MOU WITH BOARD OF SUPERVISORS-WORKFORCE DEVELOPMENT BOARD-WIOA PARTNERS.PDF

Maricopa County — Formal (2017-06-21)

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MEMORANDUM OF UNDERSTANDING
BETWEEN
MARICOPA COUNTY WORKFORCE DEVELOPMENT BOARD
AND
WORKFORCE INNOVATION & OPPORTUNITY ACT PARTNERS
Contract #: C-22-17-066-3-00
MOU Start Date: _________________
MOU Termination Date: ________________
This Memorandum of Understanding (MOU) is entered into between the Maricopa
County Board of Supervisors (“Board”); the Maricopa County Local Workforce
Development Board (Local WDB), and its Workforce Innovation & Opportunity Act
Partners (or “Partners” as defined herein and as are listed more specifically in Attachment
A hereto)(collectively referred to as the “Parties,” and individually as “Party”).
1.0. PURPOSE
This MOU is developed to confirm the understanding of the Parties regarding the
operation and management of the One Stop Centers in the Maricopa County Local
Workforce Development Area (Local WDA). The Maricopa County Local WDB
provides local oversight of workforce programming for the Maricopa County Local
WDA. The purpose of this MOU is to define the parameters within which education,
workforce, economic development, and other Partner programs and entities operating in
the Maricopa County Local WDA create a seamless, customer-focused Maricopa County
One Stop Center network that aligns service delivery across the board and enhances
access to program services. By realizing one-stop opportunities together, Partners are
able to build community-benefiting bridges, rather than silos of programmatic isolation.
These partnerships will reduce administrative burden and costs and increase customer
access and performance outcomes.
2.0. AUTHORITY
The Workforce Innovation and Opportunity Act (WIOA) sec. 121(c)(1) requires the
Local Board, with the agreement of the Chief Elected Official (CEO), to develop and
enter into a Memorandum of Understanding (MOU) between the Local Board and the
One-Stop Partners, consistent with WIOA Sec. 121(c)(2), concerning the operation of the
one-stop delivery system in a local area. This requirement is further described in the
Workforce Innovation and Opportunity Act; Joint Rule for Unified and Combined State
Plans, Performance Accountability, and the One-Stop System Joint Provisions: Final
Rule at 20 CFR 678.500, 34 CFR 361.500, and 34 CFR 463.500, and in Federal
guidance. Additionally, the sharing and allocation of infrastructure costs among one-stop
partners is governed by WIOA sec. 121(h), its implementing regulations, and the Federal

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Cost Principles contained in the Uniform Administrative Requirements, Cost Principles,
and Audit Requirements for Federal Awards (Uniform Guidance) at 2 CFR part 200.
3.0. DEFINITIONS
3.1. Additional One-Stop Partners means other participant authorized by the WDB
and Board which provide employment and training programs administered by the
Social Security Administration, including the Ticket to Work and Self-Sufficiency
Program established under sec. 1148 of the Social Security Act (42 U.S.C.
1320b–19), employment and training programs carried out by the Small Business
Administration, Supplemental Nutrition Assistance Program (SNAP) employment
and training programs, authorized under secs. 6(d)(4) and 6(o) of the Food and
Nutrition Act of 2008 (7 U.S.C. 2015(d)(4) and 2015(o)), Client Assistance
Program authorized under sec. 112 of the Rehabilitation Act of 1973 (29 U.S.C.
732), programs authorized under the National and Community Service Act of
1990 (42 U.S.C. 12501 et seq.), and other appropriate Federal, State, or local
programs, including employment, education, and training programs provided by
public libraries or in the private sector, programs providing transportation
assistance, and programs providing services to individuals with substance abuse
or mental health issues.
3.2. Arizona@ Work is the brand of the State and Local workforce development
system.
3.3. Chief Executive Official means the Maricopa County Board of Supervisors, the
chief elected executive officers of Maricopa County Workforce Development
Area.
3.4. Executive Council means the Chair, Vice Chair, Second Vice Chair and
Immediate Past Chair of the Local WDB.
3.5. FERPA means the Family Educational Rights and Privacy Act and regulations at
34 CFR 99.33 regarding the protection of educational data.
3.6. Local WDB means MCWDB, the entity accountable for oversight of the
following: youth workforce development activities authorized under WIOA
section 129(c); adult and dislocated worker employment and training activities
under WIOA sections 134(c) and (d); employer engagement; and the One-Stop
delivery system in Maricopa County.
3.7. Local Workforce Development Area or Maricopa County Workforce
Development Area means the geographic area including Maricopa County,
Arizona.
3.8. One-Stop Delivery System means the workforce development, educational, and
other human resource services joined in a seamless customer-focused service
delivery network that enhances access to the programs’ services and improves
long-term employment outcomes for individuals receiving assistance. One-stop
Partners administer separately funded programs as a set of integrated streamlined
services to customers.
3.9. One Stop Centers means the Job Centers located at:
3.9.1. 735 N. Gilbert Road, Gilbert, AZ 85234
3.9.2. 1840 N. 95th Avenue Ste. 160, Phoenix, AZ 85037; and
3.9.3. Any additional service delivery sites listed on Attachment B.
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3.10. Personally Identifiable Information or PII means information that can be used
to distinguish or trace an individual’s identify, either alone or when combined
with other personal or identifying information that is linked or linkable to a
specific individual
3.11. Vocational Rehabilitation or VR means the program authorized under title I of
the Rehabilitation Act of 1973 (29 U.S.C.720 et seq.), as amended by WIOA title
IV;
3.12. Required One-Stop Partners includes, but is not limited to the following
programs under the Department of Labor; the Department of Education; the
Department of Housing and Urban Development and the Department of Health
and Human Services:
3.12.1. Department of Labor
3.12.1.1. WIOA title I programs: Adult, Dislocated Worker, and Youth
formula programs;
3.12.1.2. Job Corps;
3.12.1.3. Youth Build;
3.12.1.4. Native American programs;
3.12.1.5. Migrant Seasonal Farmworkers (MSFW) that includes the
National Farmworker Jobs Program (NFJP);
3.12.1.6. Wagner-Peyser Act Employment Service program authorized
under the Wagner-Peyser Act (29 U.S.C. 49 et seq.), as
amended by WIOA title III;
3.12.1.7. Senior Community Service Employment Program (SCSEP)
authorized under title V of the Older Americans Act of 1965;
3.12.1.8. Trade Adjustment Assistance (TAA) activities authorized under
chapter 2 of title II of the Trade Act of 1974;
3.12.1.9. Unemployment Compensation (UC) programs;
3.12.1.10. Jobs for Veterans State Grants (JVSG) programs authorized
under chapter 41of title 38, U.S.C.;
3.12.1.11. Reentry Employment Opportunities (REO) programs (formerly
known as Reintegration of Ex-Offenders Program (RExO))
authorized under sec. 212 of the Second Chance Act of 2007
(42U.S.C. 17532) and WIOA sec. 169;
3.12.1.12. The State Vocational Rehabilitation (VR) Services program
authorized under title I of the Rehabilitation Act of 1973 (29
U.S.C.720 et seq.), as amended by WIOA title IV;
3.12.2. Department of Education
3.12.2.1. Adult Education and Family Literacy Act (AEFLA) program,
authorized under WIOA title II;
3.12.2.2. Career and technical education programs at the postsecondary
level, authorized under the Carl D. Perkins Career and
Technical Education Act of 2006 (Perkins);
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3.12.2.3. The State Vocational Rehabilitation (VR) Services program
authorized under title I of the Rehabilitation Act of 1973 (29
U.S.C.720 et seq.), as amended by WIOA title IV;
3.12.3. Department of Housing and Urban Development
3.12.3.1. Employment and training programs;
3.12.4. Department of Health and Human Services
3.12.4.1. Employment and training activities carried out under the
Community Services Block Grant (CSBG) programs (42 U.S.C.
9901 et seq.); and
3.12.4.2. Temporary Assistance for Needy Families (TANF) program
authorized under part A of Title IV of the Social Security Act
(42 U.S.C. 601 et seq.), unless exempted by the Governor under
20 CFR 678.405(b).
3.13. Unemployment Insurance or “UI” means the Federal-State unemployment
compensation (UC) program, created by the Social Security Act (SSA) of 1935,
offers the first economic line of defense against the effects of unemployment.
3.14. Workforce Innovation & Opportunity Act Partners or Partners means:
3.14.1. Maricopa County Human Service Department an administrator of the Title
I.B Programs in the Local WDB;
3.14.2. Maricopa County Adult Education Providers who administer Title II
Programs;
3.14.3. Department of Economic Security which administers Title III Programs
under the Wagner-Peyser Act and Vocational Rehabilitation programs
under Title IV; and
3.14.4. Such other required or additional entities, as may become Partners to this
MOU, as service delivery is established in the Local Workforce Area and
at the discretion of the Local Board.
4.0. TERM
The term of this MOU is July 1, 2017 through June 30, 2020, unless terminated earlier as
described herein. This MOU will become effective upon execution of the parties. This
MOU will be reviewed once every three-years to ensure appropriate funding and delivery
services.
5.0. AMENDMENT
The Parties may amend this MOU by written agreement. Any signatory of this document
may submit a 120-days’ notice of intent to amend, modify or terminate this MOU except
as otherwise provided in paragraph 6.0. Such requests shall be submitted in writing to the
MCWDB Executive Director and is subject to the review and approval of the Partners.
6.0. TERMINATION
6.1. This MOU may be terminated if:
6.1.1. All parties mutually agree to terminate this MOU prior to the end date.
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6.1.2. Federal oversight agencies charged with the administration of WIOA are
unable to appropriate funds or if funds are not otherwise made available
for continued performance for any fiscal period of this MOU succeeding
the first fiscal period. Any party unable to perform pursuant to MOU due
to lack of funding shall notify the other Parties as soon as the party has
knowledge that funds may be unavailable for the continuation of activities
under this MOU.
6.1.3. WIOA is repealed or superseded by a subsequent federal law.
6.1.4. Local area designation is changed under WIOA.
6.1.5. A party breaches any provision of this MOU and such breach is not cured
within thirty (30) days after receiving written notice from the Local WDB
specifying such breach in reasonable detail. In such event, the non-
breaching party(s) shall have the right to terminate this MOU by giving
written notice thereof to the party in breach, upon which termination will
go into effect immediately.
6.2. In the event of termination for breach, the Parties to the MOU must convene
within thirty (30) days after the breach of the MOU to discuss the formation of the
successor MOU. At that time, allocated costs must be addressed
7.0. SHARED RESPONSIBILITIES
Partners shall:
7.1. At a minimum, the Partners will make available, as applicable to their programs, and
consistent with and coordinated via the One Stop Delivery System the services more
specifically identified in Attachment B. Additional services may be provided on a
case by case basis and with the approval of the Local WDB and the Chief Executive
Officials.
7.2. Participate as members of the ARIZONA@WORK Maricopa County Workforce
Development Board Workgroup which is composed of partner representatives and
meet on a regular basis to ensure compliance with the terms of the MOU.
7.3. Ensure Universal Access to One Stop Centers: All customers, including those with
barriers to employment, will have access to services at each One-Stop Center,
designed to provide information to make career and labor market decisions.
7.4. Comply with the One-Stop System Approach: All customers may explore work
readiness preparation, foundational education, and career development services,
while having access to information on a range of employment, training, and
occupational programs. Services will be made available through the One-Stop
Centers, WIOA Partner programs, or technology based services. Access to
technology will be further developed.
7.5. Respect the Individual Choice of Customers and Clients seeking assistance:
Customers will be provided with information and have access to career, skill,
employment, education, and training information to enhance employment
opportunities, based on individual needs, and build on the advice and coaching
provided by One-Stop Center staff and Partners.
7.6. Work to Strengthen Regional Workplace Skills and Economic Development: The
ARIZONA@WORK System, working in partnership with Economic Development
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entities, strengthens the regional area workplace skills and enhances the economic
development of the area.
7.7. Operate Effectively: All Customers will have access to an efficient and
comprehensive system that enhances the participation of employers and job seekers’
served through the system, and does not duplicate services.
7.8. Comply with:
7.8.1. Section 188 of the WIOA Nondiscrimination and Equal Opportunity
Regulations (29 CFR Part 38; Final Rule, published December 2, 2016),
7.8.2. Title VI of the Civil Rights Act of 1964 (Public Law 88-352),
7.8.3. Section 504 of the Rehabilitation Act of 1973, as amended,
7.8.4. The Americans with Disabilities Act of 1990 (Public Law 101-336),
7.8.5. The Jobs for Veterans Act (Public Law 107-288) pertaining to priority of
service in programs funded by the U.S. Department of Labor,
7.8.6. Training and Employment Guidance Letter (TEGL) 37-14, Update on
Complying with Nondiscrimination Requirements: Discrimination Based
on Gender Identity, Gender Expression and Sex Stereotyping are
Prohibited Forms of Sex Discrimination in the Workforce Development
System and other guidance related to implementing WIOA sec. 188,
7.8.7. The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. §
1232g; 34 CFR part 99),
7.8.8. Confidentiality requirements governing the protection and use of personal
information held by the VR agency (34 CFR 361.38),
7.8.9. The confidentiality requirements governing the use of confidential
information held by the State UI agency (20 CFR part 603),
7.8.10. all amendments to each, and
7.8.11. all requirements imposed by the regulations issued pursuant to these acts.
7.9. Collaborate and reasonably assist each other in the development of necessary
service delivery protocols for the services outlined in the Partner Services section
above,
7.10. Agree that the provisions contained herein are made subject to all applicable
federal and state laws, implementing regulations, and guidelines imposed on
either or all Parties relating to privacy rights of customers, maintenance of
records, and other confidential information relating to customers, and
7.11. Agree that all equipment and furniture purchased by any party for purposes
described herein shall remain the property of the purchaser after the termination
of this MOU.
7.12. The Local WDB, or its designated staff, officials from the State and Local
administrative entities, the U.S. Departments of Labor, Education, and Health and
Human Services have the authority to conduct fiscal and programmatic
monitoring to ensure that:
7.12.1. Federal awards are used for authorized purposes in compliance with law,
regulations, and State policies,
7.12.2. Those laws, regulations, and policies are enforced properly,
7.12.3. Performance data are recorded, tracked, and reviewed for quality to ensure
accuracy and completeness,
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7.12.4. Outcomes are assessed and analyzed periodically to ensure that
performance goals are met,
7.12.5. Appropriate procedures and internal controls are maintained, and record
retention policies are followed, and
7.12.6. All MOU terms and conditions are fulfilled.
7.13. All Parties to this MOU should expect regular fiscal and programmatic
monitoring to be conducted by each of the above entities, as appropriate.
8.0. RESPONSIBILITIES OF THE BOARD AS CHIEF OPERATING OFFICIALS
8.1. In Partnership with the Local WDB and other applicable Partners within the
planning region, develop and submit a single regional plan that includes a
description of the activities that shall be undertaken by all Local WDBs and their
Partners, and that incorporates plans for each of the Local areas in the planning
region,
8.2. Approve the Local WDB budget and workforce center cost allocation plan,
8.3. Approve the selection of the one-stop operator following the competitive
procurement process, and
8.4. Coordinate with the Local WDB to oversee the operations of the Local WDA One
Stop Centers.
9.0. RESPONSIBILITIES OF THE LOCAL WDB
The Local WDB ensures the workforce-related needs of employers, workers, and job
seekers in the Local WDA and/or the region are met, to the maximum extent possible
with available resources. The Local WDB will, at a minimum:
9.1. In Partnership with the Chair, the Board and other applicable Partners within the
Local WDA, develop and submit a Local WDA plan that includes a description of
the activities that shall be undertaken by the Local WDB and its Partners, and that
aligns its strategic vision, goals, objectives, and workforce-related policies to the
regional plan and economy,
9.2. In Partnership with the CEO and other applicable Partners within the planning
region, develop and submit a single regional plan that includes a description of the
activities that shall be undertaken by all Local WDBs and their Partners, and that
incorporates plans for each of the Local areas in the planning region,
9.3. In collaboration and Partnership with the CEO and other applicable Partners
within the planning region, develop the strategic regional vision, goals, objectives,
and workforce-related policies,
9.4. In cooperation with the Local CEO and the other Local WDBs within the regional
area, design and approve the American Job Center network structure. This
includes, but is not limited to:
9.4.1. Adequate, sufficient, and accessible one-stop center locations and
facilities,
9.4.2. Sufficient numbers and types of providers of career and training services
(including eligible providers with expertise in assisting individuals with
disabilities and eligible providers with expertise in assisting adults in need
of adult education and literacy activities),
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9.4.3. A holistic system of supporting services, and
9.4.4. One or more competitively procured one-stop operators.
9.5. In collaboration with the CEO, designate through a competitive process, oversee,
monitor, implement corrective action, and, if applicable, terminate the one-stop
operator(s),
9.5.1. Determine the role and day-to-day duties of the one-stop operator,
9.5.2. Approve annual budget allocations for operation of the American Job
Center network,
9.5.3. Help the one-stop operator recruit operational Partners and negotiate
MOUs with new Partners,
9.5.4. Leverage additional funding for the American Job Center network to
operate and expand one-stop customer activities and resources, and
9.5.5. Review and evaluate performance of the Local WDA and one-stop
operator.
10.0. RESPONSIBILITIES OF THE LOCAL WDB STAFF
Local WDB Staff shall:
10.1. Assist the CEO and the Local WDB with the development and submission of a
single regional plan,
10.2. Support the Local WDB with the implementation and execution of the regional
vision, goals, objectives, and workforce-related policies, including all duties
outlined above,
10.3. Provide operational and grant-specific guidance to the one-stop operator,
10.4. Investigate and resolve elevated customer complaints and grievance issues,
10.5. Prepare regular reports and recommendations to the Local WDB, and
10.6. Oversee negotiations and maintenance of MOUs with one-stop Partners.
11.0. RESPONSIBILITIES OF PARTNERS
Each Partner commits to cross-training of staff, as appropriate, and to providing other
professional learning opportunities that promote continuous quality improvement.
11.1. Partners will further promote system integration to the maximum extent feasible
through:
11.1.1. Effective communication, information sharing, and collaboration with the
one-stop operator,
11.1.2. Joint planning, policy development, and system design processes,
11.1.3. Commitment to the joint mission, vision, goals, strategies, and
performance measures,
11.2. The design and use of common intake, assessment, referral, and case management
processes,
11.3. The use of common and/or linked data management systems and data sharing
methods, as appropriate,
11.4. Leveraging of resources, including other public agency and non-profit
organization services,
11.5. Participation in a continuous improvement process designed to boost outcomes
and increase customer satisfaction, and
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11.6. Participation in regularly scheduled Partner meetings to exchange information in
support of the above and encourage program and staff integration.
