TO: WIB Directors

MEMO: AP 05-09

DATE: May 24, 2005

TO: WIB Directors

WIB Chairpersons

Grant Recipients

FROM: Lorna Joseph

Director of Program Support

SUBJECT: PY 2005 WIA Contract Package

Background: The Executive Committee of the Connecticut Employment and Training Commission has approved the allocations sent in draft via AP 05-02. They are now final, and the PY 2005 contract package is being provided.

Policy: Please find as Attachment 1, the WIA PY 2005 DOL contract package for new WIA funds. These funds are to be kept separate from your PY 2004 WIA funds. The adult and dislocated worker funds were given to us by USDOL under the categories of PY 2005 and FY 2006. That means for drawdown purposes, PY 2005 funds will be available July 1, 2005, and the FY 2006 portion will become available October 1, 2005.

The PY 2005 contract package requires that all questions be addressed. Contracts will not be executed until all required items have been satisfactorily submitted, including all signed memorandums of understanding. Please ensure that the contract includes PY 05-06 projected performance standards.

Please submit three originally signed copies of this contract to Michelle LaRose, Connecticut Department of Labor, WIA Administration, 200 Folly Brook Boulevard, Wethersfield, CT 06109. We are requesting that these contracts be submitted by June 24, 2005, so that processing of the grants can be done in a timely manner.

If you have any questions on this issuance, please contact Steve Litke at (860) 263-6599, Chris Sanders at (860) 263-6583 or Susan Deschamplain at (860) 263-6600.

Attachments

Contract packages are being sent to WIB

Directors only. If you want a copy of the

attachments, please call Michelle LaRose

at (860) 263-6592.

PY 2005 WIA

DOL Contract Package

Part I. Connecticut Department of Labor (CTDOL) Contract

Parties
To
Contract: / Connecticut Department of Labor
200 Folly Brook Boulevard
Wethersfield, CT 06109
Telephone: (860) 263-6590 / CONTRACT NUMBER
Fax: (860) 263-6216 / State IRS ID No.
06 - 6000798
Contractor’s Name / Contractor IRS ID No.
and Address / Contractor Representative
Payment Address / Telephone Number
(complete if different)
Type of Ownership (check applicable classification)
Corporation Incorporated Under the Laws of the State of:
Limited Liability Company Partnership Governmental Entity
Sole Proprietorship Trusteeship / (Check each item)
Yes No
Minority Business
Women Business
Non-Profit
Contract Start Date / Contract End Date / Maximum Allowable Contract Amount
$
PURPOSE: The purpose of this contract is to provide PY 2005 local area adult, youth, and dislocated worker formula dollars
funding under the Workforce Investment Act of 1998 (PL 105-220), and to provide the Department of Labor with a description
of the systems and administrative plan.
TERMS AND CONDITIONS OF CONTRACT:
The parties hereto agree that the contractor shall provide services in accordance with its proposal, which is attached and made a part hereof. In consideration for the services to be provided by the contractor for the period shown above, the contractor will receive reimbursement not to exceed the total amount shown above; such amount to be paid pursuant to this Contract Face Sheet (Part I), Specific Terms (Part II), Systems and Administrative Plan (Part III), and General Conditions including the State of Connecticut Assurances (Part IV), which are a part of this contract. This is a performance based contract and reimbursement is based on successful performance and actual costs incurred. The State of Connecticut assumes no liability for payment under the terms of this contract, until said contractor is notified by the Connecticut Department of Labor, that said contract has received final approval. This contract is the entire agreement between the parties hereto and may be amended only in writing by the Connecticut Department of Labor.
STATUTORY AUTHORITY: Connecticut General Statutes (CGS) 4-8; 31-250; 31-253
ACCEPTANCES: In witness whereof the parties have affixed their signatures on the day, month and year written below.
COLLECTIVE BARGAINING CONCURRENCE: NOT APPLICABLE Yes, (If YES, see attachment)
CONTRACTOR APPROVAL: (Affix Corporate Seal Here)
______
Signature of Contractor’s Authorized Officer Date
______
Name and Title (please print or type)
CT DOL APPROVAL:
______
Labor Commissioner Date
______
AS TO FORM (ATTORNEY GENERAL) Date / ______
CT DOL BUSINESS MANAGEMENT Date
(For Fund Availability)

DOL-500w (Rev 12/29/99)

Connecticut DOL PY 2005 WIA Contract Face Sheet Instructions

Parties to Contract:

Contract Number - will be assigned by Connecticut Department of Labor

Contractor Name and Address

Payment Address

(if different)

Contractor IRS ID No. - enter your IRS identification number

Contractor Representative - enter the name of the individual to be contacted regarding questions/issues regarding this contract

Telephone Number - enter the telephone number of the contractor representative

Type of Ownership - check applicable classification

Minority Business - answer as appropriate

Women Business - answer as appropriate

Non-Profit - answer as appropriate

Contract Start Date - enter July 1, 2005

Contract End Date - enter June 30, 2007

Maximum Allowable Contract Amount - enter the total of your adult, youth and dislocated worker WIA allocations for PY 2005 (for your information these figures are contained as Attachment 2 to this issuance)

Purpose:

Terms and Conditions of Contract:

Statutory authority:

Acceptances

Collective Bargaining Concurrence - check the appropriate box

Contractor Approval:

Signature of Contractor's Authorized Officer - to be signed and dated by authorized officer of the contractor

Name and Title - please print or type the name and title of the Authorized Officer

Below this line is for DOL use

AFFIDAVIT

CONTRACTOR OR LESSOR

INTEGRITY IN STATE CONTRACTING POLICY

OFFICE OF THE ATTORNEY GENERAL

I, ______, hereby swear that, during the ten years preceding the date of this affidavit, neither I nor an official, employee or agent of myself or ______(legal name of entity) have provided or caused to be provided gifts, as defined in Conn. Gen. Stat. §1-79 (e), except as otherwise set forth below, including a gift for the celebration of a major live event as described in Conn. Gen. Stat. §1-79(e)(12), to a state official or employee of the contracting or leasing agency or a state official or employee of a state agency or department which has supervisory or appointing authority over the contracting or leasing agency. The contracting agency has provided me with the names of the following agencies or departments that have supervisory or appointment authority over such department:

Carl Buzzelli

______.

Name of recipient of the gift Description of gift and value Date of gift

1.  ______

2.  ______

3.  ______

4.  ______

Sworn as true to the best of my knowledge and belief, false statement punishable under law:

______

Print name: Date

Sworn and subscribed before me on this day of , 2005,

______

Commissioner of the Superior Court/

Notary Public

Instructions Regarding Certification of Signatory

(Non-governmental Entities)

In order to execute a contract, the State requires from non-governmental entities that a certified copy of a corporate resolution accompany each contract.

The certification must bear an original signature by an officer of the corporation, preferable the secretary, other than the person authorized to execute the contract.

The certification shall bear the seal of the corporation.

The certification should recite the following:

1.) the name of the body adopting the resolution;

2.) the date of the adoption;

3.) the date of the certification; and

4.) the title of the certifier

The resolution itself must authorize someone to execute the particular contract. The resolution must state the name or name/title of the person authorized to execute the contract. If the resolution only states the title, the State requires a certification by a corporate officer as to the name of the individual who holds the office.

The resolution must be adopted prior to the execution of the contract, otherwise the resolution may be treated as a ratification when there is sufficient information to determine the execution of the particular contract. However, a ratification document is preferable.

Certification, whether they are for resolutions, by-laws, or minutes should be updated annually.

The following certification resolution is an example of the format that should be used:

CERTIFICATION RESOLUTION

I, John Doe, Secretary of XYZ Corporation, a New York corporation (the "Company"), DO HEREBY certify that the following is a true and correct copy of a resolution duly adopted at a meeting of the Board of Directors of the Company duly held and convened on Month, Day, Year, at which meeting a duly constituted quorum of the Board of directors was present and acting throughout and that such resolutions has not been modified, rescinded or revoked and is present in full force:

RESOLVED: That the President Rachel Roe, is empowered to execute and deliver contracts in the name and on behalf of this Company and to affix the corporate seal.

IN WITNESS WHEREOF, the undersigned has affixed his signature and the corporate seal of the Company this "x" day of Month, Year.

(SEAL) John Doe, Secretary

In lieu of a certified resolution, a certified copy of the applicable section of the corporate by-laws which authorize execution of the contract by the signing person may be substituted along with certification that the person signing the contract, in fact, holds the office in question.

In lieu of a certified copy of the corporate resolution or by-laws, a certified copy of the corporate minutes of the meting of the board of directors may be submitted. These minutes must specifically authorize the signing person to execute the particular contract under review or the particular type of contract of which the one under review is an example.

Directions regarding Certification of Signatory

(Municipal Authority)

In order to execute any contract, the State requires from all governmental entities that a certified resolution accompany each contract.

The certification must bear an original signature by an officer of the municipality, such as the town or City Clerk, other than the person authorized to execute the contract

The certification shall bear the seal of the municipality.

The certification should recite the following:

1.)  the name of the body adopting the resolution;

2.)  the date of the adoption;

3.)  the date of certification; and

4.)  the title of the certifier.

The resolution itself must authorize someone to execute the particular contract. The resolution must state the name of or name/title of the person authorized to execute the contract. If the resolution only states the title, the State requires a certification by a corporate officer as to the name of the individual who holds the office.

The resolution must be adopted prior to the execution of the contract; otherwise, the resolution may be treated as a ratification when there is sufficient information to determine the execution of the particular contract. However, a ratification document is preferable.

Certifications, whether they are for resolutions, vote of town councils, local ordinances, etc., should be updated annually.

It is preferred that the resolution be for the specific contract or type of contract between the municipality and the Connecticut Department of Labor.

CERTIFICATION REGARDING LOBBYING

Certification for Contracts, Grants, Loans,

And Cooperative Agreements

The undersigned certifies, to the best of their knowledge and belief, that:

1.  No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person(s) 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.

2.  If any funds other than Federal appropriated funds have been paid or will be paid to any person(s) 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 undersigned shall complete and submit Standard FormLLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

3.  The undersigned shall require that the language of this certification be included in the award documents for all* sub-awards at all tiers (including subcontracts, sub-grants and contracts under grants, loans, and cooperative agreements) and that all* sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Grantee/Contractor Organization / Program/Title
Name of Certifying Official / Signature / Date

*Note: In these instances "all", in the Final Rule is expected to be clarified to show that it applies to covered contract/grant transactions over $100,000 (per OMB).

Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primarily Covered Transactions

Instructions for Certification

1. By signing and submitting this proposal, the prospective recipient of Federal assistance funds is providing the certification as set out below.

1. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of Federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment.

1. The prospective recipient of Federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of Federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations.

1. The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should the proposed covered transactions be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL.

1. The prospective recipient of Federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

1. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determined the eligibility of its principals. Each participant may but is not required to check the List of Parties Excluded from procurement or Non-Procurement Programs.

1. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

1. Except for transactions authorized under Paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is debarred, suspended, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies including suspension and/or debarment.