2020-21 Riverside County - CDBG SupplementalJune 14, 2021
Riverside County Economic Development Agency
EDA Development Manager - CDBG/ ESG Program
44-199 Monroe Street, Suite B
Indio, CA 92201
Attn: Noe Arechiga, CDBG Program Manager
Subject: City of La Quinta Community Development Block Grant (CDBG) Allocation
Dear Mr. Arechiga,
The City of La Quinta respectfully requests Riverside County to reprogram the remaining
balance from the City's Public Services allocation to the City's Public Facilities allocation.
The Boys and Girls Club of the Coachella Valley was unable to use all of the assigned
CDBG funds allocated during Fiscal Year 20/21 due to the Pandemic. Please reprogram
the excess funding in the amount of $22,105 from 4.LQ.40-20 Boys and Girls Club CV to
4.LQ.41-21 La Quinta ADA Improvements. The city understands that the reprogrammed
funding will not be available until Fiscal Year 21/22.
Thank you for your consideration of this programming change. Please do not hesitate to
contact Bryan McKinney, P.E., Public Works Director/City Engineer, at (760) 777-7045 or
Carley Escarrega, Management Assistant, at (760) 777-7096, if you have questions or
require additional information.
Sincerely,
Jon McMillen
City Manager
MEMORANDUM
DATE:
TO:
FROM:
RE:
Please list the Contracting Party / Vendor Name, type of agreement to be executed, including any change orders or
amendments, and the type of services to be provided. Make sure to list any related Project No. and Project Name.
Authority to execute this agreement is based upon:
___ Approved by City Council on ___________________________________________
___ City Manager’s signing authority provided under the City’s Purchasing Police
[Resolution No. 2019-021] for budget expenditures of $50,000 or less.
___ Department Director’s or Manager’s signing authority provided under the City’s
Purchasing Policy [Resolution No. 2019-021] for budget expenditures of $15,000 and
$5,000, respectively, or less.
Procurement Method (one must apply):
___ Bid ___ RFP ___ RFQ ___ 3 written informal bids
___ Sole Source ___ Select Source ___ Cooperative Procurement
Requesting department shall check and attach the items below as appropriate:
___ Agreement payment will be charged to Account No.: _____________________
___ Agreement term: Start Date ________________ End Date ________________
___ Amount of Agreement, Amendment, Change Order, etc.: $____________________
REMINDER: Signing authorities listed above are applicable on the aggregate Agreement amount,
not individual Amendments or Change Orders!
___ Insurance certificates as required by the Agreement for Risk Manager approval
Approved by: ______________________________ Date: _______________
___ Bonds (originals)as required by the Agreement (Performance, Payment, etc.)
___ Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s)
NOTE: Review the “Form 700 Disclosure for Consultants” guidance to determine if a Form 700 is
required pursuant FPPC regulation 18701(2)
___ Business License No. __________________; Expires: __________________
___ Requisition for a Purchase Order has been prepared (Agreements over $5,000)
-RQ 0F0LOOHQ &LW\ 0DQDJHU
-XOLH 0LJQRJQD 0DQDJHPHQW $QDO\VW
6XSSOHPHQWDO $JUHHPHQW ZLWK WKH &RXQW\ RI 5LYHUVLGH IRU WKH XVH RI &RPPXQLW\
'HYHORSPHQW %ORFN JUDQW )XQGV &'%* LQ WKH DPRXQW RI IRU WKH
&LW\
V $'$ LPSURYHPHQW SURMHFW DQG IRU WKH %R\V *LUOV &OXE
1RYHPEHU
✔
&LW\ DQ
1HHGWR VHQG WR &RXQW\
3DJHRI
)LOH1R /4DQG/4
6833/(0(17$/$*5((0(17)257+(86(2)
&20081,7<'(9(/230(17%/2&.*5$17)81'6
7KLV6XSSOHPHQWDO$JUHHPHQW ³$JUHHPHQW´ LVHQWHUHGLQWRWKLVGD\RI
BBBBBBBBBBBBBBE\DQGEHWZHHQWKH&2817<2)5,9(56,'(DSROLWLFDOVXEGLYLVLRQ
RIWKH6WDWHRI&DOLIRUQLDKHUHLQFDOOHG&2817<DQGWKH&,7<2)/$48,17$KHUHLQ
FDOOHG&,7<&2817<DQG&,7<DUHFROOHFWLYHO\UHIHUUHGWRDV³3DUWLHV´DQGLQGLYLGXDOO\DV
³3DUW\´
7KH&2817<DQG&,7<PXWXDOO\DJUHHDVIROORZV
*(1(5$/&2817<DQG&,7<KDYHH[HFXWHGD&RRSHUDWLRQ$JUHHPHQWGDWHG
-XO\ ³&RRSHUDWLRQ$JUHHPHQW´ ZKHUHE\&,7<HOHFWHGWRSDUWLFLSDWHZLWK&2817<
ZKLFKKDVTXDOLILHGDVDQ8UEDQ&RXQW\IRUSXUSRVHVRIUHFHLYLQJ&RPPXQLW\'HYHORSPHQW
%ORFN *UDQW &'%* IXQGV ³&'%*´ DQG WR DVVLVW DQG XQGHUWDNHHVVHQWLDO FRPPXQLW\
GHYHORSPHQW DQG KRXVLQJ DVVLVWDQFH DFWLYLWLHV SXUVXDQW WR WKH +RXVLQJ DQG &RPPXQLW\
'HYHORSPHQW$FWRI 7LWOHDVDPHQGHG3XEOLF/DZ KHUHLQDIWHUUHIHUUHGWRDV$FW
6DLG&RRSHUDWLRQ$JUHHPHQWGDWHG-XO\LVLQFRUSRUDWHGKHUHLQE\UHIHUHQFHDQGPDGHD
SDUWRIWKLV$JUHHPHQWDVLIHDFKDQGHYHU\SURYLVLRQZDVVHWIRUWKKHUHLQ
385326(&,7<KDVEHHQDOORFDWHGLQ&'%*(QWLWOHPHQWIXQGVIRUWKH
&'%*SURJUDP\HDU&,7<SURPLVHVDQGDJUHHVWRXQGHUWDNHDQGDVVLVWZLWKWKH
FRPPXQLW\GHYHORSPHQWDFWLYLWLHVZLWKLQLWVMXULVGLFWLRQE\XWLOL]LQJWKHVXPRI&'%*
(QWLWOHPHQW)XQGVDVVSHFLILFDOO\LGHQWLILHGLQ([KLELW V $DQG%DWWDFKHGKHUHWRDQGDUH
LQFRUSRUDWHGKHUHLQE\WKLVUHIHUHQFHIRUWKHIROORZLQJSURMHFW V FROOHFWLYHO\WKH³3URMHFWV´
$ /4%R\V *LUOV&OXERI&RDFKHOOD9DOOH\
% /4&LW\RI/D4XLQWD0LVFHOODQHRXV$'$,PSURYHPHQWV
3DJHRI
7(502)$*5((0(177KHWHUPRIWKLV$JUHHPHQWIRUWKHLPSOHPHQWDWLRQRI
WKH3URMHFW V VKDOOEHIRUDSHULRGRIRQH \HDUIURP-XO\WRWHUPLQDWLRQRQ-XQH
&203/(7,216&+('8/(&,7<VKDOOSURFHHGFRQVLVWHQWZLWKWKHFRPSOHWLRQ
VFKHGXOHVHWIRUWKLQ([KLELW V $DQG%DWWDFKHGKHUHWRDQGLQFRUSRUDWHGKHUHLQ
(;7(16,212)7,0(,QWKHHYHQWWKH3URMHFW V DUHQRWVXEVWDQWLDOO\FRPSOHWHGE\
WKHWLPHVHWIRUWKLQWKHDSSOLFDEOHFRPSOHWLRQVFKHGXOH V GXHWRDIRUFHPDMHXUHHYHQW 6HH
6HFWLRQEHORZ WKH&2817<PD\FRQVLGHUH[WHQGLQJWKHVFKHGXOHIRUWKHFRPSOHWLRQRIWKH
SURMHFW V 7LPHV RI SHUIRUPDQFH IRU RWKHU DFWLYLWLHV PD\ DOVREH H[WHQGHG LQ ZULWLQJ E\
&2817< ,I VXEVWDQWLDO SURJUHVV WRZDUG FRPSOHWLRQ LQ FRQIRUPDQFH ZLWK WKH FRPSOHWLRQ
VFKHGXOHDVGHWHUPLQHGE\&2817<LQLWVGLVFUHWLRQRIWKHSURMHFW V DUHQRWPDGHGXULQJWKH
WHUPRIWKLV6XSSOHPHQWDO$JUHHPHQW&2817<PD\VXVSHQGRUWHUPLQDWHWKLV6XSSOHPHQWDO
$JUHHPHQWSXUVXDQWWRWKHWHUPLQDWLRQSURFHGXUHVVHWIRUWKLQWKHVHFWLRQWLWOHG7HUPLQDWLRQ
DQGWKHHQWLWOHPHQWIXQGVDVVRFLDWHGZLWKWKH3URMHFW V PD\EHUHSURJUDPPHGE\WKH&2817<
DIWHUDSSURSULDWHQRWLFHLVSURYLGHGWRWKH&LW\
/(77(572352&(('&,7<VKDOOQRWLQLWLDWHQRULQFXUH[SHQVHVIRUWKH&'%*
IXQGHG3URMHFWVRUDFWLYLWLHVFRYHUHGXQGHUWKHWHUPVRIWKLV6XSSOHPHQWDO$JUHHPHQWDVVHWIRUWK
LQ([KLELW V $DQG%DWWDFKHGKHUHWRSULRUWRUHFHLYLQJZULWWHQDXWKRUL]DWLRQIURP&2817<WR
SURFHHG
127,&(6 (DFK QRWLFH UHTXHVW GHPDQG FRQVHQW DSSURYDO RURWKHU
FRPPXQLFDWLRQ KHUHLQDIWHULQWKLV6HFWLRQUHIHUUHGWRFROOHFWLYHO\DV³QRWLFHV´DQGUHIHUUHGWR
VLQJO\DVD³QRWLFH´ ZKLFKWKH&,7<RU&2817<LVUHTXLUHGRUSHUPLWWHGWRJLYHWRWKHRWKHU
SDUW\SXUVXDQWWRWKLV$JUHHPHQWVKDOOEHLQZULWLQJDQGVKDOOEHGHHPHGWRKDYHEHHQGXO\DQG
VXIILFLHQWO\JLYHQLI D SHUVRQDOO\GHOLYHUHGZLWKSURRIRIGHOLYHU\WKHUHRI DQ\QRWLFHVRGHOLYHUHG
VKDOOEHGHHPHGWRKDYHEHHQUHFHLYHGDWWKHWLPHVRGHOLYHUHG RU E VHQWE\)HGHUDO([SUHVV RU
RWKHU VLPLODU QDWLRQDO RYHUQLJKW FRXULHU GHVLJQDWLQJ HDUO\ PRUQLQJ GHOLYHU\ DQ\ QRWLFH VR
GHOLYHUHGVKDOOEHGHHPHGWRKDYHEHHQUHFHLYHGRQWKHQH[W%XVLQHVV'D\IROORZLQJUHFHLSWE\
3DJHRI
WKHFRXULHU RU F VHQWE\8QLWHG6WDWHVUHJLVWHUHGRUFHUWLILHGPDLOUHWXUQUHFHLSWUHTXHVWHG
SRVWDJHSUHSDLGDWDSRVWRIILFHUHJXODUO\PDLQWDLQHGE\WKH8QLWHG6WDWHV3RVWDO6HUYLFH DQ\
QRWLFHVRVHQWVKDOOEHGHHPHGWRKDYHEHHQUHFHLYHGWZRGD\VDIWHUPDLOLQJLQWKH8QLWHG6WDWHV
DGGUHVVHGWRWKHUHVSHFWLYHSDUWLHVDVIROORZV
&2817<&,7<
+HLGL0DUVKDOO -RQ0F0LOOHQ
5LYHUVLGH&RXQW\++3:6'LUHFWRU &LW\RI/D4XLQWD
32%R[ &DOOH7DPSLFR
5LYHUVLGH&$ /D4XLQWD&$
',6%856(0(172))81'6
$&2817<
V%RDUGRI6XSHUYLVRUVVKDOOGHWHUPLQHWKHILQDOGLVSRVLWLRQDQG
GLVWULEXWLRQRIDOOIXQGVUHFHLYHGE\&2817<XQGHUWKH$FWFRQVLVWHQWZLWK6HFWLRQVDQGRI
WKLV6XSSOHPHQWDO$JUHHPHQW&2817<WKURXJKLWV'HSDUWPHQWRI+RXVLQJ+RPHOHVVQHVV
3UHYHQWLRQDQG:RUNIRUFH6ROXWLRQVVKDOOPDNHSD\PHQWRIWKH&'%*IXQGVWR&,7<DVVHW
IRUWKLQWKHDWWDFKHG([KLELW V $DQG%,WLVWKH&,7<¶VUHVSRQVLELOLW\WRPRQLWRUDOOSURMHFW
DFWLYLWLHVVHWIRUWKLQWKHDWWDFKHG([KLELW V $DQG%DQGWRHQVXUHFRPSOLDQFHZLWKDSSOLFDEOH
IHGHUDOUHJXODWLRQVDQGWKHWHUPVRIWKLV6XSSOHPHQWDO$JUHHPHQW
%&,7<VKDOOFRPSO\ZLWKWLPHO\GUDZGRZQRI&'%*(QWLWOHPHQWIXQGLQJ
E\H[SHGLWLRXVO\LPSOHPHQWLQJDQGFRPSOHWLQJWKH&2817<DSSURYHG&'%*IXQGHG3URMHFWV
&,7<DFNQRZOHGJHVWKDW&,7<¶VGUDZGRZQSHUIRUPDQFHGLUHFWO\LPSDFWVWKH&2817<¶VRYHUDOO
SURJUDPGUDZGRZQUDWH,IWKH&,7<¶VXQREOLJDWHG&'%*IXQGEDODQFHDVRI-DQXDU\
H[FHHGVRQHKXQGUHGDQGVHYHQW\ILYHSHUFHQW RIWKH&,7<¶V&'%*DOORFDWLRQ
WKH&2817<PD\LQLWVVROHGLVFUHWLRQWDNHWKHQHFHVVDU\DGPLQLVWUDWLYHDFWLRQVWRUHGXFHWKH
&,7<¶V&'%*IXQGEDODQFH1HFHVVDU\DFWLRQVLQFOXGHEXWDUHQRWOLPLWHGWRUHSURJUDPPLQJWKH
H[FHVV&'%*IXQGEDODQFHWRRWKHUHOLJLEOHDFWLYLWLHVDVVHOHFWHGE\&2817<&2817<PD\
LQLWVVROHDQGDEVROXWHGLVFUHWLRQDXWKRUL]H&,7<LQZULWLQJSULRUWR-DQXDU\WRH[FHHG
WKH&'%*IXQGEDODQFHUHTXLUHPHQW
3DJHRI
& &,7<VKDOOFRPSO\ZLWKWLPHO\GUDZGRZQRI&'%*IXQGVE\VXEPLWWLQJ
PRQWKO\UHTXHVWVIRUUHLPEXUVHPHQWRURWKHU&2817<DSSURYHGUHLPEXUVHPHQWVFKHGXOHV$OO
GLVEXUVHPHQWVRI&'%*IXQGVZLOOEHRQDUHLPEXUVHPHQWEDVLVDQGPDGHZLWKLQWKLUW\ GD\V
DIWHUWKH&2817<KDVUHFHLYHGWKH&,7<¶VUHLPEXUVHPHQWUHTXHVWLQFOXGLQJGRFXPHQWDWLRQ
VXSSRUWLQJH[SHQGLWXUHV
' $OODXWKRUL]HGREOLJDWLRQVLQFXUUHGLQWKHSHUIRUPDQFHRIWKH6XSSOHPHQWDO
$JUHHPHQWIRUSURMHFWVHOLJLEOHXQGHUWKHIROORZLQJ&'%*UHJXODWLRQVPXVWEHUHSRUWHGLQZULWLQJ
WR&2817<QRODWHUWKDQ-XQH
$FTXLVLWLRQ>&RGHRI)HGHUDO5HJXODWLRQV &)5 D @
&OHDUDQFH$FWLYLWLHV>&)5 G @
,QWHULP$VVLVWDQFH>&)5 I @
&RGH(QIRUFHPHQW>&)5 F @
$OOSXEOLFVHUYLFHDFWLYLWLHV>&)5 H @DQGRWKHUHOLJLEOHDFWLYLWLHVXQGHUWKLV
6XSSOHPHQWDO$JUHHPHQWPXVWEHLPSOHPHQWHGFRPSOHWHGDQGREOLJDWLRQVUHSRUWHGLQZULWLQJWR
WKH&2817<E\WKH&,7<QRODWHUWKDQWKHFRPSOHWLRQVFKHGXOHVVHWIRUWKLQWKHDWWDFKHG([KLELWV
WRWKLV6XSSOHPHQWDO$JUHHPHQW´&)5´DVXVHGKHUHLQUHIHUVWRWKH&RGHRI)HGHUDO5HJXODWLRQV
5(&25'6$1',163(&7,216
$&,7<VKDOOHVWDEOLVKDQGPDLQWDLQILQDQFLDOSURJUDPPDWLFVWDWLVWLFDODQG
RWKHUVXSSRUWLQJUHFRUGVRILWVRSHUDWLRQVDQGILQDQFLDODFWLYLWLHVLQDFFRUGDQFHZLWKWKH8QLIRUP
$GPLQLVWUDWLYH5HTXLUHPHQWV&RVW3ULQFLSOHVDQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV
&)53DUW DQG&)56HFWLRQ D DVWKH\UHODWHWRWKHDFFHSWDQFHDQGXVHRIIHGHUDO
IXQGVXQGHUWKLV$JUHHPHQW6DLGUHFRUGVVKDOOEHUHWDLQHGIRUDSHULRGRIIRXU \HDUVIURPWKH
GDWHWKDWWKHDFWLYLW\RUSURJUDPIXQGHGZLWKWKH&'%**UDQWLVFORVHGRXWE\WKH&2817<DQG
UHSRUWHGDVFRPSOHWHLQWKH&RPSUHKHQVLYH$QQXDO3HUIRUPDQFHDQG(YDOXDWLRQ5HSRUW &$3(5
([FHSWLRQVWRWKHIRXU \HDUUHWHQWLRQSHULRGUHTXLUHPHQWSXUVXDQWWR&)5LQFOXGH
EXWQRWOLPLWHGWRWKHIROORZLQJ
3DJHRI
L LIDQ\OLWLJDWLRQFODLPRUDXGLWLVVWDUWHGSULRUWRWKHH[SLUDWLRQRI
WKHIRXU \HDUSHULRG
LL ZKHQWKH&,7<LVQRWLILHGLQZULWLQJE\WKH&2817<+8'RU
RWKHU)HGHUDODJHQF\WRH[WHQGWKHUHWHQWLRQSHULRG
LLL UHFRUGVIRUUHDOSURSHUW\DQGHTXLSPHQWDFTXLUHGZLWK&'%*IXQGV
PXVWEHUHWDLQHGIRUIRXU \HDUVDIWHUILQDOGLVSRVLWLRQ
LY ZKHQWKHUHFRUGVDUHWUDQVIHUUHGE\WKH&,7<WRWKH&2817<
+8'RURWKHU)HGHUDODJHQF\WKHIRXU \HDUSHULRGLVQRWDSSOLFDEOH
% &,7< VKDOO REWDLQ DQ H[WHUQDO DXGLW LQ DFFRUGDQFH ZLWK WKH 8QLIRUP
$GPLQLVWUDWLYH5HTXLUHPHQWV&RVW3ULQFLSOHVDQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV
&)56HFWLRQ $XGLWVVKDOOXVXDOO\EHSHUIRUPHGDQQXDOO\EXWQRWOHVVIUHTXHQWO\WKDQ
HYHU\WZR\HDUV1RQSURILWLQVWLWXWLRQVDQGJRYHUQPHQWDJHQFLHVWKDWH[SHQGOHVVWKDQD
\HDULQ)HGHUDODZDUGVDUHH[HPSWIURP)HGHUDODXGLWUHTXLUHPHQWVEXWUHFRUGVPXVWEHDYDLODEOH
IRUUHYLHZE\DSSURSULDWHRIILFLDOVRIWKH)HGHUDOJUDQWRUDJHQF\RUVXEJUDQWLQJHQWLW\7KHDXGLW
UHSRUWVKDOOEHVXEPLWWHGWRWKH&2817<ZLWKLQGD\VDIWHUWKHHQGRIWKH&2817<
6ILVFDO
\HDU
& &,7<VKDOOPDLQWDLQDVHSDUDWHDFFRXQWIRUWKH&,7<¶6&'%*(QWLWOHPHQW
IXQGVUHFHLYHGDVVHWIRUWKLQ([KLELW V $DQG%DWWDFKHGKHUHWR
' 3XUVXDQWWR&)5&,7<VKDOOGXULQJWKHQRUPDOEXVLQHVVKRXUV
PDNHDYDLODEOHWR&2817<WKH86'HSDUWPHQWRI+RXVLQJDQG8UEDQ'HYHORSPHQW +8'
RURWKHUDXWKRUL]HGUHSUHVHQWDWLYHIRUWKHH[DPLQDWLRQDQGFRS\LQJDOORILWVUHFRUGVDQGRWKHU
PDWHULDOVZLWKUHVSHFWWRPDWWHUVFRYHUHGE\WKLV$JUHHPHQWDQGSURYLGHUHDVRQDEOHDFFHVVWR
&,7<VWDIIIRUWKHSXUSRVHRILQWHUYLHZDQGGLVFXVVLRQUHODWHGWRWKHUHFRUGVDQGGRFXPHQWV
( &,7<VKDOOQRWUHWDLQDQ\SURJUDPLQFRPHDVGHILQHGLQ&)5
6DLGSURJUDPLQFRPHVKDOOEHXVHGRQO\IRUWKHDFWLYLWLHVWKDWDUHWKHVXEMHFWRIWKLV$JUHHPHQW
)XUWKHUDOOSURYLVLRQVRIWKLV$JUHHPHQWVKDOODSSO\WRVXFKDFWLYLWLHV
) 7KH&,7<VKDOOHQVXUHWKDWDWOHDVWILIW\RQHSHUFHQW RIWKHSHUVRQV
3DJHRI
EHQHILWLQJIURPDOO&'%*IXQGHGDFWLYLWLHVRUSURMHFWVGHVLJQDWHGDVVHUYLQJOLPLWHGFOLHQWHOH>
&)5 D L @DUHRIORZDQGPRGHUDWHLQFRPHDQGPHHWWKHDSSOLFDEOHKRXVHKROGLQFRPH
JXLGHOLQHV 7KH &,7< VKDOO SURYLGH WKH UHTXLUHG LQFRPH FHUWLILFDWLRQ DQG GLUHFW EHQHILW
GRFXPHQWDWLRQLQZULWLQJWRWKH&2817<SXUVXDQWWRWKHUHSRUWLQJUHTXLUHPHQWRIHDFKDFWLYLW\
DVVHWIRUWKLQ([KLELW V $DQG%DWWDFKHGKHUHWR,QWKHHYHQWWKDW&,7<HQJDJHVWKHVHUYLFHVRI
DVXEFRQWUDFWRUWRLPSOHPHQW&'%*IXQGHGDFWLYLWLHVWKH&,7<PXVWFROOHFWLQZULWLQJDOO
UHTXLUHG LQFRPH FHUWLILFDWLRQ DQG GLUHFW EHQHILW GRFXPHQWDWLRQIURP VXEFRQWUDFWRUV SULRU WR
VXEPLWWDOWRWKH&2817<SXUVXDQWWRWKHUHSRUWLQJUHTXLUHPHQWRIHDFKDFWLYLW\DVVHWIRUWKLQ
([KLELW V $DQG%DWWDFKHGKHUHWR
&203/,$1&(:,7+/$:6&,7<VKDOOFRPSO\ZLWKDOODSSOLFDEOHIHGHUDO
VWDWHDQGORFDOODZVUHJXODWLRQVDQGRUGLQDQFHVDQGDQ\DPHQGPHQWVWKHUHWRDQGWKHIHGHUDO
UHJXODWLRQVDQGJXLGHOLQHVQRZRUKHUHDIWHUHQDFWHGSXUVXDQWWRWKH$FW0RUHSDUWLFXODUO\&,7<
LVWRFRPSO\ZLWKWKRVHUHJXODWLRQVIRXQGLQWKH8QLIRUP$GPLQLVWUDWLYH5HTXLUHPHQWV&RVW
3ULQFLSOHVDQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV &)53DUW DQG&)53DUW
&,7<LVWRDELGHE\WKHSURYLVLRQVRIWKH&RPPXQLW\'HYHORSPHQW%ORFN*UDQW0DQXDOSUHSDUHG
E\&2817<DQGFLWHGLQWKHDERYHPHQWLRQHG&RRSHUDWLRQ$JUHHPHQW&,7<VKDOOFRPSO\LI
DSSOLFDEOHZLWK6HFWLRQRIWKH+RXVLQJ 8UEDQ'HYHORSPHQW$FWRI 86&$6HFWLRQ
X DVDPHQGHGDFRS\RIZKLFKLVDWWDFKHGKHUHWRDV([KLELW³6´DQGLQFRUSRUDWHGKHUHLQE\
WKLVUHIHUHQFH&,7<VKDOODGKHUHWRWKHUHVWULFWLRQVVHWIRUWKLQ&)5 M DQG&)5
6HFWLRQ ZKLFKLVDWWDFKHGKHUHWRDV([KLELW³5´DFRS\RIZKLFKLVLQFRUSRUDWHGKHUHLQE\
WKLVUHIHUHQFHSHUWDLQLQJWRLQKHUHQWO\UHOLJLRXVDFWLYLWLHV&,7<VKDOOFRPSO\ZLWKWKH$GGLWLRQDO
)HGHUDO5HTXLUHPHQWVLIDSSOLFDEOHDWWDFKHGKHUHWRDV([KLELW³$)5´DQGLQFRUSRUDWHGKHUHLQ
E\WKLVUHIHUHQFH
&223(5$7,21:,7++286,1*$&7,9,7,(6&,7<VKDOOFRRSHUDWHZLWK
&2817<LQXQGHUWDNLQJHVVHQWLDOFRPPXQLW\GHYHORSPHQWDQGKRXVLQJDVVLVWDQFHDFWLYLWLHV
VSHFLILFDOO\ XUEDQ UHQHZDO DQG SXEOLF DVVLVWDQFH KRXVLQJ DQG VKDOO DVVLVW &2817< LQ
LPSOHPHQWLQJDQGXQGHUWDNLQJWKHJRDOVDQGVWUDWHJLHVLGHQWLILHGLQWKH )LYH<HDU
3DJHRI
&RQVROLGDWHG 3ODQ SXUVXDQW WR &)5 3DUW DQG RWKHU UHTXLUHPHQWV RI WKH &RPPXQLW\
'HYHORSPHQW%ORFN*UDQW3URJUDP
/($' $*(1&< )25 &203/,$1&( :,7+ 7+( &$/,)251,$
(19,5210(17$/48$/,7<$&7 &(4$ 3XUVXDQWWR7LWOH&&56HFWLRQ G WKH
&,7< LV GHVLJQDWHG DV WKH OHDG DJHQF\ IRU WKH SURMHFWV WKDW DUH WKH VXEMHFW PDWWHU RI WKLV
6XSSOHPHQWDO$JUHHPHQW
+2/' +$50/(66 $1' ,1'(01,),&$7,21 ,Q FRQWHPSODWLRQ RI WKH
SURYLVLRQVRI6HFWLRQ RIWKH&DOLIRUQLD*RYHUQPHQW&RGHLPSRVLQJFHUWDLQWRUWOLDELOLW\
MRLQWO\XSRQSXEOLFHQWLWLHVVROHO\E\UHDVRQRIVXFKHQWLWLHVEHLQJSDUWLHVWRDQDJUHHPHQWDV
GHILQHGE\6HFWLRQ RIWKH&RGHWKH3DUWLHVKHUHWRSXUVXDQWWRWKHDXWKRUL]DWLRQFRQWDLQHGLQ
6HFWLRQ DQG RIWKH&RGHDJUHHWKDWHDFK3DUW\VKDOOEHOLDEOHIRUDQ\GDPDJHV
LQFOXGLQJEXWQRWOLPLWHGWRFODLPVGHPDQGVORVVHVOLDELOLWLHVFRVWVDQGH[SHQVHVLQFOXGLQJ
UHDVRQDEOHDWWRUQH\V¶IHHVUHVXOWLQJIURPWKHQHJOLJHQWRUZURQJIXODFWVRURPLVVLRQVRIWKHLU
HPSOR\HHVRUDJHQWVLQWKHSHUIRUPDQFHRIWKLV$JUHHPHQWDQGHDFK3DUW\VKDOOLQGHPQLI\GHIHQG
DQGKROGKDUPOHVVWKHRWKHU3DUWLHVIURPVXFKFODLPVGHPDQGVGDPDJHVORVVHVRUOLDELOLWLHVIRU
WKHLUQHJOLJHQFH
7KH KROG KDUPOHVV DQG LQGHPQLILFDWLRQ REOLJDWLRQV VHW IRUWK KHUHLQ VKDOO VXUYLYH WKH
WHUPLQDWLRQDQGH[SLUDWLRQRIWKLV$JUHHPHQW,QWKHHYHQWWKHUHLVFRQIOLFWEHWZHHQWKLVFODXVHDQG
&DOLIRUQLD&LYLO&RGH6HFWLRQWKLVFODXVHVKDOOEHLQWHUSUHWHGWRFRPSO\ZLWK&LYLO&RGH
6XFKLQWHUSUHWDWLRQVKDOOQRWUHOLHYHWKH&,7<IURPLQGHPQLI\LQJWKH,QGHPQLWHHVWRWKH
IXOOHVWH[WHQWDOORZHGE\ODZ
,1685$1&(:LWKRXW OLPLWLQJ RU GLPLQLVKLQJ WKH &,7<¶V REOLJDWLRQ WR
LQGHPQLI\RUKROGWKH&2817<KDUPOHVV&,7<VKDOOSURFXUHDQGPDLQWDLQRUFDXVHWREH
PDLQWDLQHGDWLWVVROHFRVWDQGH[SHQVHWKHIROORZLQJLQVXUDQFHFRYHUDJH¶VGXULQJWKHWHUPRIWKLV
$JUHHPHQW$VUHVSHFWVWRWKHLQVXUDQFHVHFWLRQRQO\WKH&2817<KHUHLQUHIHUVWRWKH&RXQW\
RI5LYHUVLGHLWV$JHQFLHV'LVWULFWV6SHFLDO'LVWULFWVDQG'HSDUWPHQWVWKHLUUHVSHFWLYHGLUHFWRUV
3DJHRI
RIILFHUV %RDUG RI &2817< 2) 5,9(56,'(6XSHUYLVRUV HPSOR\HHV HOHFWHG RU DSSRLQWHG
RIILFLDOVDJHQWVRUUHSUHVHQWDWLYHVDV$GGLWLRQDO,QVXUHGV
D :RUNHUV¶&RPSHQVDWLRQ
,IWKH&,7<KDVHPSOR\HHVDVGHILQHGE\WKH6WDWHRI&DOLIRUQLDWKH&,7<VKDOO
PDLQWDLQVWDWXWRU\:RUNHUV
&RPSHQVDWLRQ,QVXUDQFH &RYHUDJH$ DVSUHVFULEHGE\WKHODZVRI
WKH 6WDWH RI &DOLIRUQLD 3ROLF\ VKDOO LQFOXGH (PSOR\HUV¶ /LDELOLW\ &RYHUDJH % LQFOXGLQJ
2FFXSDWLRQDO'LVHDVHZLWKOLPLWVQRWOHVVWKDQSHUSHUVRQSHUDFFLGHQW7KHSROLF\VKDOO
EHHQGRUVHGWRZDLYHVXEURJDWLRQLQIDYRURIWKH&RXQW\RI5LYHUVLGH
E &RPPHUFLDO*HQHUDO/LDELOLW\
&RPPHUFLDO*HQHUDO/LDELOLW\LQVXUDQFHFRYHUDJHLQFOXGLQJEXWQRWOLPLWHGWR
SUHPLVHVOLDELOLW\FRQWUDFWXDOOLDELOLW\SURGXFWVDQGFRPSOHWHGRSHUDWLRQVOLDELOLW\SHUVRQDODQG
DGYHUWLVLQJLQMXU\DQGFURVVOLDELOLW\FRYHUDJHFRYHULQJFODLPVZKLFKPD\DULVHIURPRURXWRI
&,7<¶6SHUIRUPDQFHRILWVREOLJDWLRQVKHUHXQGHU3ROLF\VKDOOQDPHWKH&RXQW\RI5LYHUVLGHDV
$GGLWLRQDO,QVXUHG3ROLF\¶VOLPLWRIOLDELOLW\VKDOOQRWEHOHVVWKDQSHURFFXUUHQFH
FRPELQHG VLQJOH OLPLW ,I VXFK LQVXUDQFH FRQWDLQV D JHQHUDO DJJUHJDWH OLPLW LW VKDOO DSSO\
VHSDUDWHO\WRWKLVDJUHHPHQWRUEHQROHVVWKDQWZR WLPHVWKHRFFXUUHQFHOLPLW
F 9HKLFOH/LDELOLW\
,IYHKLFOHVRUPRELOHHTXLSPHQWDUHXVHGLQWKHSHUIRUPDQFHRIWKHREOLJDWLRQV
XQGHUWKLV$JUHHPHQWWKHQ&,7<VKDOOPDLQWDLQOLDELOLW\LQVXUDQFHIRUDOORZQHGQRQRZQHGRU
KLUHGYHKLFOHVVRXVHGLQDQDPRXQWQRWOHVVWKDQSHURFFXUUHQFHFRPELQHGVLQJOHOLPLW
,IVXFKLQVXUDQFHFRQWDLQVDJHQHUDODJJUHJDWHOLPLWLWVKDOODSSO\VHSDUDWHO\WRWKLVDJUHHPHQWRU
EHQROHVVWKDQWZR WLPHVWKHRFFXUUHQFHOLPLW3ROLF\VKDOOQDPHWKH&RXQW\RI5LYHUVLGHDV
$GGLWLRQDO,QVXUHG
G *HQHUDO,QVXUDQFH3URYLVLRQV$OOOLQHV
L $Q\LQVXUDQFHFDUULHUSURYLGLQJLQVXUDQFHFRYHUDJHKHUHXQGHUVKDOO
EHDGPLWWHGWRWKH6WDWHRI&DOLIRUQLDDQGKDYHDQ$0%(67UDWLQJRIQRWOHVVWKDQ$ 9,,, $
3DJH RI
XQOHVVVXFKUHTXLUHPHQWVDUHZDLYHGLQZULWLQJE\WKH&RXQW\5LVN0DQDJHU,IWKH&RXQW\¶V
5LVN0DQDJHUZDLYHVDUHTXLUHPHQWIRUDSDUWLFXODULQVXUHUVXFKZDLYHULVRQO\YDOLGIRUWKDW
VSHFLILFLQVXUHUDQGRQO\IRURQHSROLF\WHUP
LL 7KH&,7<PXVWGHFODUHLWVLQVXUDQFHVHOILQVXUHGUHWHQWLRQV,IVXFK
VHOILQVXUHGUHWHQWLRQVH[FHHGSHURFFXUUHQFHVXFKUHWHQWLRQVVKDOOKDYHWKHSULRUZULWWHQ
FRQVHQW RI WKH &RXQW\ 5LVN 0DQDJHU EHIRUH WKH FRPPHQFHPHQW RI RSHUDWLRQV XQGHU WKLV
$JUHHPHQW8SRQQRWLILFDWLRQRIVHOILQVXUHGUHWHQWLRQXQDFFHSWDEOHWRWKH&2817<DQGDWWKH
HOHFWLRQRIWKH&RXQWU\¶V5LVN0DQDJHU&,7<¶6FDUULHUVVKDOOHLWKHU UHGXFHRUHOLPLQDWHVXFK
VHOILQVXUHGUHWHQWLRQDVUHVSHFWVWKLV$JUHHPHQWZLWKWKH&2817<RU SURFXUHDERQGZKLFK
JXDUDQWHHVSD\PHQWRIORVVHVDQGUHODWHGLQYHVWLJDWLRQVFODLPVDGPLQLVWUDWLRQDQGGHIHQVHFRVWV
DQGH[SHQVHV
LLL &,7<VKDOOFDXVH&,7<¶6LQVXUDQFHFDUULHU V WRIXUQLVKWKH&RXQW\
RI5LYHUVLGHZLWKHLWKHU DSURSHUO\H[HFXWHGRULJLQDO&HUWLILFDWH V RI,QVXUDQFHDQGFHUWLILHG
RULJLQDOFRSLHVRI(QGRUVHPHQWVHIIHFWLQJFRYHUDJHDVUHTXLUHGKHUHLQDQG LIUHTXHVWHGWRGRVR
RUDOO\RULQZULWLQJE\WKH&RXQW\5LVN0DQDJHUSURYLGHRULJLQDO&HUWLILHGFRSLHVRISROLFLHV
LQFOXGLQJDOO(QGRUVHPHQWVDQGDOODWWDFKPHQWVWKHUHWRVKRZLQJVXFKLQVXUDQFHLVLQIXOOIRUFHDQG
HIIHFW)XUWKHUVDLG&HUWLILFDWH V DQGSROLFLHVRILQVXUDQFHVKDOOFRQWDLQWKHFRYHQDQWRIWKH
LQVXUDQFHFDUULHU V WKDWWKLUW\ GD\VZULWWHQQRWLFHVKDOOEHJLYHQWRWKH&RXQW\RI5LYHUVLGH
SULRUWRDQ\PDWHULDOPRGLILFDWLRQFDQFHOODWLRQH[SLUDWLRQRU UHGXFWLRQ LQ FRYHUDJH RI VXFK
LQVXUDQFH ,Q WKH HYHQW RI D PDWHULDO PRGLILFDWLRQ FDQFHOODWLRQ H[SLUDWLRQ RU UHGXFWLRQ LQ
FRYHUDJHWKLV$JUHHPHQWVKDOOWHUPLQDWHIRUWKZLWKXQOHVVWKH&RXQW\RI5LYHUVLGHUHFHLYHVSULRU
WRVXFKHIIHFWLYHGDWHDQRWKHUSURSHUO\H[HFXWHGRULJLQDO&HUWLILFDWHRI,QVXUDQFHDQGRULJLQDO
FRSLHVRIHQGRUVHPHQWVRUFHUWLILHGRULJLQDOSROLFLHVLQFOXGLQJDOOHQGRUVHPHQWVDQGDWWDFKPHQWV
WKHUHWRHYLGHQFLQJFRYHUDJH¶VVHWIRUWKKHUHLQDQGWKHLQVXUDQFHUHTXLUHGKHUHLQLVLQIXOOIRUFHDQG
HIIHFW&,7<VKDOOQRWFRPPHQFHRSHUDWLRQVXQWLOWKH&2817<KDVEHHQIXUQLVKHGRULJLQDO
&HUWLILFDWH V RI,QVXUDQFHDQGFHUWLILHGRULJLQDOFRSLHVRIHQGRUVHPHQWVDQGLIUHTXHVWHGFHUWLILHG
3DJHRI
RULJLQDOSROLFLHVRILQVXUDQFHLQFOXGLQJDOOHQGRUVHPHQWVDQGDQ\DQGDOORWKHUDWWDFKPHQWVDV
UHTXLUHGLQWKLV6HFWLRQ$QLQGLYLGXDODXWKRUL]HGE\WKHLQVXUDQFHFDUULHUWRGRVRRQLWVEHKDOI