12.0. DATA SHARING
12.1. Partners agree that the use of high-quality, integrated data is essential to inform
decisions made by policymakers, employers, and job seekers. Additionally, it is
vital to develop and maintain an integrated case management system, as
appropriate, that informs customer service throughout customers’ interaction with
the integrated system and allows information collected from customers at intake
to be captured once.
12.2. Partners further agree that the collection, use, and disclosure of Customers’
personally identifiable information (PII) is subject to various requirements set
forth in Federal and State privacy laws. Partners acknowledge that the execution
of this MOU, by itself, does not function to satisfy all of these requirements.
12.3. All data, including customer PII, collected, used, and disclosed by Partners will be
subject to the following:
12.3.1. Customer PII will be properly secured in accordance with the Local
WDB’s policies and procedures regarding the safeguarding of PII.
12.3.2. The collection, use, and disclosure of customer education records, and the
PII contained therein, as defined under FERPA, shall comply with FERPA
and applicable State privacy laws.
12.3.3. All confidential data contained in UI wage records must be protected in
accordance with the requirements set forth in 20 CFR part 603.
12.3.4. All personal information contained in VR records must be protected in
accordance with the requirements set forth in 34 CFR 361.38.
12.3.5. Customer data may be shared with other programs, for those programs’
purposes, within the American Job Center network only after the informed
written consent of the individual has been obtained, where required.
12.3.6. Customer data will be kept confidential, consistent with Federal and State
privacy laws and regulations.
12.3.7. All data exchange activity will be conducted in machine readable format,
such as HTML or PDF, for example, and in compliance with Section 508
of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794 (d)).
12.4. All one-stop center and Partner staff will be trained in the protection, use, and
disclosure requirements governing PII and any other confidential data for all
applicable programs, including FERPA-protected education records, confidential
information in UI records, and personal information in VR records.
13.0. CONFIDENTIALITY
13.1. All Parties expressly agree to abide by all applicable Federal, State, and local laws
and regulations regarding confidential information, including PII from
educational records, such as but not limited to 20 CFR Part 603, 45 CFR Section
205.50, 20 USC 1232g and 34 CFR part 99, and 34 CFR 361.38, as well as any
applicable State and local laws and regulations. In addition, in carrying out their
respective responsibilities, each Party shall respect and abide by the
confidentiality policies and legal requirements of all of the other Parties.
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13.2. Each Party will ensure that the collection and use of any information, systems, or
records that contain PII and other personal or confidential information will be
limited to purposes that support the programs and activities described in this
MOU and will comply with applicable law.
13.3. Each Party will ensure that access to software systems and files under its control
that contain PII or other personal or confidential information will be limited to
authorized staff members who are assigned responsibilities in support of the
services and activities described herein and will comply with applicable law. Each
Party expressly agrees to take measures to ensure that no PII or other personal or
confidential information is accessible by unauthorized individuals.
13.4. To the extent that confidential, private, or otherwise protected information needs
to be shared amongst the Parties for the Parties’ performance of their obligations
under this MOU, and to the extent that such sharing is permitted by applicable
law, the appropriate data sharing agreements will be created and required
confidentiality and ethical certifications will be signed by authorized individuals.
With respect to confidential unemployment insurance information, any such data
sharing must comply with all of the requirements in 20 CFR Part 603, including
but not limited to requirements for an agreement consistent with 20 CFR 603.10,
payments of costs, and permissible disclosures.
13.5. With respect to the use and disclosure of FERPA-protected customer education
records and the PII contained therein, any such data sharing agreement must
comply with all of the requirements set forth in 20 U.S.C. § 1232g and 34 CFR
Part 99.
13.6. With respect to the use and disclosure of personal information contained in VR
records, any such data sharing agreement must comply with all of the
requirements set forth in 34 CFR 361.38.
14.0. REFERRALS
14.1. The primary principle of the referral system is to provide integrated and seamless
delivery of services to workers, job seekers, and employers. In order to facilitate
such a system, Partners agree to:
14.2. Familiarize themselves with the basic eligibility and participation requirements, as
well as with the available services and benefits offered, for each of the Partners’
programs represented in the Local WDA One Stop Center network,
14.3. Develop materials summarizing their program requirements and making them
available for Partners and customers,
14.4. Develop and utilize common intake, eligibility determination, assessment, and
registration forms,
14.5. Provide substantive referrals – in accordance with the Local WDA Referral Policy
to customers who are eligible for supplemental and complementary services and
benefits under partner programs,
14.6. Regularly evaluate ways to improve the referral process, including the use of
customer satisfaction surveys,
14.7. Commit to robust and ongoing communication required for an effective referral
process, and
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14.8. Commit to actively follow up on the results of referrals and assuring that Partner
resources are being leveraged at an optimal level.
15.0. ACCESSIBILITY
15.1. Accessibility to the services provided by the One Stop Centers and all Partner
agencies is essential to meeting the requirements and goals of the Once Stop
Center. Job seekers and businesses must be able to access all information relevant
to them via visits to physical locations as well as in virtual spaces, regardless of
gender, age, race, religion, national origin, disability, veteran’s status, or on the
basis of any other classification protected under state or federal law.
15.1.1. One-stop centers will maintain a culture of inclusiveness and the physical
characteristics of the facility, both indoor and outdoor, will meet the latest
standards of accessible design. Services will be available in a convenient,
high traffic, and accessible location, taking into account reasonable
distance from public transportation and adequate parking (including
parking clearly marked for individuals with disabilities). Indoor space will
be designed in an “equal and meaningful” manner providing access for
individuals with disabilities.
15.1.2. The Local WDB will work with the Arizona State Workforce
Development Board (State WDB) to ensure that job seekers and
businesses have access to the same information online as they do in a
physical facility. Information must be clearly marked and compliant with
Section 508 of the U.S. Department of Health and Human Services code.
Partners will comply with the Plain Writing Act of 2010; the law that
requires that federal agencies use "clear Government communication that
the public can understand and use" and all information kept virtually will
be updated regularly to ensure dissemination of correct information.
15.1.3. Partners should either have their own web presence via a website and/or
the use of social media, or work out a separate agreement with the Local
WDB to post content through its website.
15.1.4. Communications access, for purposes of this MOU, means that individuals
with sensory disabilities can communicate (and be communicated with) on
an equal footing with those who do not have such disabilities. All Partners
agree that they will provide accommodations for individuals who have
communication challenges, including but not limited to individuals who
are deaf and hard of hearing, individuals with vision impairments, and
individuals with speech-language impairments.
