01-970Council File # O \ � q �Q
Green Sheet # � 03 aZ$�
Presented By
Refened To
Committee: Date
1 WAEREA5, in Council File No. O1-804, the Council of the City of Saint Paul authorized
2 the Office of License, Inspections, and Environmental Protection (LIEP) to prepare and submit,
3 on behalf of the City's Heritage Preservation Commission, a grant proposal for the purpose of
4 creating and installing signage which would identify each of the City's five historic preservation
5 districts; and
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WHEREAS, pursuant to the said authorization, LIEP staff applied for and received from
the Minnesota Historical Society a Certified Local Government Grant Agreement for the sum of
Eight Thousand Nine Hundred and Fifty Dollars ($8,950.00) which is to be utilized to for the
signage project; and
WHEREAS, the Minnesota Historical Society's grant agreement contains language
whereby the City will "indemnify and save and hold the Society and the Department of the
Interior harmless from any and al1 claims or causes of action arising from the performance of this
project by the City"; NOW, THEREFORE,
BE IT RESOLVED, that the Council of the City of Saint Pau1 hereby authorizes the
appropriate City offic3als to enter into the Certified Local Government Grant Agreement with the
Minnesota Historical Society with the said indemnification clause noted above and contained
therein at p. 3, ¶. D of the Grant Agreement.
Requested by Department of:
Adoption Certified by Council Secretary
� ,
_ • _ � i% • /�
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M1
By:
Form Approved by City Attorney
By: �� W`✓'M�s^ �' Z y— O�
Appsoved ayor £os S' to Council
By: e��' `-/�
AdopCed by Council: Date L 3 � a�
OFFICE oF LIEP Date: GREEN SHEET
�--.,. ROger C11i'tis September 4, 2001
266-9013 NO 103288 9 �
. 1 HPARTNffiNT DIRSCTOR 4 ITY CODNCIL
� Z ITY ATTORHL'Y ZTY CLER%
x�srw
ust be On COUncil Ag2nd3 by: � wcEx nxxscrox IN_ & IdGT. SVC. DIR.
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AP Consent 3 �R ��R ASSTSTANT)
„ OTAL # OF SIGNATQRE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURS)
CTION REQUESTED:
resolution authorizing the appropriate City officials to enter into a
Certified Local Government Grant Agreement with the Minnesota I-Iistorical
" Society with language stating the City will "indemnify and save and hold the
:, Society and the Department af the Interior harmless from any and all claims or
causes of action arising from the performance of this project by the City."
CON97ENDATIONS; APPR0�1E (A) OR RESSC'T (R) BRSONAL 58R�1SC8 CONTRACTS MDST ANSWSIi T88 FOLLOWING:
PLANNING COMMISSION CIVIL S&RVICE COMMISSL�N 1. Has the pexsOn(firm evet workzd undes a contsact for this department?
CIH COMMITT&S _ SVSINBSS REVIEW COUNCIL YES NO
STAFF _ Has this per5on/firm ever been a City employee?
. DIS7RICT COURT YES NO
3. Does this person/firm possess a skill not normally possessed by any
PORTS WHICH COUNCIL OHJECTFVE? Qxrrent City employee?
YSS ND
� lain all Y85 anawers oa a aeparate aheet and attach.
INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why):
VANTAGES IF APPROVED:
ISADVANTAGES IF APPROVED:
ISADVANTAGES IF NOT APPROVED:
OTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED YES NO
FUNDINCr SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (SXPI,AIN)
�t�scM ��rch C���et
S�P � �, ���
�
ORIGINAL
Council File # 4 � ���
Resolution #
Green Sheet # 143�crt
Presented By:
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
r�
ai-9?o
Referred To ' " Committee: Date
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2 WHEREAS, implementafion of a signage program identifying the City's five heritage preservation districts will
3 fiirther the City's heritage preservation policies as adopted in Saint Paul Legislative Code § 73.01; and
4
S WHEREAS, the Minnesota Historical Society's Certified Local Government Grant Program (hereinafter "Progratn"),
6 has grant money available for pubiic educafion and activities and has made "increasing community awareness of the value of
7 Minnesota's historic resources" a priority in its state historic preservation plan; and
8
9 WIIEREAS, the Council of the City of Saint Paul authorized the Office of License, Inspections and Environmental
10 Protection (hereinafter "LIEP) to prepaze and submit, on the behalf of the Heritage Preservation Commission, a grant request
11 to the Program in the amount of $8,950.00 for the purpose of creating and installing signs that identify each of the five
12 historic preservation districts; and
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14 WF�REAS, the Council of the City of Saint Paul further authorized LIEP tn provide an additional$9,196A5 as a
15 cash and in-kind match; and
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17 WHEREAS, the Proa am awazded $8,950.00 to LIEP on behalf of the Heritage Preservation Commission to
18 implement a signage program idenrifying the City's five heritage preservation districts; now, therefore, be it
19
20 RESOLVED, that the Council of the City of Saint Paul authorizes LIEP to accept $8,950.00 from the Program on
21 behalf of the Heritage Preservation Commission to 'vnplement a signage program identifying the City's five heritage
22 preservation districts.
23 Current Amended
2� Sudaet Chanae Budo'et
ZS FII3PSICING P T,AM
26 Department of Executive Administration
2� Division - License, Inspections, and
28 Environmental Protection
29
3� GL 320 33351 3400 State Direct Grants in Aid 0 8,950 8,950
31 A11 Other Activity Financi.ng 5.459,671 0 5.489.671
32 5,489,671 8,950 5,498,621
33 SPENDING PLAN �
34
35 Department of Executive Administration
36 Division - License, Inspections, and
3� Environmental Protection
;$
;9 GL 320 33351 0389 Other Misc Supplies 0 4,475 4,475
G� GL 320 33351 0299 Other Misc Services 9,762 4,475 14,237
�1 All Other Activity Spendi.ng 5.479.9Q9 0 5.479.909
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Adopted by Council: Date a
Adoption Certified by Council
By : ^'I1 \.�_� . � ._.,� - -
Approved by Mayor: Date l� i�%�
By:
5,489,671 8,g50
xequested by Department of:
5,498,621
01-d'o�t
Office of License, Inspections and 0 ����
Enviro en 1 Protec on
By:
L
Form App ved by City Attorney
By: 7'�7i-� �L✓M�^�'� ?-ll-v (
Approve Office o Financial Services:
By: �� ����'�///A�
Approved by Mayor for Submission to
Council
By : 1� i'�/�W "'�
2
�i-`1'?°
,
MINNESOTA HfSTORICAL SOClETY
CERTIFIED LOCAL GO�fERNMENT GRANT AGREEMENT
ACCOUNT NUMBER
0284
FISCAL OBTECT
YEAR CODE
zooi s�zo
FEDERALPROJECT
NUMBER
27-01-16423.008
DOLLAR AMOUNT
$8,950 HPF grnnt funds
$9,296 applicant match
This Agreement is made by and between the Minnesota Historical Society hereinafter called the
Society), and the City of St. Paul (hereinafter called the City), pursuant to authority ganted by the
National Historic Preservation Act of 1966, as amended.
WHEREAS, pursuant to the Act, the Society has been allocated funds by the United States
Department of the Interior for use by Certified Local Governments for qualifying historic
preservation activities; and
WIIEREAS, the City has applied for and been granted Certified I,ocal Govemment Status and has
made application for Certified Local Govemment funds to be utilized in carrying out the pro,}ect
described in Attachment A of this Agreement,
NOW, TF�REFORE, in considerntion of and in reliance upon the mutual covenants and a�eements
contained herein, the parties hereto do covenant and agree, each for themselves and their respective
successors and assi�s, to carry out the project under the following provisions.
I.
�
PROJECT DESCRIPTION
A. The Project Tune Period, Work Summary, Photograph Guidelines (where applicable),
Consultations and Progress Reports, Final Products, Project Airector's Report, Project
Budget, and Reimbursement Schedule are described in the Pzoject Description,
Attachment A, which is attached hereto and made a part hereof.
B. The City agrees the project will be carried out as described in the Project Description,
unless modified pursuant to the provisions of Section V of this contract.
C, The Society will rennburse the City for the budget costs identified as Historic
Preservation Fund ('rIPF) federal dollars in the Pro}ect Description, following
submittal of materials as described in Section III of this Agreement. Final products
which do not conform to the terms and conditions of this Agreement or which do not
meet the applicable Secretary of the Interior's Standazds will not be reimbursed.
ASSURANCES
A. The City assures that all work carried out on this project will conform to the
Secretary of the Interior's Standards for Archaeology and Historic Preservation (as
published in the Federal Register of September 29, 1983) and that the project
CLG Grant Agreement
personnel meet the Secretary of the Interio�s Professional Qualifications
Standards (as published in the Federal Register of September 29, 1983) as
stipulated in the Project Description.
B. The City assures that this project will be administered and conducted in accordance
with the following:
1. OMB Circulaz A-87 "Cost Principles Applicable to Grants and Contracts with
State and Local Government" and OMB Circulaz A-102 (revised) "Uniform
Requirements for Assistance to State and Local Governments."
2. Department of the Interior regulations 43 CFR Part 12, Subpart C-"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State
and Local Govemments."
01-4'fo
a. In addition to the requirements of these regulations the City will allow a
minimum of two weeks between the date bid solicitations are published and
the date bidders must respond; and allow eighteen calendar days between the
date invitations are mailed to potential bidders and the date bidders must
respond.
3. Public Law 101-517, Title V, Section 511, states: When issuing statements,
press releases, requests for proposals, bid solicitations and other documents
describing projects or programs funded in whole or in part with Federal money,
all grantees receiving Federal funds, including but not limited to State and local
govemments, shall cleazly state (1) the percentage of the total costs of the
program or project wluch will be financed with Federal money, (2) the dollaz
amount of Federal funds for the project or program, and (3) percentage and
dollar amount of the total costs of the project or program that will be fumished
by nongovernmental sources.
4. The "Single Audit Act of 1984."
5. Historic Preservation Fund (I;PF) Grants Manual (previously known as National
Register Programs Guideline NPS-49).
C. T'he City acknowledges that this project is being supported, in part, with funds from
the United States Department of the Interior. As a condition of receiviug such funds,
the City assures compliance with Title VI of the Civil Rights Act of 19b4, Section
504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
The City also agrees as follows:
In the hiring of common or skilled labor for the performance of any work hereunder,
no contractor, material supplier or vendor shall, by reason of race, creed or color,
discriminate against any person or persons who are citizens of the United States, or
resident aliens, who are qualified and available to perform the work to which the
Page 2
CLG Grant Ao eement
employment relates.
01-q'10
No contractor, material supplier or vendor shall, in any manner, discriminate against,
or intimidate, or prevent the employment of any person or persons identified in the
preceding paragraph, or on being hired, prevent, or conspire to prevent, the person or
persons from the performance of work under any contract on account of race, creed
or color.
The violation of this section is a misdemeanor pursuant to Minnesota Statutes.
This Agreement may be canceled or terminated by the Society, and all money due, or
to become due hereunder may be forfeited for a second or any subsequent violation of
the terms of this section.
D. The City will indemnify and save and hold the Society and the Department of the
Interior harmless from any and ali claims or causes of action arising from the
performance of this project by the City.
E. The City agrees to make repayment of grant funds to the Society if terms and
conditions of this Agreement are not followed or costs claimed are subsequently
disallowed.
F. The City, in accordance with provisions of 18 USC 1913 regazding lobbying, assures
that no part of grant budget will be used directly or indirectly or to pay for any
personal service, advertisement, telegam, telephone, letter, printed or written matter,
or other device intended or desia ed to influence in any manner a member of
Congress, to favor or oppose, by vote or otherwise, any legislation or appropriation
by Congress, whether before or after the introduction of any bill or resolution
proposing such legislation or appropriation. This shall not prevent communicating to
members of Congress outhe request of any member or to Congress, through the
proper official channels, requests for legislation or appropriations which they deem
necessary for the efficient conduct of the public business.
G. The City agrees any publications, studies, reports, presentations, films, audio visual
materials, e�ibits, or other material prepared with grant assistance will contain an
acknowledgment of HPF grant funds and nondiscrimination policy as follows: ___
"The activity that is the subject of this (type of publication) has been fmanced (in
parUentirely) with Federal funds from the National Park Service, U. S. Department of
the Interior. However, the contents and opinions do not necessarily reflect the views
or policies of the Department of the Interior, nor does the mention of trade names or
commercial products constitute endorsement or recommendation by the Department
of the Interior.
"This'program receives Federal financial assistance for identification and protection
of historic properties. Under Title VI of the Civil Rights Act of 1964 and Section 504
of the Rehabilitation Act of 1973, the U. S. Department of the Interior prohibits
discrimination on the basis of race, color, national origin, or disability in its federally
Page 3
CLG Grant Agreement
OI-q�o
assisted programs. If you believe you have been discriminated against in any
progam, activity, or facility as described above, or if you desire further information;
please write to: Office for Equal Opportunity, U. S. Department of the Interior,
National Pazk Service, P,O. 37127, Washington, D.C. 20013-7127."
H. The City assures that transferred federal monies will not be applied as part of the
matching (applicant) share, and that monies used as match on other federal grants
will not be used as matching (applicant) share on this project.
I. The City agrees not to contract with any party which is debarred or suspended or is
otherwise excluded from or ineligible for participation in Federal assistance progams
under Executive Order 12549, Debarment and Suspension. Current lists of such
parties are on file in the Society's Grants Office and are available for review by the
City. As a condition of this Agreement, the City shall complete and execute the
attached Certification Regazding Debazment, Suspension, Ineligibility and Voluntary
Exclusion for Lower Tier Covered Transactions (see page 7-9).
III. REIMBURSEMENT PROCEDURES
A. Payments under ttus Agreement will be made on a reimbursable basis according to
the schedule included in the Project Description (see Attachment A). All supporting
fiscal documentation must be submitted prior to reimbursement_
B. A Request for Reimbursement must include the following:
1 Request for Reimbursement Form (see Attachment B).
2. Supporting fiscal documentation for all project costs during the period covered by
the request, including both federally funded items and applicant match items.
(See Attachment C for Information on Allowable Costs.)
3. If project work begins prior to September 30, and the City wishes to claim these
costs, a Request for Reunbursement must be submitted at the end of the federal
fiscal year. Applicant match must be equal to, or may exceed, the federal funds
requested as of September 30 (also see Reimbursement Schedule of Attachment
A).
4. Final Product(s) and the Pro}ect Directoz's Report aze to be submitted with the
Final Request for Reimbursement Form (see Attachtnent A).
C. The Request for Reimbursement Forms should be submitted to Mandy Skypala,
Minnesota Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint
Paul, Minnesota 55102-1906.
