RES 2011-1334 - Agmt for rehabilitation and lead reduction work to 3959 N 36th Ave F ZJIAHA,NF9
Planning Department
r.
1/w� i lw k rcw Omaha/Douglas Civic Center
�'��+��c► 1819 Farnam Street,Suite 1100
/[2ai r` 6 ^ r Omaha,Nebraska 68183
(402)444-5150
o -tro Telefax(402)444-6140
*RD FEBR�� ! N .. S
�'s + :�i Q, { "-; R.E.Cunningham,RA,F.SAME
City of Omaha ,: f x�.g'„., al, ,
Director
Jim Suttle,Mayor
November 8,2011
Honorable President
and Members ofthe City Council,
The attached Resolution approves a Grant Agreement for the rehabilitation of the property owned by Edna Marie
Downs and Troy E. Colliers and occupied by Edna Marie Downs, and located at 3959 North 36th Avenue, Omaha,
Nebraska 68111, with funding from the Community Development Block Grant(CDBG). The contractor is Lamb's
Remodeling,Thomas Lamb,Owner.
The Planning Depaitinent Financing Guidelines for the North Neighborhood Revitalization Strategy Area(NRSA)
CDBG Target Area Rehabilitation Funds provide that hard construction costs do not exceed $55,000.00. This
project was competitively bid with the best bid being received at $29,627.00. The Planning Department believes
this bid is reasonable for the work on this property,based on the certified cost estimate and the bids received.
The total household income is 0% of the Median Income by Family Size as established by the Department of
Housing and Urban Development. The funding is comprised of a$29,627.00 grant from the CDBG Program for a
total project of$29,627.00. Funds in the amount of$29,627.00 shall be paid from the CDBG North NRSA Target
Area Rehabilitation Fund No. 12186,Organization No. 129114.
The rehabilitation of this single-family home meets the requirements of the CDBG Program, the City's
Underwriting Guidelines and is consistent with the FY 2011 Consolidated Submission for Community Planning and
Development Program approved by the City Council on December 14,2010 by Resolution No. 1356.
The Contractor, Lamb's Remodeling, Thomas Lamb, Owner, has on file a current Annual Contract Compliance
Report Form(CC-1). As is City policy, the Human Rights and Relations Department will review the Contractor to
ensure compliance with the Contract Compliance Ordinance.
Your favorable consideration of this Resolution is requested.
Sincerely, Referred to City Council for Consideration:
fleriVai (J )Qr 1a(S /o 1194/r
.Cunningh , ,F. S Date Mayor's Office Date
Planning Director
Approved as to Funding: Approved:
D�
I// 91//
Pam.Spaccarotella Date Human Rights and Relations Department Date
Figance Director
pinlsfl letter
ce(s)set forth in Btis Exhibit conditioned upon execution of a contract by the undersignedrap:•..with the City of Omaha. The '
.'::undersg I nedlcontractoragrees that if any of the representation made regarding utilization of small and/or emerging small business by the bidder knowing them to be false,or if there is a :
';hdiiure by the successful bidder(i.e.the Contractor)to implement the stated agreements.intentions,objectives,goals,and comments set forth herein without prior approval of the Public
:,Wcres Director,such action shag constitute a material breach of the contract,entittirg the City of Omaha to reject the contractor's bid or to terminate the Contract for default. The rght to
rso"erminate shall be in addition to,and not in lieu of,any other rights or rem-dies the City of Omaha may have for other defaults under the Contract under City of Omaha's Contract
:Comcliance Ordinance or otherwise oitionaly, unders4 ed.asioi r •-subject to the terms of any future contract awards.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
•
GRANT AGREEMENT
THIS AGREEMENT is entered into by and between the CITY OF OMAHA, a Municipal Corporation of
the Metropolitan class in the State of Nebraska(hereinafter referred to as CITY)and,
Edna Marie Downs and Troy E. Colliers
hereinafter referred to as OWNER(S).
