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Res.2771.08-05-2013
BILL NO. 13-111 RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH KENNETH E. FOESTE MASONRY, INC., FOR NEW TENNIS COURT RESTROOMS AT BERTLING AND SPRIGG, IN THE CITY OF CAPE GIRARDEAU, MISSOURI BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS: ARTICLE 1. The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute an Agreement with Kenneth E. Foeste Masonry, Inc., for new tennis court restrooms at Bertling and Sprigg, in the City of Cape Girardeau, Missouri. The agreement shall be in substantially the form attached hereto as Exhibit A, which document is hereby approved by the City Council, with such changes therein as shall be approved by the officers of the City executing the same. r PASSED AND ADOPTED THIS DAY OF 2013. ATTEST: Gayler. Conrad, City Cler y E. e er, Mayor CITY OF CAPE GIRARDEAU Southeast Missouri State University Masonry for New Tennis Court Restrooms Bertling & Sprigg STANDARD FORM OF AGREEMENT BETWEEN OWNER AND CONTRACTOR ON THE BASIS OF A STIPULATED PRICE THIS AGREEMENT is dated as of the day of in the year 2013 by and between the City of Cape Girardeau, Missouri (hereinafter called OWNER) and Kenneth E. Foeste Masonry, Inc. (hereinafter called CONTRACTOR). OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: Article 1. WORK. CONTRACTOR shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as follows: The work to be performed under these Contract Documents consists of... Installation of concrete masonry units, masonry accessories and all other appurtenances as described in the contract documents for the new restrooms located near the Southeast Missouri State University tennis courts at Rertling and Sprigg Article 2. ENGINEER. The City Engineer or his designee is to act as OWNER'S representative, assume all duties and responsibilities and have the rights and authority assigned to ENGINEER in the Contract Documents in connection with completion of the Work in accordance with the Contract Documents, Article 3. CONTRACT TIMES. 3.1 The work will be substantially completed within thirty ( 30) calendar days after the date when the Contract Times commence to run as provided in paragraph 2.3 of the General Conditions, and completed and ready for final payment in accordance with paragraph 14.13 of the General Conditions within forty-five (45) days after the date when the Contract Times commence to run. A-1 3.2 Liquidated Damages. OWNER and CONTRACTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not completed within the times specified in paragraph 3.1 above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the delays, expense and difficulties involved in proving the actual loss suffered by OWNER if the Work is not competed on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a penalty) CONTRACTOR shall pay OWNER four hundred seventy-five ($ 475) for each day that expires after the time specified in paragraph 3.1 for Substantial Completion until the Work is substantially complete. After Substantial Completion, if CONTRACTOR shall neglect, refuse or fail to complete the remaining Work within the time specified in paragraph 3.1 for completion and readiness for final payment or any proper extension thereof granted by OWNER, CONTRACTOR shall pay OWNER four hundred seventy-five 475 for each day that expires after the time specified in paragraph 3.1 for completion and readiness for final payment. Article 4. CONTRACT PRICE. OWNER shall pay CONTRACTOR for completion of the Work in accordance with the Contract Documents an amount in current funds equal to the sum of the amounts determined pursuant to paragraphs 4.1 and 4.2 below: 4.1 for all materials: Ten thousand four hundred fifty-nine dollars and zero cents($10,459.00) 4.2 for all labor: Fifteen thousand six hundred fortytone dollars and zero cents($15 641.00 Total Contract Price: Twenty-six thousand one hundred dollars and zero cents ($26 100,00 . As provided in paragraph 11.9 of the General Conditions estimated quantities are not guaranteed, and determinations of actual quantities and classification are to be made by ENGINEER as provided in paragraph 9.10 of the General Conditions. Unit prices have been computed as provided in paragraph 11.9.2 of the General Conditions. Article 5. PAYMENT PROCEDURES. CONTRACTOR shall submit Applications for Payment in accordance with Article 14 ofthe General Conditions. Applications for Payment will be processed by ENGINEER as provided -in the General Conditions, 5.1 Progress payments; Retainage. OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR'S Application for Payment as recommended by ENGINEER, on or about the 10th day of each month during construction as provided in paragraphs 5. 1.1 and 5.1.2 below. All such payments will be measured by the schedule of values established in paragraph 2.9 of the General Conditions (and in the case of Unit Price Work based on -the number of units completed) or, in the event there is no schedule of values, as provided in the General Requirements. A-2 51.1 Prior to Substantial Completion, progress payments will be made in an amount equal to the percentage indicated below, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with paragraph 14.7 of the General Conditions. 90% of Work completed (with the balance being retainage). If Work has been 50% completed as determined by ENGINEER, and if the character and progress of the Work have been satisfactory to OWNER and ENGINEER, OWNER, on recommendation of ENGINEER, may determine that as long as the character and progress of the Work remain satisfactory to them, there will be no additional retainage on account of Work completed, in which case, the remaining progress payments prior to Substantial Completion will be an amount equal to 100% of the Work completed. 90% (with the balance being retainage) of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentations satisfactory to OWNER as provided in paragraph 14.2 of the General Conditions). 5.1.2 Upon Substantial Completion, in an amount sufficient to increase total payments to CONTRACTOR to 95% of the Contract Price (with the balance being retainage), less such amounts as ENGINEER shall determine, or OWNER may withhold, in accordance with paragraph 14.7 of the General Conditions. 5.2 Final Payment. Upon final completion and acceptance of the Work in accordance with paragraph 14,13 of the General Conditions, OWNER shall pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph 14.13. Article 6. INTEREST. All moneys not paid when due as provided in Article 14 of the General Conditions shall bear interest at the maximum rate allowed by law at the place of the Project. Article 7. CONTRACTOR'S REPRESENTATIONS. In order to induce OWNER to enter into the Agreement, CONTRACTOR makes the following representations: 7.1 CONTRACTOR has examined and carefully studied the Contract Documents (including the Addenda listed in paragraph 8) and the other related data identified in the Bidding Documents, including "technical data". 7.2 CONTRACTOR has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost, progress, performance and furnishing of the Work. A-3 7.3 CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. 7.4 CONTRACTOR has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified. CONTRACTOR acknowledges that such reports and drawings are not Contract Documents and may not be complete for CONTRACTOR'S purposes. CONTRACTOR acknowledges that OWNER and ENGINEER do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Contract Documents with respect to Underground Facilities at or contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes responsibility for having done so) all such additional supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface, subsurface and Underground Facilities) at or contiguous to the site or otherwise which may affect cost, progress, performance or furnishing of the Work or which relate to any aspect of the means, methods, techniques, sequences and procedures of construction to be employed by CONTRACTOR and safety precautions and programs incident thereto. CONTRACTOR does not consider that any additional examinations, investigations, explorations, tests, studies or data are necessary for the performance and furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents. 7.5 CONTRACTOR is aware of the general nature of work to be performed by OWNER and others at the site that relates to the Work as indicated in the Contract Documents, 7.6 CONTRACTOR has correlated the information known to CONTRACTOR, information and observation obtained from visits to the site, reports and drawings identified in the Contract documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. 7.7 CONTRACTOR has given ENGINEERwritten notice of all conflicts, errors, ambiguities or discrepancies that CONTRACTOR has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. Article B. CONTRACT DOCUMENTS. The Contract Documents which comprise the entire agreement between OWNER and CONTRACTOR concerning the Work consist of the following: 8.1 This Agreement (pages to inclusive). 8.2 Exhibits to this Agreement (pages BF- to BF- , inclusive). UZI 8.3 Performance, Payment, and other Bonds, identified as exhibits _ and consisting of pages. 8A Notice to Proceed. 8.5 General Conditions (pages 1 to 55, inclusive). (EJCDC No. 1910-8 1990 Edition) 8.6 Supplementary Conditions (pages SC -1 to SC- 5 , inclusive). 8.7 Specifications bearing the title SEMO State University Masonry for New Tennis Court Restrooms at Bertling and Sprigg Streets. 8.8 Drawings. 8.9 Addenda numbers 1 to I., inclusive. 8.10 CONTRACTOR'S Bid (pages BF -1 to BF -7, inclusive) marked exhibit A. 8.11 Pursuant to 285.530 R,S. Mo, the contractor must affirm its enrollment and participation in a federal work authorization program with respect to the employees proposed to work in connection with the services requested herein by 1) submitting a completed, notarized copy of AFFIDAVIT OF WORK AUTHORIZATION and 2) providing documentation affirming the bidder's enrollment and participation in a federal work authorization program with respect to the employees proposed to work in connection with the services requested herein. 8.12 Documentation submitted by CONTRACTOR prior to Notice of Award (pages to inclusive). 8.13 The following which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto: All Written Amendments and other documents amending, modifying or supplementing the Contract Documents pursuant to paragraphs 3.5 and 3.6 of the General Conditions. The documents listed in paragraphs 8.2 et seq. above are attached to this Agreement (except as expressly noted otherwise above). There are no Contract Documents other than those listed above in the Article 8. The Contract Documents may only be amended, modified or supplemented as provided in paragraphs 3.5 and 3.6 of the General Conditions. Article 9. MISCELLANEOUS. 9.1 Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. A-5 9.2 No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. 9.3 OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, agreements and obligations contained in the Contract Documents. 9.4 Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. 9.5 Pursuant to 292.675, R.S. Mo, the contractor is informed that all contractors or subcontractors doing work on this project to provide, and require its on-site employees to complete, a ten (10) hour course in construction safety and health approved by the Occupational Safety and Health Administration ("OSHA") or similar program approved by the Missouri Department of Labor and Industrial Relations which is at least as stringent as an approved OSHA program. The training must be completed within sixty (60) days of the date work on the project commences. On-site employees found on the worksite without documentation of the required training shall have twenty (20) days to produce such documentation. 9.6 The General Contractor shall provide to the City of Cape Girardeau Development Services Office weekly certified payrolls from the General Contractor and all Subcontractors during the course of the project. These must be provided on a weekly basis; if no work was done, then a payroll stating "No Work Done" must be submitted. OR IN WITNESS WHEREOF, OWNER and CONTRACTOR have signed the Agreement in multiple copies, One counterpart each has been delivered to CONTRACTOR and ENGINEER and two counterparts to the OWNER. All portions of the Contract Documents have been signed, initialed or identified by OWNER and CONTRACTOR or identified by ENGINEER on their behalf. This Agreement will be effective on �uc,u.s-� �Lo , 20 �3 (which is the Effective Date of the Agreement). OWNER Ci,� of a � Girardeau CONTRACTOR Kenneth E. Foeste Masonrv, Inc. � Scott Me C' Man er e5 � t,,,,��,,.�,,,:,,,; BY• y: ,, 1 E; Yo�, CORP RA SEAL] COR RATE S L "' r � .3. �r� ;4,, �<.1;;`�, . .i(�_ �,..,J ,li. Attest Attest �; '� �` . �;�;��J � ��,�; Address for giving notices Address f r giving otices : , J. '.�''�� ,, . r ,, .' ,., .. ,,;. 401 Independence Street 347 County Road 649 >> � Cape Girardeau, MO 63703 Cape Girardeau, MO 63701 (If OWNER is a public body, attach License No. evidence of authority to sign and resolution or other documents ent for service of pro s: authorizing execution of Agreement. � ��1�' "� _ � ;� .. (I ONT CTOR s corporation, f � �1��� �� �' a ach e dence of authority to sign.) /� � � �� �� � � � , � � �° � �. �,� .�. ��r:�� 1� �' �.... .� r� u .. 4 "`�L.a,._�.��.1¢-'_S�. A-7 EXHIBIT A GITY OF GAPE GiRARDEAU Southeast Missouri State University Masonry for New Tennis Court Restrooms Berding & Sprigg BID FORM (EJCDG 1910-18) (1990) PROJECT IDENTIFICATION: The improvement consists of: .Installation of concrete masonry units, masonry accessories and all other appurtenances as described in the contract documents for the new restrooms located near the Southeast Missouri State University tennis courts at Bertling and Sprigg THIS BID IS SUBMITTED TO: CITY OF CAPE GIRARDEAU, MO DEVELOPMENT SERVICES 401 INDEPENDENCE STREET CAPE GIRARDEAU, MO 63703 1. The undersigned BiDDER proposes and agrees, if the Bid is accepted, to,enter into an agreement with OWNER in the form included in the Contract Documents to perform and furnish all Work as specified or indicated in the Contract Documents for the Bid Price and within the Bid Times indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. 2. BIDDER accepts all of the terms and conditions of the Advertisement or invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid security. This Bid will remain subject to acceptance for sixty days after the day of Bid opening. BIDDER will sign and deliver the required number of counterparts of the Agreement with the Bonds and other documents required by the Bidding Requirements within fifteen days after the date of OWNER'S notice of Award. 3. In submitting this Bid, BIDDER represents, as more fully set forth in the Agreement, that: (a) BIDDER has examined and carefully studied the Bidding Documents and the following: BF -1 ;Y Addenda, receipt of all which, is hereby acknowledged; (LSstAddenda byAddendum Slumber and Date) � 1 7 (b) BIDDER has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost, progress, performance and furnishing of the Work; (c) BIDDER is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. (d) BIDDER has carefully studied all reports of explbrations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified. -BIDDER acknowledges that -such reports and drawings are not Contract Documents and may not be complete for BIDDER'S purposes. BIDDER acknowledges that - OWNER and Engineer do not assume responsibility for accuracy or completeness of information and data shown or indicated in the Bidding Documents with respect to Underground Facilities at or contiguous to the site. BIDDER has obtairied'arid- carefully studied (or assumes resporisibilityfor having done so) all such additionaVor supplementary examinatiors, invest gatforis,' -explorations, tests, studies and data ctinceming conditions (surface, subsurface -and Underground Facilities) at or contiguous to the site or otherwise which may affect cost progress, perfarmarice or furnishing of the Work or which relate to any aspect of the: means; rbethods; techniques, sequences and procedures of construction to be employed by BIDDER and safety precautions acid programs incident thereto. BIDDERdoes riot considerthat any additional examinations, investigations, explorations, tests; studies or data are necessary for the determination of Phis Bid for. performance and furnishing -of tlf Work in acc6rdance with the times; -price and -other terms and conditions of the;Contract Dacumerits: (e) BIDDER is aware df the -general nature 'of Work to be performed -by Owner and others at the site that relates to Work for which this Bid is submitted as indicated in the Contract Documents. (f) BIDDER has correlated the information known to BIDDER, information and observation's- obtained from visits to the site,.repbrts and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. (g) BIDDER has given Engineer written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents 9PA are generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work for which this Bid is submitted. (h) This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group association, organizati,on or corporation; BIDDER has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid; BIDDER has not solicited or induced any person, firm or. corporation to refrain from bidding; and BIDDER has not sought by collusion to obtain for itself any advantage over any other Bidder or over OWNER. (i) Pursuant to 285.530 RSMo, the bidder must afFihb its enrollmen# and paiticipabon in a federal work authorization program with respect to the employees pfopased to work in connection with the services requested herein by submitting a completed, notarized copy of AFFIDAVIT OF WORK AUTHORIZATION and " • , providing documentation affirming the bidder's .enrollment. aril participation in a federal work authorization program with -respect to the employees proposed to work in connection with the services requested herein. http://www_ usci§. goy/po rtallsite/u s6is (j) Bidders are informed that the Project is subject to the requirements of Section 292.675, R.S. Mo, which requires all ,contractors or subcontractors doing work. on the Project to provide, and req:;ire its on-site employees to complete, a ten (10) -hour course in construction safety and health approved by the Occupational Safety. and. Health Administration ("OSHA„) or' similar program approved by the Missouri Department of Labor and Industrial Relations which is at .least as stringent as an approved OSHA program. The training must be completed within sixty (66) days of tF e' date- work on the Project commences. On-site, employees found on the worksite without documentation of the required training shall have twenty (2b) days to produce such documentation. BF -3 4. BIDDER will complete the Work in accordance with the Contract Documents for the following price(s): �Jt►t�iJ° /+�! 44 4.1 for all A LI, 4.2 for all laborf Total Contract Price: (Total bid amount is to be shown in both words and figures. In case of discrepancy, the amount shown in words will govern. In case of error in extension, the lump sum prices under each Pay Item will be considered correct, and these sums when properly extended, shall constitute the Bid.) BIDDER acknowledges that quantities are not guaranteed and final paymentwill be based on actual quantities determined as provided in the -Contract Documents. 5. BIDDER agrees that the Work will be substantially complete within thirty(30) calendar days after the date when the Contract Times commences to run as provided in paragraph 2.3 of the General Conditions, and completed and ready for final payment in accordance with paragraph 14.13 -of the General Conditions within - forty-five (46) calendar days after the date when the Contract Times commences to ruri. BIDDER accepts the provisions of the -Agreement as to liquidated damages in the event of failure to complete the Work within the times specified in theAgrpement.. 6. The following documents are attached to and made a condition of this Bid: (a) Required Bid Security in the form of bid'bond or cashiers check. (b) Exhibit Affidavit of Work Authorization (c) Exhibit Affidavit of Excessive Unemployment {if applicable) (d) The E-VerifyProgram ,for Unernpl4ment Verification Memorandum of Understanding ,http:l/www.uscis.govlfiles/nativedoeLin-ients/MOU.cdf (e) Exhibit Affidavit of OSHA Training (f) Certification Regarding Debarment, Suspension and Other Responsibility Matters 7. Bidder agrees to submit the following documents within three (3) business days after the opening of Bids if requested: (a) BIDDER'S Qualification Statement with supporting data. 8. Communications concerning this Bid shall be addressed to: Name ti°7rC� Address �7� �!y �� �} gip-:] (a) Performance and Payment Bonding Company Name L Address Agent\Power of Attorney`Name (if used) Address 0 9. Terms used in the Bid which are defined in the General conditions or Instructions will have the, meanings indicated in_ the General Conditions or Instructions. SUBMITTED on _ , 201!t State Contractor License No. IF BIDDER is.- An s:An Individual By doing business as Business address: Phone No.: A Partnership By (Individual's Name) (Firm Name) (General Partner) BF -5 (SEAL) EAL) Business address: Phone No.: t;orporatton _.-- By & vcs le, ,e7„ - (Corporation Name) 0 (Corporate Seal) Business address: State of Incorporation) 6 L (Name of Person Authorized to Sign) (Title) P�e-s'r' W (SEAL),,, .. '- 1 •q• � u ; it '� �1�iN6f6�f.;t#YrY'ci�t.• ' Phone No.: 0/: �c� Date of Qualification to do business is A Joint Venture By (SEAL) (Name) (Address) By (SEAL) (Name) (Address) Phone Number and Address for receipt of official communications: (Each joint venturer must sign. The manner of signing for each individual, partnership and corporation that is a party to the joint venture should be in the manner indicated above.) NO BREAKDOWN OF WORK FORCE (Required): The Contractor shall be registered with the Missouri Secretary of State in order to work on this project. BIDDER hereby states that he will perform the following items of work directly without employment of subcontractors: It is anticipated that the following subcontractors will be employed for work on this project: *SUBCONTRACTORS: (Name of Company) (Type of Work) *All subcontractors shall be registered with the Missouri Secretary of State in order to work on this project. BF -7 ..:IEV owf ;,�! --"' � E-1'6(Ft R A ta�'iLF LiAHi EVO6Fl Company ID Number: THE E -VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE 1 PURPOSE AND AUTHORITY This Memorandum of Understanding (MOU) sets rth the p ' is of agreement etween the Department of Homeland Security (DHS) and �,5`rel r3/-' AT mployer) regarding the Employer's participation in the Employment Eligibility Verifi6ation Program (E - Verify). This MOU explains certain features of the E -Verify program and enumerates specific responsibilities of DHS, the Social Security Administration (SSA), and the Employer. E Verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E -Verify is used to verify the employment eligibility of all newly hired employees and all existing employees assigned to Federal contracts. Authority for the EVerify program is found in Title IV, Subtitle A, of the Illegal immigration Reform and Immigrant Responsibility Act of 1998 (IIRiRA), Pub. L. 104-208, 110 Stat. 3009, as amended (8 U.S.C. § 1324a note). Authority for use of the E -Verify program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility Verification% of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as a "Federal contractor) to verify the employment eligibility of certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive Order 129B9, as amended. ARTICLE 11 FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available information that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the em ployment authorization of U.S. citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E -Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E -Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E -Verify program or such other persons or entities who may be authorized by SSA as governed by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1308(a)), and SSA regulations (20 CFR Part 401). Page t of 121E -Veiny MMU for Eriplaye.lRevisiw pate 1fl;WOBI �Veri - E.VEp4T R�Q:ItYKF Orr MG MlFiT1 - - Company ID Number. �?r - f 4. SSA agrees to provide a means of automated verification that is designed (in conjunction with DHS's automated system if necessary) to provide confirmation or tentative nonconfirmation of U.S. citizens' employment eligibility within 3 Federal Government work days of the initial inquiry. 5. SSA agrees to provide a means of secondary verification (Including updating SSA records as may be necessary) for employees who contest SSA tentative nonconfirmations that is designed to provide final confirmation or nonconfirmation of U.S, citizens' employment eligibility and accuracy of SSA records for both citizens and aliens within 10 Federal Government work days of the date of referral to SSA, unless SSA determines that more than 10 days may be necessary. in such cases, SSA will provide additional verification instructions. 13. RESPONSIBILITIES OF DHS 1. After SSA verifies the accuracy of SSA records for aliens through E -Verify, DHS agrees to provide the Employer access to selected data from DHS's database to enable the Employer to conduct, to the extent authorized by this MOU: . « Automated verification checks on alien employees by electronic means, and • Photo verification checks (when available) on employees. 2. DHS agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E -Verify program. DHS agrees to provide the Employer names, titles, addresses, and telephone numbers of DHS representatives to be contacted during the E -Verify process. 3. DHS agrees to provide to the Employer a manual (the E -Verify User Manual) containing instructions on E -Verify policies, procedures and requirements for both SSA and DHS, including restrictions on the use of E -Verify. DHS agrees to provide training_materials on E -Verify. 4. DHS agrees to provide to the Employer a notice, which indicates the Employer's participation in the E -Verify program. DHS also 'agrees to provide to the Employer antl- discrimination notices issued by the Office of Special Counsel for Immigration -Related Unfair Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice. 5. DHS agrees to issue the Employer a user identification number and password that permits the Employer to verify information provided by alien employees with DHS's database. 6. DHS agrees to safeguard the information provided to RHS by the Employer, and to Omit access to such information to individuals responsible for the verification of alien employment eligibility and for evaluation of the E -Verify program, or to such other persons or entities as may be authorized by applicable law. Information will be used only to verify the accuracy of Social Security Numbers and employment eligibility, to enforce the Immigration and Nationality Act (INA) and Federal criminal laws, and to administer Federal contracting requirements. 7. DHS agrees to provide a means of automated verification that is designed (In conjunction with SSA verification procedures) to provide confirmation or tentative nonconfrrmation of employees' employment eligibility within 3 Federal Government work days of the Initial inquiry. Page 2 a; 121E-Ve iy MW for Employ Rmision Dai- `: k2g�to?I a-VerI.fy E-VH1N' b liFAVICF iF LrKNtDeLt Company ID Number, 1 8. DHS agrees to provide a means of secondary verification. (including updating DHS records as may be necessary) for employees who caritest DHS tentative nonconfjrmations and photo non -match tentative nonconfirmations that Is designed to provide final confirmation or nonconfirmatian of the employees' employment eligibility within 10 Federal Government work days of the date of referral to DHS, unless DHS determines that more than 10 days may be necessary. In such cases, DHS will provide additional verification instructions. C. RESPONSIBILITIES OF THE EMPLOYER 1. The Employer agrees to display the notices supplied by DHS in a prominent place that is clearly visible to prospective employees and all employees who are to be verified through the system. 2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and telephone numbers of the Employer representatives to be contacted regarding E -Verify. 3. The Employer agrees to become familiar with and comply with the most recent version of the E -Verify User Manual. 4. The Employer agrees that any Employer Representative who will perform employment verification queries will complete the E -Verify Tutorial before that individual initiates any queries. A. The Employer agrees that all Employer representatives will take the refresher tutorials initiated by the E -Verify program as a condition of continued use of E - Verify, including any tutorials for Federal contractors if the Employer is a Federal - contractor. B. Failure to complete a refresher tutorial will prevent the Employer from continued use of the program. 5. The Employer agrees to comply with current Form 1-9 procedures, with two exceptions: • If an employee presents a "List B" identity document, the Employer agrees to only accept "List 8" documents that contain a photo, (List B documents identified in 8 C.F,R. § 274a2(b)(1)(B)) can be presented during the Form 1-9 process to establish identity.) if an employee objects to the photo requirement for religious reasons, the Employer should contact E Verify at 888-464-4218. f If an employee presents a DHS Form 1-551 (Permanent Resident Cara) or Form 1766 (Employment Authorization Document) to complete the Form 1-9, the Employer agrees to make a photocopy of the document and to retain the photocopy with the employee's Form 1-9. The employer will use the photocopy to verify the photo and to assist DHS with its review of photo non -matches that are contested by employees. Note .that employees retain the right to present any List A, or List B and List G, documentation to complete the Form 1-9. DHS may in the future designate other documents that activate the photo screening too[. S. The Employer understands that participation In E -Verify does not exempt the Employer from the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate to its employees, or from other requirements of applicable regulations or laws, including Pagel of lZIE-Verfy MMU 1 ErTgAoyegRe0s;1an Gate la..'291Q81 EVEkfI K�LRYICE GFaK MIDBGI Company 1D Number: q the obligation to comply with the antidiscrimination requirements of section 2749 of the INA with respect to Form 1-9 procedures, except for the following modified requirements applicable by reason of the Employers participation in E -Verify: (1) identity documents must have photos, as described in paragraph 5 above; (2) a rebuttable presumption is established that the Employer has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act (INA) with respect to the hiring of any individual if it obtains confirmation of the identify and employment eligibility of the individual in compliance with the terms and conditions of E -Verify; (3) the Employer must notify DHS if it continues to employ any employee after receiving a final nonconfirmation, and is subject to a civil money penalty between $550 and $1,100 for each failure to notify DHS of continued employment following a final nonconfirmation; (4) the Employer is subject to a rebuttable presumption that it has knowingly employed an unauthorized alien in violation of section 274A(a)(1)(A) if the Employer continues to employ an employee after receiving a final nonconfirmation;-and (5) no person or entity participating in E -Verify is civilly or criminally liable under any law for any action taken in good faith based on information provided through the confirmation system. QHS reserves the right to conduct Form 1-9 compliance inspections during the course of E Verify, as well as to conduct any other enforcement activity authorized by law. 7. The Employer agrees to initiate E -Verify verification procedures for new employees within 3 Employer business days after each employee has been hired (but after both sections 1 and 2 of the Form 1-9 have been completed), and to complete as many (but only as many) steps of the E -Verify process as are necessary according to the E -Verify User Manual. The Employer is prohibited from Initiating verification procedures before the employee has been hired and the Form 1-9 completed. If the automated system to be queried is temporarily unavailable, the 3 -day time period is extended until it is again operational in order to accommodate. the Employer's attempting, in good faith, to make inquiries during the period of unavailability. In all cases, the Employer must use the SSA verification procedures first, and use DHS verification procedures and photo screening tool only after the SSA verification response has been. given. Employers may initiate verification by notating the Form 1-9 in circumstances where the employee has applied for a Social Security Number (SSN) from the SSA and is waiting to receive the SSN, provided that the Employer performs an E -Verify employment verification query using the employee's SSN as soon as the SS N becomes available. B. The Employer agrees not to use E -Verify procedures for pre-employment screening of job applicants, in support of any unlawful employment practice, or for any other use not authorized by this MOU. Employers must use E -Verify for all new employees, unless an Employer is a Federal contiactor that qualifies for the exceptions described in Article II.D.1.c. Except as provided in Article 11.13, the Employer will not verify selectively and will not verify employees hired before the effective date of this MOU. The Employer understands that if the Employer uses E -Verify procedures for any purpose other than as authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its access to SSA and RHS information pursuant to this MOU. 9. The Employer agrees to follow appropriate procedures (see Article Ill. below) regarding tentative nonconfirmations, including notifying employees of the finding, providing written referral instructions to employees, allowing employees to contest the finding, and not taking adverse action against employees if they choose to contest the finding. Further, when employees contest a tentative nonconfirmation based upon -a photo non -match, the Employer is required to take affirmative steps (see Article IIi_B. below) to contact DHS with information necessary to resolve the challenge. - P --V 4 Of 421E-Va* MDU for EmpbyarikL,�isiun Bale 7 DIWON '.' . 1 w ENEfiR K �'EAYI�of ONL ♦w6S Company ID Number: 10. The Employer agrees not to take any adverse action against an employee based upon the employee's perceived employment eligibility status while SSA or DHS is processing the verification request unless the Employer obtains knowledge (as defined in 8 G.F.R. § 274a.1(1)) that the employee is not work authorized. The Employer understands that an initial inability of the SSA or DHS automated verification system to verify work authorization, a tentative nonconfirmation, a case in continuance (indicating the need for additional time fpr the government to resolve a case), or the finding bf a photo non -match, does not establish, and should not be interpreted as evidence, that the employee is not work authorized. In any of the cases listed above, the employee must be provided a full and fair opportunity to contest the finding, and if he or she does so, the employee may not be terminated or suffer any adverse employment consequences based upon the employee's perceived employment eligibility status (including denying, reducing, or extending work hours, delaying or preventing training, requiring an employee to work in poorer conditions, refusing to assign the employee to a federal contract br other assignment; or otherwise subjecting an employee to any assumption that he or she is unauthorized to work) until and unless secondary verificatjon by SSA or DHS has been completed and a final nonconfirmption has been issued. If the employee does not choose to contest a tentative nonconftrmation or a photo non -match or if a secondary verification is completed and a final nonconfirmation is issued, then the Employer can find the employee is not work authorized and terminate the employee's employment. Employers or employees with questions about a final nonconf€rmation may call E -Verify at 1-888-464-4218 or OSC at 1-800- 255-8155 or 1-800-237-2515 (TDD). 11. The Employer agrees to comply with Title VII of the Civil Rights Act of 1864. and section 274B of the iNA by not discriminating unlawfully against any individual in hiring, firing, or recruitment or referral practices because of his or her national origin or, in the case of a protected individual as defined in section 2746(a)(3) of the INA, because of his of -her citizenship status. The Employer understands that such illegal practices can include selective verification or use of E Verify except as provided in part D below, or discharging or refusing to hire employees because they appear or sound "foreign" or have received tentative nonconfrrmations. The Employer further understands that any violation of the unfair immigration -related employment practices provisions in section 274D of the INA could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject the Employer to back pay awards, compensatory and punitive damages. Violations of either section 274B of the INA or Title Vll may also lead to the termination of its participation in E -Verify. if the Employer has any questions relating to the anfi-discdmination provision, it should contact OSG at 1-800-255-8155 or 1-BDO-237-2515 (TDD). 12. The Employer agrees to record the case verification number on the employee's Form 1-9 or to print the screen containing the case verification number and attach it to the employee's Form 1-9. 13. The Employer agrees that A will use the information it receives from SSA or DHS pursuant to E -Verify and this MOU only to confirm the employment eligibility of employees as authorized by this MOU, The Employer agrees that it will safeguard this information, and means of access to it (such as PINS and passwords) to ensure that it is not used for any other purpose and as necessary to protect its confidentiality, including ensuring that it is not disseminated to any person other than employees of the Employer who are authorized to perform the . Employer's responsibilities under this MOU, except for such dissemination as may be Paps 5 of 121E•Ve4W MOU for Empbya1NE*inn Qaia 10,291DOI - . .. '. Ver . �� ELg�FT K A savu�OF'p6 NN Fcl Company Ip Number, authorized in advance by SSA or DHS for legitimate purposes. 14. The Employer acknowledges that the information which it receives from SSA is governed by the Privacy Act (5 U.S.G. § 552a(i)(1) and (3)) and the Social Security Act (42 U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses it for any purpose other than as provided for in this MOU may be subject to criminal penalties. 15. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and evaluation of E -Verify, including by permitting DHS and SSA, upon reasonable notice, to review Forms 1-9 and _other employment records and to interview it and its employees regarding the Employer's use of E -Verify, and to respond in a timely and accurate manner to DNS requests for information relating to their participation in E -Verify. D. RESPONSIBILITIES OF FEDERAL CONTRACTORS 1. The Employer understands that if it is a Federal contractor subject to the employment verification terms in Subpart 22.18 of the FAR it must verify the employment eligibility of any "employee assigned to the contract" (as defined in FAR 22.1801) in addition to verifying the employment eligibility of all other employees required to be verified under the FAR. Once an employee has been verified through E -Verify by the Employer, the Employer may not reverify the employee through E -Verify. a. Federal contractors not enrolled at the time of contract award: An Employer that is not enrolled in E -Verify as a Federal contractor at the time of a contract award must enroll as a Federal contractor in the E -Verify program within 30 calendar days of contract award and, Within 90 days of enrollment, begin to use E Verify to initiate verification of employment eligibility of new hires of the Employer who are working in the United States, whether or not assigned to the contract Once the Employer begins verifying new hires, such verification of new hires must be initiated within 3 business days after the date of hire. Once enrolled in E -Verify as a Federal contractor, the Employer must initiate verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee's assignment to the contract, whichever date is later. b. Federal contractors already enrolled at the time of a contract award: Employers enrolled in E -Verify as a Federal contractor for 90 days or more at the time of a contract award must use E -Verify to initiate verification of employment eligibility for new hires of the Employer who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire. If the Employer is enrolled in E -Verify as a Federal contractor for 90 calendar days or less at the time of contract award, the Employer must, within 90 days of enrollment, begin to use EVerify to initiate verification of new hires of the contractor who are working in the United States, whether or not assigned to the contract Such verification of new hires must be initiated within 3 business days after the date of hire. An Employer enrolled as a Federal contractor in, E -Verify must initiate verification of each employee assigned to the contract within 90 calendar days after date of contract award or within 30 days after assignment to the contract, whichever is later, C. Institutions of higher education, State, local and tribal governments and sureties: Federal contractors that are institutions of higher education (as defined at 20 U.S.C. 1001(a)) , State or local governments, governments of Federally recognized Indian tribes, or sureties Ngs 6 of 12JE-Veri4 MOU for EmpfoyerjRevision Date IMWON EVE4sT u WxvwEGW,cHmtC1 Company ID Mumber.� performing under a takeover agreement entered into with a Federal agency pursuant to a performance bond may choose to only verify new and existing employees assigned to the Federal contract. ' Such federal contractors may, however, elect to verify all new hires, and/or all existing employees hired after November 6, 1986. The provisions of Article Ii.D, paragraphs 1.a and 1.b of this MOU providing timeframes for initiating employment verification of employees assignedo a contract apply to such institutions of higher education, State, local and tribal governments, and sureties. d. Verification of all ' employees; Upon enrollment, Employers who are Federal contractors may elect to verify employment eligibility of all existing employees working in the United States who were hired after November 6, 1986, instead of verifying only those employees assigned to a covered Federal contract. After enrollment, Employers must elect to do so only in the manner designated by DHS and initiate E -Verify verification of all existing employees within 18Q days atter the election. e. Form 1-9 procedures for Federal contractors; The Employer may use a previously completed Form 1-9 as the basis for initiating E -Verify verification of an employee assigned to a contract as tong as that Form 1-9 is complete (including the SSN), complies with Article II.C.5, the employee's work authorization has not expired, and the Employer has reviewed the information reflected in the Form 1-9 either in person or in communications with the employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work authorization has not changed. (including, but not limited to, a lawful permanent resident alien having become a naturalized U.S. citizen), if the Employer is unable to determine that the Form 1-9 complies with Article II.C.5, if the employee's basis for work authorization as attested in section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise Incomplete, the Employer shall complete a new 1-9 consistent with Article II.C.5, or update the previous 1-9 to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to- date and the farm otherwise complies with Article II.C.5, but reflects documentation (such as a U.S. passport or Form 1-551) that expired subsequent to completion of the ,Form 1-9, the Employer shall not require the production of additional documentation, or use the photo screening tool described in Article Ii.C.5, subject to any additional or superseding instructions that may be provided on this subject in the E Verify User Manual. Nothing in this section shall be construed to require a second verification using 1= Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU, or to authorize verification of any existing employee by any Employer that is not a Federal contractor. 2. The Employer understands that if it is a Federal contractor, its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract, and the Employer consents to the release of information relating to Compliance with its verification responsibilities under this MOU to contracting afftcers or other officials authorized to review the Employer's compliance with Federal contracting requirements. ARTICLE III REFERRAL OF INDIVIDUALS TO SSA AND DHS A. REFERRAL TO SSA Page 7 of1Z1E-Vs* M0UrarEr,9b erlRevWcn Qaia (0/29!081 :Z-Verl"fir, E.YEl FY 6 4 ¢SqY F q' 6Yf M0 Rl1 Company iD Number: 1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print the tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. Z The Employer will refer employees to SSA field offices only as directed by the automated system based on a tentative nonconfirmation, and only after the Employer records the case verification number, reviews the input to detect any transaction errors, and determines that the employee contests the tentative nonconf€nnation. The Employer will transmit the Social Security Number to SSA for ver€fication again if this review Indicates a need to do so. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Emp€oyer receives it. 3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide the employee with a system -generated referral letter and Instruct the em ployee to visit an SSA office within.8 Federal Government work days. SSA will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that more than 10 days Is necessary. The Employer agrees to check the E Ver€fy system regularly for case updates. 4. The Employer agrees not to ask the employee to obtain a printout from the Social Security Number database (the Numident) or other written verification of the Social Security Number from the SSA B. REFERRAL TO DHS 1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print the tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the tentative nonconfirmation. 2. If the Employer finds a photo non -match for an employee who provides a document for which the automated, system has transmitted a photo, the employer must print the photo non - match tentative nonconfirmation notice as directed by the automated system and provide it to the employee so that the employee may determine whether he or she will contest the finding. 3. The Employer agrees to refer individuals to DHS only when the employee chooses to contest a tentative nonconfirmation received from DHS automated verification process or when the Employer issues a tentative nonconfin-nation based upon a photo non -match. The Employer will determine whether the employee contests the tentative nonconfirmation as soon as possible after the Employer receives it. 4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will provide the employee with a referral letter and instruct the employee to contact DHS through its toll-free hotline (as found on the referra€ letter) within 6 Federal Government work days. 5. If the employee contests a tentative nanconfrmat€on based upon a photo non -match, the Employer will provide the employee with a referral letter to DHS. DNS will electron€tally transmit Page 8 of 121E-Ve ry MOU for EmploywlRoiminn Date ID?Z910a[ EVFitlFl iAiERNi—s Cf bMb AMP iFA Company iia Number.:)_ —b 9 the result of the referral to the Employer within 10 Federal Gavemment work days of the referral unless it determines that more than 10 days is necessary. The Employer agrees to check the E - Verify system regularly for case updates. Sr The Employer agrees that if an employee contests a tentative nonconfirmation based Upon a photo non -match, the Employer will send a copy of the employee's Form 1-551 or Form 1-766 to DHS for review by- F Scanning and uploading the docum ent, or • Sending a photocopy of the document by an express mail account (furnished and paid for by DHS). 7. The Employer understands that if it cannot determine whether there is a photo match/non-match, the Employer is required to forward the employee's documentation to DHS by scanning and uploading, or by sending the document as described in the preceding paragraph, and resolving the case as specified by the Immigration Services Verifier at DHS who will determine the photo match or non -match. ARTICLE IV SERVICE PROVISIONS SSA and DHS will not charge the Employer for verification services performed under this MOU. The Employer is responsible for providing equipment needed to make inquiries. To access the E Verify System, an.Employer will need a personal computer with Internet access. ARTICLE V PARTIES A. This MOU is effective upon the signature of all parties, and shall continue in effect for as long as the SSA and DHS conduct the E -Verify program unless modified in writing by the mutual consent of all parties, or terminated by any party upon 30 days prior written notice to the others. Any and all system enhancements to the E• -Verify program by DHS or SSA, including but not limited to the E Verify checking against additional data sources and instituting new verification procedures, will be covered under this MOU and will not cause the need for a supplemental MOU that outlines these changes. DHS agrees to train employers on all changes made to E - Verify through the use of mandatory refresher• tutorials and updates to the EVerify User Manual, Even without changes to E -Verify, DHS reserves the right to require employers to take mandatory refresher tutorials. An Employer that is a Federal contractor may terminate this MOU when the Federal contract that requires its participation in E -Verify is terminated or completed. In such a circumstance, the Federal contractor must provide written notice to DNS. If an Employer that is a f=ederal contractor falls to provide such notice, that Employer will remain a participant in the E -Verify program, will remain bound by the terms of this MOU that apply to non -Federal contractor participants, and will be required to use the E -Verify procedures to verify the employment eligibility of all newly hired employees. B. Notwithstanding Article V, part A of this MOU, QHS may terminate this MOU if deemed necessary because of the requirements of law or policy, or upon a determination by SSA or page 9 of 174E-V-_ffi MOU tarEmpayeAkevizi Data M1291051 : - er Company ID Number: DNS that there has been a breach of system integrity or security by the Employer, or a failure on the part of the Employer to comply with established procedures or legal requirements. The Employer understands that if it is a Federal -contractor,, termination of this MOU by any party for any reason may negatively affect its performance of its contractual responsibilities. C. Some or all SSA and DHS responsibilities under this MOU may be performed by contractor(s), and SSA and DHS may adjust verification responsibilities between each other as they may determine necessary. By separate agreement with DHS, SSA has agreed to perform As responsibilities as described in this MOU. D. Nothing in this MOU is intended, or should be construed, to create any right or benefit, substantive or procedural, enforceable at law by any third party against the United States, its agencles•, officers, or employees, or against the Employer, its agents, officers, or employees, E. Each party shall be solely responsible for defending any claim or action against it arising out of or related to E -Verify or this MOU, whether civil or criminal, and for any liability wherefrom, including (but not limited to) any dispute between the Employer and any other person or entity regarding the applicability of Section 403(d) of llRIRA to any action taken or allegedly taken by the Employer. F. The Employer understands that the fact of its participation in E -Verify is not confidential information and may be disclosed as authorized or required by law and DHS or SSA policy, including but not limited to, Congressional oversight, E -Verify publicity and media inquiries, determinations of compliance with Federal contractual requirements, and responses to inquiries under the Freedom of Information Act (FOIA). G. The foregoing constitutes the full agreement on this subject between DHS and the Employer. H. The indiividuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and DHS respectively. To be accepted as a participant in E -Verify, you should only sign the Employer's Section of the signature page. If you h ave any questions, contact E -Verify at 888464-4218. or Security -- Verification Division Nam. Type or print) Stgaature Page 10 of l 4'E:iry MOU for Emplelpf'ReAeon Date 1 O.1291Cal Crate TKa Dafe OP .a Ver ti4 tilOp.s . 6.VFAIF(t 4 LERHCEo�Mi�Y6�Y\ � Company 1D Number, `, information Required for the &Verify Program Information relating to your Company: Gernpary Marne: 1L1 /� E IS• / /j © Company Facility Address: 7 M13. A Company Alternate- Address: lternaFteAddress: Gourty or Employer tdeniificafionv / l��Q Number-, / 1 I No:-th American Industry Ciasstfca& 5ysterrrs Y� Code: N Parent Cornpany; /"/fi Number of Employees; Number of SUes Verified for. Are you verifyirRfor mare than 1 site? If yes, please provide the number of sites verified for in Page ti of 121'E-Ve* MOU for erpfeyegRev+sion Da#e i L-'Z9ru9j X~r er, Y A. �x1 ...iE V dw1ir "'Time Evat� 1i F �RY.sE OFDULAyplu[( Company ID Number. Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Name: Tel ephoae Number. Fax Number ,,> '7 E-maAfiddrass k 7efephow Number_ Fax Numfr.. c=am- -Zc Pzge 12 of ZIE-W-AT MOU for E„n*,eriR& cion Data I M-1081 EXHIBIT AFFIDAVIT OF OSHA TRA JIN'G COMES NOW (Name) Nt% of (Company Name/Contractor) P,51 �' r� and first being duly sworn, on my oath, affirm in connection with the contracted services related to (Project Name) for the duration of the contract, as follows: I. ' Contractor shall provide a ten (10) hour Occupational Safety and Health Administration (OSHA) construction safety program for all employees who will be on-site at the Project - The construction safety program shall include a course in consttuction safety, and health that is approved by OSHA or a similar program approved by the hffisouri Department of Labor and Industria). Relations which is at least as stringent as an approved OSHA program as required by Section 292.675, RSMo. 2. Contractor s) aO require its on-site employees to complete a construction safety program within sixty (60) days after the date work on the Project commences, as required by Section 292.675, RSMo. 3. Coattactor acknowledges and agrees that any of Contractor's employees found on the Project site without documentation of the successful completion of a construction safety program shall be requited to produce such documentation within twenty (20) days, or will be subject to removal ftom the Project- 4. roject 4. Contractor shall require all of its Subcontractors to comply with the requirements of Section 292.675, RSMo, 5. Contractor acknowledges that pursuant to Section 292.675, RSMo., Contractor shall forfeit to City as a penalty two thousand five hundred dollars ($2,500.000), plus one hundred dollars ($100,00) for each on-site employee employed by Contractor or its Subcontractor, for each calendar day, or portion thereof such on-site employee is employed without the consttuction safety training required in Section 292.675, RSMo. 6. Conttactot acknowledges that violations of Section 292.675, RSMo, and imposition of the penalties described therein shall be investigated and determined by the Missouri Department of Labor and Industrial. Relations. 7. Contractor acknowledges that in the event that the Missouti Department of Labor and Industrial Relations has determined that a violation of Section 292.675, RSMo., has occatted and that a penalty shall be assessed, the City shall withhold and retain all sums and amounis due and owing when making payments to Contractor under this Contract. FURTHER AFFIANT SATM NOT, IN AFFIRMATION THEREOF, the facts stated above are true and correct (the undersigned understands that lake statements made in this filing are subject to the penalties provided in'Section 575,040, RSM-►.) f��, (acme oft oration) By: (name o offic corpozation and title) A ST: S J (oz o officer) �'!�`y�}1113071 .J.. • 1aFCORPORATION) "'4_ • 'A E OF.NiISSOURI ) CAPE GIRARDEAU } On this day of TO T 20 -LI, before ine appeared k,441 FoP31Y to me personally known,.who, being by me duly sworn, did say that he/she is the of a MI5Souti Corporation, and that the seal affixed to the foregoing instrument is the seal of said Catporation, and that the said instn=ent was signed and sealed in behalf of said Corporation by authority of its Board of Directors, and acknowledged said instrument to be the free act and deed of said Corporation. IN TESTIMONY WBEREOF, I have hereunto set my hand and affixed my official seal, at my office in Cape Girardeau, lfissouri, the day anal year first above written.. Notary Public My Commission Expires: CDLE d BOHNERf Putin . Nate Sed MWMd PMMIIUWW for Cape NGin ��gg,,2016 CMMISsion� 12418365 E�BIT AFFIDAVIT OF WORKAUTHORI7.ATION COMES NOW (Name dofm Held) J of (Company Name/Conirectos) eing duly sworn, on my oath, affit n as follows: 1. (Company is enrolled and v D continue to participate in a federal work authorization program intect to J employees that will work in connection with the contrasted services related to {Project Name e of the contract in accordance with R.SMo Chapter 285.530(2). 2. I also affirm that (Company Name/Contractor) not and will not kno 1 e Io a mon who is an unau �g y mp y thozized alien in connection with the contract services related to (Project Nam• ` for the duration of the contract- i 3, Attached hereto is documentation affirming Contractor's enrollment t participation in a federal work authorization program with respect to the employees working in connection with the contracted services. FURTHER AFFIANT SAWN NOT. IN AMRMATION THEREOF, the facts stated above are true and correct (the undersigned understands that false sta.temeurs made in this filing are subject to- the pf na #-ieg,provided in Section 575.044, RSMo.) tLt,�.�{{iililillCCf il'I. f;. BT' Se tary other officer) (SEAL OF CORPORATION) �� 31Nen+ STATE OF MISSOURI } } ss. COUNTY OF CAPE GnUMEA.0 ) On this 3'6 day of _3- / 20B before the appeared �t�oae �aPs3-e to me personally known, who, being by me duly sworn, did say that he/she is the of a Missouri Corporation, and that the seal aff x d to the foregoing instrument is the seal of said Corporation, and that the said Inst m=rat was signed and sealed in behalf of said Corporation by axxthoxity of its Board of Directors, and acknowledged said instrument to be the free act and deed of said Corpotation. IN TESTIMONY Wk EREOF, I have hereunto set my hand anis affixed my official send, at my office in Cape Girardeau, Missot5ri„ the day and year first above written- Nota4 Public My Commission Expires: m'ffyy S �W ir�o m for Cape r ��unber�.1241 7At6 s Project Number Certification Regarding Debarment, Suspension and Other Responsibility Matters The contractor hereby certifies to the best of its knowledge and belief and that it and its principals and its subcontractors and their principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from covered transactions by any Federal or State department or agency; (b) Have not within a three (3) year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain'or performing a public (Federal, State or Local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery; falsification or destruction of records, making false statements or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this subcontract had one or more public transactions (Federal, State or Local) terminated for cause or default. I understand that a false statement on this certification may be grounds for rejection of this contractor or termination of the contract. In addition, under 18 USC Sec, 1001., a false statement may result in a fine of up to $10,000 or imprisonment for up to five (5) years or both, TYP Came &Title of Authorized Representative op Signature of Authorized Representative Date ❑ I am unable to certify to the above statement My explanation is attached. 0 M3 W— Ln �3 a'3 cl MI -I Ln .0 mi it CARE—OUT sweov DELUXE r-ORFIORATI.N m 0 0 mrK M= mm O P r•sgo so Ijt is mn >1 to rrl m z 0 m CO) 0 >c 0 0 I w 1Cy) R 00