15.1.5. All Partners agree that they will not discriminate in their employment
practices or services on the basis of gender, gender identity and/or
expression, age, race, religion, national origin, disability, veteran’s status,
or on the basis of any other classification protected under state or federal
law. Partners must assure that they have policies and procedures in place
to address these issues, and policies and procedures have been
disseminated to their employees and otherwise posted as required by law.
Partners further assure that they are currently in compliance with all
applicable state and federal laws and regulations regarding these issues.
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All Partners will cooperate with compliance monitoring that is conducted
at the Local level to ensure that all One Stop Center programs, services,
technology, and materials are physically and programmatically accessible
and available to all. Additionally, staff members will be trained to provide
services to all, regardless of range of abilities, mobility, age, language,
learning style, or comprehension or education level. An interpreter will be
provided in real time or, if not available, within a reasonable timeframe to
any customer with a language barrier. Assistive devices, such as screen-
reading software programs (e.g., JAWS and DRAGON) and assistive
listening devices must be available to ensure physical and programmatic
accessibility within the One Stop Center network.
16.0. OUTREACH
The Local WDB and its Partners will develop and implement a strategic outreach plan
that will include, at a minimum:
16.1. Specific steps to be taken by each partner,
16.2. An outreach plan to the region’s human resources professionals,
16.3. An outreach and recruitment plan to the region’s job seekers, including targeted
efforts for populations most at-risk or most in need,
16.4. An outreach and recruitment plan for out-of-school youth,
16.5. Sector strategies and career pathways,
16.6. Connections to registered apprenticeship,
16.7. A plan for messaging to internal audiences,
16.8. An outreach tool kit for Partners,
16.9. Regular use of social media,
16.10. Clear objectives and expected outcomes, and
16.11. Leveraging of any statewide outreach materials relevant to the region.
17.0. DISSOLUTION RESOLUTION
17.1. It is expected that Partners will participate in decision-making by consensus.
17.2. In instances where consensus cannot be reached and service delivery for the One-
Stop System is impaired, those partners who are parties to the dispute and have
signed this MOU shall submit to the following dispute resolution process:
17.3. If Partners are unable to resolve a dispute to the satisfaction of the members who
are parties to the dispute, the dispute shall be submitted in writing to the Maricopa
County WDB’s Executive Director for referral to the Executive Committee.
17.4. The Executive Committee shall evaluate the merits of the dispute and may
attempt to resolve the dispute through mediation. However, in all cases, the
Executive Committee shall prepare a response to the dispute within thirty days.
17.5. If any party to the dispute is not satisfied with the decision of the Executive
Committee, the dispute shall be referred to a third party impartial mediator within
30 days. Costs associated with the appeal will be shared by the disputing parties.
The decision of the mediator shall be final and binding.
18.0. NON DESCRIMINATION AND EQUAL OPPORTUNITY
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18.1. All Parties to this MOU certify that they prohibit, and will continue to prohibit,
discrimination, and they certify that no person, otherwise qualified, is denied
employment, services, or other benefits on the basis of: (i) political or religious
opinion or affiliation, marital status, sexual orientation, gender, gender
identification and/or expression, race, color, creed, or national origin; (ii) sex or
age, except when age or sex constitutes a bona fide occupational qualification; or
(iii) the physical or mental disability of a qualified individual with a disability.
18.2. The Parties specifically agree that they will comply with Section 188 of the
WIOA Nondiscrimination and Equal Opportunity Regulations (29 CFR Part 38;
Final Rule December 2, 2016), the Americans with Disabilities Act (42 U.S.C.
12101 et seq.), the Non-traditional Employment for Women Act of 1991, titles VI
and VII of the Civil Rights of 1964, as amended, Section 504 of the Rehabilitation
Act of 1973, as amended, the Age Discrimination Act of 1967, as amended, title
IX of the Education Amendments of 1972, as amended, and with all applicable
requirements imposed by or pursuant to regulations implementing those laws,
including but not limited to 29 CFR Part 37 and 38.
19.0. INDEMNIFICATION
All Parties to this MOU recognize the Partnership consists of various levels of
government, not-for-profit, and for-profit entities. Each party to this MOU shall be
responsible for injury to persons or damage to property resulting from negligence on the
part of itself, its employees, its agents, or its officers. No Partner assumes any
responsibility for any other party, State or non-State, for the consequences of any act or
omission of any third party. The Parties acknowledge the Local WDB and the one-stop
operator have no responsibility and/or liability for any actions of the one-stop center
employees, agents, and/or assignees. Likewise, the Parties have no responsibility and/or
liability for any actions of the Local WDB or the one-stop operator.
20.0. INSURANCE
20.1 The Party shall procure and maintain the insurance requirements herein until all
of their obligations have been discharged and any warranty periods under this
MOU are satisfied, including insurance for claims for bodily injury to persons
or damage to property which may arise from or in connection with the
performance of the work hereunder by the Party, its agents, representatives,
employees.
20.2 The insurance requirements herein are minimum requirements for this MOU
and in no way limit the indemnity covenants contained in this MOU. The
County and State of Arizona in no way warrant that the minimum limits
contained herein are sufficient to protect the MOU or from liabilities that might
arise out of the performance of the work under this MOU by the Party, his
agents, representatives, employees or subcontractors, and the Party and any
subcontractors are free to purchase additional insurance.
20.3 MINIMUM SCOPE AND LIMITS OF INSURANCE: The Party shall
provide coverage with limits of liability not less than those stated below.
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20.3.1 Commercial General Liability – Occurrence Form
Policy shall include bodily injury, property damage, personal and
advertising injury liability and broad form contractual liability.
General Aggregate $2,000,000
Blanket Contractual Liability – Written $1,000,000
Fire Legal Liability $ 50,000
Each Occurrence $1,000,000
Sexual Abuse/Molestation $1,000,000
The policy shall be endorsed to include coverage for sexual abuse and
molestation.
20.3.2 The policy shall be endorsed to include the following as additional
insured: “Maricopa County and the State of Arizona, their departments,
agencies, boards, commissions, and their officers, officials, agents, and
employees shall be named as additional insureds with respect to liability
arising out of the activities performed by or on behalf of the Party".
20.3.3 Policy shall contain a waiver of subrogation against Maricopa County, the
State of Arizona and their departments, agencies, boards, commissions,
and their officers, officials, agents, and employees for losses arising from
work performed by or on behalf of the Party.
20.3.4 This requirement may be satisfied with a policy combining General and
Excess/Umbrella Liability, provided that the General Liability section of
the policy is written on an occurrence basis, and includes coverage for
contractual liability.
20.3.5 Business Automobile Liability
Bodily Injury and Property Damage for any owned, hired, and/or non-
owned vehicles used in the performance of this MOU.
Combined Single Limit (CSL) $1,000,000
The policy shall be endorsed to include the following as additional
insured: “Maricopa County and the State of Arizona, their
departments, agencies, boards, commissions, and their officers,
officials, agents, and employees shall be named as additional
insureds with respect to liability arising out of the activities
performed by or on behalf of the Party, involving automobiles
owned, leased, hired or borrowed by the Party".
Policy shall contain a waiver of subrogation against Maricopa County and the
State of Arizona, their departments, agencies, boards, commissions, and their
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officers, officials, agents, and employees for losses arising from work performed
by or on behalf of the Party.
This paragraph, Business Automobile Liability, shall not be applicable in the
event Party does not utilize a vehicle in any manner in the performance of this
MOU or if the utilization is used only for commuting purposes. In the event the
Party subsequently utilizes the vehicle in the performance of the MOU or utilizes
it for other than commuting purposes, this paragraph, Business Automobile
Liability, shall be fully applicable, effective the date the utilization is changed.
20.3.6 Worker's Compensation and Employers' Liability
Workers' Compensation Statutory
Employers' Liability
Each Accident $500,000
Disease – Each Employee $500,000
Disease – Policy Limit $1,000,000
Policy shall contain a waiver of subrogation against Maricopa County and the State of
Arizona, their departments, agencies, boards, commissions, and their officers, officials,
agents, and employees for losses arising from work performed by or on behalf of the
Party.
20.3.7 Professional Liability (Errors and Omissions Liability)
Each Claim $1,000,000
Annual Aggregate $2,000,000
Sexual Abuse/Molestation $1,000,000
20.3.8 In the event that the professional liability insurance required by this MOU is
written on a claims-made basis, the Party warrants that any retroactive date under
the policy shall precede the effective date of this MOU; and that either continuous
coverage will be maintained or an extended discovery period will be exercised for
a period of two (2) years beginning at the time work under this MOU is
completed.
20.3.9 The policy shall cover wrongful acts, errors and omissions committed by the
Party or its employees while performing professional services under this MOU.
20.3.10 ADDITIONAL INSURANCE REQUIREMENTS: The policies, except
Worker’s Compensation and Professional Liability insurance, are to contain, or
be endorsed to contain, the following provisions:
20.3.10.1 Maricopa County, the State of Arizona, and their respective
departments, agencies, boards, commissions, and their respective officers,
officials, agents, and employees and the Party if subcontractor(s) is/are
used shall be additional insureds to the full limits of liability purchased by
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the Party or any subcontractor(s), even if those limits of liability are in
excess of those required by the MOU.
20.3.10.2 The Party’s and its subcontractors’ insurance coverage shall be
primary insurance with respect to all other available sources.
20.3.10.3 The Party’s and its subcontractors’ insurance shall apply separately
to each insured against whom claim is made or suit is brought, except with
respect to the limits of the insurer's liability. Coverage provided by the
subcontractors shall not limit their liability assumed under the
indemnification provisions of their contracts with the Party.
20.3.11 NOTICE OF CANCELLATION: With the exception of (10) days prior written
notice of cancellation for non-payment of premium,, the insurance policies
required above, except for the professional liability policy, shall contain a
provision that (30) days prior written notice of cancellation or non-renewal shall
be sent by insurers to Maricopa County. Such notice shall be sent directly to the
certificate holder on file.
20.3.12 ACCEPTABILITY OF INSURERS: Insurance is to be placed with duly
licensed or approved non-admitted insurers in the State of Arizona with an “A.M.
Best” rating of not less than A VII. The County in no way warrants that the
above-required minimum insurer rating is sufficient to protect the Party from
potential insurer insolvency.
20.3.12.1 If the social services program utilizes the Social Service
Contractors Indemnity Pool (SSCIP) or other approved insurance pool for
insurance coverage, SSCIP or the other approved insurance pool is exempt
from the A.M. Best’s rating requirement listed in this MOU. If the Party or
it Subcontractor chooses to use SSCIP or another approved insurance pool
as its insurance provider, the MOU or Party’s Subcontract would be
considered in full compliance with insurance requirements relating to the
A.M. Best rating requirements.
20.3.12.2 Party or subcontractors submitting Certificates of Insurance
identifying SSCIP, AMRRP, or another approved insurance pool will be
considered as meeting the insurance requirements including those related
to sexual abuse and molestation.
20.3.13 VERIFICATION OF COVERAGE: Party shall furnish the County with
certificates of insurance (ACORD form or equivalent approved by the County) as
required by this MOU. The certificates for each insurance policy are to be signed
by a person authorized by that insurer to bind coverage on its behalf.
20.3.13.1 All certificates and required endorsements are to be received and
approved by Maricopa County before work commences. Each insurance
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policy required by this MOU must be in effect at or prior to
commencement of work under this MOU and remain in effect for the
duration of the MOU’s term. Failure to maintain the insurance policies as
required by this MOU, or to provide evidence of renewal, is a material
breach of contract.
20.3.13.2 All certificates required by this MOU shall be sent directly to
Office of Procurement Services and MCWDB (Attn: Executive Director),
234 N. Central Avenue, Ste. 3000, Phoenix, AZ 85004. The County’s
Contract number is to be noted on the certificate of insurance. The County
reserves the right to require complete, copies of any affected insurance
policies required by this MOU in the event pf a claim occurring.
20.3.14 APPROVAL: Any modification or variation of these Insurance Requirements
under this MOU must have prior approval from the Office of Procurement
Services, whose decision shall be final.
20.3.15 EXCEPTIONS: The Insurance Requirements do not apply to Parties which are
public entities. A public entity for the purposed of this MOU means the State or a
political subdivision of the State which is self-insured via a risk pool. Public
entities shall provide a certificate of self-insurance at the request of the County.
21.0. BACKGROUND CHECKS FOR EMPLOYMENT THROUGH CENTRAL
REGISTRY:
21.1. The provisions of A.R.S. § 8-804 (as may be amended) are hereby incorporated in
its entirety as provisions of this MOU.
21.2. The Party shall conduct Central Registry Background Checks on all employees.
The information contained in the Central Registry will be used as a factor to
determine qualifications for positions that provide direct service to juveniles,
children or vulnerable adults as follows:
21.3. Any person, their employees or volunteers who apply for a MOU with MCHSD;
or
21.3.1. All employees of the Party; or
21.3.2. A subcontractor of the Party and the subcontractor’s employees; and
21.3.3. Prospective employees of the Party or its subcontractor at the request of
the prospective employer.
21.3.4. Volunteers who provide direct services to children or vulnerable adults
shall have a Central Registry Background Check which is to be used as a
factor to determine qualifications for volunteer positions.
21.3.5. A person who is disqualified because of a Central Registry Background
Check may apply to the Board of Fingerprinting for a Central Registry
exception pursuant to A.R.S. § 41-619.57. A person who is granted a
Central Registry exception pursuant to A.R.S. § 41-619.57 is not entitled
to a contract, employment, licensure, certification or other benefit
because the person has been granted a Central Registry exception.
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21.3.6. Before being employed or volunteering in a position that provides direct
services to children or vulnerable adults under this MOU, persons shall
certify on forms provided by ADES whether an allegation of abuse or
neglect was made against them and was substantiated. The completed
forms are to be maintained as confidential.
21.3.7. A person awaiting receipt of the Central Registry Background Check
may provide direct services to clients after completion and submittal of
the Direct Service Position certification form if the certification states:
21.3.7.1. The person is not currently the subject of an investigation
of child abuse or neglect in Arizona or another state or jurisdiction;
and
21.3.7.2. The person has not been the subject of an investigation of
child abuse or neglect in Arizona, or another state or jurisdiction,
which resulted in a substantiated finding. The Certification for
Direct Service Position is located at: https://des.az.gov/documents-
center?qt-content-tab=0 in search by name field enter
“Background” and select DDD-1703A
21.3.8. If the Central Registry Background Check specifies any disqualifying
act and the person does not have a Central Registry exception, the
person shall be prohibited from providing direct services under this
MOU.
21.3.9. The Party shall maintain the Central Registry Background Check results
and any related forms or documents in a confidential file for five (5)
years after termination of the MOU.
21.3.10. Upon request the Party shall make available and provide valid
Background Check information to the County.
22.0. FINGERPRINTING
22.1. The Party shall comply with the Provisions of A.R.S. § 46-141 as may be
amended.
22.2. The Party shall comply with, and shall ensure that all Party’s employees,
independent contractor, subcontractors, volunteers and other agents comply with,
all applicable (current and future) legal requirements relating to fingerprinting,
fingerprinting clearance cards, certification regarding pending or past criminal
matters, and criminal records checks that relate to MOU performance.
22.3. Applicable legal requirements relating to fingerprinting, certification, and
criminal background checks may include, but not limited, to the following: A.R.S.
§§ 36-594.01, 36-3008, 41-1964, and 46-141. All applicable legal requirements
relating to fingerprinting, fingerprint clearance cards, certification regarding
pending or past criminal matters, and criminal records checks are hereby
incorporated in their entirety as provisions of this MOU. The Party is responsible
for knowing which legal requirements relating to fingerprinting, fingerprint
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clearance cards, certifications regarding pending or past criminal matters, and
criminal records checks relate to MOU performance.
22.4. To the extent A.R.S. §§ 46-141 is applicable to MOU performance or the services
provided under this MOU, the following provisions apply:
22.4.1. Personnel who are employed by the Party, whether paid or not, and who
are required or allowed to provide services directly to juveniles or
vulnerable adults shall have a valid fingerprint clearance card or shall
apply for a fingerprint clearance card within (7) seven working days of
employment.
22.4.2. Except as provided in A.R.S. § 46-141, this MOU may be cancelled or
terminated immediately if a person employed by the Party and who has
contact with juveniles certifies pursuant to the provisions of A.R.S § 46-
141 (as may be amended) that the person is awaiting trial or has been
convicted of any of the offenses listed therein in the State, or of acts
committed in another state that would be offenses in this State, or if the
person does not possess or is denied issuance of a valid fingerprint
clearance card.
22.4.3. Upon request the Party shall make available valid Fingerprinting
information to the County.
23.0. VERIFICATION REGARDING COMPLIANCE WITH ARIZONA REVISED
STATUTES §41-4401 AND FEDERAL IMMIGRATION LAWS AND
REGULATIONS
23.1. By entering into the MOU, the Party warrants compliance with the
Immigration and Nationality Act (INA using e-verify) and all other federal
immigration laws and regulations related to the immigration status of its
employees and A.R.S. §23-214(A). The Party shall obtain statements from its
subcontractors certifying compliance and shall furnish the statements to the
Procurement Officer upon request. These warranties shall remain in effect
through the term of the MOU. The Party and its subcontractors shall also
maintain Employment Eligibility Verification forms (I-9) as required by the
Immigration Reform and Control Act of 1986, as amended from time to time,
for all employees performing work under the MOU and verify employee
compliance using the E-verify system and shall keep a record of the
verification for the duration of the employee’s employment or at least three
years, whichever is longer. I-9 forms are available for download at
USCIS.GOV.
23.1.1. The County retains the legal right to inspect the Party and subcontractor
employee documents performing work under this MOU to verify
compliance with paragraph 23.1.1 of this Section. The Party and
subcontractor shall be given reasonable notice of the County’s intent to
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inspect and shall make the documents available at the time and date
specified. Should the County suspect or find that the Party or any of its
subcontractors are not in compliance, the County will consider this a
material breach of the MOU and may pursue any and all remedies allowed
by law, including, but not limited to: suspension of work, termination of the
MOU for default, and suspension and/or debarment of the Party. All costs
necessary to verify compliance are the responsibility of the Party.
24.0. SEVERABILITY
If any part of this MOU is found to be null and void or is otherwise stricken, the rest of
this MOU shall remain in force.
25.0. DRUG AND ALCOHOL-FREE WORKPLACE
All Parties to this MOU certify they will comply with the Drug-Free Workplace Act of
1988, 41 U.S.C. 702 et seq., and 2 CFR part 182 which require that all organizations
receiving grants from any Federal agency maintain a drug-free workplace. The recipient
must notify the awarding office if an employee of the recipient is convicted of violating a
criminal drug statute. Failure to comply with these requirements may be cause for
suspension or debarment under 2 CFR part 180, as adopted by the U.S. Department of
Education at 2 CFR 3485, and the U.S. Department of Labor regulations at 29 CFR part
94.