WITNESSETH:
WHEREAS, the OWNER(S) is the sole owner of a certain property located at 3959 North 36`h Avenue,
Omaha,Nebraska 68111 and legally described as follows,to wit:
Lot 60, Fairfax, an addition to the City of Omaha, as surveyed, platted and recorded in Douglas
County,Nebraska
(hereinafter referred to as the PROPERTY); and,
WHEREAS, the CITY has received Lead-based Paint Hazard Control Program funds awarded to the City
from the United States Department of Housing and Urban Development, Office of Healthy Homes and Lead
Hazard Control; and,
WHEREAS, the City has received Lead-based Paint Hazard Control Program funds awarded to the City
in Nebraska Revised Statues 66-1519 2 (i) through the Nebraska Department of Environmental Quality (NDEQ)
to carry out the Federal Residential Lead-based Paint Hazard Reduction Act of 1992, 42 U.S.C.4851 et seq.; and,
WHEREAS, the City has received State of Nebraska Affordable Housing Trust Fund Program funds
awarded to the City by the State of Nebraska Department of Economic Development; and,
WHEREAS, the City receives funds pursuant to an Agreement with the United States Department of
Housing and Urban Development, pursuant to the Housing and Community Development Act of 1974, Title I;
and,
WHEREAS, funds from various sources may be combined in one project; and,
WHEREAS, the OWNER(S) desire to use a portion of such funds for the purpose of controlling lead-
based paint hazards in the PROPERTY; and,
WHEREAS, the parties wish to agree upon the terms and conditions that the OWNER(S) must
abide to having accepted a grant of such funds for lead-based paint hazard control.
-1_ Revised and approved 7/16/2010
and
Development Program approved by the City Council on December 14,2010 by Resolution No. 1356.
The Contractor, Lamb's Remodeling, Thomas Lamb, Owner, has on file a current Annual Contract Compliance
Report Form(CC-1). As is City policy, the Human Rights and Relations Department will review the Contractor to
ensure compliance with the Contract Compliance Ordinance.
Your favorable consideration of this Resolution is requested.
Sincerely, Referred to City Council for Consideration:
fleriVai (J )Qr 1a(S /o 1194/r
.Cunningh , ,F. S Date Mayor's Office Date
Planning Director
Approved as to Funding: Approved:
D�
I// 91//
Pam.Spaccarotella Date Human Rights and Relations Department Date
Figance Director
pinlsfl letter
ce(s)set forth in Btis Exhibit conditioned upon execution of a contract by the undersignedrap:•..with the City of Omaha. The '
.'::undersg I nedlcontractoragrees that if any of the representation made regarding utilization of small and/or emerging small business by the bidder knowing them to be false,or if there is a :
';hdiiure by the successful bidder(i.e.the Contractor)to implement the stated agreements.intentions,objectives,goals,and comments set forth herein without prior approval of the Public
:,Wcres Director,such action shag constitute a material breach of the contract,entittirg the City of Omaha to reject the contractor's bid or to terminate the Contract for default. The rght to
rso"erminate shall be in addition to,and not in lieu of,any other rights or rem-dies the City of Omaha may have for other defaults under the Contract under City of Omaha's Contract
:Comcliance Ordinance or otherwise oitionaly, unders4 ed.asioi r •-subject to the terms of any future contract awards.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
In consideration of the mutual agreements herein contained,the parties hereto agree as follows:
Section 1. The following terms shall have the following meaning for all purposes in this Agreement:
a. "Construction Contract" shall mean the contract for certain construction work at the property as
follows:
Contractor: Lamb's Remodeling,Thomas Lamb,Owner
Date Contractor Signed: September 14,2011
LHC File No.: HCD File No: 11-HCD/3312
b. "Contractor" shall mean the contractor party to the construction contract.
c. "Director" shall mean the Director of the City of Omaha Planning Department, or his/her
designated representative.
d. "Dwelling" shall mean the dwelling structure upon which the lead-based paint hazard control
work is being performed.
e. "Housing Ordinances" shall mean any health, safety or minimum dwelling standard ordinance
applicable to the premises.
f. "Premises" shall mean the property dwelling and structures thereon.
g. "Lead-based Paint Hazard Control Work" shall mean the Lead-based paint hazard control work
agreed upon in the construction contract.
h. "HUD" shall mean the U. S. Department of Housing and Urban Development.
Section 2. The CITY agrees to grant the OWNER(S) the sum of Twenty-Nine Thousand, Six Hundred and
Twenty-Seven Dollars and No/100 ($29,627.00) or the actual funds disbursed as shown on the
HCD Loan Program Disposition of Funds Statement, provided that:
a. the proceeds from this grant shall be paid-in-full to the Contractor when the City issues a
certificate of completion pursuant to the construction contract and the City certifies that lead dust
wipe samples have met clearance standards in accordance with HUD regulations; and
b. the construction contract and any change thereto shall be first approved by the Director.
c. in the event that Lead-based Paint Hazard Control Funds are not available, the Director may
substitute Other Funds that may be available for the completion of the project.