VKDOOVLJQWKHRULJLQDOHQGRUVHPHQWVIRUHDFKSROLF\DQGWKH&HUWLILFDWHRI,QVXUDQFH
LY ,WLVXQGHUVWRRGDQGDJUHHGWRE\WKHSDUWLHVKHUHWRWKDWWKH&,7<¶6
LQVXUDQFH VKDOO EH FRQVWUXHG DV SULPDU\ LQVXUDQFH DQG WKH &2817<
6 LQVXUDQFH DQGRU
GHGXFWLEOHVDQGRUVHOILQVXUHGUHWHQWLRQ¶VRUVHOILQVXUHGSURJUDPVVKDOOQRWEHFRQVWUXHGDV
FRQWULEXWRU\
Y ,IGXULQJWKHWHUPRIWKLV$JUHHPHQWRUDQ\H[WHQVLRQWKHUHRIWKHUH
LVDPDWHULDOFKDQJHLQWKHVFRSHRIVHUYLFHV RUWKHUHLVDPDWHULDOFKDQJHLQWKHHTXLSPHQWWREH
XVHGLQWKHSHUIRUPDQFHRIWKHVFRSHRIRUWKHWHUPRIWKLV$JUHHPHQWLQFOXGLQJDQ\H[WHQVLRQV
WKHUHRIH[FHHGVILYH \HDUVWKH&2817<UHVHUYHVWKHULJKWWRDGMXVWWKHW\SHVRILQVXUDQFH
UHTXLUHGXQGHUWKLV$JUHHPHQWDQGWKHPRQHWDU\OLPLWVRIOLDELOLW\IRUWKHLQVXUDQFHFRYHUDJH¶V
FXUUHQWO\UHTXLUHGKHUHLQLI LQWKH&RXQW\5LVN0DQDJHU
VUHDVRQDEOHMXGJPHQWWKHDPRXQWRU
W\SHRILQVXUDQFHFDUULHGE\WKH&,7<KDVEHFRPHLQDGHTXDWH
YL &,7<VKDOOSDVVGRZQWKHLQVXUDQFHREOLJDWLRQVFRQWDLQHGKHUHLQWR
DOOWLHUVRIVXEFRQWUDFWRUVZRUNLQJXQGHUWKLV$JUHHPHQW
YLL 7KHLQVXUDQFHUHTXLUHPHQWVFRQWDLQHGLQWKLV$JUHHPHQWPD\EH
PHWZLWKDSURJUDP V RIVHOILQVXUDQFHDFFHSWDEOHWRWKH&2817<
YLLL &,7<DJUHHVWRQRWLI\&2817<RIDQ\FODLPE\DWKLUGSDUW\RU
DQ\LQFLGHQWRUHYHQWWKDWPD\JLYHULVHWRDFODLPDULVLQJIURPWKHSHUIRUPDQFHRIWKLV$JUHHPHQW
,1'(3(1'(17 &2175$&725 7KH &,7< LV IRU SXUSRVHV UHODWLQJWR WKLV
6XSSOHPHQWDO$JUHHPHQWDQLQGHSHQGHQWFRQWUDFWRUDQGVKDOOQRWEHGHHPHGDQHPSOR\HHRIWKH
&2817<,WLVH[SUHVVO\XQGHUVWRRGDQGDJUHHGWKDWWKH&,7< LQFOXGLQJLWVHPSOR\HHVDJHQWV
DQGVXEFRQWUDFWRU¶V VKDOOLQQRHYHQWEHHQWLWOHGWRDQ\EHQHILWVWRZKLFKWKH&2817<HPSOR\HHV
DUHHQWLWOHGLQFOXGLQJEXWQRWOLPLWHGWRRYHUWLPHDQ\UHWLUHPHQWEHQHILWVZRUNHU
VFRPSHQVDWLRQ
EHQHILWV DQG LQMXU\ OHDYH RU RWKHU OHDYH EHQHILWV 7KHUH VKDOO EH QR HPSOR\HUHPSOR\HH
UHODWLRQVKLSEHWZHHQWKHSDUWLHV DQGWKH&,7<VKDOOKROGWKH&2817<KDUPOHVVIURPDQ\DQGDOO
3DJHRI
FODLPVWKDWPD\EHPDGHDJDLQVWWKH&2817<EDVHGXSRQDQ\FRQWHQWLRQE\DWKLUGSDUW\WKDWDQ
HPSOR\HUHPSOR\HHUHODWLRQVKLSH[LVWVE\UHDVRQRIWKLV6XSSOHPHQWDO$JUHHPHQW,WLVIXUWKHU
XQGHUVWRRGDQGDJUHHGE\WKHSDUWLHVWKDWWKH&,7<LQWKHSHUIRUPDQFHRIWKLV6XSSOHPHQWDO
$JUHHPHQWLVVXEMHFWWRWKHFRQWURORUGLUHFWLRQRIWKH&2817<PHUHO\DVWRWKHUHVXOWVWREH
DFFRPSOLVKHGDQGQRWDVWRWKHPHDQVDQGPHWKRGVIRUDFFRPSOLVKLQJWKHUHVXOWV
121',6&5,0,1$7,21&,7<VKDOODELGHE\&)56HFWLRQVDQG
RI7LWOHRIWKH&RGHRI)HGHUDO5HJXODWLRQVZKLFKUHTXLUHVWKDWQRSHUVRQLQWKH8QLWHG
6WDWHVVKDOORQWKHJURXQGVRIUDFHFRORUQDWLRQDORULJLQVH[VH[XDORULHQWDWLRQJHQGHULGHQWLW\
RUYHWHUDQVVWDWXVEHH[FOXGHGIURPSDUWLFLSDWLRQLQEHGHQLHGWKHEHQHILWVRIRUEHVXEMHFWHGWR
GLVFULPLQDWLRQ XQGHU DQ\ SURJUDP RU DFWLYLW\ IXQGHG LQ ZKROH RU LQ SDUW ZLWK &RPPXQLW\
'HYHORSPHQWIXQGV
&,7< VKDOO DELGH E\ DQG LQFOXGH LQ DQ\ VXEFRQWUDFWV WR SHUIRUPZRUN XQGHU WKLV
6XSSOHPHQWDO$JUHHPHQWWKHIROORZLQJFODXVH
'XULQJWKHSHUIRUPDQFHRIWKLV6XSSOHPHQWDO$JUHHPHQW&,7<DQGLWVVXEFRQWUDFWRUV
VKDOO QRW XQODZIXOO\ GLVFULPLQDWH DJDLQVW DQ\ HPSOR\HH RU DSSOLFDQW IRU HPSOR\PHQW
EHFDXVHRIUDFHUHOLJLRQFRORUQDWLRQDORULJLQDQFHVWU\SK\VLFDOGLVDELOLW\PHGLFDO
FRQGLWLRQPDULWDOVWDWXVYHWHUDQVVWDWXVVH[XDORULHQWDWLRQJHQGHULGHQWLW\DJH RYHU
RUVH[&,7<DQGVXEFRQWUDFWRUVVKDOOLQVXUHWKDWWKHHYDOXDWLRQDQGWUHDWPHQWRIWKHLU
HPSOR\HHVDQGDSSOLFDQWVIRUHPSOR\PHQWDUHIUHHRIVXFKGLVFULPLQDWLRQ&,7<DQG
VXEFRQWUDFWRUVVKDOOFRPSO\ZLWKWKHSURYLVLRQVRIWKH)DLU(PSOR\PHQWDQG+RXVLQJ$FW
&DOLIRUQLD*RYHUQPHQW&RGH6HFWLRQ HWVHT 7KHDSSOLFDEOHUHJXODWLRQVRIWKH
)DLU(PSOR\PHQWDQG+RXVLQJ&RPPLVVLRQDUHLPSOHPHQWLQJ&DOLIRUQLD*RYHUQPHQW
&RGH6HFWLRQ HWVHTVHWIRUWKLQ&KDSWHURI'LYLVLRQRI7LWOHRIWKH&DOLIRUQLD
$GPLQLVWUDWLYH&RGHDUHLQFRUSRUDWHGLQWRWKLV$JUHHPHQWE\UHIHUHQFHDQGPDGHDSDUW
KHUHRIDVLIVHWIRUWKLQIXOO&,7<DQGLWVVXEFRQWUDFWRUVVKDOOJLYHZULWWHQQRWLFHRIWKHLU
REOLJDWLRQVXQGHUWKLVFODXVHWRODERURUJDQL]DWLRQVZLWKZKLFKWKH\KDYHDFROOHFWLYH
EDUJDLQLQJRURWKHUDJUHHPHQW
3DJHRI
352+,%,7,21$*$,167&21)/,&762),17(5(67
$ &,7<DQGLWVDVVLJQVHPSOR\HHVDJHQWVFRQVXOWDQWVRIILFHUVDQGHOHFWHG
DQG DSSRLQWHG RIILFLDOV VKDOO EHFRPH IDPLOLDU ZLWK DQG VKDOO FRPSO\ZLWKWKH8QLIRUP
$GPLQLVWUDWLYH5HTXLUHPHQWV&RVW3ULQFLSOHVDQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV
&)53DUW DQGWKH&'%*UHJXODWLRQVSURKLELWLQJFRQIOLFWVRILQWHUHVWFRQWDLQHGLQ&)5
% 7KH6XEUHFLSLHQWVKDOOPDLQWDLQDZULWWHQFRGHRUVWDQGDUGVRIFRQGXFWWKDW
VKDOOJRYHUQWKHSHUIRUPDQFHRILWVRIILFHUVHPSOR\HHVRUDJHQWVHQJDJHGLQWKHDZDUGDQG
DGPLQLVWUDWLRQRIFRQWUDFWVVXSSRUWHGE\)HGHUDOIXQGV
& 1RHPSOR\HHRIILFHURUDJHQWRIWKH6XEUHFLSLHQWVKDOOSDUWLFLSDWHLQWKH
VHOHFWLRQRULQWKHDZDUGRUDGPLQLVWUDWLRQRIDFRQWUDFWVXSSRUWHGE\)HGHUDOIXQGVLIDFRQIOLFW
RILQWHUHVWUHDORUDSSDUHQWZRXOGEHLQYROYHG
' 1R FRYHUHG SHUVRQV ZKR H[HUFLVH RU KDYH H[HUFLVHG DQ\ IXQFWLRQV RU
UHVSRQVLELOLWLHVZLWKUHVSHFWWR&'%*DVVLVWHGDFWLYLWLHVRUZKRDUHLQDSRVLWLRQWRSDUWLFLSDWHLQ
DGHFLVLRQPDNLQJSURFHVVRUJDLQLQVLGHLQIRUPDWLRQZLWKUHJDUGWRVXFKDFWLYLWLHVPD\REWDLQD
ILQDQFLDOLQWHUHVWLQDQ\FRQWUDFWRUKDYHDILQDQFLDOLQWHUHVWLQDQ\FRQWUDFWVXEFRQWUDFWRU
DJUHHPHQWZLWKUHVSHFWWRWKH&'%*DVVLVWHGDFWLYLW\RUZLWKUHVSHFWWRWKHSURFHHGVIURPWKH
&'%*DVVLVWHG DFWLYLW\ HLWKHU IRU WKHPVHOYHV RU WKRVH ZLWK ZKRP WKH\ KDYH EXVLQHVV RU
LPPHGLDWHIDPLO\WLHVGXULQJWKHLUWHQXUHRUIRUDSHULRGRIRQH \HDUWKHUHDIWHU)RUSXUSRVHV
RIWKLVSDUDJUDSKD³FRYHUHGSHUVRQ´LQFOXGHVDQ\SHUVRQZKRLVDQHPSOR\HHDJHQWFRQVXOWDQW
RIILFHURUHOHFWHGRUDSSRLQWHGRIILFLDORIWKH*UDQWHHWKH6XEUHFLSLHQWRUDQ\GHVLJQDWHGSXEOLF
DJHQF\
( &,7<XQGHUVWDQGVDQGDJUHHVWKDWQRZDLYHURIH[FHSWLRQFDQEHJUDQWHGWR
WKHSURKLELWLRQDJDLQVWFRQIOLFWRILQWHUHVWH[FHSWXSRQZULWWHQDSSURYDORI+8'SXUVXDQWWR
&)5 G $Q\UHTXHVWE\&,7<IRUDQH[FHSWLRQVKDOOILUVWEHUHYLHZHGE\&2817<WR
GHWHUPLQHZKHWKHUVXFKUHTXHVWLVDSSURSULDWHIRUVXEPLVVLRQWR+8'LQWKH&2817<¶6VROHDQG
DEVROXWHGLVFUHWLRQ,QGHWHUPLQLQJZKHWKHUVXFKUHTXHVWLVDSSURSULDWHIRUVXEPLVVLRQWR+8'
3DJHRI
&2817<ZLOOFRQVLGHUWKHIDFWRUVOLVWHGLQ&)5 G
) 3ULRUWRWKHGLVWULEXWLRQRIDQ\&'%*IXQGLQJXQGHUWKLV6XSSOHPHQWDO
$JUHHPHQW&,7<VKDOOSURYLGH&2817<LQZULWLQJDOLVWRIDOOHPSOR\HHVDJHQWVFRQVXOWDQWV
RIILFHUVDQGHOHFWHGDQGDSSRLQWHGRIILFLDOVZKRDUHLQDSRVLWLRQWRSDUWLFLSDWHLQDGHFLVLRQPDNLQJ
SURFHVVH[HUFLVHDQ\IXQFWLRQVRUUHVSRQVLELOLWLHVRUJDLQLQVLGHLQIRUPDWLRQZLWKUHVSHFWWRWKH
&'%*DFWLYLWLHVIXQGHGXQGHUWKLV$JUHHPHQW&,7<VKDOODOVRSURPSWO\GLVFORVHWR&2817<
DQ\SRWHQWLDOFRQIOLFWLQFOXGLQJHYHQWKHDSSHDUDQFHRIFRQIOLFWWKDWPD\DULVHZLWKUHVSHFWWRWKH
&'%*DFWLYLWLHVIXQGHGXQGHUWKLV6XSSOHPHQWDO$JUHHPHQW
* $Q\YLRODWLRQRIWKLV6HFWLRQVKDOOEHGHHPHGDPDWHULDOEUHDFKRIWKLV
6XSSOHPHQWDO$JUHHPHQWDQGWKH6XSSOHPHQWDO$JUHHPHQWVKDOOEHLPPHGLDWHO\WHUPLQDWHGE\
WKH&2817<
/2%%<,1*&,7<FHUWLILHVWRWKHEHVWRILWVNQRZOHGJHDQGEHOLHIWKDW
D 1RIHGHUDOO\DSSURSULDWHGIXQGVKDYHEHHQSDLGRUZLOOEHSDLGE\RURQ
EHKDOIRIWKH&,7<WRDQ\SHUVRQIRULQIOXHQFLQJRUDWWHPSWLQJWRLQIOXHQFHDQRIILFHURUHPSOR\HH
RIDQ\DJHQF\DPHPEHURI&RQJUHVVDQRIILFHURUHPSOR\HHRI&RQJUHVVRUDQHPSOR\HHRID
PHPEHURI&RQJUHVVLQFRQQHFWLRQZLWKWKHDZDUGLQJRIDQ\IHGHUDOFRQWUDFWWKHPDNLQJRIDQ\
IHGHUDOJUDQWWKHPDNLQJRIDQ\IHGHUDOORDQWKHHQWHULQJLQWRRIDQ\FRRSHUDWLYHDJUHHPHQWDQG
WKHH[WHQVLRQFRQWLQXDWLRQUHQHZDODPHQGPHQWRUPRGLILFDWLRQRIDQ\IHGHUDOFRQWUDFWJUDQW
ORDQRUFRRSHUDWLYHDJUHHPHQW
E ,IDQ\IXQGVRWKHUWKDQIHGHUDOO\DSSURSULDWHGIXQGVKDYHEHHQSDLGRUZLOO
EHSDLGWRDQ\SHUVRQIRULQIOXHQFLQJRUDWWHPSWLQJWRLQIOXHQFHDQRIILFHURUHPSOR\HHRIDQ\
DJHQF\DPHPEHURI&RQJUHVVDQRIILFHURUHPSOR\HHRI&RQJUHVVRUDQHPSOR\HHRIDPHPEHU
RI&RQJUHVVLQFRQQHFWLRQZLWKWKLVIHGHUDOFRQWUDFWJUDQWORDQRUFRRSHUDWLYHDJUHHPHQWWKH
&,7<VKDOOFRPSOHWHDQGVXEPLW6WDQGDUG)RUP///'LVFORVXUH)RUPWR5HSRUW/REE\LQJLQ
DFFRUGDQFHZLWKLWVLQVWUXFWLRQV
F &,7<VKDOOUHTXLUHWKDWWKHODQJXDJHRIWKLVFHUWLILFDWLRQEHLQFOXGHGLQWKH
DZDUGGRFXPHQWVIRUDOOVXEDZDUGVDWDOOWLHUV LQFOXGLQJVXEFRQWUDFWVVXEJUDQWVDQGFRQWUDFWV
3DJHRI
XQGHUJUDQWVORDQVDQGFRRSHUDWLYHDJUHHPHQWV DQGWKDWDOOVXEUHFLSLHQWVVKDOOFHUWLI\DQG
GLVFORVHDFFRUGLQJO\7KLVFHUWLILFDWLRQLVDPDWHULDOUHSUHVHQWDWLRQRIIDFWXSRQZKLFKUHOLDQFH
ZDVSODFHGZKHQWKLVWUDQVDFWLRQZDVPDGHRUHQWHUHGLQWR
7(50,1$7,21
$ &,7<&,7<PD\QRWWHUPLQDWHWKLV$JUHHPHQWH[FHSWXSRQH[SUHVVZULWWHQ
FRQVHQWRI&2817<SXUVXDQWWR&)5 D
% &2817< 1RWZLWKVWDQGLQJ WKH SURYLVLRQV RI 3DUDJUDSK D DERYH
&2817<PD\VXVSHQGRUWHUPLQDWHWKLV6XSSOHPHQWDO$JUHHPHQWXSRQDWHQ GD\ZULWWHQ
QRWLFHWR&,7<RIDFWLRQEHLQJWDNHQDQGWKHUHDVRQIRUVXFKDFWLRQLQFOXGLQJEXWQRWOLPLWHGWR
WKHIROORZLQJUHDVRQV
,QWKHHYHQW&,7<IDLOVWRSHUIRUPWKHFRYHQDQWVKHUHLQFRQWDLQHG
DWVXFKWLPHVDQGLQVXFKPDQQHUDVSURYLGHGLQWKLV6XSSOHPHQWDO$JUHHPHQW DQG
,QWKHHYHQWWKHUHLVDFRQIOLFWZLWKDQ\IHGHUDOVWDWHRUORFDOODZ
RUGLQDQFHUHJXODWLRQRUUXOHUHQGHULQJDQ\RIWKHSURYLVLRQVRIWKLV6XSSOHPHQWDO$JUHHPHQW
LQYDOLGRUXQWHQDEOH RU
,QWKHHYHQWWKHIXQGLQJIURPWKH'HSDUWPHQWRI+RXVLQJDQG8UEDQ
'HYHORSPHQWUHIHUUHGWRLQ6HFWLRQVDQGDERYHLVWHUPLQDWHGRURWKHUZLVHEHFRPHVXQDYDLODEOH
& 7KLV$JUHHPHQWPD\EHWHUPLQDWHGDQGRUIXQGLQJVXVSHQGHGLQZKROHRU
LQSDUWIRUFDXVHLQDFFRUGDQFHZLWKWKH8QLIRUP$GPLQLVWUDWLYH5HTXLUHPHQWV&RVW3ULQFLSOHV
DQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV &)5 &DXVHVKDOOEHEDVHGRQWKHIDLOXUH
RIWKH&,7<WRPDWHULDOO\FRPSO\ZLWKHLWKHUWKHWHUPVRUFRQGLWLRQVRIWKLV$JUHHPHQW8SRQ
VXVSHQVLRQRIIXQGLQJWKH&,7<DJUHHVQRWWRLQFXUDQ\FRVWVUHODWHGWKHUHWRRUFRQQHFWHGZLWK
DQ\ DUHD RI FRQIOLFW IURP ZKLFK WKH &2817< KDV GHWHUPLQHG WKDWVXVSHQVLRQ RI IXQGV LV
QHFHVVDU\&,7<DFNQRZOHGJHVWKDWIDLOXUHWRFRPSO\ZLWK)HGHUDOVWDWXWHVUHJXODWLRQVRUWKH
WHUPVDQGFRQGLWLRQVRIWKLV$JUHHPHQWPD\EHFRQVLGHUHGE\WKH&2817<LQHYDOXDWLQJIXWXUH
&'%*DQGQRQ&'%*IXQGLQJDSSOLFDWLRQVVXEPLWWHGE\&,7<
' 8SRQVXVSHQVLRQRUWHUPLQDWLRQRIWKLV6XSSOHPHQWDO$JUHHPHQW&,7<
3DJHRI
VKDOOUHWXUQDQ\XQHQFXPEHUHGIXQGVZKLFKLWKDVEHHQSURYLGHGE\&2817<,QDFFHSWLQJVDLG
IXQGV&2817<GRHVQRWZDLYHDQ\FODLPRUFDXVHRIDFWLRQLWPD\KDYHDJDLQVW&,7<IRUEUHDFK
RIWKLV6XSSOHPHQWDO$JUHHPHQW
( 5HYHUVLRQRI$VVHWV
8SRQH[SLUDWLRQRUWHUPLQDWLRQRIWKLV6XSSOHPHQWDO$JUHHPHQWWKH
&,7<VKDOOWUDQVIHUWRWKH&2817<DQ\&'%*IXQGVRQKDQGDWWKHWLPHRIH[SLUDWLRQRIWKH
6XSSOHPHQWDO$JUHHPHQWDVZHOODVDQ\DFFRXQWVUHFHLYDEOHKHOGE\&,7<ZKLFKDUHDWWULEXWDEOH
WRWKHXVHRI&'%*IXQGVDZDUGHGSXUVXDQWWRWKLV6XSSOHPHQWDO$JUHHPHQW
$Q\UHDOSURSHUW\XQGHUWKH&,7<¶6FRQWUROWKDWZDVDFTXLUHGRU
LPSURYHGLQZKROHRULQSDUWZLWK&'%*IXQGV LQFOXGLQJ&'%*IXQGVSURYLGHGWRWKH&,7<LQ
WKHIRUPRIDORDQ LQH[FHVVRILVHLWKHU
L 8VHGWRPHHWRQHRIWKH1DWLRQDO2EMHFWLYHVSXUVXDQWWR
