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HomeMy WebLinkAboutItem 06.cSeptember 20, 2010 GRANT 1: Continuation of Downtown Wayfinding Sign System ($11,500.00) GRANT 2: Continuation of Wayfinding System at East Community and Valley Lake Parks ($4,340.00) Proposed Action Staff recommends adoption of the following motion: Move to approve contract with Dakota County for Active Living Services. Overview Funding through Dakota County for a variety of projects associated with improving opportunities for area residents to engage in increased physical activities was made available. Previously, staff applied for and received funding for wayfinding sign systems for downtown Lakeville and East Community and Valley Lake Parks. Additional funding became available and staff submitted two grant requests; one for additional wayfinding sign systems in downtown Lakeville and one for additional wayfinding sign systems at East Community and Valley Lake Parks. Agreement has been prepared by Dakota County and reviewed and recommended by staff for approval. Primary Issues to Consider • There will be no cost to the City of Lakeville Supporting Information • Active Living Services Grant contract Gera d S. Michaud Parks & Recreation Director APPROVAL OF CONTRACT WITH DAKOTA COUNTY FOR ACTIVE LIVING SERVICES Item No. Financial Impact: $ 15,840.00 Budgeted: Y/N N Source: Dakota County SHIP Grants Related Documents (CIP, ERP, etc.): Notes: 1. GENERAL PROVISIONS. 2. TERM. 3. CONTRACTORS OBLIGATIONS. City of Lakeville- 12402.doc CONTRACT BETWEEN THE COUNTY OF DAKOTA AND CITY OF LAKEVILLE FOR ACTIVE LIVING SERVICES CONTRACT PERIOD: 07/01/2010 - 06/30/2011 DC Contract # o`l o,21- This Contract is made and entered into between the County of Dakota, by and through the Public Health Department, hereinafter "County," and City of Lakeville, 20195 Holyoke Avenue, Lakeville MN 55044, hereinafter "Contractor." WHEREAS, the County requires Active Living services; and WHEREAS, Contractor desires to and is capable of providing the necessary services according to the terms and conditions stated herein; and WHEREAS, the County Board by Resolution #10 -332, authorized the County to enter into a Contract with Contractor for the provision of said services. Now, THEREFORE, in consideration of the mutual promises and agreements contained herein the parties agree as follows: 1.1 Purpose. The purpose of this Contract is to define the rights and obligations of the parties with respect to Active Living services. 1.2 Recitals. The recitals set forth in the whereas clauses above are incorporated by reference as if fully set forth herein. 1.3 Cooperation. The County and Contractor shall cooperate and use their reasonable efforts to ensure the most expeditious implementation of the various provisions of this Contract. The parties agree to, in good faith, undertake resolution of any disputes in an equitable and timely manner. ® The term of this Contract shall be from 07/01/2010 to and including 06/30/2011, unless earlier terminated under the provisions herein or by law. ❑ This Contract shall be in effect from the date of execution by all parties, or from the commencement of services hereunder, whichever is first, and shall continue in effect until all services to be provided by Contractor pursuant to this Contract are satisfactorily completed and final payment is made unless earlier terminated by law or according to the provisions herein. 3.1 General Description. Contractor shall provide the following services generally described as: Active Living Services. 3.2 Conformance to Specifications. Services provided shall be in accordance with the criteria set out in Exhibit 3, "Services and Payment," which is attached and incorporated herein by reference. Page 1 SHIP -G (Rev. 06 -10) Unp.dot 4. PAYMENT. 4.1 Total Cost. The total amount to be paid by the County pursuant to this Contract shall not exceed: ® $15,840. 4.2 Payment Rate. The County shall pay for purchased services: ❑ at the rate of $ per ® as set out in the schedule attached as Exhibit 3. 4.3 Invoices. ® Contractor shall submit an invoice and request for payment in accordance with Exhibit 3, "Services and Payment" and Exhibit 4, "Invoice Form." ® Contractor shall, within , submit an invoice and request for payment on an invoice form acceptable to the County. The invoice shall certify expenditures and itemize (as applicable) 1) the hours of services rendered listed by classification, 2) the date such services were provided, 3) a general description of the services provided, and 4) the dates of the performance period covered by the invoice. 4.4 Payment Procedure. ® The County shall make payment to Contractor within thirty -five (35) days of the date on which the invoice is received and services are accepted by the County. If the invoice is incorrect, defective, or otherwise improper, the County will notify Contractor within ten (10) days of receiving the incorrect invoice. Upon receiving the corrected invoice from Contractor, the County will make payment within thirty -five (35) days. ❑ The County shall pay for purchased services in accordance with Exhibit , 4.5 Late Request for Payments. The County has an absolute right to refuse payment on invoices received or postmarked more than ninety (90) days after the date that invoiced services were performed. 4.6 Payment of Disputed Claims. The County may refuse to pay any claim which is not specifically authorized by this Contract. Payment of a claim shall not preclude the County from questioning the propriety of the claim. In the event that the County withholds payment for failure to provide services or failure to comply with any of the provisions of this Contract, then no interest penalty shall accrue against the County. If an audit is required by the County before an invoice is accepted for payment, then the standard payment period of thirty -five (35) days shall not commence until a completed audit is received by the County. The County reserves the right to offset any overpayment or disallowance of claim by reducing future payments. 4.7 Payment Upon Early Termination. In the event this Contract is terminated before the completion of services, the County shall pay Contractor for services provided in a satisfactory manner up to the effective date of termination, a sum based upon the actual time spent at the rates stated in paragraph 4.2. City of Lakeville- 12402.doc Page 2 SHIP -G (Rev. 06 -10) Unp.dot 5. COMPLIANCE WITH LAWS /STANDARDS. 5.1 General. Contractor shall abide by all Federal, State or local laws, statutes, ordinances, rules and regulations now in effect or hereinafter adopted pertaining to this Contract or to the facilities, programs and staff for which Contractor is responsible. This includes, but is not limited to all Standard Assurances, which are attached as Exhibit 1, "Standard Assurances." In addition to the Standard Assurances, the Contractor is required to meet additional contract requirements that exist in the Master Grant Contract between Dakota County and the Minnesota Department of Health. These requirements are outlined in Exhibit 4, "State Health Improvement Program (SHIP) Minnesota Department of Health (MDH) Master Contract Requirements." 5.2 Licenses. Contractor shall procure and maintain, at its own expense, all applicable licenses and certifications required for the provision of services contemplated by this Contract. Contractor shall provide copies of such licenses or certifications to the County upon request. Contractor shall inform the County of any changes in licenses or certifications within five (5) days of occurrence. 5.3 Violations. Any violation of such laws, statutes, ordinances, rules, or regulations, as well as loss of any applicable license or certification by Contractor shall constitute a material breach of this Contract, and shall entitle the County to terminate this Contract. The effective date of termination will be as stated in the written notice of the termination delivered to Contractor unless Contractor cures the violation prior to the termination date and provides the County with adequate proof that the violation has been cured. 5.4 Federal Financial Participation. In the event that there is a revision of Federal regulations which might make services provided under the terms of this Contract or any portion thereof ineligible for federal financial participation, all parties will review the Contract and renegotiate those items necessary to bring the Contract into compliance with the new Federal regulations. Refusal to renegotiate within seven (7) days of a request to bring the Contract into compliance shall be cause for termination of this Contract as of the date when the Contract is out of compliance for federal financial participation. 5.5 Revision of Laws. In the event that there is a revision of Federal, State or local statutes, rules or other law, which makes performance of the Contract or any portion thereof unlawful, all parties will review the Contract and renegotiate those items necessary to bring the Contract into compliance with the law. Refusal to renegotiate within seven (7) days of a request to bring the Contract into compliance shall be cause for termination of this Contract as of the date when the Contract is out of compliance. 5.6 Minnesota Law to Govern. This Contract shall be governed by and construed in accordance with the substantive and procedural laws of the State of Minnesota, without giving effect to the principles of conflict of laws. All proceedings related to this Contract shall be venued in the State of Minnesota. 6. INDEPENDENT CONTRACTOR STATUS. Contractor is an independent contractor and nothing herein contained shall be construed to create the relationship of employer and employee between County and Contractor. Contractor shall at all times be free to exercise initiative, judgment and discretion as to how to best perform or provide services. Contractor acknowledges and agrees that Contractor is not entitled to receive any of the benefits received by County employees and is not eligible for workers' or unemployment compensation benefits. Contractor also acknowledges and agrees that no withholding or deduction for state or federal income taxes, FICA, FUTA, or otherwise, will be made from the payments due Contractor and that it is Contractor's sole obligation to comply with the applicable provisions of all federal and state tax laws. 7. INDEMNIFICATION. Liable for Own Acts. Each party to this Agreement shall be liable for the acts of their own agents, volunteers or employees and the results thereof to the extent authorized by law and shall not be responsible for the acts of the other party, its agents, volunteers or employees. It is understood and City of Lakeville- 12402.doc Page 3 SHIP -G (Rev. 06 -10) Unp.dot 10. DEFAULT. agreed that the provisions of the Municipal Tort Claims Act, Minn. Stat. Ch. 466, and other applicable laws govern liability arising from the parties' acts or omissions. Each Party warrants that they are able to comply with the aforementioned indemnity requirements through an insurance or self- insurance program and that each has minimum coverage consistent with the liability limits contained in Minn. Stat. Ch. 466. 8. INSURANCE. 8.1 General Terms. In order to protect itself and to protect the County under the indemnity provisions set forth above Contractor shall, at Contractor's expense, procure and maintain policies of insurance covering the term of this Contract, as set forth in Exhibit 2, "Insurance Terms." 8.2 Inability to Obtain Coverage. If Contractor is unable to obtain coverage as required or if coverage is not renewed or is cancelled during the term of this Contract, Contractor shall immediately make good faith efforts to obtain or replace the required insurance coverage through the open market. If such efforts are unsuccessful, Contractor shall immediately apply to the Minnesota Joint Underwriting Association and Marketing Assistance Plan (MJUA) for insurance coverage in the amount of the County's statutory limit on liability certifying that it has been unsuccessful in obtaining the required insurance coverage. If MJUA is unwilling or unable to issue insurance coverage in the type and amount required by this article the coverage which is obtained from MJUA pursuant to this paragraph shall be deemed adequate, unless specifically objected to by Dakota County. 9. SUBCONTRACTING. Parties shall not enter into any subcontract for the performance of the services contemplated under this Contract nor assign any interest in the Contract without prior written consent of all parties and subject to such conditions and provisions as are deemed necessary. The subcontracting or assigning party shall be responsible for the performance of its subcontractors or assignees unless otherwise agreed. Any agreement between the Contractor and any subcontractor shall obligate the subcontractor to comply with the general terms of this Contract. If Contractor utilizes a subcontractor to perform any of its duties under this Contract, the Contractor must require the subcontractor to provide proof of insurance to the County prior to beginning work under this Contract in the coverage and amounts the same as set forth in the Insurance Terms exhibit. Contractor must also require the subcontractor to agree in writing to defend, hold harmless and indemnify the County from any and all liability arising out of the subcontractor's performance of its duties. When a subcontractor is utilized, the Contractor remains responsible for complying with all of the terms of this Contract. Contractor agrees to pay any subcontractor within ten (10) days of the Contractor's receipt of payment from the County for undisputed services provided by the subcontractor. Contractor agrees to pay interest of 11/2 percent per month or any part of a month to the subcontractor on any undisputed amount not paid on time to the subcontractor. The minimum monthly interest penalty payment for an unpaid balance of $100 or more is $10 (Minn. Stat. § 471.425). 10.1 Force Majeure. Neither party shall be liable to the other party for any loss or damage resulting from a delay or failure to perform due to unforeseeable acts or events outside the defaulting party's reasonable control, providing the defaulting party gives notice to the other party as soon as possible. Acts and events may include acts of God, acts of terrorism, war, fire, flood, epidemic, acts of civil or military authority, and natural disasters. 10.2 Inability to Perform. Contractor shall make every reasonable effort to maintain staff, facilities, and equipment to deliver the services to be purchased by the County. Contractor shall immediately notify City of Lakeville- 12402.doc Page 4 SHIP -G (Rev. 06 -10) Unp.dot the County in writing whenever it is unable to, or reasonably believes it is going to be unable to, provide the agreed upon quality and quantity of services. Upon such notification, the County and Contractor shall determine whether such inability requires a modification or cancellation of this Contract. 10.3 Changes in Policies or Staff. The County reserves the right to terminate this Contract on ten (10) days written notice if the County, in its sole discretion, does not approve of significant proposed or actual changes in Contractor's policies or staff. 10.4 Default by Contractor. Unless cured or excused by the Force Majeure provisions in paragraph 10.1 or County default, each of the following shall constitute default on the part of the Contractor: A) The written admission by the Contractor that it is bankrupt; the filing by Contractor of a voluntary petition under the Federal Bankruptcy Act; or the filing of an involuntary petition under the Federal Bankruptcy Act against the Contractor unless dismissed within ninety (90) days. The Notice of Default and cure provisions of this Contract do not apply to this paragraph. B) The making of any arrangement with or for the benefit of Contractor's creditors involving an assignment to a trustee, receiver or similar fiduciary. The Notice of Default and cure provisions of this Contract do not apply to this paragraph. C) Making material misrepresentations either in the attached exhibits and documents or in any other material provision or condition relied upon in the making of this Contract. D) The Contractor persistently disregards laws, ordinances, rules, regulations or orders of any public authority. E) Failure to perform any other material provision of this Contract. 10.5 Default by County. Unless cured or excused by the Force Majeure provisions in paragraph 10.1 or Contractor default, each of the following shall constitute default on the part of the County: A) The persistent or repeated failure or refusal by the County to pay or prevent payment of any uncontested amount to the Contractor within thirty -five (35) days of the date of the billing statement. B) Making material misrepresentations either in the attached exhibits and documents or in any other material provision or condition relied upon in the making of this Contract. C) Failure to perform any other material provision of this Contract. 10.6 Written Notice of Default. Unless a different procedure and /or effective date is provided within the specific article or paragraph of this Contract under which the default, failure or breach occurs, no event shall constitute a default giving rise to the right to terminate unless and until written Notice of Default is given to the defaulting party, specifying the particular event, series of events or failure constituting the default and cure period. 10.7 Cure Period. If the party in default fails to cure the specified circumstances as described by the Notice of Default within ten (10) days, or such additional time as may be specified under the terms of this Contract, then the whole or any part of this Contract may be terminated by written Notice of Termination. 10.8 Withholding of Payment. Notwithstanding any other provision of this Contract the County may, after giving Notice of Default, withhold, without penalty or interest, any payment which becomes due after Notice of Default is given, until the default is excused or cured, or the Contract is terminated. City of Lakeville- 12402.doc Page 5 SHIP -G (Rev. 06 -10) Unp.dot 11. TERMINATION. With or Without Cause. This Contract may be terminated without cause by either party upon thirty (30) days written notice. Either party may terminate this Contract for cause by giving ten (10) days written notice of its intent to terminate to the other party unless the other party cures the default within the ten - day period, except for violations listed in paragraph 5.3, and in that case the termination shall occur on the date provided in the written Notice of Termination. 11.2 Termination by County — Lack of Funding. Notwithstanding any provision of this Contract to the contrary, the County may immediately terminate this Contract if it does not obtain funding from the Minnesota Legislature, Minnesota Agencies or other funding source, or if its funding cannot be continued at a level sufficient to allow payment of the amounts due under this Contract. Written Notice of Termination sent by the County to Contractor by facsimile is sufficient notice under the terms of this Contract. The County is not obligated to pay for any services that are provided after written Notice of Termination for lack of funding. The County will not be assessed any penalty or damages if the Contract is terminated due to lack of funding. 11.3 Written Notice of Termination. Notice of Termination shall be made by certified mail or personal delivery to the authorized agent of the party. Notice is deemed effective upon deposit of written notice in the United States Mail, postage pre -paid and addressed to the party authorized to receive notice as specified in paragraph 14.1, below. 11.4 Duties of Contractor upon Termination. Upon delivery of the Notice of Termination, and except as otherwise provided, Contractor shall: Discontinue performance of this Contract on the date and to the extent specified in the Notice of Termination; Immediately notify all clients who are receiving services pursuant to this Contract; Cancel all orders and subcontracts to the extent that they relate to the performances cancelled by the Notice of Termination; Complete performance of such terms as shall not have been cancelled by the Notice of Termination; Return all County property in their possession within seven (7) days to the extent that it relates to the performance cancelled by the Notice of Termination; Return any unspent funds to Dakota County; and Submit a final invoice for services provided prior to termination, within thirty (30) days of the date of termination. 11.5 Duties of County upon Termination. Upon delivery of the Notice of Termination, and except as otherwise provided, the County: Shall make within thirty (30) days final payment for any services satisfactorily provided up through the date of termination in accordance with the terms of this Contract. Shall not be liable for any services provided after Notice of Termination, except as stated above or as authorized by the County in writing. 11.6 Effect of Termination. Termination of this Contract shall not discharge any liability, responsibility or right of any party which arises from the performance of or failure to adequately perform the terms of this Contract prior to the effective date of termination. Nor shall termination discharge any obligation which City of Lakeville- 12402.doc Page 6 SHIP -G (Rev. 06 -10) Unp.dot by its nature would survive after the date of termination, including by way of illustration only and not limitation, Standard Assurances attached hereto. 12. CONTRACT RIGHTS /REMEDIES. 12.1 Rights Cumulative. All remedies available to either party under the terms of this Contract or by law are cumulative and may be exercised concurrently or separately, and the exercise of any one remedy shall not be deemed an election of such remedy to the exclusion of other remedies. 12.2 Waiver. Waiver of any default shall not be deemed to be a waiver of any subsequent default. Waiver of breach of any provision of this Contract shall not be construed to be modification of the terms of this Contract unless stated to be such in writing and signed by authorized representatives of the County and Contractor. 13. DAMAGES. 13.1 Duty to Mitigate. Both parties shall use their best efforts to mitigate any damages which might be suffered by reason of any event giving rise to a remedy hereunder. Damages for Breach /Set -Off. Notwithstanding any other provision of this Contract to the contrary, upon breach of this Contract by Contractor the County may withhold final payment due Contractor for purposes of set -off until such time as the exact amount of damages due is determined. 14. REPRESENTATIVE. 14.1 Authorized Representative. 14.2 Liaison. The following named persons are designated the authorized representatives of the parties for purposes of this Contract. Notice is deemed effective upon deposit of written notice in the United States mail, postage prepaid and addressed to the party authorized to receive notice as specified below. Notification required to be provided pursuant to this Contract shall be provided to the following named persons and addresses unless otherwise stated in this Contract, or in a modification of this Contract: To COUNTY: Name: Kelly Harder Title: Community Services Director Address: Dakota County Community Services 1 Mendota Rd W, Ste 500 West St. Paul, MN 55118 -4773 Phone Number: 651 - 554 -5742 In addition, notification to the County regarding breach or termination shall be provided to the office of the County Attorney, 1560 Highway 55, Hastings, MN 55033. To assist the parties in the day -to -day performance of this Contract and to develop service, ensure compliance and provide ongoing consultation, a liaison shall be designated by Contractor and the County. The parties shall keep each other continually informed, in writing, of any change in the designated liaison. In addition, the Contractor shall inform the County of any changes to Contractor's City of Lakeville- 12402.doc To CONTRACTOR: Name: Holly Dahl Title: Mayor Address: City of Lakeville 20195 Holyoke Avenue Lakeville MN 55044 Phone Number: (952) 985 -4601 Page 7 SHIP -G (Rev. 06 -10) Unp.dot address, phone number(s), e -mail address(es), and any other contact changes. At the time of execution of this Contract the following persons are the designated liaisons: County Liaison: Therese J Branby Phone number: (651) 554 -5878 Contractor Liaison: Steve Michaud Phone number: (952) 985 -4601 15. CONFLICT OF INTEREST. Contractor agrees that it will neither contract for nor accept employment for the performance of any work or services with any individual, business, partnership, corporation, government, governmental unit, or any other organization that would create a conflict of interest in the performance of its obligations under this Contract. 16. MODIFICATIONS. Any alterations, variations, modifications, or waivers of the provisions of this Contract shall only be valid when they have been reduced to writing and signed by authorized representatives of the County and Contractor. 17. SEVERABILITY. 18. CONFIDENTIALITY. 19. OWNERSHIP OF WORK PRODUCT. City of Lakeville- 12402.doc The provisions of this Contract shall be deemed severable. If any part of this Contract is rendered void, invalid, or unenforceable, such rendering shall not affect the validity and enforceability of the remainder of this Contract unless the part or parts which are void, invalid or otherwise unenforceable shall substantially impair the value of the entire Contract with respect to either party. ❑ Contractor acknowledges that certain private or Confidential Information may be transmitted to Contractor by the County in connection with Contractor's performance of this Contract. For all the purposes hereof, the term "Confidential Information" means all information or material proprietary to the County or designated as private or confidential by the County to which Contractor may obtain knowledge or access through or as a result of Contractor's relationship with the County (including information conceived, originated, discovered or developed in whole or in part by Contractor). Confidential Information includes, but is not limited to, the following types of information and other information of a similar nature (whether or not reduced to writing): computer programs, compilations, data, documentation, and all other information of the County over which the County asserts copyright or intellectual proprietary rights, or which is classified as not public data by the Minnesota Data Practices Act. Contractor shall not, at any time, directly or indirectly reveal, report, publish, duplicate, or otherwise disclose to any third party in any way whatsoever any Confidential Information. Contractor shall receive, maintain, and use the Confidential Information with the strictest confidence; shall use its best efforts to keep the Confidential Information strictly confidential and to prevent inadvertent disclosure thereof; and shall treat the Confidential Information in at least as confidential a manner as Contractor treats its own confidential information; Contractor agrees to implement such procedures as are necessary to assure protection of Confidential Information. ® Ownership of all drawings, reports, and other work products prepared or produced in performance of this Contract shall be transmitted to the County upon completion or termination of the Contract and final payment to the Contractor. Contractor agrees that all right, title, and interest in all copyrightable material which Contractor shall conceive or originate, either individually or jointly with others, and which Page 8 SHIP -G (Rev. 06 -10) Unp.dot arises out of the performance of this Contract, are the property of Dakota County and are by this Contract assigned to Dakota County along with ownership of any and all copyrights in the copyrightable material. The County has unlimited rights to use, duplicate and make derivative works of such work product and materials, with no obligation for an accounting to Contractor. 20. MERGER. 20.1 This Contract is the final expression of the agreement of the parties and the complete and exclusive statement of the terms agreed upon, and shall supersede all prior negotiations, understandings or agreements. There are no representations, warranties, or stipulations, either oral or written, not herein contained. 20.2 Exhibits 1 through and including 5 and Attachments A and B are attached and incorporated herein by reference. Exhibit 1 — Standard Assurances Exhibit 2 — Insurance Terms Exhibit 3 — Services and Payment Exhibit 4 — Invoice Form Exhibit 5 — State Health Improvement Program (SHIP) Minnesota Department of Health (MDH) Master Contract Requirements Attachment A — Release and Consent for Use of Photographs of Adults and Children Attachment B — Model Sub - contract By signing this Contract, the Contractor certifies that none of its owners, directors, officers or principals is closely related to any County employee who has or may appear to have any control over the award, management or evaluation of this Contract. IN WITNESS WHEREOF, the parties hereto have executed this Contract on the date(s) indicated below. Approved by Dakota County Board COUNTY OF DAKOTA Resolution No. 10 -332 Approved as to form: File No. City of Lakeville- 12402.doc bz),AL.4 Assis 'nt County Attorney /Date C), /0 By Kelly Harder Title Community Services Director Date of Signature CONTRACTOR (I represent and warrant that I am authorized by law to execute this Contract and legally bind the Contractor). By Title Date of Signature (Please print name.) Page 9 SHIP -G (Rev. 06 -10) Unp.dot EXHIBIT 1 STANDARD ASSURANCES SA3 /CS Standard -CS Revised: 3/1/10 1. NON - DISCRIMINATION. During the performance of this Contract, the Contractor shall not unlawfully discriminate against any employee or applicant for employment because of race, color, creed, religion, sex, national origin, disability, sexual orientation, age, marital status or public assistance status. The Contractor will take affirmative action to ensure that applicants are employed and that employees are treated during employment without unlawful discrimination because of their race, color, creed, religion, sex, national origin, disability, sexual orientation, age, marital status or public assistance status. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices which set forth the provisions of this nondiscrimination clause. The Contractor will, in all solicitations or advertisements for employees placed by or on behalf of Contractor, state that all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, national origin, disability, sexual orientation, age, marital status, or public assistance status. No funds received under this Contract shall be used to provide religious or sectarian training or services. The Contractor shall comply with any applicable federal or state law regarding non - discrimination. The following list includes, but is not meant to limit, laws which may be applicable: A. The Equal Employment Opportunity Act of 1972, as amended, 42 U.S.C. § 2000e et seq. which prohibits discrimination in employment because of race, color, religion, sex or national origin. B. Executive Order 11246, as amended, which is incorporated herein by reference, and prohibits discrimination by U.S. Government contractors and subcontractors because of race, color, religion, sex or national origin. C. The Rehabilitation Act of 1973, as amended, 29 U.S.C. § 701 et seq. and 45 C.F.R. 84.3 (J) and (K) implementing Sec. 504 of the Act which prohibits discrimination against qualified handicapped persons in the access to or participation in federally- funded services or employment. D. The Age Discrimination in Employment Act of 1967, 29 U.S.C. § 621 et seq. as amended, and Minn. Stat. § 181.81, which generally prohibit discrimination because of age. E. The Equal Pay Act of 1963, as amended, 29 U.S.C. § 206(d), which provides that an employer may not discriminate on the basis of sex by paying employees of different sexes differently for the same work. F. Minn. Stat. Ch. 363A, as amended, which generally prohibits discrimination because of race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, disability, sexual orientation or age. G. Minn. Stat. § 181.59 which prohibits discrimination against any person by reason of race, creed, or color in any state or political subdivision contract for materials, supplies or construction. Violation of this section is a misdemeanor and any second or subsequent violation of these terms may be cause for forfeiture of all sums due under the Contract. H. Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101 through 12213, 47 U.S.C. §§ 225, 611, with regulations at 29 C.F.R. § 1630, which prohibits discrimination against qualified individuals on the basis of a disability in term, condition or privilege of employment. I. Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq. and including 45 CFR Part 80, prohibits recipients of federal financial assistance from discriminating on the basis of national origin which includes not discriminating against those persons with limited English proficiency. 2. DATA PRIVACY. For purposes of this Contract all data created, collected, received, stored, used, maintained, or disseminated by Contractor in the performance of this Contract is subject to the requirements of City of Lakeville- 12402.doc Page 10 SHIP -G (Rev. 06 -10) Unp.dot the Minnesota Government Data Practices Act, Minn. Stat. Ch. 13 and the Minnesota Rules implementing the Act now in force or hereafter adopted as well as the Federal laws on data privacy, and Contractor must comply with those requirements as if it were a governmental entity. The remedies in section 13.08 apply to the Contractor. Contractor does not have a duty to provide access to public data to the public if the public data are available from the governmental agency (County), except as required by the terms of this Contract. All subcontracts shall contain the same or similar data practices compliance requirements. 3. HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT OF 1996. The Contractor agrees to comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (codified in 45 CFR Parts 160, 162, and 164) and the amendments to HIPAA included in the Health Information Technology for Economic and Clinical Health (HITECH) Act of the American Reinvestment and Recovery Act of 2009 (Pub. Law 111 -5), which are applicable to the Contractor's duties under this Contract. In performing its obligations under this Contract, the Contractor agrees to comply with the HIPAA Privacy requirements, the HIPAA Standards for Electronic Transactions, the HIPAA Security requirements, the HIPAA Enforcement Rule, the HIPAA Breach Notification requirements, and any other applicable HIPAA laws, standards and requirements now in effect or hereinafter adopted as they become law, including any future guidance on HIPAA laws, standards or requirements issued by the Secretary of Health and Human Services. 4. RECORDS DISCLOSURE /RETENTION. Contractor's bonds, records, documents, papers, accounting procedures and practices, and other evidences relevant to this Contract are subject to the examination, duplication, transcription and audit by the County and either the Legislative or State Auditor, pursuant to Minn. Stat. § 16C.05, subd. 5. Such evidences are also subject to review by the Comptroller General of the United States, or a duly authorized representative, if federal funds are used for any work under this Contract. The Contractor agrees to maintain such evidences for a period of six (6) years from the date services or payment were last provided or made or longer if any audit in progress requires a longer retention period. 5. WORKER HEALTH, SAFETY AND TRAINING. Contractor shall be solely responsible for the health and safety of its employees in connection with the work performed under this Contract. Contractor shall make arrangements to ensure the health and safety of all subcontractors and other persons who may perform work in connection with this Contract. Contractor shall ensure all personnel of Contractor and subcontractors are properly trained and supervised and, when applicable, duly licensed or certified appropriate to the tasks engaged in under this Contract. Each Contractor shall comply with federal, state and local occupational safety and health standards, regulations and rules promulgated pursuant to the Occupational Health and Safety Act which are applicable to the work to be performed by Contractor. 6. PSYCHOTHERAPISTS. Contractor has and shall continue to comply with the provisions of Minn. Stat. Ch. 148A, as amended, with regard to any currently or formerly employed psychotherapists and /or applicants for psychotherapist positions. 7. EXCLUDED MEDICAL ASSISTANCE PROVIDERS. By signing this contract, Provider certifies that it is not excluded. 42 U.S.C. § 1397 et seq. (subch. XX) of the Social Security Act. 8. CONTRACTOR DEBARMENT, SUSPENSION AND RESPONSIBILITY CERTIFICATION. Federal Regulation 45 CFR 92.35 prohibits the State /Agency from purchasing goods or services with federal money from vendors who have been suspended or debarred by the federal government. Similarly, Minn. Stat. § 16C.03, subd. 2 provides the Commissioner of Administration with the authority to debar and suspend vendors who seek to contract with the State /Agency. Vendors may be suspended or debarred when it is determined, through a duly authorized hearing process, that they have abused the public trust in a serious manner. By Signing This Contract, The Contractor Certifies That It And Its Principals* And Employees: A. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from transacting business by or with any federal, state or local governmental department or agency; and City of Lakeville- 12402.doc Page 11 SHIP -G (Rev. 06 -10) Unp.dot B. Have not within a three (3) year period preceding this Contract: 1) been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain or performing a public (federal, state or local) transaction or contract; 2) violated any federal or state antitrust statutes; or 3) committed embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property; and C. Are not presently indicted or otherwise criminally or civilly charged by a governmental entity for: 1) commission of fraud or a criminal offense in connection with obtaining, attempting to obtain or performing a public (federal, state or local) transaction; 2) violating any federal or state antitrust statutes; or 3) committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property; and D. Are not aware of any information and possess no knowledge that any subcontractor(s) that will perform work pursuant to this Contract are in violation of any of the certifications set forth above; and E. Shall immediately give written notice to the Contracting Officer should Contractor come under investigation for allegations of fraud or a criminal offense in connection with obtaining, or performing a public (federal, state or local government) transaction; violating any federal or state antitrust statutes; or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements or receiving stolen property. *"Principals" for the purposes of this certification means officers; directors; owners; partners; and persons having primary management or supervisory responsibilities within a business entity (e.g. general manger; plant manager; head of a subsidiary, division, or business segment and similar positions). Directions for On Line Access to Excluded Providers To ensure compliance with this regulation, identification of excluded entities and individuals can be found on the Office of Inspector General (OIG) website at htto: / /oic.hhs.gov /fraud/ exclusions /I stofexcluded.html. K/Exh SA3 - Standard -CS City of Lakeville- 12402.doc Page 12 SHIP -G (Rev. 06 -10) Unp.dot INSURANCE TERMS EXHIBIT 2 Contractor agrees to provide and maintain at all times during the term of this Contract such insurance coverages as are indicated herein and to otherwise comply with the provisions that follow. Such policy(ies) of insurance shall apply to the extent of, but not as a limitation upon or in satisfaction of, the Contract indemnity provisions. The provisions of this section shall also apply to all Subcontractors, Sub - subcontractors, and Independent Contractors engaged by Contractor with respect to this Contract, and Contractor shall be entirely responsible for securing the compliance of all such persons or parties with these provisions. APPLICABLE SECTIONS ARE CHECKED 1. Workers Compensation. Workers' Compensation insurance in compliance with all applicable statutes including an All States or Universal Endorsement where applicable. Such policy shall include Employer's Liability coverage in an amount no less than $500,000. If Contractor is not required by Statute to carry Workers' Compensation Insurance, Contractor agrees: (1) to provide County with evidence documenting the specific provision under Minn. Stat. § 176.041 which excludes Contractor from the requirement of obtaining Workers' Compensation Insurance; (2) to provide prior notice to County of any change in Contractor's exemption status under Minn. Stat. § 176.041; and (3) to hold harmless and indemnify County from and against any and all claims and losses brought by Contractor or any subcontractor or other person claiming through Contractor for Workers' Compensation or Employers' Liability benefits for damages arising out of any injury or illness resulting from performance of work under this Contract. If any such change requires Contractor to obtain Workers' Compensation Insurance, Contractor agrees to promptly provide County with evidence of such insurance coverage. 2. General Liability. "Commercial General Liability Insurance" coverage (Insurance Services Office form title), providing coverage on an "occurrence" rather than on a "claims made" basis, which policy shall include, but not be limited to, coverage for Bodily Injury, Property Damage, Personal Injury, Contractual Liability (applying to this Contract), Independent Contractors, "XC &U" and Products - Completed Operations liability (if applicable). Such coverage may be provided under an equivalent policy form (or forms), so long as such equivalent form (or forms) affords coverage which is at least as broad. An Insurance Services Office "Comprehensive General Liability" policy which includes a Broad Form Endorsement GL 0404 (Insurance Services Office designation) shall be considered to be an acceptable equivalent policy form. If Commercial General Liability insurance can only be provided on a claims -made basis, the Contractor agrees to maintain such insurance for at least one (1) year from Contract termination. The retroactive date for the claims made policy must be prior to the start of the contract term. Contractor agrees to maintain at all times during the period of this Contract a total combined general liability policy limit of at least $1,500,000 per occurrence and aggregate, applying to liability for Bodily Injury, Personal Injury, and Property Damage, which total limit may be satisfied by the limit afforded under its Commercial General Liability policy, or equivalent policy, or by such policy in combination with the limits afforded by an Umbrella or Excess Liability policy (or policies); provided, that the coverage afforded under any such Umbrella or Excess Liability policy is at least as broad as that afforded by the underlying Commercial General Liability policy (or equivalent underlying policy). Such Commercial General Liability policy and Umbrella or Excess Liability policy (or policies) may provide aggregate limits for some or all of the coverages afforded thereunder, so long as such aggregate limits have not, as of the beginning of the term or at any time during the term, been reduced to less than the total required limits stated above, and further, that the Umbrella or Excess Liability policy provides coverage from the point that such aggregate limits in the underlying Commercial General Liability policy become reduced or exhausted. An Umbrella or Excess Liability policy which "drops down" to respond immediately over reduced underlying limits, or in place of exhausted underlying limits, but subject to a deductible or "retention" amount, shall be acceptable in this regard so long as such deductible or retention for each occurrence does not exceed the amount shown in the provision below. City of Lakeville- 12402.doc Page 13 SHIP -G (Rev. 06 -10) Unp.dot Contractor's liability insurance coverage may be subject to a deductible, "retention" or "participation" (or other similar provision) requiring the Contractor to remain responsible for a stated amount or percentage of each covered loss; provided, that such deductible, retention or participation amount shall not exceed $25,000 each occurrence. ❑ Such policy(ies) shall name Dakota County, its officers, employees and agents as Additional Insureds thereunder. ❑ Such policy(ies) shall name the Minnesota Department of Human Services, its officers, employees and agents as Additional Insureds thereunder. ❑ 3. Professional Liability. Professional Liability (errors and omissions) insurance with respect to its professional activities to be performed under this Contract. This amount of insurance shall be at least $1,500,000 per occurrence and aggregate (if applicable). Coverage under such policy may be subject to a deductible, not to exceed $25,000 per occurrence. Contractor agrees to maintain such insurance for at least one (1) year from Contract termination. It is understood that such Professional Liability insurance may be provided on a claims -made basis, and, in such case, that changes in insurers or insurance policy forms could result in the impairment of the liability insurance protection intended for Dakota County hereunder. Contractor therefore agrees that it will not seek or voluntarily accept any such change in its Professional Liability insurance coverage if such impairment of Dakota County's protection could result; and further, that it will exercise its rights under any "Extended Reporting Period" ( "tail coverage ") or similar policy option if necessary or appropriate to avoid impairment of Dakota County's protection. Contractor further agrees that it will, throughout the one (1) year period of required coverage, immediately: (a) advise Dakota County of any intended or pending change of any Professional Liability insurers or policy forms, and provide Dakota County with all pertinent information that Dakota County may reasonably request to determine compliance with this section; and (b) immediately advise Dakota County of any claims or threats of claims that might reasonably be expected to reduce the amount of such insurance remaining available for the protection of Dakota County. ❑ 4. Automobile Liability. Business Automobile Liability insurance covering liability for Bodily Injury and Property Damage arising out of the ownership, use, maintenance, or operation of all owned, non -owned and hired automobiles and other motor vehicles utilized by Contractor in connection with its performance under this Contract. Such policy shall provide total liability limits for combined Bodily Injury and /or Property Damage in the amount of at least $1,500,000 per accident, which total limits may be satisfied by the limits afforded under such policy, or by such policy in combination with the limits afforded by an Umbrella or Excess Liability policy(ies); provided, that the coverage afforded under any such Umbrella or Excess Liability policy(ies) shall be at least as broad with respect to such Business Automobile Liability insurance as that afforded by the underlying policy. Unless included within the scope of Contractor's Commercial General Liability policy, such Business Automobile Liability policy shall also include coverage for motor vehicle liability assumed under this contract. ❑ Such policy, and, if applicable, such Umbrella or Excess Liability policy(ies), shall include Dakota County, its officers, employees and agents as Additional Insureds thereunder. ❑ 5. Self Insurance. Dakota County recognizes that the contractor is self insured for general liability, professional liability or automobile liability and maintains excess coverage in order to meet the requirements set for the in this section of the contract. The contractor agrees to provide Dakota County with financial information to assist the County in determining the ability of the contractor to cover self insured losses. • 6. Additional Insurance. Dakota County shall, at any time during the period of the Contract, have the right to require that Contractor secure any additional insurance, or additional feature to existing insurance, as Dakota County may reasonably require for the protection of their interests or those of the public. In such event Contractor shall proceed with due diligence to make every good faith effort to promptly comply with such additional requirement(s). ▪ 7. Evidence of Insurance. Contractor shall promptly provide Dakota County with evidence that the insurance coverage required hereunder is in full force and effect prior to commencement of any work. At least City of Lakeville- 12402.doc Page 14 SHIP -G (Rev. 06 -10) Unp.dot ten (10) days prior to termination of any such coverage, Contractor shall provide Dakota County with evidence that such coverage will be renewed or replaced upon termination with insurance that complies with these provisions. Such evidence of insurance shall be in the form of the Dakota County Certificate of Insurance, or in such other form as Dakota County may reasonably request, and shall contain sufficient information to allow Dakota County to determine whether there is compliance with these provisions. At the request of Dakota County, Contractor shall, in addition to providing such evidence of insurance, promptly furnish Contract Manager with a complete (and if so required, insurer - certified) copy of each insurance policy intended to provide coverage required hereunder. All such policies shall be endorsed to require that the insurer provide at least thirty (30)- day's notice to Dakota County prior to the effective date of policy cancellation, nonrenewal, or material adverse change in coverage terms. On Certificate of Insurance, Contractor's insurance agency shall certify that he /she has Error and Omissions coverage. 8. Insurer: Policies. All policies of insurance required under this paragraph shall be issued by financially responsible insurers licensed to do business in the State of Minnesota, and all such insurers must be acceptable to Dakota County. Such acceptance by Dakota County shall not be unreasonably withheld or delayed. An insurer with a current A.M. Best Company rating of at least A -VII shall be conclusively deemed to be acceptable. In all other instances, Dakota County shall have fifteen (15) business days from the date of receipt of Contractor's evidence of insurance to advise Contractor in writing of any insurer that is not acceptable to Dakota County. If Dakota County does not respond in writing within such fifteen (15) day period, Contractor's insurer(s) shall be deemed to be acceptable to Dakota County. 9. Noncompliance. In the event of the failure of Contractor to maintain such insurance and /or to furnish satisfactory evidence thereof as required herein, Dakota County shall have the right to purchase such insurance on behalf of Contractor, which agrees to provide all necessary and appropriate information therefor and to pay the cost thereof to Dakota County immediately upon presentation of invoice. 10. Loss Information. At the request of Dakota County, Contractor shall promptly furnish loss information concerning all liability claims brought against Contractor (or any other insured under Contractor's required policies), that may affect the amount of liability insurance available for the benefit and protection of Dakota County under this section. Such loss information shall include such specifics and be in such form as Dakota County may reasonably require. ® 11. Release and Waiver. Contractor agrees to rely entirely upon its own property insurance for recovery with respect to any damage, loss or injury to the property interests of Contractor. Contractor hereby releases Dakota County, its officers, employees, agents, and others acting on their behalf, from all claims, and all liability or responsibility to Contractor, and to anyone claiming through or under Contractor, by way of subrogation or otherwise, for any loss of or damage to Contractor's business or property caused by fire or other peril or event, even if such fire or other peril or event was caused in whole or in part by the negligence or other act or omission of Dakota County or other party who is to be released by the terms hereof, or by anyone for whom such party may be responsible. Contractor agrees to effect such revision of any property insurance policy as may be necessary in order to permit the release and waiver of subrogation agreed to herein. Contractor shall, upon the request of Dakota County, promptly provide a Certificate of Insurance, or other form of evidence as may be reasonably requested by Dakota County, evidencing that the full waiver of subrogation privilege contemplated by this provision is present; and /or, if so requested by Dakota County, Contractor shall provide a full and complete copy of the pertinent property insurance policy(ies). Insure CS (Rev. 9/4/07) City of Lakeville- 12402.doc Page 15 SHIP -G (Rev. 06 -10) Unp.dot Materials and 12 large post and frame $740 Supplies Downtown way- finding signage to be placed on existing semaphore mastarms. (2) $2,000 Misc. /Other Downtown pedestrian way- finding sign (1) 3,500 GRAND TOTAL Downtown way- finding signage for light posts on the corner of Holyoke & $4,340 208 (2) 2,500 DuMor bike racks to be located in Downtown (3) 2,700 Portable Farmer's Market signs for way- finding during Farmer's Market (4) 800 GRAND TOTAL $11,500 Materials and Supplies 12 large post and frame $740 Contractual Services Way- finding signs by vendor: -- Valley Lake Park - 6 master plan sign - -East Community Park - 6 master plan sign 1,800 1,800 Misc. /Other GRAND TOTAL $4,340 Exhibit 3 Services and Payment The City of Lakeville has been awarded a total of $15,840 for two (2) Active Living Grants proposals (which are incorporated herein by reference) that are briefly described in this exhibit: The first award of $11,500 will fund the continuation of the way- finding system in downtown Lakeville that will link existing trails, parks and community recreation facilities throughout the City. Costs for materials and supplies to complete the job are itemized below. The second award of $4,340 will fund the continuation of a way- finding system at Valley Lake Park and East Community Park. The original plan has been expanded to add additional trail loops and connections. Costs for materials and supplies are itemized below. Payment: Services will be paid for using the invoice form attached as Exhibit 5. All claims will be based on the budget for purchases approved for each of the three projects. Receipts for purchases should be affixed to the invoice form. Release and Consent form: If applicable, the City agrees to provide photos of events and activities and to cooperate with the Dakota County Public Health Department to request permission for use of photos and images from parents and other adults by completing a form provided by Dakota County as: • Attachment A: Release and Consent for Use of Photographs of Adults and Children. All photos must accompany signed releases using this form. A Model Sub - contract form has been developed by the Dakota County Attorney's Office that can be used or adapted for use by the City on an as needed basis to ensure any sub - contracts also reflect the Master Contract Requirements for SHIP funding through MDH: • Attachment B: Model Sub - contract. City of Lakeville- 12402.doc Page 16 SHIP -G (Rev. 06 -10) Unp.dot Exhibit 4 Invoice Form Date: Dates covered by invoice: from: to City: City Contact: Telephone and Email: Make check payable to: Send check to (address): Expenses Invoice for Improving Environments for Active Living in Dakota County Amount Category: Materials & Supplies: Contractual Services: Printing, Postage & Publications: Training: Unit Amount Misc. /Other: (name, dates, times, activities): Total : Total Please attach your receipts. Return this form to by mail or email to: Kris Jenson, Dakota County Public Health Dept., 1 Mendota Rd. W., #410, West St. Paul, MN 55118 kris.jenson( co.dakota.mn.us Fax: (651) 554 -6130 Phone: (651) 554 -6140 City of Lakeville- 12402.doc Page 17 SHIP -G (Rev. 06 -10) Unp.dot Exhibit 5 State Health Improvement Program (SHIP) Minnesota Department of Health (MDH) Master Contract Requirements Dakota County has entered into a Master Contract Agreement with the Minnesota Department of Health (MDH) as required to receive grant funds. All providers who contract with Dakota County to deliver services paid for using grant funds are also required to adhere to the following requirements as outlined in the Master Contract: A. Publicity. Any publicity given to the program, publications, or services provided resulting from this grant contract, including but not limited to, notices, informational pamphlets, press releases, research, signs and similar public notices prepared by the Contractor or its employees individually or jointly with others, shall identify the State as the sponsoring agency and shall not be released, unless such release is approved in advance by Dakota County in conversation with the State. B. Endorsement. The Contractor must not claim that the State of Minnesota or the County of Dakota endorses its products or services. C. Audits. Contractors that expend $500,000 or more in federal assistance annually shall comply with the audit standards as set forth in the Single Audit Act of 1984, P.L. 98 -502 and the Single Audit Act Amendments of 1996, P.L. 104 -156 and Office of Management Budget Circular No. A -128, A -110, or A- 133, as applicable. D. Drug Free Workplace. Contractor agrees to comply with the Drug Free Workplace Act of 1988, as implemented at 34 CFR 85, Subpart F. E. Lobbying. The Contractor agrees to comply with the provisions of United States Code, Title 31, Section 1352. The Contractor must not use any federal funds from the State to pay any person for influencing or attempting to influence an officer or employee of a federal agency, a member of Congress, an officer or employee of Congress, or any employee of a member of Congress in connection with the awarding of any federal contract, the making of a federal grant, the making of any federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan or cooperative agreement. If the Contractor uses any federal funds from the State, to conduct any of the aforementioned activities, the Contractor must complete and submit to the State the disclosure form specified by the State. F. Rights to Inventions — Experimental, Developmental or Research Work. The Contractor agrees to comply with 37 CFR, Part 401, "Rights to Inventions Made by Nonprofit Organizations, Small Business Firms Under Government Grants, Contracts and Cooperative Agreements" and any implementing regulations issued by the awarding agency. G. Clean Air Act. The Contractor agrees to comply with all applicable standards, orders or regulations pursuant to the Clean Air Act as amended (42 U.S.C. 7401 et seq.) and the Federal Water Pollution control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). H. No Smoking. With respect to facilities over which Contractor has control, the Contractor shall prohibit smoking in any area of the hospital, health care clinic, doctor's office or other health care - related public facility, accept as allowed by Minn. Stat. § 144.414, subd. 3. I. No Conflict of Interest. The Contractor hereby assures that no interest exists, directly or indirectly, which would conflict in any manner or degree with Contractor's performance of services required to be performed under this Contract. J. No Obligation to Renew. The County is under no obligation to renew this Contract. City of Lakeville- 12402.doc Page 18 SHIP -G (Rev. 06 -10) Unp.dot Attachment A Release and Consent for Use of Photographs of Adults and Children www.d akotecoun1 y.es RELEASE AND CONSENT FOR USE OF PHOTOGRAPHS OF ADULTS AND CHILDREN I authorize Dakota County to take and use photographs of: ❑ me ❑ my child(ren) ❑ me and my child(ren), and to use the photographs to promote Dakota County and its functions, activities, and programs. I authorize Dakota County to take and use videotapes, or similar recordings of the image of: ❑ me ❑ my child(ren) ❑ me and my child(ren), and to use the videotapes to promote Dakota County and its functions, activities, and programs. I understand that allowing Dakota County to take photographs and /or video recordings of me and /or my child(ren) and to publish them in county publications, cable programs, the county website or county promotional materials is completely voluntary and that I am under no obligation to provide this consent. I understand I will not be paid for the county's use of these photographs and /or video recordings. ❑ I agree ❑ I disagree I authorize Dakota County to give these photographs and /or video recordings to media outlets for publication. ❑ I agree ❑ I disagree Attachment A Dakota County Administration Communications 1590 Highway 55 Hastings, MN 55033 I authorize Dakota County to disclose my name, the name of my child(ren), my name and the name of my child(ren) with the photograph. ❑ I agree ❑ I disagree By signing this Release and Consent, I release Dakota County and its officers and employees from any liability from the taking or use of the photographs for the purposes I have authorized. I understand that I may revoke this consent by sending a written notice of revocation to Dakota County at the address listed above; however, I understand that the revocation will not apply to the county's prior use of the photographs taken in reliance on this photographic consent. By signing this Release and Consent, I certify that I have read and understand the contents of this document and have the right and authority to execute this Release and Consent. Signature Print Name Parent/Guardian of minor child(ren) Signature Print Name City of Lakeville- 12402.doc Date Date Names of Child(ren) Civil /AttyCiv /Attorneys Folders /Photograph Release and Consent Feb 2007 Page 19 SHIP -G (Rev. 06 -10) Unp.dot Attachment B Model Sub - contract CONTRACT FOR PROFESSIONAL SERVICES IN CONNECTION WITH SHIP PROGRAM This Contract is made and entered into between the City of and , hereinafter "Contractor." WHEREAS, the City is in need of professional services and the Contractor desires to provide such services. Now, THEREFORE, in consideration of the mutual promises and agreements contained herein the parties enter into this Contract and agree as follows: TERM. The term of this Contract is from the date of execution by all parties through law or according to the provisions of this Contract. , by and through its , hereinafter "City," , unless earlier terminated by SCOPE OF SERVICES. The City requests and the Contractor agrees to provide the services attached and incorporated as Exhibit 1. PAYMENT. The City agrees to pay for the services, including expenses, in accordance with Exhibit 1 and in an amount not to exceed $ CITY LIAISON. Contractor shall work closely with the City's liaison, GENERAL CONDITIONS. The General Conditions set forth on page two of this Contract are attached and incorporated in this Contract. In addition to the General Conditions, the Contractor is required to meet the contract requirements that exist in the Master Grant Contract between Dakota County and the Minnesota Department of Health. These requirements are outlined in Exhibit 2, "State Health Improvement Program (SHIP) Minnesota Department of Health (MDH) Master Contract Requirements." ENTIRE AGREEMENT. This Contract is the final expression of the agreement of the parties and the complete and exclusive statement of the terms agreed upon. IN WITNESS WHEREOF, the parties hereto have executed this Contract on the date(s) indicated below. CITY OF CONTRACTOR (I represent and warrant that I am authorized by law to execute this Contract and legally bind the Contractor). By By (Please print name) (Please print name) Title Title Date of Signature Date of Signature Address: Address: Phone Number: Phone Number: City of Lakeville- 12402.doc Page 20 SHIP -G (Rev. 06 -10) Unp.dot INDEPENDENT CONTRACTOR. Contractor is an independent contractor and nothing in this Contract shall be construed to create the relationship of agents, partners, joint venturers, associates, or employer and employee between the City and Contractor. OWNERSHIP OF WORK PRODUCT & COPYRIGHTS. All work product, data compilations, and materials of any kind prepared pursuant to this Contract, regardless of the format in which they exist will become the sole and exclusive property of the City upon the completion of this Contract. However, upon the prior express written consent of the City, which may be granted in its sole discretion, Contractor may use portions or excerpts from the materials prepared pursuant to this Contract. To the extent Contractor uses copyrighted material of the City, Contractor shall maintain the copyrighted material to protect all right, title and interest of the City. Where applicable, works created by Contractor for the City in performance of this Contract shall be considered "works made for hire" as defined in the U.S. Copyright Act and all right, title and interest, including copyright, of the same prepared pursuant to this Contract is owned by the City. It is further agreed that the City has unlimited rights to use duplicate and make derivative works of the same, with no obligation for an accounting to Contractor. CONFIDENTIALITY CLAUSE. Contractor acknowledges that the City in connection with Contractor's performance of this Contract may transmit certain private or Confidential Information, as defined in the Minnesota Data Practices Act, to Contractor. Contractor agrees to implement such procedures as are necessary to assure protection of the private and Confidential Information. COMPLIANCE WITH LAWS /STANDARDS. Contractor shall abide by all Federal, State or local laws; statutes, ordinances, rules and regulations pertaining to this Contract and this Contract shall be construed in accordance with the substantive and procedural laws of the State of Minnesota. All proceedings related to this Contract shall be venued in the County of Dakota, State of Minnesota. LICENSES. At its own expense, Contractor shall procure all licenses, permits or other rights required for the provision of services contemplated by this Contract. Contractor shall inform the City of any changes in the above within five (5) days of occurrence. INDEMNIFICATION. To the fullest extent permitted by law, Contractor agrees to indemnify the City, its officers, employees, agents, and others acting on its behalf and to hold them harmless and defend and protect them from and against any and all loss, damage, liability, cost and expense, specifically including attorneys' fees and other costs and expenses of defense, which result from, or otherwise arise in connection with, any actions, claims or proceedings of any sort and which is caused by any act or omission of Contractor, its officers, employees or agents, or any other person(s) or entity(ies) for whose acts or omissions Contractor may be legally responsible, whether or not also caused in part by a party indemnified hereunder. ASSIGNMENT /SUBCONTRACTING. The Contractor shall not assign or subcontract this Contract without prior written consent of the City, in which case Contractor is responsible for the performance of its subcontractors or assignees and must follow the requirements of Minn. Stat. § 471.425 (payments to subcontractors). INSURANCE TERMS. (Check Applicable Provisions) Contractor shall provide to the City, prior to or concurrent with the execution of this Contract, certificate(s) of insurance naming the City as certificate holder or certified copies of such existing policies of insurance, demonstrating: ❑ General liability coverage of at least $1,500,000 per occurrence and aggregate ❑ and naming the City as an additional insured; ❑ Automobile liability coverage of at least $1,500,000 per occurrence and aggregate ❑ and naming the City as an additional insured, ❑ Professional liability (errors and omissions) insurance coverage of at least $1,500,000, and ❑ Workers' compensation coverage or certification of excluded employment from workers' compensation requirements. Contractor shall pay all retentions and deductibles under such policies of insurance. If Contractor does not have existing coverage(s) or has coverage(s) in limits less than that set out above, Contractor must obtain from the City, prior to or concurrent with the execution of this Contract, a waiver of the coverage(s) or agreement to lower coverage limits from the City. MODIFICATIONS. Any alterations, variations, modifications, or waivers of the provisions of this Contract shall only be valid when they have been reduced to writing and signed by the authorized representatives of the parties. City of Lakeville- 12402.doc GENERAL CONDITIONS Page 21 SHIP -G (Rev. 06 -10) Unp.dot TERMINATION. Either party upon thirty (30) days written notice to the other party may terminate this Contract, with or without cause. Notice of termination shall be made by certified mail or personal delivery to the person signing this Contract on behalf of the other party. Termination of this Contract shall not discharge any liability, responsibility or right of any party, which arises from the performance of or failure to adequately perform the terms of the Contract prior to the effective date of termination. TERMINATION BY CITY - LACK OF FUNDING. Notwithstanding any provision of this Contract to the contrary, the City may immediately terminate this Contract if it does not obtain funding from the Minnesota Legislature, Minnesota Agencies or other funding source, or if its funding cannot be continued at a level sufficient to allow payment of the amounts due under this Contract. Written notice of termination sent by the City to Contractor by facsimile is sufficient notice under the terms of this Contract. The City is not obligated to pay for any services that are provided after written notice of termination for lack of funding. The City will not be assessed any penalty or damages if the Contract is terminated due to lack of funding. RECORDS /AUDITS. Contractor's bonds, records, documents, papers, accounting procedures and practices, and other evidences relevant to this Contract are subject to the examination, duplication, transcription and audit by the City and either the Legislative or State Auditor, pursuant to Minn. Stat. § 16C.05, subd. 5. Such evidences are also subject to review by the Comptroller General of the United States, or a duly authorized representative, if federal funds are used for any work under this Contract. The Contractor agrees to maintain such evidences for a period of six (6) years from the date services or payment were last provided or made or longer if any audit in progress requires a longer retention period. DATA PRIVACY. For purposes of this Contract all data on individuals collected, created, received, maintained or disseminated shall be administered consistent with the Minnesota Government Data Practices Act, Minnesota Statutes Chapter 13, and the Minnesota Rules implementing the Act now in force or hereafter adopted as well as Federal laws on data privacy, and Contractor must comply with those requirements as if it were a governmental entity. The Contractor will strictly comply with these statutes and rules. All subcontracts shall contain the same or similar data practices compliance requirements. HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT OF 1996. The Contractor agrees to comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) which are applicable to the Contractor's duties under this Contract. In performing its obligations under this Contract, Contractor agrees to comply with the HIPAA Privacy requirements, the HIPAA Standards for Electronic Transactions, the HIPAA security requirements, and any other applicable HIPAA laws, standards and requirements now in effect or hereinafter adopted as they become law. NON - DISCRIMINATION. Contractor agrees that, in the hiring of all labor for the performance of any work under this Contract, it will not, by reason of race, creed, color, sex, national origin, disability, sexual orientation, age, marital status or public assistance status, discriminate against any person who is a citizen of the United States and who qualifies and is available to perform the work to which such employment relates. Contractor agrees to comply with all Federal, State, and local non - discrimination laws and ordinances, in particular the applicable provisions of the Civil Rights Act of 1964, as amended by the Equal Employment Opportunity Act of 1972. When required by law or requested by the City, Contractor shall furnish a written affirmative action plan. CONTRACTOR DEBARMENT, SUSPENSION AND RESPONSIBILITY CERTIFICATION. By signing this Contract the Contractor is certifying that the federal government or the Minnesota Commissioner of Administration has not suspended or debarred the Contractor or its Principals and Employees, based upon Federal Regulation 45 CFR 92.35 and Minn. Stat. §16C.03, subd. 2, respectively. Contractors may be suspended or debarred when it is determined, through a duly authorized hearing process, that they have abused the public trust in a serious manner. City of Lakeville- 12402.doc Page 22 SHIP -G (Rev. 06 -10) Unp.dot Exhibit 1 Services and Payment City of Lakeville- 12402.doc Page 23 SHIP -G (Rev. 06 -10) Unp.dot State Health Improvement Program (SHIP) Minnesota Department of Health (MDH) Master Contract Requirements City of Lakeville- 12402.doc Page 24 SHIP -G (Rev. 06 -10) Unp.dot Exhibit 2 Dakota County has entered into a Master Contract Agreement with the Minnesota Department of Health (MDH) as required to receive grant funds. All providers who contract with the City to deliver services paid for using such grant funds are also required to adhere to the following requirements as outlined in the Master Contract: A. Publicity. Any publicity given to the program, publications, or services provided resulting from this grant contract, including but not limited to, notices, informational pamphlets, press releases, research, signs and similar public notices prepared by the Contractor or its employees individually or jointly with others, shall identify the State as the sponsoring agency and shall not be released, unless such release is approved in advance by the City in conversation with Dakota County. B. Endorsement. The Contractor must not claim that the State of Minnesota or the County or the City endorses its products or services. C. Audits. Contractors that expend $500,000 or more in federal assistance annually shall comply with the audit standards as set forth in the Single Audit Act of 1984, P.L. 98 -502 and the Single Audit Act Amendments of 1996, P.L. 104 -156 and Office of Management Budget Circular No. A -128, A -110, or A- 133, as applicable. D. Drug Free Workplace. Contractor agrees to comply with the Drug Free Workplace Act of 1988, as implemented at 34 CFR 85, Subpart F. E. Lobbying. The Contractor agrees to comply with the provisions of United States Code, Title 31, Section 1352. The Contractor must not use any federal funds from the State to pay any person for influencing or attempting to influence an officer or employee of a federal agency, a member of Congress, an officer or employee of Congress, or any employee of a member of Congress in connection with the awarding of any federal contract, the making of a federal grant, the making of any federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan or cooperative agreement. If the Contractor uses any federal funds from the State, to conduct any of the aforementioned activities, the Contractor must complete and submit to the State the disclosure form specified by the State. F. Rights to Inventions — Experimental, Developmental or Research Work. The Contractor agrees to comply with 37 CFR, Part 401, "Rights to Inventions Made by Nonprofit Organizations, Small Business Firms Under Government Grants, Contracts and Cooperative Agreements" and any implementing regulations issued by the awarding agency. G. Clean Air Act. The Contractor agrees to comply with all applicable standards, orders or regulations pursuant to the Clean Air Act as amended (42 U.S.C. 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 et seq.). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). H. No Smoking. With respect to facilities over which Contractor has control, the Contractor shall prohibit smoking in any area of the hospital, health care clinic, doctor's office or other health care - related public facility, accept as allowed by Minn. Stat. § 144.414, subd. 3. I. No Conflict of Interest. The Contractor hereby assures that no interest exists, directly or indirectly, which would conflict in any manner or degree with Contractor's performance of services required to be performed under this Contract. J. No Obligation to Renew. The City is under no obligation to renew this Contract.