26.0. DEBARMENT AND SUSPENSION
All Parties shall comply with the debarment and suspension requirements (E.0.12549 and
12689) and 2 CFR part 180 and as adopted by the U.S. Department of Labor at 29 CFR
part 2998 and by the U.S. Department of Education at 2 CFR 3485.
27.0. CERTIFICATION REGARDING LOBBYING
All Parties shall comply with the Byrd Anti-Lobbying Amendment (31 U.S.C. Section
1352), 29 C.F.R. Part 93, and 34 CFR part 82, as well as the requirements in the Uniform
Guidance at 2 CFR 200.450. The Parties shall not lobby federal entities using federal
funds and will disclose lobbying activities as required by law and regulations.
28.0. PRIORITY OF SERVICE
All Parties certify that they will adhere to all statutes, regulations, policies, and plans
regarding priority of service, including, but not limited to, priority of service for veterans
and their eligible spouses, and priority of service for the WIOA title I Adult program, as
required by 38 U.S.C. sec. 4215 and its implementing regulations and guidance, and
WIOA sec. 134(c)(3)(E) and its implementing regulations and guidance. Partners will
target recruitment of special populations that receive a focus for services under WIOA,
such as individuals with disabilities, low-income individuals, basic skills deficient youth,
and English language learners.
29.0. BUY AMERICAN PROVISION
Each Party that receives funds made available under title I or II of WIOA or under the
Wagner-Peyser Act (29 U.S.C. Section 49, et. seq.) certifies that it will comply with
Sections 8301 through 8303 of title 41 of the United States Code (commonly known as
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the “Buy American Act.”) and as referenced in WIOA Section 502 and 20 CFR
683.200(f).
30.0. SALARY COMPENSATION AND BONUS LIMITATIONS
Each Party certifies that, when operating grants funded by the U.S. Department of Labor,
it complies with TEGL 05-06, Implementing the Salary and Bonus Limitations in Public
Law 109-234, TEGL 17-15, Workforce Innovation and Opportunity Act (WIOA) Adult,
Dislocated Worker and Youth Activities Program Allotments for Program Year (PY)
2016; Final PY 2016 Allotments for the Wagner-Peyser Act Employment Service (ES)
Program Allotments; and Workforce Information Grants to States Allotments for PY
2016, Public Laws 114-113 (Division H, title I, Section 105) and 114-223, and WIOA
section 194(15)(A), restricting the use of federal grant funds for compensation and
bonuses of an individual, whether charged to either direct or indirect, at a rate in excess
of the Federal Office of Personnel Management Executive Level II.
31.0. NON ASSIGNMENT
Except as otherwise indicated herein, no Party may, during the term of this MOU or any
renewals or extensions of this MOU, assign or subcontract all or any part of the MOU
without prior written consent of all other Parties.
32.0. GOVERNING LAW
This MOU will be construed, interpreted, and enforced according to the laws of the State
of Arizona. All Parties shall comply with all applicable Federal and State laws and
regulations, and Local laws to the extent that they are not in conflict with State or Federal
requirements.
33.0. ENTIRE MOU, MODIFICATION, ASSIGNMENT AND COUNTERPARTS.
This MOU constitutes the entire understanding between the Parties and supersedes all
prior written or oral proposals or MOUs pertaining to the subject matter herein. No
modification of this MOU will be effective unless made in writing and executed by duly
authorized representatives of each Party. This MOU may be executed in multiple
counterparts, each of which shall be deemed as original, but all of which, when taken
together, shall constitute one and the same instrument.
34.0. ISRAEL BOYCOTT.
Per A.R.S. §35-393.01, each Party certifies that it is not currently engaged in, and agrees
for the duration of the Agreement to not engage in, a boycott of Israel.
35.0. NOTICES
All notices to a Party (each a “Notice”) will be in writing, will refer specifically to this
MOU and will be hand delivered or sent by express courier service, costs prepaid to the
respective address specified below (or to such other address as may be specified by
Notice to the other Party):
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If to the Local WDB to: Patricia Wallace
Executive Director
Maricopa County Workforce Development Board
At the Address listed in Attachment A
If to the Board to: Bruce Liggett
Department Director
Human Service Department
At the Address listed in Attachment A
If to a Partner to: The name and address listed on the attach addenda A.
Such Notice will be deemed to be duly provided when received if sent by courier service or
when delivered if transmitted by hand delivery.
36.0. SURVIVAL.
The provisions of this MOU, which by their very nature would continue beyond
termination, or expiration of this MOU, will continue as valid and enforceable rights and
obligations of the Parties and survive termination or expiration of this MOU.
(Remainder of page intentionally left blank, signatures to follow on the next page)
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By signing below I certify that I have read the above information. All of my questions have
been discussed and answered satisfactorily
My signature also certifies my understating of the terms outlined herein and agreement with
this MOU and I certify that I have the legal authority to bind my agency (outlined below) to
the terms of this MOU.
WIOA Title 1B Programs (Maricopa County Local Workforce Board)
Printed Name Title
Marie Sullivan, Vice Chair of Maricopa Date
County Workforce Development Board
Signature
Agency Name
Agency Contact Information
WIOA Title IB Programs (Maricopa County)
Printed Name Title
Denny Barney, Chief Lead Elected Official Date
Maricopa County Board of Supervisors
Attested to: Approved as to Form:
__________________________________
Fran McCarroll Date Deputy County Attorney Date
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Agency Name
Agency Contact Information
WIOA Title II Programs (Arizona Department of Education)
Printed Name Title
Sheryl Hart, Deputy Associate Date
Superintendent
Agency Name
Agency Contact Information
WIOA Title II Programs (Arizona Department of Education)
Printed Name Title
Steven Paulson, Chief Procurement Officer Date
Agency Name
Agency Contact Information
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WIOA Title III Programs (Wagner-Peyser Act, Department of Economic Security)
Printed Name Title
Chevera Trillo, Workforce Administrator Date
Agency Name
Agency Contact Information
WIOA Title IV Programs (Vocational Rehabilitation, Department of Economic Security)
Printed Name Title
Jan Davis, Assistant Program Manager Date
Agency Name
Agency Contact Information
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