Section 3. This grant to the OWNER(s) shall be provided from various funding sources in the following
combination:
Lead-based Paint Hazard Control Funds $
State of Nebraska NDEQ Funds $
State of Nebraska Affordable Housing Trust Funds( ) $
Community Development Block Grant Funds $29,627.00
Other Funds $
Total amount $29,627.00
Section 4. The OWNER(S)authorizes the CITY to make grant payments directly to the Contractor.
Section 5. The OWNER(S) shall:
a. own the premises and reside at the premises for a term of at least thirty-six (36) months. The
thirty-six(36)month term shall begin the date of closing for this grant; and,
b. only use the grant for the lead-based paint hazard control work if applicable; and,
c. maintain the premises in a safe and sanitary condition, conform to CITY housing and zoning
ordinances and not commit waste; and,
d. keep the property taxes current during the 36-month term the OWNER is required to own the
dwelling; and
e. arrange for blood lead level testing before construction for all children under age six residing in
or spending at least 12 hours per week at the premises; and,
f. participate in one-on-one training on lead safe maintenance practices provided by the Planning
Department or other approved training; and,
-2- Revised and approved 7/16/2010
o
rso"erminate shall be in addition to,and not in lieu of,any other rights or rem-dies the City of Omaha may have for other defaults under the Contract under City of Omaha's Contract
:Comcliance Ordinance or otherwise oitionaly, unders4 ed.asioi r •-subject to the terms of any future contract awards.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
g. continue lead-based paint hazard control maintenance practices after the project is complete.
Section 6. The OWNER(S) shall pay any and all delinquent taxes on the above-described property prior to the
date of this Agreement.
Section 7. The OWNER(S) agree, and the CITY state that the CITY:
a. is not acting as the OWNER'S architect or engineer; and,
b. makes no warranties, express or implied, as to the lead-based paint hazard control work; and,
c. owes no duty to the OWNER(S) or any other person that shall arise because of any inspection of
the premises by the City's employees; and,
d. may inspect the premises at reasonable times; and,
e. is held harmless for all injury and damages arising by virtue of this Agreement.
Section 8. Either party may pursue any remedy to enforce this contract at law or equity; except in the event of a
breach of Section 5(a), (e) or (f) herein, the CITY shall be limited to having no further obligation to
disperse remaining grant sums and shall be reimbursed by the OWNER(S)a sum equal to 1/36 of the
grant for each remaining month of the thirty-six month term, provided that the reimbursed sum shall
not exceed the sum previously dispersed from the grant. In the event of default, gross negligence or
other substantial noncompliance by the OWNER, the outstanding amount of the grant at the time of
default shall be due and payable immediately from the OWNER(S), its successors and assigns to the
City.
Section 9. This Agreement is not assignable without prior written consent of the CITY.
Sectionl0. Attestation of Citizenship. To comply with Neb. Rev. Stat. 4-108 through 4-114, the
Developer/Owner/Subrecipient agrees to comply with the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Section 11. Employee Classification Act. To comply with the Nebraska Employee Classification Act, all general
contractors and subcontractors who perform construction or delivery service pursuant to this contract
shall submit to the City an Affidavit for Employee Classification Act(Exhibit"B") attesting that(1)
each individual performing services for such contractor is properly classified under the Nebraska
Employee Classification Act, 2010 LB 563 ("the Act:"), (2) such contractor has completed a federal
I-9 immigration form and has such form on file for each employee performing services, (3) such
contractor has complied with Neb. Rev. Stat Section 4-114(federal immigration verification system),
(4) such contractor has no reasonable basis to believe that any individual performing services for
such contractor is an undocumented worker, and (5) as of the time of the contract, such contractor is
not barred from contracting with the state or any political subdivision pursuant to the Act. The
contractor shall follow the provisions of the Act. A violation of the Act by a contractor is grounds
for rescission of the contract by the City.
(REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK)
•
•
-4- Revised and approved 7/16/2010
other substantial noncompliance by the OWNER, the outstanding amount of the grant at the time of
default shall be due and payable immediately from the OWNER(S), its successors and assigns to the
City.
Section 9. This Agreement is not assignable without prior written consent of the CITY.
Sectionl0. Attestation of Citizenship. To comply with Neb. Rev. Stat. 4-108 through 4-114, the
Developer/Owner/Subrecipient agrees to comply with the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Section 12. Interest of the City. Pursuant to Section 8.05 of the Home Rule Charter, no elected official or any
officer or employee of the CITY shall have a financial interest, direct or indirect, in any CITY
Agreement. Any violation of this section with the knowledge of the person or corporation
contracting with the CITY shall render thea47e
contract voidable by the Mayor or Council.
ZAA ,W�.��ri 4l9///// a. d
l Downs,Attorne in Fact Date
Edna Marie Downs,Owner Date Edna�ll'iarie Do ,
for Troy E. Colliers,Owner
Date Date
STATE OF NEBRASKA )
)§
COUNTY OF DOUGLAS )
On this f Q' day of Oc 2011 A.D.,before me,mar •
a Notary Public in and for said County, personally came Edna Marie Downs Iroy . Colliers, personally
to me known to be the identical person whose name is affixed to the above Mitregoing instrument and they
acknowledged the said instrument and the execution thereof to be their voluntary act and deed, for the purposes
therein expressed.
In testimony whereof, I have hereunto set my hand and affixed by my Notary Seal at Omaha, Nebraska
on the day and date last above written.
41.4:'4? NORITA A MATT'
f.f.":1:1*1 MY COMMISSION EXPIRES Notary Public
•NO1�Mri i bbt
'• b ggtV July22,2014
y omm s ,20,
ATTES CITY OF OMAHA, A Municipal Corporation
��J ,/
Cl Clerk of the City of Omaha Date ,or of the of Omaha III ate
APPROVED AS TO FO .
tl Oa& Jo//
Assis t City Attorney Date
Plnlsfl602-agreement
-5- Revised and approved 7/16/2010
th the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
•
UNITED STATES CITIZENSHIP ATTESTATION FORM FOR PUBLIC BENEFIT
For thepurposes of complyingwith Neb. Rev. Stat. 4-108 through 4-114, I attest as follows:
§§ g
❑ I am a citizen of the United States.
OR
❑ I am a qualified alien under the Federal Immigration and Nationality Act. My
immigration status and alien number as follows:
, and I agree to provide
a copy of my USCIS (United States Citizenship and Immigration Services)
documentation upon request.
I hereby attest that my response and the information provided on this form and any related
application for public benefits are true, complete and accurate and I understand that this
information may be used to verify my lawful presence in the United States.
PRINT NAME:
By:
SIGNATURE:
DATE:
A
o Poa"niNifY Created and approved 10/26/2009
dged the said instrument and the execution thereof to be their voluntary act and deed, for the purposes
therein expressed.
In testimony whereof, I have hereunto set my hand and affixed by my Notary Seal at Omaha, Nebraska
on the day and date last above written.
41.4:'4? NORITA A MATT'
f.f.":1:1*1 MY COMMISSION EXPIRES Notary Public
•NO1�Mri i bbt
'• b ggtV July22,2014
y omm s ,20,
ATTES CITY OF OMAHA, A Municipal Corporation
��J ,/
Cl Clerk of the City of Omaha Date ,or of the of Omaha III ate
APPROVED AS TO FO .
tl Oa& Jo//
Assis t City Attorney Date
Plnlsfl602-agreement
-5- Revised and approved 7/16/2010
th the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
EY ' . '^ *- 13p
AFFIDAVIT FOR EMPLOYEE CLASSIFICATION ACT
STATE OF )
) §
COUNTY OF )
I, ,being first duly sworn under oath, state and
depose as follows:
1. I am competent to testify to,and have personal knowledge of,the matters stated in this affidavit.
2. I am(a contractor)(the authorized agent of the contractor
). I attest to the following: (a) each individual performing services for such contractor is properly
classified under the Nebraska Employee Classification Act, 2010 LB 563 ("the Act"), (b) such contractor has
completed a federal 1-9 immigration form and has such form on file for each employee performing services, (c)such
contractor has complied with Neb. Rev. Stat. section 4-114 (federal immigration verification system), (d) such
contractor has no reasonable basis to believe that any individual performing services for such contractor is an
undocumented worker, and(e)as of the time of the contract, such contractor is not barred from contracting with the
state or any political subdivision pursuant to the Act.
FURTHER AFFIANT SAYETH NAUGHT.
Affiant
SUBSCRIBED AND SWORN TO before me this day of ,2011.
Notary Public
A
OPPORTUNITY Approved 6/1/10
MY COMMISSION EXPIRES Notary Public
•NO1�Mri i bbt
'• b ggtV July22,2014
y omm s ,20,
ATTES CITY OF OMAHA, A Municipal Corporation
��J ,/
Cl Clerk of the City of Omaha Date ,or of the of Omaha III ate
APPROVED AS TO FO .
tl Oa& Jo//
Assis t City Attorney Date
Plnlsfl602-agreement
-5- Revised and approved 7/16/2010
th the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
REHABILITATION CONTRACT
Loan Number: / / - c10/:3 j/;
This Contract is between Edna Marie Downs, Edna Marie Downs, Attorney-in-Fact for Troy
E. Colliers, Co-Owner
(Owner's Name)
of 3959 North 36th Avenue , Omaha,Nebraska
(Owner's Address) (City and State)
(referred to herein as the "Owner" and Lamb's Remodeling
(Contractor's Name)
of 21210 Welsh Road , Elkhorn,Nebraska
(Contractor's Address) (City and State)
a Sole Proprietorship (referred to herein as the "Contractor") warranting itself to be licensed,
and/or bonded (if applicable) and qualified to perform the work specified herein. This contract is
for the rehabilitation of property located at
at 3959 North 36th Avenue , Omaha, Nebraska
(Property Address) (City and State)
(herein after referred to as the "Property").
IN CONSIDERATION OF THEIR MUTUAL PROMISES, THE PARTIES AGREE AS
FOLLOWS:
PART I - SPECIFIC TERMS
1. EFFECTIVE DATE: This document shall have no force or effect unless and until
executed by the Owner and the Contractor, and approved by the City of Omaha, (referred to
herein as the "City"), and unless and until a properly executed and approved copy is delivered to
the Contractor. The date on which the copy is received shall be referred to as the "Effective
date." If a properly executed and approved copy of the Contract is not delivered to the
Contractor on or before, , 2011, (date equal to sixty (60)
Date)
Revised and approved 8/4/2010
- 1 -
S TO FO .
tl Oa& Jo//
Assis t City Attorney Date
Plnlsfl602-agreement
-5- Revised and approved 7/16/2010
th the following requirements:
The Developer/Owner/Subrecipient shall include the following language in all contracts and
subcontracts for the physical performance of services: "The Contractor is required and hereby agrees
to use a federal immigration verification system to determine the work eligibility status of new
employees physically performing services within the State of Nebraska. A federal immigration
verification system means the electronic verification of the work authorization program authorized by
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.0 1324a, known as
the E-verify Program, or an equivalent federal program designated by the United States Department
of Homeland Security or other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole proprietorship, the following
applies:
a) The Contractor must complete the United States Citizenship Attestation form available on
the Department of Administrative Services website at www.das.state.ne.us.
b) If the Contractor indicates on such attestation form that he or she is a qualified alien, the
Contractor agrees to provide the U.S. Citizenship and Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
S
days from date that the Contractor signs this contract), the Contractor may refuse to be bound by
the terms of this Contract. If, however, a properly executed and approved copy of this Contract is
delivered after the above date and the Contractor subsequently performs work or delivers
materials to the Property, the Contractor shall be bound by the contract. For the purposes of this
paragraph, a copy of this Contract shall be deemed to have been delivered to and received by the
Contractor upon mailing by the City to the Contractor's address shown above. The Contractor
shall not be compensated under this Contract for work commenced or materials delivered to the
Property before the Effective Date.
2. THE CONTRACT: This Contract consists only of this Part 1 (Specific Terms)
and the following attachments:
A. Schedule of Work (work write-up dated August 8, 2011);
B. Other, (identify) (1) Part II - STANDARD TERMS
(2) Section 3 Clause
(3) City of Omaha Contract Compliance Ordinance
(4) Change Order and/or Addendum (if applicable)
3. TIME FOR COMMENCEMENT AND COMPLETION. The Contractor agrees
to complete, free of liens or rights of liens of contractors, mechanics, suppliers, or laborers, all
work listed in the Schedule of Work by the completion date indicated on the Proceed Order,
subject to extensions approved by the Owner(s) and the City for the period of any excusable
delays (including strikes, acts of God, or any other reasons beyond the control of the Owner(s) or
Contractor). The Contractor agrees that time is of the essence in this Contract.
4. CONTRACT PRICE: The Contractor agrees to accomplish work as
described in the Schedule of Work in accordance with each and every term and condition of this
Contract, for a total contract price of$29,627.00. The price of specific items of work is stated in
the Schedule of Work.
5. PROGRESS PAYMENTS: The Contractor agrees that the total contract price
shall be paid in one or more progress payments, based on the value of the work completed at the
time the progress payment request is made. Should any work for which payment is requested,
not be completed, be completed incorrectly, or not be done in a high quality workmanlike
manner, the amount of such work shall be deducted from the payment request. Payment for any
work so deducted may be requested on future requests for payment; provided, said work has
been satisfactorily completed and the reason for the initial denial of payment no longer exists.
