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ESD Grant Disbursement Agreement Terms & Conditions -- Page 1
Grant Disbursement Agreement
All Applicants who receive their Eligible Funding Award will be required to enter into an ESD Grant
Disbursement Agreement.
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ESD Grant Disbursement Agreement Terms & Conditions -- Page 2
This GRANT DISBURSEMENT AGREEMENT (“Agreement”) includes all exhibits and attachments hereto
and is made on the terms and by the parties listed below and relates to the Project described below:
NEW YORK STATE 633 Third Avenue
URBAN DEVELOPMENT New York, NY 10017
CORPORATION d/b/a Contact: «Project_Manager»
EMPIRE STATE DEVELOPMENT Phone: «Project_Mgr_Phone»
("ESD"): Fax: «Project_Mgr_Fax»
e-mail: «Project_Mgr_email»
THE GRANTEE: «Orgn_Name_Client»
«Street_Address_Client»
«CitySTZip_Client»
Contact: «Contact_Name_Client», «Contact_Title_Client»
Phone: «Phone_Client»
e-mail: «Client_email»
Federal Taxpayer ID#:
THE PROJECT: «Project_Name»
PROJECT NUMBER: «Project_Number»
GRANT AMOUNT: «Grant_Amt»
FUNDING SOURCE: «Fund_Source»
ESD APPROVAL DATE: «Approval_Date»
EXPIRATION DATE: [Date]
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ESD Grant Disbursement Agreement Terms & Conditions -- Page 3
TERMS AND CONDITIONS
1. The Project
(a) The project will occur as described in Exhibit A and the ESD Approval materials attached.
The Grantee will perform the tasks on the schedule and as described in Exhibit A to this
Agreement.
(b) The Grantee will submit to ESD the report(s) as required in Exhibit B.
(c) The Grantee will provide the subgrantee/consultant/contractor/vendor disclosure
required by Exhibit C.
2. Project Budget and Use of Funds
The Grantee will perform the project in accordance with the overall project budget, which
includes the Grant funds, set forth in Exhibit D to this Agreement. The Grant will be applied only to
eligible expenses, which are separately identified.
3. Conditions Precedent to Disbursement of the Grant
No grant funds shall be disbursed unless the Grantee is in compliance with the terms and
conditions of this Agreement, including, but not limited to, Exhibit F (Disbursement Terms), and the
following conditions have been satisfied (and as to 3 (c) below continues to be satisfied prior to each
disbursement):
(a) If the Grant amount exceeds $100,000, ESD has received an opinion of Grantee's counsel,
in substantially the form appended to this Agreement as Exhibit E.
(b) Any necessary approval has been issued by the Director of Budget of the state of New
York, and the Grant funds have been received by ESD.
(c) There have been no materially adverse changes in the financial condition of the Grantee
since the date of submission of its application to ESD.
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4. Disbursement
Subject to the terms and conditions contained in this Agreement, ESD shall disburse the Grant to
the Grantee as follows:
(a) ESD shall reimburse the Grantee, in the manner as set forth in Exhibit F, the amount of eligible
expenses actually incurred by the Grantee, upon presentation to ESD of a Payment
Requisition Form, together with such supporting documentation as ESD may require, in the
form attached to this Agreement as Exhibit G and its attachments.
(b) The last 10 percent (10%) of the Grant shall not be disbursed by ESD until all of the tasks and
reports required under this Agreement have been completed to ESD’s satisfaction.
(c) In no event will ESD make any payment which would cause ESD's aggregate disbursements
to exceed the Grant amount.
5. Non-Discrimination and Contractor & Supplier Diversity
The Grantee will comply with ESD's Non-Discrimination and Contractor & Supplier Diversity
policies set forth in Exhibit H to this Agreement.
6. No Liability of ESD
ESD shall not in any event whatsoever be liable for any injury or damage, cost or expense of any
nature whatsoever that occurs as a result of or in any way in connection with the Project and the Grantee
hereby agrees to indemnify and hold harmless ESD, the State and their respective agents, officers,
employees and directors (collectively, the "Indemnitees ") from and against any and all such liability
other than that caused by the gross negligence or the willful misconduct of the Indemnitees.
7. Responsibility Provisions
(a) The Grantee shall at all times during the Agreement term remain responsible. The Grantee
agrees, if requested by the President and Chief Executive Officer of ESD or his or her designee,
to present evidence of its continuing legal authority to do business in New York State,
integrity, experience, ability, prior performance, and organizational and financial capacity.
(b) The President and Chief Executive Officer of ESD or his or her designee, in his or her sole
discretion, reserves the right to suspend any or all activities under this Agreement, at any
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ESD Grant Disbursement Agreement Terms & Conditions -- Page 5
time, when he or she discovers information that calls into question the responsibility of the
Grantee. In the event of such suspension, the Grantee will be given written notice outlining
the particulars of such suspension. Upon issuance of such notice, the Grantee must comply
with the terms of the suspension order. Activities under this Agreement may resume at such
time as the President and Chief Executive Officer of ESD or his or her designee issues a written
notice authorizing a resumption of performance under this Agreement.
(c) Upon written notice to the Grantee, and a reasonable opportunity to be heard with
appropriate ESD officials or staff, this Agreement may be terminated by the President and
Chief Executive Officer of ESD or his or her designee at the Grantee’s expense where the
Grantee is determined by the President and Chief Executive Officer of ESD or his or her
designee to be non-responsible. In such event, the President and Chief Executive Officer of
ESD or his or her designee may complete the requirements of this Agreement in any manner
he or she deem advisable and pursue available legal or equitable remedies for breach.
8. Representations, Warranties and Covenants
The Grantee represents, warrants and covenants that:
(a) It has full power and authority to execute and deliver this Agreement and to perform its
obligations hereunder.
(b) This Agreement was duly authorized, executed and delivered by the Grantee and is
binding and enforceable against the Grantee in accordance with its terms.
(c) It is duly organized, validly existing and in good standing under the laws of the State of
its organization, has full power and authority to own its assets and to conduct the
activities in which it is now engaged or proposed to be engaged and is duly qualified and
in good standing under the laws of each other jurisdiction in which such qualification is
required and shall maintain its existence in good standing in each such jurisdiction.
(d) There are no actions, suits or proceedings or, to the knowledge of Grantee, threatened
against, or affecting Grantee before any court, governmental entity or arbitrator, which
may, in any one case or in the aggregate, materially adversely affect the financial
condition, operations, properties or business of the Grantee, except as may have been
disclosed in writing to ESD.
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(e) Grantee is in compliance and shall continue to comply in all material respects with all
material applicable laws, rules, regulations and orders. The Grant shall be used solely for
Eligible Expenses in accordance with the terms and conditions of this Agreement.
(f) The information contained in the application submitted by the Grantee in connection
with the project and the Grant, as such application may have been amended or
supplemented (the “Application”), is incorporated herein by reference in its entirety. In
the event of an inconsistency between the descriptions, conditions, and terms of this
Agreement and those contained in the Application, the provisions of this Agreement
shall govern. The Grantee hereby acknowledges that ESD has relied on the statements
and representations made by the Grantee in the Application in making the Grant. The
Grantee hereby represents and warrants that it has made no material misstatement or
omission of fact in the Application or otherwise in connection with the Grant and that
the information contained in the Application continues on the date hereof to be
materially correct and complete.
(g) The relationship of the Grantee (including, for purposes of this paragraph, its officers,
employees, agents and representatives) to ESD arising out of this Agreement shall be that
of an independent contractor. The Grantee covenants and agrees that it will conduct
itself in a manner consistent with such status, that it will neither hold itself out as, nor
claim to be, an officer, employee, agent or representative of ESD or the State by reason
hereof, and that it will not by reason thereof, make any claim, demand or application for
any right or privilege applicable to an officer, employee, agent or representative of ESD
or the State, including without limitation, worker's compensation coverage,
unemployment insurance benefits, social security coverage or retirement membership
or credit.
(h) Neither the Grantee nor any of the members of its Board of Directors or other governing
body or its employees have given anything of value to anyone to procure the Grant or to
influence any official act or the judgment of any person in the performance of any of the
terms of this Agreement.
(i) The Grant shall be used solely for eligible expenses in accordance with the terms and
conditions of this Agreement.
(j) It is solely responsible and has sufficient funding for all Project costs in excess of the
Grant.
(k) No materials, if any, purchased with the Grant will be used for any purpose other than
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the Project.
(l) The Grantee shall report in writing to ESD any grants, commitments or funds received by
the Grantee from any source, governmental or non-governmental, in connection with
the carrying out of the Project, other than the grant of funds received under this
Agreement. No part of the Grant will be applied to any expenses paid or payable from
any other funding source.
(m) The Grant shall not be used in any manner for any of the following purposes:
(i) political activities of any kind or nature, including, but not limited to, furthering
the election or defeat of any candidate for public, political or party office, or for
providing a forum for such candidate activity to promote the passage, defeat, or
repeal of any proposed or enacted legislation;
(ii) religious worship, instruction or proselytizing as part of, or in connection with,
the performance of this Agreement;
(iii) payments to any firm, company, association, corporation or organization in
which a member of the Grantee's Board of Directors or other governing body, or
any officer or employee of the Grantee, or a member of the immediate family of
any member of the Grantee's Board of Directors or other governing body, officer,
or employee of the Grantee has any ownership, control or financial interest. For
purposes of this paragraph, "ownership" means ownership, directly or indirectly,
of more than five (5) percent of the assets, stock, bonds or other dividend or
interest bearing securities; and "control" means serving as a member of the
board of directors or other governing body, or as an officer in any of the above;
and
(iv) payment to any member of Grantee's Board of Directors or other governing body
of any fee, salary or stipend for employment or services, except as may be
expressly provided for in this Agreement.
(n) Any report or other product of the Grant, after approval of such product by ESD, shall contain
the following acknowledgment:
"Funding provided by a grant from
Empire State Development"
(o) ESD may make reasonable use of any report or other product of the Grant upon notice to the
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Grantee.
(p) Grantee is in compliance and shall continue to comply with Section 7 of this Agreement.
9. Default and Remedies
(a) Each of the following shall constitute a default by the Grantee under this Agreement:
(i) Failure to perform or observe any obligation or covenant of the Grantee
contained herein to the reasonable satisfaction of ESD and within the time
frames established therefor under this Agreement.
(ii) Failure to comply with any request for information reasonably made by ESD to
determine compliance by the Grantee with the terms of this Agreement or
otherwise reasonably requested by ESD in connection with the Grant.
(iii) The making by the Grantee of any false statement or the omission by the Grantee
to state any material fact in or in connection with this Agreement or the Grant.
(iv) A default beyond any applicable grace period by the Grantee, or any entity which
Grantee directly or indirectly controls, is controlled by, or is under common
control with, under any other agreement with ESD.
(v) Failure by the Grantee, for any period of time, to comply with Section 7 of this
Agreement.
(b) Upon the serving of notice to the Grantee of the occurrence of a default (which notice
shall specify the nature of the default), ESD shall have the right to terminate this
Agreement, provided that if the default is pursuant to paragraph 9(a)(i) or 9(a)(ii), no
default shall be deemed to have occurred if Grantee cures such default within ten (10)
days of notice from ESD or, if the default cannot reasonably be cured within such ten-day
period, Grantee commences to cure such default within the ten-day cure period and
cures the default within ninety (90) days thereafter, provided further that ESD shall not
be obligated to make any disbursements during any such cure period.
(c) Upon such termination of this Agreement, ESD shall withhold any Grant proceeds not yet
disbursed and may require repayment of Grant proceeds already disbursed. If ESD
determines that any Grant proceeds had previously been released based upon fraudulent
representations or other willful misconduct, ESD may require repayment of those funds
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and may refer the matter to the appropriate authorities for prosecution. ESD shall be
entitled to exercise any other rights and seek any other remedies provided by law.
10. Term
The term of this Agreement shall commence on the date hereof and expire on the Expiration
Date, as set forth on the first page of this Agreement.
11. Books and Records; Project Audit
(a) The Grantee will maintain accurate books and records concerning the Project for the term of
this Agreement and for three (3) years from the expiration or earlier termination of this
Agreement and will make those books and records available to ESD, its agents, officers and
employees during Grantee's business hours upon reasonable request.
(b) ESD shall have the right, upon reasonable notice, to conduct, or cause to be conducted, one
or more audits, including field inspections, of the Grantee to assure that the Grantee is in
compliance with this Agreement. This right to audit shall continue for three (3) years following
the expiration or earlier termination of this Agreement.
12. Survival of Provisions
It is agreed that: (a) the provisions of Sections 6, 8(g), (j) and 9, 11, , 13, 14, 15, 16, 17, 18, 21
and 22 (except insofar as any of the aforesaid Sections have been waived in accordance with the terms
of Exhibit I to this Agreement) shall survive the expiration or early termination of this Agreement; and
(b) such expiration or early termination shall not serve to limit, alter or modify any of the Grantee’s
obligations or responsibilities under the aforesaid Sections, and/or ESD’s rights under such Sections,
referenced in subsection (a) of this Section 13 of this Agreement. It is further agreed, moreover, that
notwithstanding the expiration or early termination of this Agreement, ESD shall nevertheless retain
the right to pursue, through and until the expiration of any applicable period of limitations established
under the statutory or common law of the State of New York, any claim or claims arising from any
Section of this Agreement, including but not limited to the above referenced Sections 6, 8(g), (j) and 9,
11, 13, 14, 15, 16, 17, 18, 21 and 22 of this Agreement, and the expiration or early termination of this
Agreement shall not constitute a defense to any such timely filed claim or cause of action that is
asserted on ESD’s behalf.
13. Notices
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(a) All notices, demands, requests or other communications permitted or required hereunder
shall be in writing and shall be transmitted either:
(i) via certified or registered United States mail, return receipt requested;
(ii) by facsimile transmission;
(iii) by personal delivery;
(iv) by expedited delivery service; or
(v) by e-mail.
