aht Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-7 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
Year 4 by Task Detail
• Abt Associates
Research Partner for Guaranteed Income Pilot Program
City of Alameda
PoP: 11-01-25 to 10-31-26 3 5
Task 1: Program Task 4:
Design and Task 2: Research Task 3: Data Task 5: Project Total Base Task 6: Optional 30 Task 7: Optional Total Base Plus Analysis and Contract Month Survey Options
NAME, PROJECT ROLE/TITLE Participant Methodology Collection Reporting Management (Taske 1-5) Qualitative Study Selection
Hours Price Hours Price Hours Price Hours Price [Hours Price Price Hours Price Hours Price Hours Price Sarah Prenovitz, Social Science Economics 0 0 45 45
Senior Associate
. lasmine Harmon, Sciance and Research Analyst
Haishong Yang, Social Science Research 0
10 147 157
Monitoring Eval Senior Analyst
Zoe Greenwood, Science and Research 0
10 83 93
Associate Analyst
Tresa Kappil, Social Science Research 16 0 16
Monitoring Eval Associate
Randall Juras, Social Science Economics Senior 8
Associate
Meryl Finkel, Social Science Economics Principal 3
3 0
Associate
Michelle Kahmann, Social Science Research 0 30
Survey Associate
Wyatt Bush, Social Science Survey Research
Analyst
Terrence Ceranski, Application Developer 4
Christopher Miler, Application Developer 4
Laurie Cottrell, Data Analytics 4 •• •0 c • • ••c 0000C 00ooo Kevin McMahon, Data Preparation Manager
Patrick Flaherty, Data Preparation Lead
AsLee Smith, Social Science Research
Monitoring Eval Senior Analyst
Project Financial Analyst
8 g
Production/Graphics
LABOR TOTAL SO 16 $6.151 $6.151 511 $83,574
Business Registration SO
Класк. SO $O
85 8 888 838888 8иїзg2
DalPau 50 30
Interview Incentives 50 SO
IT Rental (Tablets) $0 SO
Misc. Printing and Shipping Costs for Research $0 SO SO SO $150 Fellow
Printing and Malling SO SO $156
Incentives 50
Postage SO 38888 2027;
ODC TOTAL 30 30 30
TOTAL PRICE SO SO SA 151 $A
Aht Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-8 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Budget Assumptions for Base Contract (Tasks 1 through 5) Direct Labor
Abt Associates uses a total time reporting system to record all hours worked by exempt employees. This is consistent with the preferred U.S. Government accounting treatment of labor costs. Abt Associates uses a 2,080 hour person-year for estimating purposes. This 2,080 hour person- year becomes a 1,850 hour effective person-year after subtracting vacations, holidays and sick leave.
Personnel
Abt Associates provides assurances that the personnel named in this proposal are prepared to commit to the time budgeted.
Other Direct Costs (ODCs)
Abt has budgeted for the following ODC line items.
• Business Registration - Abt has budgeted $209 annually for years 1 through 3 for a City of Alameda Business License. $627 total cost.
• Knack - Abt has budgeted $30 annually for years 2 through 3. $60 total cost. • Dialpad - Abt has budgeted $360 annually for years 2 through 3. $720 total cost. • IT Rental (Tablets) - Abt has budgeted $100 annually for years 2 through 3. $200 total cost. This is for in- person field work a research fellow may conduct.
• Misc. Printing and Shipping Costs for Research Fellow - Abt has budgeted $150 annually for years 2 through
3. $300 total cost.
• Printing and Mailing to research participants - Abt has budgeted $652 total for Printing and Mailing for years 1 through 3 for follow-up surveys.
• Incentives - Abt has budgeted $27,390 total for Incentives for years 1 through 3. Abt has budgeted $5 for the tracking incentive and $52 for the survey incentive ($50 per respondents along with a $2 fee). Below is a detailed breakdown by year:
1. Year 1: $5*165 tracking incentives = $825
2. Year 2: $5*165 tracking incentives = $825; $52*248 = $13,695
3. Year 3: $52*248 = $12,870
• Postage - Abt has budgeted $1,516 total for Postage for years 1 through 3.
Aht Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-9 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Task Assumptions for Base Contract
The following assumptions form the basis of this pricing. Changes to these assumptions may result in a change to the negotiated price.
Task 1. Program Design and Participant Selection
Subtasks 1.1 Kick-off Meeting
In year 1, we have budgeted for the project director (PD) and the quantitative Principal Investigator to attend a 1 hour remote kick off meeting with City staff in the beginning of the contract. Three days prior to the meeting, the team will prepare an agenda.
Subtask 1.2 Prepare for launch of application
The team will attend remote meetings with City staff in preparation for the launch of the GI pilot. We have budgeted for the team to attend bi-weekly meetings with city staff for the first five months of the contract while the City launches the pilot. The team will work with the City to set eligibility criteria, finalize survey languages, determine research questions, and create the survey and interview schedule.
Subtask 1.3. Secure benefits waivers
In Year 1, we have budgeted for the team to provide needed documentation to the City of Alameda so that the city can secure benefits waivers.
Subtask 1.4 IRB Review
In Year 1, we have budgeted for the Abt team to secure IRB approval for all components of the study. The team will work with the Abt IRB to secure approval for the random assignment design. The team will create a data security plan as a part of the IRB application in Year 1.
Subtask 1.5 Attend Advisory Board meetings
We have budgeted to for two staff to attend two virtual, 1-hour meetings with the advisory committee during the first year of the contract. The City of Alameda will set the agenda and the team will be available to contribute to agenda and answer questions.
Task 2. Research Methodology
Subtask 2.1. Design Report
In the first year of the contract, the team has budgeted for updating an internal design document.
Task 3: Data Collection
Subtask 3.1 Quant data collection
The survey data collection task has budgeted the following:
• Program and field web-based baseline survey in six languages (Spanish, Mandarin, Cantonese, Tagalog, Vietnamese, and Korean). The Spanish and Vietnamese surveys are already programmed. The City will need to translate only the informed consent and eligibility criteria into these languages. The city would need to translate the survey, consent, and eligibility criteria in Mandarin, Cantonese, Tagalog, and Korean. - Randomize participants and find replacements as needed • Program and field 12-month survey in English and six languages (Spanish, Mandarin, Cantonese, Tagalog, Vietnamese, and Korean) to 330 study participants.
- Send advance letter via USPS with survey link
- Emails and text reminders about completing survey
- Provide $50 VISA gift card to participants upon completion via email or mail • Conduct a brief tracking survey to include questions on income volatility over prior months in six languages (at 6- and 18-months) to 330 study participants. The City would need to translate this tracking survey into Spanish, Mandarin, Cantonese, Tagalog, Vietnamese, and Korean. - Provide $5 cash or gift card to participants upon completion • Program and field online 24-month survey in six languages (Spanish, Mandarin, Cantonese, Tagalog, Vietnamese, and Korean) to 330 study participants.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-10 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
- Send advance letter via USPS with survey link
- Emails and text reminders about completing survey
- Provide $50 VISA gift cards to participants upon completion via email or mail Task 4 Analysis and Reporting
Subtask: 4.1 Analysis
The team has budgeted to conduct high quality analysis on the survey data.
Subtask 4.2 Reporting
In Year 2, the team has budgeted for a final evaluation brief that will be approximately 10-15 pages in length, which will integrate information for all aspects of the evaluation. The team will submit a draft and a revised version (final). We have also budgeted for one virtual briefing to City staff and the Advisory Board.
Task 5: Project Management
After the launch of the survey, we have budgeted for the Project Director to meet with the City of Alameda as needed, up to four times a year. Additional resources are included in this task to implement monthly project management activities, including regular internal project reviews to assess overall project quality, potential risks and challenges, and oversight of the project budget and staffing.
Task 6: Optional 30-month Survey
Should the City of Alameda wish to exercise the optional 30-month survey, they will need to exercise this option by two months prior to the last disbursement. For example, if the final disbursement is planned to be April 1, 2024, then the City would need to exercise the option to conduct the 30-month survey by February 1, 2024. The 30-month survey data collection task has budgeted the following:
Subtask 6.1 Field 30-month Survey
Program and field online 30-month survey in six languages (Spanish, Mandarin, Cantonese, Tagalog, Vietnamese, and Korean) to 330 study participants.
- Send advance letter via USPS with survey link
- Emails and text reminders about completing survey
- Provide $50 VISA gift cards to participants upon completion via email or mail Subtask 6.2 Analysis and Brief
In Year 4, as part of the optional 30-month survey, the team has budgeted for a final evaluation brief that will be approximately 5-10 pages in length to report out findings from the 30 month survey in relation to the previous findings from the evaluation. The team will submit a draft and a revised version (final). We have also budgeted for one virtual briefing to City staff and the Advisory Board.
Subtask 6.3 Project Management
We have budgeted for the Project Director to meet with the City of Alameda as needed, up to four times a year.
Additional resources are included in this task to implement monthly project management activities, including regular internal project reviews to assess overall project quality, potential risks and challenges, and oversight of the project budget and staffing.
Other Direct Costs (ODCs) for 30-month Survey
Abt has budgeted for the following ODC line items for fielding the 30-month survey data collection. • Business Registration - Abt has budgeted $209 for year 4 for a City of Alameda Business License. • Knack - Abt has budgeted $30 for year 4.
• Dialpad - Abt has budgeted $360 for year 4.
• IT Rentals - Abt has budgeted $100 for IT Rentals for year 4.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-11 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
• Misc. Printing and Shipping Costs - Abt has budgeted $150 for misc. printing and shipping costs for year 4. • Printing and Mailing to research participants - Abt has budgeted $156 total for Printing and Mailing for year 4 for the 30-month survey.
