HomeMy WebLinkAboutState of California Department of Community Services and Development (CSD) 2020-08-24State of California-Health and Human Services Agency DEPARTMENT OF COMMUNITY SERVICES AND DEVELOPMENT 2389 Gateway Oaks Drive,Sulte 100,Sacra rnento,CA 95833 Telephone:(916)576-7109 1 Fax:(916)263-1406 a www.c d.ca, ov DAVID 5CRI9NER X: ACTING DIRECTOR GAVIN NEWSOM GOVERNOR August 24, 2020 Mr. Sage Sangiacomo, City Manager City of Ukiah 300 Seminary Avenue Ukiah, CA 95482 Dear Mr. Sangiacomo: Re: Contract Number 20Y-2025 Enclosed is a copy of the signed and executed contract referenced above. If you have any questions regarding the contract process, you may contact me at 916) 576-7182. Sincerely, Jay Kubo Contract Services Unit Enclosure Serving Low-Income Families Through Community Partners f;t1H i Fi L i STATr OF Cr1E.PO NIA• 5'lAN©AR DhORi I?MILK AGRnoietri'Nt3LIBF:P T _. PURCHAS AIT MRtTYN[JMBl:10fappli ble) 7i7,Z l3(i?ev Os","b1D)CSi}tRCy 07 20t9)_ 2U r_ii35 Tlll$1 greet mt is enter-ed into 17vtWBCtl€ontr Li Agency mid the Contractor named below CONT'RAUING AGENCY NOV R. .*kt•ttnesat of Cookounity BeruiceS sold Developinent CONTRtAC-1109 NAME City 2. Thc:term s7ftEiis---- April 1,2020 throtigh March 31.2023 i, rf'Eli1G'Jit is 111C maximum amount ToTal U0 of this Agreement.isc 4, The p itties agree to with the teens and 6onditions of the following exhibits that are by this reference trade a part of the Agrw-,meot: Article l -Scope of WA* Article 2-Reporting Requirements, Miele 3 (contraot Construction,Adminis(Talion laid Procedure' Article 4 -Stale Contracting RequiremenIs-General Tcrtns and Conditions GTC 61 O,t Article 5 -Adminisi native Policies,Terms and Conditions* Attachi-bent 1 -Direct Paymejit Summary" Cbems sho Km with an asterisk(*)taro hereby incorporated by reference and made a.pat-t of this agreement as if attached hereto. IN WITNESS WHERV..GY',THIS AGRr,%W E,NT HAS REEK FXEC'.tlTt'.D BY Till, PJ RTiES HERETO ca n Y Iiforoh CONTRACTOR i)cpnrlmcrttni'Etencrxlcrvices Approvni(or 4nmptioa,if apptiC0112) F C()NTRACTOit NAME (if athir that oil IM-h idrIO.slake W.101:er a WrPOPT lOM iwlydIt his,M-) City of Wall CO JRACT'OR BUSlta SS AL)L)MS,CITY,STATt' Ztp 00&tilt gy Avonue,Lkuqh,CA 95481 PRIKT;D NAMS.OF PrRS0N SIGNMIC, i Tn LE - Sage Sangiacomo City Managere0naftas n have Cl C 1"i?R A[Ft HCit21Z SlfiNAFUh1: -- DATE SIGNEDbem eemptW whk mod Mla doegmmt Is eumpt from tide Dement of General Servkee STATC OF CALIFORNIA approval. C:ON't3tACI'i;+iGr\GL CYNA2<4F. Y—T Depurtmont orCamtttuntty§erytces tspd Deveio meat_ CONTRACTR+GAril-N(:Y.4DDR1:Ss crrY STt1 iv. ZIP 2389 Gateway Oatts Urine,Suite 101) Sacramento _ CA 95933 3 RINTCb NAME CA:PERSON SEGNiNC t'Tt1.4; I Chris Vaii _ _Ci1ia:fflualie:a[Officer l CC)X RtAC'I'L-14Q AGENCY AUMORIZUV SIONATI.T.F. ATE S1tiNM State of Californla-Health and Human Services A en DEPARTMENT OF COMMUNITY SERVICES AND DEVEWPMENT 2389 Gateway Oaks Drive,Suite 100,Sacramento,CA 95833 Telephone,(916)576-7I09 1 Fax;(916)263-140 www.csd.ca. ov DAVID SCRIBNER GAVIN NEWSOM ACTING DIRECTOR GOVERNOR March 11, 2020 To: All Direct Payment Program Participants: April 1 2020— March 31 2023 Direct Payment Agreement Attached, is the Agreement referenced above for your approval and signature. Please feel free to use this letter as a checklist: Please review your Agreement carefully. Complete and sign Payee Data Record (std. 204). Have your authorized representative sign two copies of the Agreement Facesheet std. 213). The Agreement must remain unchanged; CSD is not able to process Agreements that have been changed by a company. If you see the need to make changes to the Agreement, please contact your Project Coordinator, Debra Brown at(916) 576- 7154, who will arrange for Contract Services Unit to immediately mail your company a corrected Agreement. Do not use correction fluid or tape. If a correction to any page is necessary, please contact your Program Coordinator. Return the signed Agreement and associated documentation within 30 days of the date of this letter to: Contract Services Unit Department of Community Services and Development 2389 Gateway Oaks Drive, Suite 100 Sacramento, CA 95833-4246 If you are unable do so, please contact your Project Coordinator. If you have questions regarding the contracting process, you may contact Jay Kubo of my staff at (916) 576-7182. For questions regarding any other requirements, please contact Ms. Brown at the number above. Serving Low-Income Families Through Community Partners April 1,2020 March 31,2023 Direct Pay) Sincerely, Jeffrey Kjer Budgets and Contracts Services Manager JUK Enclosure STATE OF CALIFORNIA-DEPARTMENT OF FINANCE I I LPAYEEDATARECORD Required when receiving payment from the State of California in lieu of IRS W-9 or W-7) i' ^ t T. STD zoo(Rev.1012019) tL INSTRUCTIONS:Type or print the information. Complete all information on this form. Sign, date,and return to the state 1 agency(department/office)address shown in Box 6. Prompt return of this fully completed form will prevent delays when processing payments. Information provided in this form will be used by California state agencies to prepare Information Returns(Form1099). See next page for more information and Privacy Statement. NOTE:Governmental entities,i.e.federal,state,and local(including school districts),are not required to submit this form. BUSINESS NAME(As shorn on yourincome tax return) 2 NIA SOLE PROPRIETOR,SINGLE MEMBER LLC,INDIVIDUAL(vameasstxnvnonSSNorIRN)Last,Frrs7 Mr E-MAIL ADDRESS MAILING ADDRESS BUSINESS ADDRESS CITY STATE I ZIP CODE CITY STATE ZIP CODE 3 ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER(FEIN): L I El NOTE: Payment will not PAYEE PARTNERSHIP CORPORATION: be processed ENTITY F1 ESTATE OR TRUST 0 MEDICAL(e.g.,dentistry,psychotherapy,chiropractic,el ) without an TYPE Q LEGAL(e.g.,attorney services) accompanying taxpayer 0 EXEMPT(nonproril) Identification CHECK 0 ALL OTHERS number. ONE BOX ONLY ENTER SSN OR ITIN; SOLE PROPRIETOR,INDIVIDUAL,OR Social Security Number(SSN)or Individual Taxpayer ldentilkatten SINGLE MEMBER LLC(Disregarded Enlily)Number(ITIN)are required by authority of California Revenue and Tax Code sections 18646 and 18661) 4 CALIFORNIA RESIDENT-Qualified to do business in California or maintains a permanent place of business in California. CALIFORNIA NON RESIDENT(see next page formore information)-Payments to nonresidents for services may be subject PAYEE to slate Income tax withholding. RESIDENC Q No services performed in California. STATUS O Copy of Franchise Tax Board waiver of state withholding attached. I hereby certify under penalty of perjury that the information provided on this document is true and correct. 5 Should my residency status change,I will promptly notify the state agency below. AUTHORIZED PAYEE REPRESENTATIVE'S NAME(Type or Print) TITLE TELEPHONE(include area code) SIGNATURE DATE E-MAIL ADDRESS Please return completed form to: 6 DEPARTMENTIOFFICE UNITISECTION MAILING ADDRESS TELEPHONE(include area code) FAX CITY STATE"CODE E-MAIL ADDRESS STATE of CALIFORNIA-DEPARTMENT OF FINANCE PAYEE DATA RECORD Required when receiving payment from the Stale of California in lieu of IRS W-9 or W 7) STD 204(Rev.1012019) Requirement to Complete the Payee Data Record,STD 204 A completed Payee Data Record,STD 204 form,is required for all payees(non-governmental entities or individuals)entering into a transaction that may lead to a payment from the state. Each state agency requires a completed,signed,and dated STO 204 on file;therefore,it is possible for you to receive this form from multiple state agencies with which you do business. Payees who do not wish to complete the STD 204 may elect not to do business with the state.If the payee does not complete the STD 204 and the required payee data is not otherwise provided,payment may be reduced for federal and state backup withholding.Amounts reported on Information Returns(Form 1099)are in accordance with the Internal Revenue Code(IRC)and the California Revenue and Taxation Code(R&TC). Enter the payee's legal business name.The name must match the name on the payee's tax return as filed with the federal 2 Internal Revenue Service.Sole proprietorships and single member limited liability companies(LLCs)must also include the owner's full name.An individual must list his/her full name as shown on the SSN or as entered on the W-7 form for ITIN. The mailing address should be the address at which the payee chooses to receive correspondence.The business address is the address of the business'physical location. Check only one box that corresponds to the payee business type. Corporations must check the box that identifies the type of 3 corporation. The State of California requires that all parties entering into business transactions that may lead to payment(s)from the state provide their Taxpayer Identification Number(TIN).The TIN is required by the RUC sections 18646 and 18661 to facilitate tax compliance enforcement activities and the preparation of Form 1099 and other information returns as required by the IRC section 6109(a)and RUC section 18662 and its regulations. Payees must provide one of the following TINS on this form:social security number(SSN),individual taxpayer identification number(ITIN),or federal employer identification number(FEIN).The TIN for sole proprietorships,single member LLC disregarded entities),and individuals is the SSN or ITIN.Only partnerships,estates,trusts,corporations,and LLCs(taxed as partnerships or corportations)will enter their FEIN. Are you a California resident or nonresident? 4. A corporation will be defined as a"resident"if it has a permanent place of business in California or is qualified through the Secretary of State to do business in California. A partnership Is considered a resident partnership if it has a permanent place of business in California.An estate is a resident if the decedent was a California resident at time of death.A trust is a resident if at least one trustee is a California resident. i For individuals and sole proprietors,the term"resident"includes every individual who is in California for other than a temporary or transitory purpose and any individual domiciled in California who Is absent for a temporary or transitory purpose.Generally, an individual who comes to California for a purpose that will extend over a long or indefinite period will be considered a resident. However,an individual who comes to perform a particular contract of short duration will be considered a nonresident. Payments to all nonresidents may be subject to withholding. Nonresident payees performing services in California or receiving rent,lease,or royalty payments from property(real or personal)located in California will have 7%of their total payments withheld for state income taxes. However, no withholding is required if total payments to the payee are$1,500 or less for the calendar year. For information on Nonresident Withholding,contact the Franchise Tax Board at the numbers listed below: Withholding Services and Compliance Section: 1-888-792-4900 E-mail address:wscs.gen@ftb.ca.gov For hearing impaired with TDD,call: 1-800-822-6268 Website:www.ftb.ca,gov J Provide the name,title,email address,signature,and telephone number of the individual completing this form. Provide the date the form was completed. 6 This section must be completed by the state agency requesting the STD 204. Privacy Statement Section 7(b)of the Privacy Act of 1974(Public Law 93-679)requires that any federal,state,or local governmental agency,which requests an individual to disclose their social security account number,shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory or other authority such number is solicited,and what uses wilt be made of it. It is mandatory to furnish the information requested. Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and state law imposes noncompliance penalties of up to$20,000, You have the right to access records containing your personal information,such as your SSN.To exercise that right,please contact the business services unit or the accounts payable unit of the state agency(ies)with which you transact that business. All questions should be referred to the requesting state agency listed on the bottom front of this form. City of Ukiah Direct Payment Agreement Agreement No. 20Y-2025 STATE OF CALIFORNIA AGREEMENT TABLE OF CONTENTS AGREEMENT.............................................................................................................................. I ARTICLE1 —SCOPE OF WORK.......................................................................................... 1 1.1 Purpose............................................................................................................................... 1 1.2 Term................................................................................................................................... 1 1.3 Project Coordinators........................................................................................................ 1 1.4 CSD Requirements............................................................................................................2 1.5 Utility Requirements.........................................................................................................3 1.6 Payment Issuance and Processing...................................................................................4 1.7 Direct Payment Summary and Account Reconciliation................................................5 1.8 Pledges Under Energy Crisis Intervention Program/Fast Track.................................6 ARTICLE 2--REPORTING REQUIREMENTS.................................................................. 7 2.1 Quarterly Pledge Reports.................................................................................................7 ARTICLE 3 -- CONTRACT CONSTRUCTION,ADMINISTRATION AND PROCEDURE............... 8 3.1 State Contracting Requirements—"Utility Certification Clauses, CCC 04/2017".....8 3.2 Applicable Laws and Requirements .................................. 3.3 Additional Provisions........................................................................................................8 ARTICLE 4—STATE CONTRACTING REQUIREMENTS - GENERAL TERMS AND CONDITIONSGTC 610......................................................................................................... 10 ARTICLE 5—ADMINISTRATIVE POLICIES,TERMS AND CONDITIONS ............... 8 5.1 Confidentiality...................................................................................................................8 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 This Agreement consists of this Direct Pay Agreement("Agreement"), and Attachment 1,which is incorporated herein by this reference. This Agreement is entered into between the California Department of Community Services and Development(CSD), and the City of Ukiah, Utility"): ARTICLE 1 —SCOPE OF WORK 1.1 Purpose A. CSD will make payments to Utility for the purpose of crediting the accounts of qualified low-income energy customers of Utility, who have been identified as eligible for utility assistance payments under the Low-Income Home Energy Assistance Program (LIHEAP) or other utility assistance program being offered by CSD. Categories of payment assistance include the Home Energy Assistance Program (HEAP) and Energy Crisis Intervention Program_ Fast Track (ECIP FT). HEAP provides one-time financial assistance to help offset an eligible household's energy costs (utility bill). ECIP-FT provides one-time assistance to low-income households that are in a crisis situation. B. In order to carry out the purpose of this Agreement, CSD's local LIHEAP Service Providers (LSPs)will submit LIHEAP benefit pledges for low-income utility customers at risk of service disconnection or interruption due to nonpayment. The LIHEAP benefit pledge is intended to immediately notify utility companies of a low-income utility customers participation in LIHEAP and the amount of qualifying assistance the customer is to receive. 1.2 Term The term of this Agreement shall be April 1, 2020 through March 31, 2023. 1.3 Project Coordinators The Project Coordinator is designated to manage all CSD inquiries regarding pledge payments or issues with the pledge process, mishandled or incorrect payments, clarification and updates of reports, and fraud and abuse. The Project Coordinators during the term of this Agreement are list below. Either Party may designate a different Project Coordinator by notifying the other party in writing. City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 UTILITY'S PROJECT COORDINATOR Name and Title: Lori Martin, Customer Service and Billing Manager Company Name:City of Ukiah Address: 300 Seminary Avenue City, State, and ZIP Code: Ukiah, California 95482 Email:lmartin@cityofukiah.com Phone: ( 707 ) 463 - 6747 CSD'S PROJECT COORDINATOR Debra Brown, Staff Services Manager Energy &Environmental Services Division Department of Community Services and Development 2389 Gateway Oaks Drive, Suite 100 Sacramento, CA 95833 Email: Debra.Brown@csd.ca.gov Phone: (916) 576-7154 1.4 CSD Requirements A. CSD's LSPs, and/or CSD personnel in some instances, will process applications and make a determination of applicant's eligibility for utility assistance based upon pre-established criteria in accordance with federal and state LIHEAP requirements. B. CSD will make every effort to ensure the timely fulfillment of benefit payment on LIHEAP pledges within the 60 days, from the date the pledge was made. C. CSD will host a File Transfer Protocol (FTP) site. CSD will provide Utility with specifications, documentation, and sample of FTP Client configuration screens, as necessary, to enable Utility's use of the FTP site. 2 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 D. In the course of performing the services under this Agreement, CSD may have access to confidential, commercial, or personal information concerning,but not limited to, technology, rate making, legislative, and personnel matters and practices of the Utility, its subsidiaries, affiliates, or members of the public. CSD shall not disclose any such information without the prior written approval of Utility. E. Any representation herein made by CSD relating to confidentiality or the operations, limitations, and requirements for the furnishing of personnel records, as set forth below shall be subject to the Information Practices Act of 1977, Section 1798 et seq. of the California Civil Code, and the California Public Records Act, Section 6250 et seq. of the California Government Code. F. The State Controller's Office(SCO) shall issue payments in the form of a State of California warrant, and CSD will provide a Direct Payment Summary(Attachment 1), Pay Run Funding File, and Pay Run Total Sheet. The Pay Run Funding File shall provide Utility with the pay run date, the account holder's name, account number and LIHEAP benefit amount associated with the warrant. The Pay Run Total Sheet provides the program year, total number of payments, and total amount of all payments associated with the warrant total. 1.5 Utility Requirements A. Utility shall review and reconcile the Direct Payment Summaries as necessary to ensure that undelivered LIHEAP benefits have been returned to CSD, within 30 calendar days of receipt of warrant. B. Utility shall track the liquidation of applied LIHEAP benefit or credit for a period of twelve (12) months or until credit is fully liquidated, whichever occurs first. C. If a LIHEAP benefit or credit is not fully liquidated and the client's account is closed within twelve(12) months from the date of the LIHEAP benefit or credit, the Utility shall treat the credit as an overpayment and shall return the credit to CSD within 30 days of the account closure. Utility shall identify the account holder's name, the account number, account address, amount of credit returned and date the original credit posted to the account. D. If a LIHEAP benefit or credit is not fully liquidated and the client's account is closed after twelve (12) months from the date of the LIHEAP benefit or credit, the Utility shall treat the credit as a customer overpayment and shall return the credit to the account holder(s) within 30 days of the account closure. E. To enable CSD to effectively monitor the pledge process is working as intended and payment on LIHEAP pledges are made timely, CSD requires Utility to report 3 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 specific information on broken and cancelled LIHEAP benefit pledges. Utility will establish a process to report"broken"or"cancelled"pledges" as defined in Article 1.8. F. Utility shall charge the eligible household, in the normal billing process, an amount not to exceed the difference between the actual cost of the home energy usage and the LIHEAP benefit amount. The actual costs of the home energy usage shall be consistent with appropriate utility company tariffs as approved by the CPUC, if applicable. G. No customer receiving LIHEAP assistance pursuant to this Agreement will be subjected to disparate or adverse treatment by Utility due to receipt of such assistance, in accordance with applicable state laws. H. CSD will notify Utility, via a phone call and following up with an e-mail, when a submission error has occurred that resulted in a payment to the wrong account or wrong Utility, etc. and request a refund of the LIHEAP benefit. Utility shall respond within two business days and refund the LIHEAP benefit to CSD within ten days from the date of CSD's e-mail. Utility shall identify the account holder's name, the account number, and date of pay run with the returned payment. 1.6 Payment Issuance and Processing A. Payment for applicant's electric and/or gas energy bills shall be made by CSD, via SCO, directly to Utility in the form of a warrant, payable to the Utility. B. The Utility must use the FTP site to retrieve all Direct Pay records. The Utility will use credentials furnished to them in order to receive Direct Pay data records provided by CSD. C. CSD will post to the FTP site Utility's Direct Pay Summary, Pay Run Funding File, and Pay Run Total Summary of payments for the purpose of reconciling the warrant. D. Within 30 calendar days of receipt of the warrant, Utility agrees to process the LIHEAP benefit in accordance with the following: 1. Credit Accounts. Credit accounts of qualified low-income customers upon receipt of the State of California warrant. The credit should appear on the first billing statement after the credit has been posted. Utility will provide notification of LIHEAP benefit amount to each customer for whom a credit is made. The wording of said notification must contain the words LIHEAP credit" and date credit was applied to customer's account. 4 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 2. New Accounts. If the qualified low-income customer's account on the Pay Run Funding File has been closed and a new account has been opened with the same Utility, the LIHEAP benefit shall be credited to the new account. 3. Closed Accounts. If the qualified Iow-income customer's account on the Pay Run Funding File has been closed, between the time a pledge has been made by the LSP and the Utility's receipt of the LIHEAP benefit, and the account has an owing balance, the Utility shall apply the LIHEAP benefit to the closed account. Any remaining amount of the LIHEAP benefit shall be refunded to CSD. If the qualified low-income customer's account number is closed with no outstanding balance, the total amount of the LIHEAP benefit shall be returned to CSD. All LIHEAP benefits returned to CSD shall be in accordance with section 1.7 of this Agreement. 4. Full Payment Return. The Utility shall make all reasonable attempts to identify the account and complete delivery of LIHEAP benefit. In the event the account cannot be identified, and the benefit cannot be posted to a customer's account, Utility shall return the full LIHEAP benefit with the Direct Payment Summary. 1.7 Direct Payment Summary and Account Reconciliation A. Completion of Direct Payment Summary. Within 30 calendar days of receipt of the warrant, Utility is responsible for completing and returning the Direct Payment Summary to CSD. The Direct Payment Summary shall include the following information: 1. Total number of customer accounts where the Utility was successful in crediting full amount of eligible LIHEAP benefit; 2. Total number of customer accounts where the Utility was only able to credit a partial amount of the LIHEAP benefit, also referred to as Partial Payment Return; and 3. Total number of customer accounts where the Utility was unable to credit any of the eligible LIHEAP assistance amount, also referred to as Full Payment Return. B. Account Reconciliation Report. The Utility shall return an Account Reconciliation Report, as an attachment to the completed Direct Payment Summary. The Reconciliation report shall include all details provided to the 5 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 Utility on the Pay Run Funding file in addition to the following account information: 1. Identify the customer's account and the LIHEAP benefit amount applied to the account as a partial or full payment; 2. Identify the date each LIHEAP benefit was posted to the account; 3. Identify the customer's account and the amount of returned LIHEAP benefit resulting from unapplied benefits; and 4. Identify the reason Utility was unable to apply the partial or full LIHEAP benefit. 1.8 Pledges Under Energy Crisis Intervention Program/Fast Track A. Customers applying for LIHEAP assistance who have received a shutoff or disconnection notice may qualify for the Energy Crisis Intervention Program or Fast Track(ECIP FT) as determined by the LSP or CSD staff processing the application. In order to render more timely assistance to low-income utility customers at-risk of experiencing service disruption or service termination due to non-payment, CSD has devised a process whereby direct payment utility companies can receive immediate notification of an at-risk low-income utility customer's participation in LIHEAP and the qualifying amount of LIHEAP assistance the utility customer is to receive. The notification of customer's participation in LIHEAP and the amount of the qualifying LIHEAP benefit will be made by LSPs using the Utility's preferred method of notification. B. The Utility agrees to accept a pledge submission as notification of the customer's participation in LIHEAP, from the LSP or CSD staff and post the LIHEAP pledge amount as a credit pending on the customer's account. Utility agrees to honor the pledge for up to 60 days and take into account the LIHEAP benefit amount when determining any scheduled disconnection or service action against the account during the pledge period. C. Payment for LIHEAP pledges will be issued by CSD directly to the Utility in accordance with payment issuance and processing instructions reflected in Section 1.6. D. Fraud Prevention. If the Utility's personnel responsible for receiving pledges have any concerns or questions about the legitimacy of a pledge, or the caller's authority to make pledges, Utility should notify the agency's contact person or CSD's Project Coordinator immediately to verify the validity of the pledge. 6 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 ARTICLE 2—REPORTING REQUIREMENTS 2.1 Quarterly Pledge Reports The Utility shall provide CSD with a Pledge Report, on a quarterly basis or as requested by CSD, to include: A. Number of pledges received during the quarter; B. Average value of pledges; C. Number of cancelled pledges; D. Broken Pledges: 1. Number of pledged accounts that received a benefit, after 60 days from the initial receipt of the pledge. 2. Number of pledged accounts that have not received a benefit after the initial receipt of the pledge and were not cancelled. 3. A detailed report of broken pledges to include the follow: a.Program Year; b. Account number; C. Pledge Date; d. Pledge amount; e.CSD's LSP that made the pledge(Provider name or Provider number); f.Name of employee that made the pledge; g. Date credit was applied to the account, if account was credited; and h. Number of days between initial receipt of pledges and delivery of benefit to customers' accounts, if account was credited. E. Definitions: 1. LIHEAP Pledge: A guarantee of payment made by the LSP or CSD staff for low-income customers at-risk of experiencing service disruption or 7 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 service termination due to non-payment, which is made to Utility using the Utility's preferred method of notification. 2. Broken Pledge: A pledge is deemed broken if the Utility does not receive a LIHEAP benefit payment to a pledged account within 60 days, from the date the pledge was made, or if the benefit is never received by the utility. 3, Cancelled Pledge: A pledge that is cancelled by the LSP due to an error being detected with the benefit amount or eligibility determination during the final application processing or data entry. 8 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 ARTICLE 3 -- CONTRACT CONSTRUCTION,ADMINISTRATION AND PROCEDURE 3.1 State Contracting Requirements—"Utility Certification Clauses, CCC 0412017" In accordance with State contracting requirements, specified contracting terms and conditions are made a part of this agreement and are fully binding on the parties in accordance with State law.The provisions in their entirety are found at the Department of General Services' website at: htt s:i:`www.d s.ca. ov/OLS/Resources-Pa e-Content::Office-of-Le al-Seivices- Resources-List-Folder/Standard-Contract-Language Click the"CCC 0412017"link to download the current requirements. 3.2 Applicable Laws and Requirements All set-vices and activities undertaken by the parties in connection with this Agreement shall be performed in accordance with all applicable federal, state, and local laws and regulations, as may be amended from time to time, including any relevant memoranda of understanding and/or other cooperative agreements established between CSD, utility providers, and/or the Public Utilities Commission. 3.3 Additional Provisions A. Amendment. Changes to this Agreement shall be made by formal amendment with exceptions specified in Section F, below. B. Assignment. Neither this Agreement nor any of the rights, interests, or obligations under this Agreement shall be assigned by any party without the prior written consent of the other parties, except in the case where responsibility for program implementation and oversight may be transferred by the State to another State agency. In the event of such transfer, this Agreement is binding on the agency to which the program is assigned. C. Cancellation/Termination. Either party may terminate this Agreement by giving 30 days written notice to the other party. D. Dispute Resolution. Unless otherwise mutually agreed to, any disputes between CSD and Utility regarding the construction or application of this Agreement and claims arising out of this Agreement or its breach shall be submitted to mediation within 30 calendar days of the written request of one party after the service of that request on the other party, in accordance with the following procedures: 8 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 The parties shall make best efforts to settle all disputes arising under this Agreement as a matter of normal business and without recourse to either mediation or litigation. If the parties are unable to resolve a dispute with respect to this Agreement, either party may send a notice to the other requesting a meeting at which senior officers or officials of the parties will attempt to resolve the dispute. If the parties are unable to resolve the dispute within ten(10) days after the meeting notice is received by the party to whom it is directed, or such longer period as the parties may agree,then either party may initiate mediation as set forth herein. E. Merger/Entire Agreement. This Agreement(including the attachments, documents and instruments referred to in this Agreement) constitutes the entire agreement and understanding of the parties with respect to the subject matter of this Agreement and supersedes all prior understandings and agreements, whether written or oral, among the parties with respect to such subject matter. F. Minor Modifications. Utility and/or CSD may request modifications to make minor adjustments during the contract term to implement process improvements and program efficiencies as appropriate. G. Nonwaiver. The waiver by either party of any breach of any term, covenant, or condition contained in this Agreement, or any default in the performance of any obligations under this Agreement, shall not be deemed to be a waiver of any other breach or default of the same or any other term, covenant, condition, or obligation; nor shall any waiver of any incident of breach or default constitute a continuing waiver of the same. All waivers shall be in writing. H. Seve rability. If any provision of this Agreement is found invalid or unenforceable in any respect for any reason, the validity and enforceability of any such provision in any other respect and of the remaining provisions of this Agreement will not be in any way impaired and shall remain in full force and effect. I.Subcontracts. No subcontracts shall be permitted under this Agreement; therefore, references to subcontractor or subcontracts as part of standard provisions that have been included herein shall have no applicability. J.Venue. In the event that suit shall be brought by either party to this Agreement, the parties agree that venue shall be exclusively vested in the State Courts of the County of Sacramento, or where otherwise appropriate, exclusively in the United States District Court for the Eastern District of California in Sacramento, California. 9 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 ARTICLE 4—STATE CONTRACTING REQUIREMENTS - GENERAL TERMS AND CONDITIONS GTC 610 4.1 APPROVAL: This Agreement is of no force or effect until signed by both parties and approved by the Department of General Services, if required. Utility may not commence performance until such approval has been obtained. 4.2 AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid unless made in writing, signed by the parties and approved as required. No oral understanding or Agreement not incorporated in the Agreement is binding on any of the parties. 4.3 ASSIGNMENT: This Agreement is not assignable by the Utility, either in whole or in part, without the consent of the State in the form of a formal written amendment. 4.4 AUDIT: Utility agrees that the awarding department, the Department of General Services, the Bureau of State Audits, or their designated representative shall have the right to review and to copy any records and supporting documentation pertaining to the performance of this Agreement. Utility agrees to maintain such records for possible audit for a minimum of three(3) years after final payment, unless a longer period of records retention is stipulated. Utility agrees to allow the auditor(s) access to such records during normal business hours and to allow interviews of any employees who might reasonably have information related to such records. Further, Utility agrees to include a similar right of the State to audit records and interview staff in any subcontract related to performance of this Agreement. (Gov. Code §8546.7, Pub. Contract Code §10115 et seq., Cal. Code Regs., Title 2, §1896). 4.5 INDEMNIFICATION: Utility agrees to indemnify, defend and save harmless the State, its officers, agents and employees from any and all claims and losses accruing or resulting to any and all contractors, sub-contractors, suppliers, laborers, and any other person, firm or corporation furnishing or supplying work services, materials, or supplies in connection with the performance of this Agreement, and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by Utility in the performance of this Agreement. 4.6 DISPUTES: Utility shall continue with the responsibilities under this Agreement during any dispute. 4.7 TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of any payments should the Utility fail to perform the requirements of this Agreement at the time and in the manner herein provided. In the event of such termination the State may proceed with the work in any manner deemed proper by the State. All costs to the State shall be deducted from any sum due the Utility under this Agreement and the balance, if any, shall be paid to the Utility upon demand. 10 City of Ukiah Utility Direct Payment Agreement Agreement No.20Y-2025 4.8 INDEPENDENT CONTRACTOR: Utility, and the agents and employees of Utility, in the performance of this Agreement, shall act in an independent capacity and not as officers or employees or agents of the State. 4.9 RECYCLING CERTIFICATION: The Utility shall certify in writing under penalty of perjury, the minimum, if not exact,percentage of post-consumer material as defined in the Public Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the State regardless of whether the product meets the requirements of Public Contract Code Section 12209. With respect to printer or duplication cartridges that comply with the requirements of Section 12156(e), the certification required by this subdivision shall specify that the cartridges so comply(Pub. Contract Code §12205). 4.10 NONDISCRIMINATION CLAUSE: During the performance of this Agreement, Utility and its sub-contractors shall not unlawfully discriminate, harass, or allow harassment against any employee or applicant for employment because of sex, race, color, ancestry, religious creed, national origin,physical disability(including HIV and AIDS),mental disability, medical condition(e.g., cancer), age (over 40), marital status, and denial of family care leave. Utility and sub-contractors shall insure that the evaluation and treatment of their employees and applicants for employment are free from such discrimination and harassment. Utility and sub-contractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12990(a-f) et seq.) and the applicable regulations promulgated thereunder(Cal. Code of Regs., Title 2, 7285 et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code Section 12990 (a-f), set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations, are incorporated into this Agreement by reference and made a part hereof as if set forth in full. Utility and its sub- contractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. Utility shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the Agreement. 4.11 CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES contained in the document CCC 307 are hereby incorporated by reference and made a part of this Agreement by this reference as if attached hereto. 4.12 TIMELINESS: Time is of the essence in this Agreement. 4.13 COMPENSATION: The consideration to be paid Utility, as provided herein, shall be in compensation for all of Utility's expenses incurred in the performance hereof, including travel, per diem, and taxes, unless otherwise expressly so provided. 4.14 GOVERNING LAW: This Agreement is governed by and shall be interpreted in accordance with the laws of the State of California. 11 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 4.15 ANTITRUST CLAIMS: The Utility by signing this Agreement hereby certifies that if these services or goods are obtained by means of a competitive bid, the Utility shall comply with the requirements of the Government Code Sections set out below. a. The Government Code Chapter on Antitrust claims contains the following definitions: 1. "Public purchase" means a purchase by means of competitive bids of goods, services, or materials by the State or any of its political subdivisions or public agencies on whose behalf the Attorney General may bring an action pursuant to subdivision(c) of Section 16750 of the Business and Professions Code. 2. "Public purchasing body" means the State or the subdivision or agency making a public purchase. Government Code Section 4550. b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder. Government Code Section 4552. C.If an awarding body or public purchasing body receives, either through judgment or settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand, recover from the public body any portion of the recovery, including treble damages, attributable to overcharges that were paid by the assignor but were not paid by the public body as part of the bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code Section 4553. d. Upon demand in writing by the assignor, the assignee shall, within one year from such demand, reassign the cause of action assigned under this part if the assignor has been or may have been injured by the violation of law for which the cause of action arose and (a)the assignee has not been injured thereby, or(b) the assignee declines to file a court action for the cause of action. See Government Code Section 4554. 4.16 CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of$100,000, the contractor acknowledges in accordance with Public Contract Code 7110, that: 12 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 a. The contractor recognizes the importance of child and family support obligations and shall fully comply with all applicable state and federal laws relating to child and family support enforcement, including,but not limited to, disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8 (commencing with section 5200) of Part 5 of Division 9 of the Family Code; and b. The contractor, to the best of its knowledge is fully complying with the earnings assignment orders of all employees and is providing the names of all new employees to the New Hire Registry maintained by the California Employment Development Department. 4.17 UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is unenforceable or held to be unenforceable, then the parties agree that all other provisions of this Agreement have force and effect and shall not be affected thereby. 4.18 PRIORITY HIRING CONSIDERATIONS: If this Agreement includes services in excess of$200,000, the Utility shall give priority consideration in filling vacancies in positions funded by the Agreement to qualified recipients of aid under Welfare and Institutions Code Section 11200 in accordance with Pub. Contract Code section 10353. 419 SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING REQUIREMENTS: a. If for this Agreement the Utility made a commitment to achieve small business participation, then the Utility must within 60 days of receiving final payment under this Agreement(or within such other time period as may be specified elsewhere in this Agreement) report to the awarding department the actual percentage of small business participation that was achieved. (Gov. Code 14841.) b. If for this Agreement the Utility made a commitment to achieve disabled veteran business enterprise(DVBE)participation, then the Utility must within 45 days of receiving final payment under this Agreement (or within such other time period as may be specified elsewhere in this Agreement)certify in a report to the awarding department: (1) the total amount the Utility received under the Agreement; (2)the name and address of the DVBE(s) that participated in the performance of the Agreement; (3) the amount each DVBE received from the Utility; (4) that all payments under the Agreement have been made to the DVBE; and(5) the actual percentage of DVBE participation that was achieved. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation. (Mil. &Vets. Code §999.5(d); Gov. Code §14841.) 4.20 LOSS LEADER: If this Agreement involves the furnishing of equipment, materials, or supplies then the following statement is incorporated: It is unlawful for any person 13 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 engaged in business within this state to sell or use any article or product as a"loss leader" as defined in Section 17030 of the Business and Professions Code. (Pub. Contract Code 10344(e).) 14 City of Ukiah Utility Direct Payment Agreement Agreement No. 20Y-2025 ARTICLE 5—ADMINISTRATIVE POLICIES,TERMS AND CONDITIONS 5.1 Confidentiality A. In the course of performing the services under this Agreement, CSD may have access to confidential, commercial, or personal information concerning, but not limited to, technology, rate making, legislative, and personnel matters and practices of the Utility, its subsidiaries, affiliates, or members of the public. CSD agrees not to disclose any such information without the prior written approval of Utility. B. Utility hereby agrees to provide required security to ensure the confidential, physical security and safekeeping of all data, information, files, and documents customer information.")pertaining to the recipients of LIHEAP utility assistance payments, while such customer information is in its possession. Utilizing security procedures and measures no less effective than those employed by CSD, Utility will, in accordance with applicable law and the terms of this agreement,protect from unauthorized use and disclosure all sensitive data, documentation, or other customer information provided to Utility by CSD for purposes of this Agreement. C. Any representation herein made by CSD relating to confidentiality or the operations, limitations, and requirements for the furnishing of personnel records, as set forth below in Section 3.4, CSD's Use of Utility's Property, shall be subject to the Information Practices Act of 1977, Section 1798 et seq. of the California Civil Code, and the California Public Records Act, Section 6250 et seq. of the California Government Code. 8 City of Ukiahcow V, : 75 Utility Direct Payment Agreement IM 1) 3 Agreement No.20Y-2025 IN WITNESS WHEREOF, this Agreement has executed by the parties hereto: Utility Name City of Ukiah Aut rize Si ature Date Signed Sage Sangiacorno Printed Name and Title of Person Signing Address:300 Seminary Avenue Ukiah,California 95482 Telephone: (707)463-6221 Email: ssan igacomo@citvrofukiah.com STATE OF CALIFORNIA Department of Community Services and Development By: Authorized Signature Date Signed Chris Vail Chief Financial Officer Address: 2389 Gateway Oaks Drive, Suite 100 Sacramento, California 95833 Telephone: (916) 576-7109 Email: C Direct Payment LIHEAP Direct Payment Sample Attachment 1 — LIHEAP Direct Pa ment Summary State of California-Health and Human ices Agency DEPARTMENT OF COMMUNITY VFd%D VELOPMENT 2389 Gateway Oaks DQ{ l3n4t t 00 i'c a'm nto, CA 95833 Telephone:(916)576-710 Fax:V,1,6 26,K406 DAVID SCRIBNER GAVIN NEWSOMACTINGDIRECTOR GOVERNOR ATTACHMENT LIHEAP DIRECT PAYMENT SUMMARY PLEASE COMPLETE FOR EACH DIRECT PAYMENT BATCH C) E) B) Total Number Total Number A) Total Number of Accounts D) of of Accounts Receiving Total Number Partial and/or Total Number Receiving FULL PARTIAL of Accounts Full Credit CSD RUN of Accounts on LIHEAP LIHEAP UNABLE TO RETURNS DATE this Pay Run PAYMENT PAYMENT CREDIT Column C + D Total Dollar Total Dollar Amount of Total Dollar Total Dollars Total Dollar Amount of PARTIAL Amount of RETURNED Amount from FULL LIHEAP CREDIT FULL CREDIT (Partial plus CSD PAYMENTS RETURNS RETURNS Full Credit I T COMPLETED BY: ` PHONE: UTILITY COMPANY: DATE UTILITY ACCOUNTS CREDITED: This SUMMARY SHEET must be returned within 30 working days of receipt. Please attach the Account Reconciliation Report and check for the amount of the return payments, associated with this pay run to the address below. RETURN SUMMARY SHEET TO: Albert Cobian, Energy Services HOME ENERGY ASSISTANCE PROGRAM 2389 GATEWAY OAKS DRIVE, SUITE 100 SACRAMENTO,CA 95833 Or Fax 916-263-1651 Or Email to Energy.He1 Des1CCSD.CA.GOV If you have any questions, please contact Albert Cobian (916) 576-7180. CSD UsE ONLY CHECK RECEIVED I YES I NO I CHECK NUMBER AMOUNT RETURNED Serving Low-Income Families Through Community Partners