Such notices shall be addressed as follows or to such different addresses as the parties may
from time-to-time designate:
Empire State Development
Name: «Project_Manager»
Title: Project Manager
Address: 633 Third Avenue, 34
th
Floor, New York, NY 10017
Telephone Number: «Project_Mgr_Phone»
Facsimile Number: «Project_Mgr_Fax»
E-Mail Address: «Project_Mgr_email»
With a copy to:
Title: General Counsel
Address: 633 Third Avenue, 34
th
Floor, New York, NY 10017
Telephone Number: (212) 803-3750
Facsimile Number: (212) 803-3975
«Orgn_Name_Client»
Name: «Contact_Name_Client»
Title: «Contact_Title_Client»
Address: «Street_Address_Client», «CitySTZip_Client»
Telephone Number: «Phone_Client»
Facsimile Number: «Fax_Client»
E-Mail Address: «Client_email»
(b) Any such notice shall be deemed to have been given either at the time of personal delivery
or, in the case of expedited delivery service or certified or registered United States mail, as
of the date of first attempted delivery at the address and in the manner provided herein,
or in the case of facsimile transmission or email, upon receipt.
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(c) The parties may, from time to time, specify any new or different address in the United
States as their address for purpose of receiving notice under this Agreement by giving
fifteen (15) days written notice to the other party sent in accordance herewith. The parties
agree to mutually designate individuals as their respective representatives for the
purposes of receiving notices under this Agreement. Additional individuals may be
designated in writing by the parties for purposes of implementation and
administration/billing, resolving issues and problems and/or for dispute resolution.
14. No Assignment
The Grantee may not assign or transfer this Agreement or any of its rights hereunder.
15. No Waiver
No waiver of any ESD's rights arising under this Agreement, or any other source, can occur
unless such waiver shall be in writing and signed by ESD and such written document manifests a clear
and unequivocal intent by ESD to waive its contractual or other legal rights. The term "waiver" as
used herein is a term of art as used in the legal profession. ESD may not be estopped from asserting any
of its legal rights, including but not limited to its rights under this agreement, unless ESD has signed a
written document that clearly and unequivocally states that the other party may detrimentally rely upon
the terms of such written document. Absent such written document, there shall be no estoppel against
ESD and the other parties' alleged detrimental reliance shall be deemed to be unreasonable. The term
"estoppel" is used herein is a term of art as used in the legal profession.
16. Integration/Modification
This Agreement contains the entire agreement of the parties with respect to the subject matter
hereof and supersedes all prior oral or written agreements or statements relating to such subject matter.
In addition, this Agreement may be modified only by a written instrument executed by the party against
whom enforcement of such modification is sought.
17. Governing Law
This Agreement shall be governed by and construed in accordance with the laws of the State of
New York. This Agreement shall be construed without the aid of any presumption or other rule of law
regarding construction against the party drafting this Agreement or any part of it. In case any one or
more of the provisions of this Agreement shall for any reason be held to be invalid, illegal or
unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other
provision hereof and this Agreement shall be construed as if such provision(s) had never been contained
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ESD Grant Disbursement Agreement Terms & Conditions -- Page 12
herein. In the event of a conflict between the Directors’ materials attached hereto as Exhibit A-1 and
any other term or condition of this Agreement, then the term or condition of this Agreement shall
govern.
18. Confidentiality of Information
Information contained in reports made to ESD or otherwise obtained by ESD relating to trade
secrets, operations and commercial or financial information, including but not limited to the nature,
amount or source of income, profits, losses, financial condition, marketing plans, manufacturing
processes, production costs, productivity rates, or customer lists, provided that such information is
clearly marked “Confidential” by the Grantee, will be kept confidential by ESD, to the extent such
information is determined by ESD to be exempt from public disclosure under the Freedom of Information
Law and not otherwise required by law to be disclosed. Notwithstanding the foregoing, ESD will not be
liable for any information disclosed, in ESD’s sole discretion, pursuant to the Freedom of Information
Law or other applicable law, or which ESD is required to disclose pursuant to legal process.
19. Special Provisions
The Grantee shall comply with the special provisions, if any, set forth in Exhibit I.
20. Litigation Costs
The Grantee shall pay, in any action or proceeding that is commenced to enforce and/or involves
the enforcement of the terms and conditions of this Agreement, all of ESD’s costs including, without
limitation, ESD’s attorneys’ fees. The Grantee shall also pay any and all of ESD’s collection costs
including, without limitation, its attorneys’ fees.
21. Waiver
The Grantee knowingly and expressly waives the right to a trial by jury and the right to interpose
any counterclaims in any action brought by ESD under the terms of this Agreement.
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ESD Grant Disbursement Agreement Terms & Conditions
«Project_Name», Project Number «Project_Number»
In witness whereof, the parties have executed this Agreement by their duly authorized representatives
as of the latest date written below:
NEW YORK STATE URBAN DEVELOPMENT CORPORATION
d/b/a EMPIRE STATE DEVELOPMENT
(Signature) Edwin Lee, Senior Vice President, Loans and Grants
____________________________________
(date)
GRANTEE: «Orgn_Name_Client»
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______________________________________________________________________________
(Signature)
(Printed name and title)
Date: _______________________________
Rev. 11/25/2019
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ESD Grant Disbursement Agreement Terms & Conditions
ESD GRANT DISBURSEMENT AGREEMENT
EXHIBITS
EXHIBIT A Project Description
EXHIBIT A-1 ESD Approval Materials
EXHIBIT B Report
EXHIBIT C Subgrantee/Consultant/Contractor/Vendor
Disclosure Statement
EXHIBIT D Project Budget
EXHIBIT E Opinion of Counsel
EXHIBIT F Disbursement Terms
EXHIBIT G Payment Requisition Form
EXHIBIT G-1 Payment Requisition Cover Letter
EXHIBIT G-2 Project Cost Documentation
EXHIBIT G-3 Project Cost Affidavit
EXHIBIT H Non-Discrimination and Contractor & Supplier Diversity –
Requirements and Procedures
EXHIBIT H-1 M/WBE Participation / Equal Opportunity Policy Statement
EXHIBIT H-2 Staffing Plan
EXHIBIT H-3 Workforce Employment Utilization Report
EXHIBIT H-4 M/WBE Utilization Plan
EXHIBIT H-5 Waiver Request Form
EXHIBIT H-6 M/WBE Contractor Compliance and Payment Report
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBITS, Cont.
EXHIBIT I Special Provisions
EXHIBIT J Disclosure and Accountability Certifications
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT A: Project Description
«Orgn_Name_Client»
«Project_Name», Project «Project_Number»
TASKS and TIMELINE
Include detailed task descriptions. Include dates of completion for each task.
NOTE: 75% of the grant proceeds must be allocated to approved not-for-profits.
Project Activities Description
Provide a description of project activities to be funded and which entities (Grantee, NFPs, or a
combination) will be performing them, including any expenditures that the applicant will make
directly. Activities described may include one or more of the following:
1. Community outreach
2. Distribution of literature,
3. Door-to-door conversations
4. Conducting informational sessions about the census and process
5. Conducting special events and census mobilizing
6. Development of digital media capped at 5% of the budget
7. Interpretation and translation services
8. Implementation of developed targeted media campaigns
9. Informational kiosks and presentations
10. Development of outreach materials (brochures, fliers, newsletters, and other targeted
advertising such as billboards and other outlets with broad reach)
11. Other specific activities to increase 2020 Census participation that align with goals described in
the Report: https://www.ny.gov/programs/2020-census.
In the chart below, please indicate who will be responsible for providing the project activity (a
grantee, a subgrantee not-for-profit (NFP) contractor—or both, working together) and which activity
is being conducted (see examples below). Be sure to list each activity/provider pairing on a separate
row. Please add additional rows as needed.
Project Activity
Provider
Anticipated Timeline
e.g. conducting informational sessions about
the census and process at a senior living
facility
e.g., Grantee
name
e.g. conducting informational sessions about
the census and process at a senior living
facility
e.g., Subgrantee
name
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT A-1: ESD Approval Materials
Director Materials Attached which will provided by ESD
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT B: Report
«Project_Name», Project «Project_Number»
All projects must submit an Interim/Final Report. The Interim/Final Report, which
outlines the project's goals, implementation, results and challenges, is subject to review
and comment by ESD/DOL/DOS. The last disbursement of Grant funds, pursuant to
Exhibit F of this Agreement, will not be made until the Final Report is approved by ESD.
Date of report: Type of report: Interim/Final
If Final Report: Amount of Grant: «Grant_Amt» Total Program Cost: $_________________
Project start date: Project completion date: __________________
Attach additional pages to answer the following questions:
I. Describe the goals of the project.
II. Describe the steps implemented to achieve those goals (to date).
III. Describe specific results of the Project (to date).
IV. Evaluate the Project's overall effectiveness (to date).
V. Describe any challenges or unexpected events that arose in implementing the Project
(to date).
VI. Provide the expected number of hard-to-count communities the Grantee reached to
date.
VII. Provide the projected number of residents in hard-to-count populations the Grantee
expects to complete the census questionnaire.
VIII. A description of the outcome of the Grantee’s plan to increase participation in hard-to-
count communities in the 2020 Census.
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT C: Subgrantee/Consultant/Contractor/Vendor Disclosure Statement
«Orgn_Name_Client»
«Project_Name», Project «Project_Number»
Grantee must complete this form for each subgrantee/consultant/contractor/vendor it uses
whose fee amounts to at least 10% of the total grant or $500, whichever is less.
Grantee must attach a contract for any subgrantee(s)/consultant(s)/contractor(s)/vendor(s)
used.
I, , am the
____________________________of (the “Grantee”), an entity
that is duly organized and validly existing under the laws of the State of New York.
I attest that (Subgrantee/Consultant/Contractor/Vendor)________________was chosen
as a consultant/contractor/vendor on Project #«Project_Number» by the Grantee to (Describe
Services.
______________________________________________________________________________
______________________________________________________________________________
_______________________________________________. No member of the Grantee's Board
of Directors or other governing body, or any officer or employee of the Grantee, or a member
of the immediate family of any member of the Grantee's Board of Directors or other governing
body, officer, or employee of the Grantee has any ownership, control or financial interest in the
consultant/contractor/vendor as defined by Section 8(m)(iii) of this agreement.
I attest that (Subgrantee/Subgrantee/Consultant/Vendor)_________________________
was chosen for its services/ products through a process of (Describe method of selection, and a
description of any relationship between the grantee and the
Subgrantee/Consultant/Contractor/Vendor.)
Signature: __________________________________ Print Name: _____________________
Title: _______________________________________Date: __________________________
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ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT D: Project Budget
«Orgn_Name_Client»
«Project_Name», Project «Project_Number»
Budget Summary
NOTE: 75% of the grant proceeds must be allocated to approved not-for-profits. For Libraries that are
not incorporated as 501(c)(3) status, the counties or the designated cities can elect to treat libraries
incorporated under a different status as part of the nor-for-profit allocation with a reasonable
explanation in their application.
Examples of eligible budget activities include, but are not limited, to:
• Community outreach
• Distribution of literature
• Door-to-door conversations
• Conducting informational sessions about the census and process
• Conducting special events and census mobilizing
• Development of digital media capped at 5% of the budget
• Interpretation and translation services
• Implementation of developed targeted media campaigns
• Informational kiosks and presentations
• Development of outreach materials (brochures, fliers, newsletters, and other targeted
advertising such as billboards and other outlets with broad reach)
• Other specific activities to increase 2020 Census participation
• Purchase of goods and services that directly support eligible budget activities
• Purchase of consumable electronics limited up to $500 per item and not to exceed
$2,500 in aggregate
• An administrative expense of a rate of up to 5% of the grant funding
All costs incurred must be reasonable and necessary for the performance of work within the scope of
Project.
The State funds should leverage and build on State and regional efforts, create new and innovative
local efforts, and should not be used to supplant or replace other funding for census activities. Travel
costs included in the budget will be reimbursed based on approved NYS rates and per diems outlined
by the U.S. General Services Administration (https://www.gsa.gov/travel-resources).
An administrative rate of up to 5% may be applied to this grant. This will allow the Grantee to receive
funding for administrative costs associated with service delivery and grant management, such as outside
contract management services.
Administrative Expenses are those expenses authorized and allowable pursuant to applicable agency
regulations, contracts or other rules that govern reimbursement with State funds or State-authorized
payments that are incurred in connection with the Grantee’s overall management and can be attributed
directly to the provision of program services. Please note that the Grantee must retain backup
documentation detailing how administrative funds were spent and submit this documentation with the
required reports.
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ESD Grant Disbursement Agreement Terms & Conditions
Funds for the following expenditures will not be allowed:
• Purchase, lease, or rental of any equipment or operational software
• Political activities of any kind
• Electoral activities of any kind
• Acquisition of voter registration data, voter profiles or similar programs or data commonly
used in political campaigns
• Awards of cash, gift cards, trophies or the like
• Purchase, lease, and/or rental of: computers, mobile computing devices such as iPads,
tablets etc., cellular telephones and related devices that exceed $500 per item and are more
than $2,500 in aggregate
• Audit services
• Acquisition, construction, or renovation of buildings or other real estate
• Entertainment
• Religious activity
• Alcohol
• Expenses incurred prior to March 10, 2020 or ESD Award letter date, whichever sooner
• Costs of organized fundraising
• Interest, taxes and penalties
• Overhead expenses
• Any other cost incurred in violation of the terms of the GDA as defined in the agreement
In the chart below, please detail the budget summary for this project.
Grantee Name:
Budget Period: 3/10/2020 to 09/30/2020
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
Fringe
Personnel Services
Title
Annual Salary
(%)
Total
Justification: Completely justify all positions. Describe duties and contributions to the
project. Include a brief description of duties/responsibilities for each position.
Personnel Services Total (dollar value):
Cost Categories
Total Project Cost by
Category (dollar value):
1.
Personnel Services
2.
Fringe
3.
Travel
4.
Contractual Services
5.
Advertising & Printing
6.
Non-Personnel Services
7
Administrative Costs (up to 5%)
TOTAL PROJECT COST
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
Describe and justify each fringe in detail, including fringe rate, and what is included as part of fringe
benefits.
Fringe Total (dollar value):
Travel
Describe and justify all travel in detail, including cost per item. Justify the need for travel and how it
will benefit the project.
Travel Total (dollar value):
ESD TRAVEL EXPENSE REIMBURSEMENT POLICY
REIMBURSEMENT FOR APPROVED TRAVEL MAY NOT EXCEED THE FOLLOWING LEVELS:
A. Personal Car Mileage Internal Revenue Service standard mileage
allowance rate in effect when the expense is
incurred*; actual for trips, site visits, meetings, and
to/from airport.
B. Personal Car-Overtime Actual - $50.00 limit when working overtime
(including mileage rate, tolls, parking)
C. Car Rental (compact category) Actual, not to include Collision Damage Waiver
insurance
D. Airline (coach category) & other Public Transportation Actual
E. Taxi Fares Actual - $50.00 limit when working overtime
*See http://www.osc.state.ny.us/agencies/travel/travel.htm for a schedule of standard mileage reimbursement
allowance rates.
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
Contractual Services
While noting the requirement that 75% of the grant proceeds must be allocated to approved not-
for-profits, describe all contractual services in detail, including cost per item and allocation per
provider indicated on the Project Activity Description attachment. Justify the need for these
services, and how they will benefit the project. For items that will be shared across other programs,
please describe allocation methodology.
Contractual Total (dollar value):
Advertising & Printing
Describe and justify all printing and advertising costs in detail, including cost per item. Justify the
need for printing and advertising, and how it will benefit the project.
Advertising & Printing Total (dollar value):
Non-Personnel Services
Describe and justify all non-personnel services in detail, including cost per item. Justify the need for
these non-personnel services, and how they will benefit the project.
Non-personnel Services Total (dollar value):
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
Administrative Costs (up to 5%)
Describe and justify all administrative costs in detail, including cost per item. Justify the need for
these administrative costs, and how they will benefit the project.
Administrative Costs Total (dollar value):
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT E: Opinion of Counsel
[Letterhead of Counsel to the Grantee]
[Date]
Empire State Development10017
633 Third Avenue
New York, New York 10017
Attention: «Project_Manager»
Re: «Project_Name», Project «Project_Number»
Ladies and Gentlemen:
We have acted as special counsel to «Orgn_Name_Client», a government or
organization (the “Grantee”), in connection with the execution and delivery of the Grant
Disbursement Agreement dated [Date of Agreement] (the “Agreement”) between New York
State Urban Development Corporation d/b/a Empire State Development (“ESD”) and the
Grantee.
This opinion letter is being furnished to you at our client’s request pursuant to
Section 3(a) of the Agreement. Capitalized terms used but not defined herein shall have the
meanings assigned thereto in the Agreement.
In rendering the opinions set forth herein, we have examined originals, or copies
certified or otherwise identified to our satisfaction, of such documents, corporate records and
other instruments as we have deemed necessary or appropriate for the purposes of this opinion
letter, including (a) the Agreement, (b) the certificate of incorporation of the Grantee and (c) the
by-laws of the Grantee. We have also examined and relied upon such other matters of law,
documents, certificates of public officials and representations of officers and other
representatives of the Grantee as we have deemed relevant, appropriate or necessary to the
rendering of our opinions.
In rendering the opinions expressed below, we have assumed the legal capacity of
all natural persons signing documents and that the signatures of persons signing all documents
in connection with which this opinion letter is rendered are genuine, all documents submitted to
us as originals or duplicate originals are authentic and all documents submitted to us as copies,
whether certified or not, conform to authentic original documents. Additionally, we have
assumed and relied upon the accuracy and completeness of all certificates and other statements,
documents, records, financial statements and papers reviewed by us, and the accuracy and
completeness of all representations, warranties, confirmations, schedules and exhibits contained
in the Agreement, with respect to the factual matters set forth therein.
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
As to any facts material to the opinions expressed herein that we did not
independently establish or verify, we have relied upon written statements and representations
of officers and other representatives of the Grantee and of certain public officials. We have also
assumed and relied upon the accuracy and completeness of all certificates and other statements,
representations, documents, records, financial statements and papers reviewed by us, and the
accuracy and completeness of all representations, warranties and exhibits contained in the
Agreement with respect to the factual matters set forth therein.
Based upon the foregoing and subject to the assumptions, qualifications and other
matters set forth herein, we are of the opinion that:
1. The Grantee is validly existing and in good standing under the laws of the
State of New York and has full power and authority to execute and deliver the Agreement and to
perform its obligations thereunder.
2. The Agreement has been duly authorized, executed and delivered by the
Grantee and (assuming its due authorization, execution and delivery by ESD) is binding on and
enforceable against the Grantee in accordance with its terms, subject to applicable bankruptcy,
insolvency reorganization, arrangement, liquidation, moratorium, fraudulent conveyance or
transfer and other similar laws relating to or affecting creditors’ rights generally from time to
time in effect and to general principles of equity (regardless of whether enforcement is sought in
a proceeding in equity or at law), and except as rights under the Agreement to indemnity and
contribution may be limited by federal or state laws.
We are admitted to practice in the State of New York and we express no opinion
as to any matters governed by any laws other than the laws of the State of New York. The
opinions expressed herein that are based on the laws of the State of New York are limited to the
laws generally applicable in transactions of the type covered by the Agreement.
This opinion letter is for the benefit solely of ESD and not for the benefit of any
other person. We are opining herein only as of the date hereof and we undertake no, and
disclaim any, obligation to advise you of any changes in any matter set forth herein, regardless
of whether changes in such matters come to our attention after the date hereof. No attorney-
client relationship exists or has existed with ESD by reason of our preparation, execution and
delivery of this opinion letter. By providing this opinion letter and permitting reliance hereon by
you, we are not acting as your counsel and have not assumed any responsibility to advise you
with respect to the adequacy of this opinion letter for your purposes. This opinion letter may not
be relied upon by any other person or for any other purpose or used, quoted or otherwise
referred to for any other purpose.
Very truly yours,
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT F: Disbursement Terms
«Orgn_Name_Client»
«Project_Name», Project «Project_Number»
Subject to the terms and conditions contained in this Agreement ESD shall disburse the
Grant to the Grantee as follows:
First 70%
Upon the execution of this Agreement by the Grantee and its delivery to ESD, and the
satisfaction of the conditions set forth in Section 3 of the Agreement, ESD shall disburse to
the Grantee as an advance a sum equal to Forty percent (70%) of the Grant ($XXXXXX).
Next 20%
The next Fifty percent (20%) of the grant ($XXXX) shall be disbursed as an advance upon
supporting documentation* of eligible expenditures of 50% of initial advance ($XXXXX),
including an Interim/ Report and cash flow projection of how the second advance of 20% of
the grant will be spent, assuming that all project approvals have been completed and the
Grantee is otherwise in compliance with the terms and conditions of this Agreement.
Last 10%
As stated in Section 4, paragraph (b) of this Agreement the final ten percent (10%) of the
Grant shall be disbursed in arrears upon completion of all tasks and reports required to
ESD's satisfaction and supporting documentation* for 100% of the grant amount has been
provided, and upon submission of the Final Report, assuming that all project approvals have
been completed and the Grantee is otherwise in compliance with the terms and conditions
of this Agreement.
Expenses must be incurred between ESD Award Letter and August 31, 2020 to be considered
eligible project costs. All disbursements in connection with this Project must be requested by no
later than December 31, 2020.
*Supporting documentation may include copies of invoices as well as proof of payment (e.g., bank
statements, paid credit card statements, or other proof of payment), contracts or letters of intent.
ESD reserves the right to require additional documentation to support payment requisitions.
ESD Grant Disbursement Agreement Terms & Conditions
Wire Transfer Information:
If ESD assistance is $10,000 or greater, please provide:
Letter from a financial officer of the grantee certifying to the accuracy of the following information:
Bank Name: ___________________________
ABA #: ___________________________
Account Name: ___________________________
Account #: ___________________________
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT G: Payment Requisition Form
«Project_Name», Project «Project_Number» (attn: «Project_Manager»)
Payment Request # , for $ ________________ for work completed between and , for
Task(s) #
Note to Grantee: Do not re-type this form. Fill in only the version included in the executed GDA. ESD funds may be
applied by Grantee in payment or reimbursement of the following costs:
THIS REQUEST
USES A: ESD SHARE
ESD APPROVED
REVISIONS
C: THIS REQUEST
D: TOTAL
REQUESTED TO
DATE
E: A-C-D BALANCE
TOTAL $0
(10 % Retainage) 0
AVAILABLE $0
Use Wrap Text if text is
too long for the cell width
(icon is in center of
ribbon); alternately, you
can click Format (icon is
4th from right on ribbon)
> Row Height (and adjust
FUNDING STATUS
1
Total Project Cost per Exhibit D
2
Total Eligible Expenses Incurred to Date (including this request)
3
Balance to be Expended (Line 1 minus Line 2)
ESTIMATED SALARY SCHEDULE
If information in grantee’s request for reimbursement of wages differs substantially from the
below schedule, Grantee must submit a written letter requesting to modify the salary schedule
before funds can be disbursed. If an employee receives Benefits (such as pension, 401(k)
employer contributions, employer portion of health benefits, employer FICA) greater than 33%
of their Gross pay specific details must be disclosed to ESD in writing.
Full-Time Employees
A: Employee Name B: Title
C: Gross Pay (Per Pay
Period including
Fringe Benefits)
D: Frequency
(Weekly, Bi-weekly,
Monthly)
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT G: Payment Requisition Form, Cont.
Part-Time Employees
A: EMPLOYEE NAME B:TITLE C:HOURLY WAGE
CERTIFICATION
I hereby warrant and represent to Empire State Development ("ESD") that:
1) To the best of my knowledge, information and belief, the expenditures for which «Orgn_Name_Client» is seeking payment
and/or reimbursement comply with the requirements of the Agreement between ESD and «Orgn_Name_Client», are Eligible
Expenses, and that the payment and/or reimbursement of expenditures for which it is seeking payment and/or reimbursement
from ESD does not duplicate reimbursement or disbursement of costs and/or expenses from any other source.
2) I have the authority to submit this invoice on behalf of «Orgn_Name_Client». The tasks have been completed in the manner
outlined in the Agreement.
3) The disclosures made to ESD by Grantee on Grantee’s Disclosure and Accountability Certifications continue to be complete and
correct, except as may otherwise have been subsequently disclosed to ESD in writing.
4) I hereby attach the following documents for ESD approval, in support of this requisition:
Final report indicating project completion date and what was accomplished with grant funds (Exhibit B)
Consultant/Contractor/Vendor Disclosure Statement (Exhibit C) including contracts as applicable
Project Cost Documentation (Exhibit G-2) – Invoices/receipts for Eligible Expense goods/services with Back-up Summary
Disclosure & Accountability Certifications (Exhibit J; required only if there is a change to that previously submitted)
5) There have been no materially adverse changes in the financial condition of the Grantee, except as disclosed
in writing to ESD, from the date of submission of the Application to the date hereof.
6) The Grantee has acted responsibly from the date of submission of the Application to the date hereof in full
compliance with the terms and conditions of Section 7 of the Agreement.
7) Representations, Warranties and Covenants made in Section 8 of the Agreement are still true, complete and
accurate, unless waived in Exhibit I of the Agreement.
Signature: Date:_______________________________________
Print Name: ___________ Title:_______________________________________
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT G-1: Payment Requisition Cover Letter
*ON GRANTEE'S LETTERHEAD*
Date
«Project_Manager»
Empire State Development
633 Third Avenue
New York, New York 10017
RE: «Project_Name», Project «Project_Number»
Dear «Project_Manager»:
Enclosed please find our request for payment/reimbursement. The package includes the following:
1. Completed Exhibit B: Interim/Final Report
2. Completed Exhibit C: Consultant/Contractor/Vendor Disclosure Statement including
contracts as applicable
3. Completed Exhibit G: Payment Requisition Form
4. Project Cost Documentation – Completed Exhibit G-2 – Payment Requisition Back-up
Summary, including supporting documentation and invoices
5. Completed Exhibit J: Disclosure & Accountability Certifications form (required only if there
is a change to that previously submitted)
If any further information is needed, please give me a call at ( ) .
Signature
Print Name ________________________________________________________
Title _____________________________________________________________
Enclosure
DRAFT
ESD Grant Disbursement Agreement Terms & Conditions
Exhibit G-2: DOCUMENTATION OF PROJECT COSTS
Project Cost Summary
«Project_Name», Project #«Project_Number»
Item # * Check # $ Amount Invoice date Vendor Name Description of Item or Service
TOTAL:
PREPARED BY: DATE:
* Items shall be numbered 1, 2, 3, etc. Also indicate the corresponding item number clearly on any supporting documentation such as
cancelled checks, bank statements and invoices.
ESD Grant Disbursement Agreement Terms & Conditions
EXHIBIT G-3: PROJECT COST AFFIDAVIT
«Project_Name», Project Number «Project_Number»
should not include financing from sources other than the Grantee.
*Project Cost should correspond to the total stated in Exhibit G-2
STATE OF NEW YORK )
) ss.:
COUNTY OF )
The Undersigned, being duly sworn, deposes and says:
1. I,_____________ , am the_____________________________ of
___________________________ (the “Organization”), a not-for-profit that is duly organized and
validly existing under the laws of ________________________, and is authorized to do business and
is in good standing in the State of New York.
2. I have read and know the contents of a certain Grant Disbursement Agreement (the
“Agreement”) executed by and between New York State Urban Development Corporation d/b/a
Empire State Development (“ESD”) and the Organization dated the ________ day of ____________ ,
20_____.
3. After having read and reviewed the Agreement, invoices and payments relating
thereto, statements of cost and equity, and such other documents as I consider necessary to render
the certifications contained herein, I do certify, on the Organization’s behalf, that the costs for the
project were incurred in the manner set forth in the Agreement and the total cost of the project** [to
date] was equal to or greater than
__________________________________Dollars ($________________).
4. I make this affidavit and the certifications contained herein to induce ESD to disburse
the grant under the terms of the Agreement, knowing that ESD will rely on the statements contained
herein. I am aware that the swearing of a false oath is a Class A misdemeanor and may be a Class E
felony.
_________________________
By:
Name:
Title:
Subscribed and sworn to before me
this day of , 20
Notary Public
EXHIBIT H: PARTICIPATION BY MINORITY GROUP MEMBERS AND WOMEN WITH RESPECT TO
STATE CONTRACTS: REQUIREMENTS AND PROCEDURES
ESD Grant Disbursement Agreement Terms & Conditions
I. General Provisions
A. Empire State Development (ESD) is required to implement the provisions of New York
State Executive Law Article 15-A and 5 NYCRR Parts 142-144 (“MWBE Regulations”) for all
State contracts as defined therein, with a value (1) in excess of $25,000 for labor, services,
equipment, materials, or any combination of the foregoing or (2) in excess of $100,000 for
real property renovations and construction.
B. The Recipient of the subject Grant Disbursement Agreement (the “Recipient” and the
“Contract,” respectively) agrees, in addition to any other nondiscrimination provision of
the Contract and at no additional cost to ESD, to fully comply and cooperate with the ESD
in the implementation of New York State Executive Law Article 15-A. These requirements
include equal employment opportunities for minority group members and women (“EEO”)
and contracting opportunities for certified minority and women-owned business
enterprises (“MWBEs”). Recipient’s demonstration of “good faith efforts” pursuant to 5
NYCRR §142.8 shall be a part of these requirements. These provisions shall be deemed
supplementary to, and not in lieu of, the nondiscrimination provisions required by New
York State Executive Law Article 15 (the “Human Rights Law”) or other applicable federal,
state or local laws.
C. Failure to comply with all of the requirements herein may result in a finding of non-
responsiveness, non-responsibility and/or a breach of contract, leading to the withholding
of funds or such other actions, liquidated damages pursuant to Section VII of this Appendix
or enforcement proceedings as allowed by the Contract.
II. Contract Goals
A. For purposes of this Contract, the ESD encourages the use of Minority and Women-Owned
Business Enterprises (“MWBE”) participation.
B. For purposes of providing meaningful participation by MWBEs on the Contract and
achieving the Contract Goals established in Section II-A hereof, Recipient should reference
the directory of New York State Certified MWBEs found at the following internet address:
http://www.esd.ny.gov/mwbe.html
Additionally, Recipient is encouraged to contact the Division of Minority and Woman
Business Development ((518) 292-5250; (212) 803-2414; or (716) 846-8200) to discuss
additional methods of maximizing participation by MWBEs on the Contract.
C. Where MWBE goals have been established herein, pursuant to 5 NYCRR §142.8, Recipient
must document “good faith efforts” to provide meaningful participation by MWBEs as
subcontractors or suppliers in the performance of the Contract. In accordance with
Section 316-a of Article 15-A and 5 NYCRR §142.13, the Recipient acknowledges that if
Recipient is found to have willfully and intentionally failed to comply with the MWBE
participation goals set forth in the Contract, such a finding constitutes a breach of contract
EXHIBIT H: PARTICIPATION BY MINORITY GROUP MEMBERS AND WOMEN WITH RESPECT TO
STATE CONTRACTS: REQUIREMENTS AND PROCEDURES
ESD Grant Disbursement Agreement Terms & Conditions
and the Recipient shall be liable to the ESD for liquidated or other appropriate damages,
as set forth herein.
III. Equal Employment Opportunity (EEO)
A. Recipient agrees to be bound by the provisions of Article 15-A and the MWBE Regulations
promulgated by the Division of Minority and Women's Business Development of the
Department of Economic Development (the “Division”). If any of these terms or provisions
conflict with applicable law or regulations, such laws and regulations shall supersede these
requirements.
B. Recipient shall comply with the following provisions of Article 15-A:
1. Recipient and subcontractors shall undertake or continue existing EEO programs to
ensure that minority group members and women are afforded equal employment
opportunities without discrimination because of race, creed, color, national origin,
sex, age, disability or marital status. For these purposes, EEO shall apply in the areas
of recruitment, employment, job assignment, promotion, upgrading, demotion,
transfer, layoff, or termination and rates of pay or other forms of compensation.
2. The Recipient shall submit an EEO policy statement to the ESD with the executed
Contract.
3. If Recipient or subcontractor does not have an existing EEO policy statement, the ESD
may provide the Recipient or subcontractor a model statement (see EXHIBIT H-1:
M/WBE Participation/Equal Employment Opportunity Policy Statement).
4. The Recipient’s EEO policy statement shall include the following language:
a. The Recipient will not discriminate against any employee or applicant for
employment because of race, creed, color, national origin, sex, age, disability or
marital status, will undertake or continue existing EEO programs to ensure that
minority group members and women are afforded equal employment
opportunities without discrimination, and shall make and document its
conscientious and active efforts to employ and utilize minority group members
and women in its work force.
b. The Recipient shall state in all solicitations or advertisements for employees that,
in the performance of the Contract, all qualified applicants will be afforded equal
employment opportunities without discrimination because of race, creed, color,
national origin, sex, age, disability or marital status.
c. ‘The Recipient shall request each employment agency, labor union, or authorized
representative of workers with which it has a collective bargaining or other
agreement or understanding, to furnish a written statement that such
employment agency, labor union, or representative will not discriminate on the
basis of race, creed, color, national origin, sex age, disability or marital status and
that such union or representative will affirmatively cooperate in the
implementation of the Recipient's obligations herein.
EXHIBIT H: PARTICIPATION BY MINORITY GROUP MEMBERS AND WOMEN WITH RESPECT TO
STATE CONTRACTS: REQUIREMENTS AND PROCEDURES
ESD Grant Disbursement Agreement Terms & Conditions
d. The Recipient will include the provisions of Subdivisions (a) through (c) of this
Subsection 4 and Paragraph “E” of this Section III, which provides for relevant
provisions of the Human Rights Law, in every subcontract in such a manner that
the requirements of the subdivisions will be binding upon each subcontractor as
to work in connection with the Contract.
C. EXHIBIT H-2: Staffing Plan
To ensure compliance with this Section, the Recipient shall submit a staffing plan to
document the composition of the proposed workforce to be utilized in the performance
of the Contract by the specified categories listed, including ethnic background, gender, and
Federal occupational categories. Recipients shall complete the Staffing plan form and
submit it as part of the executed Contract.
D. EXHIBIT H-3: Work Force Employment Utilization Report (“Workforce Report”)
1. Once a contract has been awarded and during the term of Contract, Recipient is
responsible for updating and providing notice to the ESD of any changes to the
previously submitted Staffing Plan. This information is to be submitted on a quarterly
basis during the term of the contract to report the actual workforce utilized in the
performance of the contract by the specified categories listed including ethnic
background, gender, and Federal occupational categories. The Workforce Report must
be submitted to report this information.
2. Separate forms shall be completed by Recipient and any subcontractor performing
work on the Contract.
3. In limited instances, Recipient may not be able to separate out the workforce utilized
in the performance of the Contract from Recipient's and/or sub's total workforce.
When a separation can be made, Recipient shall submit the Workforce Report and
indicate that the information provided related to the actual workforce utilized on the
Contract. When the workforce to be utilized on the contract cannot be separated out
from Recipient's and/or subcontractor's total workforce, Recipient shall submit the
Workforce Report and indicate that the information provided is Recipient's total
workforce during the subject time frame, not limited to work specifically under the
contract.
E. Recipient shall comply with the provisions of the Human Rights Law, all other State and
Federal statutory and constitutional non-discrimination provisions. Recipient and
subcontractors shall not discriminate against any employee or applicant for employment
because of race, creed (religion), color, sex, national origin, sexual orientation, military
status, age, disability, predisposing genetic characteristic, marital status or domestic
violence victim status, and shall also follow the requirements of the Human Rights Law
with regard to non-discrimination on the basis of prior criminal conviction and prior arrest.
EXHIBIT H-1: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
M/WBE PARTICIPATION / EQUAL EMPLOYMENT OPPORTUNITY POLICY STATEMENT
ESD Grant Disbursement Agreement Terms & Conditions
I,___________________________________(REPRESENTATIVE), of the __________________________
(AWARDEE/CONTRACTOR) agree to adopt the following policies with respect to the project being developed or
services rendered at
_________________________________________________________________________
(a) This organization will not discriminate against any employee or applicant for employment because
of race, creed, color, national origin, sex, age, disability or marital status, will undertake or continue
existing programs of affirmative action to ensure that minority group members are afforded equal
employment opportunities without discrimination, and shall make and document its conscientious
and active efforts to employ and utilize minority group members and women in its work force on
state contracts.
(b) This organization shall state in all solicitation or advertisements for employees that in the
performance of the State contract all qualified applicants will be afforded equal employment
opportunities without discrimination because of race, creed, color, national origin, sex disability or
marital status.
(c) At the request of the contracting agency, this organization shall request each employment agency,
labor union, or authorized representative will not discriminate on the basis of race, creed, color,
national origin, sex, age, disability or marital status and that such union or representative will
affirmatively cooperate in the implementation of this organization’s obligations herein.
(d) This organization will include the provisions of sections (a) through (c) of this agreement in every
subcontract in such a manner that the requirements of the subdivisions will be binding upon each
subcontractor as to work in connection with the State contract.
Agreed on this day of _____________________, 20 .
By: _____________________________________________
(SIGNATURE)
Print Name: ________________________________________
Title: ________________________________________
EQUAL EMPLOYMENT OPPORTUNITY POLICY (EEO)
EXHIBIT H-2: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
STAFFING PLAN
ESD Grant Disbursement Agreement Terms & Conditions
Intentionally Deleted
EXHIBIT H-3: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
WORKFORCE EMPLOYMENT UTILIZATION REPORT
ESD Grant Disbursement Agreement Terms & Conditions
Intentionally Deleted
EXHIBIT H-4: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
M/WBE UTILIZATION PLAN
ESD Grant Disbursement Agreement Terms & Conditions
Intentionally Deleted
EXHIBIT H-5: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
WAIVER REQUEST FORM
ESD Grant Disbursement Agreement Terms & Conditions
Intentionally Deleted
EXHIBIT H-6: OFFICE OF CONTRACTOR AND SUPPLIER DIVERSITY
M/WBE CONTRACTOR COMPLIANCE AND PAYMENT REPORT
ESD Grant Disbursement Agreement Terms & Conditions
Intentionally Deleted
EXHIBIT I: Special Provisions
In the event of any conflict between Exhibit A-1 of this Agreement and any other provisions of
this Agreement, the terms of such other provisions shall govern.
Neither the Grant, nor any equipment or facility funded in part or whole by the Grant, shall be
used at any time or in any manner for religious worship, instruction or proselytizing.
Funds for the following expenditures will not be allowed:
• Purchase, lease, or rental of any equipment or operational software
• Political activities of any kind
• Electoral activities of any kind
• Acquisition of voter registration data, voter profiles or similar programs or data
commonly used in political campaigns
• Awards of cash, gift cards, trophies or the like
• Purchase, lease, and/or rental of: computers, mobile computing devices such as
iPads, tablets etc., cellular telephones and related devices that exceed $500 per item
and are more than $2,500 in aggregate
• Audit services
• Acquisition, construction, or renovation of buildings or other real estate
• Entertainment
• Religious activity
• Alcohol
• Expenses incurred prior to March 10, 2020 or ESD Award letter date, whichever
sooner
• Costs of organized fundraising
• Interest, taxes and penalties
• Overhead expenses
• Any other cost incurred in violation of the terms of the GDA as defined in the
agreement
An administrative rate of up to 5% may be applied to this grant. This will allow the Grantee to
receive funding for administrative costs associated with service delivery and grant
management.
Administrative Expenses are those expenses authorized and allowable pursuant to applicable
agency regulations, contracts or other rules that govern reimbursement with State funds or
State-authorized payments that are incurred in connection with the Grantee’s overall
management can be attributed directly to the provision of program services. Please note that
the Grantee must retain backup documentation detailing how administrative funds were spent.
This back up must be made available for review by State personnel upon request.
ESD Grant Disbursement Agreement Terms & Conditions
Subgrantee Eligibility Requirements:
Subgrantees must be: i) municipal sub-divisions of New York State, ii) not-for-profit
organizations with 501(c)(3) IRS status, iii) 501(c)(3) IRS status public charities, iv) 501(c)(3) IRS
status private foundations, or iv) libraries.
Not-for-profit organizations must be approved through review process which will be posted
online by New York State on https://www.ny.gov/programs/2020-census.
The not-for-profit entities which have undergone prior assessments and are consequently
deemed suitable to provide as needed services within the scope of the grant disbursement
agreement.
Grantee must contract with each subgrantee in accordance with applicable law, and in a
manner that specifies all services each subgrantee agrees to provide. The Grantee will be
responsible for ensuring the responsibility of each subgrantee and coordinating subgrantee
activities to avoid duplication of effort and to maximize effectiveness of the project and its
activities.
In addition, subgrantees can subcontracting funds to other approved not-for-profits by New
York State and must adhere to all terms and conditions of this grant disbursement agreement.
ESD Grant Disbursement Agreement Terms & Conditions
Exhibit J: DISCLOSURE & ACCOUNTABILITY CERTIFICATIONS
Intentionally Deleted