&)5XQWLOILYH\HDUVDIWHUH[SLUDWLRQRIWKLVDJUHHPHQWRUIRUVXFKORQJHUSHULRGRIWLPH
DVGHWHUPLQHGWREHDSSURSULDWHE\WKH&2817< RU
LL 1RWXVHGLQDFFRUGDQFHZLWK&ODXVH L DERYHLQZKLFKHYHQW
WKH&,7<VKDOOSD\WKH&2817<DQDPRXQWHTXDOWRWKHFXUUHQWPDUNHWYDOXHRIWKHSURSHUW\OHVV
DQ\SRUWLRQRIWKHYDOXHDWWULEXWDEOHWRH[SHQGLWXUHVRIQRQ&'%*IXQGVIRUWKHDFTXLVLWLRQRIRU
LPSURYHPHQWWRWKHSURSHUW\
38%/,&,7<$Q\SXEOLFLW\JHQHUDWHGE\&,7<IRUWKH3URMHFWVIXQGHGSXUVXDQWWR
WKLV 6XSSOHPHQWDO $JUHHPHQW ZLOO PDNH UHIHUHQFH WR WKH FRQWULEXWLRQ RI WKH &2817< WKH
'HSDUWPHQW RI +RXVLQJ +RPHOHVVQHVV 3UHYHQWLRQ DQG :RUNIRUFH 'HYHORSPHQW DQG WKH
&RPPXQLW\'HYHORSPHQW%ORFN*UDQW3URJUDPLQPDNLQJWKHSURMHFWSRVVLEOH
352*5$0021,725,1*$1'(9$/8$7,21&,7<DQGLWVVXEFRQWUDFWRUV
VKDOOEHPRQLWRUHGDQGHYDOXDWHGLQWHUPVRILWVHIIHFWLYHQHVVDQGWLPHO\FRPSOLDQFHZLWKWKH
SURYLVLRQVRIWKLV6XSSOHPHQWDO$JUHHPHQWDQGWKHHIIHFWLYHDQGHIILFLHQWDFKLHYHPHQWRIWKH
&'%*1DWLRQDO2EMHFWLYHVDVVHWIRUWKLQ([KLELW V $DQG%DWWDFKHGKHUHWR4XDUWHUO\UHSRUWV
VKDOOEHGXHRQWKHODVWGD\RIWKHPRQWKLPPHGLDWHO\IROORZLQJWKHHQGRIWKHTXDUWHUEHLQJ
3DJHRI
UHSRUWHG7KHTXDUWHUO\ZULWWHQUHSRUWVVKDOOLQFOXGHEXWVKDOOQRWEHOLPLWHGWRWKHIROORZLQJGDWD
HOHPHQWV
$ 7LWOHRISURJUDPOLVWLQJRIFRPSRQHQWVGHVFULSWLRQRIDFWLYLWLHVRSHUDWLRQV
% 7KHSURMHFWHGJRDOVLQGLFDWHGQXPHULFDOO\DQGDOVRWKHJRDOVDFKLHYHG IRU
HDFKUHSRUWSHULRG ,QDGGLWLRQLGHQWLI\E\SHUFHQWDJHDQGGHVFULSWLRQWKHSURJUHVVDFKLHYHG
WRZDUGVPHHWLQJWKHVSHFLILHGJRDOVDQGLGHQWLI\DQ\SUREOHPVHQFRXQWHUHGLQPHHWLQJJRDOV
& ,IWKH&'%*IXQGHGDFWLYLW\PHHWVD1DWLRQDO2EMHFWLYHXQGHU&)5
D L &,7<ZLOOUHSRUWWKHIROORZLQJ
7RWDO QXPEHU RI GLUHFW EHQHILFLDULHV FOLHQWHOH VHUYHG ZLWK
KRXVHKROGLQFRPHVDW
x$ERYH0+,
x%HWZHHQDQG0+, /RZ,QFRPH
x%HWZHHQDQG0+, 9HU\/RZ,QFRPH
x/HVVWKDQ0+, ([WUHPHO\/RZ,QFRPH
7RWDOQXPEHUDQGSHUFHQW RIWKHFOLHQWHOHVHUYHGWKDWKDYH
KRXVHKROGLQFRPHVDWRUEHORZ0+,
5DFLDOHWKQLFLW\RIFOLHQWHOH
1XPEHURI)HPDOH+HDGHG+RXVHKROGV
' &,7<VKDOOUHSRUWLQZULWLQJDQGFDXVHLWVVXEFRQWUDFWRUVWRUHSRUWLQ
ZULWLQJ EHQHILFLDU\ VWDWLVWLFV PRQWKO\ WR +RXVLQJ +RPHOHVVQHVV 3UHYHQWLRQ DQG :RUNIRUFH
6ROXWLRQV ++3:6 RQ WKH SUHDSSURYHGDirect Benefit Form DQG Self-Certification Form
FHUWLI\LQJLQFRPHIDPLO\VL]HDQGUDFLDOHWKQLFLW\ DVUHTXLUHGE\+8'8SGDWHGIRUPVDUHWREH
SURYLGHG WR &,7< E\ ++3:6 VKRXOG +8' LPSOHPHQW FKDQJHV GXULQJ WKH WHUP RI WKLV
6XSSOHPHQWDO$JUHHPHQW&,7<DQGVXEFRQWUDFWRUVZLOOFROOHFWDQGSURYLGHDOOQHFHVVDU\GDWD
UHTXLUHG E\ +8' SHUWDLQLQJ WR WKH 6SHFLILF 2XWFRPH ,QGLFDWRUV DV LGHQWLILHG LQ +8'¶V
&RPPXQLW\3ODQQLQJDQG'HYHORSPHQW &3' 2XWFRPH3HUIRUPDQFH0HDVXUHPHQW6\VWHP
35,25$87+25,=$7,21&,7< VKDOO REWDLQ &2817<
V ZULWWHQDSSURYDO
3DJHRI
IURP++3:6SULRUWRLPSOHPHQWLQJWKHIROORZLQJ³KLJKULVN´DFWLYLWLHVIXQGHGZLWK&'%*
DVVLVWDQFH
$ &RQVWUXFWLRQRISXEOLFIDFLOLWLHV SURMHFWSODQVDQGVSHFLILFDWLRQV
% $FTXLVLWLRQRIUHDOSURSHUW\
& +LVWRULF3UHVHUYDWLRQ
' 5HORFDWLRQ DQG
) (FRQRPLF'HYHORSPHQW
35,25&2817<$33529$/ &216758&7,21$&7,9,7,(6 &,7<VKDOO
REWDLQ&2817<
VZULWWHQDSSURYDOWKURXJKLWV++3:6RIWKHSURMHFWSODQVVSHFLILFDWLRQV
DQGFRQVWUXFWLRQGRFXPHQWVSULRUWR&,7<¶6FRQVWUXFWLRQRIVDPHIRUDOOSURMHFWVFRQVLVWLQJRI
&'%*IXQGHGFRQVWUXFWLRQDFWLYLWLHV.7KH&2817<QHLWKHUXQGHUWDNHVQRUDVVXPHVQRUZLOO
KDYHDQ\UHVSRQVLELOLW\RUGXW\WR&,7<RUWRDQ\WKLUGSDUW\WRUHYLHZLQVSHFWVXSHUYLVHSDVV
MXGJPHQW XSRQ RU LQIRUP &,7< RU DQ\ WKLUG SDUW\ RI DQ\ PDWWHU LQ FRQQHFWLRQ ZLWK WKH
GHYHORSPHQWRUFRQVWUXFWLRQRIWKHLPSURYHPHQWVZKHWKHUUHJDUGLQJWKHTXDOLW\DGHTXDF\RU
VXLWDELOLW\RIWKHSODQVDQ\ODERUVHUYLFHHTXLSPHQWRUPDWHULDOIXUQLVKHGWRWKHSURSHUW\DQ\
SHUVRQIXUQLVKLQJWKHVDPHRURWKHUZLVH&,7<DQGDOOWKLUGSDUWLHVVKDOOUHO\XSRQLWVRUWKHLU
RZQMXGJPHQWUHJDUGLQJVXFKPDWWHUVDQGDQ\UHYLHZLQVSHFWLRQVXSHUYLVLRQH[HUFLVHRI
MXGJPHQWRULQIRUPDWLRQVXSSOLHGWR&,7<RUWRDQ\WKLUGSDUW\E\WKH&2817<LQFRQQHFWLRQ
ZLWKVXFKPDWWHULVIRUWKHSXEOLFSXUSRVHRIDVVLVWLQJZLWKDFRPPXQLW\GHYHORSPHQWDQG
KRXVLQJDFWLYLW\SXUVXDQWWRWKH$FWDQGQHLWKHU&,7< H[FHSWIRUWKHSXUSRVHVVHWIRUWKLQWKLV
$JUHHPHQW QRUDQ\WKLUGSDUW\LVHQWLWOHGWRUHO\WKHUHRQ7KH&2817<VKDOOQRWEHUHVSRQVLEOH
IRUDQ\RIWKHZRUNRIFRQVWUXFWLRQLPSURYHPHQWRUGHYHORSPHQWRIWKHSURSHUW\
,WLVWKHUHVSRQVLELOLW\RI&,7<ZLWKRXWFRVWWR&2817<WRHQVXUHWKDWDOODSSOLFDEOH
ORFDOMXULVGLFWLRQODQGXVHUHTXLUHPHQWVZLOOSHUPLWGHYHORSPHQWRIWKHSURSHUW\DQGFRQVWUXFWLRQ
RI WKH LPSURYHPHQWV DQG WKH XVH RSHUDWLRQ DQG PDLQWHQDQFH RIVXFK ,PSURYHPHQWV LQ
DFFRUGDQFHZLWKWKHSURYLVLRQVRIWKLV$JUHHPHQW1RWKLQJFRQWDLQHGKHUHLQVKDOOEHGHHPHGWR
HQWLWOH6SRQVRUWRDQ\ORFDOMXULVGLFWLRQRU&RXQW\SHUPLWRURWKHUORFDOMXULVGLFWLRQRU&RXQW\
3DJHRI
DSSURYDO QHFHVVDU\ IRU WKH GHYHORSPHQW RI WKH 3URSHUW\ RU ZDLYH DQ\ DSSOLFDEOH ORFDO
MXULVGLFWLRQRU&RXQW\UHTXLUHPHQWVUHODWLQJWKHUHWR7KLV$JUHHPHQWGRHVQRW D JUDQWDQ\ODQG
XVHHQWLWOHPHQWWR&,7< E VXSHUVHGHQXOOLI\RUDPHQGDQ\FRQGLWLRQZKLFKPD\EHLPSRVHG
E\WKHORFDOMXULVGLFWLRQLQFRQQHFWLRQZLWKDSSURYDORIWKHGHYHORSPHQWGHVFULEHGKHUHLQ F
JXDUDQWHHWR&,7<RUDQ\RWKHUSDUW\DQ\SURILWVIURPWKHGHYHORSPHQWRIWKH3URSHUW\RU G
DPHQGDQ\ORFDOMXULVGLFWLRQRU&RXQW\ODZVFRGHVRUUXOHV
35,25&2817<$33529$/ $48,6,7,21$&7,9,7,(6 &,7<VKDOOREWDLQ
&2817<
VZULWWHQDSSURYDODQGDXWKRUL]DWLRQWRSURFHHGWKURXJKLWV++3:6RIDOO&'%*
IXQGHGUHDOSURSHUW\DFTXLVLWLRQDFWLYLWLHV
5($/ 3523(57< $&48,5(' 25 38%/,& )$&,/,7< &216758&7('
:,7+&'%*)81'6:KHQ&'%*IXQGVDUHXVHGLQZKROHRULQSDUWE\&,7<WRDFTXLUH
UHDOSURSHUW\RUWRFRQVWUXFWDSXEOLFIDFLOLW\&,7<ZLOOFRPSO\ZLWKWKH8QLIRUP$GPLQLVWUDWLYH
5HTXLUHPHQWV&RVW3ULQFLSOHVDQG$XGLW5HTXLUHPHQWVIRU)HGHUDO$ZDUGV &)56HFWLRQ
1DWLRQDO (QYLURQPHQWDO 3ROLF\ $FW RI 86&$ HW VHT WKH
&DOLIRUQLD(QYLURQPHQWDO4XDOLW\$FW &DO3XE5HVRXUFHV&RGHHWVHT WKH8QLIRUP
5HORFDWLRQ$VVLVWDQFHDQG5HDO3URSHUW\$FTXLVLWLRQ3ROLFLHV$FWRI DVDPHQGHG
86&$HWVHT DQGWKH&2817<¶V)LYH<HDU&RQVROLGDWHG3ODQ,QDGGLWLRQWKH
IROORZLQJLVWRRFFXU
D 7LWOHWRWKHUHDOSURSHUW\VKDOOYHVWLQ&,7<
E 7KHUHDOSURSHUW\ZLOOEHKHOGE\&,7<RUWKHFRQVWUXFWHGIDFLOLW\ZLOOEH
PDLQWDLQHGE\WKH&,7<IRUDPLQLPXPSHULRGRIILYH \HDUVIURPWKHGDWHWKH&'%*IXQGHG
DFWLYLW\LVFORVHGRXWDQGUHSRUWHGDVFRPSOHWHE\WKH&2817<WKURXJKWKH&RPSUHKHQVLYH
$QQXDO3HUIRUPDQFHDQG(YDOXDWLRQ5HSRUW &$3(5
F :KLOHKHOGE\&,7<WKHUHDOSURSHUW\RUWKHFRQVWUXFWHGIDFLOLW\LVWREH
XVHGH[FOXVLYHO\IRUWKHSXUSRVHVIRUZKLFKDFTXLVLWLRQRUFRQVWUXFWLRQZDVRULJLQDOO\DSSURYHG
E\&2817<
3DJH RI
G :ULWWHQDSSURYDOIURP&2817<PXVWEHVHFXUHGLIWKHSURSHUW\RUWKH
IDFLOLW\ LV WR EH SXW WR DQ DOWHUQDWH XVH WKDW LV FRQVLVWHQW ZLWK WKH &2817<¶6 )LYH <HDU
&RQVROLGDWHG3ODQRUWKHDSSOLFDEOHIHGHUDOUHJXODWLRQVJRYHUQLQJ&'%*IXQGV
H 6KRXOG&,7<GHVLUHWRXVHWKHUHDOSURSHUW\RUWKHFRQVWUXFWHGIDFLOLW\SULRU
WRWKHFRPSOHWLRQRIWKHPDQGDWRU\ILYH\HDUSHULRGIRUDSXUSRVHQRWFRQVLVWHQWZLWKDSSOLFDEOH
IHGHUDOUHJXODWLRQVJRYHUQLQJ&'%*IXQGVRUWRVHOOWKHUHDOSURSHUW\RUIDFLOLW\WKHQ
,I&,7<GHVLUHVWRUHWDLQWLWOH&,7<ZLOOUHLPEXUVH&2817<WKH
DPRXQW WKDW UHSUHVHQWV WKH SHUFHQWDJH RI FXUUHQW IDLU PDUNHW YDOXH WKDW LV LGHQWLFDO WR WKH
SHUFHQWDJHWKDW&'%*IXQGVLQLWLDOO\FRPSULVHGRIPRQLHVSDLGWRDFTXLUHWKHSURSHUW\RU
FRQVWUXFWWKHIDFLOLW\ RU
,I &,7< VHOOV WKH SURSHUW\ RU IDFLOLW\ RU LV UHTXLUHG WR VHOO WKH
SURSHUW\RUIDFLOLW\&,7<VKDOOUHLPEXUVH&2817<WKHDPRXQWWKDWUHSUHVHQWVWKHSHUFHQWDJH
RISURFHHGVUHDOL]HGE\WKHVDOHWKDWLVLGHQWLFDOWRWKHSHUFHQWDJHWKDW&'%*IXQGVLQLWLDOO\
FRPSULVHGRIPRQLHVSDLGWRDFTXLUHWKHSURSHUW\RUFRQVWUXFWWKHIDFLOLW\7KLVSHUFHQWDJH
DPRXQWZLOOEHFDOFXODWHGDIWHUGHGXFWLQJDOODFWXDODQGUHDVRQDEOHFRVWRIVDOHIURPWKHVDOH
SURFHHGV
(17,5( $*5((0(17 7KLV 6XSSOHPHQWDO $JUHHPHQW LQFOXGLQJ DQ\
DWWDFKPHQWVRUH[KLELWVKHUHWRFRQVWLWXWHVWKHHQWLUH6XSSOHPHQWDO$JUHHPHQWRIWKHSDUWLHVZLWK
UHVSHFW WR LWV VXEMHFW PDWWHU DQG VXSHUVHGHV DOO SULRU DQG FRQWHPSRUDQHRXV UHSUHVHQWDWLRQV
SURSRVDOVGLVFXVVLRQVDQGFRPPXQLFDWLRQVZKHWKHURUDORULQZULWLQJ1RRUDOXQGHUVWDQGLQJRU
DJUHHPHQWQRWLQFRUSRUDWHGKHUHLQVKDOOEHELQGLQJRQDQ\RIWKHSDUWLHVKHUHWR(DFKRIWKH
DWWDFKPHQWVDQGH[KLELWVDWWDFKHGKHUHWRLVLQFRUSRUDWHGKHUHLQE\WKLVUHIHUHQFH
6(9(5$%,/,7< (DFKVHFWLRQSDUDJUDSKDQGSURYLVLRQRIWKLV6XSSOHPHQWDO
$JUHHPHQWLVVHYHUDEOHIURPHDFKRWKHUSURYLVLRQDQGLIDQ\SURYLVLRQRUSDUWWKHUHRILVGHFODUHG
LQYDOLGWKHUHPDLQLQJSURYLVLRQVVKDOOUHPDLQLQIXOOIRUFHDQGHIIHFW
(03/2<0(1723325781,7,(672%(&$86('%<352-(&7&,7<
DJUHHVWRQRWLI\LQZULWLQJDQGWRFDXVHDQ\VXEFRQWUDFWRULPSOHPHQWLQJ&'%*IXQGHG3URMHFWV
3DJHRI
WRQRWLI\LQZULWLQJWKH5LYHUVLGH&RXQW\:RUNIRUFH'HYHORSPHQW&HQWHURIDQ\DQGDOOMRE
RSHQLQJVWKDWDUHFDXVHGE\WKH&'%*IXQGHG3URMHFWVXQGHUWKLV6XSSOHPHQWDO$JUHHPHQW
0,1,67(5,$/$&767KH'LUHFWRURI+RXVLQJ+RPHOHVVQHVV3UHYHQWLRQDQG
:RUNIRUFH6ROXWLRQVRUGHVLJQHH V DUHDXWKRUL]HGWRWDNHVXFKPLQLVWHULDODFWLRQVDVPD\EH
QHFHVVDU\RUDSSURSULDWHWRLPSOHPHQWWKHWHUPVSURYLVLRQVDQGFRQGLWLRQVRIWKLV6XSSOHPHQWDO
$JUHHPHQWDVLWPD\EHDPHQGHGIURPWLPHWRWLPHE\&2817<
352-(&7(/,*,%,/,7<$VWR&,7<RULWVFODLPDQWV&2817<VKDOOEHDUQR
OLDELOLW\IRUDQ\ODWHUGHWHUPLQDWLRQE\WKH8QLWHG6WDWHV*RYHUQPHQWWKH86'HSDUWPHQWRI
+RXVLQJDQG8UEDQ'HYHORSPHQWRUDQ\RWKHUSHUVRQRUHQWLW\WKDW&,7<LVRULVQRWHOLJLEOH
XQGHU&)53DUWWRUHFHLYH&'%*HQWLWOHPHQWIXQGVIURPWKH&2817<
6285&(2))81',1*&,7<DFNQRZOHGJHVWKDWWKHVRXUFHRIIXQGLQJSXUVXDQW
WRWKLV6XSSOHPHQWDO$JUHHPHQWLV&RPPXQLW\'HYHORSPHQW%ORFN*UDQWIXQGV &)'$
DQGWKH*UDQW$ZDUG1XPEHULV%8&
$66,*10(177KH&,7<VKDOOQRWPDNHDQ\DVVLJQPHQWRUWUDQVIHULQDQ\IRUP
ZLWKUHVSHFWWRWKLV6XSSOHPHQWDO$JUHHPHQWZLWKRXWSULRUZULWWHQDSSURYDORIWKH&2817<
,17(535(7$7,21$1'*29(51,1*/$:7KLV6XSSOHPHQWDO$JUHHPHQW
DQGDQ\GLVSXWHDULVLQJKHUHXQGHUVKDOOEHJRYHUQHGE\DQGLQWHUSUHWHGLQDFFRUGDQFHZLWKWKHODZV
RIWKH6WDWHRI&DOLIRUQLD7KLV6XSSOHPHQWDO$JUHHPHQWVKDOOEHFRQVWUXHGDVDZKROHDFFRUGLQJ
WRLWVIDLUODQJXDJHDQGFRPPRQPHDQLQJWRDFKLHYHWKHREMHFWLYHVDQGSXUSRVHVRIWKHSDUWLHV
KHUHWRDQGWKHUXOHRIFRQVWUXFWLRQWRWKHHIIHFWWKDWDPELJXLWLHVDUHWREHUHVROYHGDJDLQVWWKH
GUDIWLQJSDUW\VKDOOQRWEHHPSOR\HGLQLQWHUSUHWLQJWKLV6XSSOHPHQWDO$JUHHPHQWDOOSDUWLHV
KDYLQJEHHQUHSUHVHQWHGE\FRXQVHOLQWKHQHJRWLDWLRQDQGSUHSDUDWLRQKHUHRI
:$,9(5 )DLOXUHE\DSDUW\WRLQVLVWXSRQWKHVWULFWSHUIRUPDQFHRIDQ\RIWKH
SURYLVLRQVRIWKLV6XSSOHPHQWDO$JUHHPHQWE\WKHRWKHUSDUW\RUWKHIDLOXUHE\DSDUW\WRH[HUFLVH
LWVULJKWVXSRQWKHGHIDXOWRIWKHRWKHUSDUW\VKDOOQRWFRQVWLWXWHDZDLYHURIVXFKSDUW\¶VULJKWVWR
LQVLVW DQG GHPDQG VWULFW FRPSOLDQFH E\ WKH RWKHU SDUW\ ZLWK WKHWHUPV RIWKLV 6XSSOHPHQWDO
$JUHHPHQWWKHUHDIWHU
3DJHRI
-85,6',&7,21$1'9(18( $Q\DFWLRQDWODZRULQHTXLW\DULVLQJXQGHUWKLV
6XSSOHPHQWDO$JUHHPHQWRUEURXJKWE\DSDUW\KHUHWRIRUWKHSXUSRVHRIHQIRUFLQJFRQVWUXLQJRU
GHWHUPLQLQJWKHYDOLGLW\RIDQ\SURYLVLRQRIWKLV6XSSOHPHQWDO$JUHHPHQWVKDOOEHILOHGRQO\LQ
WKH6XSHULRU&RXUWRIWKH6WDWHRI&DOLIRUQLDORFDWHGLQ5LYHUVLGH&DOLIRUQLDDQGWKHSDUWLHVKHUHWR
ZDLYHDOOSURYLVLRQVRIODZSURYLGLQJIRUWKHILOLQJUHPRYDORUFKDQJHRIYHQXHWRDQ\RWKHUFRXUW
RUMXULVGLFWLRQ
86(2)3523(57<:KHQHYHUIHGHUDO&'%*IXQGVRUSURJUDPLQFRPHDUHXVHG
LQZKROHRULQSDUWIRUWKHSXUFKDVHRIHTXLSPHQWRUSHUVRQDOSURSHUW\WKHSURSHUW\VKDOOQRWEH
WUDQVIHUUHGIURPLWVRULJLQDOO\IXQGHGXVHE\&,7<RUWKH&,7<¶6VXEFRQWUDFWRULPSOHPHQWLQJ
WKH&'%*IXQGHGDFWLYLW\IRUDSHULRGRIILYH \HDUVIURPWKHFORVHRXWGDWHRIWKHJUDQWIURP
ZKLFK&'%*DVVLVWDQFHZDVSURYLGHG7KH&,7<VKDOOPDLQWDLQDFXUUHQWLQYHQWRU\IRU&2817<
PRQLWRULQJDQGUHYLHZ
$87+25,7< 72 (;(&87( 7KH SHUVRQV H[HFXWLQJ WKLV 6XSSOHPHQWDO
$JUHHPHQWRUH[KLELWVDWWDFKHGKHUHWRRQEHKDOIRIWKHSDUWLHVWRWKLV6XSSOHPHQWDO$JUHHPHQW
KHUHE\ZDUUDQWDQGUHSUHVHQWWKDWWKH\KDYHWKHDXWKRULW\WRH[HFXWHWKLV6XSSOHPHQWDO$JUHHPHQW
DQGZDUUDQWDQGUHSUHVHQWWKDWWKH\KDYHWKHDXWKRULW\WRELQGWKHUHVSHFWLYHSDUWLHVWRWKLV
6XSSOHPHQWDO$JUHHPHQWWRWKHSHUIRUPDQFHRILWVREOLJDWLRQVKHUHXQGHU
())(&7,9('$7(7KHHIIHFWLYHGDWHRIWKLV6XSSOHPHQWDO$JUHHPHQWLVWKHGDWH
WKHSDUWLHVVLJQWKH6XSSOHPHQWDO$JUHHPHQW,IWKHSDUWLHVVLJQWKH6XSSOHPHQWDO$JUHHPHQWRQ
PRUHWKDQRQHGDWHWKHQWKHODVWGDWHWKH6XSSOHPHQWDO$JUHHPHQWLVVLJQHGE\DSDUW\VKDOOEH
WKHHIIHFWLYHGDWH
&2817(53$576 7KLV 6XSSOHPHQWDO $JUHHPHQW PD\ EH VLJQHG E\WKH
GLIIHUHQWSDUWLHVKHUHWRLQFRXQWHUSDUWVHDFKRIZKLFKVKDOOEHDQRULJLQDOEXWDOORIZKLFKWRJHWKHU
VKDOOFRQVWLWXWHRQHDQGWKHVDPHDJUHHPHQW
)25&(0$-(85(
$ 3HUIRUPDQFHE\HLWKHUSDUW\KHUHXQGHUVKDOOQRWEHGHHPHGWREHLQGHIDXOW
ZKHUHGHOD\VRUGHIDXOWVDUHGXHWRZDULQVXUUHFWLRQVWULNHVORFNRXWVULRWVIORRGVHDUWKTXDNHV
3DJHRI
ILUHV FDVXDOWLHV DFWV RI *RG DFWV RI WKH SXEOLF HQHP\ HSLGHPLFV SDQGHPLF TXDUDQWLQH
UHVWULFWLRQV IUHLJKW HPEDUJRHV ODFN RI WUDQVSRUWDWLRQ JRYHUQPHQWDO UHVWULFWLRQV RU SULRULW\
OLWLJDWLRQXQXVXDOO\VHYHUHZHDWKHULQDELOLW\WRVHFXUHQHFHVVDU\ODERUPDWHULDORUWRROVGHOD\V
RIDQ\FRQWUDFWRUVXEFRQWUDFWRURUVXSSOLHUDFWVRIWKHRWKHUSDUW\DFWVRUIDLOXUHWRDFWRIDSXEOLF
RUJRYHUQPHQWDODJHQF\RUHQWLW\RUDQ\FDXVHVEH\RQGWKHFRQWURORUZLWKRXWWKHIDXOWRIWKHSDUW\
FODLPLQJDQH[WHQVLRQRIWLPHWRSHUIRUP
% $QH[WHQVLRQRIWLPHIRUDQ\VXFKFDXVH D³)RUFH0DMHXUH'HOD\´ VKDOOEH
IRUWKHSHULRGRIWKHHQIRUFHGGHOD\DQGVKDOOFRPPHQFHWRUXQIURPWKHWLPHRIWKHFRPPHQFHPHQW
RIWKHFDXVHLIQRWLFHE\WKHSDUW\FODLPLQJVXFKH[WHQVLRQLVVHQWWRWKHRWKHUSDUW\ZLWKLQWKLUW\
FDOHQGDU GD\V RI NQRZOHGJH RI WKH FRPPHQFHPHQW RI WKH FDXVH 1RWZLWKVWDQGLQJ WKH
IRUHJRLQJQRQHRIWKHIRUHJRLQJHYHQWVVKDOOFRQVWLWXWHD)RUFH0DMHXUH'HOD\XQOHVVDQGXQWLO
WKHSDUW\FODLPLQJVXFKGHOD\DQGLQWHUIHUHQFHGHOLYHUVWRWKHRWKHUSDUW\ZULWWHQQRWLFHGHVFULELQJ
WKHHYHQWLWVFDXVHZKHQDQGKRZVXFKSDUW\REWDLQHGNQRZOHGJHWKHGDWHWKHHYHQWFRPPHQFHG
DQGWKHHVWLPDWHGGHOD\UHVXOWLQJWKHUHIURP$Q\SDUW\FODLPLQJD)RUFH0DMHXUH'HOD\VKDOO
GHOLYHUVXFKZULWWHQQRWLFHZLWKLQWKLUW\ FDOHQGDUGD\VDIWHULWREWDLQVNQRZOHGJHRIWKHHYHQW
02',),&$7,212) $*5((0(177KLV6XSSOHPHQWDO$JUHHPHQWPD\EH
PRGLILHG RU DPHQGHG RQO\ E\ D ZULWLQJ VLJQHG E\ WKH GXO\ DXWKRUL]HG DQG HPSRZHUHG
UHSUHVHQWDWLYHRI&2817<DQG&,7<UHVSHFWLYHO\
',*,7$/$1'(/(&7521,&6,*1$785(67KHSDUWLHVDJUHHVWRWKHXVHRI
HOHFWURQLF VLJQDWXUHV VXFK DV GLJLWDO VLJQDWXUHV WKDW PHHW WKH UHTXLUHPHQWV RI WKH&DOLIRUQLD
8QLIRUP(OHFWURQLF7UDQVDFWLRQV$FW ³&8(7$´ &DO&LY&RGHWR 7KH
SDUWLHVIXUWKHUDJUHHWKDWWKHHOHFWURQLFVLJQDWXUHVRIWKHSDUWLHVLQFOXGHGLQWKLV$JUHHPHQWDUH
LQWHQGHG WR DXWKHQWLFDWH WKLV ZULWLQJ DQG WR KDYH WKH VDPH IRUFH DQG HIIHFW DV PDQXDO
VLJQDWXUHV(OHFWURQLFVLJQDWXUHPHDQVDQHOHFWURQLFVRXQGV\PERORUSURFHVVDWWDFKHGWRRU
ORJLFDOO\DVVRFLDWHGZLWKDQHOHFWURQLFUHFRUGDQGH[HFXWHGRUDGRSWHGE\DSHUVRQZLWKWKHLQWHQW
WRVLJQWKHHOHFWURQLFUHFRUGSXUVXDQWWR&8(7$DVDPHQGHGIURPWLPHWRWLPH'LJLWDOVLJQDWXUH
3DJHRI
PHDQVDQHOHFWURQLFLGHQWLILHUFUHDWHGE\FRPSXWHULQWHQGHGE\WKHSDUW\XVLQJLWWRKDYHWKHVDPH
IRUFHDQGHIIHFWDVWKHXVHRIDPDQXDOVLJQDWXUHDQGVKDOOEHUHDVRQDEO\UHOLHGXSRQE\WKHSDUWLHV
)RUSXUSRVHVRIWKLVVHFWLRQDGLJLWDOVLJQDWXUHLVDW\SHRIHOHFWURQLFVLJQDWXUHDVGHILQHGLQ
VXEGLYLVLRQ L RI6HFWLRQRIWKH&LYLO&RGH
>5HPDLQGHURI3DJH,QWHQWLRQDOO\%ODQN@
>6LJQDWXUHVRQ)ROORZLQJ3DJH@
EXHIBIT "R"
(Page 1 of 6)
24 C.F.R. § 5.109
Equal participation of faith-based organizations in
HUD programs and activities.
Effective: May 4, 2016
(a) Purpose.
Consistent with Executive Order 13279 (issued on December 12, 2002, 67 FR
77141), entitled “Equal Protection of the Laws for Faith–Based and Community
Organizations,” as amended by Executive Order 13559 (issued on November 17,
2010,75 FR 71319), entitled “Fundamental Principles and Policymaking
Criteria for Partnerships With Faith–Based and Other Neighborhood
Organizations,” this section describes requirements for ensuring the equal
participation of faith-based organizations in HUD programs and activities.
These requirements apply to all HUD programs and activities, including all
of HUD’s Native American Programs, except as may be otherwise noted in the
respective program regulations in title 24 of the Code of Federal Regulations
(CFR), or unless inconsistent with certain HUD program authorizing statutes.
b) Definitions. The following definitions apply to this section:
Direct Federal financial assistance means Federal financial assistance
provided when a Federal Government agency or an intermediary, as defined in
this section, selects the provider and either purchases services from that
provider (i.e., via a contract) or awards funds to that provider to carry
out an activity (e.g., via grant, sub-grant, sub-award, or cooperative
agreement). The recipients of sub-grants or sub-awards that receive Federal
financial assistance through State-administered programs (e.g., flow-through
programs) are considered recipients of direct Federal financial assistance.
In general, Federal financial assistance shall be treated as direct, unless
it meets the definition of indirect Federal financial assistance.
Federal financial assistance means assistance that non–Federal entities
receive or administer in the forms of grants, contracts, loans, loan
guarantees, property, cooperative agreements, food commodities, direct
appropriations, or other assistance, but does not include a tax credit,
deduction, or exemption.
Indirect Federal financial assistance means Federal financial assistance
provided when the choice of the provider is placed in the hands of the
beneficiary, and the cost of that service is paid through a voucher,
certificate, or other similar means of Government-funded payment. Federal
financial assistance provided to an organization is considered indirect when
the Government program through which the beneficiary receives the voucher,
certificate, or other similar means of Government-funded payment is neutral
EXHIBIT "R"
(Page 2 of 6)
toward religion; the organization receives the assistance as a result of a
decision of the beneficiary, not a decision of the Government; and the
beneficiary has at least one adequate secular option for the use of the
voucher, certificate, or other similar means of Government-funded payment.
Intermediary means an entity, including a nongovernmental organization,
acting under a contract, grant, or other agreement with the Federal
Government or with a State, tribal or local government that accepts Federal
financial assistance and distributes that assistance to other entities that,
in turn, carry out activities under HUD programs.
(c) Equal participation of faith-based organizations in HUD programs and
activities.
Faith-based organizations are eligible, on the same basis as any other
organization, to participate in HUD programs and activities. Neither the
Federal Government, nor a State, tribal or local government, nor any other
entity that administers any HUD program or activity, shall discriminate
against an organization on the basis of the organization’s religious
character or affiliation, or lack thereof. In addition, decisions about
awards of Federal financial assistance must be free from political
interference or even the appearance of such interference and must be made on
the basis of merit, not based on the religious character or affiliation, or
lack thereof, of an organization.
(d) Separation of explicitly religious activities from direct Federal
financial assistance.
(1) A faith-based organization that applies for, or participates in, a HUD
program or activity supported with Federal financial assistance retains its
independence and may continue to carry out its mission, including the
definition, development, practice, and expression of its religious beliefs,
provided that it does not use direct Federal financial assistance that it
receives (e.g., via contract, grant, sub-grant, sub-award or cooperative
agreement) to support or engage in any explicitly religious activities
(including activities that involve overt religious content such as worship,
religious instruction, or proselytization), or in any other manner prohibited
by law.
(2) A faith-based organization that receives direct Federal financial
assistance may use space (including a sanctuary, chapel, prayer hall, or
other space) in its facilities (including a temple, synagogue, church,
mosque, or other place of worship) to carry out activities under a HUD
program without removing religious art, icons, scriptures, or other religious
symbols. In addition, a faith-based organization participating in a HUD
program or activity retains its authority over its internal governance, and
may retain religious terms in its organization’s name, select its board
members on a religious basis, and include religious references in its
organization’s mission statements and other governing documents.
EXHIBIT "R"
(Page 3 of 6)
(e) Explicitly religious activities.
If an organization engages in explicitly religious activities (including
activities that involve overt religious content such as worship, religious
instruction, or proselytization), the explicitly religious activities must
be offered separately, in time or location, from the programs or activities
supported by direct Federal financial assistance and participation must be
voluntary for the beneficiaries of the programs or activities that receive
direct Federal financial assistance.
(f) Intermediary responsibilities to ensure equal participation of faith-
based organizations in HUD programs.
If an intermediary—acting under a contract, grant, or other agreement with
the Federal Government or with a State, tribal or local government that is
administering a program supported by Federal financial assistance—is given
the authority to select a nongovernmental organization to receive Federal
financial assistance under a contract, grant, sub-grant, sub-award, or
cooperative agreement, the intermediary must ensure that such organization
complies with the requirements of this section. If the intermediary is a
nongovernmental organization, it retains all other rights of a
nongovernmental organization under the program’s statutory and regulatory
provisions.
(g) Beneficiary protections.
Faith-based organizations that carry out programs or activities with direct
Federal financial assistance from HUD must give written notice to
beneficiaries and prospective beneficiaries of the programs or activities
describing certain protections available to them, as provided in this
subsection. In addition, if a beneficiary or prospective beneficiary objects
to the religious character of the organization carrying out the programs or
activities, that organization must promptly undertake reasonable efforts to
identify and refer the beneficiary or prospective beneficiary to an
alternative provider to which the beneficiary or prospective beneficiary has
no such objection.
(1) Written notice. The written notice must state that:
(i) The organization may not discriminate against a beneficiary or
prospective beneficiary on the basis of religion, religious belief, a refusal
to hold a religious belief, or a refusal to attend or participate in a
religious practice;
(ii) The organization may not require beneficiaries to attend or participate
in any explicitly religious activities that are offered by the organization,
and any participation by beneficiaries in such activities must be purely
voluntary;
EXHIBIT "R"
(Page 4 of 6)
(iii) The organization must separate, in time or location, any privately
funded explicitly religious activities from activities supported by direct
Federal financial assistance;
(iv) If a beneficiary objects to the religious character of the organization,
the organization must undertake reasonable efforts to identify and refer the
beneficiary to an alternative provider to which the beneficiary has no such
objection; and
(v) Beneficiaries or prospective beneficiaries may report an organization’s
violation of these protections, including any denial of services or benefits
by an organization, by contacting or filing a written complaint to HUD or
the intermediary, if applicable.
(2) Timing of notice. The written notice must be given to prospective
beneficiaries before they enroll in any HUD program or activity. When the
nature of the program or activity or exigent circumstances make it
impracticable to provide the written notice in advance, the organization
must provide written notice to beneficiaries of their protections at the
earliest available opportunity.
(3) Referral requirements.
(i) If a beneficiary or prospective beneficiary of a program or activity
that receives direct Federal financial assistance from HUD objects to the
religious character of an organization that carries out the program or
activity, that organization must promptly undertake reasonable efforts to
identify and refer the beneficiary or prospective beneficiary to an
alternative provider to which the beneficiary or prospective beneficiary has
no such objection.
(ii) A referral may be made to another faith-based organization, if the
beneficiary or prospective beneficiary has no objection to that provider
based on the provider’s religious character. But if the beneficiary or
prospective beneficiary requests a secular provider, and a secular provider
is available, then a referral must be made to that provider.
(iii) Except for activities carried out by telephone, Internet, or similar
means, the referral must be to an alternative provider that is in reasonable
geographic proximity to the organization making the referral and that carries
out activities that are similar in substance and quality to those offered by
the organization. The alternative provider also must have the capacity to
accept additional beneficiaries.
(iv) If the organization determines that it is unable to identify an
alternative provider, the organization shall promptly notify the
intermediary or, if there is no intermediary, HUD. If HUD or an intermediary
is notified that an organization is unable to identify an alternative
provider, HUD or the intermediary, as appropriate, shall promptly determine
EXHIBIT "R"
(Page 5 of 6)
whether there is any other suitable alternative provider to which the
beneficiary or prospective beneficiary may be referred. An intermediary that
receives a request for assistance in identifying an alternative provider may
request assistance from HUD.
(4) Recordkeeping.
A faith-based organization providing a referral under paragraph (g)(3) of
this section must document a beneficiary or prospective beneficiary’s request
for a referral, whether the beneficiary or prospective beneficiary was
referred to another provider, to which provider the beneficiary or
prospective beneficiary was referred, and if the beneficiary or prospective
beneficiary contacted the alternative provider, unless the beneficiary or
prospective beneficiary requests no follow up.
(h) Nondiscrimination requirements.
Any organization that receives Federal financial assistance under a HUD
program or activity shall not, in providing services or carrying out
activities with such assistance, discriminate against a beneficiary or
prospective beneficiary on the basis of religion, religious belief, a refusal
to hold a religious belief, or a refusal to attend or participate in a
religious practice. However, this section does not require any organization
that only receives indirect Federal financial assistance to modify its
program or activities to accommodate a beneficiary that selects the
organization to receive indirect aid.
(i) Exemption from Title VII employment discrimination requirements.
A religious organization’s exemption from the Federal prohibition on
employment discrimination on the basis of religion, set forth in section
702(a) of the Civil Rights Act of 1964 (42 U.S.C. 2000e–1), is not forfeited
when the organization participates in a HUD program. Some HUD programs,
however, contain independent statutory provisions that impose certain
nondiscrimination requirements on all grantees. Accordingly, grantees should
consult with the appropriate HUD program office to determine the scope of
applicable requirements.
(j) Acquisition, construction, and rehabilitation of structures.
Direct Federal financial assistance may be used for the acquisition,
construction, or rehabilitation of structures only to the extent that those
structures are used for conducting eligible activities under a HUD program
or activity. Where a structure is used for both eligible and explicitly
religious activities (including activities that involve overt religious
content such as worship, religious instruction, or proselytization), direct
Federal financial assistance may not exceed the cost of the share of
acquisition, construction, or rehabilitation attributable to eligible
activities in accordance with the cost accounting requirements applicable to
EXHIBIT "R"
(Page 6 of 6)
the HUD program or activity. However, acquisition, construction, or
rehabilitation of sanctuaries, chapels, or other rooms that a HUD–funded
faith-based organization uses as its principal place of worship, may not be
paid with direct Federal financial assistance. Disposition of real property
by a faith-based organization after its use for an authorized purpose, or
any change in use of the property from an authorized purpose, is subject to
Government-wide regulations governing real property disposition (2 CFR part
200, subpart D) and the HUD program regulations, as directed by HUD.
k) Commingling of Federal and State, tribal, and local funds.
If a State, tribal, or local government voluntarily contributes its own funds
to supplement direct Federal financial assistance for an activity, the State,
tribal or local government has the option to segregate those funds or
commingle them with the direct Federal financial assistance. However, if the
funds are commingled, the requirements of this section apply to all of the
commingled funds. Further, if a State, tribal, or local government is
required to contribute matching funds to supplement direct Federal financial
assistance for an activity, the matching funds are considered commingled
with the direct Federal financial assistance and, therefore, subject to the
requirements of this section. Some HUD programs’ requirements govern any
activity assisted under those programs. Accordingly, recipients should
consult with the appropriate HUD program office to determine the scope of
applicable requirements.
Credits
[69 FR 41717, July 9, 2004; 80 FR 75934, Dec. 7, 2015; 81 FR 19416, April 4,
2016]
SOURCE:61 FR 5202, Feb. 9, 1996; 61 FR 9041, March 6, 1996; 61 FR 9537,
March 8, 1996; 61 FR 11113, March 18, 1996; 61 FR 13616, March 27, 1996; 61
FR 54498, Oct. 18, 1996; 70 FR 77743, Dec. 30, 2005; 73 FR 72340, Nov. 28,
2008;75 FR 66258, Oct. 27, 2010; 77 FR 5674, Feb. 3, 2012; 80 FR 42352,
July 16, 2015; 81 FR 19416, April 4, 2016; 81 FR 80798, Nov. 16, 2016; 81 FR
90657, Dec. 14, 2016, unless otherwise noted.
AUTHORITY:12 U.S.C. 1701x;42 U.S.C. 1437a,1437c,1437d,1437f,1437n,
3535(d); Sec. 327, Pub.L. 109–115, 119 Stat. 2936; Sec. 607, Pub.L. 109–162,
119 Stat. 3051 (42 U.S.C. 14043e et seq.);E.O. 13279, 67 FR 77141, 3 CFR,
2002 Comp., p. 258; and E.O. 13559, 75 FR 71319, 3 CFR, 2010 Comp., p. 273.;
29 U.S.C. 794,42 U.S.C. 1437a,1437c,1437c–1(d),1437d,1437f,1437n,
3535(d), and Sec. 327, Pub.L. 109–115, 119 Stat. 2936; 42 U.S.C. 3600–3620;
42 U.S.C. 5304(b);42 U.S.C. 12101 et seq.;42 U.S.C. 12704–12708;E.O.
11063, 27 FR 11527, 3 CFR, 1958–1963 Comp., p. 652; E.O. 12892, 59 FR 2939,
3 CFR, 1994 Comp., p. 849.
EXHIBIT “S”
Page 1 of 2
Economic Opportunities for Section 3 Residents
and Section 3 Business Concerns
Sec. 135.38 Section 3 clause.
All section 3 covered contracts shall include the following clause (referred
to as the Section 3 clause):
A.The work to be performed under this contract is subject to the requirements
of section 3 of the Housing and Urban Development Act of 1968, as amended,
12 U.S.C.A. 1701u (section 3). The purpose of section 3 is to ensure that
employment and other economic opportunities generated by HUD assistance or
HUD-assisted projects covered by section 3, shall, to the greatest extent
feasible, be directed to low- and very low-income persons, particularly
persons who are recipients of HUD assistance for housing.
B.The parties to this contract agree to comply with HUD's regulations in
24 CFR part 135, which implement section 3. As evidenced by their execution
of this contract, the parties to this contract certify that they are under
no contractual or other impediment that would prevent them from complying
with the part 135 regulations.
C.The contractor agrees to send to each labor organization or representative
of workers with which the contractor has a collective bargaining agreement
or other understanding, if any, a notice advising the labor organization or
workers' representative of the contractor's commitments under this section
3 clause, and will post copies of the notice in conspicuous places at the
work site where both employees and applicants for training and employment
positions can see the notice. The notice shall describe the section 3
preference, shall set forth minimum number and job titles subject to hire,
availability of apprenticeship and training positions, the qualifications
for each; and the name and location of the person(s) taking applications for
each of the positions; and the anticipated date the work shall begin.
EXHIBIT “S”
Page 2 of 2
D. The contractor agrees to include this section 3 clause in every
subcontract subject to compliance with regulations in 24 CFR part 135, and
agrees to take appropriate action, as provided in an applicable provision of
the subcontract or in this section 3 clause, upon a finding that the
subcontractor is in violation of the regulations in 24 CFR part 135. The
contractor will not subcontract with any subcontractor where the contractor
has notice or knowledge that the subcontractor has been found in violation
of the regulations in 24 CFR part 135.
E. The contractor will certify that any vacant employment positions,
including training positions, that are filled (1) after the contractor is
selected but before the contract is executed, and (2) with persons other
than those to whom the regulations of 24 CFR part 135 require employment
opportunities to be directed, were not filled to circumvent the contractor's
obligations under 24 CFR part 135.
F. Noncompliance with HUD's regulations in 24 CFR part 135 may result in
sanctions, termination of this contract for default, and debarment or
suspension from future HUD assisted contracts.
G. With respect to work performed in connection with section 3 covered Indian
housing assistance, section 7(b) of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450e) also applies to the work to be
performed under this contract. Section 7(b) requires that to the greatest
extent feasible (i) preference and opportunities for training and employment
shall be given to Indians, and (ii) preference in the award of contracts and
subcontracts shall be given to Indian organizations and Indian-owned Economic
Enterprises. Parties to this contract that are subject to the provisions of
section 3 and section 7(b) agree to comply with section 3 to the maximum
extent feasible, but not in derogation of compliance with section 7(b).
ADDITIONAL FEDERAL REQUIREMENTS
EXHIBIT “AFR”
Additional Federal Requirements
Whereas, the work under this Agreement is subject to applicable Federal,
State, and local laws and regulations, including but not limited to the
regulations pertaining to the Community Development Block Grant (24 CFR
Part 570) and the Uniform Administrative Requirements, Cost Principles
and Audit Requirements for Federal Awards (2 CFR 200). All contractors,
sub-contractors, consultants, and sub-consultants agree to comply with,
and are subject to, the following Federal requirements (if applicable):
1.Equal Employment Opportunity: Compliance with Executive Order 11246 of
September 24, 1965, entitled "Equal Employment Opportunity", as amended by
Executive Order 11375 of October 13, 1967, and as supplemented in
Department of Labor Regulations (41 CFR chapter 60). The SUBRECIPIENT will
not discriminate against any employee or applicant for employment because
of race, color, religion, sex, or national origin. SUBRECIPIENT will
ensure that all qualified applicants will receive consideration for
employment without regard to race, color, religion, sex or national
origin. The SUBRECIPIENT will take affirmative action to ensure that
applicants are employed and the employees are treated during employment,
without regard to their race color, religion, sex, or national origin.
Such actions shall include, but are not limited to, the following:
employment, up-grading, demotion, or transfer; recruitment or recruitment
advertising; rates of pay or other forms of compensation; and selection
for training, including apprenticeship. The SUBRECIPIENT agrees to post
in a conspicuous place, available to employees and applicants for
employment, notices to be provided by the County setting forth the
provisions of this non-discrimination clause;
2.Copeland “Anti-Kickback” Act (18 U.S.C. Section 874 and 40 U.S.C.A.
Section 3145): All contracts and subgrants in excess of $2,000 for
construction or repair awarded by recipients and subrecipients shall
include a provision for compliance with the Copeland “Anti-Kickback” Act
(18 U.S.C. Section 874), as supplemented by Department of Labor
Regulations (29 CFR Part 3, “Contractors and Subcontractors on Public
Building or Public Work Financed in Whole or in Part by Loans or Grants
from the United States”) (“ACT”). The Act provides that each contractor or
subrecipient shall be prohibited from inducing, by any means, any person
employed in the construction, completion, or repair of public work, to
give up any part of the compensation to which he is otherwise entitled.
The recipient shall report all suspected or reported violations to HUD.
3.Davis-Bacon Act, as amended (40 U.S.C.A. Section 3141-3148):When required
by Federal program legislation, all construction contracts awarded by the
ADDITIONAL FEDERAL REQUIREMENTS
EXHIBIT “AFR”
recipients and subrecipients of more than $2,000 shall include a provision
for compliance with the Davis-Bacon Act (40 U.S.C.A. Section 3148) and as
supplemented by Department of Labor Regulations (29 CFR Part 5, “Labor
Standards Provisions Applicable to Contracts Covering Federally Financed
and
Assisted Construction”). Under the Davis Bacon Act, contractors shall be
required to pay wages to laborers and mechanics at a rate not less than
the minimum wages specified in a wage determination made by the U.S.
Secretary of Labor. In addition, contractors shall be required to pay
wages not less than once a week. The recipient shall place a copy of the
current prevailing wage determination issued by the U.S. Department of
Labor in each solicitation and the award of a contract shall be
conditioned upon the acceptance of the wage determination. The recipient
shall report all suspected or reported violations to HUD.
4.Contract Work Hours and Safety Standards Act (40 U.S.C.A. 3701-3708):
Where applicable, all contracts awarded by SUBRECIPEINT in excess of
$2,000 for construction contracts and in excess of $2,500 for other
contracts that involve the employment of mechanics or laborers shall
include a provision for compliance with the Contract Work Hours and Safety
Standards (40 U.S.C.A. 3701-3708), as supplemented by Department of Labor
Regulations (29 CFR Part 5). Under Section 40 U.S.C.A. 3702, each
contractor shall be required to compute the wages of every mechanic and
laborer on the basis of a standard workweek of 40 hours. Work in excess of
the standard workweek is permissible provided that the worker is
compensated at a rate of not less than 1 1/2 times the basic rate of pay
for all hours worked in excess of 40 hours in the workweek. 40 U.S.C.A.
3704 is applicable to construction work and provides that no laborer or
mechanic shall be required to work in surroundings or under working
conditions which are unsanitary, hazardous or dangerous. These
requirements do not apply to the purchases of supplies or materials or
articles ordinarily available on the open market, or contracts for
transportation or transmission of intelligence.
5.Rights to Inventions Made Under a Contract or Agreement: Contracts or
agreements for the performance of experimental, developmental, or research
work shall provide for the rights of the Federal Government and the
recipient in any resulting invention in accordance with 37 CFR Part 401,
“Rights to Inventions Made by Nonprofit Organizations and Small Business
Firms Under Government Grants, Contracts and Cooperative Agreements,” and
any implementing regulations issued by HUD.
6.Rights to Data and Copyrights: Contractors and consultants agree to comply
with all applicable provisions pertaining to the use of data and
copyrights pursuant to 48 CFR Part 27.404-3, Federal Acquisition
ADDITIONAL FEDERAL REQUIREMENTS
EXHIBIT “AFR”
Regulations (FAR).
7.Air Pollution and Control (formally known as the Clean Air Act) (42
U.S.C.A. 7401 et seq.) and the Federal Water Pollution Control Act (33
U.S.C.A. Section 1251 et seq.), as amended: Contracts and subgrants of
amounts in excess of $100,000 shall contain a provision that requires the
recipient to agree to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act (42 U.S.C.A. 7401 et
seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C.A.
Section 1251 et seq.). Violations shall be reported to HUD and the
Regional Office of the Environmental Protection Agency (EPA).
8.Anti-Lobbying Certification (31 U.S.C.A. 1352): The language of the
certification set forth in this paragraph below shall be included in all
contracts or subcontracts entered into in connection with this grant
activity and all SUBRECIPIENTS shall certify and disclose accordingly.
This certification is a material representation of fact upon which
reliance was placed when this transaction was made or entered into.
Submission of this certification is a prerequisite for making or entering
into this transaction imposed by 31 U.S.C.A. Section 1352. Any person who
fails to file the required certification shall be subject to a civil
penalty of not less than $10,000 and no more than $100,000 for such
failure.
“The undersigned certifies, to the best of his or her knowledge or belief,
that:
No Federal appropriated funds have been paid or will be paid, by or on
behalf of it, to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in connection
with the awarding of any Federal contract, the making of any Federal
grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement;
If any funds other than Federal appropriated funds have been paid or will
be paid to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in connection
with this Federal contract, grant loan or cooperative agreement, he/she
will complete and submit Standard Form – LLL, “Disclosure Form to Report
Lobbying,” in accordance with its instructions.”
9.Debarment and Suspension (Executive Orders (E.O.) 12549 and 12689): No
contract shall be made to parties listed on the General Services
ADDITIONAL FEDERAL REQUIREMENTS
EXHIBIT “AFR”
Administration's List of Parties Excluded from Federal Procurement or
Nonprocurement Programs in accordance with E.O.s 12549 and 12689,
“Debarment and Suspension,” as set forth at 2 CFR Part 2424. This list
contains the names of parties debarred, suspended, or otherwise excluded
by agencies, and contractors declared ineligible under statutory or
regulatory authority other than E.O. 12549. Contractors with awards that
exceed the small purchase threshold shall provide the required
certification regarding its exclusion
status and that of its principal employees.
10.Drug-Free Workplace Requirements: The Anti-Drug Abuse Act of 1988 (41
U.S.C.A. Section 8101-8103) requires grantees (including individuals) of
federal agencies, as a prior condition of being awarded a grant, to
certify that they will provide drug-free workplaces. Each potential
recipient must certify that it will comply with drug-free workplace
requirements in accordance with the Act and with HUD's rules at 2 CFR Part
2424.
11.Access to Records and Records Retention: The Consultant or Contractor, and
any sub-consultants or sub-contractors, shall allow all duly authorized
Federal, State, and/or County officials or authorized representatives
access to the work area, as well as all books, documents, materials,
papers, and records of the Consultant or Contractor, and any sub-
consultants or sub-contractors, that are directly pertinent to a specific
program for the purpose of making audits, examinations, excerpts, and
transcriptions. The Consultant or Contractor, and any sub-consultants or
sub-contractors, further agree to
maintain and keep such books, documents, materials, papers, and records,
on a current basis, recording all transactions pertaining to this
agreement in a form in accordance with generally acceptable accounting
principles. All such books and records shall be retained for such periods
of time as required by law, provided, however, notwithstanding any shorter
periods of retention, all books, records, and supporting detail shall be
retained for a period of at least four (4) years after the expiration of
the term of this Agreement.
12.Federal Employee Benefit Clause: No member of or delegate to the congress
of the United States, and no Resident Commissioner shall be admitted to
any share or part of this agreement or to any benefit to arise from the
same.
13.Energy Efficiency: Mandatory standards and policies relating to energy
efficiency which are contained in the State energy conservation plan
issued in compliance with the Energy Policy and Conservation Act (Pub. L.
94 - 163, Dec. 22, 1975; 42 U.S.C.A. Section 6201, et seq., 89 Stat. 871).
14.Procurement of Recovered Materials (2 CFR 200.322.): A non-Federal entity
that is a state agency or agency of a political subdivision of a state and
ADDITIONAL FEDERAL REQUIREMENTS
EXHIBIT “AFR”
its contractors must comply with 42 U.S.C. Section 6962 of the Solid Waste
Disposal Act (42 U.S.C.A. Section 6901, et seq.), as amended by the
Resource Conservation and Recovery Act. The requirements of Section 6002
include procuring only items designated in guidelines of the Environmental
Protection Agency (EPA) at 40 CFR Part 247 that contain the highest
percentage of recovered materials practicable, consistent with maintaining
a satisfactory level of competition, where the purchase price of the item
exceeds $10,000 or the value of the quantity acquired by the preceding
fiscal year exceeded $10,000; procuring solid waste management services in
a manner that maximizes energy and resource recovery; and establishing an
affirmative procurement program for procurement of recovered materials
identified in the EPA guidelines.
EXHIBIT A
File No.: 4.LQ.40-20
Page 1 of 6
SUPPLEMENTAL AGREEMENT
SCOPE OF WORK
(PUBLIC SERVICE)
I. GENERAL INFORMATION
CITY NAME: City of La Quinta DUNS#:968847715
ADDRESS: 78495 Calle Tampico, La Quinta, CA 92253
La Quinta, CA 92253
CITY PROGRAM CONTACTS: Quinton Egson, CEO
SUBRECIPIENT NAME: Boys & Girls Clubs of Coachella Valley
ADDRESS: 42-600 Cook Street, Suite 120, La Quinta, CA 92211
PHONE: (760) 836-1160 FAX : (760) 776-9111
E-MAIL: qegson@bgcofcv.org
PROJECT NAME: Boys & Girls Clubs of Coachella Valley
PROJECT LOCATION: 49-995 Moon River Drive La Quinta, CA 92253
LEVEL OF ENVIRONMENTAL CLEARANCE: EXEMPT [24 CFR 58.34 (a)(4)]
CDBG ELIGIBILITY CODE: 24 CFR 570.201 (e) Public Services
PROJECT FUNDING SUMMARY: $23,380
Project to be administered by County (HHPWS) on behalf of CITY: YES NO
II. SCOPE OF SERVICE
A. Activities
City will be responsible for administering a 2020-2021 Community Development Block Grant for the Boys
& Girls Clubs of Coachella Valley in a manner satisfactory to the County of Riverside and consistent with
any standards required as a condition of providing these funds. Such program will include the following
activities eligible under the Community Development Block Grant program:
Activity #1 The Boys and Girls Club will use CDBG funds to provide membership
"Scholarships" to youth/children from low-income families. These scholarships
will allow eligible individuals to participate in after-school programs including
concerts, recreation, and arts and crafts activities.
EXHIBIT A
File No.: 4.LQ.40-20
Page 2 of 6
B. National Objective
All activities funded with CDBG funds must comply with one of more of the CDBG program’s National
Objective Criteria as required under 24 CFR 570.200(a)(2). CITY certifies that the activity (ies) carried out
under this Agreement will meet the following National Objective:
National Objective Criteria: 570.208 (a)(2)(i)(B)
CFR Reference: Low Mod Limited Clientele Income Certification
C. Levels of Accomplishment – Goals and Performance Measures
The City agrees to provide the following levels of program services:
Activity Units Total Total
per Month Units/Year Unduplicated Persons
Activity #1 180 180
Unit of Service is defined as: Students receiving scholarships
CPD OUTCOME PERFORMANCE MEASUREMENT
Objectives (select one): Creating Suitable Living Environments
Providing Decent Affordable Housing
Creating Economic Opportunities
Outcome (select one): Availability/Accessibility
Affordability
Sustainability (promoting livable or viable communities)
D. City Capacity
By executing this Supplemental Agreement, the City certifies that it and its subrecipients have the appropriate
number of trained and knowledgeable staff, adequate facilities, proper equipment, required licensing and
permitting, and sufficient amount of financial resources necessary to implement and carry out the activities
funded with CDBG funds.
City will immediately notify County of any significant changes in organizational management, assigned staff,
change in facilities, loss or change in matching funds, or any other event that could potentially impact City’s
performance under this Agreement. Any changes in the above items are subject to the prior approval of the
County.
E. Performance Monitoring
The County of Riverside will monitor the performance of the City and its subrecipients against goals and
performance standards as stated above. Substandard performance as determined by the County will
constitute noncompliance with this Agreement. If action to correct such substandard performance is not
taken by the City within a reasonable period of time after being notified by the County, contract suspension
or termination procedures will be initiated.
EXHIBIT A
File No.: 4.LQ.40-20
Page 3 of 6
F. Program Budget
It is expressly agreed and understood that the total amount to be paid by the County under this Agreement
shall not exceed $23,380. Drawdowns for the payment of eligible expenses shall be made against the line
item budgets specified in this Section and in accordance with performance. Payments may be contingent
upon certification of the Subrecipient’s financial management system in accordance with the standards
specified in Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal
Awards (2 CFR Part 200).
The County may require a more detailed budget breakdown than the one contained herein, and the City
shall provide such supplementary budget information in a timely fashion in the form and content prescribed
by the County. Any amendments to the budget must be approved in writing by both the County and City.
Line Item CDBG Granted
Funds
Total Non-
CDBG Funds
Total
Activity/Project
Budget
Notes
Total Direct Program
Expenses
$
Salaries
Fringe
Office Space (Program Only)
Utilities
Communications
Reproduction/Printing
Supplies and Materials
Mileage
Equipment (Program Only)
Audit
Transportation
Other: Scholarships $23,380 $23,380
Total Indirect Program
Expenses
$
Indirect Costs (Specify)*
TOTAL CDBG BUDGET $23,380 $23,380
* All indirect costs must be pre-approved by the County. City must submit an Indirect Cost Allocation
Plan to County, in a form specified by County, demonstrating the appropriate share of general and
administrative costs.
G. Total Amount of Non- CDBG Leveraging
TYPE SOURCE AMOUNT SOURCE AMOUNT SOURCE AMOUNT TOTAL
EXHIBIT A
File No.: 4.LQ.40-20
Page 4 of 6
FEDERAL
STATE/LOCAL
PRIVATE
OTHER
TOTAL: ___________________
III. ADMINISTRATIVE REQUIREMENTS
A. Accounting Standards
The City agrees to comply with the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards (2 CFR Part 200), and agrees to adhere to the accounting
principles and procedures required therein, utilize adequate internal controls, and maintain
necessary source documentation for all costs incurred.
B. Cost Principles
The City shall administer its program in conformance with the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200).
These principles shall be applied for all costs incurred whether charged on a direct or indirect basis.
C. Documentation and Record Keeping
1. Records to be Maintained.
The City and its subrecipients will maintain all records required by the Federal regulations specified in 24
CFR 570.506, that are pertinent to the activities to be funded under this Agreement. Such records shall
include but not be limited to:
i Records providing a full description of each activity undertaken;
ii. Records demonstrating that each activity undertaken meets one of the National
Objectives of the CDBG program;
iii. Records required to determine the eligibility of activities;
iv. Records required to document the acquisition, improvement, use or disposition of
real property acquired or improved with CDBG assistance;
v. Records documenting compliance with the fair housing and equal opportunity
components of the CDBG program;
vi. Financial records as required by 24 CFR 570.502, and 2 CFR 200; and
vii. Other records necessary to document compliance with Subpart K of 24 CFR Part
570.
2. Records Retention:
The City shall retain all CDBG-related financial records, supporting documents, contracts, and agreements
for a period of four (4) years. The retention period begins on the date of the submission of the County’s
annual performance and evaluation report to HUD in which the activities assisted under the Agreement are
reported for the final time. The City will retain all National Objective documentation, including low-
moderate income certification, ethnicity, and other pertinent data for a period of four (4) years after
EXHIBIT A
File No.: 4.LQ.40-20
Page 5 of 6
submission of the County’s annual performance and evaluation report to HUD. Notwithstanding the above,
if there is litigation, claims, audits, negotiations or other actions that involve any of the records cited and
that have started before the expiration of the four-year period, then such records must be retained until
completion of the actions and resolution of all issues.
3. Client Data:
The City shall maintain client data demonstrating client eligibility for services provided. Such data shall
include, but not be limited to, client name, address, income level or other basis for determining eligibility,
and description of service provided. Such information shall be made available to County monitors or their
designees for review upon request.
4. Disclosure:
The City understands that client information collected under this contract is private and the use or disclosure
of such information, when not directly connected with the administration of the County’s or City’s
responsibilities with respect to services provided under this contract, is prohibited by applicable federal and
State law unless written consent is obtained from such person receiving service and, in the case of a minor,
that of a responsible parent/guardian.
5. Close-outs:
The City’s obligation to the County shall not end until all close-out requirements are completed. Activities
during this close-out period shall include, but are not limited to: making final payments, disposing of
program assets (including the return of all unused materials, equipment, unspent cash advances, program
income balances, and accounts receivable to the County), and determining the custodianship of records.
Notwithstanding the foregoing, the terms of this Agreement shall remain in effect during any period that
the City has control over CDBG funds, including program income.
6. Audits & Inspections:
All City records with respect to any matters covered by this Agreement shall be made available to the
County, HUD, and the Controller General of the United States or any of their authorized representatives, at
any time during normal business hours, as often as deemed necessary, to audit, examine, and make excerpts
or transcripts of all relevant data. Any deficiencies noted in audit reports must be fully cleared by the City
within 30 days after receipt by the City. Failure of the City to comply with the above audit requirements
will constitute a violation of this contract and may result in the withholding of future payments. The City
hereby agrees to have an annual agency audit conducted in accordance with current County policy
concerning subrecipient audits, the Single Audit Act, and the Office of Management and Budget (OMB)
Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Costs
Principles, and Audit Requirements for Federal Awards (Uniform Guidance).
IV. PROJECT IMPLEMENTATION AND SCHEDULE
Unless pre-approved by County, CITY will perform and complete the activities described in
Section II in conformance with the schedule of tasks and milestones listed below:
Tasks / Milestone Start Date Completion Date
City/Subrecipient Complete Subrecipient July 2020 August 2020
Training
EXHIBIT A
File No.: 4.LQ.40-20
Page 6 of 6
Implement Program Activities July 1, 2020 1 ----------------
Execute Supplemental Agreement October 2020 November 2020
& Notice to Incur Cost
City Submits Approved Subrecipient October 2020 November 2020
Agreement to HHPWS
City Submit Quarterly November 2020 March 12, 2021 2
Performance Reports to County
City Submits Monthly November 2020 March 12, 2021 3
Direct Benefit Reports
City Submits Reimbursement November 2020 March 12, 2021 4
Requests
1 The Notice to Incur Cost Letter will provide the specific program implementation date for this
CDBG-funded activity.
2, 3, 4 Submittal of required documentation is determined by the specific benefit period of the CDBG-
funded activity. Confirm performance requirements with CDBG Program Manager.
CDBG Program Services Complete March 12, 2021
V. SPECIAL CONDITIONS /PERFORMANCE REQUIREMENTS
City/Subrecipient must collect income self-certifications from every individual or family participating in
CDBG-funded activities or the parent or legal guardian of every child participating in CDBG-funded
activities. This includes family income, family size, and ethnicity. Sponsor is required to collect income
verification documentation from at least 10% of the participants. All of this documentation must be
submitted to HHPWS on a monthly basis unless otherwise authorized in writing by CDBG program staff.
Once the Notice to Incur Cost letter is received, City/Subrecipient must submit monthly reimbursement
requests unless another schedule is approved, in writing, by EDA. Further, at least 75% of all 2020-21
CDBG funds must be drawn down by January 14, 2021, and 100% of all 2020-21 CDBG funds must be
drawn down by March 12, 2021. Failure to meet this draw down schedule will result in the closing or
cancellation of the CDBG grant and reprograming of remaining funds.
EXHIBIT B
File No.: 4.LQ.41-20
Page 1 of 6
SUPPLEMENTAL AGREEMENT
SCOPE OF WORK
(NON-PUBLIC SERVICE)
I. GENERAL INFORMATION
CITY NAME: City of La Quinta DUNS #: 158241765
ADDRESS: 78495 Calle Tampico
La Quinta, CA 92253
PROGRAM CONTACTS: Jon McMillen, City Manager
PHONE: (760) 777-7000 FAX: (760) 777-7030
E-MAIL: jmcmillen@laquintaca.gov
PROJECT NAME: City of La Quinta Miscellaneous ADA Improvements
PROJECT LOCATION: Various city streets, buildings, etc., in City's ADA Transition Plan
LEVEL OF ENVIRONMENTAL CLEARANCE: Categorical Exclusion
CDBG ELIGIBILITY CODE: 570.201 (c)
PROJECT FUNDING SUMMARY: $127,462
Project to be administered by County (HHPWS) on behalf of City: YES NO
II. SCOPE OF SERVICE
A. Activities
City will be responsible for administering a 2020-2021 Community Development Block Grant for the City
of La Quinta Miscellaneous ADA Improvements in a manner satisfactory to the County of Riverside and
consistent with any standards required as a condition of providing these funds. Such program will include
the following activities eligible under the Community Development Block Grant program:
Activity #1 The City of La Quinta will use CDBG funds to pay for costs associated with the
construction of ADA improvements at various city-owned public facilities, as well as the
installation of intersection curbs and compliant sidewalks, all prioritized improvements
recommended in the City's ADA Transition Plan report. CDBG funds will be used for design,
construction, project management, and inspection/testing costs.
EXHIBIT B
File No.: 4.LQ.41-20
Page 2 of 6
B. National Objective
All activities funded with CDBG funds must comply with one of more of the CDBG program’s National
Objective Criteria as required under 24 CFR 570.200(a)(2). City certifies that the activity(ies) carried out
under this Agreement will meet the following National Objective:
National Objective Criteria: 570.208 (a)(2)(i)(A)
CFR Reference: Low Mod Limited Clientele Presumed
C. Levels of Accomplishment – Goals and Performance Measures
The City agrees to implement and complete the following activity(ies):
Activity #1 Implement and complete the design and construction activities.
CPD OUTCOME PERFORMANCE MEASUREMENT
Objectives (select one): Creating Suitable Living Environments
Providing Decent Affordable Housing
Creating Economic Opportunities
Outcome (select one): Availability/Accessibility
Affordability
Sustainability (promoting livable or viable communities)
D. City Capacity
By executing this Supplemental Agreement, the City certifies that it has the appropriate number of trained
and knowledgeable staff, adequate facilities, proper equipment, required licensing and permitting, and
sufficient amount of financial resources necessary to implement and carry out the activities funded with
CDBG funds.
City will immediately notify County of any significant changes in organizational management, assigned staff,
change in facilities, loss or change in matching funds, or any other event that could potentially impact the
City or subrecipient’s performance under this Agreement.
Any changes in the above items are subject to the prior approval of the County.
E. Performance Monitoring
The County of Riverside will monitor the performance of the City and its subrecipients against goals and
performance standards as stated above. Substandard performance as determined by the
County will constitute noncompliance with this Agreement. If action to correct such substandard
performance is not taken by the City within a reasonable period of time after being notified by the County,
contract suspension or termination procedures will be initiated.
EXHIBIT B
File No.: 4.LQ.41-20
Page 3 of 6
F. Program Budget
It is expressly agreed and understood that the total amount to be paid by the County under this Agreement
shall not exceed $127,462 Drawdowns for the payment of eligible expenses shall be made against the line
item budgets specified in this Section and in accordance with performance. Payments may be contingent
upon certification of the Subrecipient’s financial management system in accordance with the Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part
200).
The County may require a more detailed budget breakdown than the one contained herein, and the City
shall provide such supplementary budget information in a timely fashion in the form and content prescribed
by the County. Any amendments to the budget must be approved in writing by both the County and City.
Line Item CDBG Granted
Funds
Total of Non-
CDBG Funds
Total Activity/Project
Budget
Notes
Design/Engineering Costs x
Project Administration
Costs
X
Construction Costs
x
Acquisition Costs
Relocations Costs
Capital Equipment Costs
Code Enforcement
Clearance
Interim Assistance
Indirect Costs:
TOTAL CDBG BUDGET $127,462 $127,462
EXHIBIT B
File No.: 4.LQ.41-20
Page 4 of 6
G. Total Amount of Non- CDBG Leveraging
TYPE SOURCE AMOUNT SOURCE AMOUNT SOURCE AMOUNT TOTAL
FEDERAL
STATE/LOCAL
PRIVATE
OTHER
TOTAL: $0
III. ADMINISTRATIVE REQUIREMENTS
A. Accounting Standards
The City agrees to comply with the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards (2 CFR Part 200) and agrees to adhere to the accounting
principles and procedures required therein, utilize adequate internal controls, and maintain
necessary source documentation for all costs incurred.
B. Cost Principles
The City shall administer its program in conformance with the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200).
These principles shall be applied for all costs incurred whether charged on a direct or indirect basis.
C. Documentation and Record Keeping
1. Records to be Maintained
The Subrecipient shall maintain all records required by the Federal regulations specified in 24 CFR
570.506 that are pertinent to the activities to be funded under this Agreement. Such records shall include
but not be limited to:
I Records providing a full description of each activity undertaken;
ii. Records demonstrating that each activity undertaken meets one of the National Objectives of the
CDBG program;
iii. Records required to determine the eligibility of activities;
iv. Records required to document the acquisition, improvement, use or disposition of real property
acquired or improved with CDBG assistance;
v. Records documenting compliance with the fair housing and equal opportunity components of the
CDBG program;
vi. Financial records as required by 24 CFR 570.502, and 2 CFR 200; and
vii. Other records necessary to document compliance with Subpart K of 24 CFR Part 570.
EXHIBIT B
File No.: 4.LQ.41-20
Page 5 of 6
2. Records Retention
The City shall retain all CDBG-related financial records, supporting documents, contracts, and
agreements for a period of four (4) years. The retention period begins on the date of the
submission of the County’s annual performance and evaluation report to HUD in which the
activities assisted under the Agreement are reported for the final time. The City will retain all
National Objective documentation, including low-moderate income certification, ethnicity, and
other pertinent data for a period of four (4) years after submission of the County’s annual
performance and evaluation report to HUD. Notwithstanding the above, if there is litigation,
claims, audits, negotiations or other actions that involve any of the records cited and that have
started before the expiration of the four-year period, then such records must be retained until
completion of the actions and resolution of all issues.
3. Client Data
The City shall maintain client data demonstrating client eligibility for services provided. Such data shall
include, but not be limited to, client name, address, income level or other basis for determining
eligibility, and description of service provided. Such information shall be made available to County
monitors or their designees for review upon request.
4. Disclosure
The City understands that client information collected under this contract is private and the use or
disclosure of such information, when not directly connected with the administration of the County’s or
City’s responsibilities with respect to services provided under this contract, is prohibited by applicable
federal and State law unless written consent is obtained from such person receiving service and, in the
case of a minor, that of a responsible parent/guardian.
5. Close-outs
The City’s obligation to the County shall not end until all close-out requirements are completed.
Activities during this close-out period shall include, but are not limited to: making final payments,
disposing of program assets (including the return of all unused materials, equipment, unspent cash
advances, program income balances, and accounts receivable to the County), and determining the
custodianship of records. Notwithstanding the foregoing, the terms of this Agreement shall remain in
effect during any period that the City has control over CDBG funds, including program income.
6. Audits & Inspections
All City records with respect to any matters covered by this Agreement shall be made available to the
County, HUD, and the Controller General of the United States or any of their authorized representatives,
at any time during normal business hours, as often as deemed necessary, to audit, examine, and make
excerpts or transcripts of all relevant data. Any deficiencies noted in audit reports must be fully cleared
by the City within 30 days after receipt by the City. Failure of the City to comply with the above audit
requirements will constitute a violation of this contract and may result in the withholding of future
payments. The City hereby agrees to have an annual agency audit conducted in accordance with current
County policy concerning subrecipient audits the Single Audit Act, and the Office of Management and
Budget (OMB) Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative
Requirements, Costs Principles, and Audit Requirements for Federal Awards (Uniform Guidance).
EXHIBIT B
File No.: 4.LQ.41-20
Page 6 of 6
IV. PROJECT IMPLEMENTATION AND SCHEDULE
Unless pre-approved by County, City will perform and complete the activities described in Section
II in conformance with the schedule of tasks and milestones listed below:
Tasks / Milestone Start Date Completion Date
Complete CDBG Training July 2020 July 2020
Execute Supplemental Agreement September 2020 October 2020
& Notice to Incur Cost
Implement Project Activities Upon Notification from HHPWS
Submit Quarterly Performance October 2020 June 2022
Reports to County
County Monitoring of City To be determined by Program Manager
Program/Performance
Specific Project Activities
1. City executes Supplemental Agreement; receives Authorization to Incur Cost letter
2. City prepares final construction documents (incorporating Special Federal Provisions) for
HHPWS review and approval
3. HHPWS authorizes City to advertise for bids
4. HHPWS reviews and approves bidding process
5. City awards construction contract
6. City and HHPWS conduct “pre-construction meeting”
7. HHPWS authorizes City to issue “Notice to Proceed”
City Submits Reimbursement
Requests
Monthly Submittal
Other Schedule
CDBG-funded Project Complete June 15, 2022
V. SPECIAL CONDITIONS /PERFORMANCE REQUIREMENTS
City must follow proper procurement and construction policies and procedures of the City and CDBG
regulations. No construction will shall commence using CDBG funding without prior Notice to Proceed.