HomeMy WebLinkAboutWashington Dept of Archaeology & Historic Preservation - DAHP Contract #FY16-61016-011STATE OF WASHINGTON
Department of Archaeology and Historic Preservation
1063 S. Capitol Way, Suite 106 • PO Box 48343 • Olympia, Washington 98504-8343
(360) 586-3065 • Fax Number (360) 586-3067 • www.dahp.wa.gov
DAHP Contract #FY16-61016-011
Grant Agreement
Between
Washington State
Department of Archaeology and Historic Preservation
And
City of Yakima
Grant No.: Historic Inventory
Contact Person: Loren Doolittle (360) 586-3072
Federal Grant No.: N/A
CFDA No.: 15-904
Grant Title: City of Yakima
Effective Date: October 1, 2015
Expiration Date: August 31, 2016
Historic Preservation Element of the Comprehensive Plan
This agreement is made between The Department of Archaeology and Historic
Preservation hereinafter referred to as the DEPARTMENT, and City of Yakima,
hereinafter referred to as the GRANTEE.
Section 1. Responsibilities of the Grantee
A. The GRANTEE will perform or cause others to perform the work described in the
"Scope of Work" (Attachment 2). Additional special conditions or specifics about
the work required by this agreement, if any, are in attachments as enumerated and
described in Section 3. The GRANTEE agrees to perform the work in accordance
with any such special conditions or specifics.
B. The GRANTEE understands that the work called for under this agreement must
conform to federal administrative requirements as they relate to the
DEPARTMENT, and the GRANTEE agrees to comply with all such
DAHP Contract #FYI6-61016-011
requirements. The following documents summarize some of these requirements
and are incorporated herein and made a part hereof as though set forth in full:
(1) The requirements of OMB Circular A-133 for States, Local Governments,
and Non-profit organizations.
(2) The "Secretary of Interior Standards and Guidelines for Archaeology and
Historic Preservation." All products under this contract must be in
compliance with the relevant Secretary's Standards and Guidelines e.g.
Preservation Planning, Identification, Evaluation, Registration, Historic
Research and Documentation, Architectural and Engineering
Documentation, Archeological Investigation, Historic Preservation
Projects, and Preservation Terminology.
(3)
The "Historic Preservation Fund Grants Manual." - Latest Revision,
September 2005.
(4) "Grants in Aid Manual." Department of Community Trade and Economic
Development, Office of Archaeology and Historic Preservation.
(5)
"Fiscal Year 2013 Historic Preservation Fund Annual Grant Application
and Budget Changes / Special Conditions."
(6) "43 CFR 17 Civil Rights, Subpart A, Implementing Title VI of the Civil
Rights Act of 1964; and Subpart B, Implementing Section 504 of the
Rehabilitation Act of 1973; and Subpart C, Implementing the Age
Discrimination Act of 1975; and subpart E, Enforcement of
Nondiscrimination on the Basis of Handicap in Programs or Activities
Conducted by the Department of the Interior."
"Americans with Disabilities Act of 1990," 42 U.S.C. 1201 et seg. (ADA)
provides comprehensive civil rights to individuals with disabilities in the
areas of employment, public accommodations, state and local government
services, and telecommunications.
(7)
c. The GRANTEE agrees to comply with the restrictions of 18 U.S.C. 1913
concerning lobbying with appropriated funds: "No part of the money appropriated
by any enactment of Congress shall, in the absence of express authorization by
Congress, be used directly or indirectly to pay for any personal service,
advertisement, telegram, telephone, letter, printed or written matter, or other
device, intended or designed to influence in any manner a Member of Congress, to
favor or oppose, by vote or otherwise, any legislation or appropriation by
Congress, whether before or after the introduction of any bill or resolution
DAHP Contract #FY16-61016-011
proposing such legislation or appropriation; but this shall not prevent officers or
employees of the United States or its departments or agencies from
communicating to Members of Congress at the request of any Member, or to
Congress through the proper official channels, requests for legislation or
appropriations which they deem necessary for the efficient conduct of the public
business."
D. The GRANTEE agrees to maintain records in a manner which will provide an
audit trail to all expenditures reported to the DEPARTMENT. The GRANTEE
agrees to keep these records for at least four years following the ending date of the
grant. In the event that an audit of the GRANTEE or of the DEPARTMENT
should take exception to any expenditures by the GRANTEE, the GRANTEE
agrees to refund to the DEPARTMENT on demand the amount determined by the
audit as due. In the event that the DEPARTMENT is required to institute legal
proceedings to enforce this repayment provision, the DEPARTMENT shall be
entitled to its costs thereof, including reasonable attorney's fees. When arranging
for an audit, the DEPARTMENT should contact:
Jeff Peters (509) 575-6163
129 North Second Street
Yakima, WA 98901 jpeters@ci.yakima.wa.us
E. The GRANTEE agrees to pay all the costs involved in carrying out the terms of
this agreement prior to seeking reimbursement as provided for in Section 2. a.
When seeking reimbursement, the GRANTEE will submit a completed
reimbursement form in writing to the DEPARTMENT and provide such
documents as an affidavit of publication for newspaper advertising soliciting bids,
contracts, photocopies of canceled checks and invoices, and other documents as
may be requested by the DEPARTMENT. The DEPARTMENT will provide the
GRANTEE with the reimbursement form and guidelines for financial reporting
procedures. The GRANTEE agrees to submit its request for reimbursement within
thirty (30) days following completion of the work.
F. The GRANTEE agrees to provide the DEPARTMENT with a completion report
following a form provided by the DEPARTMENT. The GRANTEE will submit
this report on or before the end date. The GRANTEE agrees that the
DEPARTMENT shall have the right to withhold all or part of the payment
required in Section 2.a. pending receipt of this completion report.
G. The GRANTEE agrees that the "Budget" (Attachment 1) shall be a financial guide
for the work called for by this agreement. The GRANTEE may exceed the
budgeted amounts, but this shall in no way obligate the DEPARTMENT for a
DAHP Contract #FY16-61016-011
greater amount than that stipulated as DEPARTMENT share. In the event that the
GRANTEE should spend less than the budgeted amount on an object or element in
the budget, the DEPARTMENT may either reduce its obligation proportionately or
it may terminate this agreement. The GRANTEE agrees to maintain records which
will render an accurate accounting by the elements or objects in the budget. The
actual expenditures for the amounts reflected in the budget may vary by 15 percent
without requiring an amendment to this grant agreement.
H. The GRANTEE agrees that the DEPARTMENT shall have the right to terminate
this agreement if the GRANTEE shall fail to fulfill in a timely and proper manner
its obligations under this agreement or if the GRANTEE shall violate any of the
covenants, conditions, or stipulations of the agreement. In case of such
termination by the DEPARTMENT, the GRANTEE agrees to return to the
DEPARTMENT within thirty (30) days of the effective date of termination, any
payments made by the DEPARTMENT to the GRANTEE under the terms of this
agreement or any portion of such payments as may be directed by the
DEPARTMENT.
The GRANTEE agrees to submit the products identified in the Scope of Work on
or before the grant end date. GRANTEE acknowledges and understands that final
products which do not conform to the terms and conditions of this agreement or
which do not meet the applicable Secretary of the Interior's Standards will not be
reimbursed.
L The GRANTEE agrees to submit a "Schedule for Project Completion"
(Attachment 6) before beginning work under this agreement. Said schedule form
shall list each element described in the "Scope of Work" and shall indicate the
approximate date when completion of each can be expected.
J. The GRANTEE will maintain regular contact with the DEPARTMENT regarding
the progress of the grant project. The GRANTEE agrees that the DEPARTMENT
shall have the right to monitor the work called for by this agreement.
x. The GRANTEE agrees to use competitive negotiation procedures (or small
purchase procedures for under $25,000) for procurement of professional services
and subcontracts. GRANTEE agrees to maintain records sufficient to detail the
significant history of a procurement and to forward evidence of competitive
procurement to the DEPARTMENT prior to reimbursement of funds under this
agreement. (See Section 3, Attachment 7.)
L. The GRANTEE agrees that it, its agents and employees, and any other person or
entity performing any work under this agreement, are independent contractors and
not employees of the State of Washington.
DAHP Contract #FY16-61016-011
M. Federal funds are the basis for this contract. The GRANTEE certifies that neither
it nor its principals are presently debarred, declared ineligible, or voluntarily
excluded from participation in transactions by any federal department or agency.
Should for any reason the Federal funds which are the basis for this agreement
become withdrawn, the agreement may be terminated without penalty to the
DEPARTMENT.
N. To the fullest extent permitted by law, Contractor shall indemnify, defend and
hold harmless State, agencies of State and all officials, agents and employees of
State, from and against all claims for injuries or death arising out of or resulting
from the performance of the Contract. Contractor's obligation to indemnify,
defend, and hold harmless includes any claim by Contractors' agents, employees,
representatives, or any subcontractor or its employees.
Contractor expressly agrees to indemnify, defend, and hold harmless the State for
any claim arising out of or incident to Contractor's or any subcontractor's
performance or failure to perform the Contract. Contractor's obligation to
indemnify, defend, and hold harmless the State shall not be eliminated or reduced
by any actual or alleged concurrent negligence of State or its agents, agencies,
employees and officials.
Consistent with RCW 43.17.320.340, the parties shall make every effort to
resolve disputes arising out of, or relating to, this contract through discussion and
negotiation.
Should discussion and negotiation fail to resolve a dispute arising under this
contract, the parties shall select a dispute resolution team to resolve the dispute.
The team shall consist of a representative appointed by the director of each party
and a third party mutually agreed upon by the director of each party. The team
shall attempt, by majority vote, to resolve the dispute. If the dispute cannot be
resolved in this fashion, either party may request assistance from the Governor
pursuant to RCW 43.17.330.
o. The GRANTEE agrees to provide or purchase industrial insurance coverage, as
applicable, prior to performing work under this agreement. The DEPARTMENT
will not be responsible for payment of industrial insurance premiums or for any
other claim or benefit for this GRANTEE, or any sub -grantee or employee of the
GRANTEE, which might arise under the industrial insurance laws during
performance of duties and services under this agreement. If the Department of
Labor and Industries, upon audit, determines that industrial insurance payments
are due and owing as a result to work performed under this agreement, those
payments shall be made by the GRANTEE; the GRANTEE shall indemnify the
DEPARTMENT and guarantee payment of such amounts.
DAHP Contract #FY16-61016-011
P. The GRANTEE agrees to include written acknowledgment of National Park
Service, Department of Community Trade and Economic Development, and
Office of Archaeology and Historic Preservation support for all grant -related
publications and public information materials including audio-visual and
workshop materials. The GRANTEE further agrees that the written
acknowledgment shall comply with the form and content stipulated in the
"Historic Preservation Fund Grants Manual — Latest Revision September 2005."
Q. The GRANTEE agrees to any additional conditions identified in section 3 and
attached to this agreement.
R. There shall be no discrimination against any person employed by the GRANTEE
in connection with work covered by or related to this agreement, or against any
applicant for such employment, because of race, creed, color, sex, age, martial
status, national origin, or the presence of any sensory, mental, or physical
handicap in accordance with Chapter 49.60RCW. This provision shall include, but
not be limited to, the following: employment, upgrading, demotion, or transfer;
recruitment or advertising; layoff or termination; rates of pay or other forms of
compensation and selection for training. The GRANTEE shall insert a similar
provision in all subcontracts for services covered by this agreement.
During the performance of this Contract, the Contractor shall comply with all
federal and state nondiscrimination laws, regulations and policies.
s. In accordance with legislative findings and policies set forth in Chapter 39.19
RCW the GRANTEE is encouraged in the participation and use of Minority and
Women's Business Enterprise firms certified by OMWB.
T. The GRANTEE agrees to a 100 / 00 match of funds. On hundred percent (100%)
being the full amount of the grant. The GRANTEE agrees that any match
specifically identified to this grant agreement by the GRANTEE, the GRANTEE
will not claim such match for any other grant, agreement or contract. The
DEPARTMENT has first and exclusive claim to match provided by the
GRANTEE to this agreement as indirect eligible match to the National Park
Service, Historic Preservation Fund Grant awarded to the DEPARTMENT.
DEPARTMENT: Grant Amount: $10,500.00. GRANTEE: Minimum Grant Match
Amount: $0.00. Note: GRANTEE has proposed a non -required match of
$8,012.41.
DAHP Contract # FYI6-61016-011
Section 2. Responsibilities of the DEPARTMENT
A. The DEPARTMENT agrees to reimburse the GRANTEE one hundred (100)
percent of its actual authorized expenditures for the purpose of this agreement,
provided:
(1) The total paid by the DEPARTMENT shall not exceed the amount
stipulated in the "Budget" (Attachment 1) as DEPARTMENT share.
(2) All expenditures were incurred between the beginning and ending dates of
the grant.
(3)
No expenditures have been previously claimed in any other grant from any
agency of the state or federal government.
(4) The DEPARTMENT has authority to expend the funds required to meet
the obligations contained herein.
(5) The GRANTEE has met all requirements contained in this agreement.
B. The DEPARTMENT agrees to consider requests from the GRANTEE for
progress payments if, in the DEPARTMENT'S judgment, the public interest will
be served by doing so and if such payments are administratively practical.
C. The DEPARTMENT may unilaterally terminate all or part of this contract, or may
reduce its scope of work and budget, if there is a reduction in funds by the source
of those funds, and if such funds are the basis for this contract.
Section 3. Attachments
The following attachments are hereby incorporated into and made a part of this agreement.
Attachment #1. "Budget," consisting of one page.
Attachment #2 "Scope of Work consisting of two pages.
Attachment #3A. "Civil Rights Assurance", consisting of one page.
Attachment #3B, "Understanding Grant Requirements", consisting of one page.
Attachment #3C. "Certification Regarding Debarment," consisting of one page.
Attachment #4. "State Form A19-1 Invoice Voucher" to be used as basis for
billing, consisting of one page.
Attachment #5 "Report of Services/ Labor Value Appraisal" form to be used by
GRANTEE to document labor costs, consisting of one page.
Attachment #6 "Schedule for Project Completion" form, consisting of one page
DAHP Contract # FY16-61016-010
Attachment #7 "Competitive Negotiation and Small Purchases Contracting
Documentation," consisting of one page, for a total of ten (10) pages.
Section 4. Amendments
This grant agreement may only be amended if such amendment is in writing (with the
exception of the 15% variance for actual expenditures identified in Section 1.g), agreed to
and signed by all the parties, and attached hereto.
DEPARTMENT:
14/
Allyson Brooks, Director
7/('t ll 1
Date
GRANTEE:
Date
Fed ID No.
CITY CONTRAC r NO
RESOLUTION NO: //bfr
ATTACHMENT 1
PROJECT BUDGET
ELEMENT/OBJECT
Salaries
(include each position- volunteer or
staff - and attach hourly wage
justification if needed)
Federal
Dollars
(CLG grant
requested)
Hard Match*
(Local government
cash match = Staff
Hours)
Soft Match*
(Donated goods and
services = volunteer
hours)
Total
Supervising Planner
$10500
$34.35/hr
50 hrs
_ .
$1717.50
Senior Planner
$27.22/hr
100 hrs
_
$2722
Assistant Planner
$21.21/hr
100 hrs
$2121
Department Assistant
$14.18/hr
25 hrs
$354.50
Preservation Commissioners
$20.25/hr
50 hrs
$1012.50
Indirect 0/0
(*Include justification for indirect %)
Total Element/Object:
$6914.50
$1012.50
$7927
GOODS & SERVICES
Contract Services
Federal
Dollars
Hard Match
Soft Match
Total
HP Planning Consultant
$10500
1500 @ _`
$.01585 _;
_ .
$10500
Materials/Supplies/Equipment
Federal Dollars
_ _ _,_
Soft Match
Total Project Cost
Black and white copies
$10500
1500 @ _`
$.01585 _;
_ .
$23.77
Color copies
200@ .$.0582.
$11.64
Large posters/maps
5 @ $10/ea
$50.00
Travel
Other
Total Goods & Services:
Federal Dollars
Hard Match
Soft Match
Total Project Cost
Total Funding Request
$10500
$6999.91
$1012.50
$18512.41
Contract # FY16-61016-011
ATTACHMENT 2
Scope of Work
I. WORK TO BE ACCOMPLISHED: The GRANTEE shall conduct the following activities:
A. THE CITY OF YAKIMA HISTORIC PRESERVATION ELEMENT of the
COMPREHENSIVE PLAN: The GRANTEE shall create a historic preservation
element the purpose of which shall serve to guide the City and interested
members of the public in directing the future of cultural and historic resources
in Yakima. The Element shall include, but not be limited to, the following:
1. Description of the process for involving the public in the Element's
development.
2. Identification of issues, events, circumstances, threats and/or
opportunities that may affect cultural and historic resources in Yakima
during the plan timeframe.
3. Identification of the planning context in which the Historic Preservation
Element will be developed; to include identifying and discussing
related land use and environmental statutes and procedures; related
planning documents and processes; and growth management
regulations and requirements that may affect cultural and historic
resources
4. Identification of historic preservation policies, goals, objectives, and
action items.
5. Identification of implementation of element's goals and objectives.
6. Identification of the process for the plan's adoption and integration
with related planning documents and processes.
7. Other sections addressing issues or topics related to the future of
cultural and historic properties in Yakima.
B. HISTORIC PRESERVATION PLAN PROJECT MANAGER: The GRANTEE shall
ensure that the personnel directing the Yakima Historic Preservation planning
activities meet the professional qualifications in 36 CFR 61, Appendix A. The
personnel must be procured..using a -competitive process as outlined in the
Historic Preservation Fund Grants Manual, October 1997, see Attachment #7.
Before final selection, the GRANTEE shall afford the DEPARTMENT an
opportunity to review and approve candidates for the historic preservation
consultant writing the plan.
C. The document shall include in their entirety the following acknowledgement,
disclaimer, and non-discrimination statements:
This plan has been financed in part with Federal funds from the National Park
Service, Department of the Interior administered by the Department of
Archaeology and Historic Preservation (DAHP) and the City of Yakima.
However, the contents and opinions do not necessarily reflect the views or
policies of the Department of the Interior, DAHP, nor does the mention of
trade names or commercial products constitute endorsement or
recommendation by the Department of the Interior or DAHP.
This program received Federal funds from the National Park Service.
Regulations of the U.S. Department of Interior strictly prohibit unlawful
discrimination in departmental Federally Assisted Programs on the basis of
Page 1
Contract # FY16-61016-011
race, color, national origin, age, or handicap. Any person who believes he or
she has been discriminated against in any program, activity, or facility
operated by a recipient of Federal assistance should write to: Director, Equal
Opportunity Program, U.S. Department of the Interior, National Park Service,
1849 C Street, NW, Washington, D.C. 20240.
D. The GRANTEE shall submit to the DEPARTMENT a draft copy of the Yakima
Historic Preservation Plan. Drafts of the project are due on May 2, 2016 for
the first draft and July 15, 2016 for the second draft. Final projects must be
turned in by August 31, 2016. The DEPARTMENT shall respond to the
GRANTEE within thirty days of each draft submittal with comments. If the
DEPARTMENT has not responded within thirty days, the GRANTEE shall
assume that the DEPARTMENT has no comment on the draft submittals.
E. INCOMPLETE OR UNACCEPTABLE MATERIALS: Any required materials
submitted which are not considered acceptable or complete—which do not
meet the DEPARTMENT's Historic Preservation Planning editorial standards
and/or do not contain the required level of information—will be returned to
the GRANTEE for completion within the grant period.
F. REIMBURSEMENT: The GRANTEE will only be reimbursed for preparing an
acceptable and complete Historic Preservation Element of the Comprehensive
Plan during the grant period.
II. REPORTING ACTIVITIES
A. GRANT ADMINISTRATION: The GRANTEE shall establish and maintain contact
with the DEPARTMENT throughout the grant period as to the status of all
grant activities by preparing and submitting the products listed on the
SCHDEULE
III. PRODUCTS: The GRANTEE shall at a minimum submit the following products to the
DEPARTMENT:
A. THE CITY OF YAKIMA'S HISTORIC PRESERVATION ELEMENT of the
COMPREHENSNE PLAN N =
Page 2
ATTACHMENT ,
U. S. DEPARTMENT OF THE INTERIOR
CIVIL RIGHTS ASSURANCE
As the authorized representative of the applicant, I certify that the applicant agrees that, as a
condition to receiving any Federal financial assistance from the Department of the Interior, it will
comply with all Federal laws relating to nondiscrimination. These laws include, but are not limited
to: (a) Title VI of Civil Rights Act of 1964 (42 U.S.C. 2000d-1), which prohibits discrimination on the
basis of race, color, or national origin; (b) Section 504 of the Rehabilitation Act of 1973, as amended
(29 U.S.C. 794), which prohibits discrimination on the basis of handicap; (c) the Age Discrimination
Act of 1975, as amended (42 U.S.C. 6101 et. seq.), which prohibits discrimination on the basis of
age; and applicable regulatory requirements to the end that no person in the United States shall, on
the grounds of race, color, national origin, handicap or age, be excluded from participation in, be
denied the benefits of, or be otherwise subjected to discrimination under any program or activity
conducted by the applicant. THE APPLICANT HEREBY GIVES ASSURANCE THAT it will immediately
take any measures necessary to effectuate this agreement.
THIS ASSURANCE shall apply to all aspects of the applicant's operations including those parts that
have not received or benefited from Federal financial assistance.
If any real property or structure thereon is provided or improved with the aid of Federal financial
assistance extended to the Applicant by the Department, this assurance shall obligate the Applicant,
or in the case of any transfer of such property, any transferee, for the period during which the real
property or structure is sued for a purpose for which the Federal financial assistance is extended or
for another purpose involving the provision of similar services or benefits. If any personal property
is so provided, this assurance shall obligate the Applicant for the period during which it retains
ownership or possession of the property. In all other cases, this assurance shall obligate the
Applicant for the period during which the Federal financial assistance is extended to it by the
Department.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all Federal
grants, loans, contracts, property, discounts or other Federal financial assistance extended after the
date hereof to the Applicant by the Department, including installment payments after such date on
account of applicants for Federal financial assistance which were approved before such date.
The Applicant recognizes and agrees that such Federal financial assistance will be extended in
reliance on the representations and agreements made in this assurance, and that the United States
shall have the right to seek judicial enforcement of the assurance. This assurance is binding on the
Applicant, its successors, transferees, assignees, and subrecipients and the person whose signature
appears below who is authorized to sign this assurance on behalf of the Applicant.
SIGNATURE OF AUTHO iZED CERTIFYING OFFICIAL
TITLE
re- Y Cain, gkia/iii at/
kia
APPI INT/ORGANIZATION
2
DATE SUBMITTED
APPLICANT/ORGANIZATION MAILING ADDRESS
(a g N.- aKd sir
ya.CC )tAk W4 ' P O 1
BUREAU OR OFFICE EXTENDING ASSISTANCE
Previous Edition Usable
Authorized for Local Reproduction
DI -1350
(REV 6/91)
Standard Form 424D (Rev.7-97)
Prescribed by OMB Circular A-102
ATTACHMENT 38
STATEMENT OF UNDERSTANDING FOR GRANT MANAGEMENT REQUIREMENTS
• CLGs receiving HPF grant assistance must fulfill the terms of their grant agreement
with the state and adhere to all requirements of the National Register Programs
Manual. This requirement includes compliance with Title VI of the Civil Rights Act of
1964, 78 Stat. 241, as amended, which provides that no person on the grounds of
age, race, color, or national origin shall be excluded from participation in, be denied
the benefits of, or be subject to discrimination under any activity receiving Federal
financial assistance.
• Local financial management systems shall be in accordance with the standards
specified in OMB Circular A-128, "Standards for Grantee Financial Management
Systems."
• Indirect costs may be charged as part of the CLG grant only if the CLG subgrantee
meets the requirements of the manual. Unless the CLG has a current indirect cost
rate approved by the cognizant federal agency, only direct costs may be charged.
• Grant recipients must maintain auditable financial records in accordance with the
General Accounting Office's Standards for Audit of Governmental Organizations,
Programs, Activities, and Functions.
• The CLG subgrantee will provide, with request for reimbursement, documentation to
support billings (time sheets, front and back canceled checks, etc.) for federal and
non-federal share claimed.
• Repayment will be made to the SHPO organization if terms and conditions of the
subgrant agreement are not followed or costs claimed are disallowed following audit.
CLG
1 % /(
A!
SIGNS URE OF APPLICANT
TITLE
DATE
A-1
ATTACHMENT 3C9
U.S. Department of the Interior
Certification Regarding
Debarment, Suspension, Ineligibility and
Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Order
12549, Debarment and Suspension, 43 CFR Part 12, Section 12.510,
Participants' responsibilities. The regulations were published as Part VII of the
May 26, 1988 Federal Register (pages 19160-19211). Copies of the
regulations are included in the proposal package. For further assistance in
obtaining a copy of the regulations, contact the U.S. Department of the
Interior, Acquisition and Assistance Division, Office of Acquisition and Property
Management, 18th and C Streets, N.W., Washington, D.C. 20240.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON NEXT PAGE)
(1) The prospective lower tier participant certifies, by submission of this
proposal that neither it nor its principals is presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department
or agency.
(2) Where the prospective lower tier participant is unable to certify to any of
the statements in this certification, such prospective participant shall
attach an explanation to this proposal.
j Oa/A �(?:ti�nAl s.2vchY art rn r�vt4r y G'e%d/�'r�.
Name and Title of Authorized `Representative
Signature /J / Date
1L --/5—'/s^
FORM
A19 -1A
STATE OF WASHINGTON
INVOICE VOUCHER
AGENCY NAME
Department of Archaeology and Historic Preservation
PO Box 48343
1063 South Capital Way Suite
Olympia, Wa 98504-8343
ATTN:
VENDOR OR CLAIMANT (warrant is to be payable to)
City of Yakima
129 North Second Street
Yakima, WA 98901
Attachement Four
AGENCY USE ONLY
AGENCY NO.
CONTRACT NO. OR GA AUTH. NO.
103
FY16-61016-011
INSTRUCTIONS TO VENDOR OR CLAIMANT:
In the absence of a detailed invoice, submit this form to claim payment for
materials, merchandise or services. Show complete detail for each item.
Vendor's Certificate:
1 hereby certify under penalty of perjury that the items and totals listed herein
are proper charges for materials, merchandise or services furnished to the
State of Washington, and that all goods furnished and/or services rendered have
been provided without discrimination because of age, sex, marital status, race,
creed, color, national origin, handicap, religion, or Vietnam era or disabled
veteran status.
By:
(Sign in ink)
(Title)
(Date)
FEDERAL I.D. NO. OR SOCIAL SECURITY NO.
RECEIVED BY
DATE RECEIVED
DATE
DESCRIPTION
QUANTITY
UNIT PRICE
AMOUNT
PREPARED BY (Fiscal)
DATE
DIVISION APPROVAL
DATE
DOC DATE
CURRENT DOC NO
REF DOC NO
VENDOR NUMBER
VENDOR MESSAGE
SUF
TRANS
CODE
M
0
D
FUND
APPN
INDEX
PROGRAM
INDEX
SUB
OBJ
SUB
SUB
OBJ
CNTY
CITY
PROJECT
AMOUNT
INVOICE
NUMBER
GENERAL
LEDGER
APPROVED FOR PAYMENT BY FISCAL
DATE
WARRANT TOTAL
Approved CTED Form A19 -1A (10/15/95)
Name of Project:
Year:
Name of Person Performing Services:
Monday
Address:
Wednesday
Telephone:
Labor value appraisal on reverse side of this form.
Other, explain:
Did you receive any compensation for the time you
devoted to this project?
Yes 0 No 0
If yes, who paid you?
How much were you paid?
Attachment 5
REPORT OF SERVICES
Month:
Year:
Sunday
Monday
Describe the services you performed. (If you supervised others, include their names
and positions.)
Wednesday
How was the hourly rate shown below determined?
Labor value appraisal on reverse side of this form.
Other, explain:
Saturday
Total number of hours worked each day duriiLlthis month:
Beginning
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Totals
I hereby swear that I devoted the time reported above, performing the
work described on the project named. This time has not been reported
for any other Federal or State project.
Date
I supervised or coordinated this person's work and verify that it was
performed as indicated above.
Date
Washington State Office of Archaeology and Historic Preserva
1063 S. Capitol Way, Suite 106
PO Box 48343
Olympia, WA 98504-8343
2003 Reprint
Total hours this
month:
4 of hours
Hourly rate:
$
Per hour
Amount charged to
project:
$
INSTRUCTIONS:
on Use this form to document all labor, whether paid or
voluntary, which is claimed against a grant or used
for the matching share of a grant. Complete it on a
timely basis, i.e., fill it out immediately after the
service is provided.
ATTACHMENT 6
SCHEDULE FOR PROJECT COMPLETION
List each proposed grant activity separately estimating the start and
completion dates. This should be a complete listing of all potential activities
associated with the grant including the two draft submittal dates of May 2,
2016 for the first draft and July 15, 2016 for the second draft. Final projects
must be submitted by August 31, 2016.
WORK TO BE ACCOMPLISHED
Estimated
Starting Date
Estimated
Completion Date
Solicit/identify and select qualified Consultant
and develop Scope of Work
1 Oct 2015
30 Oct 2015
Sign Contract with Consultant
13 Nov 2015
Initial Meeting with Board/Consultant
Nov 2015
Dec 2015
Background Research
Dec 2015
Feb 2016
Prepare for and conduct public outreach
Jan 2016
Feb 2016
Consultant Preparation of Plan Draft
Feb 2016
April 2016
Submit Plan Draft to DAHP
2 May 2016
2 May 2016
Coordination and review of Plan Draft
April 2016
May 2016
Review Meeting with Historic Preservation
Board/consultant
May 2016
July 2016
Submit 2nd Draft Nomination to DAHP
2 July 2016
30 July 2016
Public Hearing and recommendation of
plan
August 2016
August 2016
;Submit Final Plan to DAHP __� x.;31
August
'2016
31 August 2016 .-
City Council Meeting to adopt Plan _ _;
August 2016
August 2016
Submit Reimbursement to DAHP
_
September
2016
September 2016
fl
ATTACHMENT 7
COMPETITIVE NEGOTIATION AND SMALL
PURCHASES CONTRACTING DOCUMENTATION
THIS FORMAT SHOULD BE USED FOR CONTRACTS FOR PROFESSIONAL
SERVICES AND OTHER PROCUREMENT TO DOCUMENT COMPLIANCE
WITH FEDERAL PROCUREMENT STANDARDS.
1. Grant Number:
2. Type of Contract: Professional Services
Printing
Equipment/Supplies
Other
3. Addresses of Contractors Contacted:
Name of Person/Business:
Street or PO Box:
City/State/Zip Code:
Work Telephone Number:
Quote/Bid given:
Name of Person/Business:
Street or PO Box:
City/State/Zip Code:
Work Telephone Number:
Quote/Bid given:
Name of Person/Business:
Street or PO Box:
City/State/Zip Code:
Work Telephone Number:
Quote/Bid given:
Contractor Selected:
Basis for Selection:
Lowest Price Other
If the basis for selection was not the lowest price, explain the basis used:
Signature of Grantee Official Date
STATE OF WASHINGTON
Department of Archaeology and Historic Preservation
1063 S. Capitol Way, Suite'106 • PO Box 48343 • Olympia, Washington 98504-8343
(360) 586-3065 • Fax Number (360) 586-3067
DAHP Contract No: FY16-61016-011
Amendment A
The Department of Archaeology and Historic Preservation, the DEPARTMENT, and City of Yakima, the
GRANTEE, hereby mutually agree to amend Grant FY16-61016-011 to increase the total grant amount
from $10,500.00 to $12,100.00.
Per this Amendment A, the total grant amount shall be increased by $1,600.00.
The DEPARTMENT acknowledges and approves the requested changes by the GRANTEE for the above
change to the total grant amount. All other terms or conditions of the contract remain as set forth in the
body of the contract and amended herein by Amendment A.
Department: Grantee:
/,1I�
1v
By
Allyson :rooks'
Director
Title
Date:
IREVo2. / aRrx,J
ASS nczATE P AW&R.
Title
Date: (LAY 2.S, 2 01 6
rItlfuevby •K'
CITU CONTRACT NO: .1 4/'^(97 1407041/0Id'r
RESOLUTION P40: 11/4'
��9 DEPARTMENT OF ARCHAEOLOGY & HISTORIC PRESERVATION
� Protect the Post, Shope the Future
I9kItt
STATE OF WASHINGTON
Department of Archaeology and Historic Preservation
1063 S. Capitol Way, Suite 106 • PO Box 48343 • Olympia, Washington 98504-8343
(360) 586-3065 • Fax Number (360) 586-3067
Contract No: FY16-61016-011
Amendment B
The Department of Archaeology and Historic Preservation, the DEPARTMENT, and City of Yakima, the
GRANTEE, hereby mutually agree to amend Grant FY16-61016-011 to decrease the amount of the
contract from $12,100.00 back to the original amount of $10,500.00.
Contract amount currently reads: $12,100.00
Per this Amendment B Contract amount shall now read: $10,500.00.
The DEPARTMENT acknowledges and approves the requested changes by the GRANTEE for the above
change to the total grant amount. All other terms or conditions of the contract remain set forth in the body
of the contract and amended herein by Amendment B.
Department:
By:
Allyson
os
Grantee:
Director Ctrs( MANA be
Title Title
Date: (t/
Date: &'o" ,20) aup
CITY CONTRACT NO C219 / ^ / 17
RESOLUTION NO: ANA
'DEPARTMENT OF ARCHAEOLOGY & HISTORIC PRESERVATION
Pro•`ect the Post. Shopthe future
RECEIVED
OCT 132016
CITY OF YAKIMA
MAMMA DIY.