D. When both the financial documentation and the product documentation has been
found to be acceptable by the Society, funds will be requested from the Department
Page 4
CLG Grant Agreement
O�- qr10
' of the Interior and will be forwarded to the City when the funds have been received
by the Society_
IV. AUDIT
The City must submit a copy of all audited financial statements completed pursuant to OMB Circulaz
A-128 for all fiscal years which include the project period. These must be submitted to Greg
Oldenkamp, Minnesota Historical Society, Finance Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota SS102-190b, within 120 days of their completion.
V. AMENDMENTS AND CANCELLATION
A. Amendments
1. Any s o�nificant variations from the approved work summary, products, budget,
and performance/reporting milestones described in Attachment A which aze
experienced or anticipated during the course of the project and any significant
problems, delays, or adverse conditions which materially affect planned
performance should be submitted in writing to Mandy Skypala, Minnesota
Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota, 55102-1906. The Society will respond in writing, either approving or
not approving the changes, and may amend the contrnct if deemed necessary.
The City is aware that some changes may require approval by the National Park
Service and agrees to submit any necessary changes as early as possible during
the project period. Variations which are not known until the conclusion of the
project may be submitted with the final Request for Reunbursement; however,
the City undersTands that costs may be disallowed if changes are not approved.
2. If any part of the budgeted federal grant funds will not be used, the City must
notify the Society at least sixty (60) days before the project's ending date. Failure
of the City to notify the Society may result in the loss of federal funds to the
state, and may have an adverse effect on future applications for CLG funds by
the City. --- - - -
B. Cancellation. The Society reserves the right of termination for cause on a thirty (30)
day notice should it be determined that the City has failed to materially comply with
the terms and conditions of this Agreement. This Agreement may also be terminated
when both parties agree that the project will not produce beneficial results
commensurate with fiuther expenditure of funds or because of circumstances beyond
• the control of the Society and/or the City. In the event of termination, the City may
be reimbursed for eligible expenses incused prior to termination or by a negotiated
settlement.
Page 5
CLG Grant Agreement
(date)
Once this Agreement is signed, it controls a1l=activities during the pzoject time period. `
IN WITNESS WHEREOF, the parties have caused this A�eement to be duly executed on the date(s)
indicated below intending to be bound thereby.
Minnesota Historical Society
345 Kellogg Boulevard West
Saint Paul, Minnesota 55102
Nina M. Archabal, D'uector
MinnesoYa Historical Society and
State Historic Preservation Officer
City of St. Paul
c/o LIEP
350 St. Peter Street, Suite 300
St. Pau155102-1510
signature (authorized official)
o�-��o
(date)
(print name)
Britta L. Bloomberg (date)
Deputy State Historic Preservation Officer
s
Chris Bonnell
MHS Contract Officer
9
(signahue-City Clerk or City Manager) (date)
(print name)
(date) (signature- HPC Chairperson) (date)
(print name)
Page 6
U.S. Deparfinent of the Interior
o1-q'lo
Certificafions Regarding Debarment, Suspension, and
Other Responsibility"Matters, Drug-Free Workplace '
Requirements and Lobbying
Pecsons sigoing ihis form should refer to the:egulations refeienced Certification Regarding Debarmrnt, Suspeusioq Ineligibility and
below for complete ias4uclions: . Voluntary Exclusion - Lower Yier Coveced Traasaclions -(See
Appendix B of Subpart D of 43 CFR Part 12)
Certification Regarding Debazmen[, Susprnsion, and Otha
Responsibility Mattecs - Primary Covered I'rnnsactions -[The
prospective primary participant fuither agees by submitting llus
proposaL tLat it will includc the ctause titled, "Certification Regarding
Debarment, Suspeasion, IneligibiliTy and Voluntary Exclusion - Lower
Tier Coveced Truuaction," provided by the depaztment or agency
entecing into iLis covered hansaction, without modification, in all
lower tier covered uansactions and in all solicitations for lower [ier
covered trmsactions. See below for language to be used; use this focm
for certification and sign; or use Department of tfie Interior Form 1954
(DI-1954). See Appendix A of Subpart D of 43 CFR 12.
Cer[ifica[ion Regarding Thug-Free Workplace Requirements - AI[emate
I. (Gmntces Other Than Individuals) and Altecnate II. (Gmntees Who
aze Individuals) -(See Appendix C of Subpart D of 43 CFR Part 12)
Sig�ature on this form pmvides for compliance wiih cert�cation
requiremeats under 43 CFR Pazis 12 and 18. TLe ce�tifications shall be
treated as a material representation of fact upon which reliance will be
placed when t6e Depar[ment of the Interior detevnines to award the
covered transaciion, grnut, cooperative agreement or loan.
PART A: Certifica[ion Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions '
CFiECK _ IF THIS CERTIFICAiTON IS FOR A PRIIvIARY COVERED TRANSACTION AND IS APPLICABLE.
(1) "Ihe prospective primary recipient ceitifies to the best of its knowledge and belief, tha[ it and its principals:
(a) Are noi pruently deharred, suspended, proposed for debazment, declared ineligible, or voluntarily excluded from covered transactiovs by any
Federnl depaztment or agency;
(b) Have no[ wiUiln a tiuee-year period preceding ttis proposal bee¢ convic[ed of or had a civil judgnent rendered against them for coaunission of
fiaud or a criminal offense in connection with obtaining, attempting to obtain, or perfosming a pubiic (Federnl, SEate or local) hansaction or con4ac[
under a public tmnsaction; violation of Federal or State antihust staNtes or commission of embezzlement, theft, forgery, bdbery, falsification or
desWCtion of records, making false statements, or receiving stolen property;
(c) Are no[ presenUy indicted for or o[hecwise criminally or civilly cl�arged by a govemmenial entity (Federel, Sta[e or local) with co¢unission of any
of the offenses enumereted in paragraph (lxb) of this cectification; and
(d) Have not wi[Lin a t6ree-year period preceding this application/pmposal 6ad one or more public transac[ions (Federal, State or local) telminated for
cause or defau(t.
(2) Where the pmsputive peimary pazticipan[ is unable to ceRify [o any of the siatemenu in this cer[ificatioq such prospecave participant sttall attach an
explanalion [o this pmposal.
PART B: Certification Regarding Debarment� Suspension, Ineligibility and Volun[ary Exclusion - Lower Tier Transactions
CHECK X IF THIS CERTIFICATION IS FOR A LOWER TIER COVERED TRANSACTION AND IS APPUCAB[.E.
(1) The prospective lower tier paz[icipant certifies, by submission of tFils proposal, that neither it nor its principals is presently debazred, suspended, proposed
for debazment, declared ineligible, or voluntarily excluded from participation in this transaction by any Fedeml department or agency.
(2) Where the prospective lower [ier paRicipant is unable to certify to any of the statements in tlus certifica[ioq such prospective pazticipant shal( attach an
ezptanation to [his proposal.
Page 7
a �-g10
PART C: Certification Regarding Drue-Free Workplace Requirementt
CHECK X IF THIS CERTIFICATION IS FOR AN APPLiCANT WHO IS NOT AN INDNIDUAL
Altemate I. (Grantees Other TLan Individuals) � e
A. The gantee cerufia that it will provide or continue m provide a drvg-free worl�lace by:
(a) Publishing a statement notifying employces ihat the unlawful manufacnse, dismbutioa, dispensing, possession, or use of a controlled substance is
pmhibited in the gantee's workpiace and specifying the actions that will be taken agaiust employees for viotation of such pmltibition;
(b) Establishing an ongoing drug-free awareness progmm to inform employees about—
(1) 'Ihe dangers of dcug abuse in the workplace; �
(2) The gantee's policy of mainiaining a d+ug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assutance pm$�ams; and
(4) The penalties that may be 'vnposed upon employees for diug abuse violations occu[ring in the workplace;
(c) Making it a requirement that each employee [o be engaged iu the performance of the gmnt be given a copy of the statement requ'ved by parzgaph
� ,
(d) Notifying the employee in tLe siatement required by paza�aph (a) Ihat, as a condition of employmen[ uader the gant, the employee will—
(I) Abide by the terms of the statemenh, and
(2) Notify the employer in wri[ing of his or her convicfion for a violation of a criminal dmg statute occurring in the workplace no tater than Eve
calendar days after such conviction;
(e) Notifying the agency in writing within ten calendaz days after receiving notice under subpazagrnph (d)(2) from an employee or othelwise receiving
acNal notice of sucL wnviction. Employecs of convicted employees must provide notice, including position [iUe, to every gavt offica on whose
gan[ activiry the convicted employee was working, unless the Federal agency hu designated a cenhal point for tfie receipt of such notices. Notice
shall include [he identification number(s) of each affected gmnt; "
(� Taking one of the following actions, within 30 calendaz days of receiving notice under subpaagreph (d)(2), with respect to any emptoyee who is so
convicted—
(i) Taking appropriate personnel action agains[ such employee, up to and including terminetion, consis[ent with Ihe requirements of the
Rehabilita[ion Act of 1973, as amended; or
(2) Requiring such employee to participate satisfacrorily in a dcvg abuse assistance or rehabilitation progam approved for such pueposes by a
Federel, State, or local6ealth, Iaw enforcemen[, or other appropdate agency;
(g) Making a good faith effoR to continue [o maintain a drug-free workplace Uuough implementation of pazagmphs (a), (b), (c), (d), (e), and (�.
B. Eae gantee may inseR in the space provided below the si[e(s) for the perfoimance of work done in connection wi[h the specific gCant:
Place of Pedonnance (SVeet address, city, counTy, siate, zip code)
Check if there aze workplaces on file that aze no[ identified here.
PART D: Certifica[ian Regarding Drug-Free Workplace Requirements
CHECK ff THIS CERTIFICATION IS FOR AN APPLICANT WHO IS AN INDNIDUAL
Altemate II. (Grentees Who Are Individuals) -
(a) The gan[ee certifies that, az a condition of the gant, he or she wiR no[ engage in the unlawful manufacnue, distribution, dispensing, possession, or
use of a controlled substance in conduc[ing any ac[iviry with [he gant; �
(b) If convicted of a crimiaal drug offense resutting from a violation occumng during ihe conduct of any grant activity, he or 5he will report the
conviclioq in wri[ing, within 10 calendaz days of the convictioq to the gant officer or other daig¢ee, unless the Federal ageucy designata a
cen[ml point for We receipt of such noUCes. When notice is made to such a centml point, it shall inciude the identification numbel(s) of each
affected gant. _ _
�
Ol-q'lo
Part E: Certification Regardine Lobbying
Certification for Contracts, Gran2s, Loans, and Cooperative Agreements
CfiECS� _ IF CERTIFICATSON IS FOR TAE AWARD OF ANY OF THE FOLLAWINCs AND
THE AMOLIM EXCEEDS 5100,000: A FEDERAL GRANT OR COOPERATIVE AGREEMENY;
SUBCONTRACT, OR SUBGRANT UIJDER THE GRAM OR COOPERATIVE AGREEMEM.
CHECK _ IF CERTIFICA'IION IS FOR THE AWARD OF A FEDERAL
LAAN EXCEEDING THE AMOLJNT OF 5150,000, OR A SUBGRANT OR
SUBCONTRACT EXCEEDING 3100,000 UNDER 7'HE LOAN.
The undasigned ceRifies, to the best oFhis or her ]mowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, 6y or on 6ehalf of the uadecsip�ed, to any pecson for influencing or attemp[iag to influence
an o$cer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Memba of Coagess in wnnection
with the awarding of any Federa] contmct, We making of any Federnl grnnt, the making of any Federal lo�, the eutering in[o of any coopeative
ageemen[, and the extensioq continua[ion, renewal, amendmec�t, or modification of auy Fedea] contrac[, gant, loau, or cooperative agreement.
(2) If any funds other than Federnl appropriated funds have been paid or will be paid [o any pecson for influencing or attemp[ing to influence an officer or
employee of any agrncy, a Member of Congess, an officer or employee of Congress, or an employee of a Member of Cong`us in connection with [his
Fedemi contract, grant, loan, or cooperarive agreemen[, the undeisigned shall complete and submit Standazd Foim-LLL, "Disclosure Polm to Report
Lobbying," in accordance with its inst�uc[ions.
(3) 'Ihe undersig�ed shall require tLat the language of this ceRification be included in the award documents for all subawards at all tiers (including
subcon4acts, sub�ants, and conhactr under gants, loans, and coopemtive agreements) and that all subrecipients shal] certify accordingly.
This ceitification is a material representation of fact upon which reliance waz placed when t6is t2nsaction was made or entered iuto. Submission of Ihis
ceRification is a prerequisite for making or entering into tivs Ilansaction imposed by Section 1352, title 31, U.S. Code. P.ny pecson who fails to file the
required certificalion sLall be subject [o a civil penalty of no[ less than $10,000 and no[ more fLan $IOQ000 for each such failure.
As the authorized certifying official, [ hereby cer[ify tha[ [he above-specified certifica[ions are We.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
tYPED NAME AND TITLE
i.�:vr�y�.r.�x.�
('ILis consolidated form may be used in place of the DI-1953, D7-1954, DI-1955, DI-1956, and DI-1963 foims.)
Page 9
0\— �''l
Attachment A: Ciry of St. Pau1
PROJECT DESCRIPTION
City (CLG):
Federal Grant No:
Grant Time Period:
City of St. Paul
�Ij6('�y7L�1I1F3
July 1, 2001 to July 31, 2002
Federal Grant No: 27-01
Work Summary: T'he purpose of this project is to create and install signage that will identify St. Paul's
five local Heritage Preservation Dishicts. The project will be accomplished under the supervision of
personnel meeting the Secretary of the Interior's Professional Qualificarions Standazds.
Consultations and Progress Reports:
1. The CITY will infozm the SOCIETY'S C,rants Office of the name and qualifications of the
historian, azchitectural historian, or historical architect with whom it has contracted within fifteen
15 da s of the contract's execution. The CITY will at the same rime provide a copy of the
contract and a complete report on the procurement process demonstrating compliance with Federal
comperifive procurement requirements. (See II. ASSURANCES, item B, CLG Agreement, and
Part VI of 2001 CLG Grants Manual.)
.
2. The CITY will submit a brief Monthly Progress Report (See 2001 CLG Grants Manual -
Attachment F.) to the SOCIETY'S Grants Office by the 15�' of each month for the duration of the
project period. Product submittals will accompany the monthly reports as specified below.
3.
�
5.
�
By November, 2001, the CITY will submit a draft of the sign designs to the SOCIETY'S Grazits
Office.
By January, 2002, the CITY will submit a list of the number and location of the signs to the
SOCIETY'S Grants Office.
