06-951Council File #
Green Sheet #
Presented By:
I,
RESOLUTION
OF SAINT PAUL, NIINNESOTA
r��-9s l
3032590
I�
Referred To: Committee:Date:
1 WHEREAS, the City of 5aint Paul, Police Department, has been awarded an Compliance Check grant
2 to monitor and conduct surveillance on liquor establishments within the City of Saint Paul for tLe period
3 of August 15, 2006 through October 15, 2006; and
4
5 BE IT RESOLVED, that the Saint Paul City Council accepts this grant and authorizes the City of
6 Saint Paul to enter into, and Chief John Harrington to implement the attached agreement with the
7 Minnesota Department of Public SafeTy, which includes an indemnificarion clause. A copy of said
8 agreement is to be kept on file and on record in the Office of Financial Services.
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Adopted by Council: Date: /�, //_ ,�?/p�
Adoption CerHfied by
BY� �/�/sir�
Secretary:
�
����
Requested by Department of:
Q \FiscalWO&CR�2006\MNAlcoholGamblingcompliancecheckAug75-Od752006.cr.xls
Approved b ayor far Submission to Council:
By: ����L�--�L-sl
� Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet �
D�-9s 1
PD �
Contact Person & Phone:
Chief,bhn Hamngton
26fr5,�88
Must Be on Council Agenda by (Date):
27-SEP-06
Doc. Type: RESOLUiION VYf9�idS'4e7-
E�Documen}rReqarte'd: - Y -
DocumentContact: CdrToddAxtell
uate mroatea:
07SEP-06 i Green Sheet NO: 3032590
� ! Deparhnent _ SentToPerson In
' 0 •Pdice DepaNnent ___ � PWice Deoarhnent
Assign ' 1 Pa_ce De�ent . Police Depar6vent '
Number ' 2 �FinancialServices ___ __Qvecto�Financ_a1Se_ , _
For - _ - __- ___- _ ._-_ _-__..
Routing � 3 Gity_Atiorney_ ___________._ ._City_Attomey_. ,. _._
_ _ _
Order . 4 3Y1?ro=gOffice ____ _ __ _____ _._.. MaYOr__ •
5 Cwncil. _ _ ____ _ __.C�tyCouncil ._ ___
__'__"'' ____'___"_______'_'__'__.. ._ ",
i 6 ��Clerk '___ _ _' __"_ i____City_Clerk _ ' _ _ __
I 7 IPolice Deparlment � Police DeparLmen[
✓ _
CdnW ct Phone: 26S692i` , ! ! -- --- �- - — -� -� � - - - - -
. . .. .__ _.___._-__—_ - �_ � — _--_ _- __ — _— ___ __._ _ _
ToWI # of Signature Pages �(Clip All Locations for Signature)
Action RequesMd: ,
Signatures requested on the attached council resolution accepting a grant from the Minnesota Department of Public Safety, Alcohol �
and Gambling Enforcement Division, and authorizing the City of Saint Paul, Police Depar[ment, to enter into, and Chief John ;
Harrington to implement the attached agreement. ,
Recommendations� Appro�e (A) or Reject (R). �, Personal Service Conhacts Must Mswer the Following Questions: ,
Planning Commission
q6 Committee
CiNI Se[eice Commission
1. Has this person/firm e�r worked under a contract for this depadment?
Yes No .
2. Has this personlfirtn e�er been a city employee?
Yes No
� i,, 3. Dces this persoNfirtn possess a skill not normally possessed by any �,
'I cuveM city employee� ''�
Yes No
' I� Explain all yes answers on separate sheet and attach to green sheet I
„ - - - . _. ._ . __ ___ - _ ____ -. __ - ___ __ _ ___'____ __.__ .—_. ____'_. —
. .. - --____.__..... _._ _ ____'
� Initiating Problem, Issues, Opportunity (Who, What, When, Where, Why): �
„ The Minnesota Depaztment of Public Safery, Alcohol and Gambling Enforcement Division, has awazded a grant to the Ciry of Samt ,
� , Paul, Police Department, for alternate enforce_ment to monitor and conduct surveillance on liquor establishments within the City of Saiut �
Pau( for the period of Augus[ 15, 2006 through October I5, 2006. I
- - -- --
'AtivantapeslfApproved: " ',
� Ab�l�ty to accept graat funds awarded to reduce underage drinking within the CiTy of Saint Paul. ��,
� - - t - Y �------------ ------''�
� NoneVantaqes HApproved: ` � � Q06 ;
� T �
j t, p w
������� ������ �
"_"' _"_ __ _'_-_ - __ __- ________-__ -- __ ___'_
Disativantaqes If No[Approved:
Lost opportunity to accept grant funds available.
Total Amount of
Transaction:
FundinSi Source:
F ina ncial Information:
(Explain)
5000
MN Dept of Public
Safety
----- �--------------- -���-� - -- ,
CosURevenue 8udgeted: ��
ActivityNumber, i'EP Z � �uu1i ',
a�
��u��;t ��<r �{V� °��,i�s �i�' A�`�������
��`.�..�.�_ ___ ____.____.__.___.__._._____..____ _-.--_
September7, 2006 12:34 PM Page 1
ANNUAL PLAN GRANT CONTRACT
ENCUMBRANCE WORKSHEET
v� -9�"i
ro #:
State Accountina tniormanon:
Agency: P07 Fiscal Year: 2Q07
Total Amount of Contract: $5,000.00
object Code: SBOO Object Code:
1 nmauns: ec nnn nn nmoont
Distrfbntion i:
Fund: 30d
Appr: 91�
m�sub: 911s
Rept Catg: 9l 1 �
Amount Q� nnn
Fund:
Appr:
OrglSub:
Rept Catg:
Amawt
Contract Start Date: Augustl5, 2005
Expirarion Date: October I5, 2006
Contractor Name and Address:
Cit�of Saint Pani
Saint Panl Police Department
367 Gmve Street
St. Paui. MN 55101
Soc. Sec. or Federal Employer I.D. No. 416005521
Minnesota Tax I.D. No. (if app2icable) 8025095
Vendor Number: 200417118-00
ObjectCode:
Amaunt:
2:
Fund:
pppr:
6rg/Su6:
Rept Catg=
Amount:
3:
Object Codes:
SA00 Caunties
SB60 Cities
SC00 School Distcicts
SI300 Aigher Education
SEOfl Other Government
SF00 Inter-Agency
SG00 Non-government
SH00 Individual
This Page Contains Private Data
Do Not CirculaYe
DO NOT REPRODUCE
OR DISTRIBUTE EXTERNALLY WITHOUT EXPRESS
WRITTEN PERMI5SION OF THE CONTRACTOR.
�jev. 64l06
II
Annual Plan Grant Conhact No.
STATE OF MINNESOTA �(Q 'G� I
ANIVIJAL PLAN GRANT CONTRACT
This grant contract is between the State of Minnesota, acting through its Commissioner of Public Safetv Alcohol &
Gambline Enforcement Division 444 Cedar Street Suite 133 Town Square, St. Paul MN 55101-5133 ("State") and C�
of Saint Paul Saint Paul Palice De artment 367 Crrove Slreet St. Paul MN 55101 (('mantee ).
Recitals
1 Under Minn. Stat. § 299A.01, Subd 2(41 the State is empowered to enter into this grant contract.
2 Federal Funds for this grant contract are provided under the Office of Juvenile Jusfice and Delmquency Prevention,
Office of Jusrice Programs, Department of Justice to enforce underage drinldng laws by prohibiting the sale or
consumption of alcoholic beverages by minors.
3 The State is in need of a compliance checks progam by local law enforcement of liquor establishments within thair
jurisdiction.
4 The Grantee represents that it is duly qualified and agrees to perform all services described in this grant conh'act to the
sarisfaction of the State.
Grant Contract
1 Term of Grant Contract
1.1 Effecrive date: August 15 2006, or the date the State obtains all required signatures under Minnesota Statutes
Section 16C.05, subdivision 2, whichever is later. Once this grant contract is fully executed, the Grantee may
claim reimbursement for expenditures incuxred pursuant to Clause 42 of this grant contract. Reimbursements will
only be made for those expenditures made according to the terms of this grant contract.
12 Expiration date: October 15, 2006, or unril all obligations have been sarisfactorily fulfilled, whichever occurs
first.
13 Survival of Terms. The following clauses survive the expiration or cancellation of this grant contract: 8. Liability;
9. State Audits; 10. Government Data Practices; 12. Publicity and Endorsement; 13. Goveming Law, Jurisdicrion,
and Venue; and 15. Data Disclosure.
Grantee's Duties
The Cnantee, who is not a state employee, will:
2.1 Conduct independent compliance checks at licensed liquor establishments within their jurisdicrions as specified in
Attachment A, which is attached and incorporated into this grant coniract.
2.2 Report findings back to the State using the State approved reporting form.
23 Report all licensed liquor establishments failing compliance check to local liquor license issuer to impose penalty
pursuant to Minn. Stat. § 340A.415.
3 Time
The Grantee must comply with all the rime requirements described in this grant contract. In the performance of this
grant contract, rime is of the essence.
4 Consideration and Payment
4.1 Considerafion. The State will pay for all services performed by the Grantee under this grant coniract as follows:
(1) Compensafion. The Grantee will be paid an amount not to exceed $5,000.00 based on the following
method of payment: $30 00 �er comnleted compliance check.
(2) Total Obligation. The total obligarion of the State for all compensarion and reimbursements to the Crrantee
under this grant contract will not exceed $5.000.00. Five Thousand Dollars and no 100 dollars.
FY07 AP Compliance Check 04/06
6 (� - t�
Annual Plan Grant Contract No.
4.2 Payment
(1) Invoices. The State will prompfly pay the Grantee after the Grantee presents an itemized invoice for e
services actually performed and the State's Authorized Representative accepts die invoiced services.
Invoices must be submitted timely and according to the following schedule:
Itemized invoice and report must be filed together, in arrears, and within 3� daYs of the period covered by
the invoice for work sarisfactorily performed using the form titled "Underage Drinking Compliance Check
Invoice for Payment Form" provided by the State and attached to this �ant contract. Final invoice and
r ort must be received b the State no later than November 15 2006.
(2) Federal funds. (Where applicable, if blank this secrion does not apply) Payments under this grant contract
will be made from federal funds obtained by the State through Title Juvenile Justice & Delinauencv
Prevenrion CFDA number 16.727 of the Denarhnent of Jusrice Act of 1974 Sec. 261 262 Public law 93-415
and amendments thereto. The Grantee is responsible for compliance with all federal requirements imposed
on these funds and accepu full financial responsibility for any requirements imposed by the Grantee's failure
to comply with federal requirements.
Conditions of Payment
All services provided by the Grantee under this grant contract must be performed to the State's sarisfaction, as
determined at the sole discretion of the State's Authorized Representative and in accordance with all applicable
federal, state, and local laws, ordinances, rules, and regularions. The Cttautee will not receive payment for work
found by the State to be unsatisfactory or performed in violation of federal, state, or local law.
6 Authorized Representative
The State's Authorized Representative is Mariene Kielsber� Sunervisor 444 Cedar Sh'eet Suite 133 Town 5auare,
St. Paul N1N 55101-5133 651 201-7503, or her successor, and has the respons�bihty to momtor the Grantee s
performance and the authority to accept the services provided under this grant coniract. If the services are
sarisfactory, the State's Authorized Representative will certify acceptance on each invoice submitted for payment.
The Grantee's Authorized Representative is Chief John Harrineton 367 Grove Street St Paul MN 55101 (6511
291-1 ll L If the Grantee's Authorized Representative changes at any time dunng this grant contract, the Grantee
must immediately norify the State.
Assignment, Amendments, Waiver, and Grant Contract Complete
71 AssignmenG The Grantee may neither assign nor transfer any rights or obligations under this grant contract
without the prior consent of the State and a fully executed Assignment Agreement, executed and approvedby
the same parties who executed and approved this grant contract, or their successors in office.
7.2 Amendments. Any amendment to this grant contract must be in wriring and will not be effecfive until it has
been executed and approved by the same parties who executed and approved the original grant coniract, or
their successors in office.
73 Waiver. If the State fails to enforce any provision of this grant contract, that failure does not waive the
provision or its right to enforce it.
7.4 Grant Contract Complete. This grant contract contains all negotiations and agreements between the State and
the Cttantee. No other understanding regazding this grant contract, whether written or oral, may be used to
bind either party
Liability
The Grantee must indemnify, save, and hold the State, its agents, and employees harmless from any claims or
causes of acrion, including attorney's fees incurred by the State, arising from the performance of this grant contract
by the Grantee or the Grantee's agents or employees. This clause will not be construed to bar any legal remedies
the Grantee may have for the State's failure to fulfill its obligarions under this grant conisact.
FY07 AP Compliance Check 04/O6
�(� � 951
Annual Plan Grant Con�act No. _
State Audits
Under Minn• Stat. § 16C.05, subd. 5, the Grantee's books, records, documents, and accounting procedures an
practices relevant to this grant conhzct aze subject to exaznination by the State andlor the State Auditor or
Legislarive Auditor, as appropriate, for a minimum of six years from the end of this grant contract.
Cttantee will also comply with all federal audit requirements specified in Attachment B, which is attached and
incorporated into this grant contract.
10 Government Data Practices
The Grantee and State must comply with the Minnesota Government Data Practices Act, Minn. Stat. Ch. 13, as it
applies to all data provided by the State under this grant contract, and as it applies to all data created, collected,
received, stored, used, maintained, or disseminated by the Grantee under this grant contract. The civil remedies of
Minn. Stat. § 13.08 apply to the release of the data referred to in this clause by either the Grantee or the State.
If the Crrantee receives a request to release the data referred to in this Clause, the Cnantee must immediately notify
the State. The State will give the Grantee instrucrions conceming the release of the data to the requesring party
before the data is released.
11 Workers' Compensation
The Grantee certifies that it is in compliance with Minn. Stat. § 176.181, subd. 2, pertaining to workers'
compensation insurance coverage. The Crrantee's employees and agents will not be considered State employees.
Any claims that may arise under the Minnesota Workers' Compensation Act on behalf of these employees and any
claims made by any third parry as a consequence of any act or omission on the part of these employees are in no
way the State's obligation or responsibility.
12 Publicity and Endorsement
12.1 Publicity. Any publicity regarding the subject matter of this grant contract must idenrify the State as the
sponsoring agency and must not be released without prior written approval from the State's Authorized
Representarive. For purposes of this provision, publicity includes notices, informational pamphlets, press
releases, research, reports, signs, and similaz public notices prepared by or for the Crrantee individually or
joinfly with others, or any subcontractors, with respect to the program> publications, or services provided
resulting from this grant contract.
12.2 Endorsement. The Grantee must not claim that the State endorses its products or services.
13 Governing Law, Jurisdiction, and Venue
Minnesota law, without regard to its choice-of-law provisions, governs this grant confract. Venue for all legal
proceedings out of this grant contract, or its breach, must be in the appropriate state or federal court with competent
jurisdiction in Ramsey County, Minnesota.
14 Termination
14.1 Termination by the Statz The State may cancel this grant contract at any rime, with or without cause, upon
30 days' written notice to the Grantee. Upon termination, the Grantee will be entitled to payment, determined
on a pro rata basis, for services sarisfactorily performed.
14.2 Termination for Insuffzcient Funding. The State may immediately temunate this grant contract if it does
not obtain funding from the Minnesota Legislature, or other funding source; or if funding cannot be continued
at a level sufficient to allow for the payment of the services covered here. Tzrmination must be by written or
faac notice to the Grantee. The State is not obligated to pay for any services that are provided after norice and
effecrive date of texmination. However, the Grantee will be entitled to payment, determined on a pro rata basis,
for services sarisfactorily performed to the extent that funds are available. The State will not be assessed any
FY07 AP Compliance Check 04/O6
or�-�si
Annual Plan Grant Contcact No.
penalty if the grant contract is temiinated because of the decision of the Minnesota Legislature, or other
funding source, not to appropriate fimds. "I'he State must provide the Grantee notice of the lack of funding
within a reasonable time of the State receiving that norice.
15 Data Disclosure
Under Minn. Stat. § 270C.65, and other applicable law, the Crrantee consents to disclosure of its social security
number, federal employer tax identification number, and/or Minnesota tac identification number, akeady provided
to the State, to federal and state taac agencies and state personnel involved in the payment of state obligarions.
These identificarion numbers may be used in the enforcement of federal and state taac laws which could result in
acrion requiring the Grantee to file state tac retums and pay delinquent state t� liabilities, if any, or pay other state
liabiliries.
1. ENCUMBRANCE VERIFICATION
Individua[ cut fes that funds Aave been encumbued as
reguired by Minn. Stat. §§ 16A.75 and 16C.05.
Signed: � ]_�-�'���
Date: 1 �d
Annual Plan Grant Contract No. — ll � v� �
3. STATE AGENCY
By:
(with delegated authority)
Title: _
Date:
2. GRANTEE
The Graniee certifier (hat the appropriaee person(s)
have executed !he grant corstract on 6ehalf of the Gran[ee ar
required by applicab u, , resolutions, or ordinances.
�
!�
C'i,ty Attorney
Title:
Date:
By:
Tit
Dat
B
T�t
Dat
FY07 AP Compliance Check 04/06
Dismbution:
DPS/FAS
Grantee
Shete's Authorized Representative
0�-9��
Alternate Enforcement Application
Grant Year # 8
DATE: May 3 ,2006
Attachment °A"
D2paTtTrierit N2Tri0: Saint Paul Police Department
�s�;
39b .�'s'^�°�
Department Address: 36� c�o�e st�eet , St. Paul , Minnesota 55101
Department Phone Number: 6s� 29�-1 � � i
Chief Law Enforcement Officer Name: chief Jon� x�in�ton
Grant Funding Coordinator Name: s�t. cr�ig Gromek
Grant Coordinator Phone Number: 6s� 26s- 693s
Federal Employer ID
# 416005521
ID #008025095
MN Tax
Anticipated date(s) when Alternate Enforcement activities
will be conducted:
l.) June 1, 2006
2.) August 6, 2006
�f� �ysl
3.) September 2,2006
Describe type of Alternate Enforcement Planned: Use
under age decoys to go into bars, liquor stores and
restaurants near our colleges , and conduct compliance
checks. Bars and liquor establishments in these areas
number over one hundred and fifty.
Number of Officers needed for each Activity: _two officers
and two under age people.
Number of Hours for each Activity: Each date that a
compliance check is done. Two under age people will be
used . Two police off'icers will be needed. Each detail will
be six hours long. Approx. 201ocations will be checked.
We will need five different dates to complete these checks.
Twenty four employee hours will be used on each date. A
grand total of 120 hours will be needed to complete the
checks.
Additional information or comments: A second goal of
the Vice Unit will be to target adults who provide alcohol
to minors.
_The City of St. Paul has over five hundred businesses that
hold a liquor license in our city. The Vice Unit conducts
b�,y�1
compliance checks on all establishments in our city. If a
business fails on a compliance check. A follow up check
will be completed on that business within 90 days.
Last ReviewedlModified:
iJItI, http://www.dps.state.mn.us/alcgamb/alcenf/fnd
eturu to Alcohol Enforcement Home Page
eturn to Public Safety Home Page
D(�-q� l
3.)Bee Hive Bar ;(37 E. 3 rd Street
4.)BonSre Woodfire Cooldng ; 850 Grand Ave.
5.) Cab's Pub & Eatery ; 992 Arcade Ave.
b.) Clnb Milton ; 334 Miiton Ave.
7.) Como Golf Course ;1431 Le�ngton Ave.
8.) Dara Thai Resturant ; 769 Milton St. N.
9.) Family Inn ; 561 Edmund Ave.
10.) Fhima;s 6 6 th Street W.
11.) Half Time Rec. 1013 Front St.
12.)La Hacienda Restaurant ; 2467 7 th Street
13.) Lonetti's Lounge 1091 Rice Street
14.) Minnehaha Lanes 955 Seminary Ave.
15.)Mr. C's 429 Robert St.
17.)Rainbow Foods ; 892 Arcade Ave.
18.) Steiner Liquors 137 W. Maryland Ave.
19.)The Spot Bar ; 859 Randolph Ave
20JThe Vintage ; 579 Selby Ave.
List additional names / addresses on a separate page. The City of St. Paul has over 500 Liquor
Licenses issued . The Vice Unit does compliance checks on every establishment , each year.
�e ��� 1��,�� .� d us„�� ���
Page 2
Application for Year #8Program Funds
--�_�
Total Ye1m ursemeIIt amount Yequested: ($30 per round each establishment checked)
^ $3,500.00
0(�-�-r'�7
Explain DepartmentOs Plan for Use of Funds: The Vice Unit will use under age
decoys to go into all licensed liquor establishments in the city to perform a
compliance check. If the business fails the compliance check. St Paul will go back to
this business and do another compliance check within 90 days.
If you have questions regarding specific funding requests, contact: Alcohol &
Gambling EnforcementDivision at (651) 282-52I8, LELO Brian %ringere.
Iast Reviewed/Modified:
URL http://www.dps.state.mn.us/alcgamb/alcenf/fnd-req
eturn to Alcohol Enforcement Home Page
eturn to Public Safety Home Page
D(�
DEPARTMENT OF POLICE
John M. Hacrington, Chief of Police
CITY OF SAINT PAUL
Randy C. Kelly, Mayor
367G>oveStreet Telephone:651-297-/111
St. Paul, Minnesom 55107 Facsimile: 651-266-5717
July 24, 2006
Brian Kringen
Alcohol and Gambiing Enforcement
444 Cedar Street
Suite 133
Saint Paul, MN 55101
Deaz Mr. Kringen,
As you requested, I am enclosing the Saint Paul Police DepartrnenYs 2006 / 2007 Compliance Check list
of businesses.
Sincerely, /
�. �� ��
Officer Heather Grulkowski for Sgt. C. Gromek
Saint Paul Police Department
651 265-6934
pA-ADA-EEO Employer
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Exhibit B, page 1 of 2
FEDERAL AUDR REQUIREMENTS
For subrea 'ents that are state or Iocal ovemments non- rofrt o anrzations or indian fibes
If the grantee expendstota� federal a�nce of $500,000 or more per year, the grardee a9reesto ob�m
either a single audit or a program-specific audit made for the fiscai year in accordance with the terms of
the Single AudR ActAmendmeMs of 1996.
Audits shafl be made annually unless the shate or local govemment has, by January 1,1987, a
cons6tutional or stahrtory �e4uirement for less frequent audiLs. For those govemmenis, the federal
cogn¢aM agency shall permit biennial audiis, covering both years, ifthe govemmentso requesis. ftshali
aiso honor requests for biennial audiis by 8ovemmenis ihat have an administrative poGcy ca�FR9 �� ��
less frequent ttian annual, but onty audits prior to 1987 or administrative policies in place prior to
January 1,1987.
For subrecipients that are institutions of hiaher education or hosaitals
If the grantee expends total direct and indired federai assistance of $500,000 or more per year, the
grantee agrees to obtain a financiai and compliance audit made in accordance with OMB Circular A-110
"Requiremerds for Grenis and Agreementswith Universities, Haspitalsand OfherNonproffi Organ¢ations"
as applicabie. The audit shall cover e'dherthe entire organ'¢ation or ail federal funds ofthe organization.
The audft must determine whether the subreapient spent federal assistance furnis isi accordance wikh
applicable laws and regulations.
2. The audit shall be made by an independent auditor. An independent auditor is a state or local govemmeM
aud"dor or a public accountant who meels the independence standards speafied'm the General AcxouMing
Office`s "Standards for Audit of Govemmemat Organizations, Progrems, Activities, and Functions °
3. Theaud'RreportshallstatethattheauditwasperformedinaccordancewiththeprovisionsofOMBCircular
A 133 (or /�110 as applicable).
The reportir�g requiremeMs for audit reports shali be in accordance with the American Insfihrte ofCertified
Public Accourds' (AICPA) audit guide, "Audits of�State and Locai Govemmental Un"rts," issued in 1986.
The federal govemmeM has approved the use of the audit guide.
in add'fion to the aud'R report, the recipient shall provide comments on the findings and recommendations
in the report, inciuding a plan for corrective action taken or planned and comments on the status of
correcbve aciion taken on prior findings. If cortective action is not necessary, a statement describing the
reason it is not should accompany the audit report.
4. The grantee agrees that the grantor, the Legislative Auditor, the State Auditor, and any independent
auditor designated bythe grantor sha�l have such access to grantee's records and finandal statemeMs as
may be necessary for the grantor ta comply wilh ths Single Audit Act Amendments of 1996 and OMB
CircularA 133.
5. GranYees of federal finanaal assistance from subreapier�ts are also required to comply with 1he Single
Audit Acf and OMB Circular A-133.
6. The Statement of Expenditures form can be �sed for the schedule of federal assistance.
m m�s
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Alcohol and Gambling Enforcement
444 Cedaz Street • Suite 133 • Saint Paul, Minnesota 55101-5133
Phone: 651296.6159 • Fa�c: 651.297.5259 • TTY: 651.282.6555
www.dps.state.mn.us
5tate Statnte / I.,ocal Ordinance
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Verification Form
The Minnesota Department of Public Safety: Alcohol and Gambling Enforcement
Division advises local liquor licensing officials that they must pursue civil penalries
against licensees whose establishments sell alcohol to minors during underage
compliance checks. Civil acrion by either city or county ordina�ice or by application of
M.S340A.415 must be taken by the local licensing authority. By application for
underage grant dollazs and by signing below, each community acl�owledges and accepts
the responsibility for imposing civil penalties against failing licensees_ This form must
be returned alon� with the si�ned contracts to assure eli�ibilitv for ¢rant dollars.
Check fhe one below that applies to your county or cxty:
We will be using MN. Statute 340A.415 as a basis for civil penalty imposed on
licensees who fail.
We wiil be using our city or county ordinance as a basis for civil penalty imposed
on licensees who fail. (Please attach a copv of most current ordinance to this form).
Chief Law Enforcement Officer (Signature)
Print Name of Above Officer
Title of Above Officer
Date
,...,�'..�
Local Licensing Authority Representative (Signature)
Print Name of Above Representative
Title of Above Representative
Date
EQUAL OPPORTUNITY EMPLOYER
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