• Incentives - Abt has budgeted $12,870 total for Incentives for year 4. Abt has $52 for the survey incentive ($50 per respondents along with a $2 fee). Below is a detailed breakdown by year:
Year 4: $52*248
• Postage - Abt has budgeted $347 total for Postage for year 4.
Task 7: Optional Qualitative Study
Should the City of Alameda wish to exercise the optional qualitative study, they will need to exercise this option by one month after disbursement of the first payment. For example, if disbursement of the first guaranteed income payment happens April 1, 2023, the City would need to exercise the optional qualitative study by May 1, 2023.
Subtask 7.1 Qualitative Research Design
In the second year of the contract, we have budgeted for the creation of a qualitative interview protocol that is approximately 60 minutes in length. We have also budgeted for the development of an informed consent document. Our team will work with the city to finalize the protocol. These materials will be submitted to the IRB for approval.
Subtasks 7.2 Qualitative Data Collection
In the second year of the contract, the team has budgeted to conduct up to 40 interviews. We have budgeted for two analysts to fly into Alameda and stay five days to conduct interviews, along with the local site lead. We have budgeted for the interview protocol to be translated into Spanish. One analyst will be fluent in Spanish and conduct 10 interviews in Spanish, along with some English interviews. All 40 interviews will be transcribed by professional transcription firm (the Spanish interviews will be transcribed into English as well). We have budgeted for each respondent to be given a $60 gift card for participating in an interview.
Subtask 7.3 Qualitative Analysis
In year 2 the team has budgeted to conduct high quality analysis on both the baseline survey data and the qualitative interview data collected during the study (Year 2).
Subtask 7.4 Reporting
In Year 3, the team has budgeted for a report that will include descriptive analysis of the findings from the qualitative interviews. The report will be approximately 15 pages, including appendices. The team has budgeted for one draft and one revised version (final) to be submitted to the city. The team also budgeted for one virtual briefing to the City staff and the Advisory Board. We have also budgeted for one hybrid (some staff remote, some in person) briefing to City staff and the Advisory Board.
Other Direct Costs for Qualitative Data Collection
• Interview Incentives - Abt has budgeted $2,480 for interview incentives in year 2 only. This cost is based on $62 per incentive times 40. ($60 per respondent, along with a $2 fee for gift cards from the vendor). • Translation Cost of Qual. Interview into Spanish - Abt has budgeted $662 for translation cost of the Qual.
Interview in year 2. This cost is based on 3,600 words translated at $.184/word. $662 total cost. • Transcription Costs - Abt has budgeted $10,050 for transcription costs in year 2. This cost is based on the following:
• $175*30=$5,250
• $480*10=$4,800 (for Spanish to English transcription) Optional Task Qualitative Data Collection Travel and per Diem Travel has been budgeted according to Abt Associates' Travel Policy which is consistent with Federal Travel Regulations (FTR). Abt researched airfares online and used GSA domestic per diem rates. We envision travel in Year 2 only totaling $5,755. The snapshots below provide price details for travel related costs:
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-12 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section 1: Work Plan, Fee Proposal, and Schedule
TASK # TASK NAME Year Purpose
Task 3: Data Collection 2
Description Unit Cost #Trips #People #Days/Nights Total Airfare 1: Houston to San Francisco $708.96 1 1 $ 708.96 Per Diem Lodging $288.00 1 1,440.00
Per Diem M&IE $79.00 ---- 395.00
Partial Per Diem M&JE $59.25 2 $ 118,50
Ground Transportation from Airport to Hotel $75.00 2 $ 150.00 $ 2,812.46
TASK # TASK NAME Year Purpose
Task 3: Data Collection 2
Description Unit Cost #Trips #People #Days/Nights Total Airfare 1: Washington, DC to San Francisco $838.96 1 1 $ 838.96 Per Diem Lodging $288.00 1 1,440.00
Per Diem M&IE $79.00 1 395.00
Partial Per Diem M&IE $59.25 1 2 $ 118.50
Ground Transportation from Airport to Hotel $75.00 2 $ 150.00 $ 2,942.46
Administrative Data
This proposal fully conforms to the RFP, entitled Research Partner for Guaranteed Income Pilot Program issued by the City of Alameda. Abt Associates does not take any exceptions or deviations with the provisions of the RFP. This proposal has been prepared based on the following understandings and assumptions:
Terms and Conditions
1. Our proposal is valid for a period of 180 days from the date submission of this proposal.
2. The budgets contained in this proposal for the base contract assume a starting date of November 1, 2022 for a three-year period of performance. The Optional 30-month survey assumes a one-year period of performance beginning October 30, 2025.
3. Our budget further assumes a Firm Fixed Price contract resulting from this solicitation.
4. The names and telephone numbers of Abt Associates' authorized representatives for negotiation are:
Melissa B. Ashcraft Kathleen Aguilar
VP, Contracts and Procurement Contracts Senior Manager
6130 Executive Blvd. 6130 Executive Blvd.
Or
Rockville, MD 20852-4907 Rockville, MD 20852-4907
301-347-5915 (301) 347-5093 voice
Lisa_ [email protected] [email protected]
5. The name of Abt Associates' corporate representative for CPAR postings is:
Kyle Hall
Contracts Administrator 2
301-347-5117
[email protected]
6. Abt Associates will provide all equipment and facilities necessary for the performance of this contract. Abt Associates does not have any government-owned property or property acquired with Federal funds to be used in the performance of this contract.
7. Abt Associates provides assurances that the personnel proposed are prepared to commit to the time budgeted.
8. Abt Associates has completed the online representations and certifications applications at the System for Award Management (SAM) site.
9. Abt Associates has sufficient capacity, working capital, and other resources to perform the work of the proposed contract without assistance from any outside source. The company has negotiated a line of credit with a major Boston bank sufficient to augment working capital needs that cannot be satisfied by operations.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-13 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Response to RFP: City of Alameda Research Partner
Section I: Work Plan, Fee Proposal, and Schedule
Dun & Bradstreet assigns a 1R3 rating to Abt Associates. The accounting firm of Grant Thornton audits our corporate records.
10. Abt Associates has delivered more than a billion and a half dollars in Federal, State and local government contracts, as well as countless private sector projects for over 50 years. As such, Abt Associates has the necessary organizational, experience, accounting and operational controls, and technical skills to perform the proposed contract. Abt Associates retains sufficient professional, technical, and support staff to deliver our contractual obligations; this record of performance capability can be substantiated by the contracts performed previously.
11. Abt Associates' accounting system has been audited by the Boston Branch Office of DCAA and was determined adequate for accumulating and billing costs under U.S. Government contracts.
12. In accordance with FAR 44.305-1 and FAR 44.305-2, Abt Associates' cognizant Administrative Contracting Officer granted approval of Abt's purchasing system effective January 17, 2020. Confirmation of the purchasing system approval can be obtained, if necessary, from:
Ms. Eugenia L. Brown
Cognizant Administrative Contracting Officer, USAID
1300 Pennsylvania Avenue, NW
Washington, DC 20523
13. Abt Associates uses a total time reporting system to record all hours worked by employees classified as Exempt.
14. Abt has the capability to deliver the proposed solution in-house and does not anticipate a need to subcontract any portion of the scope of work.
15. Abt Associates conducts itself with the highest degree of integrity and honesty. Abt Associates has a written code of business ethics and conduct and promotes compliance with this code with employee training programs. Compliance is monitored through an internal controls system to facilitate timely discovery and disclosure of improper conduct, and to ensure that corrective measures are promptly instituted and carried out should improper conduct be found.
16. A core component of Abt Associates' bids - as well as that of our team members - is the conduct of independent research and analysis. Accordingly, the ability to retain our intellectual property is of great importance. We request that the client include FAR Clause 52.227-14, Data Rights General, Alt. IV, in the contract, to allow Abt Associates and our team members to assert copyright to all data first produced under this contract.
17. Upon project termination, Abt Associates would be pleased to do a Quick Closeout in accordance with FAR
42.708 to avoid changes in rates impacting the total project payments.
Abt Associates Evaluation of Alameda GI Pilot October 17, 2022 | 1-14 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Exhibit C
Additional Provisions
The following paragraphs) are added to the Agreement:
1. CONFLICTING PROVISIONS
In the event of a conflict between the terms and conditions of this Agreement and any other applicable terms and conditions, including Exhibits furnished by Provider to be made part of this Agreement, the terms and conditions of this Agreement shall prevail, except that Exhibit C-1 (Grant Conditions) shall prevail over any provision that conflict with the Agreement.
RECORDS
Notwithstanding Paragraph 17 (RECORDS), GRANTEE shall be solely responsible to implement internal controls and record keeping procedures that comply with this AGREEMENT and all applicable laws. GRANTEE's administrative, programmatic and financial records pertaining to the Program, or the AGREEMENT collectively, must sufficiently support the determination that expenditures are allowable. GRANTEE shall retain all records pertinent to this AGREEMENT for a period of five (5) years from the date of final payment or disbursement to U.S. Treasury of unexpended Coronavirus State and Local Fiscal Recovery Funds (SLFF) subawards. GRANTEE shall retain such records beyond five (5) years so long as any litigation, audit, dispute or claim is pending.
3.NO THIRD-PARTY RIGHTS
This Agreement does not constitute a binding commitment to any client or agency except CITY and GRANTEE. No third-party rights are created for clients or other individuals.
4. GRANT CONDITIONS
Notwithstanding Paragraph 29 of the Agreement, the GRANTEE's grant conditions. attached hereto as Exhibit C-1, are hereby expressly made part of the Agreement between the parties.
18 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Exhibit C-1
ARPA Subrecipient Certification
Section 602(b) of the Social Security Act (the Act), as added by section 9901 of the American Rescue Plan Act ("ARPA"), Pub. L. No. 117-2 (March 11, 2021), authorizes the Department of the Treasury (Treasury) to make payments to certain subrecipients from the Coronavirus State and Local Fiscal Recovery Fund ("SLFRF"). The City of Alameda has signed and certified a separate agreement with Treasury as a condition of receiving such payments from the Treasury. This agreement is between your organization and the State and your organization is signing and certifying the same terms and conditions included in the State's separate agreement with Treasury. Your organization is referred to as a GRANTEE.
As a condition of your organization receiving federal recovery funds from the City, the authorized representative below hereby (i) certifies that your organization will carry out the activities listed in section 602(c) of the Act and (ii) agrees to the terms attached hereto as Exhibit C-2 (ARPA Subrecipient Grant Agreement).
Under penalty of perjury, the undersigned official certifies that the authorized representative has read and understood the organization's obligations in the Assurances of Compliance and Civil Rights Requirements, attached hereto as Exhibit C-3 (ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS), that any information submitted in conjunction with this assurances document is accurate and complete, and that the organization complies with the nondiscrimination requirements.
SUBRECIPIENT/GRANTEE:
ABT ASSOCIATES INC.,
Digitally signed by
Melissa B. Melissa B. Ashcraft
Date: 2022.10.28
Ashcraft
08:15:50-04'00
Melissa B. Ashcrafi
Vice President, Contracts and Procurement
(AUTHORIZED REPRESENTATIVE)
19 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Exhibit C-2
ARPA Subrecipient Grant Agreement
This Subrecipient Agreement ("Grant Agreement") is dated the effective date of the Agreement, by and between the Subrecipient Abt Associates Inc. ("GRANTEE") and the City of Alameda, a California municipal corporation ("CITY").
WHEREAS, the United States Department of the Treasury ("Treasury") has allocated CITY federal stimulus funding from the Coronavirus State and Local Fiscal Recovery Funds under CFDA No. 21.027 ("ARPA Funds") under Section 603(b) of the Social Security Act, as amended by Section 9901 of the America Rescue Plan Act ("ARPA"), of which $28,679,908 was allocated to CITY in two tranches on June 17, 2021, and June 17, 2022, subject to applicable laws, rules, regulations and guidance, including without limitation, the Coronavirus State and Local Fiscal Recovery Funds Final Rule ("Final Rule"), identified as Attachment A (dated January 6, 2022), and the Compliance and Reporting Guidance for State and Local Fiscal Recovery Funds ("Compliance & Reporting Guidelines"), identified as Attachment B, and Uniform Guidance (2 CFR Part 200). Attachments A and B attached hereto and incorporated herein by this reference.
WHEREAS, Treasury authorizes CITY to expend ARPA Funds for the following eligible purposes as outlined in the Final Rule as follows:
(1) To respond to the COVID-19 public health emergency or its negative economic impacts, including assistance to houscholds, small businesses, and nonprofits, or aid to impacted industries such as tourism, travel, and hospitality;
(2) To respond to workers performing essential work during the COVID-19 public health emergency by providing premium pay to eligible workers; (3) For the provision of government services to the extent of the reduction in revenue due to the COVID-19 public health emergency relative to revenues collected in the most recent full fiscal year prior to the emergency; and
(4) To make necessary investments in water, sewer, or broadband infrastructure (collectively "Eligible Uses").
Pursuant to ARPA, Eligible Uses under this non-R&D federal program must be obligated no earlier than March 3, 2021 and no later than December 31, 2024, with final disbursement of all funds no later than December 31, 2026.
WHEREAS, CITY desires to allocate portions of the ARPA Funds to certain nonprofits whose operations are critical to those individuals, families, and entities adversely impacted by the COVID-19 public health emergency, whether through a reduction in income/revenues, increase in operating costs related to implementing COVID-19 prevention or mitigation tactics or other higher operating costs experienced during the pandemic, business disruption or closure, event cancellation, and/or other similar circumstances during the 20 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF pandemic that created a financial hardship, with such allocation of funds to be consistent with the Eligible Uses of ARPA Funds outlined above.
WHEREAS, CITY and GRANTEE desire to enter into the Agreement so that CITY may provide a subaward of ARPA Funds for appropriate and qualifying expenditures of grant funds advanced to GRANTEE by CITY for Eligible Uses set forth in Exhibit A (Scope of Work), as allowed under Final Rule.
NOW, THEREFORE, in consideration of the foregoing recitals which are incorporated herein by reference, and the terms and conditions set forth below, the parties agree as follows:
i. Effective Date and Term. The Grant Agreement shall be coterminous with the term of the Agreement.
ii. ARPA Funds. CITY agrees to provide the GRANTEE a total sum not to exceed the value of the Agreement for Eligible Uses set forth in the Exhibit A (Scope of Work). iii. Use of ARPA Funds. GRANTEE shall ensure that the ARPA Funds requests are necessary Eligible Uses under one of the following cost categories: a) To respond to the COVID-19 public health emergency or its negative economic impacts, including assistance to households, small businesses, and nonprofits, or aid to impacted industries such as tourism, travel, and hospitality, b) To respond to workers performing essential work during the COVID-19 public health emergency by providing premium pay to eligible workers, c) For the provision of government services to the extent of the reduction in revenue due to the COVID-19 public health emergency relative to revenues collected in the most recent full fiscal year prior to the emergency; and d) To make necessary investments in water, sewer, or broadband infrastructure.
iv. Pre-award Costs. Pre-award costs, as defined in 2 C.F.R. $ 200.458, may not be paid with funding from this award.
V. Administrative Costs. GRANTEE may use funds provided under this award to cover both direct and indirect costs.
vi. Ineligible Uses. Ineligible or non-allowable uses of ARPA Funds include, without limitation, the following: a) usage of funds to either directly or indirectly offset a reduction in net tax revenue resulting from a change in law, regulation or administrative interpretation during the covered period that reduces any tax or delays the imposition of any tax or tax increase; b) damages covered by insurance; c) usage of funds as a deposit into any pension fund; d) expenses that have been or will be reimbursed under any federal program; e) debt service costs; f) contributions to a "rainy day" fund; and d) legal settlements.
vii. SAM.gov Requirements. If applicable, GRANTEE must obtain and maintain an active registration with the System for Award Management ("SAM") (https://www.sam.gov) pursuant to 2 CFR Part 25.
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF vili. Reimbursement Requests and Reporting Requirements. To facilitate the release of ARPA Funds by CITY to GRANTEE and CITY's compliance with reporting requirements for usage of ARPA funding, GRANTEE may submit one request per month to CITY consistent with compensation provisions of the Agreement (Paragraph 3, Compensation to Provider). CITY shall then disburse ARPA Funds, as requested by GRANTEE to fund services set forth in Exhibit A (Scope of Services) of the Agreement, ("Reimbursement Request Funds"). Such schedule may be modified with the prior written approval of CITY.
Failure to provide any of the required documentation may result in the withholding and/or nonpayment of all or a portion of the request, and termination of the Agreement. Following receipt of the Reimbursement Request Funds from CITY and demonstrated compliance with the Agreement, as determined by CITY, GRANTEE will, if applicable, disburse the Reimbursement Request Funds to the approved recipients within 10 business days, and provide on a monthly basis a report to and in a form approved by CITY detailing the grant awards disbursed by GRANTEE.
ix. Records, Reports and Audits. As a subrecipient of ARPA Funds, GRANTEE may be subject to the Single Audit Act and 2 CFR part 200, subpart F regarding audit requirements.
1. Establishment and Maintenance of Records. GRANTEE shall maintain records, including but not limited to, books, financial records, supporting documents, statistical records, personnel, property, and all other pertinent records sufficient to reflect properly:
a. All direct and indirect costs of whatever nature claimed to have been incurred and anticipated to be incurred to perform this AGREEMENT, and b. All other matters covered by this AGREEMENT. Such records shall be maintained in accordance with requirements now or hereafter prescribed by CITY.
2. Preservation of Records. GRANTEE shall preserve and make available its records:
a. for a period of five (5) years from the date of final payment to GRANTEE under this AGREEMENT; or
b. for such longer period. if any, as may be required by applicable law: or c. if this AGREEMENT is completely or partially terminated, for a period of five (5) years from the date of any resulting final settlement.
GRANTEE make all reasonable efforts to meet CITY's requests for records or other lemands to ensure the parties
including requests made by the U.S. Treasury and the Government Accountability Office ("GAO").
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF
3. Examination of Records; Facilities. At any time during normal business hours, and as often as may be deemed necessary by CITY, GRANTEE agrees that CITY, and/or any of its authorized representatives, shall:
a. for a period of five (5) years after final payment under this AGREEMENT; or, b. for such longer period as may be required by applicable law; or c. if this AGREEMENT is completely or partially terminated, for a period of five (5) years from the date of any resulting settlement;
d. have access to and the right to examine its plants, offices and facilities engaged in performance of this AGREEMENT and all its records with respect to all matters covered by this AGREEMENT.
GRANTEE also agrees that CITY, or any of its respective authorized representatives. shall have the right to audit, examine, and make excerpts or transcripts of and from such records, and to make audits of all contracts and subcontracts, invoices, payrolls, records of personnel, conditions of employment, materials, and all other data relating to matters covered by this AGREEMENT, all as set forth in Section D, below.
Notwithstanding anything in this AGREEMENT to the contrary for monitoring purposes, CITY shall not require access to any information of GRANTEE mutually determined by the parties hereto to be proprietary.
4. Audit of Records. If an audit is required, the following provisions apply:
a. Funds from the subaward will be set aside in GRANTEE's budget for the independent audit. A separate line item will be established. b. GRANTEE shall enter into an agreement with an independent public accountant certified to practice in the State of California no later than sixty (60) days before the end of this AGREEMENT to perform audit of GRANTEE's fiscal year which ends concurrently with or immediately after the end of this AGREEMENT. c. The audit must be completed and sent to CITY's Finance Department staff within the later of one hundred fifty (150) days of the end of this AGREEMENT or ninety (90) days after the end of GRANTEE's fiscal year. d. If GRANTEE does not enter into the agreement with an independent public accountant certified to practice in the State of California, or if an audit is not completed in a timely manner, CITY, at its sole discretion, may enter into an agreement with an independent public accountant certified to practice in the State of California to perform the audit and utilize GRANTEE's set-aside funds for the audit.
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF e. The independent fiscal audit shall conform to generally accepted governmental auditing principals and, when applicable, Office of Management and Super Circular, "Attachment P, Audit Requirements." Such audits shall identify the funds received and disbursed under this AGREEMENT and include the following components:
i. Balance sheet;
ii. Statement of Financial Position;
iii. Statement of Support, Revenue and Expenses and Changes in Fund Balances or Statement Activities;
iv. Statement of Functional Expenses;
v. Independent Auditor's Report on the Financial Statement and Schedule of Expenditures of Federal Awards;
vi. Auditor's Report on Internal Control over Financial Reporting and on Compliance and Other Matters;
vii. Auditor's Report on Compliance with Requirements Applicable to Major Programs and on Internal Control over Compliance;
vili. Schedule of Findings and Questioned Costs;
ix. Summary of Schedule of Prior Audit Findings;
x. Corrective Action Plan;
xi. Data Collection Form; and
xii. Communication of Internal Control Related Maters Identified in an Audit (Management Letter) from Auditor (if one was issued).
f. For grantees that expend $750,000 or more of Federal financial assistance in a fiscal year. in addition to conducting normal financial audit procedures. the GRANTEE's independent public accountant certified to practice in the State of California shall perform tests to ascertain that:
1. Expenditures submitted for reimbursement are allowable under 2 CFR 200:
a. Expenditures comply with the Agreement between CITY and GRANTEE; and
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF b. Applicable laws and regulations. Further, the independent publie accountant certified to practice in the State of California shall render an opinion as to whether the Expenditures complied with the Single Audit Act of 1984 and Appendix XI to 2 CFR Part 200-Compliance Supplement previously known as the Circular A-133 Compliance Supplement); and
c. Funds from the subaward may be set aside in GRANTEEs budget for a reasonable share of a Single Audit if required. A separate line item will be established.
g. For GRANTEES that expend more than $750,000 of financial assistance in a fiscal year, the audit shall identify in a Schedule of Governmental Financial Assistance the gross amounts of grants obtained by GRANTEE from all governmental sources, the periods covered by the grants, and the grant contract or identification numbers), if any, under which funds were received and disbursed by GRANTEE during the audited fiscal year. In addition, the Schedule of Governmental Financial Assistance shall show the amount received and disbursed under each grant during the audited fiscal year, including the amount received and disbursed under this AGREEMENT.
h. GRANTEE's independent public accountant certified to practice in the State of California shall perform reviews of GRANTEE's internal control systems and GRANTEE's compliance with applicable laws, regulations and the requirements of this AGREEMENT.
The independent public accountant certified to practice in the State of California shall issue a report on the financial statements and the Schedule of Governmental Financial Assistance, a report on the study and evaluation of internal controls and a report on GRANTEE compliance. The three reports may be bound into a single report, or presented at the same time as separate documents.
Disallowed or Ineligible Costs. If it is determined during the course of the audit that GRANTEE was reimbursed for unallowable costs or for ineligible uses under this Agreement, GRANTEE agrees to promptly reimburse the CITY for such payments upon request.
x. Fiscal Responsibilities of GRANTEE. GRANTEE shall:
1. the financid audaccouring thentics of the GRANTEE, inchaling respecipe in disbursement of GRANTEE funds.
B. Establish and maintain a system of accounts that shall be in conformance with generally accepted principles of accounting for budgeted funds. Such system of accounts shall be subject to review and approval of CITY. 25 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF C. Document all costs by maintaining complete and accurate records of all financial transactions, including but not limited to contracts, invoices, time cards, cash receipts, vouchers, canceled checks, bank statements and/or other official documentation evidencing in proper detail the nature and propriety of all charges.
D. Submit to the CITY, within thirty (30) calendar days of the end of the preceding month, requests for reimbursement, together with documentation required by CITY.
E. Certify insurability subject to CITY approval as outlined in Paragraph 11 of the Agreement, entitled "INSURANCE."
F. Submit to CITY at such times and in such forms as CITY may require, such statements, records, reports, data, and information pertaining to matters covered by the Agreement.
G. Administer all programs in conformance with OMB Circular A-122, "Cost Principles for Non-Profit Organizations." These principles shall be applied for all costs incurred whether charged in a direct or indirect basis.
H. Develop an indirect cost allocation plan for determining the appropriate GRANTEE's share of administrative costs if indirect costs are charged and submit such plan to the CITY for approval in a form specified by the CITY prior to submitting reimbursement requests.
xi. Compliance with Laws.
A. Federal regulations applicable to this award include, without limitation, the following:
i. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 C.F.R. Part 200, other than such provisions as Treasury may determine are inapplicable to this Award and subject to such exceptions as may be otherwise provided by Treasury. Subpart F - Audit Requirements of the Uniform Guidance, implementing the Single Audit Act, shall apply to this award. ii. Universal Identifier and System for Award Management (SAM), 2 C.F.R. Part 25, pursuant to which the award term set forth in Appendix A to 2 C.F.R. Part 25 is hereby incorporated by reference.
ili. Reporting Subaward and Executive Compensation Information, 2 C.F.R. Part 170, pursuant to which the award term set forth in Appendix A to 2 C.F.R. Part 170 is hereby incorporated by reference.
iv. OMB Guidelines to Agencies on Government wide Debarment and Suspension (Nonprocurement), 2 C.F.R. Part 180, including the requirement to include a term or condition in all lower tier covered transactions (Agreements and Subcontractors 26 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF described in 2 C.F.R. Part 180, subpart B) that the award is subject to 2 C.F.R. Part 180 and Treasury's implementing regulation at 31 C.F.R. Part 19. v. Subrecipient Integrity and Performance Matters, pursuant to which the award term set forth in 2 C.F.R. Part 200, Appendix XII to Part 200 is hereby incorporated by reference.
vi. Government wide Requirements for Drug-Free Workplace, 31 C.F.R. Part 20. vii. New Restrictions on Lobbying, 31 C.F.R. Part 21.
vili. Uniform Relocation Assistance and Real Property Acquisitions Act of 1970(42 U.S.C. $8 4601-4655) and implementing regulations.
ix. Generally applicable federal environmental laws and regulations. x. Any other applicable law or regulation, including the Final Rule and Compliance & Reporting Guidelines, to the extent applicable, when disbursing ARPA Funds to recipients or when seeking Reimbursement from the CITY.
B. Statutes and regulations prohibiting discrimination applicable to this award include, without limitation, the following:
i. Title VI of the Civil Rights Act of 1964 (Title VI) Public Law 88-352, 42 U.S.C. 2000d-1 et seq., and the Department's implementing regulations, 31 CFR part 22; Section 504 of the Rehabilitation Act of 1973 (Section 504), Public Law 93- 112, as amended by Public Law 93-516, 29 U.S.C. 794; Title IX of the Education Amendments of 1972 (Title IX), 20 U.S.C. 1681 et seq., and the Department's implementing regulations, 31 CFR part 28, which prohibit discrimination on the basis of race, color, or national origin under programs or activities receiving federal financial assistance;
ii. The Fair Housing Act, Title VIII of the Civil Rights Act of 1968(42 U.S.C. §§ 3601 et seq.), which prohibits discrimination in housing on the basis of race, color, religion, national origin, sex, familial status, or disability; iii. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of disability under any program or activity receiving federal financial assistance;
iv. The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101 et seq.), and Treasury's implementing regulations at 31 C.F.R. Part 23, which prohibit discrimination on the basis of age in programs or activities receiving federal financial assistance; and
v. Title Il of the Americans with Disabilities Act of 1990, as amended (42 27 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF U.S.C. §$ 12101 et seq.), which prohibits discrimination on the basis of disability under programs, activities, and services provided or made available by state and local governments or instrumentalities or agencies thereto.
C. GRANTEE will also obtain and maintain all licenses and permits appropriate to its proper and effective performance of the Agreement prior to the date of commencement. GRANTEE is responsible for contacting the appropriate offices and filing the necessary documents to comply with these requirements. xii. Remedial Actions. In the event of GRANTEE's noncompliance with section 602 of the Act, other applicable laws, Treasury's implementing regulations, guidance, or any reporting or other program requirements, Treasury may impose additional conditions on the receipt of a subsequent tranche of future award funds, if any, or take other available remedies as set forth in 2 C.F.R. § 200.339. In the case of a violation of section 602(c) of the Act regarding the use of funds, previous payments shall be subject to recoupment as provided in section 602(e) of the Act and any additional payments may be subject to withholding as provided in sections602(b)(6)(A)(ii)(III) of the Act, as applicable. xiii. Hatch Act. GRANTEE agrees to comply, as applicable, with requirements of the Hatch Act (5 U.S.C.SS 1501-1508 and 7324-7328), which limit certain political activities of State or local government employees whose principal employment is in connection with an activity financed in whole or in part by this federal assistance. xiv. False Statements. GRANTEE understands that making false statements or claims in connection with this award is a violation of federal law and may result in criminal, civil, or administrative sanctions, including fines, imprisonment, civil damages and penalties, debarment from participating in federal awards or Agreements, and/or any other remedy available by law.
XV. Publications. Any publications produced with funds from this award must display the following language: "This project [is being] [was] supported, in whole or in part, by federal allocation number SLT-7032 allocated to the City of Alameda by the U.S.
Department of the Treasury."
xvi. Debts Owed the Federal Government.
1. Any funds paid to the GRANTEE (1) in excess of the amount to which GRANTEE is finally determined to be authorized to retain under the terms of this award; (2) that are determined by the Treasury Office of Inspector General to have been misused; or (3) that are determined by Treasury to be subject to a repayment obligation pursuant to sections 602(e) and 603(b)(2)(D) of the Act and have not been repaid by the GRANTEE shall constitute a debt to the federal government.
2. Any debts determined to be owed to the federal government must be paid promptly by GRANTEE. A debt is delinquent if it has not been paid by the date specified ir Treasury's initial written demand for payment, unless other satisfactory arrangement 28 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF have been made or if the GRANTEE knowingly or improperly retains funds that are a debt as defined in paragraph 14(a). Treasury will take any actions available to it to collect such a debt.
xvii. Disclaimer.
1. The United States expressly disclaims any and all responsibility or liability to GRANTEE or third persons for the actions of GRANTEE or third persons resulting in death, bodily injury, property damages, or any other losses resulting in any way from the performance of this award or any other losses resulting in any way from the performance of this award or any Agreement, or Subcontractor under this award.
2. The acceptance of this award by GRANTEE does not in any way establish an agency relationship between the United States and GRANTEE.
xviii. Protections for Whistleblowers.
1. In accordance with 41 U.S.C. § 4712, GRANTEE may not discharge, demote, or otherwise discriminate against an employee in reprisal for disclosing to any of the list of persons or entities provided below, information that the employee reasonably believes is evidence of gross mismanagement of a federal Agreement or grant, a gross waste of federal funds, an abuse of authority relating to a federal Agreement or grant, a substantial and specific danger to public health or safety, or a violation of law, rule, or regulation related to a federal Agreement (including the competition for or negotiation of an Agreement) or grant.
2. The list of persons and entities referenced in the paragraph above includes the following:
i. A member of Congress or a representative of a committee of Congress; ii. An Inspector General;
iii. The Government Accountability Office:
iv. A Treasury employee responsible for Agreement or grant oversight or management;
v. An authorized official of the Department of Justice or other law enforcement agency:
vi. A court or grand jury; or
vii. A management official or other employee of GRANTEE, Contractor, or 29 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Subcontractor who has the responsibility to investigate, discover, or address misconduct.
C. GRANTEE shall inform its employees in writing of the rights and remedies provided under this section, in the predominant native language of the workforce.
xix. Increasing Seat Belt Use in the United States. Pursuant to Executive Order 13043, 62 FR 19217 (Apr. 18, 1997), GRANTEE should encourage its Contractors to adopt and enforce on-the-job seat belt policies and programs for their employees when operating company-owned, rented or personally owned vehicles.
xx. Reducing Text Messaging While Driving. Pursuant to Executive Order 13513, 74 FR 51225 (Oct. 6, 2009), GRANTEE should encourage its employees, Subrecipients, and Contractors to adopt and enforce policies that ban text messaging while driving, and GRANTEE should establish workplace safety policies to decrease accidents caused by distracted drivers. xxi. Improper Influence. Each party warrants that it did not and will not employ, retain, or contract with any person or entity on a contingent compensation basis for the purpose of seeking, obtaining, maintaining, or extending this Agreement.
Each party agrees, warrants, and represents that no gratuity whatsoever has been or will offered or conferred with a view towards obtaining, maintaining, or extending this Agreement.
xxii. Conflict of Interest. The elected and appointed officials and employees of the parties shall not have any personal interest, direct or indirect, which gives rise to a conflict of interest.
xxiii. Survival. The provisions of this Agreement that by their sense and purpose should survive expiration or termination of the Agreement shall so survive. Those provisions include without limitation Indemnification and Maintenance and Audit of Records.
xxiv. Governing Law; Venue. The Agreement will be governed in all respects by the XXV. Binding Effect. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors.
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF xxvi. Counterparts. This Agreement may be executed in one or more counterparts, any of which shall be deemed an original but all of which together shall constitute one and the same instrument.
xxvii. Authorization. Each party signing below warrants to the other, that they have the full power and authority to execute this Agreement on behalf of the party for whom they purport to sign.
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DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF
ASSURANCES OF COMPLIANCE WITH CIVIL RIGHTS
REQUIREMENTS
ASSURANCES OF COMPLIANCE WITH
TITLE VI OF THE CIVIL RIGHTS ACT OF
1964
As a condition of receipt of federal financial assistance from the Department of the Treasury, the GRANTEE provides the assurances stated herein. The federal financial assistance may include federal grants, loans and Agreements to provide assistance to the GRANTEE's beneficiaries, the use or rent of Federal land or property at below market value, Federal training, a loan of Federal personnel, subsidies, and other arrangements with the intention of providing assistance. Federal financial assistance does not encompass Agreements of guarantee or insurance, regulated programs, licenses, procurement Agreements by the Federal government at market value, or programs that provide direct benefits.
The assurances apply to all federal financial assistance from or funds made available through the Department of the Treasury, including any assistance that the GRANTEE may request in the future.
The Civil Rights Restoration Act of 1987 provides that the provisions of the assurances apply to all of the operations of the GRANTEE's program(s) and activity(ies), so long as any portion of the GRANTEE's programs) or activity(ies) is federally assisted in the manner prescribed above.
1. GRANTEE ensures its current and future compliance with Title VI of the Civil Rights Act of 1964, as amended, which prohibits exclusion from participation, denial of the benefits of, or subjection to discrimination under programs and activities receiving federal financial assistance, of any person in the United States on the ground of race, color, or national origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury Title VI regulations at 31 CFR Part 22 and other pertinent executive orders such as Executive Order 13166, directives, circulars, policies, memoranda, and/or guidance documents.
2. GRANTEE acknowledges that Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency," seeks to improve access to federally assisted programs and activities for individuals who, because of national origin, have Limited English proficiency (LEP). GRANTEE understands that denying a person access to its programs, services, and activities because of LEP is a form of national origin discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the Department of the Treasury's implementing regulations. Accordingly, GRANTEE shall initiate reasonable steps, or comply with the Department of the Treasury's directives, to ensure that LEP persons have meaningful access to its programs, services, and activities.
GRANTEE understands and agrees that meaningful access may entail providing language assistance services, including oral interpretation and written translation where necessary, to ensure effective communication in the GRANTEE's programs, services, and activities.
3. GRANTEE agrees to consider the need for language services for LEP persons when GRANTEE develops applicable budgets and conducts programs, services, and activities. 32 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF As a resource, the Department of the Treasury has published its LEP guidance at 70 FR 6067. For more information on taking reasonable steps to provide meaningful access for LEP persons, please visit http://www.lep.gov.
4. GRANTEE acknowledges and agrees that compliance with the assurances constitutes a condition of continued receipt of federal financial assistance and is binding upon GRANTEE and GRANTEE's successors, transferees, and assignees for the period in which such assistance is provided.
5. GRANTEE acknowledges and agrees that it must require any sub-grantees, contractors, subcontractors, successors, transferees, and assignees to comply with assurances 1-4 above, and agrees to incorporate the following language in every Agreement or agreement subject to Title VI and its regulations between the GRANTEE and the GRANTEE's sub-grantees, Contractors, Subcontractors, successors, transferees, and assignees:
The sub-grantee, Contractor, Subcontractor, successor, transferee, and assignee shall comply with Title VI of the Civil Rights Act of 1964, which prohibits GRANTEEs of federal financial assistance from excluding from a program or activity, denying benefits of. or otherwise discriminating against a person on the basis of race, color, or national origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury's Title VI regulations, 3/ CFR Part 22, which are herein incorporated by reference and made a part of this Agreement (or agreement). Title VI also includes protection to persons with "Limited English Proficiency" in any program or activity receiving federal financial assistance, 42
U.S.C. § 2000d et seg., as implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22, and herein incorporated by reference and made a part of this Agreement or agreement.
6. GRANTEE understands and agrees that if any real property or structure is provided or improved with the aid of federal financial assistance by the Department of the Treasury, this assurance obligates the GRANTEE, or in the case of a subsequent transfer, the transferee, for the period during which the real property or structure is used for a purpose for which the federal financial assistance is extended or for another purpose involving the provision of similar services or benefits. If any personal property is provided, this assurance obligates the GRANTEE for the period during which it retains ownership or possession of the property.
7. GRANTEE shall cooperate in any enforcement or compliance review activities by the Department of the Treasury of the aforementioned obligations. Enforcement may include investigation, arbitration, mediation, litigation, and monitoring of any settlement agreements that may result from these actions. The GRANTEE shall comply with information requests, on-site compliance reviews and reporting requirements.
8. GRANTEE shall maintain a complaint log and inform the Department of the Treasury of any complaints of discrimination on the grounds of race, color, or national origin, and limited English proficiency covered by Title VI of the Civil Rights Act of 1964 and implementing regulations and provide, upon request, a list of all such reviews or proceedings based on the 33 ARPA Subrecipient
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF complaint, pending or completed, including outcome. GRANTEE also must inform the Department of the Treasury if GRANTEE has received no complaints under Title VI.
9. GRANTEE must provide documentation of an administrative agency's or court's findings of non- compliance of Title VI and efforts to address the non-compliance, including any voluntary compliance or other agreements between the GRANTEE and the administrative agency that made the finding. If the GRANTEE settles a case or matter alleging such discrimination, the GRANTEE must provide documentation of the settlement. If GRANTEE has not been the subject of any court or administrative agency finding of discrimination, please so state.
10. If the GRANTEE makes sub-awards to other agencies or other entities, the GRANTEE is responsible for ensuring that sub-grantees also comply with Title VI and other applicable authorities covered in this document State agencies that make sub-awards must have in place standard grant assurances and review procedures to demonstrate that that they are effectively monitoring the civil rights compliance of sub- GRANTEEs.
The United States of America has the right to seck judicial enforcement of the terms of this assurances document and nothing in this document alters or limits the federal enforcement measures that the United States may take in order to address violations of this document or applicable federal law.
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF
EXHIBIT D
SUBRECIPIENT DISCLOSURES PER 2 CFR SECTION 200.331
Fiscal Year: 2022-2023
Agency Name: U.S Department of Treasury
Program Name: City of Alameda Guaranteed Income Pilot Program Amount of Grant: $309,940
CFDA Number No. 21.027
Coronavirus State and Local Fiscal Recovery
CFDA Title Fund
Name of Federal Agency U.S. Department of Treasury
Unique Entity Identifier/UEI C9S1NLQ67626
Subrecipient Name Abt Associates
Federal Award Date (Date of award to City by March 11, 2021 Treasury)
Federal Award Identification Number SLT-7032
Subaward Period of Performance Start and
End Date 2022 to May 30, 2026
Federal Funds Obligated by this Agreement $309,940
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Certification of Compliance
With the City of Alameda's Vaccination Requirement
The City of Alameda ("City") requires all individuals who perform work for the City to be fully vaccinated' against COVID-19. All service providers and contractors for the City must sign the following statement certifying compliance with this requirement.
By signing below, I certify that all of our personnel who are performing work for the City are fully vaccinated against COVID-19. 1 also acknowledge that the City reserves the right to review any relevant records to demonstrate our compliance with this requirement.
I declare under penalty of perjury that the foregoing is true and correct.
Abt Associates 11/30/22
Date:
Meryl Finkel (signed digitally)
By: Meryl Finkel, Ph.D.
Its Account Lead: Housing and Communities
" For the purposes of this Certification of Compliance, an individual is considered to be fully vaccinated if two wecks have passed since their second dose in a 2-dose series (such as the Pfizer or Moderna vaccines) or if two weeks have passed since receiving their single-dose vaccine (such as Johnson & Johnson's Janssen vaccine). 2 DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Page 1 of 1
DATE (MM/DD/YYYY)
ACORD CERTIFICATE OF LIABILITY INSURANCE
10/17/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements).
COME Wi111s Towers Watson Certificate Center
Willis Towers Watson Northeast, Inc.
(AiC. No. Exty: 1-877-945-7378 (AIG. No): 1-888-467-2378 c/o 26 Century Blvd E-MAIL
P.O. Box 305191 ADDRESS: [email protected]
Nashville, TN 372305191 USA INSURER(S) AFFORDING COVERAGE NAIC I INSURERA: Hartford Underwriters Insurance Company 30104 INSURED INSURER B: Hartford Casualty Insurance Company 29424 Abt Associates Inc.
10 Faucett St. INSURER C: Iwin City Fire Insurance Company 29459 Cambridge, MA 02138 INSURER D: ACE American Insurance Company 22667 INSURER E :
INSURER F:
COVERAGES CERTIFICATE NUMBER: W26310593 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR ADDL SUBR POLICY EFF POLICY EXP
LIR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 1,000,000
PREMISES (Ea occurrence)
A MED EXP (Any one persan) $ 10,000
08 DEN BA5241 12/31/2021 12/31/2022 PERSONAL & ADV INJURY 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 PRO × Loc 2,000,000
POLICY PRODUCTS - COMP/OP AGG
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) 1,000,000
ANY AUTO. BODILY INJURY (Per person) $
OWNED SCHEDULED 08 UEN BA5239 12/31/2021 12/31/2022 BODILY INJURY (Per accident)
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
X
AUTOS ONLY AUTOS ONLY (Per accident)
UMBRELLA LIAB X OCCUR EACH OCCURRENCE 2,000,000
EXCESS LIAB CLAIMS-MADE 08 RHU BA6260 12/31/2021 12/31/2022 AGGREGATE 2,000,000 DED X RETENTIONS 10,000
WORKERS COMPENSATION PER OTH-
STATUTE ER
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR PARTNER/EXECUTIVE E.L. EACH ACCIDENT 1,000,000 OFFICER/MEMBEREXCLUDED? NIA 08 WB CT5395 12/31/2021 12/31/2022 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 1,000,000 yes. deschbe Lind
ESCRIPTION OF OPERATIONS belc E.L. DISEASE - POLICY LIMIT 3 1,000,000 Professional Liability D95694731 016 12/31/2021 12/31/2022 Bach Claim $2,000,000 Aggregate $2,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder ia included as an Additional Traured aR respects to General lability and Auto Liability
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
City of Alameda
Attn: Risk Manager
AUTHORIZED REPRESENTATIVE
community Development Departmen
50 west Mall square 2nd F100 gulumloves
Alameda, CA 94501
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 3R ID: 23203465 BATCH: 2706397
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Broker Notation: Policy #08 UEN BA5241
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional If notice is mailed, proof of mailing to the last known Conditions: mailing address of the certificate holders) on file with A. If this policy is cancelled by the Company, other the agent of record or the Company will be sufficient than for nonpayment of premium, notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holders) who were to the certificate holders) with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company. policy's term.
B. If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium, or by the insured, notice holder(s) will not amend or extend the date the of such cancellation will be provided within (10) cancellation becomes effective, nor will it negate days of the cancellation effective date to cancellation of the policy. Failure to send notice shall certificate holder(s) with mailing addresses on file impose no liability of any kind upon the Company or its with the agent of record or the Company. agents or representatives.
Form IH 03 13 06 11 Page 1 of 1
© 2011, The Hartford
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Broker Notation; Policy # 08 UEN BA5239
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional If notice is mailed, proof of mailing to the last known Conditions: mailing address of the certificate holders) on file with A. If this policy is cancelled by the Company, other the agent of record or the Company will be sufficient than for nonpayment of premium, notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holders) who were to the certificate holders) with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company. policy's term.
B. If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium, or by the insured, notice holder(s) will not amend or extend the date the of such cancellation will be provided within (10) cancellation becomes effective, nor will it negate days of the cancellation effective date to cancellation of the policy. Failure to send notice shall certificate holder(s) with mailing addresses on file impose no liability of any kind upon the Company or its with the agent of record or the Company. agents or representatives.
Form IH 03 13 06 11 Page 1 of 1
© 2011, The Hartford
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF W-9 Request for Taxpayer Give Form to the
Form
(Rev. October 2018) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS.
Internal Revenue Service • Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Name is required on this line: do not leave this line blank.
Abt Associates Inc.
2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the 4 Exemptions (codes apply only to following seven boxes. certain entities, not individuals: see instructions on page 3):
Individual/sole proprietor or C Corporation • s Corporation Partnership • Trust/estate single-member LLC Exempt payee code (if any)
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) • Print or type. See Specific Instructions on page 3. Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code (if any)
another LLC that is not disregarded from the owner for U,S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Other (see instructions) • (Apples to accounts maintained calside the U.S./ 5 Address (number, street, and apt, or suite no.) See instructions. Requester's name and address (optional) 6130 Executive Blvd.
6 City, state, and ZIP code
Rockville, MD 20852
7 List account numbers) here (optional)
Part 1 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 (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. 0 4 2 3 4 7 6 4 3
Part II 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. I am not subject to backup withholding because: (a) 1 am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subjeot 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. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATA code(s) entered on this form (if any) indicating that I am exempt from FATA 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 for Part Il, later.
Sign Digitally signed by Melissa B.
Signature of Melissa B. Ashcraft
Here U.S. person • Date: 2022.07.06 18:13:44 Date •
Ashcraft 04:00
General Instructions • Form 1099-DIV (dividends, including those from stocks or mutual funds)
Section references are to the Internal Revenue Code unless otherwise • Form 1099-MISC (various types of income, prizes, awards, or gross noted. proceeds)
Future developments. For the latest information about developments • Form 1099-B (stock or mutual fund sales and certain other related to Form W-9 and its instructions, such as legislation enacted transactions by brokers)
after they were published, go to www.irs.gov/FormW9.
• Form 1099-S (proceeds from real estate transactions)
Purpose of Form • Form 1099-K (merchant card and third party network transactions) An individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest), 1098-E (student loan interest). information return with the IRS must obtain your correct taxpayer 1098-T (tuition) identification number (TIN) which may be your social security number • Form 1099-C (canceled debt) (SSN), individual taxpayer identification number (ITIN), adoption • Form 1099-A (acquisition or abandonment of secured property) taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other Use Form W-9 only if you are a U.S. person (including a resident amount reportable on an information return. Examples of information alien), to provide your correct TIN. returns include, but are not limited to, the following. If you do not return Form W-9 to the requester with a TIN, you might • Form 1099-INT (interest earned or paid) be subject to backup withholding. See What is backup withholding. later.
Cat, No. 10231X Form W-9 (Rev. 10-2018)
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Form W-9 (Rev. 10-2018) Page 2
By signing the filled-out form, you: Example. Article 20 of the U.S.-China income tax treaty allows an
1. Certify that the TIN you are giving is correct (or you are waiting for a exemption from tax for scholarship income received by a Chinese number to be issued), student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in
2. Certify that you are not subject to backup withholding, or the United States exceeds 5 calendar years. However, paragraph 2 of
3. Claim exemption from backup withholding if you are a U.S. exempt the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows payee. If applicable, you are also certifying that as a U.S. person, your the provisions of Article 20 to continue to apply even after the Chinese allocable share of any partnership income from a U.S. trade or business student becomes a resident alien of the United States. A Chinese is not subject to the withholding tax on foreign partners' share of student who qualifies for this exception (under paragraph 2 of the first effectively connected income, and protocol) and is relying on this exception to claim an exemption from tax
4. Certify that FATCA code(s) entered on this form (if any) indicating on his or her scholarship or fellowship income would attach to Form that you are exempt from the FATA reporting, is correct. See What is W-9 a statement that includes the information described above to FATCA reporting, later, for further information. support that exemption.
Note: If you are a U.S. person and a requester gives you a form other If you are a nonresident alien or a foreign entity, give the requester the than Form W-9 to request your TIN, you must use the requester's form if appropriate completed Form W-8 or Form 8233. it is substantially similar to this Form W-9.
Backup Withholding
Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such • An individual who is a U.S. citizen or U.S. resident alien:
payments. This is called "backup withholding." Payments that may be • A partnership, corporation, company, or association created or subject to backup withholding include interest, tax-exempt interest. organized in the United States or under the laws of the United States; dividends, broker and barter exchange transactions, rents, royalties, • An estate (other than a foreign estate); or nonemployee pay. payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat • A domestic trust (as defined in Regulations section 301.7701-7). operators. Real estate transactions are not subject to backup Special rules for partnerships. Partnerships that conduct a trade or withholding business in the United States are generally required to pay a withholding You will not be subject to backup withholding on payments you tax under section 1446 on any foreign partners' share of effectively receive if you give the requester your correct TIN, make the proper connected taxable income from such business. Further, in certain cases certifications, and report all your taxable interest and dividends on your where a Form W-9 has not been received, the rules under section 1446 tax return. require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person Payments you receive will be subject to backup withholding if:
that is a partner in a partnership conducting a trade or business in the 1. You do not furnish your TIN to the requester, United States, provide Form W-9 to the partnership to establish your
2. You do not certify your TIN when required (see the instructions for U.S. status and avoid section 1446 withholding on your share of Part Il for details).
3. The IRS tells the requester that you furnished an incorrect TIN, In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding 4. The IRS tells you that you are subject to backup withholding withholding on its allocable share of net income from the partnership because you did not report all your interest and dividends on your tax conducting a trade or business in the United States. return (for reportable interest and dividends only), or • In the case of a disregarded entity with a U.S. owner, the U.S. owner 5. You do not certify to the requester that you are not subject to of the disregarded entity and not the entity; backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and Certain payees and payments are exempt from backup withholding. not the trust; and See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information.
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Also see Special rules for partnerships, earlier.
Foreign person. If you are a foreign person or the U.S. branch of a What is FATCA Reporting? foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see The Foreign Account Tax Compliance Act (FATCA) requires a Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign participating foreign financial institution to report all United States Entities). account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce reporting code, later, and the Instructions for the Requester of Form W-9 for more information.
or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions Updating Your Information specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise You must provide updated information to any person to whom you become a U.S. resident alien for tax purposes. claimed to be an exempt payee if you are no longer an exempt payee If you are a U.S. resident alien who is relying on an exception and anticipate receiving reportable payments in the future from this contained in the saving clause of a tax treaty to claim an exemption person. For example, you may need to provide updated information if from U.S. tax on certain types of income, you must attach a statement you are a C corporation that elects to be an S corporation, or if you no to Form W-9 that specifies the following five items. longer are tax exempt. In addition, you must furnish a new Form W-9 if
1. The treaty country, Generally, this must be the same treaty under the name or TIN changes for the account; for example, if the grantor of a which you claimed exemption from tax as a nonresident alien. grantor trust dies.
2. The treaty article addressing the income.
Penalties
3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. Failure to furnish TIN. If you fail to furnish your correct TIN to a
4. The type and amount of income that qualifies for the exemption requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.
5. Sufficient facts to justify the exemption from tax under the terms of Civil penalty for false information with respect to withholding. If you the treaty article. make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Form W-9 (Rev. 10-2018) Page 3
Criminal penalty for falsifying information. Willfully falsifying IF the entity/person on line 1 is THEN check the box for ... certifications or affirmations may subject you to criminal penalties a(n) ... including fines and/or imprisonment.
Misuse of TiNs. If the requester discloses or uses TINs in violation of • Corporation Corporation federal law, the requester may be subject to civil and criminal penalties. • Individual Individual/sole proprietor or single- • Sole proprietorship, or member LLC
Specific Instructions • Single-member limited liability company (LLC) owned by an
Line 1 individual and disregarded for U.S.
You must enter one of the following on this line; do not leave this line federal tax purposes. blank. The name should match the name on your tax return. • LLC treated as a partnership for Limited liability company and enter If this Form W-9 is for a joint account (other than an account U.S. federal tax purposes, the appropriate tax classification. maintained by a foreign financial institution (FFi)), list first, and then • LLC that has filed Form 8832 or | (P= Partnership; C= C corporation; circle, the name of the person or entity whose number you entered in 2553 to be taxed as a corporation, or S= S corporation) Part I of Form W-9. If you are providing Form W-9 to an FFi to document a joint account, each holder of the account that is a U.S. person must • LLC that is disregarded as an
entity separate from its owner but
a. Individual. Generally, enter the name shown on your tax return. If the owner is another LLC that Is you have changed your last name without informing the Social Security not disregarded for U.S. federal tax Administration (SSA) of the name change, enter your first name, the last purposes. name as shown on your social security card, and your new last name.
Note: ITIN applicant: Enter your individual name as it was entered on • Partnership Partnership your Form W-7 application, line 1a. This should also be the same as the • Trust/estate Trust/estate name you entered on the Form 1040/1040A/1040EZ you filed with your application. Line 4, Exemptions
b. Sole proprietor or single-member LLC. Enter your individual If you are exempt from backup withholding and/or FATCA reporting, name as shown on your 1040/1040A/1040EZ on line 1. You may enter enter in the appropriate space on line 4 any code(s) that may apply to your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single-member LLC, C Exempt payee code. corporation, or S corporation. Enter the entity's name as shown on the • Generally, individuals (including sole proprietors) are not exempt from entity's tax return on line 1 and any business, trade, or DBA name on backup withholding. • Except as provided below, corporations are exempt from backup d. Other entities. Enter your name as shown on required U.S. federal withholding for certain payments, including interest and dividends. tax documents on line 1. This name should match the name shown on the • Corporations are not exempt from backup withholding for payments charter or other legal document creating the entity. You may enter any made in settlement of payment card or third party network transactions. business, trade, or DBA name on line 2
• Corporations are not exempt from backup withholding with respect to e. Disregarded entity. For U.S. federal tax purposes, an entity that is attorneys' fees or gross proceeds paid to attorneys, and corporations disregarded as an entity separate from its owner is treated as a that provide medical or health care services are not exempt with respect "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter to payments reportable on Form 1099-MISC. the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the The following codes identify payees that are exempt from backup name shown on the income tax retum on which the income should be withholding. Enter the appropriate code in the space in line 4. reported. For example, if a foreign LL that is treated as a disregarded 1-An organization exempt from tax under section 501(a), any IRA, or entity for U.S. federal tax purposes has a single owner that is a U.S. a custodial account under section 403(b)(7) if the account satisfies the person, the U.S. owner's name is required to be provided on line 1. If requirements of section 401(f)(2) the direct owner of the entity is also a disregarded entity, enter the first 2-The United States or any of its agencies or instrumentalities owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity 3-A state, the District of Columbia, a U.S. commonwealth or name." If the owner of the disregarded entity is a foreign person, the possession, or any of their political subdivisions or instrumentalities owner must complete an appropriate Form W-8 instead of a Form W-9. 4-A foreign government or any of its political subdivisions, agencies, This is the case even if the foreign person has a U.S. TIN. or instrumentalities Line 2 5-A corporation
6-A dealer in securities or commodities required to register in the If you have a business name, trade name, DA name, or disregarded United States, the District of Columbia, or a U.S. commonwealth or entity name, you may enter it on line 2.
possession
Line 3 7-A futures commission merchant registered with the Commodity Check the appropriate box on line 3 for the U.S. federal tax Futures Trading Commission classification of the person whose name is entered on line 1. Check only 8-A real estate investment trust one box on line 3. 9-An entity registered at all times during the tax year under the Investment Company Act of 1940
10—A common trust fund operated by a bank under section 584(a) 11 - A financial institution
12-A middleman known in the investment community as a nominee or custodian
13-A trust exempt from tax under section 664 or described in section 4947
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Form W-9 (Rev. 10-2018) Page 4
The following chart shows types of payments that may be exempt M-A tax exempt trust under a section 403(b) plan or section 457(g) from backup withholding. The chart applies to the exempt payees listed plan above, 1 through 13. Note: You may wish to consult with the financial institution requesting IF the payment is for... THEN the payment is exempt this form to determine whether the FATA code and/or exempt payee for... code should be completed.
Interest and dividend payments All exempt payees except Line 5 for 7
Enter your address (number, street, and apartment or suite number).
Broker transactions Exempt payees 1 through 4 and 6 This is where the requester of this Form W-9 will mail your information through 11 and all C corporations. returns. If this address differs from the one the requester already has on S corporations must not enter an file, write NEW at the top. If a new address is provided, there is still a exempt payee code because they chance the old address will be used until the payor changes your are exempt only for sales of address in their records.
noncovered securities acquired Line 6
prior to 2012.
Enter your city, state, and ZIP code.
Barter exchange transactions and Exempt payees 1 through 4 patronage dividends Part I. Taxpayer Identification Number (TIN) Payments over $600 required to be Generally, exempt payees Enter your TIN in the appropriate box. If you are a resident alien and reported and direct sales over 1 through 5° you do not have and are not eligible to get an SSN, your TIN is your IRS $5,000' individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN Payments made in settlement of Exempt payees 1 through 4 payment card or third party network If you are a sole proprietor and you have an EIN, you may enter either transactions
your SSN or EIN.
' See Form 1099-MISC, Miscellaneous Income, and its instructions. If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner's SSN (or EIN, if the owner has Reportable on Form 1095-MiC are not exempt from backup one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN.
withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and Note: See What Name and Number To Give the Requester, later, for payments for services paid by a federal executive agency. further clarification of name and TIN combinations.
Exemption from FATA reporting code. The following codes identify How to get a TIN. If you do not have a TIN, apply for one immediately. payees that are exempt from reporting under FATA. These codes To apply for an SSN, get Form SS-5, Application for a Social Security apply to persons submitting this form for accounts maintained outside. Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213. of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United Use Form W-7, Application for IRS Individual Taxpayer Identification States, you may leave this field blank. Consult with the person Number, to apply for an ITIN, or Form SS-4, Application for Employer requesting this form if you are uncertain if the financial institution is Identification Number, to apply for an EIN. You can apply for an EIN subject to these requirements. A requester may indicate that a code is online by accessing the IRS website at www.irs.gov/Businesses and not required by providing you with a Form W-9 with "Not Applicable" (or clicking on Employer Identification Number (EIN) under Starting a any similar indication) written or printed on the line for a FATCA Business. Go to www.irs.goviForms to view, download, or print Form exemption code. W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 A-An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) If you are asked to complete Form W-9 but do not have a TIN, apply B- The United States or any of its agencies or instrumentalities for a TIN and write "Applied For" in the space for the TIN, sign and date C-A state, the District of Columbia, a U.S. commonwealth or the form, and give it to the requester. For interest and dividend possession, or any of their political subdivisions or instrumentalities payments, and certain payments made with respect to readily tradable D-A corporation the stock of which is regularly traded on one or instruments, generally you will have 60 days to get a TIN and give it to more established securities markets, as described in Regulations the requester before you are subject to backup withholding on section 1.1472-1(c)(1)i) payments. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until E-A corporation that is a member of the same expanded affiliated you provide your TIN to the requester. group as a corporation described in Regulations section 1.1472-1(c)(1)i) Note: Entering "Applied For" means that you have already applied for a F-A dealer in securities, commodities, or derivative financial TIN or that you intend to apply for one soon. instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8.
G-A real estate investment trust Part II. Certification H-A regulated investment company as defined in section 851 or an To establish to the withholding agent that you are a U.S. person, or entity registered at all times during the tax year under the Investment resident alien, sign Form W-9. You may be requested to sign by the Company Act of 1940 withholding agent even if item 1, 4, or 5 below indicates otherwise. 1-A common trust fund as defined in section 584(a) For a joint account, only the person whose TIN is shown in Part I J-A bank as defined in section 581 should sign (when required). In the case of a disregarded entity, the K-A broker person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier.
L-A trust exempt from tax under section 664 or described in section 4947(a)(1) Signature requirements. Complete the certification as indicated in items 1 through 5 below.
DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Form W-9 (Rev. 10-2018) Page 5
1. Interest, dividend, and barter exchange accounts opened For this type of account: Give name and EIN of:
before 1984 and broker accounts considered active during 1983.
14. Account with the Department of The public entity
You must give your correct TIN, but you do not have to sign the Agriculture in the name of a public
certification.
entity (such as a state or local
2. Interest, dividend, broker, and barter exchange accounts government, school district, or opened after 1983 and broker accounts considered inactive during prison) that receives agricultural 1983. You must sign the certification or backup withholding will apply. If program payments
you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the 15. Grantor trust filing under the Form The trust certification before signing the form. 1041 Filing Method or the Optional
3. Real estate transactions. You must sign the certification. You may Form 1099 Filing Method 2 (see cross out item 2 of the certification. Regulations section 1.671-4(b)(2)0)(B))
4. Other payments. You must give your correct TIN, but you do not * List first and circle the name of the person whose number you furnish. have to sign the certification unless you have been notified that you If only one person on a joint account has an SSN, that person's number have previously given an incorrect TIN. "Other payments" include must be fumished. payments made in the course of the requester's trade or business for 2 Circle the minor's name and furnish the minor's SSN. rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to 3 You must show your individual name and you may also enter your a nonemployee for services, payments made in settlement of payment business or DBA name on the "Business name/disregarded entity" card and third party network transactions, payments to certain fishing name line. You may use either your SSN or EIN (if you have one), but the boat crew members and fishermen, and gross proceeds paid to IRS encourages you to use your SSN attorneys (including payments to corporations). * List first and circle the name of the trust, estate, or pension trust. (Do
5. Mortgage interest paid by you, acquisition or abandonment of not furnish the TIN of the personal representative or trustee unless the secured property, cancellation of debt, qualified tuition program legal entity itself is not designated in the account title.) Also see Special payments (under section 529), ABLE accounts (under section 529A), rules for partnerships, earlier.
IRA, Coverdell ESA, Archer MSA or HSA contributions or *Note: The grantor also must provide a Form W-9 to trustee of trust. distributions, and pension distributions. You must give your correct Note: If no name is circled when more than one name is listed, the TIN, but you do not have to sign the certification. number will be considered to be that of the first name listed.
What Name and Number To Give the Requester Secure Your Tax Records From Identity Theft For this type of account: Give name and SSN of:
Identity theft occurs when someone uses your personal information
1. Individual The individual such as your name, SSN, or other identifying information, without your
2. Two or more individuals joint The actual owner of the account or, if permission, to commit fraud or other crimes. An identity thief may use account) other than an account combined funds, the first individual on your SSN to get a job or may file a tax retum using your SSN to receive maintained by an FFI the account'
3. Two or more U.S. persons Each holder of the account To reduce your risk:
(joint account maintained by an FFI) • Protect your SSN,
4. Custodial account of a minor The minor? • Ensure your employer is protecting your SSN, and (Uniform Gift to Minors Act) • Be careful when choosing a tax preparer.
5. a. The usual revocable savings trust The grantor-trustee' If your tax records are affected by identity theft and you receive a (grantor is also trustee)
The actual owner' notice from the IRS, respond right away to the name and phone number b. So-called trust account that is not
printed on the IRS notice or letter.
a legal or valid trust under state law
If your tax records are not currently affected by identity theft but you
6. Sole proprietorship or disregarded The owner? think you are at risk due to a lost or stolen purse or wallet, questionable entity owned by an individual credit card activity or credit report, contact the IRS Identity Theft Hotline
7. Grantor trust filing under Optional The grantor® at 1-800-908-4490 or submit Form 14039.
Form 1099 Filing Method 1 (see For more information, see Pub. 5027, Identity Theft Information for Regulations section 1.671-4(b)(2Ni) Taxpayers.
(A)) Victims of identity theft who are experiencing economic harm or a For this type of account: Give name and EIN of: systemic problem, or are seeking help in resolving tax problems that
8. Disregarded entity not owned by an The owner have not been resolved through normal channels, may be eligible for individual Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
9. A valid trust, estate, or pension trust Legal entiy calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.
10. Corporation or LLC electing The corporation Protect yourself from suspicious emails or phishing schemes. corporate status on Form 8832 or Phishing is the creation and use of email and websites designed to Form 2553 mimic legitimate business emails and websites. The most common act
11. Association, club, religious, The organization is sending an email to a user falsely claiming to be an established charitable, educational, or other tax- legitimate enterprise in an attempt to scam the user into surrendering exempt organization private information that will be used for identity theft.
12. Partnership or multi-member LLC The partnership
13. A broker or registered nominee The broker or nominee DocuSign Envelope ID: 668B80E1-1FBF-4FA4-BEF8-B9DE62EFF6CF Form W-9 (Rev. 10-2018) Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the Privacy Act Notice IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access Section 6109 of the Internal Revenue Code requires you to provide your information for their credit card, bank, or other financial accounts. correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or If you receive an unsolicited email claiming to be from the IRS, certain other income paid to you; mortgage interest you paid; the forward this message to [email protected]. You may also report misuse acquisition or abandonment of secured property; the cancellation of of the IRS name, logo, or other IRS property to the Treasury Inspector debt; or contributions you made to an IRA, Archer MSA, or HSA. The General for Tax Administration (TIGTA) at 1-800-366-4484. You can person collecting this form uses the information on the form to file forward suspicious emails to the Federal Trade Commission at information returns with the IRS, reporting the above information. [email protected] or report them at www.ftc.gov/complaint. You can Routine uses of this information include giving it to the Department of contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).
Justice for civil and criminal litigation and to cities, states, the District of If you have been the victim of identity theft, see www.ldentityTheft.gov Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other Visit www.irs.gov/IdentityTheft to learn more about identity theft and countries under a treaty, to federal and state agencies to enforce civil how to reduce your risk. and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent