Agreement with Defensewerx (Updated 11/22/2024)*
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CITY OF GLENDALE’S CONTRACT NO. C24-1220
DEFENSEWERX – ENERGYWERX
TERMS AND CONDITIONS AGREEMENT
This Terms and Conditions Agreement (“TCA or Agreement”) is made and entered into as of the Effective Date by and
between DEFENSEWERX d/b/a ENERGYWERX (“DEFENSEWERX”), a Florida not-for-profit corporation with its principal
place of business located at 1140 E John Sims Parkway No. 1, Niceville, FL 32578 and City of Glendale, Arizona
(“Selectee”), with its principal place of business located at 5901 N Glen Harbor Blvd. Glendale, AZ 85307-4502 (each a
“Party” and collectively the “Parties”).
RECITALS
WHEREAS, DEFENSEWERX is a not-for-profit corporation, acting as a partnership intermediary for the United States of
America (the “Government”), chartered to create an innovative environment for bringing together the best minds of
industry, academia, and Government to collaborate and find solutions to the toughest science and technology
challenges while championing science, technology, engineering, and mathematics education for all levels of society,
including, but not limited to, support of the Partnership Intermediary Agreement (“PIA”) between DEFENSEWERX and
the Department of Energy (“DOE”).
WHEREAS, Selectee is a Public Utility entity with expertise and capabilities deemed to be valuable to the purposes of
the associated DOE opportunity.
WHEREAS, the PIA, entered into under 15 U.S.C. § 3715, authorizes DEFENSEWERX, under the direction and approval
of DOE, to enter into terms and conditions agreements with entities such as Selectee.
WHEREAS, DEFENSEWERX wishes to engage Selectee to perform tasks (“Services”) in furtherance of the purposes of
the associated DOE opportunity.
WHEREAS, Selectee wishes to provide DEFENSEWERX with Services.
NOW, THEREFORE, in acknowledgment of the recitals above and in consideration of the terms, covenants, and
conditions hereinafter set forth, including in the attached and hereto incorporated Exhibits, and for other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties, each intending to
be legally bound, hereby agree as follows:
ARTICLE I – RETENTION AND SERVICES
1.1.
Term. This Agreement shall become effective on the date of the last signature (“Effective Date”) and, unless
otherwise terminated in accordance with the terms of Section 1.10 of this Agreement or stated to survive
termination, will continue for sixty (60) days after the final deliverable date specified in the Statement of Effort
(“SOE”) in Exhibit I.
1.2.
Services. Selectee, in providing the Services contemplated under this Agreement, shall:
a. Perform the Services as more particularly set forth in the SOE contained in Exhibit I in a timely,
professional, and workmanlike manner in accordance with applicable and relevant industry
standards, including any requirements and obligations set forth in the SOE;
b. In its performance of this Agreement, utilize properly trained, skilled, and experienced personnel,
supplied with all necessary and adequate equipment and personal protective gear;
c.
Timely disclose all circumstances to DEFENSEWERX that currently exist or arise during performance
of this Agreement that create a conflict of interest in accordance with Section 4.3;
d. Communicate with DEFENSEWERX regarding performance of Services under this Agreement, and
progress thereof, as often as reasonably necessary and upon DEFENSEWERX’s request;
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e. Provide DEFENSEWERX with all relevant information, documents, and technical support reasonably
necessary for performance of Services under this Agreement, and provide the same at the request of
DEFENSEWERX; and
f.
Deliver all Milestones by the date set forth in Exhibit I.
1.3.
No Assurances. Neither Party guarantees any results, including, without limitation, their nature, utility, or
economic or commercial value, of the required Services more particularly set forth in the SOE. Selectee shall
provide Services, more particularly set forth in the SOE, on a best-efforts basis.
1.4.
Timing and Delay. Selectee recognizes and agrees that failure to meet the milestones in accordance with the
delivery schedule detailed in the SOE under Exhibit I (“Milestones”) may result in administrative expense or
other damages to DEFENSEWERX and DOE. Selectee shall, therefore, inform DEFENSEWERX immediately of
any anticipated delays in Milestone delivery and of any remedial actions being taken to ensure completion of
the Milestone according to such delivery schedule. Selectee shall have the opportunity to cure such delays
within thirty (30) days of the original deadline, or if mutually agreed by DOE and the Parties in writing, the
delivery schedule of the SOE may be adjusted.
1.5.
Reports. Selectee shall provide DEFENSEWERX with a status summary of work in progress of its activities based
on the schedule defined in the SOE in Exhibit I.
1.6.
Audits. During the Term under Section 1.1 and surviving for three (3) years thereafter, DEFENSEWERX shall
have the right from time to time to inspect and audit all records relating to Services under this Agreement and
otherwise as to this Agreement to the extent necessary for DEFENSEWERX or DOE to comply with any audit
to which DEFENSEWERX or DOE are subjected. Selectee shall cooperate with any audit right exercised by
DEFENSEWERX under this Section 1.6.
1.7.
Independent Contractor. The Parties agree to perform the Services hereunder solely as independent
contractors. The Parties will remain independent contractors in their relationship with one other. The Parties
agree that nothing in this Agreement shall be construed as creating a joint venture, partnership, franchise,
agency, employer/employee, or other similar relationship between the Parties, or as authorizing either Party
to act as the agent of the other Party. DEFENSEWERX shall not be responsible for withholding taxes with
respect to Selectee’s compensation hereunder. The Parties shall not have a claim against the other for vacation
pay, sick leave, retirement benefits, social security, worker’s compensation, health or disability benefits,
unemployment insurance benefits, or employee benefits of any kind. Nothing in this Agreement shall create
any obligation between either Party and a third-party except with respect to the protections of the
Government and DOE as set forth herein.
1.8.
Attestations. Each Party attests and certifies as follows:
a. It has full power, authority, legal competency, and right to enter into and perform its obligations
under this Agreement;
b. This Agreement is a legal, valid, and binding obligation of each Party, legally enforceable against it in
accordance with its terms;
c.
Entering into this Agreement will not violate the charter or bylaws of either Party or any material
contract to which that Party is also a Party;
d. It is financially able to satisfy any funding commitments made pursuant to this Agreement;
e. It has the sole right to control and direct the means, details, manner, and method by which the
Services are carried out;
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f.
It has the necessary knowledge, skills, experience, and ability to perform the required Services; and
g. It has the right to perform the Services at any place or location, and at such times as it shall determine.
1.9.
Event of Default. Each of the following events shall constitute an “Event of Default”:
a. Selectee’s Services, as enumerated by the SOE in Exhibit I, being performed by any party other than
Selectee;
b. Services, as enumerated by the SOE in Exhibit I, being performed by Selectee after the Term under
Section 1.1 or Termination under Section 1.10; and
c.
Selectee’s failure to perform any obligation under Section 1.2, including failure to perform by any
associated Milestone delivery date.
1.10.
Termination. This Agreement may be terminated by:
a. Either Party, or by DOE pursuant to an instruction to DEFENSEWERX, upon thirty (30) days written
notice to the other Party, with or without cause;
b. Either Party, or by DOE pursuant to an instruction to DEFENSEWERX, upon a material breach of any
term of this Agreement by the other Party, if the other Party’s material breach is not cured within
thirty (30) days written notice thereof;
c.
Either Party, or by DOE pursuant to an instruction to DEFENSEWERX, if the other Party files a
bankruptcy petition that is not dismissed within ten (10) business days, the other Party is adjudicated
bankrupt or is otherwise insolvent, or the other Party ceases to do business or otherwise terminates
its business operations; or
d. DEFENSEWERX upon any Event of Default.
1.11.
Post-Termination. Selectee shall submit an invoice to DEFENSEWERX based on the prorated fixed price for
that Milestone and such proration will be based on effort expended from the last Milestone payment up to
the point of termination. The DOE Agreements Officer (“AO”), in consultation with DEFENSEWERX and in their
discretion, will determine if and how much of an appropriate prorated payment is warranted. Selectee
acknowledges and agrees that no other compensation, of any nature or type, shall be payable hereunder
following the termination of this Agreement.
1.12.
Remedies. If either Party materially breaches any term of this Agreement or terminates this Agreement due
to an Event of Default, in addition to any rights and remedies under this Agreement, the non-breaching or
non-terminating Party shall have the right to exercise any and all remedies at law or in equity. All rights and
remedies under this Agreement and at law or in equity are cumulative and shall not preclude one another.
Notwithstanding any other term of this Agreement, a Party may immediately seek injunctive relief to protect
Confidential Information or any intellectual property.
ARTICLE II – PAYMENT
2.1.
Payment. DEFENSEWERX shall pay to Selectee a total sum of $300,000 (USD) in accordance with the Schedules
& Milestones in Table 1 and the Payment Schedule in Table 2 of Exhibit I. If Selectee anticipates non-
cancellable incurred costs, then the estimated cost(s) should be identified, substantiated, and addressed by
proposing a modification to Milestone/Payment #1 in the Payment Schedule in Table 2 of Exhibit I.
2.2.
Payment Modification. No modification, increase, or other adjustment to the fee of Section 2.1 or Exhibit I
may be made except those made by mutual agreement and executed by both Parties, in writing, and affixed
to this Agreement in Exhibit J: Engineering Change Proposal.
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2.3.
Invoices. DEFENSEWERX’s payments to Selectee in accordance with Section 2.1 and Exhibit I is expressly
conditioned on Selectee’s submission of a sufficiently detailed invoice to DEFENSEWERX upon, and only upon,
full completion of each Milestone as identified in the Schedules & Milestones in Table 1 and the Payment
Schedule in Table 2 of Exhibit I.
2.4.
Taxes and Expenses. Each Party shall be solely responsible for payment of its own respective income, social
security, workers' compensation, other employment related, other foreign or domestic, and any other taxes
of any type. All fees due to Selectee are expressly enumerated by this Agreement, and DEFENSEWERX shall
not pay to Selectee any fees other than that indicated by Section 2.1 and Exhibit I, or otherwise mutually
agreed to by the Parties in writing, including any costs or expenses incurred by Selectee related to its
performance of this Agreement.
2.5.
Payment After Default. Notwithstanding Section 2.1 or Exhibit I, DEFENSEWERX shall not pay to Selectee any
fees, or portion of any fees, except to the extent required by Section 1.11, when (i) prohibited by any applicable
Government law, regulation, or policy; or (ii) Selectee is in default pursuant to Section 1.9; or (iii) this
Agreement is terminated pursuant Section 1.10. Furthermore, all fees due to Selectee under this Agreement
are expressly conditioned upon DEFENSEWERX’s receipt of funding associated with Selectee’s Services under
the PIA.
ARTICLE III – NON-DISCLOSURE AND INDEMNIFICATION
3.1.
Non-Disclosure.
a. The Parties acknowledge that the existence and the terms of this Agreement and any oral or written
information, including intellectual property of any kind, exchanged between the Parties in connection
with the preparation and performance this Agreement are regarded as DEFENSEWERX business
proprietary information (“BPI”). The Parties may exchange BPI amongst each other, with the DOE
Point of Contact(s) listed in Exhibit I, and, only to the extent necessary for performance of a Party’s
obligations under this Agreement, with a Party’s officers, members, managers, employees, agents,
contractors, subsidiaries, successors, and assigns. Selectee’s right to disclose BPI to any of Selectee’s
officers, members, managers, employees, agents, contractors, subsidiaries, successors, and assigns
is expressly conditioned on Selectee acquiring such officers, members, managers, employees, agents,
contractors, subsidiaries, successors, and assigns’ written agreement to this Section 3.1. Selectee
shall not release BPI to any third-party, except as allowed under this Section 3.1(a), unless:
i. The DOE AO has given prior written approval;
ii. Disclosure is required by the Freedom of Information Act or any other applicable law or
regulation;
iii. Disclosure is required for Selectee to perform the Services as defined by Exhibit I;
iv. The BPI is otherwise in public domain before the date of release;
v. The BPI is limited to the content of the general agreement and objectives between DOE,
DEFENSEWERX, and Selectee, and is used to establish network relationships and/or support
activities for the partnership; or
vi. Disclosure of the BPI is requested pursuant to a subpoena issued by a court of competent
jurisdiction; provided however that in this instance the Selectee shall provide DEFENSEWERX
and DOE prompt notice of the subpoena and a reasonable opportunity, prior to any
disclosure of the BPI, to formally object to the subpoena and/or seek an injunction or other
relief from the court preventing disclosure of the BPI.
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b. Requests for approval under Section 3.1(a)(i) shall identify the specific BPI to be released, the medium
to be used, and the purpose for the release. Selectee shall submit its requests under this Section
3.1(b) simultaneously through DEFENSEWERX and to the DOE AO per the guidance provided in the
SOE in Exhibit I.
c.
Notwithstanding the permissibility of Disclosure of BPI under Sections 3.1(a)(i)-(v), Selectee will make
reasonable efforts to notify and coordinate with DEFENSEWERX or DOE prior to disclosure of any BPI
such that DEFENSEWERX or DOE are aware of such disclosure and may request redactions to the
extent permitted by law. If Selectee does not comply with a reasonable request for redactions,
Selectee shall not disclose the associate BPI.
d. By entering into this Agreement, Selectee does not and will not require its employees or contractors
to sign internal nondisclosure or confidentiality agreements or statements prohibiting or otherwise
restricting its employees or contactors from lawfully reporting waste, fraud, or abuse to a designated
investigative or law enforcement representative of a federal department or agency authorized to
receive such information.
e. The undersigned further attests that Selectee does not and will not use any Federal funds to
implement or enforce any nondisclosure and/or confidentiality policy, form, or agreement it uses
unless it contains the following provisions:
i. These provisions are consistent with and do not supersede, conflict with, or otherwise alter
the employee obligations, rights, or liabilities created by existing statute or Executive order
relating to (1) classified information, (2) communications to Congress, (3) the reporting to
an Inspector General of a violation of any law, rule, or regulation, or mismanagement, a
gross waste of funds, an abuse of authority, or a substantial and specific danger to public
health or safety, or (4) any other whistleblower protection. The definitions, requirements,
obligations, rights, sanctions, and liabilities created by controlling Executive orders and
statutory provisions are incorporated into this Agreement and are controlling.
ii. The limitation above shall not contravene requirements applicable to Standard Form 312,
Form 4414, or any other form issued by a Federal department or agency governing the
nondisclosure of classified information.
iii. Notwithstanding provision listed in paragraph Section 3.1(e)(i), a nondisclosure or
confidentiality policy form or agreement that is to be executed by a person connected with
the conduct of an intelligence or intelligence-related activity, other than an employee or
officer of the United States Government, may contain provisions appropriate to the
particular activity for which such document is to be used. Such form or agreement shall, at
a minimum, require that the person will not disclose any classified information received in
the course of such activity unless specifically authorized to do so by the United States
Government. Such nondisclosure or confidentiality forms shall also make it clear that they
do not bar disclosures to Congress, or to an authorized official of an executive agency or the
Department of Justice, that are essential to reporting a substantial violation of law.
f.
The terms of this Section 3.1 shall survive termination of this Agreement pursuant to Section 1.1 for
a period of nine (9) years thereafter.
3.2.
Indemnification.
a. Selectee shall defend, indemnify, and hold DEFENSEWERX, including its officers, members, managers,
employees, agents, contractors, subsidiaries, successors, and assigns, harmless from and against any
third-party claims, actions, or damages arising out of Selectee’s performance under this Agreement,
provided, however, Selectee shall not offer settlement in any such claim without the agreement of
DEFENSEWERX, which agreement shall not be unreasonably withheld. Selectee shall be liable to
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DEFENSEWERX for any claims, actions, or damages due to Selectee’s own negligence or intentional
acts. Failure of insurance coverage, if any, for any reason, shall not exonerate Selectee from its
indemnity obligations hereunder. This obligation to defend shall include all costs of defense as they
accrue. This Section 3.2(a) shall survive termination of this Agreement, for any reason, for a period of
three (3) years thereafter.
b. DEFENSEWERX shall defend, indemnify, and hold Selectee harmless from and against any third-party
claims, actions, or damages arising out of DEFENSEWERX’s performance under this Agreement,
provided, however, DEFENSEWERX shall not offer settlement in any such claim without the
agreement of Selectee, which agreement shall not be unreasonably withheld. DEFENSEWERX shall be
liable to Selectee for any third-party claims, actions, or damages due to DEFENSEWERX’s own
negligence or intentional acts. Failure of insurance coverage, if any, for any reason, shall not
exonerate DEFENSEWERX from its indemnity obligations hereunder. This obligation to defend shall
include all costs of defense as they accrue.
ARTICLE IV – ADHERENCE TO APPLICABLE POLICIES, REGULATIONS, AND LAWS
4.1.
Real Property and Equipment. Real property and equipment purchased with project funds (federal share and
Selectee cost share) under this Agreement must be used by Selectee in the program or project for which it
was acquired as long as it is needed, whether or not the project or program continues to be supported by the
federal funding. Title to Selectee property acquired will conditionally vest upon acquisition with Selectee.
Selectee cannot encumber this property and must request disposition instructions prior to disposing of or
selling the property as long as it maintains a Current Fair Market Value of $5,000 or more. Selectee may
continue to use the real property and equipment after the conclusion of the agreement period of performance
so long as Selectee submits a written Request for Continued Use for DOE authorization, which is approved by
the DOE Agreements Officer1 (AO). The non-federal entity must comply with the property use, maintenance
and insurance, and disposition requirements at 2 C.F.R. § 200.310-.316 unless explicitly directed otherwise, in
writing, by the DOE AO. This Section 4.1 shall not apply if no project funds are used by Selectee to purchase
real property or equipment.
4.2.
Access to Records. In accordance with 42 U.S.C. § 7137, the Comptroller General of the United States, or any
of his duly authorized representatives, shall have access to and the right to examine any books, documents,
papers, records, or other recorded information of Selectee receiving Federal funds or assistance under this
Agreement, including subagreements.
4.3.
No Conflicts of Interest, Other Activities.
a. Performance of Work in the United States. All work under this Agreement must be performed in the
United States (i.e., Selectee must expend 100% of the total project effort in the United States) unless
Selectee receives advance written authorization from DEFENSEWERX (in coordination with the DOE
AO) to perform certain work overseas. To request a waiver for this requirement, Selectee shall submit
a Foreign Work Approval Request using the Foreign Work Approval Request form found at:
https://energywerx.wufoo.com/forms/wi7lppx0cvl9cs/.
b. Lobbying Restrictions. By accepting funds under this Agreement, Selectee agrees that none of the
funds obligated to this Agreement shall be expended, directly or indirectly, to influence congressional
action on any legislation or appropriation matters pending before Congress, other than to
communicate to Members of Congress as described in 18 U.S.C. § 1913. This restriction is in addition
to those prescribed elsewhere in statute and regulation.
1 Cognizant Contracting Officer/Agreements Officer (CO): A Government employee who can bind the Government to
an agreement, such as an other transaction (OT) or similar agreement, with a partnership intermediary within the scope
of the authority delegated to the CO by the cognizant HCA or by the Department’s Senior Procurement Executive (SPE).
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c.
The DOE interim Conflict of Interest (“COI”) Policy can be found at the following link:
https://www.energy.gov/management/pf-2022-17-department-energy-interim-conflict-interest-
policy-requirements-financial. The interim COI Policy is applicable to all non-Federal entities that
receive DOE funding by means of a financial assistance award or other transactions and, through the
implementation of this interim COI Policy by the entity, to each Investigator who is planning to
participate in, or is participating in, the project funded wholly or in part under the DOE award. The
interim COI Policy establishes standards that provide a reasonable expectation that the design,
conduct, and reporting of projects funded wholly or in part under DOE awards will be free from bias
resulting from financial conflicts of interest or organizational conflicts of interest. Selectee is subject
to the requirements of the interim COI Policy, and Selectee must certify that it is compliant with all
requirements in the interim COI Policy. Selectee must flow down the requirements of the interim COI
Policy to any subrecipient non-Federal entities.
4.4.
Foreign Collaboration. Selectee must provide DEFENSEWERX, for coordination with DOE, with advanced
written notification of any existing or potential collaboration with foreign organizations or governments in
connection with its DOE-funded agreement scope. Selectee must await further guidance from the DOE AO
prior to contacting the proposed foreign organization or government regarding the potential collaboration or
negotiating the terms of any potential agreement.
a. Description of new and existing collaborations that should be reported: In general, a collaboration
will involve some provision of a thing of value to, or from, Selectee. A thing of value includes but may
not be limited to all resources made available to, or from, the Selectee in support of and/or related
to this Agreement, regardless of whether or not they have monetary value. Things of value also may
include in-kind contributions (such as office/laboratory space, data, equipment, supplies, employees,
students). Collaborations do not include routine workshops, conferences, use of Selectee’s services
and facilities by foreign investigators resulting from its standard published process for evaluating
requests for access, or the routine use of foreign facilities by Selectee staff in accordance with
Selectee’s standard policies and procedures.
b. Export Controls. The United States government regulates the transfer of information, commodities,
technology, and software considered to be strategically important to the United States to protect
national security, foreign policy, and economic interests without imposing undue regulatory burdens
on legitimate international trade. There is a network of Federal agencies and regulations that govern
exports that are collectively referred to as “Export Controls.” Selectee is responsible for ensuring
compliance with all applicable United States Export Control laws and regulations relating to any work
performed under this Agreement. Selectee must immediately report to DEFENSEWERX and DOE any
Export Controls violations related to the project funded under this Agreement, at the Selectee sub
level, and provide the corrective action(s) to prevent future violations.
4.5.
Suspension and Debarment. In accordance with Executive Orders 12549 and 12689, the regulations at 2 C.F.R.
Part 180, Guidance for Governmentwide Debarment and Suspension (Nonprocurement), are applicable to this
Agreement.
4.6.
U.S. Competitiveness. The Selectee agrees that any products embodying any subject invention or produced
through the use of any subject invention will be manufactured substantially in the United States unless
otherwise approved by DOE. In the event DOE agrees to foreign manufacture, there will be a requirement that
the Government's support of the technology be recognized in some appropriate manner, e.g., alternative
binding commitments to provide an overall net benefit to the United States economy. Selectee agrees that it
will not license, assign or otherwise transfer any of its subject inventions to any entity, at any tier, unless that
entity agrees to these same requirements. Should any entity receiving rights in the invention(s) from Selectee:
(1) undergo a change in ownership amounting to a controlling interest, or (2) sell, assign, or otherwise transfer
title or exclusive rights in the invention(s), then the assignment, license, or other transfer of rights in the
subject invention(s) is/are suspended until approved in writing by DOE. DEFENSEWERX and Selectee, including
Selectee’s successors or assigns, will convey to DOE, upon written request from DOE, title to any subject
invention, upon a breach of this paragraph. Selectee will include this paragraph in all subawards/contracts,
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regardless of tier, for experimental, developmental or research work. A subject invention is any invention
conceived or first actually reduced in performance of work under an agreement. An invention is any invention
or discovery which is or may be patentable. At any time in which an entity cannot meet the requirements of
this Section 4.6, the entity may request a modification or waiver of this Section 4.6. For example, the entity
may propose modifying the language of this Section 4.6 in order to change the scope of the requirements or
to provide more specifics on the application of the requirements for a particular technology. As another
example, the entity may request that this Section 4.6 be waived in lieu of a net benefits statement or United
States manufacturing plan. The statement or plan would contain specific and enforceable commitments that
would be beneficial to the United States economy and competitiveness. Commitments could include
manufacturing specific products in the United States, making a specific investment in a new or existing United
States manufacturing facility, keeping certain activities based in the United States or supporting a certain
number of jobs in the United States related to the technology. If DOE, in its sole discretion, determines that
the proposed modification or waiver promotes commercialization and provides substantial United States
economic benefits, DOE may grant the request and, if granted, modify the Agreement terms and conditions
for the requesting entity accordingly. This Section 4.6 is implemented by DOE pursuant to a Determination of
Exceptional Circumstances under the Bayh-Dole Act and DOE Patent Waivers.
4.7.
OIG. The mission of the DOE Office of Inspector General (“OIG”) is to strengthen the integrity, economy and
efficiency of DOE’s programs and operations including deterring and detecting fraud, waste, abuse, and
mismanagement. The OIG accomplishes this mission primarily through investigations, audits, and inspections
of DOE activities to include grants, cooperative agreements, loans, and contracts. The OIG maintains a Hotline
for reporting allegations of fraud, waste, abuse, or mismanagement. To report such allegations, please visit
https://www.energy.gov/ig/office-inspector- general. Selectee must disclose, in a timely manner, in writing to
DOE all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting
this Agreement.
4.8.
Cost Share. If the Cost Share Agreement terms are applicable to Selectee’s Services, as indicated by Exhibit A,
Selectee shall execute Exhibit B and comply with the obligations set forth thereby.
4.9.
Cybersecurity Plan. If a Cybersecurity Plan is required for the performance of Selectee’s Services, as indicated
by Exhibit A, Selectee shall execute Exhibit C and comply with the obligations set forth thereby.
4.10.
NEPA. If the National Environmental Policy Act (“NEPA”) is applicable to Selectee’s Services, as indicated by
Exhibit A, Selectee shall execute Exhibit D and comply with the obligations set forth thereby.
4.11.
CPS. If the Current and Pending Support (“CPS”) terms are applicable to Selectee’s Services, as indicated by
Exhibit A, Selectee shall execute Exhibit E and comply with the obligations set forth thereby.
4.12.
Davis-Bacon Act. If the Davis-Bacon Act is applicable to Selectee’s Services, as indicated by Exhibit A, Selectee
shall execute Exhibit F and comply with the obligations set forth thereby.
4.13.
BABA. If the Build America, Buy America Act (“BABA”) is applicable to Selectee’s Services, as indicated by
Exhibit A, Selectee shall execute Exhibit G and comply with the obligations set forth thereby.
4.14.
Confidentiality. If special confidentiality consideration are applicable to Selectee’s Services, as indicated by
Exhibit A, Selectee shall execute Exhibit H and comply with the obligations set forth thereby.
4.15.
Intellectual Property. If Selectee’s Services sufficiently involve intellectual property, as indicated by Exhibit A,
Selectee shall execute Exhibit L and comply with the obligations set forth thereby.
4.16.
Publicity and Publication. The addendum which applies (either Exhibit M or Exhibit N) to appropriately
address DOE’s communications strategy for this Opportunity will be indicated in Exhibit A.
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ARTICLE V – GENERAL TERMS
5.1.
Insurance. Each Party shall procure and maintain, at each Party’s own cost and expense, throughout the term
of this Agreement, insurance or indemnity protection that is commercially reasonable or required by
applicable relevant law. Selectee shall provide to DEFENSEWERX a certificate of insurance as evidence of such
coverage upon DEFENSEWERX’s request.
5.2.
Assignment. Selectee shall not assign or otherwise transfer its rights or obligations under this Agreement
without express written consent of DEFENSEWERX and DOE. Any assignment or transfer made without such
express written consent shall be void and constitute a material breach of this Agreement.
5.3.
Successors and Assigns. This Agreement is for the sole benefit of the Parties hereto, and reference to a Party
or the Parties shall include, as applicable, a Party’s successors and permitted assigns. Nothing herein shall confer
upon any other third-party any legal or equitable right, benefit, or remedy of any nature whatsoever, under
or by reason of this Agreement, unless expressly stated otherwise.
5.4.
Modification. No amendment, modification, or supplement to this Agreement shall be effective unless in
writing and signed by an authorized representative of each Party.
5.5.
Waiver. No waiver by either Party of any term of this Agreement will be effective unless explicitly set forth in
writing and signed by the waiving Party. No waiver by either Party will operate or be construed as a waiver of
any failure, breach, or default not expressly identified by such written waiver, whether of a similar or different
character, and whether occurring before or after said waiver. Except as otherwise set forth in this Agreement,
no failure to exercise, or delay in exercising, any right, remedy, power, or privilege arising from this Agreement
will operate or be construed as a waiver thereof. No single or partial exercise of any right, remedy, power, or
privilege hereunder will preclude any other or further exercise thereof or the exercise of any other right,
remedy, power, or privilege.
5.6.
Force Majeure. Neither Party shall be liable to the other Party for failure to perform any of its obligations
under this Agreement, except for those obligations under Section 2.1 to the extent a Milestone has been met
by Selectee, during any time in which such performance is prevented by fire, flood, or other natural disaster,
pandemic, war, embargo, riot, civil disobedience, or the intervention of any government authority, or any
other cause outside of the reasonable control of the Parties, provided that the Party so prevented uses its best
efforts to perform under this Agreement and provided further, that such Party provide reasonable written
notice to the other Party of such inability to perform. Performance obligations of the Parties may be extended
by the amount of delay caused by Force Majeure events under this Section 5.6, upon mutual written
agreement.
5.7.
Dispute Resolution.
a. In General. The Parties must resolve any dispute, controversy, or claim arising out of or relating to
this Agreement, or alleged breach or invalidity hereof (each, a “Dispute”), pursuant to this Section 5.7.
Provided, however, that the commencement of the Dispute resolution process set forth in this
Section 5.7 shall not limit either Party’s rights or remedies contained elsewhere in this Agreement.
b. Informal. The Parties must first attempt in good faith to resolve the Dispute by informal consultation
and negotiation. Any Dispute which is not resolved through this process after a period of five (5)
business days from an initial written notice of attempting to resolve such Dispute by negotiation and
consultation from a Party (or such shorter period designated by a Party due to time constraints
relevant to the specific Dispute), shall be resolved as described below.
c.
Mediation. If the Dispute is not resolved pursuant to Section 5.7(b) above, then the Dispute shall be
submitted to non-binding mediation. The Parties shall engage in the mediation process in good faith
and select a mutually acceptable mediator. If the Parties cannot agree on a mutually acceptable
mediator, the first available mediator residing in the County of Okaloosa, State of Florida, based upon
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the mediator database maintained by the Florida State Courts shall be selected. Each Party shall bear
its own expenses to prepare for and attend mediation, including attorneys’ fees, if any. Fees of the
mediator shall be split equally between the Parties. Any mediation under this Section 5.7(c) shall be
attended by representatives of each Party with decision making authority virtually or in person in the
County of Okaloosa, State of Florida.
d. Litigation. No Party shall institute any litigation in a court of law with respect to a Dispute other than
(i) if the other Party to the Dispute refuses or fails to comply with the Dispute resolution process set
forth above, or (ii) if the Dispute is not resolved pursuant to Section 5.7(c) above.
e. Costs. Excluding Sections 5.7(a)-(c), a non-prevailing Party to any Dispute litigated under
Section 5.7(d) shall reimburse the prevailing Party for its reasonable attorneys’ fees, court costs, and
all other expenses, whether or not taxable by the court as costs, in addition to any other relief to
which the prevailing Party may be entitled. Furthermore, and notwithstanding any other term of this
Agreement, Selectee shall reimburse DEFENSEWERX for any administrative costs and expenses
incurred by Selectee’s failure to meet the Milestones identified by the SOE of Exhibit I.
5.8.
Limitation of Liability. Notwithstanding anything to the contrary in this Agreement, in no event will either
Party be liable for any indirect, punitive, special, incidental, or consequential damages arising under or related
to this Agreement, including, but not limited to, loss of profits, use, data, or other economic advantage.
Provided, however, this Section 5.8 shall not apply if the breach is caused by a Party’s willful, reckless, or
negligent action, inaction, or omission.
5.9.
Corporate Felony Conviction and Federal Tax Liability Assurance. This term applies to Selectees that are
organized as corporations. A corporation includes any entity that has filed articles of incorporation in any of
the 50 states, the District of Columbia, or the various territories of the United States, but not foreign
corporations. It includes both for-profit and non-profit organizations. By entering into this Agreement, the
Selectee attests that its corporation has not been convicted of a felony criminal violation under Federal law in
the twenty-four (24) months preceding the date of Selectee’s signature herein. The Selectee further attests
that its corporation does not have any unpaid Federal tax liability that has been assessed, for which all judicial
and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely
manner pursuant to an agreement with the authority responsible for collecting the tax liability.
5.10.
Governing Law. The validity, interpretation, construction, performance, enforcement, and remedies of or
relating to this Agreement, and the rights and obligations of the Parties to this Agreement, shall be governed
and construed in all respects by the substantive laws of the State of Florida, without regard to the conflict of
laws rules or statutes of Florida or any other jurisdiction that might result in the application of other law.
5.11.
Venue. All disputes arising under or related to this Agreement, to the extent allowed by Section 5.7 or other
applicable Sections, shall be commenced and maintained exclusively in the federal or state courts situated in
the County of Okaloosa, State of Florida, and all Parties hereby irrevocably submit to the jurisdiction and venue
of any such court.
5.12.
Counterparts. This Agreement may be executed in counterparts, each of which shall be deemed an original,
but all of which together are deemed to be one and the same Agreement. A signed copy of this Agreement
delivered by facsimile, email, or other means of electronic transmission is deemed to have the same legal
effect as delivery of an original signed copy of this Agreement. DocuSign shall have the same force and effect
as an original signature.
5.13.
Severability. If any term of this Agreement is invalid, illegal, or unenforceable in any jurisdiction, such
invalidity, illegality, or unenforceability will not affect the enforceability of any other term of this Agreement
or invalidate or render unenforceable such term in any other jurisdiction. Upon a determination that any term
is invalid, illegal, or unenforceable, the Parties shall negotiate in good faith to modify this Agreement to affect
the original intent of the Parties as closely as possible in order that the rights and obligations contemplated
hereby be consummated as originally contemplated to the greatest extent possible.
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5.14.
Merger. This Agreement, including and together with any related Exhibits, is the sole and entire agreement of
the Parties with respect to the subject matter herein, and supersedes all prior and contemporaneous
understandings, agreements, representations, and warranties, whether written or oral, regarding such subject
matter.
5.15.
Conflicts. In the event of any conflict between, or any ambiguity caused by, the terms of this Agreement and
its incorporated Exhibits, this Agreement shall control.
5.16.
Headings. The headings or captions used in this Agreement are for reference purposes only and are not
intended to be used or relied upon in interpreting or enforcing this Agreement.
5.17.
Funding. Funding for this Agreement is provided by PI Project Order PPO-2.
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of this date last below written:
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit A: Checklist of Possible Requirements for the SELECTEE
This DOE program or effort mandates that the SELECTEE adhere to specific requirements beyond the TCA.
Per guidance from DOE, the following Exhibits apply to this program or effort. As such, the SELECTEE is subject to the
terms and conditions of each identified applicable provision, noted with an “X” in the Required column:
Required
Exhibit
Requirement
X
Exhibit B
Cost Sharing Agreement
X
Exhibit C
Cybersecurity Plan
Exhibit D
National Environmental Policy Act (NEPA) Implementing Procedures Agreement
Exhibit E
Current and Pending Support (CPS)
X
Exhibit F
Davis-Bacon Act Requirements associated with the Bipartisan Infrastructure Law (BIL)
X
Exhibit G
Build America, Buy America Act
Exhibit H
Non-Disclosure Agreement (NDA)
X
Exhibit I
Statement of Effort
X
Exhibit J
Engineering Change Proposal (ECP)
Exhibit K
Intellectual Property (IP) Disclosure Form
Exhibit L
Intellectual Property
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit B: Cost Sharing Agreement
Cost Sharing may be applicable in some instances. The SELECTEE’s cost share for the budget must reflect the
overall cost share ration negotiated by the parties. This ratio must be at least the statutory minimum based on
the nature of the project.
a.
Cost Sharing Obligations. By accepting federal funds under this Agreement, the SELECTEE agrees that it is
liable for the stated percentage of the total allowable project costs, as specified below:
The SELECTEE is required to pay the “Cost Share” amount as a percentage of the total project costs in each
invoice period for the duration of the period of performance. If the project is terminated or is otherwise not
funded to completion, the SELECTEE is not required to pay the entire “Cost Share” amount; however, the
SELECTEE is required to pay its share (i.e., percentage) of the total project cost incurred to date as of the
termination or end date of the Agreement.
b. Source of Cost Share. Cost share shall be provided by non-Federal funds unless otherwise authorized by
statute. In calculating the amount of the non-Federal contribution:
i.
Base the non-Federal contribution on total project costs, including the cost of work where funds
are provided directly to a partner, consortium member or subrecipient, such as a Federally Funded
Research and Development Center;
ii.
Include the following costs as allowable in accordance with the applicable cost principles:
1. Cash;
2. Personnel costs;
3. The value of a service, other resource, or third-party in-kind contribution;
4. Indirect costs or facilities and administrative costs; and/or
5. Any funds received under the power program of the Tennessee Valley Authority
(except to the extent that such funds are made available under an annual
appropriation Act);
iii.
Exclude the following costs:
1. Revenues or royalties from the prospective operation of an activity beyond the time
considered in the award;
2. Proceeds from the prospective sale of an asset of an activity; or
3. Other appropriated Federal funds.
iv.
Repayment of the Federal share of a cost-shared activity under Section 988 of the Energy Policy
Act of 2005 shall not be a condition of the award.
c.
Cost Share Recordkeeping. The SELECTEE is required to document and maintain records of project costs
paid by DOE and project costs that the SELECTEE claims as cost sharing, including in-kind contributions.
Upon request, the SELECTEE is required to provide such records to the PI, who will provide the records to
the Agreements Officer.
d. Inability to Comply with Cost Sharing Obligations. If the SELECTEE determines that it might be unable to
Government Share
$ / %
SELECTEE Share
$ / %
Total Project Cost
$300,000 / 48%
$327,746 / 52%
$627,746
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meet its cost sharing obligations, the SELECTEE is required to notify DEFENSEWERX immediately, who will
notify the Agreements Officer. The notification must include the following information:
i.
whether the SELECTEE intends to continue or phase out the project, and
ii.
if the SELECTEE intends to continue the project, how the SELECTEE will pay (or secure replacement
funding for) the SELECTEE’s share of the total project cost.
If the SELECTEE fails to meet its cost sharing obligations, DEFENSEWERX will consult with the Agreements
Officer and may terminate this Agreement or otherwise recover some or all of the financial assistance
provided.
e. Modifying Cost Sharing Contributions. The SELECTEE must notify the PI, who will submit and receive
written authorization from the Agreements Officer, before modifying the amount of cost share
contribution.
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit C: Cybersecurity Plan
The SELECTEE must meet the stated objectives and milestones set forth in its Cybersecurity Plan, which is
incorporated in this Exhibit C.
A report on the SELECTEE’s progress towards meeting the objectives and milestones set forth in the Cybersecurity
Plan must be included in the continuation application.
Any DOE and/or Laboratory review comments or feedback provided to SELECTEE does not constitute an
endorsement or approval of any specific elements within the cybersecurity plan or the proposed security
approach. Therefore, such feedback should not be referenced or used in marketing or promotional materials.
The Cybersecurity Checklist starts on the next page.
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Cybersecurity Plan Checklist
The Bipartisan Infrastructure Law (BIL) provides a strategic opportunity to upgrade the nation’s energy
infrastructure for a clean, resilient, secure energy future. America’s safety and well-being depends on
cybersecurity. It is critical that we ensure cybersecurity is embedded in BIL-funded systems and
technologies to minimize potential disruptions to our energy supply chain, infrastructure, and economy. To
that end, development of a cybersecurity plan, outlining important details such as goals, activities, &
milestones, is required for all BIL-funded projects to ensure that the project cybersecurity runs smoothly.
Asset, Change, & Inventory Management
1. Are you installing an Information Technology (IT) asset/equipment for this project? (Note: IT assets
are a discrete set of electronic information resources organized for the collection, processing,
maintenance, use, sharing, dissemination, or disposition of information)
☐Yes ☒No ☐N/A
If yes, please provide a brief description of the IT asset/equipment
2. Are you installing an Operational Technology (OT) asset(s)/equipment for this project? (Note: OT
assets are assets that are necessary for service delivery or production activities. Examples include
industrial control systems, building management systems, process control systems, safety
instrumented systems)
☐Yes ☒No ☐N/A
If yes, please provide a brief description of the OT asset/equipment
If you answered “Yes” for any of the questions above, please proceed to questions 3-10
Risk & Vulnerabilities
3. Are there any potential cybersecurity vulnerabilities & risks for the IT/OT asset(s) in this project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of all identified risks and vulnerabilities for the IT/OT
asset(s) in this project
4. Are there currently measures, or measures to be implemented, to address identified vulnerabilities
& risks for the IT/OT asset(s) in this project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of plan to address identified vulnerabilities and risks
for the IT/OT asset(s) in this project
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Identity and Access Management
5. Are there currently measures, or measures to be implemented, to manage physical & electronic
control access to IT/OT asset(s) and facility?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of plan to manage physical & electronic control access
to the IT/OT asset(s) and facility
Situational Awareness, Event Incident and Response, & Continuity of Operations
6. Are there currently measures, or measures to be implemented, to document & address
cybersecurity events or incidents for the IT/OT asset(s) in this project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of plan to document & address cybersecurity events
or incidents for the IT/OT asset(s) in this project
Supply Chain and Third-Party Risk Management
7. Are there currently measures, or measures to be implemented, to manage third-party or supply
chain cybersecurity risks (e.g., purchase of counterfeit hardware, software from unknown
provenance, etc.) for the IT/OT asset(s) in this project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of plan to manage third-party or supply chain
cybersecurity risks for the IT/OT asset(s) in this project
Training
8. Will there be cybersecurity training required for operating and/or installing the IT/OT asset(s) in
this project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of the necessary training required for operating
and/or installing the IT/OT asset(s) in this project
Cybersecurity Architecture
9. Are there currently in place, or going to be implemented, the appropriate controls and protections
(e.g., network protection, software protection, IT/OT asset security) for the IT/OT asset(s) in this
project?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of existing, or going to be implemented, controls and
protections for the IT/OT asset(s) in this project
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Cybersecurity Program Management
10. Will there be cybersecurity management processes to oversee and ensure cybersecurity activities
are completed for this project are met?
☐Yes ☐No ☐N/A
If yes, please provide a brief description of the plan to manage the cybersecurity activities for
this project
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Exhibit D: National Environmental Policy Act (NEPA) Implementing Procedures Agreement
NEPA is not applicable for this effort.
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Exhibit E: Current and Pending Support (CPS)
Current and pending support is not applicable for this effort.
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Exhibit F: Davis-Bacon Act Requirements associated with the Bipartisan Infrastructure Law (BIL)
This award is funded under Division D of the Bipartisan Infrastructure Law (BIL). All laborers and mechanics employed
by the SELECTEE, subrecipients, contractors or subcontractors in the performance of construction, alteration, or
repair work in excess of $2000 on an award funded directly by or assisted in whole or in part by funds made available
under this award shall be paid wages at rates not less than those prevailing on similar projects in the locality, as
determined by the Secretary of Labor in accordance with subchapter IV of chapter 31 of title 40, United States Code
commonly referred to as the “Davis-Bacon Act” (DBA).
SELECTEES shall provide written assurance acknowledging the DBA requirements for the award or project and
confirming that all of the laborers and mechanics performing construction, alteration, or repair work in excess of
$2000 on projects funded directly by or assisted in whole or in part by and through funding under the award are paid
or will be paid wages at rates not less than those prevailing on projects of a character similar in the locality as
determined by Subchapter IV of Chapter 31 of Title 40, United States Code (Davis-Bacon Act).
The SELECTEE must comply with all of the Davis-Bacon Act requirements, including but not limited to:
(1) ensuring that the wage determination(s) and appropriate Davis-Bacon clauses and requirements are flowed down
to and incorporated into any applicable subcontracts or subrecipient awards.
(2) being responsible for compliance by any subcontractor or subrecipient with the Davis-Bacon labor standards.
(3) receiving and reviewing certified weekly payrolls submitted by all subcontractors and subrecipients for accuracy
and to identify potential compliance issues.
(4) maintaining original certified weekly payrolls for 3 years after the completion of the project and must make those
payrolls available to the DOE or the Department of Labor upon request, as required by 29 CFR 5.6(a)(2).
(5) conducting payroll and job-site reviews for construction work, including interviews with employees, with such
frequency as may be necessary to assure compliance by its subcontractors and subrecipients and as requested or
directed by the DOE.
(6) cooperating with any authorized representative of the Department of Labor in their inspection of records,
interviews with employees, and other actions undertaken as part of a Department of Labor investigation.
(7) posting in a prominent and accessible place the wage determination(s) and Department of Labor Publication: WH-
1321, Notice to Employees Working on Federal or Federally Assisted Construction Projects.
(8) notifying the Contracting Officer of all labor standards issues, including all complaints regarding incorrect payment
of prevailing wages and/or fringe benefits, received from the SELECTEE, subrecipient, contractor, or subcontractor
employees; significant labor standards violations, as defined in 29 CFR 5.7; disputes concerning labor standards
pursuant to 29 CFR parts 4, 6, and 8 and as defined in FAR 52.222-14; disputed labor standards determinations;
Department of Labor investigations; or legal or judicial proceedings related to the labor standards under this
Contract, a subcontract, or subrecipient award.
(9) preparing and submitting to the Contracting Officer, the Office of Management and Budget Control Number 1910-
5165, Davis Bacon Semi-Annual Labor Compliance Report, by April 21 and October 21 of each year. Form submittal
will be administered through the iBenefits system (https://doeibenefits2.energy.gov) or its successor system.
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The SELECTEE must undergo Davis-Bacon Act compliance training and must maintain competency in Davis-Bacon Act
compliance. The Contracting Officer will notify the SELECTEE of any DOE sponsored Davis-Bacon Act compliance
trainings. The Department of Labor offers free Prevailing Wage Seminars several times a year that meet this
requirement, at https://www.dol.gov/agencies/whd/government-contracts/construction/seminars/events.
The Department of Energy has contracted with a third-party DBA electronic payroll compliance software application.
The SELECTEE must ensure the timely electronic submission of weekly certified payrolls as part of its compliance with
the Davis-Bacon Act unless a waiver is granted to a particular SELECTEE, contractor, or subcontractor because they
are unable or limited in their ability to use or access the software.
Davis Bacon Act Electronic Certified Payroll Submission Waiver
A waiver must be granted before the award starts. The applicant does not have the right to appeal EERE’s decision
concerning a waiver request.
For additional guidance on how to comply with the Davis-Bacon provisions and clauses, see:
https://www.dol.gov/agencies/whd/government-contracts/construction and
https://www.dol.gov/agencies/whd/government-contracts/protections-for-workers-in-construction
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit G: Build America, Buy America Act
This provision applies to designated Buy American Requirement for Infrastructure Projects.
A. Definitions
Components are defined as the articles, materials, or supplies incorporated directly into the end manufactured
product(s).
Construction Materials are an article, material, or supply—other than an item primarily of iron or steel; a
manufactured product; cement and cementitious materials; aggregates such as stone, sand, or gravel; or aggregate
binding agents or additives—that is used in an infrastructure project and is or consists primarily of non-ferrous
metals, plastic and polymer-based products (including polyvinylchloride, composite building materials, and polymers
used in fiber optic cables), glass (including optic glass), lumber, drywall, coatings (paints and stains), optical fiber, clay
brick; composite building materials; or engineered wood products.
Domestic Content Procurement Preference Requirement- means a requirement that no amounts made available
through a program for federal financial assistance may be obligated for an infrastructure project unless—
(A) all iron and steel used in the project are produced in the United States;
(B) the manufactured products used in the project are produced in the United States; or
(C) the construction materials used in the project are produced in the United States.
Also referred to as the Buy America Requirement.
Infrastructure includes, at a minimum, the structures, facilities, and equipment located in the United States, for:
roads, highways, and bridges; public transportation; dams, ports, harbors, and other maritime facilities; intercity
passenger and freight railroads; freight and intermodal facilities; airports; water systems, including drinking water
and wastewater systems; electrical transmission facilities and systems; utilities; broadband infrastructure; and
buildings and real property; and generation, transportation, and distribution of energy -including electric vehicle (EV)
charging. The term “infrastructure” should be interpreted broadly, and the definition provided above should be
considered as illustrative and not exhaustive.
Manufactured Products are items used for an infrastructure project made up of components that are not primarily of
iron or steel; construction materials; cement and cementitious materials’ aggregates such as stone, sand, or gravel; or
aggregate binding agents or additives.
Primarily of iron or steel means greater than 50% iron or steel, measured by cost.
Project- means the construction, alteration, maintenance, or repair of infrastructure in the United States.
Public- The Buy America Requirement does not apply to non-public infrastructure. For purposes of this guidance,
infrastructure should be considered “public” if it is: (1) publicly owned or (2) privately owned but utilized primarily for
a public purpose. Infrastructure should be considered to be “utilized primarily for a public purpose” if it is privately
operated on behalf of the public or is a place of public accommodation.
B. Buy America Requirement
None of the funds provided under this award (federal share or SELECTEE cost-share) may be used for a project for
infrastructure unless:
1. All iron and steel used in the project is produced in the United States—this means all manufacturing
processes, from the initial melting stage through the application of coatings, occurred in the United States;
2. All manufactured products used in the project are produced in the United States—this means the
manufactured product was manufactured in the United States; and the cost of the components of the
manufactured product that are mined, produced, or manufactured in the United States is greater than 55
percent of the total cost of all components of the manufactured product, unless another standard for
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determining the minimum amount of domestic content of the manufactured product has been established
under applicable law or regulation; and
3. All construction materials are manufactured in the United States—this means that all manufacturing
processes for the construction material occurred in the United States.
The Buy America Requirement only applies to articles, materials, and supplies that are consumed in, incorporated
into, or permanently affixed to an infrastructure project. As such, it does not apply to tools, equipment, and
supplies, such as temporary scaffolding, brought into the construction site and removed at or before the
completion of the infrastructure project. Nor does a Buy America Requirement apply to equipment and furnishings,
such as movable chairs, desks, and portable computer equipment, that are used at or within the finished
infrastructure project but are not an integral part of the structure or permanently affixed to the infrastructure
project.
SELECTEES are responsible for administering their award in accordance with the terms and conditions, including the
Buy America Requirement. The SELECTEE must ensure that the Buy America Requirement flows down to all
subawards and that the subawardees and subrecipients comply with the Buy America Requirement. The Buy
America Requirement term and condition must be included all sub-awards, contracts, subcontracts, and purchase
orders for work performed under the infrastructure project.
C. Certification of Compliance
The SELECTEE must certify or provide equivalent documentation for proof of compliance that a good faith effort
was made to solicit bids for domestic products used in the infrastructure project under this Award.
The SELECTEE must also maintain certifications or equivalent documentation for proof of compliance that those
articles, materials, and supplies that are consumed in, incorporated into, affixed to, or otherwise used in the
infrastructure project, not covered by a waiver or exemption, are produced in the United States. The certification
or proof of compliance must be provided by the suppliers or manufacturers of the iron, steel, manufactured
products and construction materials and flow up from all subawardees, contractors and vendors to the SELECTEE.
The SELECTEE must keep these certifications with the award/project files and be able to produce them upon
request from DOE, auditors or Office of Inspector General.
D. Waivers
When necessary, the SELECTEE may apply for, and DOE may grant, a waiver from the Buy America Requirement.
Requests to waive the application of the Buy America Requirement must be in writing to the Contracting Officer.
Waiver requests are subject to review by DOE and the Office of Management and Budget, as well as a public
comment period of no less than 15 calendar days.
Waivers must be based on one of the following justifications:
1.
Public Interest- Applying the Buy America Requirement would be inconsistent with the public interest;
2.
Non-Availability- The types of iron, steel, manufactured products, or construction materials are not produced
in the United States in sufficient and reasonably available quantities or of a satisfactory quality; or
3.
Unreasonable Cost- The inclusion of iron, steel, manufactured products, or construction materials produced
in the United States will increase the cost of the overall project by more than 25 percent.
Requests to waive the Buy America Requirement must include the following:
•
Waiver type (Public Interest, Non-Availability, or Unreasonable Cost);
•
SELECTEE name and Unique Entity Identifier (UEI);
•
Award information (Federal Award Identification Number, Assistance Listing number);
•
A brief description of the project, its location, and the specific infrastructure involved;
•
Total estimated project cost, with estimated federal share and SELECTEE cost share breakdowns;
•
Total estimated infrastructure costs, with estimated federal share and SELECTEE cost share breakdowns;
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•
List and description of iron or steel item(s), manufactured goods, and/or construction material(s) the
SELECTEE seeks to waive from the Buy America Preference, including name, cost, quantity(ies),
country(ies) of origin, and relevant Product Service Codes (PSC) and North American Industry Classification
System (NAICS) codes for each;
•
A detailed justification as to how the non-domestic item(s) is/are essential the project;
•
A certification that the SELECTEE made a good faith effort to solicit bids for domestic products supported
by terms included in requests for proposals, contracts, and non-proprietary communications with
potential suppliers;
•
A justification statement—based on one of the applicable justifications outlined above—as to why the
listed items cannot be procured domestically, including the due diligence performed (e.g., market
research, industry outreach, cost analysis, cost-benefit analysis) by the SELECTEE to attempt to avoid the
need for a waiver. This justification may cite, if applicable, the absence of any Buy America-compliant bids
received for domestic products in response to a solicitation; and
•
Anticipated impact to the project if no waiver is issued.
The SELECTEE should consider using the following principles as minimum requirements contained in their waiver
request:
•
Time-limited: Consider a waiver constrained principally by a length of time, rather than by the specific
project/award to which it applies. Waivers of this type may be appropriate, for example, when an item
that is “non-available” is widely used in the project. When requesting such a waiver, the SELECTEE should
identify a reasonable, definite time frame (e.g., no more than one to two years) designed so that the
waiver is reviewed to ensure the condition for the waiver (“non-availability”) has not changed (e.g.,
domestic supplies have become more available).
•
Targeted: Waiver requests should apply only to the item(s), product(s), or material(s) or category(ies) of
item(s), product(s), or material(s) as necessary and justified. Waivers should not be overly broad as this
will undermine domestic preference policies.
•
Conditional: The SELECTEE may request a waiver with specific conditions that support the policies of
IIJA/BABA and Executive Order 14017.
DOE may request, and the SELECTEE must provide, additional information for consideration of this wavier. DOE
may reject or grant waivers in whole or in part depending on its review, analysis, and/or feedback from OMB or the
public. DOEs final determination regarding approval or rejection of the waiver request may not be appealed.
Waiver requests may take up to 90 calendar days to process.
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By: ___________________________________
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
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By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit H: Non-Disclosure Agreement (NDA)
Non-Disclosure Agreement is not applicable for this effort.
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Exhibit I: Statement of Effort (SOE)
1
BACKGROUND
DEFENSEWERX has the primary objective to provide services for the Department of Energy (DOE) to increase the
likelihood of success in the conduct of cooperative or joint activities typically with small business firms and
educational institutions. DEFENSEWERX serves as the Partnership Intermediary to work with the DOE’s Office of
Manufacturing and Energy Supply Chains (MESC) office on facilitating the Industrial Assessment Centers (IAC)
Implementation Funding Program. For this purpose, DEFENSEWERX is doing business as ENERGYWERX.
2
PURPOSE
This is a project to work with DEFENSEWERX (DEFENSEWERX), doing business as ENERGYWERX, as a Partnership
Intermediary to facilitate critical activity that aligns with the broader IAC Implementation Funding Program
objectives, focused in the area of the Implementation Funding: IAC Implementation Grants workstream. The
workstream provide funding to small- and medium-sized manufacturers (SMMs) who have received assessments
from either an IAC or CHP/Onsite Energy TAP between 2018 and 2024, or other qualified third party assessor since
2021. Recipients are eligible to receive a maximum award of $300,000, and a maximum 50% federal cost share.
3
SCOPE/OBJECTIVES
3.1
Overall expectations for the Implementation Funding: IAC Implementation Grants workstream:
3.1.1
Identify eligible SMMs who have received either an IAC or CHP TA/Onsite Energy TAP assessment between
2018 and 2024, or qualified third party assessor assessment between 2021 and 2024.
3.1.2
Evaluate eligible SMMs who have received either IAC or CHP/Onsite Energy TAP assessments between 2018
and 2024, or a qualified third party assessor assessment between 2021 and 2024, to determine which
entities receive an award.
3.1.3
Select eligible recipients and begin finalizing project scope of work, budget, and terms and agreement.
3.1.4
Recipients to align with PI on reporting and funding schedule.
3.2
City of Glendale, Arizona (“SELECTEE”) shall work with ENERGYWERX and DOE to implement funded projects
from IAC or CHP TAP assessments and capture estimated impacts that meet the Implementation Funding: IAC
Implementation Grants workstream.
4
SPECIFIC TASKS
4.1
Programmatic – SELECTEE shall:
4.1.1
Collaborate with DOE Program Office personnel, U.S. Federal Government employees, industry, and/or
academic partners as required by DOE Program Manager (PM) and Subject Matter Investigators (SMIs).
4.1.2
Generate finalized scope of work with the Partnership Intermediary – including final budget figures (DOE and
Applicant Costs), Schedule of the Project, an
4.1.2.1 Note: ENERGYWERX (ENWX) understands that estimates received in the past may no longer be
accurate. If the SELECTEE finds that the actual cost is more than the estimate, please reach out to
ENWX for further assistance.
4.1.2.2 Note: The maximum Federal Cost Share contribution remains $300,000.
4.1.3
The SELECTEE will follow the reporting structure/requirement laid out in table 2 below.
4.1.4
The SELECTEE shall complete the following documentation to ensure documentation of findings, results,
and/or recommended next steps.
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4.1.4.1 Overall Project Health Form: Providing a narrative on project progress, accomplishments, or
concerns [Attachment 1]
4.1.4.1.1
Note: Please submit one attachment per recommendation 2
4.1.4.2 Project Financials Form: Outlining spend to date on funded projects with respective invoices.
[Attachment 2]
4.1.4.2.1
Note: Please submit one attachment per recommendation3
4.1.4.3 Project Impact Form: Outlining project impact across key metrics for implemented projects.
[Attachment 3]
4.1.4.3.1
Note: Please submit one attachment per recommendation4
4.1.5
Provide finalized list of recommendations to implement in the table below to ensure sufficient
documentation of recommendation progress.
Recommendation Description
Davis Bacon Act Applies
1
Replace old chillers
Yes
Table 1: List of Recommendations to Implement
4.1.6
Coordinate directly with DOE, and their designated transfer office, on specific terms and negotiation of
shared patent rights between DOE and identified partners.
4.2
All Phases – SELECTEE shall:
4.2.1
Provide own facilities, materials, and labor to support Implementation Funding: IAC Implementation Grants
workstream in accordance with the TCA as well as any mandated exhibits from the SOE’s addendums.
4.2.2
Provide a written status to DEFENSEWERX (dba ENWX) quarterly.
4.2.3
Utilize Teams Video Teleconference (or approved alternative) for all virtual meetings, technical program
reviews, and/or demonstrations.
4.2.4
If requested, conduct in-person meetings and/or technical demonstrations at locations TBD by DOE PM and
SMI(s).
2 If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then the applicant will fill out 3 separate forms for each recommendation
3 If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then the applicant will fill out 3 separate forms for each recommendation
4 If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then the applicant will fill out 3 separate forms for each recommendation
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5
SCHEDULE AND MILESTONES
The following schedule and milestones are proposed for this effort depending on the timeline implementation. Below
is a schedule of the anticipated milestones. There will be quarterly check ins (due on the 15th of the month) where the
SELECTEE provides a bulleted status to info@energywerx.org. Twice a year, in June and December, SELECTEE will also
provide reporting documentation in addition to the bulleted status update. The reporting documentation can be
found at the end of this agreement and in the ENERGYWERX Invoicing One Drive: https://8502264383-
my.sharepoint.com/:f:/g/personal/info_energywerx_org/Euo9NzS2j71BomBDPpAtAzQBnCw6bxcn00G1knPt4noi5w?
e=eF0vnc.
Milestone
Due
ENWX provides notice to proceed; B2B
Agreement executed & SELECTEE completes
ENWX Invoice Intake Form
November 2024
SELECTEE completes email check in providing
project status to ENWX & program team.
December 15,2024
SELECTEE completes email check in providing
project status to ENWX & program team & first
batch of reporting documentation
March 15, 2025
SELECTEE completes email check in providing
project status to ENWX & program team
June 15, 2025
SELECTEE completes email check in providing
project status to ENWX & program team &
second batch of reporting documentation
September 15,2025
SELECTEE completes email check in providing
project status to ENWX & program team
December 15, 2025
SELECTEE completes email check in providing
project status to ENWX & program team & third
batch of reporting documentation
March 15, 2026
SELECTEE completes email check in providing
project status to ENWX & program team
June 15, 2026
SELECTEE completes email check in providing
project status to ENWX & program team &
fourth batch of reporting documentation
September 15, 2026
SELECTEE submits batch final of reporting
documentation & final deliverable package
September – December 2026
Program review of final batch of reporting
documentation complete
September – December 2026
Address any critical follow ups from program
team second batch of reporting documentation
September – December 2026
Final Deliverable Approved – Project
Completion
September – December 2026
Note: Projects shorter than 2 years will submit their final batch of reporting and address any critical follow ups from
the program team during the quarter following project completion.
Table 2: Project Schedule & Milestones
6
SECURITY
This is an unclassified activity; however, all work, communication, documentation, and participant details are
Business Proprietary. Information may only be exchanged between parties working directly on the program.
Requests for publication or distribution of information to media or outside parties must be made in writing to
DEFENSEWERX (dba ENERGYWERX) pursuant to Paragraph 19 the Research and Development Agreement for
coordination with DOE. No publication or distribution of information may be made prior to DOE approval, and such
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information will be withheld from public disclosure to the extent permitted by law, including the Freedom of
Information Act. Without assuming any liability for inadvertent disclosure, the Parties will seek to limit disclosure of
such information to their respective employees on a need-to-know basis, and to outside reviewers only when
necessary and in coordination with DOE. This restriction does not limit the U.S. Federal Government’s right to use the
information if it is obtained from another source.
Personnel performing work under this Statement of Effort may receive, have access to or participate in the
development of proprietary or source selection information (e.g., cost or pricing information, budget information or
analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or
subsequent Organizational Conflict of Interest (OCI) as defined in FAR Subpart 9.5. The Parties shall notify DOE
immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI
and shall promptly submit a plan to avoid or mitigate any such OCI.
SELECTEE certifies that it qualifies as a domestic entity. To qualify as a domestic entity, the entity must be organized,
chartered or incorporated (or otherwise formed) under the laws of a particular state or territory of the United States;
have majority domestic ownership and control; and have a physical place of business in the United States.
SELECTEE certifies that it is not owned by, controlled by, or subject to the jurisdiction or direction of government of
Country of Risk, and that individuals performing this work are not part of a foreign talent program sponsored by a
Country of Risk. DOE defines Country of Risk to include China, Russia, North Korea and Iran. This list is subject to
change.
7
GOVERNMENT FURNISHED EQUIPMENT, INFORMATION, AND FACILITIES
The U.S. Federal Government will not provide any equipment or facilities.
8
DESIRED OUTCOME AND DELIVERABLES
8.1
SELECTEE shall work to deliver:
8.1.1.1 Completion of the reporting documentation as called out in section 4.1.3
8.1.1.1.1
The final set of reporting documentation to outline the following detail including – final
project spend across the targeted recommendations, realized cost and energy savings, CO2
emissions impact, and/or number of jobs created
8.1.1.2 Finalize implementation of targeted recommendations
8.1.1.3 Public Summary Sheet providing an overview of the project(s) implemented.
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9
PAYMENT SCHEDULE
DEFENSEWERX, dba ENERGYWERX, proposes milestone payments and purchase order details in conjunction with the
work to be performed (NOTE: Timeline may be accelerated, if applicable). Please be advised this agreement is
contingent upon DEFENSEWERX receipt of task funding through the Partnership Intermediary Agreement with DOE.
City of Glendale, Arizona has been awarded $300,000 to support the estimated total value of the work $627,746 ,
with your contribution then being $327,746 .
Pmt
Invoice Submission
Milestone
Pmt Amt
Cumulative
1
December 2024
SELECTEE completes email check in
providing project status to ENWX &
program team
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount
2
March 2025
SELECTEE completes email check in
providing project status to ENWX &
program team & first batch of reporting
documentation
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
December
Cumulative
3
June 2025
SELECTEE completes email check in
providing project status to ENWX &
program team
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
March
Cumulative
4
September 2025
SELECTEE completes email check in
providing project status to ENWX &
program team & second batch of reporting
documentation
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount + June
Cumulative
5
December 2025
SELECTEE completes email check in
providing project status to ENWX &
program team
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
September
Cumulative
6
March 2026
SELECTEE completes email check in
providing project status to ENWX &
program team & third batch of reporting
documentation
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
December
Cumulative
7
June 2026
SELECTEE completes email check in
providing project status to ENWX &
program team
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
March
Cumulative
8
September 2026
SELECTEE completes email check in
providing project status to ENWX &
program team & fourth batch of reporting
documentation
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
September
Cumulative
9
Project Completion
SELECTEE submits batch final of reporting
documentation & final deliverable package
50% of total costs
incurred up to
(Federal Cost Share
– 10%)
= Payment
Amount +
Cumulative to
Date
Month after project
completion
DOE review of final batch of reporting
documentation complete
N/A
Month after DOE
review of final batch
of reporting
Address any critical follow ups from
program team second batch of reporting
documentation
N/A
10
Month after follow
ups addressed
Final Deliverable Approved – Project
Completion
=10% of total
award
= $300,000
Note: All invoices submitted through the ENWX Invoicing System need to include documentation in support of the
milestone. This should include receipts that show payments have been made by SELECTEE, copies of emails sending
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quarterly status, copies of reporting documentation during the applicable quarter).
Final reporting documentation invoice can be submitted one month after project is complete, regardless of what
month it is completed in. Final invoice for 10% of the federal cost share can be submitted after DOE approves the
reporting documentation.
Tables 3: Project implementation payment schedule
10 POINTS OF CONTACT
The following points of contact (POCs) will be used for the duration of the agreement. All parties must be notified if a
change in POC is requested.
Points of Contact:
DOE PM
Name: Jeremy Avins
Email: Jeremy.avins@hq.doe.gov
DOE Technical POC/Subject Matter Investigator
Name / Primary: Mustafa Mahmoud
Email: Mustafa.mahmoud@hq.doe.gov
DOE Technical POC/Subject Matter Investigator
Name / Alternate: Clifton Yin
Email: Clifton.yin@hq.doe.gov
DOE Agreements Officer
Name / Alternate: Laura Merrick
Email: laura.merrick@ee.doe.gov
ENERGYWERX Director
Name: Carla Heron
Email: cheron@ENERGYWERX.org
ENERGYWERX Deputy Directory
Name: Christi Pezzone
Email: cpezzone@ENERGYWERX.org
DEFENSEWERX Financial POC
Name: Joanna Gomez
Email: jgomez@defensewerx.org
City of Glendale, Arizona Primary Technical Program Manager POC
Name:
Email:
Phone:
City of Glendale, Arizona Alternate Technical Program Manager POC
Name:
Email:
Phone:
City of Glendale, Arizona Primary Administrative POC
Name:
Email:
Phone:
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City of Glendale, Arizona Alternate Administrative POC
Name:
Email:
Phone:
For DEFENSEWERX (dba ENERGYWERX)
For City of Glendale, Arizona
By: __________________________________
By: __________________________________
Christi Pezzone
ENERGYWERX Deputy Director
Date:
Name: Michael D. Bailey
Title: City Attorney
Date:
By: __________________________________
Name: Jamsheed Mehta
Title: City Manager
Date:
By: __________________________________
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit J: Engineering Change Proposal (ECP)
As of the Effective Date, there are no modifications. Should any modifications be required, this exhibit will be
updated to reflect those mutually agreed to changes and affixed with signatures of both parties below.
IN WITNESS WHEREOF, the parties hereto have signed and sealed this Agreement as of the day and year first
above written,
DEFENSEWERX
By:
Name: Christi Pezzone
Title: ENERGYWERX Deputy Director
Date:
City of Glendale, Arizona
By:
Name: Michael D. Bailey
Title: City Attorney
Date:
By:
Name: Jamsheed Mehta
Title: City Manager
Date:
By:
Name: Julie K. Bower
Title: City Clerk
Date:
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Exhibit K: Declaration of Background Intellectual Property (IP)
Declaration of Background Intellectual Property (IP) is not applicable for this effort.
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Exhibit L: Intellectual Property
Intellectual Property (IP) is not applicable for this effort.
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Attachment 1: Overall Project Health Form
Note: If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then fill out 3 separate forms for each recommendation
Date (update using field at right):
August 14, 2023
CONTRACTOR Project Lead Name:
CONTRACTOR Organization:
CONTRACTOR Facility Address
CONTRACTOR City, State, Zip Code:
Project Name:
Project Start Date:
Project Health Indicators:
The CONTRACTOR project team has assigned the following health indicators for the project scope, schedule
and budget:
Health Indicator
(Green, Yellow, or Red)
Comments (Required)
Scope
Schedule
Budget
Green = Project is on track; Yellow = Project has a few issues, but issues are being managed and closely
monitored; Red = Project has serious issues, estimated deadlines are being missed
Project Progress/Accomplishments: Overview on implementation progress & accomplishments to date
Project Concerns and/or required support: Overview on any concerns on project meeting aligned scope
This document does not prescribe or approve any specific changes to the project scope or budget. Such
changes must be undertaken with the approval of the Department of Energy
CONTRACTOR Project Lead Name:
CONTRACTOR Project Lead
Signature:
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Attachment 2: Project Financials Form
Note: If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then fill out 3 separate forms for each recommendation
Date (update using field at right):
August 14, 2023
CONTRACTOR Project Lead Name:
CONTRACTOR Organization:
CONTRACTOR Facility Address
CONTRACTOR City, State, Zip Code:
Recommendation Name:
Recommendations Start Date:
Expenditures: In the table below, please provide a list of all expenditures (equipment,
contractors, permitting, etc.) to date for implementing the project
Description5
MFG Serial
Number6
Purchase
Date7
Install
Date
Purchase
Cost8
Proof of
Purchase
Submitted?9
1
2
3
4
5
CONTRACTOR Project Lead Name:
CONTRACTOR Project Lead
Signature:
5 Brief description of the item or service
6 As applicable, enter the manufacturer's serial number, model number, Federal stock number, national stock
number, or other identification number.
7 Date of purchase for item in MM/DD/YYYY
8 Cost of item or service
9 Provide proof of purchase (e.g., invoice, receipts, contract, etc.)
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Attachment 3: Project Impact Form
Note: If an awarded applicant plans to implement 3 different recommendations (e.g., LED light replacement, HVAC
replacements, and solar panel installation), then the applicant will fill out 3 separate forms for each recommendation
Date (update using field at right):
August 14, 2023
CONTRACTOR Project Lead Name:
CONTRACTOR Organization:
CONTRACTOR Facility Address
CONTRACTOR City, State, Zip Code:
Recommendation Name:
Recommendations Start Date:
Project Impact: In the tables below, please provide an update (as applicable) regarding the
following metrics for the specific recommendation
Metric10
Unit11
Value12
Comments13
1
Annual Electricity Savings
KwH/yr.
2
Annual CO2 Emissions
Reduction
Kg of
CO2/yr.
3
Annual Cost Savings
$/yr.
4
# of Permanent Jobs
Created or Maintained
due to Project
#
5
# of Temporary Jobs
Created or Maintained
due to Project
#
6
Jobs & Training Outcome
#
Comments on recommendation impact on site’s operation, & economic & energy performance
CONTRACTOR Project Lead Name:
CONTRACTOR Project Lead
Signature:
10 Metric to report with respect to the recommendation. For projects recently completed, for annual metrics, feel
free to report estimated yearly impact via extrapolation of actual data
11 Unit of measure for the metric
12 Actual value of metric
13 Provide any commentary that you may believe is useful for the DOE and PI to know