By Mazch, 2002, the CITI' will submit the final designs and locations of the signs to the
SOCIETX'S Cmnts Office.
The SOCIETY may request other written progress reports and on-site reviews of pro}ect progress,
as necessary.
Final Products The Final Products to be submitted with the Request for Reunbursement (see Part III of
the CLG Agreement) and the Project D'uector's Report will be three copies of each of the final camera-
v �-�� o
Attachment A: City of St. Pau1
Federal Grznt No: 27-01-16423.008
ready versions of each sign prototype, a map of sign locarions, and a representative sample of photo`graphs
of the installed signs.
Project D'uector's Repozt: The report will include a brief description of the administration of the project.
Two copies of this report will be submitted to the SOCIETY'S Grants Office with the Final Products and
the Request for Reimbursement Form (see Part III of the Grant Agreement).
Yroject Sudget:
BUDGBTITEMS
Sign Fabricator
($50/sign X 95 signs)
($40/sign X 35 signs)
Sign Hazdware
($10.50 x 95)
($16 X 35)
Sign Tnstallation
(lOb/hr X 36 hours)
Project management
($21.63/hr X 85 hours)
GRANT
$6150
RECIPIENT MATCH
Cash � In-Kind � Other
$1557.50
$360D
$1838.55
TOTAL
$6150
$1557.50
$3600
$1838.55
Reimbursement Schedule The CITY will be reimbursed, in total amount not to exceed $8,950, for the
actual amounts expended under the federal (HPF) portion of the budget. The CIT'Y must submit a Request
for Reimbursement Form along with appropriate fiscal documentation, Final Products, and Project
Director's Report to the SOCIE'TY'S Grants Office no later than August 15, 2002. All pro}ect work must
be completed no later than July 31, 2002.
Minnesota Historical Society
Grants Office
Request far Reimbursement for Federal HPF Grants
Project:
City:
Address:
Proiect Expenditure Classification:
(use budget items from Attachment A of the
Grant Agreement)
.
�����
Federal Grant Number:
MHS Contract Number:
Federal Grant Amount:
Total Expenditures
Federal
Ot-t'�
Attachment B
Applicant Match
Supporting documentation for all costs claimed in this request must be attached. Each supporting document
should be labeled with the appropriate Project Expenditure Classification.
I certify that this request for Reimbursement represents actual project expenditures carried out within the
period of the project.
Date:
Signature:
Print name
and tide:
Telephone:
01-9'lr�
Attachment C
SUPPLEMENTAL INFORMATION ON ALLOWABLE COSTS
All costs for this project must be in conformance with OMB Circulaz A-87 and A-102 (revised)
and the National Register Programs Guidelines 13PS-49. The following points provide
supplementary guidance and emphasis for areas where quesrions or problems may arise.
1. The project budget is divided into those costs to be reimbursed by Historic Preservation
Funds (HPF federal dollazs) and those costs which are covered by the City (applicant
match). All costs--both HPF federal dollars and the applicant match--must be adequately
documented on a Request for Reimbursement Form. The applicant match portion must
total, at a minimum, an amount equal to the federal portion.
2. All costs must be in payment of an obligation incurred during the grant time period.
3. All costs must represent expenditures which aze necessary for the accomplishment of
approved grant objectives.
4. Transferred federal monies cannot be applied as matching applicant shaze; monies used
as match on other federal grants may not be used as matcYung share on this project.
5. Specific cost categories:
A. Personnel
(1) Proiect Specific Personnel aze hired as regulaz employees specifically for
the grant project. Eligible costs may include salary expenses as well as
other project related expenses incurred for the benefit of the project
specific personnel. T`hese costs may be charged to the federal portion
and/or to the applicant portion of the proj ect budget. Costs included on a
Request for Reimbursement Form must be supported with copies of time
sheets showing the employee's name, dates and hours worked, dollar
amount, description of work performed, employee's signature, and the
signature of the employee's supervisor. Either the City's time sheets with
the above information or MHS rime sheets (see Attachment D) are
- acceptable.
o�- 410
(2) In-Kind Services (force account personnel) aze regulaz employees of the
City who spend all or part of their time on the grant project. Eligible costs
include the actual salary of the employee including fringe benefits. (The
employee must be working in the same skill for which he/she is normally
paid, otherwise, only minimum wage can be used.) These costs may be
charged to the federal portion and/or to the applicant portion of the project
budget. Costs included on a Request for ReimbursemenCFonn must be
supported with copies of rime sheets containing information described
under S.A.(1) above as well as documentation supporting the claimed
wage rate(s).
(3) Donated Services (volunteer personnel) contribute time to the grant
project. I£ a volunteer is performing tasks within hisiher normal trade or
profession, the value of the contribution is based on the volunteer's normal
rate of pay or the rates listed below. (The Society will furnish rates for
other areas upon request.) Benefits are not eligible. If the volunteer is
performing tasks outside of hislher profession, only minimum wage rate
can be used. These contributions may be utilized only for the applicant
portion of the budget. Costs included on a Request for Reimbursement
Fozm must be supported by time sheets with information described
under S.A.(1) above.
Rates for Volunteer Personnel
Appraiser
Archaeologist
Architect
Attomey
Bookkeeper/accountant
Crraphic Arts Specialist
Historian
Librarian
Management Specialist
Planner
Photographer
Researcher
Secretary
Word Processing Operatoz
Writer/editor
MINIMUM WAGE RATE
$1437 per hour
$14.82 per hour
$15.62 per hour
$24.62 per how
$ 8.60 per hour
$14.00 per hour
� 17.06 per hour
$20.26 per hour
$14.21 per hour
$15.75 per hour
$ 9.40 per hour
$12.93 perhour
$ 9.38 per hour
$ 8.69 ger hour
$17.04 per hour
$ 5.15 per hour
2
O�- 9'1C
B. Contractual Services are services necessary for the completion of the project
which are contracted by the City. The City must follow the requirements of OMS
Circulaz A-102 (revised) regazding procurement standards in arranging for such
services. Eligible costs may include the rates actually paid to the contractor.
T'hese costs may be charged to the state portion and/or to the applicant poztion of
the project budget. Costs included on a Request for I2eimbursement Form must
be supported by copies of invoices and copies of canceled checks.
C. Supplies and Materials
(1) Donated supplies and materials aze those taken out of City stock or
donated by third parties. The cost of these supplies and/or materials may
be charged only to the applicant portion of the budget. Costs included on
a Request for Reimbursement Form must be supported by a Value of
Donated Supplies and Materials Form {see Attachment E) wiuch must
include a description of the materials and/or supplies, date of donation, fair
market value, basis for the valuation (i.e., invoice price, price in retail
outlet, etc.), and signature of verifying o�cial.
(2) Purchased supplies and materials are those items bought specifically for
the project. The City must follow the requirements of OMB Circular A-
102 revised) in the purchase of supplies and materials. The cost of these
supplies and/or materials may be charged to the federal portion and/or to
the applicant portion of the budget. Costs included on a Request for
Reimbursement Form must be supported by copies of invoices and copies
of cancelled checks.
D. Indirect Costs may be chazged to the project only if the City has a current rate that
has been approved by the City's cognizant federal agency and is currently in
effect. These costs may be charged onl to the appiicant portion of the budget.
Those costs must be included on page four of the City's CLG grant applicarion.
E. Mileage Costs may be charged to the project for necessary costs incurred
excluding costs ofmileage from place of residence of project personnel to the
project site. Mileage paid for by the City may be chazged to the federal portion
and/or to the applicant portion of the budget; donated mileage may be charged
only to the applicant portion. Costs included on a Request for Reimbursement
Form must be supported with the following information: project personnel
name, date of travel, purpose of travel, beginning and ending mileage, and rate
claimed. Maximuzn rate allowable is $.31 per mile.
oi-��to
Minnesota Historical Society
Value of In-Kincj and/or ponated Services
Time Sheets
City and Project Name
Name of Person Contributing Services
Hourly Rate — Based on:
Attachment D
Federal Grant Number
of Worked Performed
(research, planning, secretarial, etc.)
Volunteer personnel donating hisfher time to a project may be credited with an agreed rate (See
Attachment C of Grant Agreement) unless he/she is professionally skilled in the work he/she is
performing on the project. When this is the case, the wage rate the individual is normally paid for
performing his/her service may be credited to the project. If a higher rate than the published volunteer
rate is used, additional documentation and verification is required. Please consult with the Grants
Office before claiming the higher rate.
Si�ature of Person Donating Time
Date
Supervisor Verifying Accuracy Date
o�-g10
Attachment E
Minnesota Historical Society
Value of Donated Supplies and Materials
City and Project Name
Name and Address of Donor
Federal Grant Number
Description of Supplies and Donation
Material Donated Date Fair Value Basis of Value
Total Value of Donation
Supervisor Verifying Accuracy Date
4 �- �t1 O
AtEachment F
MINNESOTA HtSTORICAL SOCIETY
STATE HISTORIG PRESERVATION OFFICE �
Monthly Progress Reporf Form — CLG Grants-
Grantee:
Report for the Month of:
Federal Project No.
Contact: Daytime Telephone:
i. Aescribe month's progress toward accomplishing the goals of the project Refer
to "consultations" and "final products" listed in Attachment A.
2. Is the project currently on schedule? If not, please explain why.
3. Describe any sign�cant problems encountered this month which may impede the
successful completion of the project.
4. Is the project on budget? Approximate costs incurred since the previous progress
report (estimate only, including both federal and matching share).
Prepared by: Signature:
Council File # O \ � q �Q
Green Sheet # � 03 aZ$�
Presented By
Refened To
Committee: Date
1 WAEREA5, in Council File No. O1-804, the Council of the City of Saint Paul authorized
2 the Office of License, Inspections, and Environmental Protection (LIEP) to prepare and submit,
3 on behalf of the City's Heritage Preservation Commission, a grant proposal for the purpose of
4 creating and installing signage which would identify each of the City's five historic preservation
5 districts; and
6
10
11
12
13
14
15
16
17
18
19
2Q
21
22
WHEREAS, pursuant to the said authorization, LIEP staff applied for and received from
the Minnesota Historical Society a Certified Local Government Grant Agreement for the sum of
Eight Thousand Nine Hundred and Fifty Dollars ($8,950.00) which is to be utilized to for the
signage project; and
WHEREAS, the Minnesota Historical Society's grant agreement contains language
whereby the City will "indemnify and save and hold the Society and the Department of the
Interior harmless from any and al1 claims or causes of action arising from the performance of this
project by the City"; NOW, THEREFORE,
BE IT RESOLVED, that the Council of the City of Saint Pau1 hereby authorizes the
appropriate City offic3als to enter into the Certified Local Government Grant Agreement with the
Minnesota Historical Society with the said indemnification clause noted above and contained
therein at p. 3, ¶. D of the Grant Agreement.
Requested by Department of:
Adoption Certified by Council Secretary
� ,
_ • _ � i% • /�
I
%►�� iA�'� %�
M1
By:
Form Approved by City Attorney
By: �� W`✓'M�s^ �' Z y— O�
Appsoved ayor £os S' to Council
By: e��' `-/�
AdopCed by Council: Date L 3 � a�
OFFICE oF LIEP Date: GREEN SHEET
�--.,. ROger C11i'tis September 4, 2001
266-9013 NO 103288 9 �
. 1 HPARTNffiNT DIRSCTOR 4 ITY CODNCIL
� Z ITY ATTORHL'Y ZTY CLER%
x�srw
ust be On COUncil Ag2nd3 by: � wcEx nxxscrox IN_ & IdGT. SVC. DIR.
�
AP Consent 3 �R ��R ASSTSTANT)
„ OTAL # OF SIGNATQRE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURS)
CTION REQUESTED:
resolution authorizing the appropriate City officials to enter into a
Certified Local Government Grant Agreement with the Minnesota I-Iistorical
" Society with language stating the City will "indemnify and save and hold the
:, Society and the Department af the Interior harmless from any and all claims or
causes of action arising from the performance of this project by the City."
CON97ENDATIONS; APPR0�1E (A) OR RESSC'T (R) BRSONAL 58R�1SC8 CONTRACTS MDST ANSWSIi T88 FOLLOWING:
PLANNING COMMISSION CIVIL S&RVICE COMMISSL�N 1. Has the pexsOn(firm evet workzd undes a contsact for this department?
CIH COMMITT&S _ SVSINBSS REVIEW COUNCIL YES NO
STAFF _ Has this per5on/firm ever been a City employee?
. DIS7RICT COURT YES NO
3. Does this person/firm possess a skill not normally possessed by any
PORTS WHICH COUNCIL OHJECTFVE? Qxrrent City employee?
YSS ND
� lain all Y85 anawers oa a aeparate aheet and attach.
INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why):
VANTAGES IF APPROVED:
ISADVANTAGES IF APPROVED:
ISADVANTAGES IF NOT APPROVED:
OTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED YES NO
FUNDINCr SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (SXPI,AIN)
�t�scM ��rch C���et
S�P � �, ���
�
ORIGINAL
Council File # 4 � ���
Resolution #
Green Sheet # 143�crt
Presented By:
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
r�
ai-9?o
Referred To ' " Committee: Date
1
2 WHEREAS, implementafion of a signage program identifying the City's five heritage preservation districts will
3 fiirther the City's heritage preservation policies as adopted in Saint Paul Legislative Code § 73.01; and
4
S WHEREAS, the Minnesota Historical Society's Certified Local Government Grant Program (hereinafter "Progratn"),
6 has grant money available for pubiic educafion and activities and has made "increasing community awareness of the value of
7 Minnesota's historic resources" a priority in its state historic preservation plan; and
8
9 WIIEREAS, the Council of the City of Saint Paul authorized the Office of License, Inspections and Environmental
10 Protection (hereinafter "LIEP) to prepaze and submit, on the behalf of the Heritage Preservation Commission, a grant request
11 to the Program in the amount of $8,950.00 for the purpose of creating and installing signs that identify each of the five
12 historic preservation districts; and
13
14 WF�REAS, the Council of the City of Saint Paul further authorized LIEP tn provide an additional$9,196A5 as a
15 cash and in-kind match; and
16
17 WHEREAS, the Proa am awazded $8,950.00 to LIEP on behalf of the Heritage Preservation Commission to
18 implement a signage program idenrifying the City's five heritage preservation districts; now, therefore, be it
19
20 RESOLVED, that the Council of the City of Saint Paul authorizes LIEP to accept $8,950.00 from the Program on
21 behalf of the Heritage Preservation Commission to 'vnplement a signage program identifying the City's five heritage
22 preservation districts.
23 Current Amended
2� Sudaet Chanae Budo'et
ZS FII3PSICING P T,AM
26 Department of Executive Administration
2� Division - License, Inspections, and
28 Environmental Protection
29
3� GL 320 33351 3400 State Direct Grants in Aid 0 8,950 8,950
31 A11 Other Activity Financi.ng 5.459,671 0 5.489.671
32 5,489,671 8,950 5,498,621
33 SPENDING PLAN �
34
35 Department of Executive Administration
36 Division - License, Inspections, and
3� Environmental Protection
;$
;9 GL 320 33351 0389 Other Misc Supplies 0 4,475 4,475
G� GL 320 33351 0299 Other Misc Services 9,762 4,475 14,237
�1 All Other Activity Spendi.ng 5.479.9Q9 0 5.479.909
1
1
2
3
4
5
6
7
s
9
10
11
12
13
14
15
16
17
18
19
20
21
s,. _
Adopted by Council: Date a
Adoption Certified by Council
By : ^'I1 \.�_� . � ._.,� - -
Approved by Mayor: Date l� i�%�
By:
5,489,671 8,g50
xequested by Department of:
5,498,621
01-d'o�t
Office of License, Inspections and 0 ����
Enviro en 1 Protec on
By:
L
Form App ved by City Attorney
By: 7'�7i-� �L✓M�^�'� ?-ll-v (
Approve Office o Financial Services:
By: �� ����'�///A�
Approved by Mayor for Submission to
Council
By : 1� i'�/�W "'�
2
�i-`1'?°
,
MINNESOTA HfSTORICAL SOClETY
CERTIFIED LOCAL GO�fERNMENT GRANT AGREEMENT
ACCOUNT NUMBER
0284
FISCAL OBTECT
YEAR CODE
zooi s�zo
FEDERALPROJECT
NUMBER
27-01-16423.008
DOLLAR AMOUNT
$8,950 HPF grnnt funds
$9,296 applicant match
This Agreement is made by and between the Minnesota Historical Society hereinafter called the
Society), and the City of St. Paul (hereinafter called the City), pursuant to authority ganted by the
National Historic Preservation Act of 1966, as amended.
WHEREAS, pursuant to the Act, the Society has been allocated funds by the United States
Department of the Interior for use by Certified Local Governments for qualifying historic
preservation activities; and
WIIEREAS, the City has applied for and been granted Certified I,ocal Govemment Status and has
made application for Certified Local Govemment funds to be utilized in carrying out the pro,}ect
described in Attachment A of this Agreement,
NOW, TF�REFORE, in considerntion of and in reliance upon the mutual covenants and a�eements
contained herein, the parties hereto do covenant and agree, each for themselves and their respective
successors and assi�s, to carry out the project under the following provisions.
I.
�
PROJECT DESCRIPTION
A. The Project Tune Period, Work Summary, Photograph Guidelines (where applicable),
Consultations and Progress Reports, Final Products, Project Airector's Report, Project
Budget, and Reimbursement Schedule are described in the Pzoject Description,
Attachment A, which is attached hereto and made a part hereof.
B. The City agrees the project will be carried out as described in the Project Description,
unless modified pursuant to the provisions of Section V of this contract.
C, The Society will rennburse the City for the budget costs identified as Historic
Preservation Fund ('rIPF) federal dollars in the Pro}ect Description, following
submittal of materials as described in Section III of this Agreement. Final products
which do not conform to the terms and conditions of this Agreement or which do not
meet the applicable Secretary of the Interior's Standazds will not be reimbursed.
ASSURANCES
A. The City assures that all work carried out on this project will conform to the
Secretary of the Interior's Standards for Archaeology and Historic Preservation (as
published in the Federal Register of September 29, 1983) and that the project
CLG Grant Agreement
personnel meet the Secretary of the Interio�s Professional Qualifications
Standards (as published in the Federal Register of September 29, 1983) as
stipulated in the Project Description.
B. The City assures that this project will be administered and conducted in accordance
with the following:
1. OMB Circulaz A-87 "Cost Principles Applicable to Grants and Contracts with
State and Local Government" and OMB Circulaz A-102 (revised) "Uniform
Requirements for Assistance to State and Local Governments."
2. Department of the Interior regulations 43 CFR Part 12, Subpart C-"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State
and Local Govemments."
01-4'fo
a. In addition to the requirements of these regulations the City will allow a
minimum of two weeks between the date bid solicitations are published and
the date bidders must respond; and allow eighteen calendar days between the
date invitations are mailed to potential bidders and the date bidders must
respond.
3. Public Law 101-517, Title V, Section 511, states: When issuing statements,
press releases, requests for proposals, bid solicitations and other documents
describing projects or programs funded in whole or in part with Federal money,
all grantees receiving Federal funds, including but not limited to State and local
govemments, shall cleazly state (1) the percentage of the total costs of the
program or project wluch will be financed with Federal money, (2) the dollaz
amount of Federal funds for the project or program, and (3) percentage and
dollar amount of the total costs of the project or program that will be fumished
by nongovernmental sources.
4. The "Single Audit Act of 1984."
5. Historic Preservation Fund (I;PF) Grants Manual (previously known as National
Register Programs Guideline NPS-49).
C. T'he City acknowledges that this project is being supported, in part, with funds from
the United States Department of the Interior. As a condition of receiviug such funds,
the City assures compliance with Title VI of the Civil Rights Act of 19b4, Section
504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
The City also agrees as follows:
In the hiring of common or skilled labor for the performance of any work hereunder,
no contractor, material supplier or vendor shall, by reason of race, creed or color,
discriminate against any person or persons who are citizens of the United States, or
resident aliens, who are qualified and available to perform the work to which the
Page 2
CLG Grant Ao eement
employment relates.
01-q'10
No contractor, material supplier or vendor shall, in any manner, discriminate against,
or intimidate, or prevent the employment of any person or persons identified in the
preceding paragraph, or on being hired, prevent, or conspire to prevent, the person or
persons from the performance of work under any contract on account of race, creed
or color.
The violation of this section is a misdemeanor pursuant to Minnesota Statutes.
This Agreement may be canceled or terminated by the Society, and all money due, or
to become due hereunder may be forfeited for a second or any subsequent violation of
the terms of this section.
D. The City will indemnify and save and hold the Society and the Department of the
Interior harmless from any and ali claims or causes of action arising from the
performance of this project by the City.
E. The City agrees to make repayment of grant funds to the Society if terms and
conditions of this Agreement are not followed or costs claimed are subsequently
disallowed.
F. The City, in accordance with provisions of 18 USC 1913 regazding lobbying, assures
that no part of grant budget will be used directly or indirectly or to pay for any
personal service, advertisement, telegam, telephone, letter, printed or written matter,
or other device intended or desia ed to influence in any manner a member of
Congress, to favor or oppose, by vote or otherwise, any legislation or appropriation
by Congress, whether before or after the introduction of any bill or resolution
proposing such legislation or appropriation. This shall not prevent communicating to
members of Congress outhe request of any member or to Congress, through the
proper official channels, requests for legislation or appropriations which they deem
necessary for the efficient conduct of the public business.
G. The City agrees any publications, studies, reports, presentations, films, audio visual
materials, e�ibits, or other material prepared with grant assistance will contain an
acknowledgment of HPF grant funds and nondiscrimination policy as follows: ___
"The activity that is the subject of this (type of publication) has been fmanced (in
parUentirely) with Federal funds from the National Park Service, U. S. Department of
the Interior. However, the contents and opinions do not necessarily reflect the views
or policies of the Department of the Interior, nor does the mention of trade names or
commercial products constitute endorsement or recommendation by the Department
of the Interior.
"This'program receives Federal financial assistance for identification and protection
of historic properties. Under Title VI of the Civil Rights Act of 1964 and Section 504
of the Rehabilitation Act of 1973, the U. S. Department of the Interior prohibits
discrimination on the basis of race, color, national origin, or disability in its federally
Page 3
CLG Grant Agreement
OI-q�o
assisted programs. If you believe you have been discriminated against in any
progam, activity, or facility as described above, or if you desire further information;
please write to: Office for Equal Opportunity, U. S. Department of the Interior,
National Pazk Service, P,O. 37127, Washington, D.C. 20013-7127."
H. The City assures that transferred federal monies will not be applied as part of the
matching (applicant) share, and that monies used as match on other federal grants
will not be used as matching (applicant) share on this project.
I. The City agrees not to contract with any party which is debarred or suspended or is
otherwise excluded from or ineligible for participation in Federal assistance progams
under Executive Order 12549, Debarment and Suspension. Current lists of such
parties are on file in the Society's Grants Office and are available for review by the
City. As a condition of this Agreement, the City shall complete and execute the
attached Certification Regazding Debazment, Suspension, Ineligibility and Voluntary
Exclusion for Lower Tier Covered Transactions (see page 7-9).
III. REIMBURSEMENT PROCEDURES
A. Payments under ttus Agreement will be made on a reimbursable basis according to
the schedule included in the Project Description (see Attachment A). All supporting
fiscal documentation must be submitted prior to reimbursement_
B. A Request for Reimbursement must include the following:
1 Request for Reimbursement Form (see Attachment B).
2. Supporting fiscal documentation for all project costs during the period covered by
the request, including both federally funded items and applicant match items.
(See Attachment C for Information on Allowable Costs.)
3. If project work begins prior to September 30, and the City wishes to claim these
costs, a Request for Reunbursement must be submitted at the end of the federal
fiscal year. Applicant match must be equal to, or may exceed, the federal funds
requested as of September 30 (also see Reimbursement Schedule of Attachment
A).
4. Final Product(s) and the Pro}ect Directoz's Report aze to be submitted with the
Final Request for Reimbursement Form (see Attachtnent A).
C. The Request for Reimbursement Forms should be submitted to Mandy Skypala,
Minnesota Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint
Paul, Minnesota 55102-1906.
D. When both the financial documentation and the product documentation has been
found to be acceptable by the Society, funds will be requested from the Department
Page 4
CLG Grant Agreement
O�- qr10
' of the Interior and will be forwarded to the City when the funds have been received
by the Society_
IV. AUDIT
The City must submit a copy of all audited financial statements completed pursuant to OMB Circulaz
A-128 for all fiscal years which include the project period. These must be submitted to Greg
Oldenkamp, Minnesota Historical Society, Finance Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota SS102-190b, within 120 days of their completion.
V. AMENDMENTS AND CANCELLATION
A. Amendments
1. Any s o�nificant variations from the approved work summary, products, budget,
and performance/reporting milestones described in Attachment A which aze
experienced or anticipated during the course of the project and any significant
problems, delays, or adverse conditions which materially affect planned
performance should be submitted in writing to Mandy Skypala, Minnesota
Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota, 55102-1906. The Society will respond in writing, either approving or
not approving the changes, and may amend the contrnct if deemed necessary.
The City is aware that some changes may require approval by the National Park
Service and agrees to submit any necessary changes as early as possible during
the project period. Variations which are not known until the conclusion of the
project may be submitted with the final Request for Reunbursement; however,
the City undersTands that costs may be disallowed if changes are not approved.
2. If any part of the budgeted federal grant funds will not be used, the City must
notify the Society at least sixty (60) days before the project's ending date. Failure
of the City to notify the Society may result in the loss of federal funds to the
state, and may have an adverse effect on future applications for CLG funds by
the City. --- - - -
B. Cancellation. The Society reserves the right of termination for cause on a thirty (30)
day notice should it be determined that the City has failed to materially comply with
the terms and conditions of this Agreement. This Agreement may also be terminated
when both parties agree that the project will not produce beneficial results
commensurate with fiuther expenditure of funds or because of circumstances beyond
• the control of the Society and/or the City. In the event of termination, the City may
be reimbursed for eligible expenses incused prior to termination or by a negotiated
settlement.
Page 5
CLG Grant Agreement
(date)
Once this Agreement is signed, it controls a1l=activities during the pzoject time period. `
IN WITNESS WHEREOF, the parties have caused this A�eement to be duly executed on the date(s)
indicated below intending to be bound thereby.
Minnesota Historical Society
345 Kellogg Boulevard West
Saint Paul, Minnesota 55102
Nina M. Archabal, D'uector
MinnesoYa Historical Society and
State Historic Preservation Officer
City of St. Paul
c/o LIEP
350 St. Peter Street, Suite 300
St. Pau155102-1510
signature (authorized official)
o�-��o
(date)
(print name)
Britta L. Bloomberg (date)
Deputy State Historic Preservation Officer
s
Chris Bonnell
MHS Contract Officer
9
(signahue-City Clerk or City Manager) (date)
(print name)
(date) (signature- HPC Chairperson) (date)
(print name)
Page 6
U.S. Deparfinent of the Interior
o1-q'lo
Certificafions Regarding Debarment, Suspension, and
Other Responsibility"Matters, Drug-Free Workplace '
Requirements and Lobbying
Pecsons sigoing ihis form should refer to the:egulations refeienced Certification Regarding Debarmrnt, Suspeusioq Ineligibility and
below for complete ias4uclions: . Voluntary Exclusion - Lower Yier Coveced Traasaclions -(See
Appendix B of Subpart D of 43 CFR Part 12)
Certification Regarding Debazmen[, Susprnsion, and Otha
Responsibility Mattecs - Primary Covered I'rnnsactions -[The
prospective primary participant fuither agees by submitting llus
proposaL tLat it will includc the ctause titled, "Certification Regarding
Debarment, Suspeasion, IneligibiliTy and Voluntary Exclusion - Lower
Tier Coveced Truuaction," provided by the depaztment or agency
entecing into iLis covered hansaction, without modification, in all
lower tier covered uansactions and in all solicitations for lower [ier
covered trmsactions. See below for language to be used; use this focm
for certification and sign; or use Department of tfie Interior Form 1954
(DI-1954). See Appendix A of Subpart D of 43 CFR 12.
Cer[ifica[ion Regarding Thug-Free Workplace Requirements - AI[emate
I. (Gmntces Other Than Individuals) and Altecnate II. (Gmntees Who
aze Individuals) -(See Appendix C of Subpart D of 43 CFR Part 12)
Sig�ature on this form pmvides for compliance wiih cert�cation
requiremeats under 43 CFR Pazis 12 and 18. TLe ce�tifications shall be
treated as a material representation of fact upon which reliance will be
placed when t6e Depar[ment of the Interior detevnines to award the
covered transaciion, grnut, cooperative agreement or loan.
PART A: Certifica[ion Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions '
CFiECK _ IF THIS CERTIFICAiTON IS FOR A PRIIvIARY COVERED TRANSACTION AND IS APPLICABLE.
(1) "Ihe prospective primary recipient ceitifies to the best of its knowledge and belief, tha[ it and its principals:
(a) Are noi pruently deharred, suspended, proposed for debazment, declared ineligible, or voluntarily excluded from covered transactiovs by any
Federnl depaztment or agency;
(b) Have no[ wiUiln a tiuee-year period preceding ttis proposal bee¢ convic[ed of or had a civil judgnent rendered against them for coaunission of
fiaud or a criminal offense in connection with obtaining, attempting to obtain, or perfosming a pubiic (Federnl, SEate or local) hansaction or con4ac[
under a public tmnsaction; violation of Federal or State antihust staNtes or commission of embezzlement, theft, forgery, bdbery, falsification or
desWCtion of records, making false statements, or receiving stolen property;
(c) Are no[ presenUy indicted for or o[hecwise criminally or civilly cl�arged by a govemmenial entity (Federel, Sta[e or local) with co¢unission of any
of the offenses enumereted in paragraph (lxb) of this cectification; and
(d) Have not wi[Lin a t6ree-year period preceding this application/pmposal 6ad one or more public transac[ions (Federal, State or local) telminated for
cause or defau(t.
(2) Where the pmsputive peimary pazticipan[ is unable to ceRify [o any of the siatemenu in this cer[ificatioq such prospecave participant sttall attach an
explanalion [o this pmposal.
PART B: Certification Regarding Debarment� Suspension, Ineligibility and Volun[ary Exclusion - Lower Tier Transactions
CHECK X IF THIS CERTIFICATION IS FOR A LOWER TIER COVERED TRANSACTION AND IS APPUCAB[.E.
(1) The prospective lower tier paz[icipant certifies, by submission of tFils proposal, that neither it nor its principals is presently debazred, suspended, proposed
for debazment, declared ineligible, or voluntarily excluded from participation in this transaction by any Fedeml department or agency.
(2) Where the prospective lower [ier paRicipant is unable to certify to any of the statements in tlus certifica[ioq such prospective pazticipant shal( attach an
ezptanation to [his proposal.
Page 7
a �-g10
PART C: Certification Regarding Drue-Free Workplace Requirementt
CHECK X IF THIS CERTIFICATION IS FOR AN APPLiCANT WHO IS NOT AN INDNIDUAL
Altemate I. (Grantees Other TLan Individuals) � e
A. The gantee cerufia that it will provide or continue m provide a drvg-free worl�lace by:
(a) Publishing a statement notifying employces ihat the unlawful manufacnse, dismbutioa, dispensing, possession, or use of a controlled substance is
pmhibited in the gantee's workpiace and specifying the actions that will be taken agaiust employees for viotation of such pmltibition;
(b) Establishing an ongoing drug-free awareness progmm to inform employees about—
(1) 'Ihe dangers of dcug abuse in the workplace; �
(2) The gantee's policy of mainiaining a d+ug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assutance pm$�ams; and
(4) The penalties that may be 'vnposed upon employees for diug abuse violations occu[ring in the workplace;
(c) Making it a requirement that each employee [o be engaged iu the performance of the gmnt be given a copy of the statement requ'ved by parzgaph
� ,
(d) Notifying the employee in tLe siatement required by paza�aph (a) Ihat, as a condition of employmen[ uader the gant, the employee will—
(I) Abide by the terms of the statemenh, and
(2) Notify the employer in wri[ing of his or her convicfion for a violation of a criminal dmg statute occurring in the workplace no tater than Eve
calendar days after such conviction;
(e) Notifying the agency in writing within ten calendaz days after receiving notice under subpazagrnph (d)(2) from an employee or othelwise receiving
acNal notice of sucL wnviction. Employecs of convicted employees must provide notice, including position [iUe, to every gavt offica on whose
gan[ activiry the convicted employee was working, unless the Federal agency hu designated a cenhal point for tfie receipt of such notices. Notice
shall include [he identification number(s) of each affected gmnt; "
(� Taking one of the following actions, within 30 calendaz days of receiving notice under subpaagreph (d)(2), with respect to any emptoyee who is so
convicted—
(i) Taking appropriate personnel action agains[ such employee, up to and including terminetion, consis[ent with Ihe requirements of the
Rehabilita[ion Act of 1973, as amended; or
(2) Requiring such employee to participate satisfacrorily in a dcvg abuse assistance or rehabilitation progam approved for such pueposes by a
Federel, State, or local6ealth, Iaw enforcemen[, or other appropdate agency;
(g) Making a good faith effoR to continue [o maintain a drug-free workplace Uuough implementation of pazagmphs (a), (b), (c), (d), (e), and (�.
B. Eae gantee may inseR in the space provided below the si[e(s) for the perfoimance of work done in connection wi[h the specific gCant:
Place of Pedonnance (SVeet address, city, counTy, siate, zip code)
Check if there aze workplaces on file that aze no[ identified here.
PART D: Certifica[ian Regarding Drug-Free Workplace Requirements
CHECK ff THIS CERTIFICATION IS FOR AN APPLICANT WHO IS AN INDNIDUAL
Altemate II. (Grentees Who Are Individuals) -
(a) The gan[ee certifies that, az a condition of the gant, he or she wiR no[ engage in the unlawful manufacnue, distribution, dispensing, possession, or
use of a controlled substance in conduc[ing any ac[iviry with [he gant; �
(b) If convicted of a crimiaal drug offense resutting from a violation occumng during ihe conduct of any grant activity, he or 5he will report the
conviclioq in wri[ing, within 10 calendaz days of the convictioq to the gant officer or other daig¢ee, unless the Federal ageucy designata a
cen[ml point for We receipt of such noUCes. When notice is made to such a centml point, it shall inciude the identification numbel(s) of each
affected gant. _ _
�
Ol-q'lo
Part E: Certification Regardine Lobbying
Certification for Contracts, Gran2s, Loans, and Cooperative Agreements
CfiECS� _ IF CERTIFICATSON IS FOR TAE AWARD OF ANY OF THE FOLLAWINCs AND
THE AMOLIM EXCEEDS 5100,000: A FEDERAL GRANT OR COOPERATIVE AGREEMENY;
SUBCONTRACT, OR SUBGRANT UIJDER THE GRAM OR COOPERATIVE AGREEMEM.
CHECK _ IF CERTIFICA'IION IS FOR THE AWARD OF A FEDERAL
LAAN EXCEEDING THE AMOLJNT OF 5150,000, OR A SUBGRANT OR
SUBCONTRACT EXCEEDING 3100,000 UNDER 7'HE LOAN.
The undasigned ceRifies, to the best oFhis or her ]mowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, 6y or on 6ehalf of the uadecsip�ed, to any pecson for influencing or attemp[iag to influence
an o$cer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Memba of Coagess in wnnection
with the awarding of any Federa] contmct, We making of any Federnl grnnt, the making of any Federal lo�, the eutering in[o of any coopeative
ageemen[, and the extensioq continua[ion, renewal, amendmec�t, or modification of auy Fedea] contrac[, gant, loau, or cooperative agreement.
(2) If any funds other than Federnl appropriated funds have been paid or will be paid [o any pecson for influencing or attemp[ing to influence an officer or
employee of any agrncy, a Member of Congess, an officer or employee of Congress, or an employee of a Member of Cong`us in connection with [his
Fedemi contract, grant, loan, or cooperarive agreemen[, the undeisigned shall complete and submit Standazd Foim-LLL, "Disclosure Polm to Report
Lobbying," in accordance with its inst�uc[ions.
(3) 'Ihe undersig�ed shall require tLat the language of this ceRification be included in the award documents for all subawards at all tiers (including
subcon4acts, sub�ants, and conhactr under gants, loans, and coopemtive agreements) and that all subrecipients shal] certify accordingly.
This ceitification is a material representation of fact upon which reliance waz placed when t6is t2nsaction was made or entered iuto. Submission of Ihis
ceRification is a prerequisite for making or entering into tivs Ilansaction imposed by Section 1352, title 31, U.S. Code. P.ny pecson who fails to file the
required certificalion sLall be subject [o a civil penalty of no[ less than $10,000 and no[ more fLan $IOQ000 for each such failure.
As the authorized certifying official, [ hereby cer[ify tha[ [he above-specified certifica[ions are We.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
tYPED NAME AND TITLE
i.�:vr�y�.r.�x.�
('ILis consolidated form may be used in place of the DI-1953, D7-1954, DI-1955, DI-1956, and DI-1963 foims.)
Page 9
0\— �''l
Attachment A: Ciry of St. Pau1
PROJECT DESCRIPTION
City (CLG):
Federal Grant No:
Grant Time Period:
City of St. Paul
�Ij6('�y7L�1I1F3
July 1, 2001 to July 31, 2002
Federal Grant No: 27-01
Work Summary: T'he purpose of this project is to create and install signage that will identify St. Paul's
five local Heritage Preservation Dishicts. The project will be accomplished under the supervision of
personnel meeting the Secretary of the Interior's Professional Qualificarions Standazds.
Consultations and Progress Reports:
1. The CITY will infozm the SOCIETY'S C,rants Office of the name and qualifications of the
historian, azchitectural historian, or historical architect with whom it has contracted within fifteen
15 da s of the contract's execution. The CITY will at the same rime provide a copy of the
contract and a complete report on the procurement process demonstrating compliance with Federal
comperifive procurement requirements. (See II. ASSURANCES, item B, CLG Agreement, and
Part VI of 2001 CLG Grants Manual.)
.
2. The CITY will submit a brief Monthly Progress Report (See 2001 CLG Grants Manual -
Attachment F.) to the SOCIETY'S Grants Office by the 15�' of each month for the duration of the
project period. Product submittals will accompany the monthly reports as specified below.
3.
�
5.
�
By November, 2001, the CITY will submit a draft of the sign designs to the SOCIETY'S Grazits
Office.
By January, 2002, the CITY will submit a list of the number and location of the signs to the
SOCIETY'S Grants Office.
By Mazch, 2002, the CITI' will submit the final designs and locations of the signs to the
SOCIETX'S Cmnts Office.
The SOCIETY may request other written progress reports and on-site reviews of pro}ect progress,
as necessary.
Final Products The Final Products to be submitted with the Request for Reunbursement (see Part III of
the CLG Agreement) and the Project D'uector's Report will be three copies of each of the final camera-
v �-�� o
Attachment A: City of St. Pau1
Federal Grznt No: 27-01-16423.008
ready versions of each sign prototype, a map of sign locarions, and a representative sample of photo`graphs
of the installed signs.
Project D'uector's Repozt: The report will include a brief description of the administration of the project.
Two copies of this report will be submitted to the SOCIETY'S Grants Office with the Final Products and
the Request for Reimbursement Form (see Part III of the Grant Agreement).
Yroject Sudget:
BUDGBTITEMS
Sign Fabricator
($50/sign X 95 signs)
($40/sign X 35 signs)
Sign Hazdware
($10.50 x 95)
($16 X 35)
Sign Tnstallation
(lOb/hr X 36 hours)
Project management
($21.63/hr X 85 hours)
GRANT
$6150
RECIPIENT MATCH
Cash � In-Kind � Other
$1557.50
$360D
$1838.55
TOTAL
$6150
$1557.50
$3600
$1838.55
Reimbursement Schedule The CITY will be reimbursed, in total amount not to exceed $8,950, for the
actual amounts expended under the federal (HPF) portion of the budget. The CIT'Y must submit a Request
for Reimbursement Form along with appropriate fiscal documentation, Final Products, and Project
Director's Report to the SOCIE'TY'S Grants Office no later than August 15, 2002. All pro}ect work must
be completed no later than July 31, 2002.
Minnesota Historical Society
Grants Office
Request far Reimbursement for Federal HPF Grants
Project:
City:
Address:
Proiect Expenditure Classification:
(use budget items from Attachment A of the
Grant Agreement)
.
�����
Federal Grant Number:
MHS Contract Number:
Federal Grant Amount:
Total Expenditures
Federal
Ot-t'�
Attachment B
Applicant Match
Supporting documentation for all costs claimed in this request must be attached. Each supporting document
should be labeled with the appropriate Project Expenditure Classification.
I certify that this request for Reimbursement represents actual project expenditures carried out within the
period of the project.
Date:
Signature:
Print name
and tide:
Telephone:
01-9'lr�
Attachment C
SUPPLEMENTAL INFORMATION ON ALLOWABLE COSTS
All costs for this project must be in conformance with OMB Circulaz A-87 and A-102 (revised)
and the National Register Programs Guidelines 13PS-49. The following points provide
supplementary guidance and emphasis for areas where quesrions or problems may arise.
1. The project budget is divided into those costs to be reimbursed by Historic Preservation
Funds (HPF federal dollazs) and those costs which are covered by the City (applicant
match). All costs--both HPF federal dollars and the applicant match--must be adequately
documented on a Request for Reimbursement Form. The applicant match portion must
total, at a minimum, an amount equal to the federal portion.
2. All costs must be in payment of an obligation incurred during the grant time period.
3. All costs must represent expenditures which aze necessary for the accomplishment of
approved grant objectives.
4. Transferred federal monies cannot be applied as matching applicant shaze; monies used
as match on other federal grants may not be used as matcYung share on this project.
5. Specific cost categories:
A. Personnel
(1) Proiect Specific Personnel aze hired as regulaz employees specifically for
the grant project. Eligible costs may include salary expenses as well as
other project related expenses incurred for the benefit of the project
specific personnel. T`hese costs may be charged to the federal portion
and/or to the applicant portion of the proj ect budget. Costs included on a
Request for Reimbursement Form must be supported with copies of time
sheets showing the employee's name, dates and hours worked, dollar
amount, description of work performed, employee's signature, and the
signature of the employee's supervisor. Either the City's time sheets with
the above information or MHS rime sheets (see Attachment D) are
- acceptable.
o�- 410
(2) In-Kind Services (force account personnel) aze regulaz employees of the
City who spend all or part of their time on the grant project. Eligible costs
include the actual salary of the employee including fringe benefits. (The
employee must be working in the same skill for which he/she is normally
paid, otherwise, only minimum wage can be used.) These costs may be
charged to the federal portion and/or to the applicant portion of the project
budget. Costs included on a Request for ReimbursemenCFonn must be
supported with copies of rime sheets containing information described
under S.A.(1) above as well as documentation supporting the claimed
wage rate(s).
(3) Donated Services (volunteer personnel) contribute time to the grant
project. I£ a volunteer is performing tasks within hisiher normal trade or
profession, the value of the contribution is based on the volunteer's normal
rate of pay or the rates listed below. (The Society will furnish rates for
other areas upon request.) Benefits are not eligible. If the volunteer is
performing tasks outside of hislher profession, only minimum wage rate
can be used. These contributions may be utilized only for the applicant
portion of the budget. Costs included on a Request for Reimbursement
Fozm must be supported by time sheets with information described
under S.A.(1) above.
Rates for Volunteer Personnel
Appraiser
Archaeologist
Architect
Attomey
Bookkeeper/accountant
Crraphic Arts Specialist
Historian
Librarian
Management Specialist
Planner
Photographer
Researcher
Secretary
Word Processing Operatoz
Writer/editor
MINIMUM WAGE RATE
$1437 per hour
$14.82 per hour
$15.62 per hour
$24.62 per how
$ 8.60 per hour
$14.00 per hour
� 17.06 per hour
$20.26 per hour
$14.21 per hour
$15.75 per hour
$ 9.40 per hour
$12.93 perhour
$ 9.38 per hour
$ 8.69 ger hour
$17.04 per hour
$ 5.15 per hour
2
O�- 9'1C
B. Contractual Services are services necessary for the completion of the project
which are contracted by the City. The City must follow the requirements of OMS
Circulaz A-102 (revised) regazding procurement standards in arranging for such
services. Eligible costs may include the rates actually paid to the contractor.
T'hese costs may be charged to the state portion and/or to the applicant poztion of
the project budget. Costs included on a Request for I2eimbursement Form must
be supported by copies of invoices and copies of canceled checks.
C. Supplies and Materials
(1) Donated supplies and materials aze those taken out of City stock or
donated by third parties. The cost of these supplies and/or materials may
be charged only to the applicant portion of the budget. Costs included on
a Request for Reimbursement Form must be supported by a Value of
Donated Supplies and Materials Form {see Attachment E) wiuch must
include a description of the materials and/or supplies, date of donation, fair
market value, basis for the valuation (i.e., invoice price, price in retail
outlet, etc.), and signature of verifying o�cial.
(2) Purchased supplies and materials are those items bought specifically for
the project. The City must follow the requirements of OMB Circular A-
102 revised) in the purchase of supplies and materials. The cost of these
supplies and/or materials may be charged to the federal portion and/or to
the applicant portion of the budget. Costs included on a Request for
Reimbursement Form must be supported by copies of invoices and copies
of cancelled checks.
D. Indirect Costs may be chazged to the project only if the City has a current rate that
has been approved by the City's cognizant federal agency and is currently in
effect. These costs may be charged onl to the appiicant portion of the budget.
Those costs must be included on page four of the City's CLG grant applicarion.
E. Mileage Costs may be charged to the project for necessary costs incurred
excluding costs ofmileage from place of residence of project personnel to the
project site. Mileage paid for by the City may be chazged to the federal portion
and/or to the applicant portion of the budget; donated mileage may be charged
only to the applicant portion. Costs included on a Request for Reimbursement
Form must be supported with the following information: project personnel
name, date of travel, purpose of travel, beginning and ending mileage, and rate
claimed. Maximuzn rate allowable is $.31 per mile.
oi-��to
Minnesota Historical Society
Value of In-Kincj and/or ponated Services
Time Sheets
City and Project Name
Name of Person Contributing Services
Hourly Rate — Based on:
Attachment D
Federal Grant Number
of Worked Performed
(research, planning, secretarial, etc.)
Volunteer personnel donating hisfher time to a project may be credited with an agreed rate (See
Attachment C of Grant Agreement) unless he/she is professionally skilled in the work he/she is
performing on the project. When this is the case, the wage rate the individual is normally paid for
performing his/her service may be credited to the project. If a higher rate than the published volunteer
rate is used, additional documentation and verification is required. Please consult with the Grants
Office before claiming the higher rate.
Si�ature of Person Donating Time
Date
Supervisor Verifying Accuracy Date
o�-g10
Attachment E
Minnesota Historical Society
Value of Donated Supplies and Materials
City and Project Name
Name and Address of Donor
Federal Grant Number
Description of Supplies and Donation
Material Donated Date Fair Value Basis of Value
Total Value of Donation
Supervisor Verifying Accuracy Date
4 �- �t1 O
AtEachment F
MINNESOTA HtSTORICAL SOCIETY
STATE HISTORIG PRESERVATION OFFICE �
Monthly Progress Reporf Form — CLG Grants-
Grantee:
Report for the Month of:
Federal Project No.
Contact: Daytime Telephone:
i. Aescribe month's progress toward accomplishing the goals of the project Refer
to "consultations" and "final products" listed in Attachment A.
2. Is the project currently on schedule? If not, please explain why.
3. Describe any sign�cant problems encountered this month which may impede the
successful completion of the project.
4. Is the project on budget? Approximate costs incurred since the previous progress
report (estimate only, including both federal and matching share).
Prepared by: Signature:
Council File # O \ � q �Q
Green Sheet # � 03 aZ$�
Presented By
Refened To
Committee: Date
1 WAEREA5, in Council File No. O1-804, the Council of the City of Saint Paul authorized
2 the Office of License, Inspections, and Environmental Protection (LIEP) to prepare and submit,
3 on behalf of the City's Heritage Preservation Commission, a grant proposal for the purpose of
4 creating and installing signage which would identify each of the City's five historic preservation
5 districts; and
6
10
11
12
13
14
15
16
17
18
19
2Q
21
22
WHEREAS, pursuant to the said authorization, LIEP staff applied for and received from
the Minnesota Historical Society a Certified Local Government Grant Agreement for the sum of
Eight Thousand Nine Hundred and Fifty Dollars ($8,950.00) which is to be utilized to for the
signage project; and
WHEREAS, the Minnesota Historical Society's grant agreement contains language
whereby the City will "indemnify and save and hold the Society and the Department of the
Interior harmless from any and al1 claims or causes of action arising from the performance of this
project by the City"; NOW, THEREFORE,
BE IT RESOLVED, that the Council of the City of Saint Pau1 hereby authorizes the
appropriate City offic3als to enter into the Certified Local Government Grant Agreement with the
Minnesota Historical Society with the said indemnification clause noted above and contained
therein at p. 3, ¶. D of the Grant Agreement.
Requested by Department of:
Adoption Certified by Council Secretary
� ,
_ • _ � i% • /�
I
%►�� iA�'� %�
M1
By:
Form Approved by City Attorney
By: �� W`✓'M�s^ �' Z y— O�
Appsoved ayor £os S' to Council
By: e��' `-/�
AdopCed by Council: Date L 3 � a�
OFFICE oF LIEP Date: GREEN SHEET
�--.,. ROger C11i'tis September 4, 2001
266-9013 NO 103288 9 �
. 1 HPARTNffiNT DIRSCTOR 4 ITY CODNCIL
� Z ITY ATTORHL'Y ZTY CLER%
x�srw
ust be On COUncil Ag2nd3 by: � wcEx nxxscrox IN_ & IdGT. SVC. DIR.
�
AP Consent 3 �R ��R ASSTSTANT)
„ OTAL # OF SIGNATQRE PAGES 1 (CLIP ALL LOCATIONS FOR SIGNATURS)
CTION REQUESTED:
resolution authorizing the appropriate City officials to enter into a
Certified Local Government Grant Agreement with the Minnesota I-Iistorical
" Society with language stating the City will "indemnify and save and hold the
:, Society and the Department af the Interior harmless from any and all claims or
causes of action arising from the performance of this project by the City."
CON97ENDATIONS; APPR0�1E (A) OR RESSC'T (R) BRSONAL 58R�1SC8 CONTRACTS MDST ANSWSIi T88 FOLLOWING:
PLANNING COMMISSION CIVIL S&RVICE COMMISSL�N 1. Has the pexsOn(firm evet workzd undes a contsact for this department?
CIH COMMITT&S _ SVSINBSS REVIEW COUNCIL YES NO
STAFF _ Has this per5on/firm ever been a City employee?
. DIS7RICT COURT YES NO
3. Does this person/firm possess a skill not normally possessed by any
PORTS WHICH COUNCIL OHJECTFVE? Qxrrent City employee?
YSS ND
� lain all Y85 anawers oa a aeparate aheet and attach.
INITIATING PROBLEM, ISSUE, OPPORTUNITY (Who, What, When, Where, Why):
VANTAGES IF APPROVED:
ISADVANTAGES IF APPROVED:
ISADVANTAGES IF NOT APPROVED:
OTAL AMOUNT OF TRANSACTION $ COST/REVENUE BUDGETED YES NO
FUNDINCr SOURCE ACTIVITY NUMBER
FINANCIAL INFORMATION: (SXPI,AIN)
�t�scM ��rch C���et
S�P � �, ���
�
ORIGINAL
Council File # 4 � ���
Resolution #
Green Sheet # 143�crt
Presented By:
RESOLUTION
C1TY OF SAINT PAUL, MINNESOTA
r�
ai-9?o
Referred To ' " Committee: Date
1
2 WHEREAS, implementafion of a signage program identifying the City's five heritage preservation districts will
3 fiirther the City's heritage preservation policies as adopted in Saint Paul Legislative Code § 73.01; and
4
S WHEREAS, the Minnesota Historical Society's Certified Local Government Grant Program (hereinafter "Progratn"),
6 has grant money available for pubiic educafion and activities and has made "increasing community awareness of the value of
7 Minnesota's historic resources" a priority in its state historic preservation plan; and
8
9 WIIEREAS, the Council of the City of Saint Paul authorized the Office of License, Inspections and Environmental
10 Protection (hereinafter "LIEP) to prepaze and submit, on the behalf of the Heritage Preservation Commission, a grant request
11 to the Program in the amount of $8,950.00 for the purpose of creating and installing signs that identify each of the five
12 historic preservation districts; and
13
14 WF�REAS, the Council of the City of Saint Paul further authorized LIEP tn provide an additional$9,196A5 as a
15 cash and in-kind match; and
16
17 WHEREAS, the Proa am awazded $8,950.00 to LIEP on behalf of the Heritage Preservation Commission to
18 implement a signage program idenrifying the City's five heritage preservation districts; now, therefore, be it
19
20 RESOLVED, that the Council of the City of Saint Paul authorizes LIEP to accept $8,950.00 from the Program on
21 behalf of the Heritage Preservation Commission to 'vnplement a signage program identifying the City's five heritage
22 preservation districts.
23 Current Amended
2� Sudaet Chanae Budo'et
ZS FII3PSICING P T,AM
26 Department of Executive Administration
2� Division - License, Inspections, and
28 Environmental Protection
29
3� GL 320 33351 3400 State Direct Grants in Aid 0 8,950 8,950
31 A11 Other Activity Financi.ng 5.459,671 0 5.489.671
32 5,489,671 8,950 5,498,621
33 SPENDING PLAN �
34
35 Department of Executive Administration
36 Division - License, Inspections, and
3� Environmental Protection
;$
;9 GL 320 33351 0389 Other Misc Supplies 0 4,475 4,475
G� GL 320 33351 0299 Other Misc Services 9,762 4,475 14,237
�1 All Other Activity Spendi.ng 5.479.9Q9 0 5.479.909
1
1
2
3
4
5
6
7
s
9
10
11
12
13
14
15
16
17
18
19
20
21
s,. _
Adopted by Council: Date a
Adoption Certified by Council
By: ^'I1 \.�_� . �._..�- -
Approved by Mayor: Date l� i�%�
By:
5,489,671 8,g50
xequested by Department of:
5,498,621
01-d'o�t
Office of License, Inspections and 0 ����
Enviro en 1 Protec on
By:
L
Form App ved by City Attorney
By: 7'�7i-� �L✓M�^�'� ?-ll-v (
Approve Office o Financial Services:
By: �� ����'�///A�
Approved by Mayor for Submission to
Council
By : 1� i'�/�W "'�
2
�i-`1'?°
,
MINNESOTA HfSTORICAL SOClETY
CERTIFIED LOCAL GO�fERNMENT GRANT AGREEMENT
ACCOUNT NUMBER
0284
FISCAL OBTECT
YEAR CODE
zooi s�zo
FEDERALPROJECT
NUMBER
27-01-16423.008
DOLLAR AMOUNT
$8,950 HPF grnnt funds
$9,296 applicant match
This Agreement is made by and between the Minnesota Historical Society hereinafter called the
Society), and the City of St. Paul (hereinafter called the City), pursuant to authority ganted by the
National Historic Preservation Act of 1966, as amended.
WHEREAS, pursuant to the Act, the Society has been allocated funds by the United States
Department of the Interior for use by Certified Local Governments for qualifying historic
preservation activities; and
WIIEREAS, the City has applied for and been granted Certified I,ocal Govemment Status and has
made application for Certified Local Govemment funds to be utilized in carrying out the pro,}ect
described in Attachment A of this Agreement,
NOW, TF�REFORE, in considerntion of and in reliance upon the mutual covenants and a�eements
contained herein, the parties hereto do covenant and agree, each for themselves and their respective
successors and assi�s, to carry out the project under the following provisions.
I.
�
PROJECT DESCRIPTION
A. The Project Tune Period, Work Summary, Photograph Guidelines (where applicable),
Consultations and Progress Reports, Final Products, Project Airector's Report, Project
Budget, and Reimbursement Schedule are described in the Pzoject Description,
Attachment A, which is attached hereto and made a part hereof.
B. The City agrees the project will be carried out as described in the Project Description,
unless modified pursuant to the provisions of Section V of this contract.
C, The Society will rennburse the City for the budget costs identified as Historic
Preservation Fund ('rIPF) federal dollars in the Pro}ect Description, following
submittal of materials as described in Section III of this Agreement. Final products
which do not conform to the terms and conditions of this Agreement or which do not
meet the applicable Secretary of the Interior's Standazds will not be reimbursed.
ASSURANCES
A. The City assures that all work carried out on this project will conform to the
Secretary of the Interior's Standards for Archaeology and Historic Preservation (as
published in the Federal Register of September 29, 1983) and that the project
CLG Grant Agreement
personnel meet the Secretary of the Interio�s Professional Qualifications
Standards (as published in the Federal Register of September 29, 1983) as
stipulated in the Project Description.
B. The City assures that this project will be administered and conducted in accordance
with the following:
1. OMB Circulaz A-87 "Cost Principles Applicable to Grants and Contracts with
State and Local Government" and OMB Circulaz A-102 (revised) "Uniform
Requirements for Assistance to State and Local Governments."
2. Department of the Interior regulations 43 CFR Part 12, Subpart C-"Uniform
Administrative Requirements for Grants and Cooperative Agreements to State
and Local Govemments."
01-4'fo
a. In addition to the requirements of these regulations the City will allow a
minimum of two weeks between the date bid solicitations are published and
the date bidders must respond; and allow eighteen calendar days between the
date invitations are mailed to potential bidders and the date bidders must
respond.
3. Public Law 101-517, Title V, Section 511, states: When issuing statements,
press releases, requests for proposals, bid solicitations and other documents
describing projects or programs funded in whole or in part with Federal money,
all grantees receiving Federal funds, including but not limited to State and local
govemments, shall cleazly state (1) the percentage of the total costs of the
program or project wluch will be financed with Federal money, (2) the dollaz
amount of Federal funds for the project or program, and (3) percentage and
dollar amount of the total costs of the project or program that will be fumished
by nongovernmental sources.
4. The "Single Audit Act of 1984."
5. Historic Preservation Fund (I;PF) Grants Manual (previously known as National
Register Programs Guideline NPS-49).
C. T'he City acknowledges that this project is being supported, in part, with funds from
the United States Department of the Interior. As a condition of receiviug such funds,
the City assures compliance with Title VI of the Civil Rights Act of 19b4, Section
504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
The City also agrees as follows:
In the hiring of common or skilled labor for the performance of any work hereunder,
no contractor, material supplier or vendor shall, by reason of race, creed or color,
discriminate against any person or persons who are citizens of the United States, or
resident aliens, who are qualified and available to perform the work to which the
Page 2
CLG Grant Ao eement
employment relates.
01-q'10
No contractor, material supplier or vendor shall, in any manner, discriminate against,
or intimidate, or prevent the employment of any person or persons identified in the
preceding paragraph, or on being hired, prevent, or conspire to prevent, the person or
persons from the performance of work under any contract on account of race, creed
or color.
The violation of this section is a misdemeanor pursuant to Minnesota Statutes.
This Agreement may be canceled or terminated by the Society, and all money due, or
to become due hereunder may be forfeited for a second or any subsequent violation of
the terms of this section.
D. The City will indemnify and save and hold the Society and the Department of the
Interior harmless from any and ali claims or causes of action arising from the
performance of this project by the City.
E. The City agrees to make repayment of grant funds to the Society if terms and
conditions of this Agreement are not followed or costs claimed are subsequently
disallowed.
F. The City, in accordance with provisions of 18 USC 1913 regazding lobbying, assures
that no part of grant budget will be used directly or indirectly or to pay for any
personal service, advertisement, telegam, telephone, letter, printed or written matter,
or other device intended or desia ed to influence in any manner a member of
Congress, to favor or oppose, by vote or otherwise, any legislation or appropriation
by Congress, whether before or after the introduction of any bill or resolution
proposing such legislation or appropriation. This shall not prevent communicating to
members of Congress outhe request of any member or to Congress, through the
proper official channels, requests for legislation or appropriations which they deem
necessary for the efficient conduct of the public business.
G. The City agrees any publications, studies, reports, presentations, films, audio visual
materials, e�ibits, or other material prepared with grant assistance will contain an
acknowledgment of HPF grant funds and nondiscrimination policy as follows: ___
"The activity that is the subject of this (type of publication) has been fmanced (in
parUentirely) with Federal funds from the National Park Service, U. S. Department of
the Interior. However, the contents and opinions do not necessarily reflect the views
or policies of the Department of the Interior, nor does the mention of trade names or
commercial products constitute endorsement or recommendation by the Department
of the Interior.
"This'program receives Federal financial assistance for identification and protection
of historic properties. Under Title VI of the Civil Rights Act of 1964 and Section 504
of the Rehabilitation Act of 1973, the U. S. Department of the Interior prohibits
discrimination on the basis of race, color, national origin, or disability in its federally
Page 3
CLG Grant Agreement
OI-q�o
assisted programs. If you believe you have been discriminated against in any
progam, activity, or facility as described above, or if you desire further information;
please write to: Office for Equal Opportunity, U. S. Department of the Interior,
National Pazk Service, P,O. 37127, Washington, D.C. 20013-7127."
H. The City assures that transferred federal monies will not be applied as part of the
matching (applicant) share, and that monies used as match on other federal grants
will not be used as matching (applicant) share on this project.
I. The City agrees not to contract with any party which is debarred or suspended or is
otherwise excluded from or ineligible for participation in Federal assistance progams
under Executive Order 12549, Debarment and Suspension. Current lists of such
parties are on file in the Society's Grants Office and are available for review by the
City. As a condition of this Agreement, the City shall complete and execute the
attached Certification Regazding Debazment, Suspension, Ineligibility and Voluntary
Exclusion for Lower Tier Covered Transactions (see page 7-9).
III. REIMBURSEMENT PROCEDURES
A. Payments under ttus Agreement will be made on a reimbursable basis according to
the schedule included in the Project Description (see Attachment A). All supporting
fiscal documentation must be submitted prior to reimbursement_
B. A Request for Reimbursement must include the following:
1 Request for Reimbursement Form (see Attachment B).
2. Supporting fiscal documentation for all project costs during the period covered by
the request, including both federally funded items and applicant match items.
(See Attachment C for Information on Allowable Costs.)
3. If project work begins prior to September 30, and the City wishes to claim these
costs, a Request for Reunbursement must be submitted at the end of the federal
fiscal year. Applicant match must be equal to, or may exceed, the federal funds
requested as of September 30 (also see Reimbursement Schedule of Attachment
A).
4. Final Product(s) and the Pro}ect Directoz's Report aze to be submitted with the
Final Request for Reimbursement Form (see Attachtnent A).
C. The Request for Reimbursement Forms should be submitted to Mandy Skypala,
Minnesota Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint
Paul, Minnesota 55102-1906.
D. When both the financial documentation and the product documentation has been
found to be acceptable by the Society, funds will be requested from the Department
Page 4
CLG Grant Agreement
O�- qr10
' of the Interior and will be forwarded to the City when the funds have been received
by the Society_
IV. AUDIT
The City must submit a copy of all audited financial statements completed pursuant to OMB Circulaz
A-128 for all fiscal years which include the project period. These must be submitted to Greg
Oldenkamp, Minnesota Historical Society, Finance Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota SS102-190b, within 120 days of their completion.
V. AMENDMENTS AND CANCELLATION
A. Amendments
1. Any s o�nificant variations from the approved work summary, products, budget,
and performance/reporting milestones described in Attachment A which aze
experienced or anticipated during the course of the project and any significant
problems, delays, or adverse conditions which materially affect planned
performance should be submitted in writing to Mandy Skypala, Minnesota
Historical Society, Grants Office, 345 Kellogg Boulevazd West, Saint Paul,
Minnesota, 55102-1906. The Society will respond in writing, either approving or
not approving the changes, and may amend the contrnct if deemed necessary.
The City is aware that some changes may require approval by the National Park
Service and agrees to submit any necessary changes as early as possible during
the project period. Variations which are not known until the conclusion of the
project may be submitted with the final Request for Reunbursement; however,
the City undersTands that costs may be disallowed if changes are not approved.
2. If any part of the budgeted federal grant funds will not be used, the City must
notify the Society at least sixty (60) days before the project's ending date. Failure
of the City to notify the Society may result in the loss of federal funds to the
state, and may have an adverse effect on future applications for CLG funds by
the City. --- - - -
B. Cancellation. The Society reserves the right of termination for cause on a thirty (30)
day notice should it be determined that the City has failed to materially comply with
the terms and conditions of this Agreement. This Agreement may also be terminated
when both parties agree that the project will not produce beneficial results
commensurate with fiuther expenditure of funds or because of circumstances beyond
• the control of the Society and/or the City. In the event of termination, the City may
be reimbursed for eligible expenses incused prior to termination or by a negotiated
settlement.
Page 5
CLG Grant Agreement
(date)
Once this Agreement is signed, it controls a1l=activities during the pzoject time period. `
IN WITNESS WHEREOF, the parties have caused this A�eement to be duly executed on the date(s)
indicated below intending to be bound thereby.
Minnesota Historical Society
345 Kellogg Boulevard West
Saint Paul, Minnesota 55102
Nina M. Archabal, D'uector
MinnesoYa Historical Society and
State Historic Preservation Officer
City of St. Paul
c/o LIEP
350 St. Peter Street, Suite 300
St. Pau155102-1510
signature (authorized official)
o�-��o
(date)
(print name)
Britta L. Bloomberg (date)
Deputy State Historic Preservation Officer
s
Chris Bonnell
MHS Contract Officer
9
(signahue-City Clerk or City Manager) (date)
(print name)
(date) (signature- HPC Chairperson) (date)
(print name)
Page 6
U.S. Deparfinent of the Interior
o1-q'lo
Certificafions Regarding Debarment, Suspension, and
Other Responsibility"Matters, Drug-Free Workplace '
Requirements and Lobbying
Pecsons sigoing ihis form should refer to the:egulations refeienced Certification Regarding Debarmrnt, Suspeusioq Ineligibility and
below for complete ias4uclions: . Voluntary Exclusion - Lower Yier Coveced Traasaclions -(See
Appendix B of Subpart D of 43 CFR Part 12)
Certification Regarding Debazmen[, Susprnsion, and Otha
Responsibility Mattecs - Primary Covered I'rnnsactions -[The
prospective primary participant fuither agees by submitting llus
proposaL tLat it will includc the ctause titled, "Certification Regarding
Debarment, Suspeasion, IneligibiliTy and Voluntary Exclusion - Lower
Tier Coveced Truuaction," provided by the depaztment or agency
entecing into iLis covered hansaction, without modification, in all
lower tier covered uansactions and in all solicitations for lower [ier
covered trmsactions. See below for language to be used; use this focm
for certification and sign; or use Department of tfie Interior Form 1954
(DI-1954). See Appendix A of Subpart D of 43 CFR 12.
Cer[ifica[ion Regarding Thug-Free Workplace Requirements - AI[emate
I. (Gmntces Other Than Individuals) and Altecnate II. (Gmntees Who
aze Individuals) -(See Appendix C of Subpart D of 43 CFR Part 12)
Sig�ature on this form pmvides for compliance wiih cert�cation
requiremeats under 43 CFR Pazis 12 and 18. TLe ce�tifications shall be
treated as a material representation of fact upon which reliance will be
placed when t6e Depar[ment of the Interior detevnines to award the
covered transaciion, grnut, cooperative agreement or loan.
PART A: Certifica[ion Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions '
CFiECK _ IF THIS CERTIFICAiTON IS FOR A PRIIvIARY COVERED TRANSACTION AND IS APPLICABLE.
(1) "Ihe prospective primary recipient ceitifies to the best of its knowledge and belief, tha[ it and its principals:
(a) Are noi pruently deharred, suspended, proposed for debazment, declared ineligible, or voluntarily excluded from covered transactiovs by any
Federnl depaztment or agency;
(b) Have no[ wiUiln a tiuee-year period preceding ttis proposal bee¢ convic[ed of or had a civil judgnent rendered against them for coaunission of
fiaud or a criminal offense in connection with obtaining, attempting to obtain, or perfosming a pubiic (Federnl, SEate or local) hansaction or con4ac[
under a public tmnsaction; violation of Federal or State antihust staNtes or commission of embezzlement, theft, forgery, bdbery, falsification or
desWCtion of records, making false statements, or receiving stolen property;
(c) Are no[ presenUy indicted for or o[hecwise criminally or civilly cl�arged by a govemmenial entity (Federel, Sta[e or local) with co¢unission of any
of the offenses enumereted in paragraph (lxb) of this cectification; and
(d) Have not wi[Lin a t6ree-year period preceding this application/pmposal 6ad one or more public transac[ions (Federal, State or local) telminated for
cause or defau(t.
(2) Where the pmsputive peimary pazticipan[ is unable to ceRify [o any of the siatemenu in this cer[ificatioq such prospecave participant sttall attach an
explanalion [o this pmposal.
PART B: Certification Regarding Debarment� Suspension, Ineligibility and Volun[ary Exclusion - Lower Tier Transactions
CHECK X IF THIS CERTIFICATION IS FOR A LOWER TIER COVERED TRANSACTION AND IS APPUCAB[.E.
(1) The prospective lower tier paz[icipant certifies, by submission of tFils proposal, that neither it nor its principals is presently debazred, suspended, proposed
for debazment, declared ineligible, or voluntarily excluded from participation in this transaction by any Fedeml department or agency.
(2) Where the prospective lower [ier paRicipant is unable to certify to any of the statements in tlus certifica[ioq such prospective pazticipant shal( attach an
ezptanation to [his proposal.
Page 7
a �-g10
PART C: Certification Regarding Drue-Free Workplace Requirementt
CHECK X IF THIS CERTIFICATION IS FOR AN APPLiCANT WHO IS NOT AN INDNIDUAL
Altemate I. (Grantees Other TLan Individuals) � e
A. The gantee cerufia that it will provide or continue m provide a drvg-free worl�lace by:
(a) Publishing a statement notifying employces ihat the unlawful manufacnse, dismbutioa, dispensing, possession, or use of a controlled substance is
pmhibited in the gantee's workpiace and specifying the actions that will be taken agaiust employees for viotation of such pmltibition;
(b) Establishing an ongoing drug-free awareness progmm to inform employees about—
(1) 'Ihe dangers of dcug abuse in the workplace; �
(2) The gantee's policy of mainiaining a d+ug-free workplace;
(3) Any available drug counseling, rehabilitation, and employee assutance pm$�ams; and
(4) The penalties that may be 'vnposed upon employees for diug abuse violations occu[ring in the workplace;
(c) Making it a requirement that each employee [o be engaged iu the performance of the gmnt be given a copy of the statement requ'ved by parzgaph
� ,
(d) Notifying the employee in tLe siatement required by paza�aph (a) Ihat, as a condition of employmen[ uader the gant, the employee will—
(I) Abide by the terms of the statemenh, and
(2) Notify the employer in wri[ing of his or her convicfion for a violation of a criminal dmg statute occurring in the workplace no tater than Eve
calendar days after such conviction;
(e) Notifying the agency in writing within ten calendaz days after receiving notice under subpazagrnph (d)(2) from an employee or othelwise receiving
acNal notice of sucL wnviction. Employecs of convicted employees must provide notice, including position [iUe, to every gavt offica on whose
gan[ activiry the convicted employee was working, unless the Federal agency hu designated a cenhal point for tfie receipt of such notices. Notice
shall include [he identification number(s) of each affected gmnt; "
(� Taking one of the following actions, within 30 calendaz days of receiving notice under subpaagreph (d)(2), with respect to any emptoyee who is so
convicted—
(i) Taking appropriate personnel action agains[ such employee, up to and including terminetion, consis[ent with Ihe requirements of the
Rehabilita[ion Act of 1973, as amended; or
(2) Requiring such employee to participate satisfacrorily in a dcvg abuse assistance or rehabilitation progam approved for such pueposes by a
Federel, State, or local6ealth, Iaw enforcemen[, or other appropdate agency;
(g) Making a good faith effoR to continue [o maintain a drug-free workplace Uuough implementation of pazagmphs (a), (b), (c), (d), (e), and (�.
B. Eae gantee may inseR in the space provided below the si[e(s) for the perfoimance of work done in connection wi[h the specific gCant:
Place of Pedonnance (SVeet address, city, counTy, siate, zip code)
Check if there aze workplaces on file that aze no[ identified here.
PART D: Certifica[ian Regarding Drug-Free Workplace Requirements
CHECK ff THIS CERTIFICATION IS FOR AN APPLICANT WHO IS AN INDNIDUAL
Altemate II. (Grentees Who Are Individuals) -
(a) The gan[ee certifies that, az a condition of the gant, he or she wiR no[ engage in the unlawful manufacnue, distribution, dispensing, possession, or
use of a controlled substance in conduc[ing any ac[iviry with [he gant; �
(b) If convicted of a crimiaal drug offense resutting from a violation occumng during ihe conduct of any grant activity, he or 5he will report the
conviclioq in wri[ing, within 10 calendaz days of the convictioq to the gant officer or other daig¢ee, unless the Federal ageucy designata a
cen[ml point for We receipt of such noUCes. When notice is made to such a centml point, it shall inciude the identification numbel(s) of each
affected gant. _ _
�
Ol-q'lo
Part E: Certification Regardine Lobbying
Certification for Contracts, Gran2s, Loans, and Cooperative Agreements
CfiECS� _ IF CERTIFICATSON IS FOR TAE AWARD OF ANY OF THE FOLLAWINCs AND
THE AMOLIM EXCEEDS 5100,000: A FEDERAL GRANT OR COOPERATIVE AGREEMENY;
SUBCONTRACT, OR SUBGRANT UIJDER THE GRAM OR COOPERATIVE AGREEMEM.
CHECK _ IF CERTIFICA'IION IS FOR THE AWARD OF A FEDERAL
LAAN EXCEEDING THE AMOLJNT OF 5150,000, OR A SUBGRANT OR
SUBCONTRACT EXCEEDING 3100,000 UNDER 7'HE LOAN.
The undasigned ceRifies, to the best oFhis or her ]mowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, 6y or on 6ehalf of the uadecsip�ed, to any pecson for influencing or attemp[iag to influence
an o$cer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Memba of Coagess in wnnection
with the awarding of any Federa] contmct, We making of any Federnl grnnt, the making of any Federal lo�, the eutering in[o of any coopeative
ageemen[, and the extensioq continua[ion, renewal, amendmec�t, or modification of auy Fedea] contrac[, gant, loau, or cooperative agreement.
(2) If any funds other than Federnl appropriated funds have been paid or will be paid [o any pecson for influencing or attemp[ing to influence an officer or
employee of any agrncy, a Member of Congess, an officer or employee of Congress, or an employee of a Member of Cong`us in connection with [his
Fedemi contract, grant, loan, or cooperarive agreemen[, the undeisigned shall complete and submit Standazd Foim-LLL, "Disclosure Polm to Report
Lobbying," in accordance with its inst�uc[ions.
(3) 'Ihe undersig�ed shall require tLat the language of this ceRification be included in the award documents for all subawards at all tiers (including
subcon4acts, sub�ants, and conhactr under gants, loans, and coopemtive agreements) and that all subrecipients shal] certify accordingly.
This ceitification is a material representation of fact upon which reliance waz placed when t6is t2nsaction was made or entered iuto. Submission of Ihis
ceRification is a prerequisite for making or entering into tivs Ilansaction imposed by Section 1352, title 31, U.S. Code. P.ny pecson who fails to file the
required certificalion sLall be subject [o a civil penalty of no[ less than $10,000 and no[ more fLan $IOQ000 for each such failure.
As the authorized certifying official, [ hereby cer[ify tha[ [he above-specified certifica[ions are We.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
tYPED NAME AND TITLE
i.�:vr�y�.r.�x.�
('ILis consolidated form may be used in place of the DI-1953, D7-1954, DI-1955, DI-1956, and DI-1963 foims.)
Page 9
0\— �''l
Attachment A: Ciry of St. Pau1
PROJECT DESCRIPTION
City (CLG):
Federal Grant No:
Grant Time Period:
City of St. Paul
�Ij6('�y7L�1I1F3
July 1, 2001 to July 31, 2002
Federal Grant No: 27-01
Work Summary: T'he purpose of this project is to create and install signage that will identify St. Paul's
five local Heritage Preservation Dishicts. The project will be accomplished under the supervision of
personnel meeting the Secretary of the Interior's Professional Qualificarions Standazds.
Consultations and Progress Reports:
1. The CITY will infozm the SOCIETY'S C,rants Office of the name and qualifications of the
historian, azchitectural historian, or historical architect with whom it has contracted within fifteen
15 da s of the contract's execution. The CITY will at the same rime provide a copy of the
contract and a complete report on the procurement process demonstrating compliance with Federal
comperifive procurement requirements. (See II. ASSURANCES, item B, CLG Agreement, and
Part VI of 2001 CLG Grants Manual.)
.
2. The CITY will submit a brief Monthly Progress Report (See 2001 CLG Grants Manual -
Attachment F.) to the SOCIETY'S Grants Office by the 15�' of each month for the duration of the
project period. Product submittals will accompany the monthly reports as specified below.
3.
�
5.
�
By November, 2001, the CITY will submit a draft of the sign designs to the SOCIETY'S Grazits
Office.
By January, 2002, the CITY will submit a list of the number and location of the signs to the
SOCIETY'S Grants Office.
By Mazch, 2002, the CITI' will submit the final designs and locations of the signs to the
SOCIETX'S Cmnts Office.
The SOCIETY may request other written progress reports and on-site reviews of pro}ect progress,
as necessary.
Final Products The Final Products to be submitted with the Request for Reunbursement (see Part III of
the CLG Agreement) and the Project D'uector's Report will be three copies of each of the final camera-
v �-�� o
Attachment A: City of St. Pau1
Federal Grznt No: 27-01-16423.008
ready versions of each sign prototype, a map of sign locarions, and a representative sample of photo`graphs
of the installed signs.
Project D'uector's Repozt: The report will include a brief description of the administration of the project.
Two copies of this report will be submitted to the SOCIETY'S Grants Office with the Final Products and
the Request for Reimbursement Form (see Part III of the Grant Agreement).
Yroject Sudget:
BUDGBTITEMS
Sign Fabricator
($50/sign X 95 signs)
($40/sign X 35 signs)
Sign Hazdware
($10.50 x 95)
($16 X 35)
Sign Tnstallation
(lOb/hr X 36 hours)
Project management
($21.63/hr X 85 hours)
GRANT
$6150
RECIPIENT MATCH
Cash � In-Kind � Other
$1557.50
$360D
$1838.55
TOTAL
$6150
$1557.50
$3600
$1838.55
Reimbursement Schedule The CITY will be reimbursed, in total amount not to exceed $8,950, for the
actual amounts expended under the federal (HPF) portion of the budget. The CIT'Y must submit a Request
for Reimbursement Form along with appropriate fiscal documentation, Final Products, and Project
Director's Report to the SOCIE'TY'S Grants Office no later than August 15, 2002. All pro}ect work must
be completed no later than July 31, 2002.
Minnesota Historical Society
Grants Office
Request far Reimbursement for Federal HPF Grants
Project:
City:
Address:
Proiect Expenditure Classification:
(use budget items from Attachment A of the
Grant Agreement)
.
�����
Federal Grant Number:
MHS Contract Number:
Federal Grant Amount:
Total Expenditures
Federal
Ot-t'�
Attachment B
Applicant Match
Supporting documentation for all costs claimed in this request must be attached. Each supporting document
should be labeled with the appropriate Project Expenditure Classification.
I certify that this request for Reimbursement represents actual project expenditures carried out within the
period of the project.
Date:
Signature:
Print name
and tide:
Telephone:
01-9'lr�
Attachment C
SUPPLEMENTAL INFORMATION ON ALLOWABLE COSTS
All costs for this project must be in conformance with OMB Circulaz A-87 and A-102 (revised)
and the National Register Programs Guidelines 13PS-49. The following points provide
supplementary guidance and emphasis for areas where quesrions or problems may arise.
1. The project budget is divided into those costs to be reimbursed by Historic Preservation
Funds (HPF federal dollazs) and those costs which are covered by the City (applicant
match). All costs--both HPF federal dollars and the applicant match--must be adequately
documented on a Request for Reimbursement Form. The applicant match portion must
total, at a minimum, an amount equal to the federal portion.
2. All costs must be in payment of an obligation incurred during the grant time period.
3. All costs must represent expenditures which aze necessary for the accomplishment of
approved grant objectives.
4. Transferred federal monies cannot be applied as matching applicant shaze; monies used
as match on other federal grants may not be used as matcYung share on this project.
5. Specific cost categories:
A. Personnel
(1) Proiect Specific Personnel aze hired as regulaz employees specifically for
the grant project. Eligible costs may include salary expenses as well as
other project related expenses incurred for the benefit of the project
specific personnel. T`hese costs may be charged to the federal portion
and/or to the applicant portion of the proj ect budget. Costs included on a
Request for Reimbursement Form must be supported with copies of time
sheets showing the employee's name, dates and hours worked, dollar
amount, description of work performed, employee's signature, and the
signature of the employee's supervisor. Either the City's time sheets with
the above information or MHS rime sheets (see Attachment D) are
- acceptable.
o�- 410
(2) In-Kind Services (force account personnel) aze regulaz employees of the
City who spend all or part of their time on the grant project. Eligible costs
include the actual salary of the employee including fringe benefits. (The
employee must be working in the same skill for which he/she is normally
paid, otherwise, only minimum wage can be used.) These costs may be
charged to the federal portion and/or to the applicant portion of the project
budget. Costs included on a Request for ReimbursemenCFonn must be
supported with copies of rime sheets containing information described
under S.A.(1) above as well as documentation supporting the claimed
wage rate(s).
(3) Donated Services (volunteer personnel) contribute time to the grant
project. I£ a volunteer is performing tasks within hisiher normal trade or
profession, the value of the contribution is based on the volunteer's normal
rate of pay or the rates listed below. (The Society will furnish rates for
other areas upon request.) Benefits are not eligible. If the volunteer is
performing tasks outside of hislher profession, only minimum wage rate
can be used. These contributions may be utilized only for the applicant
portion of the budget. Costs included on a Request for Reimbursement
Fozm must be supported by time sheets with information described
under S.A.(1) above.
Rates for Volunteer Personnel
Appraiser
Archaeologist
Architect
Attomey
Bookkeeper/accountant
Crraphic Arts Specialist
Historian
Librarian
Management Specialist
Planner
Photographer
Researcher
Secretary
Word Processing Operatoz
Writer/editor
MINIMUM WAGE RATE
$1437 per hour
$14.82 per hour
$15.62 per hour
$24.62 per how
$ 8.60 per hour
$14.00 per hour
� 17.06 per hour
$20.26 per hour
$14.21 per hour
$15.75 per hour
$ 9.40 per hour
$12.93 perhour
$ 9.38 per hour
$ 8.69 ger hour
$17.04 per hour
$ 5.15 per hour
2
O�- 9'1C
B. Contractual Services are services necessary for the completion of the project
which are contracted by the City. The City must follow the requirements of OMS
Circulaz A-102 (revised) regazding procurement standards in arranging for such
services. Eligible costs may include the rates actually paid to the contractor.
T'hese costs may be charged to the state portion and/or to the applicant poztion of
the project budget. Costs included on a Request for I2eimbursement Form must
be supported by copies of invoices and copies of canceled checks.
C. Supplies and Materials
(1) Donated supplies and materials aze those taken out of City stock or
donated by third parties. The cost of these supplies and/or materials may
be charged only to the applicant portion of the budget. Costs included on
a Request for Reimbursement Form must be supported by a Value of
Donated Supplies and Materials Form {see Attachment E) wiuch must
include a description of the materials and/or supplies, date of donation, fair
market value, basis for the valuation (i.e., invoice price, price in retail
outlet, etc.), and signature of verifying o�cial.
(2) Purchased supplies and materials are those items bought specifically for
the project. The City must follow the requirements of OMB Circular A-
102 revised) in the purchase of supplies and materials. The cost of these
supplies and/or materials may be charged to the federal portion and/or to
the applicant portion of the budget. Costs included on a Request for
Reimbursement Form must be supported by copies of invoices and copies
of cancelled checks.
D. Indirect Costs may be chazged to the project only if the City has a current rate that
has been approved by the City's cognizant federal agency and is currently in
effect. These costs may be charged onl to the appiicant portion of the budget.
Those costs must be included on page four of the City's CLG grant applicarion.
E. Mileage Costs may be charged to the project for necessary costs incurred
excluding costs ofmileage from place of residence of project personnel to the
project site. Mileage paid for by the City may be chazged to the federal portion
and/or to the applicant portion of the budget; donated mileage may be charged
only to the applicant portion. Costs included on a Request for Reimbursement
Form must be supported with the following information: project personnel
name, date of travel, purpose of travel, beginning and ending mileage, and rate
claimed. Maximuzn rate allowable is $.31 per mile.
oi-��to
Minnesota Historical Society
Value of In-Kincj and/or ponated Services
Time Sheets
City and Project Name
Name of Person Contributing Services
Hourly Rate — Based on:
Attachment D
Federal Grant Number
of Worked Performed
(research, planning, secretarial, etc.)
Volunteer personnel donating hisfher time to a project may be credited with an agreed rate (See
Attachment C of Grant Agreement) unless he/she is professionally skilled in the work he/she is
performing on the project. When this is the case, the wage rate the individual is normally paid for
performing his/her service may be credited to the project. If a higher rate than the published volunteer
rate is used, additional documentation and verification is required. Please consult with the Grants
Office before claiming the higher rate.
Si�ature of Person Donating Time
Date
Supervisor Verifying Accuracy Date
o�-g10
Attachment E
Minnesota Historical Society
Value of Donated Supplies and Materials
City and Project Name
Name and Address of Donor
Federal Grant Number
Description of Supplies and Donation
Material Donated Date Fair Value Basis of Value
Total Value of Donation
Supervisor Verifying Accuracy Date
4 �- �t1 O
AtEachment F
MINNESOTA HtSTORICAL SOCIETY
STATE HISTORIG PRESERVATION OFFICE �
Monthly Progress Reporf Form — CLG Grants-
Grantee:
Report for the Month of:
Federal Project No.
Contact: Daytime Telephone:
i. Aescribe month's progress toward accomplishing the goals of the project Refer
to "consultations" and "final products" listed in Attachment A.
2. Is the project currently on schedule? If not, please explain why.
3. Describe any sign�cant problems encountered this month which may impede the
successful completion of the project.
4. Is the project on budget? Approximate costs incurred since the previous progress
report (estimate only, including both federal and matching share).
Prepared by: Signature: