Arcadis Well Site Pump to Waste Design - All Documentation
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CITY OF EL MIRAGE
CDD – Engineering Division
10000 N. El Mirage Road.
El Mirage, Arizona 85335
Phone: (623) 972-8116
Fax: (623) 876-4605
ON-PROFESSIONAL SERVICES
FOR
DESIGN & CONSTRUCTION
EM21-OCPS01
Notice of Intent to Award
Solicitation Description: On-Call Professional Services for Design and
Construction Projects (FY2021/2022 through
FY2024/2025)
City Project No. EM21-OCP01
Issue Date:
May 19, 2021
The following list is the top fifteen evaluated firms that have made The City of El Mirage short list:
Note: No binding contract will exist between the firm/individual and the City of El Mirage until the City executes a
written contract.
Note: The below list does not obligate the City of El Mirage to any cost or guarantee any firm will be
awarded a contract.
1. NFra, Inc.
2. Arcadis
3. Consultant Engineering, Inc.
4. Kimley-Horn
5. Wood Environmental & Infrastructure Solutions
6. EPS Group
7. Dibble
8. Greenlight Traffic Engineering
9. Rick Engineering Company
10. Speedie & Associates
11. Entellus
12. Dibble CM
13. J2 Engineering & Environmental Design
14. Lee Engineering
15. Ritoch-Powell & Associates
All awards are subject to Council approval. The acceptance of offer and contract will be executed upon Council
approval.
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Arcadis U.S., Inc.
426 N. 44th Street
Suite 340
Phoenix, AZ 85008
United States
Phone: 602 438 0883
Fax: 602 438 0102
www.arcadis.com
Scott Ketchmark
Utilities Supervisor
City of El Mirage
10355 N. 121st Avenue
El Mirage, Arizona 85335
Date: September 6, 2024
Our Ref: 30059433
Subject: Canterbury Pump to Waste Line
Scope and Fee Proposal
Dear Mr. Ketchmark,
Arcadis is pleased to submit our Scope and Fee proposal to provide professional design services for the City of El
Mirage (City) for the Canterbury Well Site Pump to Waste Line project (Project). We understand the Project will be
funded under a grant for water conservation.
Project Understanding
We understand Canterbury Well site (Site), located at 12500 W Canterbury Drive (APN 501-44-004M), has an
existing production well that produces approximately 830 gallons per minute (gpm) of water that is conveyed to
the on-site storage reservoir. The production well is currently configured to waste (pump-to-waste) the initial five
(5) minutes of pumped groundwater to a splash box that discharges through a 15” reinforced concrete pipe (RCP)
gravity line into a storm drain manhole located west of the site off N 125th Avenue. Once the pump-to-waste
operation is complete, water is directed to the on-site storage reservoir using flow control valves.
The Project will reconfigure the pump-to-waste system to discharge water to the City sanitary sewer instead of the
storm drain manhole so that the water can be beneficially reused. The existing 15” RCP pump-to-waste gravity
line routed to the storm sewer will be capped. The existing splash box will be reused (if possible) and (re)located
on-site to allow pump-to-waste water to be discharged from the Site to the City’s sewer collection system. The
aboveground wellhead pump-to-waste piping and control valves will be reconfigured to discharge to the
(re)located splash box. The planned pump-to-waste discharge will be an underground gravity pipe routed under
the existing Site perimeter concrete masonry unit (CMU) wall in an alignment that will limit impact to the
landscape vegetation located between the exterior wall and sidewalk. The underground gravity pipe will be
designed to connect the splash box to the proposed sewer manhole located immediately south of the site on W
Canterbury Drive within the roadway. The proposed manhole is installed on a 10-inch sewer line. An existing on-
site drain from the Chlorination Building also connects into the splash box and will be extended to connect to the
(re)located splash box.
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
2/7
Scope of Services
Arcadis will complete the scope of services outlined below to design the production well pump-to-waste system
for discharge to the City sewer system. The scope tasks proposed for this design are provided below.
Task 1 – Project Management
Arcadis will provide coordination of project work with disciplines to ensure project deliverables are met. Arcadis
will complete project setup, closeout, and invoicing during the course of the project. Arcadis will use a computer-
based project management and scheduling system to monitor the status of the project and be responsive to input
from the City.
Arcadis will attend a project kick-off meeting and three project meetings during design. A written agenda and
updated project schedule will be prepared prior to the meeting. Meeting summary notes will be prepared and
submitted to the City Project Manager after the meeting. The meetings during the design are as follows:
•
Kick-off Meeting
•
Draft Basis of Design Report (BODR) Review Meeting
•
60% Design Review Meeting
•
90% Design Review Meeting
Task 2 – Basis of Design Report
Arcadis will prepare a BODR to document the initial analysis of the major components of the project to establish
design criteria and project requirements. BODR is a requirement of the permitting efforts described under Task 3.
The topics that will generally be included are as follows:
•
Summary of project purpose, goals, requirements, and constraints;
•
Summary of permit and regulatory requirements including type, permitting agency, submittal schedule,
and responsible party;
•
Discussion of existing and design conditions;
•
Preliminary cost estimates;
•
Project phasing requirements/recommendations;
•
Coordination requirements with other projects (as appropriate); and
•
Approach to maintaining operation of existing facilities during construction (as required).
Arcadis will prepare a Draft BODR for City review and comment. A Draft BODR review meeting will be held to
discuss City comments. Arcadis will prepare a Draft Final BODR that incorporates City review comments and
submit with the 90% progress submittal. The Final BODR submitted as part of the permitting efforts.
Arcadis will sub-contract services to complete a full site survey of existing conditions, topography, and as-built
verification for the area specific to the planned improvements.
Meetings
•
Draft BODR Review Meeting
Deliverables
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
3/7
•
Draft BODR in electronic *.pdf format
•
Draft Final BODR in electronic *.pdf format
•
Final BODR in electronic *.pdf format
City Responsibilities
•
Provide site access
•
Arrange meetings as needed with City staff
•
Prepare review comments on Draft BODR and Draft Final BODR
Task 3 – Permitting
The construction package will be reviewed in accordance with City and Maricopa County Environmental Services
Department (MCESD) requirements for obtaining construction permits.
MCESD requires that design and construction of new projects related to water quality, storage or treatment be
submitted for review and approval. The permitting and inspection process is anticipated to be completed through
the MCESD Approval to Construct (ATC) process.
Once construction drawings are ready for review, the Engineer will prepare an ATC application package for
review by the MCESD. The reviews and coordination will require the following:
•
Prepare the required construction drawings and BODR to submit to MCESD for review and respond to
MCESD review comments after consulting with Water Services staff;
•
Assist in obtaining any permits from MCESD that are in advance of construction.
Drawings and other documents that are submitted to MCESD must be prepared with sufficient detail to show code
compliance.
Allowances are provided to cover review fees for submitting to MCESD for ATC permits as well as submitting for
required building permits with the City of El Mirage. MCESD review period can be reduced in half for double the
review fee if required to meet City’s project schedule.
Task 4 – Detailed Design and Construction Documents
Arcadis will prepare detailed design and construction documents for the Project in accordance with City of El
Mirage and Maricopa Association of Governments (MAG) standards and details. Arcadis will prepare three
separate design submittals for the project.
Utility Mapping and Utility Conflict Review
Arcadis will submit a Bluestake ticket to obtain all information from utility companies within the immediate area of
the Project. Arcadis will map the locations of these utilities and evaluate potential conflicts as the detailed design
is developed. Following the 60% design submittal, a utility conflict review package will be submitted to the utility
companies for review and notification of potential conflicts that may require realignment of their utilities that are
not able to be address with design changes. A second utility conflict review package will be submitted to utility
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
4/7
companies following the 90% design submittal to resolve any remaining utility conflicts. The duration of each of
the utility conflict reviews is anticipated to be 30 days.
Sixty Percent (60%) Progress Submittal
Arcadis will prepare a 60% level of design including construction drawings and specifications. At the 60% design
phase, the design intent is established, and the work is shown in sufficient detail that a contractor can recognize
general building elements and requirements for construction. Draft specifications are assembled. Design
calculations shall be essentially complete.
The 60% construction drawings and specifications will be submitted to the City for a two-week review and
comment period. A formal review meeting will be conducted by Arcadis following the City’s two-week review and
comment period. This review meeting will focus on City’s comments from the 60% design submittal.
Based on City review comments, revisions will be incorporated for the 90% progress submittal.
Meetings
•
60% Design Package Review Meeting
Deliverables
•
60% design package in electronic *.pdf format
•
Review meeting materials
•
Review meeting notes
City Responsibilities
•
Provide site access
•
Arrange meetings as needed with City staff
•
Prepare review comments on 60% design package
Ninety Percent (90%) Progress Submittal
Arcadis will advance the design beyond the 60% submittal, incorporating City review comments. Arcadis will
prepare a 90% level of design including construction drawings and specifications. Drawings and details in all
disciplines should be complete. Specifications should be essentially complete. Design calculations in all
disciplines shall be essentially complete and checked. Specification text is complete.
Comments on design, drawings and specifications from previous reviews must have appropriate responses
before the 90% progress submittal is submitted. Comments from both the BODR and 60% reviews by City staff,
any constructability reviews, and review comments from regulatory agencies must have appropriate responses or
actions.
The 90% construction drawings and specifications will be submitted to the City for a two-week review and
comment period. A final formal review meeting with the City will be conducted by Arcadis following the City’s two-
week review and comment period. This review meeting will focus on accuracy and completeness of the design
products including:
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
5/7
•
Verifying that prior City comments of the 60% submittal have been incorporated
•
Validating compliance with City and County standards and permitting requirements
•
Reviewing drawing and specification consistency
•
Addressing O&M and constructability considerations
Items identified in the review will be incorporated in the 100% submittal.
Arcadis will prepare an Engineers Opinion of Probable Construction (EOPC) cost estimate at the 90% level of
design. The cost estimate will be provided at the time of 90% submittal to the City. The EOPC cost estimate will
be prepared in accordance with the American Association of Cost Engineers (AACE) International cost estimate
Class 1, representing an accuracy range of -10 percent to +15 percent.
Meetings
•
90% Design Package Review Meeting
Deliverables
•
90% construction document package in electronic *.pdf format
•
Review meeting materials
•
Review meeting notes
•
EOPC Cost estimate
City Responsibilities
•
Coordinate review meeting and invite attendees
•
Prepare review comments on 90% design package
•
Distribute 90% design package to JOC, if required
Final Design (Issued for Construction)
Arcadis will finalize the construction drawings and specifications, incorporating all comments from prior submittal
stages and agency reviews. Construction drawings and specifications will be complete and accepted by the City.
Task 5 – Allowances
Arcadis will subcontract a survey to be performed of the site to identify existing conditions, topography, and as-
built verification. The site survey will be provided under a project allowance. All allowance use is subject to prior
approval by the City. In addition, allowances are provided for permitting fees, including MCESD ATC permitting
fees and City of El Mirage permitting fees. These items are considered project expenses that can be reimbursed
by the City with a paid invoice or proof of purchase. Reimbursements contain no markups.
Assumptions
The following assumptions were considered in preparation of the Scope of Services presented.
•
MCESD Approvals are assumed to be required since the project will be a change in the potable water
and sewer collection systems.
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
6/7
•
Application fees for MCESD ATC and City of El Mirage construction permitting are assumed to be paid by
Arcadis and reimbursed by the City. All other construction permitting fees will be paid by the City or
Contractor.
•
Coordination of all other onsite improvement projects whether in planning, design, or construction will be
coordinated by the City.
•
City will provide all communications with the Public.
•
No coordination with other consultants/contractors will be provided by Arcadis and are excluded from this
scope of work.
•
City and MAG standard details will be utilized.
•
Existing waste line piping and splash box will be repurposed and relocated for this Project.
•
The project is to be delivered through City’s selection of a JOC.
•
Geotechnical investigation is assumed as unnecessary since the pump-to-waste components will be
installed in previously developed areas.
•
No electrical or instrumentation and controls engineering required. The City does not desire modifications
for control or monitoring of waste line. Any change in programming required will be provided by City or
JOC programmers and is not included in this scope of work.
•
City standard specifications will be used as available.
•
Arcadis will supplement specifications as required.
Preliminary Drawing List
•
G-1
COVER SHEET
•
G-2
GENERAL NOTES & LEGEND
•
G-3
DEMOLITION PLAN
•
C-1
SITE PLAN
•
C-2
PROFILES
•
M-1
PIPING PLAN
•
M-2
DETAILS
Schedule
We anticipate this Project will be completed in 35 weeks from the issuance of a notice to proceed. Refer to Exhibit
A for the detailed schedule.
Basis of Compensation
This work will be completed on a Time and Materials (T&M) basis. The estimated cost to complete this project is
$62,400. Exhibit B provides a fee schedule with a breakdown of the costs for each task.
Scott Ketchmark
City of El Mirage
9/6/2024
www.arcadis.com
7/7
Terms and Conditions
Arcadis assumes that this assignment will be authorized by a Purchase Order issued under the current On-Call
Professional Services for Design and Construction, City Project No. EM21-OCPS01.
Closing
Thank you for the opportunity to serve the City. We look forward to working with you on this assignment.
Sincerely,
Arcadis U.S., Inc.
Brian Newhouse, PE
Principal Engineer
Email: Brian.Newhouse@arcadis.com
Direct Line: 602.797.4507
CC.
Kim Tanner, PE
Jacob Emmons, PE
Exhibits:
A. Schedule
B. Fee Schedule
Canterbury Pump to Waste Line
City of El Mirage
Exhibit A
Schedule
0
1
2
3
4
5
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
Notice to Proceed
Kickoff Meeting
Task 1: Project Management
Task 2: Basis of Design Report
DRAFT
Task 3: Permitting
Task 4: Detailed Design and Construction
Documents
60%
90%
Utility Conflict Review
Task 5: Allowances
Anticipated Completion
Arcadis Project Development
Utility Conflict Review Periods
City of El Mirage Review Periods
Regulatory Review/Document Revisions
TASK
WEEK
DRAFT
FINAL
1/1
City of El Mirage
Canterbury Pump to Waste Line
El Mirage, Arizona
Exhibit B
Fee Estimate
Principal Engineer
Staff Engineer
Technician/Project
Assistant1
Labor
Hours
Expenses
Totals
Kim Tanner
Brian Newhouse
Jacob Emmons
Task
$265.00
$180.00
$135.00
Task 100 - Project Management
10
8
18
36
$6,520.00
Task 200 - Basis of Design Report
4
32
20
56
$9,520.00
Task 300 - Permitting
2
8
0
10
$1,970.00
Task 400 - Detailed Design and Construction Documents
10
88
140
238
$37,390.00
Task 500 - Allowances
$7,000.00
$7,000.00
Surveying
$5,000.00
MCESD ATC Permitting Fee
$1,500.00
El Mirage Permitting Fee
$500.00
TOTALS
26
136
178
304
TOTAL FEE
$62,400.00
1 Includes: CADD Designer/Project Support Specialist
1/1
Water Conservation Grant Fund Agreement
Page 1 of 13
AGREEMENT:
.
WATER CONSERVATION GRANT FUND AGREEMENT
BETWEEN
___________________
AND
The Water Infrastructure Finance Authority of Arizona
THIS GRANT AGREEMENT (the
) is made effective as of the date of signature of the last
signatory hereto (the
), by and between the Water Infrastructure Finance Authority of
Arizona (the
), a body corporate and politic, and ___________________
(the
). The Authority and the Grantee may individually be referred to as
or collectively
as the
RECITALS
WHEREAS
Act
ARPA
Treasury
SLFRF
WHEREAS, the funds are purposed for use in responding to the COVID-19 public health
emergency and its economic impacts through the categories of eligible uses and activities described in 31
C.F.R. Part 35, Subpart A, including for making necessary investments in water, sewer, and broadband
infrastructure, and
WHEREAS, the source of funding for the Award is the ARPA, specifically the SLFRF, with
Catalog of Federal Domestic Assistance (
) Assistance Listing 21.027 for all activity pursuant to
this Agreement, and
WHEREAS
WCGF
administered by the Authority, and
WHEREAS, the Office of the Governor, in fulfilling its duty to administer the Coronavirus State
and Local Fiscal Recovery Funds allocated to the State of Arizona, entered into an Interagency Service
Agreement (ISA-ARPA-WIFA-070122-01), as amended on November 3, 2023, to provide funding to the
Authority through the WCGF to support COVID-19 related activities in accordance with State Fiscal
Recovery Fund Expenditure Category 5.8 Clean Water: Water Conservation, and
WHEREAS, the Authority is authorized to issue grants from the WCGF to eligible entities for
water conservation programs and projects that are expected to result in: (1) long-term reductions in water
use; (2) improvements in water use efficiency; or (3) improvements in water reliability. And
WHEREAS, WCGF grants may be issued for any of the purposes specified in A.R.S. §
49-1332(B), and
WC1-013-2023
CITY OF EL MIRAGE
City of El Mirage
Water Conservation Grant Fund Agreement
Page 2 of 13
WHEREAS, G
pursuant to the Application attached to this Agreement as Exhibit A [Grant Application]; and
WHEREAS, by the Board resolution attached to this Agreement as Exhibit B [Board Resolution],
the Authority has determined Grantee is eligible for financial assistance from the WCGF and has reviewed
NOW THEREFORE, in consideration of the mutual promises and covenants set forth below, the
Authority and Grantee agree as follows:
ARTICLE I - Definitions
1.1.
Act (42 § U.S.C. 801 et seq.), as amended.
1.2.
Grant Fund, attached to this Agreement as Exhibit A [Grant Application] and incorporated herein.
1.3.
1.4.
1.5.
by the Director to act on behalf of the Authority, with respect to this Agreement.
1.6.
1.7.
Scope of Work], attached to
this Agreement and incorporated herein.
1.8.
1.9.
1.10.
Any capitalized terms used and not defined herein shall have the meanings ascribed to such terms
in the Exhibits.
ARTICLE II - Award
2.1.
The Award. The Authority hereby agrees to provide the Grantee with an award in the amount of
Award
the terms and conditions set forth in this Agreement and availability of funds. The Authority shall
make the Award available to Grantee upon execution of this Agreement by the parties. Subject to
existence of a breach or default, or any event, circumstance, act, or omission which with the giving
of notice, the passage of time, or both would constitute a breach, default or give rise to the
termination of this Agreement, the Authority agrees to disburse the Award to the Grantee in
accordance with the provisions of Article III [Disbursement and Funding].
2.2.
Acceptance of Award. Grantee hereby accepts the Award under the terms and conditions of this
Agreement, and agrees to execute and return this Agreement to the Authority within thirty (30)
Two Hundred Fifty Thousand Dollars and 00/100
250,000.00
Water Conservation Grant Fund Agreement
Page 3 of 13
calendar days of receipt unless Grantee receives a written waiver of this requirement by the
Authority.
2.3.
Purpose and Use of Award. Grantee agrees to undertake and complete the Scope of Work in a timely
manner, and to receive and expend the Award in accordance with this Agreement. Grantee agrees
to utilize the Award only for the purpose of implementing the Scope of Work. Any expenditure
documents and attachments from the Application are incorporated herein by reference. If content
in the Application differs from or conflicts with terms presented elsewhere in this Agreement, this
Agreement takes precedence.
2.4.
Prior Costs Incurred. The Award may be used for costs incurred prior to the Effective Date of this
Agreement, but may not be used for costs incurred or for which commitment was made before July
6, 2022.
2.5.
Time of Performance. Grantee may use the Award for costs incurred and activities performed
between July 6, 2022, and June 30, 2026.
2.5.1. Grantee shall complete the Scope of Work no later than June 30, 2026.
2.5.2. Grantee shall make sufficient progress on the Scope of Work, in good faith and in manner
acceptable to the Authority. For purposes of this section, unless otherwise agreed to by
complied with all schedules and deadlines listed in the Scope of Work.
2.5.3.
schedule, which the Authority may, but is not required to approve. The written request
shall detail: (1) the nature of the delay(s); (2) the amended schedule dates; and (3) any
efforts to be implemented to adhere to the amended schedule.
2.6.
Benchmarks. Failure to adhere to the benchmarks listed below shall constitute a breach of this
Agreement and may result in the loss of all or part of the Award. In addition to any schedule or
deadline identified in the Scope of Work, Grantee shall, at a minimum, comply with the
following benchmarks:
2.6.1. Expend 5% of the Award by December 2, 2024.
2.6.2. Expend 50% of the Award by December 31, 2025.
2.6.3. Expend 75% of the Award by March 31, 2026.
2.7.
Term of Agreement. This Agreement remains in effect until all reporting requirements described in
Term
2.8.
Grantee Obligations. This Agreement constitutes the valid and binding obligations of the Grantee,
enforceable in accordance with its terms. The obligation and utilization of the Award provided
through this Agreement are subject to the proper observation of the Agreement and any
requirements incorporated by reference.
Water Conservation Grant Fund Agreement
Page 4 of 13
2.8.1. Assignments. The Grantee agrees not to transfer, assign, or pledge any right or interest in
any payment or advance due pursuant to this Agreement, or any of the other benefits
thereof, without the prior written consent of the Authority. Any such assignment made or
attempted by the Grantee without the prior written consent of the Authority shall be void
and of no effect. No consent by the Authority to an assignment by the Grantee shall release
the Grantee as the party primarily obligated and liable under the terms of this Agreement,
unless the Authority specifically releases the Grantee in writing.
2.8.2. Compliance with Applicable Laws. The Grantee shall perform all activities under this
Agreement in accordance with all applicable (whether present or future) laws, ordinances,
rules, regulations, requirements and orders of any governmental or administrative authority
cooperate in all ways reasonable and necessary to comply with the applicable statutes,
including amending this Agreement as needed in the future and making any refunds or
payments that might be required to bring the Parties into full compliance with applicable
law.
2.8.3. Subcontractors. Grantee shall require any subcontracting entities to observe and follow
all provisions of this Agreement.
2.9.
Exhibits. The terms and conditions of this Agreement include the terms and conditions set forth in
the Exhibits, which are part of this Agreement.
2.10.
Fund Availability. Any action by the Parties under this Agreement requiring the expenditure of
funds is conditioned upon the availability of funds appropriated, assigned, and allocated for the
payment of such obligation. If funds are not appropriated, assigned, allocated, and available or if
longer being available for the continuance of this Agreement, this Agreement may be terminated
by the Parties at the end of the period for which funds are available. No liability shall accrue to
the Parties in the event this provision is exercised, and the Parties shall not be obligated or liable
for any future payments or for any damages as a result of termination under this paragraph.
2.11.
Notices. All notices required or permitted under this Agreement, including technical
correspondence, invoices, and reports from Grantee, or other communications hereunder shall be
sufficiently given and shall be deemed given when hand delivered, mailed by registered or
certified mail, or emailed to Grantee or the Authority at the following addresses:
WIFA Project Manager
Laurie Gehlsen, Grants Coordinator
Water Infrastructure Finance Authority of Arizona
100 N 7th Ave, Suite 130
Phoenix, AZ 85007
Direct: (480) 647-4462
LGehlsen@azwifa.gov
Water Conservation Grant Fund Agreement
Page 5 of 13
Grantee Project Manager
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
Either Party may designate any further or different addresses to which subsequent notices or other
communications shall be sent, by notice in writing given to the other Party.
ARTICLE III - Disbursement and Funding
3.1.
Reimbursement Basis. The Authority shall disburse the Award on a reimbursement basis, upon
presentation of accurate and complete claims to the Authority. Except as hereinafter provided,
disbursements shall be made only:
3.1.1. For reimbursement of expenses incurred in accordance with this Agreement; and
3.1.2. When a request for reimbursement is submitted in substantially the form provided by the
Authority and is accompanied by the necessary certifications and documentation as
required by the Authority; and
3.1.3. When an Authorized Officer of the Authority has determined that such disbursement is
proper.
3.2.
Request for Reimbursement. Grantee shall submit requests for reimbursement to the Authority
using forms provided by the Authority on a monthly basis, unless otherwise approved by the
Authority in writing. Requests for reimbursement shall be submitted to the Authority no later than
the fifteenth (15th) day of each month. The Authority shall not distribute the Award to the Grantee
until the Authority has received and processed a request for reimbursement. The Authority shall
verify the request and claimed expenses against the reports required in this Agreement. To receive
payment, requests for reimbursement for work performed during the term of this Agreement must
be submitted no later than June 15, 2026, unless otherwise approved by the Authority in writing. A
request for reimbursement must contain:
3.2.1. An itemized accounting of grant expenses incurred;
3.2.2. Receipts, vendor invoices, documentation of in-kind labor, and other documentation of
costs incurred;
3.2.3. Certification that: the reimbursement amount requested is a proper cost as evidenced by
attached invoices;
3.2.4. Certification that the signatory is duly authorized to submit the reimbursement request; and
3.2.5. Any additional documents or information deemed necessary by the Authority.
3.3.
Method of Disbursement. The Authority may disburse the Award by check, electronic means,
Nick Russo, Public Works Director
City of El Mirage
10000 N. El Mirage Road
El Mirage, Arizona 85335
Direct: (623)876-4235
nrusso@elmirageaz.gov
Water Conservation Grant Fund Agreement
Page 6 of 13
of the request for reimbursement, subject to funding availability. An Authorized Officer of the
Authority shall approve disbursements directly to Grantee and shall provide Grantee with a copy
of the approval and the date approved.
3.4.
Affirmation of Representations and Warranties. Each request for reimbursement, disbursement, or
all representations and warranties of the Grantee as described in this Agreement or any Exhibit
therein, are true and correct as of the date thereof and throughout the Term of the Agreement, unless
the Grantee notifies the Authority to the contrary in writing prior to the request for reimbursement
or release of the disbursement.
3.5.
Withholding Disbursements. The Authority may elect in its sole discretion to withhold payment of
the Award in whole or in part if Grantee breaches any provision of this Agreement or any Exhibit
therein.
3.6.
Required Notice. Grantee shall provide the Authority with immediate written notification:
3.6.1. Of any inability to expend the Award in accordance with the Scope of Work; and
3.6.2. Prior to any expenditure of the Award deviating from the Scope of Work.
3.7.
xpenses and Operations. Subject and pursuant to the provisions of Section 2.2 of
the General Terms and Conditions included in Exhibit D, the Authority shall have the option to
information included in and with any and/or all requests for reimbursements under this Agreement.
ARTICLE IV - Representations and Warranties
4.1.
Grantee hereby represents and warrants that it is a: (check appropriate)
Municipal water delivery system as defined
in A.R.S. § 42-5301.
County water augmentation authority
established under A.R.S. Title 45, Chapter 11.
County water authority established under
A.R.S. Title 45, Chapter 13.
An Indian Tribe.
Community facilities district as established
by A.R.S. Title 48, Chapter 4.
Public water system as prescribed in A.R.S.
§ 49-3 2.
Natural resource conservation district.
City, town, county, district, commission,
authority or other public entity that is
organized and that exists under the statutory
law of this state or under a voter-approved
charter or initiative of Arizona.
Nongovernment organization that focuses on
water
conservation
or
environmental
protection
who
has
partnered
with
____________________________________,
an eligible entity as defined under A.R.S. § 49-
1301. If selected, Grantee must submit a
completed Partnership Certification with this
Agreement.
4.2.
Conflicts of Interest. The Parties each represent that, as of the date of execution of this Agreement,
they are not aware of any facts or circumstances which would give rise to a cancellation right in
Water Conservation Grant Fund Agreement
Page 7 of 13
favor of any Party pursuant to A.R.S. § 38-511. Grantee represents and warrants that there exists
the event such conflict or potential conflict arises during the Term of this Agreement, or any
extension thereof, the Grantee shall immediately notify the Authority in writing.
4.3.
Adverse Proceedings. Grantee represents and warrants that there are no proceedings pending or, so
far as the Grantee knows, threatened, before any court or administrative agency that will materially
perform the Scope of Work, the Grantee shall promptly notify the Authority in writing.
4.4.
Authority to Sign. Grantee represents and warrants that the Grantee and the person signing on
behalf of the Grantee have the full power and authority to enter into and execute this Agreement,
to legally bind the Grantee and to perform and comply with the terms and conditions set forth
herein.
4.5.
Debarment, Suspension, U.S. Government Restricted Party Lists. Grantee warrants that it is not,
and its contractors or subcontractors are not, on
Unverified List, the Entities List, the Specifically Designated Nationals and Blocked Parties List,
and neither the Grantee nor any contractors or subcontractors are presently debarred, suspended,
proposed for debarment or otherwise declared ineligible for award of federal contracts or
participation in federal assistance programs or activities.
4.6.
Grantee Matching. Pursuant to A.R.S. § 49-1333(B)(4), at least a twenty-five percent (25%) match
is required for each water conservation program or project.
4.6.1. Funds provided under one federal program may not be used to meet a non-federal match
or cost-share requirements of another federal program. 2 CFR 200.306(b)(5).
4.6.2. As stated in the Treasury's SLFRF Final Rule, Grantees may fund a program or project
nding provided that the costs are eligible
costs under each source program and are compliant with all other related statutory and
4.6.3.
required by ARPA. Grantee represents and warrants that Grantee has satisfied or will satisfy
contribution may not include any monies provided by the Authority.
4.6.4. Failure to adhere to the state matching requirement under A.R.S. § 49-1333(B)(4) shall
constitute a breach of this Agreement and may result in the loss of all or part of the Award.
4.7.
Indemnification. Grantee shall protect, defend, indemnify, and hold harmless the Authority and its
board and committees, the State of Arizona, its elected and appointed officials, its agents,
commissions, officers, directors, employees, volunteers and affiliates and each of them from any
fees, expert fees, losses or liability, in law or in equity, of every kind and nature whatsoever arising
Water Conservation Grant Fund Agreement
Page 8 of 13
limited to bodily injury, emotional injury, sickness or disease, or death to persons and/or damage
to property of anyone, including loss of use thereof, caused or alleged to be caused by any act or
omission of Grantee, or any subcontractor, or anyone directly or indirectly employed by any of
them or anyone for the full period of time allowed by the law, regardless of any limitation of
coverage by insurance, with the exception of the sole negligence or willful misconduct of the
Authority. The provisions of this section shall survive the expiration or termination of this
Agreement.
4.8.
Liability. Failure on the part of the Authority in any instance or under any circumstance to observe
or perform fully any obligation assumed by or imposed upon the Authority by this Agreement or
by law shall not make the Authority liable in damages to Grantee or relieve Grantee from fully
performing any other obligation required of it under this Agreement; provided, however, that
Grantee may have and pursue any and all other remedies provided by law for compelling
performance by the Authority of such obligation assumed by or imposed upon the Authority.
Neither the Authority nor its board or committees, the State of Arizona, its elected and appointed
officials, its agents, commissions, officers, directors, employees, volunteers or affiliates shall in
any event be liable for damages, if any, for the nonperformance of any obligation or agreement of
any kind whatsoever set forth in this Agreement.
4.9.
Permits. Grantee represents and warrants that all permits necessary or required in connection with
the award have been or will be obtained, and all fees and bonds required in connection therewith
have been or will be paid and/or posted as the circumstances may require.
Records and Reports
5.1.
Financial Records. Grantee shall maintain satisfactory financial accounts, books, records,
documents, and other evidence sufficient to properly reflect the amount, receipt, and expenditure
that section and guidance regarding the eligible uses of funds. Records shall be maintained by the
Grantee for a period of five years after the Award funds have been expended or returned to Treasury,
whichever is later. Failure to maintain proper financial records required under this Agreement as
required is cause for termination of this Agreement or withholding of future disbursements.
5.2.
Reporting Requirements. Grantee shall provide reports of all activities related to this Agreement
both as identified in the Agreement and as requested by the Authority. Grantee shall also provide
to the Authority any additional written information requested by the Authority in a timely manner
and within reasonable deadlines as shall be set by the Authority.
5.2.1.
All financial reports required under this Agreement shall be prepared in accordance with
GAAP standards, and shall be in form and substance satisfactory to the Authority and as
may be required by the United States Department of Treasury.
5.2.2. If there is any amount of the Award remaining after the Scope of Work is completed,
Grantee shall report the remaining balance to the Authority.
5.2.3.
https://home.treasury.gov/system/files/136/Apr-2023-PE-Report-User-Guide.pdf.
5.2.4. Grantee shall provide the following performance metrics required for water-related
infrastructure projects:
Water Conservation Grant Fund Agreement
Page 9 of 13
Projected/actual construction start date (month/year);
Projected/actual initiation of operations date (month/year);
Location;
Whether the project prioritizes local hires;
Whether the project has a Community Benefit Agreement, with a description of any
such agreement;
National Pollutant Discharge Elimination System (NPDES) Permit Number (if
applicable; for projects aligned with the Clean Water State Revolving Fund);
Public Water System (PWS) ID number (if applicable; for projects aligned with the
Drinking Water State Revolving Fund);
Median Household Income of service area; and
Lowest Quintile Income of the service area.
5.2.5. Failure to provide reports required under this Agreement as required is cause for
termination of this Agreement or withholding of future disbursements.
5.3.
M
the status of the Scope of Work on the fifteenth (15th) day of each month following the date of this
Agreement, and on the fifteenth (15th) day of every month thereafter until Grantee expends the
entire Award or completes the Scope of Work, whichever is first. Monthly reports shall be in a form
acceptable to the Authority. The Authority may revise the form of the monthly report from time to
time. The Authority reserves the right to request additional reports relating to the expenditure of
the Award or additional information as needed for ARPA reporting requirements.
5.4.
F
Final Report
to the Authority.
5.4.1. The Final Report shall be submitted to the Authority within thirty (30) calendar days of one
of the following occurrences: (1) the Award funds have been expended; (2) the Scope of
Work has been completed; or (3) the Agreement has otherwise been terminated.
Notwithstanding the foregoing, the Final Report shall be submitted to the Authority no later
than June 15, 2026.
5.4.2. The Final Report shall contain the information deemed necessary by the Authority.
5.4.3. Following the receipt and approval of the Final Report, the Authority will notify Grantee
in writing that the Agreement is administratively closed.
5.4.4. After the project is administratively closed, Grantee shall submit all required audits to the
Authority. All audits for fiscal years in which Grantee received Award funds from the
Authority must be received, reviewed, and found to be satisfactory by the Authority.
5.4.5. In the event that the Authority determines that any project costs described in a post-funding
audit are unjustified or describe ineligible activities, Grantee shall refund such monies back
to the Authority.
Water Conservation Grant Fund Agreement
Page 10 of 13
ARTICLE VI - Enforcement & Remedies
6.1.
Breach. The Parties agree that all conditions set forth herein are material to this and the
occurrence of any of the following events is a Grantee breach under this Agreement:
6.1.1. Any certification, statement, representation, or warranty contained in this Agreement or
report required under this Agreement, the Application, or any other document related to the
award which the Authority determines at any time to be incorrect or misleading in any
material respect either on the date when made or on the date when reaffirmed.
6.1.2.
agreement contained in this Agreement.
6.1.3.
in manner acceptable to the Authority in accordance with sections 2.5 and 2.6 of this
Agreement.
6.1.4.
the provisions of this Agreement.
6.1.5. The Grantee fails to comply with any law, ordinance, code, order, rule, or regulation of any
governmental or administrative authority having jurisdiction over the Scope of Work
within thirty (30) calendar days after notice in writing of such failure to comply has been
given to the Grantee from such governmental or administrative authority.
6.2.
Notice of Breach. Cure Period. Upon the occurrence of a breach, the Authority shall issue a written
notice of breach, identifying the nature of the breach and providing thirty (30) calendar days (or a
lesser or additional time as may be agreed to by the Parties) in which the Grantee shall have an
liability for damages.
6.3.
Default. If Grantee fails to cure a breach within the period specified in the written notice, Grantee
is in default of its obligations, and the Authority may exercise any or all of the following remedies:
6.3.1. Withhold applicable payment until the default is remedied;
6.3.2. Terminate this Agreement, in whole or in part;
6.3.3. Recapture Award funds provided to Grantee under this Agreement, in whole or in part;
6.3.4.
award; and/or;
6.3.5. Proceed at any time, or from time to time, to protect and enforce all rights and remedies
available to the Authority, including demanding repayment of Award funds, by suit or other
appropriate proceedings, whether for specific performance of any covenant, term, or
condition set forth in this Agreement, or for damages or other relief, or proceed to take any
action authorized or permitted under applicable law, regulation, or in equity.
Water Conservation Grant Fund Agreement
Page 11 of 13
6.4.
Good Faith. The Parties will attempt in good faith to resolve all disputes, disagreements, or claims
relating to this Agreement.
6.5.
De-obligation. The Authority may de-obligate Award funds under this Agreement upon written
notice to Grantee. The Authority may de-obligate and reduce Award funds under the following
circumstances:
6.5.1. Grantee has completed performance under the Scope of Work without using all of the
Award provided by the Authority under this Agreement;
6.5.2. This Agreement expires and all Award funds have not been expended;
6.5.3. Grantee, with the consent of the Authority, cancelled or changed an activity required under
the Scope of Work for reasons other than nonperformance;
6.5.4. This Agreement has otherwise been terminated in whole or in part; or
6.5.5. Mutual consent by the Parties.
6.6.
Disallowed Costs. An expenditure that is reimbursed under this Agreement and that does not
comply with this Agreement shall constitute a disallowed cost and be subject to recapture by the
Authority and repayment to the Authority. Within fourteen (14) calendar days of the date of the
period is approved by the Authority in writing,
Grantee shall repay the Authority any portion of the Award paid by the Authority which the
Authority has in its sole discretion determined constitutes a disallowed cost.
6.7.
Repayment. Grantee agrees to repay the Award in whole or in part if the Authority determines that
Grantee has failed to use the Award in compliance with the terms of this Agreement or the
requirements of applicable laws and regulations. The Authority may specify, in writing, the terms
of the repayment or alternative terms in lieu of repayment, however, in no such case shall repayment
or alternative terms be accomplished later than one hundred eighty (180) calendar days following
the written determination of non-compliance by the Authority. This section does not apply to a
Grantee made good faith efforts to complete the Scope of Work within the time for performance.
6.8.
Remedies Cumulative and Concurrent. No remedy herein conferred upon or reserved to the
Authority is intended to be exclusive of any other remedies provided for in this Agreement, and
each and every such remedy shall be cumulative, and shall be in addition to every other remedy
given hereunder, or under this Agreement, or now or hereafter existing at law or in equity by statute.
Every right, power, and remedy given to the Authority shall be concurrent and may be pursued
separately, successively, or together against the Grantee, and every right, power, and remedy given
the Authority may be exercised from time to time as often as may be deemed expedient by the
Authority.
6.9.
Strict Performance. No delay or omission of the Authority to exercise any right, power, or remedy
accruing upon the happening of a Default shall impair any such right, power, or remedy, or shall be
construed to be a waiver of any such Default or any acquiescence therein. No delay or omission on
the part of the Authority to exercise any option granted to the Authority under this Agreement, in
any one or more instances, shall constitute a waiver of any such Default and each such option shall
remain continuously in full force and effect.
Water Conservation Grant Fund Agreement
Page 12 of 13
6.10.
A
connection with the enforcement of this Agreement. If the Authority terminates this Agreement
ARTICLE VII - Miscellaneous
7.1.
Amendments and Modifications. This Agreement may be amended by mutual agreement in writing
between Grantee and the Authority. Any request to amend this Agreement by Grantee must be in
writing and state the amendment request and reason for the request. Grantee shall make requests
in a timely manner and in no event less than thirty (30) calendar days before the effective date of
the proposed amendment. Any amendment, modification, or extension of this Agreement must be
submitted through the Sub-recipient Management Tool (SRM), eCivis, and approved by both
Parties.
7.2.
Insurance. Grantee agrees to comply with the Insurance Requirements set forth in Exhibit D
[General Terms and Conditions]. Failure to maintain the required insurance at all times shall
constitute a breach of this Agreement that is subject to penalties up to and including suspension of
payments and/or termination of this Agreement.
7.3.
licenses, or authorizations required from government authorities prior to initiation of the Scope of
Work or required to be obtained by the time of completion of the Scope of Work to be eligible for
reimbursement funds under this Agreement.
7.4.
No Implied Duties. This Agreement does not create a duty or responsibility unless the intention to
do so is clearly and unambiguously stated in this Agreement. This Agreement shall not relieve the
Parties of any obligation or responsibility imposed on it by law. This Agreement does not imply
Authority to perform any tasks or accept any responsibility not expressly stated in this Agreement.
7.5.
No Obligation of State General Appropriations Funds. Nothing herein shall be construed as
obligating state general appropriation funds for payment of any debt or liability or any nature
arising hereunder. The parties expressly recognize that payments to be made by the Authority under
this Agreement may come from federal funds made available to the Authority for this purpose.
7.6.
Survival. Those articles, sections, and subsections of this Agreement which by their nature are
Indemnification, shall survive the completion of the Scope of Work and the expiration or earlier
termination of this Agreement.
7.7.
Time of the Essence. Time is of the essence with regard to each provision of this Agreement as to
which time is an element.
7.8.
Acknowledgment of Funding Source. Unless otherwise agreed upon in writing between the Parties,
Grantee agrees that any publications, studies, or reports which are made possible by or derived, in
whole or in part, from this Agreement, and any news articles, brochures, seminars, or other
promotional materials or media or events through which Grantee publicizes the Scope of Work
funded in whole or in part by this Agreemen
/contributed by the Water Infrastructure Finance
Water Conservation Grant Fund Agreement
Page 13 of 13
7.9.
Entire Agreement. This Agreement and any attached Exhibits shall constitute the entire agreement
of the Parties relating to the Award and supersedes all prior and contemporaneous agreements,
understandings, and inducements, whether express or implied, oral, or written.
Exhibit A
Grant Application
Exhibit B
Board Resolution
Exhibit C
Scope of Work
Exhibit D
General Terms and Conditions
Exhibit E
Federal Provisions
Exhibit F
Affidavit
Exhibit G
Reimbursement Request & Monthly Reporting Form
Exhibit H
Partnership Certification (if applicable)
ARTICLE VIII - Certification & Signatures
The Grantee, ______________________________, hereby accepts this Agreement according to the above
terms and conditions. I hereby certify that I represent a legal entity with authority to enter into this
Agreement.
I further certify that the Scope of Work complies with all applicable state, local, and federal laws and
regulations, and that I am authorized to enter into and sign a binding Agreement with the Authority
By:_________________________________________
Date:____________________________
Signature
_________________________________________________________________________________
Print Name and Title
For: ________________________________________
Tax ID No.:_______________________
Name
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their duly authorized
officers or officials, all as of the date first above written.
Signature
Chuck Podolak
Printed Name
Director,
Water Infrastructure Finance Authority
Title
Date
Signature
Printed Name
Title
Date
CITY OF EL MIRAGE
J. Crystal Dyches, City Manager
CITY OF EL MIRAGE
86-6000767
J. Crystal Dyches
City Manager
EXHIBIT A
Application
[See attached]
EXHIBIT B
Board Resolution
[See attached]
Water Infrastructure Finance Authority of Arizona
Page 1 of 2
Section 1: Resolution
WHEREAS, the Water Infrastructure Fi
Authority
from the City of El Mirage (th
Grant Application
Grant
WHEREAS, the Authority has determined that the Local Grantee has met the applicable
2702 et seq. and 49-1331 et. seq.; and
WHEREAS the terms and conditions under which the Grant will be made, and the obligations of
Grant Agreement
by the Local Grantee and the Authority.
NOW, THEREFORE BE IT RESOLVED BY THE BOARD OF DIRECTORS OF THE
AUTHORITY AS FOLLOWS:
The Board approves the Grant Application.
The Director of the Authority is hereby authorized and directed to execute the Grant Agreement
with the Local Grantee to evidence a Grant in accordance with all applicable laws, the Grant
Application, and the Summary detailed in Section 2 of this Grant Resolution.
The Director and other Authority officials, as appropriate, are authorized and directed to sign any
document and take such actions as necessary and appropriate to consummate the transactions
contemplated by this Resolution.
This Resolution shall take effect immediately.
PASSED AND ADOPTED by the Board of Directors for the Water Infrastructure Finance Authority
of Arizona on this 15th day of May 2024.
The Chairman of the Board of Directors certifies that the above is a true and correct copy of the
resolution that was duly adopted at a public meeting of the Water Infrastructure Finance Authority
on the date referenced above.
By:
Signature of Chairman
Water Infrastructure Finance Authority of Arizona
Page 2 of 2
Section 2: Summary
2.1 Grant Number
WC1-013-2023
2.2 Description
El Mirage will install a system to capture the portion of well water that is being discharged
into the Agua Fria wash due to excess
Reclamation Facility through the collection system to be recharged into the local aquifer.
2.3 Grant Amount Requested
$250.000
Page 1 of 2
EXHIBIT C
Scope of Work
Program/Project Title:
Grant Award:
Match Amount and Source of
Match (Cash and/or In-kind):
(Breakdown the amount of cash and/or in-kind match being provided)
Scope of Work:
Purpose of project/program:
Water Production Facility Conservation Project
$250,000
MATCH: $62,500
Project name
Canterbury Well Site Conservation Project
Introduction / Background to project
Deliverables
Long term reductions in water use, improvements in water use efficiency, improvement in water reliability
Constraints
Project time of year should be considered. Interrupting the site ability to produce water during the peak demand season should be avoided.
Key people / Key stakeholders
Project Lead
Scott Ketchmark, Utilities Superintendent
Responsible for Water/Wastewater Utilities
Project Coordinator
Kyle Huttenhow, Utilities Supervisor
Responsible for Project Operations
In scope
This project will require:
Out of scope
Project administration, monitoring and reporting
El Mirage will install a system to capture the portion of well water that is being discharged
Reclamation Facility through the collection system to be recharged into the local aquifer.
Page 2 of 2
Scope of Work Schedule
Estimated grant draws by month for the fiscal period beginning November 2023 and ending
June 2026
Jul-23
Aug-23
Sep-23
Oct-23
Nov-23
Dec-23
N/A
N/A
N/A
N/A
$
$
Jan-24
Feb-24
Mar-24
Apr-24
May-24
Jun-24
$
$
$
$
$
$
Jul-24
Aug-24
Sep-24
Oct-24
Nov-24
Dec-24
$
$
$
$
$
$
Jan-25
Feb-25
Mar-25
Apr-25
May-25
Jun-25
$
$
$
$
$
$
Jul-25
Aug-25
Sep-25
Oct-25
Nov-25
Dec-25
$
$
$
$
$
$
Jan-26
Feb-26
Mar-26
Apr-26
May-26
Jun-26
$
$
$
$
$
$
Total $
-
Note all grants must adhere to the following benchmarks as described in section 2.6.3 of this grant
agreement.
Expend 5% of the Award by December 2, 2024.
Expend 50% of the Award by December 31, 2025.
Expend 75% of the Award by March 31, 2026.
Scope of Work Schedule Narrative:
(Describe timelines, expectations of when projects will start/complete, etc.)
62,500
62,500
62,500
62,500
Project procurement will be sought using City of El Mirage existing JOC contracts for water
system projects. Quotations will be sought in August 2024 with an anticipated council
action in September 2024. Project work can be scheduled as soon as October 2024.
Depending on asset lead times, the project is estimated to take between 6 to 8 months with
an anticipated completion of June/July 2025.
Page 1 of 5
EXHIBIT D
General Terms and Conditions
All defined terms used herein that are not otherwise defined or described herein, shall have the
meanings ascribed to them in the Agreement attached hereto.
1.
Agreement Interpretation.
1.1. Captions and Headings. The captions and headings contained in this Agreement are included for
convenience of reference only and are not intended to limit or enlarge the terms of this Agreement.
1.2. Choice of Law. The substantive laws of Arizona shall govern the interpretation, validity, performance
and enforcement of this Agreement. A tribal government, by executing this Agreement, hereby waives
any defense it may have of tribal sovereign immunity for the limited purpose of providing for the
enforcement of this Agreement in accordance with its terms.
1.3. Date Calculation. If the last day of any time stated herein shall fall on a Saturday, Sunday, or legal
holiday in the State of Arizona, then the duration of such time shall be extended so that it shall end on
the next succeeding day which is not a Saturday, Sunday, or legal holiday.
1.4. Implied Agreement Terms. Each provision of law and any terms required by law to be in this
Agreement are a part of this Agreement as if fully stated in it.
1.5. Order of Precedence. In the event of a conflict in the provisions of the Agreement, as accepted by the
Grantee and the Authority, and as they may be amended from time to time, the following shall prevail
in the order set forth below:
1.5.1. Federal provisions;
1.5.2. Agreement Amendments;
1.5.3. Agreement; then
1.5.4. General Terms and Conditions.
1.6. Relationship of Parties. Neither Party to this Agreement shall be deemed to be the employee or agent
of the other Party to the Agreement.
1.7. Severability. If any provision of this Agreement or the application thereof is held invalid, that
invalidity shall not affect other provisions or applications of this Agreement which can be given effect
without the invalid provision or application, and to this end the provisions of this Agreement are
severable.
1.8. Third-Party Rights. Nothing in this Agreement is intended to create any third-party beneficiary rights;
and Grantee and the Authority expressly state that this Agreement does not create any third-party
rights of enforcement.
1.9. Waivers. No term or provision hereof will be considered waived by either Party, and no breach is
excused or consented to by either Party, unless such waiver or consent is in writing and signed on
behalf of the Party against whom the waiver is asserted. No express or implied consent by either Party
to, waiver of, or failure of a Party to enforce its rights with respect to a breach by the other Party shall
constitute consent to or, waiver of any subsequent or other breach by the other Party. Neither the
failure nor the delay of the Authority to exercise any right, power or privilege under this Agreement
Page 2 of 5
shall operate as a waiver thereof or shall any single or partial exercise of any right, power or privilege
preclude any further exercise of any other right, power or privilege.
2. Agreement Administration and Operation.
2.1. Accounting. Grantee shall maintain for the purposes of this Agreement an accounting system or
procedures and practices that conforms to generally accepted accounting procedures.
2.2. Audits and Inspections. The Authority shall have the right of access to records of the Grantee in order
shall be provided with access and shall have the right to examine all documents, financial records,
ormance of this Agreement and to the receipt and
expenditure of the Award. Grantee agrees to rectify issues identified in audits within the Authority
prescribed time periods. Failure to comply with the request for audit or inspection, or a lack of
documentation and records, is cause for termination of this Agreement or withholding of future
disbursements.
2.3. Audit Exceptions. If federal or state audit exceptions are made relating to this Agreement, Grantee
shall reimburse all costs incurred by the State of Arizona and the Authority associated with defending
against the audit exception or performing an audit or follow-up audit including but not limited to:
whatever nature. Immediately upon notification from the Authority, Grantee shall reimburse the
amount of the audit exception and any other related costs directly to the Authority as specified by the
Authority in the notification.
2.4. Procurement. Procurement of labor, services, supplies, materials, and equipment shall be conducted
according to applicable federal, state, and local statutes. The Authority may review any procurement
laws, regulations, and Agreement terms. If during its review, the Authority identifies any deficiencies,
then the Authority shall communicate those deficiencies to the Grantee within seven (7) business days.
2.5. Retention. Pursuant to A.R.S. § 35-214 and 35-215, Grantee shall retain all records relating to this
Agreement for a period of five years from the date of final payment to Grantee or as required by
applicable law, whichever is longer.
3. Insurance. Grantee and its subcontractors shall procure and maintain, until all of their obligations have
been discharged, including any warranty periods under this Agreement, insurance against claims for injury
to persons or damage to property arising from, or in connection with, the performance of the work
hereunder by the Grantee, its agents, representatives, employees or subcontractors.
3.1. The Insurance Requirements herein are minimum requirements for this Agreement and in no way
limit the indemnity covenants contained in this Contract. The State of Arizona in no way warrants that
the minimum limits contained herein are sufficient to protect the Grantee from liabilities that arise out
of the performance of the work under this Agreement by the Grantee, its agents, representatives,
employees or subcontractors, and the Grantee is free to purchase additional insurance.
3.2. Minimum Scope and Limits of Insurance. Grantee shall provide coverage with limits of liability not
less than those stated below.
Page 3 of 5
3.2.1.
Policy shall include bodily injury,
property damage, and broad form contractual liability coverage.
$1,000,000
$50,000
$1,000,000
3.2.1.1. The policy shall be endorsed, as required by this written agreement, to include the State
of Arizona, and its departments, agencies, boards, commissions, universities, officers,
officials, agents, and employees as additional insureds with respect to liability arising out
of the activities performed by or on behalf of the Grantee.
3.2.1.2. The policy shall contain a waiver of subrogation endorsement, as required by this written
agreement, in favor of the State of Arizona, and its departments, agencies, boards,
commissions, universities, officers, officials, agents, and employees for losses arising
from work performed by or on behalf of the Grantee.
3.2.2. Business Automobile Liability. Bodily Injury and Property Damage for any owned, hired,
and/or non-owned automobiles used in the performance of this Contract.
3.2.2.1. The policy shall be endorsed, as required by this written agreement, to include the State
of Arizona, and its departments, agencies, boards, commissions, universities, officers,
officials, agents, and employees as additional insureds with respect to liability arising out
of the activities performed by, or on behalf of, the Grantee involving automobiles owned,
hired and/or non- owned by the Grantee.
3.2.2.2. The policy shall contain a waiver of subrogation endorsement as required by this written
agreement in favor of the State of Arizona, and its departments, agencies, boards,
commissions, universities, officers, officials, agents, and employees for losses arising
from work performed by or on behalf of the Grantee.
3.2.3.
o
Each Accident
$1,000,000
o
$1,000,000
o
$1,000,000
3.2.3.1. The policy shall contain a waiver of subrogation endorsement, as required by this written
agreement, in favor of the State of Arizona, and its departments, agencies, boards,
commissions, universities, officers, officials, agents, and employees for losses arising
from work performed by or on behalf of the Grantee.
3.2.3.2. This requirement shall not apply to any entity that is exempt under A.R.S. § 23-901, and
when such entity executes the appropriate waiver form (Sole Proprietor or Independent
Contractor).
Page 4 of 5
3.3. Additional Insurance Requirements. The policies shall include, or be endorsed to include, as required
by this written agreement, the following provisions:
3.3.1.
shall be primary and that any insurance carried by the Authority, its agents, officials,
employees or the State of Arizona shall be excess and not contributory insurance, as provided
by A.R.S. § 41-621(E).
3.3.2.
indemnification provisions of this Agreement.
3.4. Notice of Cancellation. Applicable to all insurance policies required within the Insurance
be canceled, or be materially changed for any reason without thirty (30) days prior written notice to
the State of Arizona. Within two (2) business days of receipt, Grantee must provide notice to the State
of Arizona if they receive notice of a policy that has been or will be suspended, canceled, materially
changed for any reason, has expired, or will be expiring. Such notice shall be sent directly to the
Department and shall be mailed, emailed, hand delivered or sent by facsimile transmission to (State
3.5.
Arizona or hold approved non-admitted status on the Arizona Department of Insurance List of
The State of Arizona in no way warrants that the above-required minimum insurer rating is sufficient
to protect the Grantee from potential insurer insolvency.
3.6. Verification of Coverage. Contractor shall furnish the Authority with certificates of insurance (valid
ACORD form or equivalent approved by the State of Arizona) evidencing that Grantee has the
insurance as required by this Contract. An authorized representative of the insurer shall sign the
certificates. All such certificates of insurance and policy endorsements must be received by the State
endorsements that do not comply with this written agreement shall not waive or otherwise affect the
requirements of this agreement. Each insurance policy required by this Agreement must be in effect
at, or prior to, commencement of work under this Agreement. Failure to maintain the insurance
policies as required by this Agreement, or to provide evidence of renewal, is a material breach of the
Agreement. All certificates required by this Agreement shall be sent directly to the Authority. The
State of Arizona project/Agreement number and project description shall be noted on the certificate
of insurance. The Authority reserves the right to require complete copies of all insurance policies
required by this Agreement at any time.
3.7.
or Grantee shall be responsible for ensuring and/or verifying that all subcontractors have valid and
collectable insurance as evidenced by the certificates of insurance and endorsements for each
subcontractor. All coverages for subcontractors shall be subject to the minimum Insurance
Requirements identified above. The Authority reserves the right to require, at any time throughout the
life of this contract, proof from the Grantee that its subcontractors have the required coverage.
3.8. Exceptions. In the event the Grantee or subcontractor(s) is/are a public entity, then the Insurance
Requirements shall not apply. Such public entity shall provide a certificate of self- insurance. If the
Grantee or subcontractor(s) is/are a State of Arizona agency, board, commission, or university, none
of the above shall apply.
Page 5 of 5
4.
Certifications Required by State Law.
4.1. If the Grantee is a Company as defined in A.R.S. § 35-393, the Grantee certifies that it is not currently
engaged in a boycott of Israel as described in A.R.S. § 35-393 and will refrain from any such boycott
for the duration of this Agreement.
4.2. The Grantee further certifies that it shall comply with A.R.S. § 35-394, regarding use of the forced
labor of ethnic Uyghurs, as applicable.
4.3. Immigration Laws. Grantee certifies and warrants that it is in compliance with A.R.S. § 41-4401 and
further acknowledges that any contractor or subcontractor who is contracted by Grantee to perform
work related to this Agreement shall warrant its compliance with all federal immigration laws and
regulations that relate to its employees and its compliance with A.R.S. § 23-214(A). Any breach of
this warranty shall be deemed a material breach of this Agreement that is subject to penalties up to
and including termination of this Agreement. The Authority retains the legal right to inspect the
employment records of any employee of any contractor or subcontractor who performs work related
to this Agreement to ensure that the contractor or subcontractor is complying with the warranty in this
paragraph and that the contractor agrees to make all employment records of said employee available
during normal working hours to facilitate such an inspection.
4.4. Non-Discrimination. Grantee certifies and warrants that it shall comply with the provisions of State
Executive Order 2009-9. In performing this Agreement, Grantee shall not, and shall ensure that any
and all contractors, subcontractors, employees, agents, volunteers, officers, officials, directors,
volunteers, and affiliates, also shall not discriminate, harass, or allow harassment against any person
on the basis of sex, race, color, ancestry, religious cred, national origin, physical disability, mental
disability, medical condition, age, marital status, or any other basis prohibited under law. Grantee
shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to
perform work under this Agreement.
5.
Reversion of Remaining Funds. Upon expiration or termination of this Agreement, Grantee shall
transfer to the Authority any unexpended funds provided to Grantee by the Authority under this
Agreement.
Acknowledgment
The Grantee, ______________________________, hereby acknowledges and accepts the above
terms and conditions. I hereby certify that I represent a legal entity with authority to enter into this Agreement.
By:_________________________________________
Date:____________________________
Signature
_________________________________________________________________________________
Print Name and Title
For: ________________________________________
Tax ID No.:_______________________
Name
CITY OF EL MIRAGE
J. Crystal Dyches, City Manager
CITY OF EL MIRAGE
86-6000767
Page 1 of 9
EXHIBIT E
Federal Provisions
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,
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 contracts of guarantee or insurance, regulated
programs, licenses, procurement contracts 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
or activity(ies) is federally assisted in the manner prescribed above.
All defined terms used herein that are not otherwise defined or described herein, shall have the
meanings ascribed to them in the Agreement attached hereto.
ARTICLE I - ARPA Terms and Conditions
1.1.
Accounting. Grantee shall maintain for the purposes of this Agreement an accounting system or
procedures and practices that conforms to Generally Accepted Accounting Principles. As defined by
ing specified in accounting standards issued by
the Government Accounting Standards Board and the Financial Accounting Standards Board.
1.2.
Use of Funds. Grantee understands and agrees that the funds disbursed under this award may only be
implementing that section, and guidance issued by Treasury regarding the foregoing.
1.3.
Capabilities. Grantee will determine prior to engaging in any project using this assistance that it has
the institutional, managerial, and financial capability to ensure proper planning, management, and
completion of such project.
1.4.
Reporting. The Grantee agrees to comply with any reporting obligations established by Treasury as
they relate to this award.
1.5.
Maintenance of and Access to Records. Grantee shall maintain records and financial documents
that section, and guidance issued by Treasury regarding the foregoing. The Treasury Office of the
Inspector General and the Government Accountability Office, or their authorized representatives,
shall have the right of access to records (electronic and otherwise) of Grantee in order to conduct
audits or other investigations. Records shall be maintained by Grantee for a period of five (5) years
after all funds have been expended or returned to Treasury, whichever is later.
1.6.
Pre-Award Costs. Pre-award costs are allowable only to the extent permitted in 2 C.F.R. § 200.458.
e ARPA final rule permits funds to be used to
cover costs incurred beginning on March 3, 2021. Pre-award costs shall be allowable subject to the
terms and conditions of the Agreement.
Page 2 of 9
1.7.
Administrative Costs. Grantee may use funds provided under this award to cover both direct and
indirect costs.
1.8.
Compliance with Applicable Law and Regulations. Grantee agrees to comply with the requirements
of section 603 of the Act, regulations adopted by Treasury pursuant to section 603(f) of the Act, and
guidance issued by Treasury regarding the foregoing. Grantee also agrees to comply with all other
applicable federal statutes, regulations, and executive orders, and Grantee shall provide for such
compliance by other parties in any agreements it enters into with other parties relating to this award.
Federal regulations applicable to this award include, without limitation, the following:
1.8.1. 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
Audit Act, shall apply to this award.
1.8.2. 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.
1.8.3. 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.
1.8.4. OMB Guidelines to Agencies on Governmentwide 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 (contracts and subcontracts described in 2 C.F.R. Part
regulation at 31 C.F.R. Part 19.
1.8.5. Grantee 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.
1.8.6. Governmentwide Requirements for Drug-Free Workplace, 31 C.F.R. Part 20.
1.8.7. New Restrictions on Lobbying, 31 C.F.R. Part 21.
1.8.8. Generally applicable federal environmental laws and regulations.
1.9.
Statutes and regulations prohibiting discrimination applicable to this award include, without
limitation, the following:
1.9.1.
implementing regulations at 31 C.F.R. Part 22, which prohibit discrimination on the basis of
race, color, or national origin under programs or activities receiving federal financial
assistance.
1.9.2. 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;
Page 3 of 9
1.9.3.
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;
1.9.4. Title II of the Americans with Disabilities Act of 1990, as amended (42 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; and
1.9.5. The Hatch Act (5 U.S.C. §§ 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.
1.10.
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 603(c) of the Act regarding the use of funds, previous payments shall be
subject to recoupment as provided in section 603(e) of the Act.
1.11.
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 contracts, and/or any other remedy available by law.
1.12.
Publications. Any publications produced with funds from this award must display the following
whole or in part, by federal award number [enter
project FAIN] awarded to [name of Grantee]
1.13.
Debts Owed the Federal Government. Any funds paid to 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 section 603(e) of the Act
and have not been repaid by Grantee shall constitute a debt to the federal government. Any debts
determined to be owed the federal government must be paid promptly by Grantee. A debt is delinquent
other satisfactory arrangements 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.
1.14.
Disclaimer. The United States expressly disclaims 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 contract, or subcontract under this
award. The acceptance of this award by Grantee does not in any way establish an agency relationship
between the United States and Grantee.
1.15.
Protections for Whistleblowers. 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
Page 4 of 9
gross mismanagement of a federal contract or grant, a gross waste of federal funds, an abuse of
authority relating to a federal contract or grant, a substantial and specific danger to public health or
safety, or a violation of law, rule, or regulation related to a federal contract (including the competition
for or negotiation of a contract) or grant. The list of persons and entities referenced in the paragraph
above includes the following:
1.15.1. A member of Congress or a representative of a committee of Congress.
1.15.2. An Inspector General.
1.15.3. The Government Accountability Office.
1.15.4. A Treasury employee responsible for contract or grant oversight or management. An
authorized official of the Department of Justice or other law enforcement agency;
1.15.5. A court or grand jury; or
1.15.6. A management official or other employee of Grantee, contractor, or subcontractor who has
the responsibility to investigate, discover, or address misconduct.
1.15.7. Grantee shall inform its employees in writing of the rights and remedies provided under this
section, in the predominant native language of the workforce.
1.16.
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.
1.17.
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.
2.1.
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.
2.2.
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
persons have meaningful access to its programs, services, and activities. Grantee understands and
Page 5 of 9
agrees that meaningful access may entail providing language assistance services, including oral
interpretation and written translation where necessary, to ensure effective communication in the
2.3.
Grantee agrees to consider the need for language services for LEP persons when Grantee develops
applicable budgets and conducts programs, services, and activities. 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. OMB
Approved No. 1505-0271 Expiration Date: April 30, 2025.
2.4.
Grantee acknowledges and agrees that compliance with the assurances constitutes a condition of
transferees, and assignees for the period in which such assistance is provided.
2.5.
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 contract or agreement subject to Title VI and its regulations between
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
herein incorporated by reference and made a part of this contract (or agreement). Title VI also includes
financial assistance, 42 U.S.C. § 2000d et seq., as
Title VI regulations, 31 CFR Part 22, and herein incorporated by reference and made a part of this
contract or agreement.
2.6.
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.
2.7.
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.
2.8.
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 complaint, pending or completed,
including outcome. Grantee also must inform the Department of the Treasury if Grantee has received
no complaints under Title VI.
2.9.
Page 6 of 9
compliance of Title VI and efforts to address the non-compliance, including any voluntary compliance
or other OMB Approved No. 1505-0271 Expiration Date: April 30, 2025, 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.
2.10.
If the Grantee makes sub-awards to other agencies or other entities, the Grantee is responsible for
ensuring that sub-recipients 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 subrecipients. The United States of America has the right to seek 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. Under penalty of perjury, the undersigned official(s) certifies that official(s) has read and
conjunction with this assurances document is accurate and complete, and that the Grantee is in
compliance with the aforementioned nondiscrimination requirements.
ARTICLE III - Conflicts of Interest Acknowledgment
3.1.
Conflicts of Interest. Grantee understands and agrees it must maintain a conflict of interest policy
consistent with 2 C.F.R. § 200.318(c) and that such conflict of interest policy is applicable to each
activity (program or project) funded under this award. Grantee must disclose in writing to the
Authority, as appropriate, any potential conflict of interest affecting the awarded funds in accordance
with 2 C.F.R. § 200.112.
3.1.1. The Grantee must maintain standards of conduct covering conflicts of interest and governing
the actions of its employees engaged in the selection, award, and administration of contracts.
The standards of conduct must provide for disciplinary actions to be applied for violations of
such standards by
Grantee.
3.1.2. Such a conflict of interest would arise when the employee, officer, or agent, any member of
his or her immediate family, his or her partner, or an organization which employs or is about
to employ any of the parties indicated herein, has a financial or other interest in or a tangible
personal benefit from a firm considered for a contract.
3.1.3.
Grantee may neither solicit nor accept gratuities,
favors, or anything of monetary value from contractors or parties to subcontracts. No
employee, officer, or agent may participate in the selection, award, or administration of a
contract supported by a federal award if he or she has a real or apparent conflict of interest.
However, Grantees may set standards for situations in which the financial interest is not
substantial, or the gift is an unsolicited item of nominal value.
ARTICLE IV - Debarment and SAM.GOV Certification
4.1.
The Grantee certifies that, neither the Grantee nor any owner, partner, director, officer, or principal
of the Grantee, nor any person in a position with management responsibility or responsibility for the
administration of federal funds:
4.1.1. Is presently debarred, suspended, proposed for debarment, and declared ineligible or
Page 7 of 9
voluntarily excluded from covered transactions by any federal or state department/agency;
4.1.2. Has within a three-year period preceding this certification been convicted of or had a civil
judgment rendered against it for: commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public transaction or contract (federal,
state, or local); violation of federal or state antitrust statutes; or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
4.1.3. Is presently indicted for or otherwise criminally or civilly charged by a governmental entity
(federal, state, or local) with commission of any of the offenses enumerated in paragraph (b)
above; or
4.1.4. Has within a three-year period preceding this certification had one or more public
transactions or contracts (federal, state, or local) terminated for cause or default.
4.2.
assigned the following UEI Number: __________________________ found at www.sam.gov.
Include
date
SAM.GOV
registration
begins
and
ends
_____________________________________________.
4.3.
The Grantee further certifies that it shall not knowingly enter into any transaction with any
subcontractor, material supplier, or vendor who is debarred, suspended, declared ineligible, or
voluntarily excluded from covered transactions by any federal or state department/agency.
ARTICLE V - Lobbying Certificate Disclosure
5.1.
For each bid, request for reimbursement, or offer, that exceeds $100,000, the Grantee certifies, to
the best of his or her knowledge and belief, that:
5.1.1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the Grantee,
to any person for influencing or attempting to influence an officer or employee of an agency,
a Member of Congress, an officer or employee of Congress, or an employee of a Member
of Congress in connection with the awarding of any Federal contract, the making of any
Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement.
5.1.2. If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
Grantee shall complete and submit Standa
with its instructions.
5.1.3. The Grantee shall require that the language paragraph 1 and 2 of this anti-lobbying
certification be included in the award documents for all subawards at all tiers (including
subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and
that all subrecipients shall certify and disclose accordingly.
5.2.
This certification is a material representation of the fact upon which reliance was placed when this
N7NGSJEHMBP7
June 25, 2024
Page 8 of 9
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering this transaction imposed by 31 CFR Part 21.
ARTICLE VI - Audit Statement
6.1.
Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards, 2 CFR 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.
Audit Requirements of the Uniform Guidance, implementing the Single Audit Act, shall apply to
this award.
6.2.
If Grantee expends more than seven hundred and fifty thousand dollars ($750,000) in federal awards
during a fiscal year, Grantee will be subject to an audit under the Single Audit Act and its
implementing regulation at 2 C.F.R. Part 200, Subpart F regarding audit requirements and Grantee
must:
6.2.1.
6.2.2.
reporting area.
7.1.
Supplanting. Federal funds must be used to supplement existing funds for program activities and
must not replace those funds that have been appropriated for the same purpose. Supplanting shall be
the subject of application review, as well as pre-award review, post-award monitoring, and audit. If
the Authority has reason to believe supplanting has or will occur, the Grantee shall supply
documentation demonstrating that the reduction in non-federal resources occurred for reasons other
than the receipt or expected receipt of federal funds.
7.2.
Certification. By signing this Agreement, the Grantee certifies that any funds awarded under this
Agreement shall be used to supplement existing funds for activities contemplated under this
Agreement and will not supplant or replace nonfederal funds that have been appropriated for the
purposes and goals of the Agreement.
7.3.
Penalties. The Grantee understands that supplanting violations may result in a range of penalties,
including but not limited to suspension of future funds awarded under the Agreement, suspension or
debarment from federal grants, recoupment of monies provided under this Agreement, and civil
and/or criminal penalties.
8.1.
Grantee shall take affirmative steps to solicit and include small, minority, and women owned
businesses, when possible, in an effort to encourage participation and fair competition in providing
supplies/services described in this solicitation. As set forth in 2 C.F.R. § 200.321(b)(1)-(5), such
affirmative steps must include: (1) Placing qualified small and minority businesses and women's
business enterprises on solicitation lists; (2) Assuring that small and minority businesses, and
women's business enterprises are solicited whenever they are potential sources; (3) Dividing total
requirements, when economically feasible, into smaller tasks or quantities to permit maximum
Page 9 of 9
participation by small and minority businesses, and women's business enterprises; (4) Establishing
delivery schedules, where the requirement permits, which encourage participation by small and
minority businesses, and women's business enterprises; and (5) Using the services and assistance, as
appropriate, of such organizations as the Small Business Administration and the Minority Business
Development Agency of the Department of Commerce. If subcontracts are to be let, Grantee shall
and labor surplus area firms are used as required by 2 C.F.R. § 200.321.
ARTICLE IX - Acknowledgment
The Grantee, ______________________________, hereby acknowledges and accepts the above terms and
conditions. I hereby certify that I represent a legal entity with authority to enter into this Agreement.
By:_________________________________________
Date:____________________________
Signature
_________________________________________________________________________________
Print Name and Title
For: ________________________________________
Tax ID No.:_______________________
Name
CITY OF EL MIRAGE
J. Crystal Dyches, City Manager
CITY OF EL MIRAGE
86-6000767C
Page 1 of 3
EXHIBIT F
Affidavit
AUTHORIZED REPRESENTATIVE
I HEREBY AFFIRM THAT:
I am the [title] _____________________________________ and the duly authorized representative
of the Grantee and that I possess the legal authority to make this Affidavit on behalf of myself and the
Grantee for which I am acting.
AFFIRMATION REGARDING BRIBERY CONVICTIONS
I FURTHER AFFIRM THAT:
Neither I, nor to the best of my knowledge, information, and belief, the Grantee, nor any of its officers,
directors, partners, or any of its employees, if any and as applicable, directly involved in obtaining or
performing under agreements, contracts, loans, grants, or awards with public bodies, has been
convicted of, or has had probation before judgment imposed, or has pleaded nolo contendere to a
charge or bribery, attempted bribery, or conspiracy to bribe in violation of Arizona law, or the law of
any other state, or federal law, except as follows [indicate the reasons why the affirmation cannot
be given and list any conviction, plea, or imposition of probation before judgment with the date,
court, official or administrative body, the sentence or disposition, the name(s) of person(s) involved,
and their current positions and responsibilities with the Grantee]:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
AFFIRMATION REGARDING OTHER CONVICTIONS
I FURTHER AFFIRM THAT:
Neither I, nor to the best of my knowledge, information, and belief, the Grantee, nor any of its officers,
directors, partners, or any of its employees, if any and as applicable, directly involved in obtaining or
performing under agreements, contracts, loans, grants, or awards with public bodies, has:
1.
Been convicted under state or federal statute of a criminal offense incident to obtaining,
attempting to obtain, or performing a public or private contract, fraud, embezzlement, theft,
forgery, falsification or destruction of records, or receiving stolen property.
2.
Been convicted of any criminal violation of a state or federal antitrust statute.
3.
Been convicted under the provisions of Title 18 of the United States Code for violation of the
Racketeer Influenced and Corrupt Organization Act, 18 U.S.C. § 1961, et seq., or the Mail
Fraud Act, 18 U.S.C. § 1341, et seq., for acts arising out of the submission of bids or proposals
for a public or private contract.
City Manager
N/A
Page 2 of 3
4.
Been convicted of conspiracy to commit any act or omission that would constitute grounds
for conviction or liability under any law or statute described in subsection (1), (2), or (3)
above.
5.
Been found civilly liable under a state or federal antitrust statute for acts or omissions in
connection with the submission of bids or proposals for a public or private contract.
6.
Admitted in writing or under oath, during the course of an official investigation or other
proceedings, acts, or omissions that would constitute grounds for conviction or liability under
any law or statute described above, except as follows [list each debarment or suspension,
providing the dates of the suspension or debarment, the name of the public entity and the
status of the proceeding, the name(s) of the person(s) involved and their current positions
and responsibilities with the Grantee, and the status of any debarment]:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
AFFIRMATION REGARDING DEBARMENT
I FURTHER AFFIRM THAT:
Neither I, nor to the best of my knowledge, information, and belief, the Grantee, nor any of its officers,
directors, partners, or any of its employees, if any and as applicable, directly involved in obtaining or
performing under agreements, contracts, loans, grants, or awards with public bodies, has ever been
suspended or debarred (including being issued a limited denial of participation) by any public entity,
except as follows [indicate reasons why the affirmations cannot be given, and list any conviction,
plea, or imposition of probation before judgment with the date, court, official or administrative
body, the sentence or disposition, the name(s) of the person(s) involved and their current positions
and responsibilities with the Grantee, the grounds of the debarment or suspension, and the details
suspension]:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
SUBCONTRACT AFFIRMATION
I FURTHER AFFIRM THAT:
Neither I, nor to the best of my knowledge, information, and belief, the Grantee, has knowingly entered into
a contract with a public body under which a person debarred or suspended will provide, directly or indirectly,
supplies, services, architectural services, construction related services, leases of real property, or construction.
AFFIRMATION REGARDING COLLUSION
I FURTHER AFFIRM THAT:
Neither I, nor to the best of my knowledge, information, and belief, the Grantee, nor any of its officers,
directors, partners, or any of its employees, if any and as applicable, have in any way:
N/A
N/A
Page 3 of 3
1.
Agreed, conspired, connived, or colluded to produce a deceptive show of competition in the
compilation of the award that is being entered into with the Authority.
2.
In any manner, directly or indirectly, entered into any agreement of any kind to fix the bid
price or price proposal of the Grantee or of any competitor, or otherwise take any action in
restraint of free competitive bidding in connection with the award that is being entered into
with the Authority.
3.
Colluded with anyone to obtain information concerning the award that would give the Grantee
an unfair advantage over others.
ACKNOWLEDGMENT
I ACKNOWLEDGE THAT this Affidavit is to be furnished to the Authority and may be distributed to units
of the State of Arizona and the federal government. I further acknowledge that this Affidavit is subject to
applicable laws of the United States and the State of Arizona, both criminal and civil, and that nothing in this
Affidavit or any contract resulting from the submission of this application for an award shall be construed to
supersede, amend, modify, or waive the exercise of any statutory right or remedy conferred by the Constitution
and the laws of Arizona with respect to any misrepresentation made or any violation of the obligations, terms,
and covenants undertaken by the Grantee with respect to this Affidavit, the award, and other Affidavits
comprising part of this Agreement.
I DECLARE AND AFFIRM UNDER THE PENALTY OF PERJURY, UNDER THE LAWS OF THE
STSTE OF ARIZONA, THAT THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO
THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF.
Date: _____________________
By: __________________________________________
Name:
Title:
(Authorized Representative and Affiant)
Page 1 of 3
EXHIBIT G
Reimbursement Request & Monthly Reporting Form
This Reimbursement Request & Monthly Reporting Form is included as an example of the type of report
Grantee should expect to submit on a monthly basis. The Authority reserves the right to request
additional information and to modify this form.
Grantee Information (Subrecipient)
Organization
Grant No.
Contact Person
Contact Title
Physical
Address
City, State, Zip
Phone Number
Email
Sam.Gov UEI #
Organization Internal Account Number:
Median Household Income of service area
Lowest Quintile Income of the service area
Project/Program Information
Grant Amount
Match Amount
Total Project Cost
Since the previous disbursement request have
total project/program cost estimates changed by
5% or more due to a Change Order or other
project/program event? If Yes, explain
Yes
No
Projected/actual construction start date
(month/year)
Projected/actual initiation of operations date
(month/year)
Project/Program Location (address, City, and
zipcode)
Does the project/program prioritize local hires?
Yes
No
Does the project/program have a Community
Benefit Agreement? If yes include a description
of any such agreement
Yes
No
Is this project aligned with another federal
award? If yes, provide the federal award
information and the PWS # for drinking water
projects or the NPDES # for clean water projects
Yes
No
Federal Grant:
PWS:
NPDES:
Obligated Amount/Contract Amount
Date Obligated/Contract Executed Date
Vendor Name
Vendor Physical Address
Vendor City, State, Zip
Vendor Sam.Gov UEI #
Vendor Debarment Statement Y or N
Expenditure during this reporting period (attach
invoices for payment)
Remaining contract amount
Page 2 of 3
All procurement documentation of Award
expenditures has been maintained and can be
produced upon request?
Yes
No
Invoices, Receipts, and other Payment Tracki
List of each contractor, subcontractor, or vendor
that provided supplies, equipment, construction,
or other goods or services included in this
disbursement request.
List of each invoice number and invoice date
The amount being requested from grant proceeds
The amount the grantee will provide as part of the
25% match requirement and the source of the
match
The total invoice amount (the amount requested,
plus the match amount must equal the total
invoice amount)
Performance Measures & Outcomes
Have you started the program/project?
Yes
No
If you answered Yes, what date did program/project start?
Is the program/project 25% complete?
Yes
No
Is the program/project 50% complete?
Yes
No
Is the program/project 75% complete?
Yes
No
Is the program/project on schedule to complete the Scope of Work as described in
the grant agreement? If no, please note an amended Scope of Work Schedule must be
submitted
Yes
No
Actual water savings in acre-feet associated with this grant award (as available)
Projected water savings in acre- feet associated with this grant award (if changed
from original application)
Most recent reported system deliveries:
Page 3 of 3
To receive reimbursement:
Grantee must attach invoices for costs incurred;
Vendors must be registered through SAM.GOV and have an active Unique Entity
Identifier (UEI) Number.
Grantee Representative Signature
Printed Name
Title
Signature
Date