Partial lien waivers from general contractor shall be provided with each progress payment
requested. Progress payments will be made up to and including 90% of the value of the work
completed. Any further payment would be made when project is 100% complete. In the case of
inclement weather or any other factor that the City determines that will prevent project
completion, the Contractor will be paid based on the actual amount of work completed. Final
Revised and approved 8/4/2010
-2 -
nd Immigration Services documentation
required to verify the Contractor's lawful presence in the United States using the Systematic
Alien Verification for Entitlements(SAVE)Program.
c) The Contractor understands and agrees that lawful presence in the United States is required
and the Contractor may be disqualified or the contract terminated if such lawful presence
cannot be verified as required by Neb. Rev. Stat. 4-108."
The Developer/Owner/Subrecipient shall have each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
lien waivers shall be presented from the general contractor at the time the request for final
payment is made. Such progress payments shall be disbursed at the request of the Owner(s),
after inspection and approval of the work by the Owner(s) and the City. Final payment shall be
due upon satisfactory completion and acceptance of work as being in compliance with this
Contract by the Owner and the City, permit sign-off (if applicable), submission of satisfactory
waiver(s) of liens, or a bond satisfactory to the Owner and the City indemnifying the Owner
against any lien, and the submission of all warranties and guarantees to the Owner through the
City. The Owner shall not withhold payment to the Contractor except for non-compliance with
the terms of this Contract, and SHALL NOT REQUEST THE CONTRACTOR TO PERFORM
WORK OUTSIDE THE SCOPE OF THIS CONTRACT AS A CONDITION OF RECEIVING
PAYMENT. Any work completed that is not in compliance with the items set out in the
Schedule of Work will not be paid for out of the rehabilitation funds unless said
additions/deletions/changes have been authorized by a written and approved change order
executed by all parties PRIOR TO the commencement of such work. Payment for any work
completed without a written and approved change order is the sole responsibility of the Owner
and/or the Contractor. The Contractor shall not refuse to complete the work set forth in the
Schedule of Work because of any dispute between himself/herself and the Owner relative to
work contracted "on the outside" or outside the scope of work as set forth above.
The Contractor acknowledges that it is a material breach of this Contract to request or accept a
progress or final payment which is in excess of the price of the work completed at the time such
payment is requested.
6. WARRANT: The Contractor warrants that all improvements, hardware, and
fixtures of whatever kind of nature to be installed or constructed on the Property by the
Contractor or the Contractor's sub-contractors will be of good quality, suitable for their purpose,
and free from defects in workmanship or materials or other deficiencies. This is a full warranty
extending to the Owner and subsequent Owners of the Property; provided, however, that
warranty set forth in this paragraph shall apply only to the deficiencies and defects about which
the Owner or subsequent Owner(s) shall have notified the Contractor at the address stated above
WITHIN ONE YEAR, except for any longer warranty periods specified in the warranty. (Note:.
Contractor to supply extended warranty documents to homeowner(s) at the time of final
inspection)
7. ATTESTATION OF CITIZENSHIP. To comply with Neb. Rev. Stat. 4-108
through 4-114, the Developer/Owner/Subrecipient agrees to comply with the following
requirements:
A. The Developer/Owner/Subrecipient shall include the following language
in all contracts and subcontracts for the physical performance of services:
"The Contractor is required and hereby agrees to use a federal
immigration verification system to determine the work eligibility status of
new employees physically performing services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
1324a, known as the E-Verify Program, or an equivalent federal program
designated by the United States Department of Homeland Security or
other federal agency authorized to verify the work eligibility status of a
newly hired employee. If the Contractor is an individual or sole
proprietorship, the following applies:
1) The Contractor must complete the United States Citizenship
Attestation Form available on the Department of Administrative
Services website at www.das.state.ne.us.
2) If the Contractor indicates on such attestation form that he or she is
a qualified alien, the Contractor agrees to provide the U.S.
Citizenship and Immigration Services documentation required to
verify the Contractor's lawful presence in the United States using
the Systematic Alien verification for Entitlements (SAVE)
Program.
3) The Contractor understands and agrees that lawful presence in the
United States is required and the Contractor may be disqualified or
the contract terminated if such lawful presence cannot be verified
as required by Neb. Rev. Stat. 4-108."
8. EMPLOYEE CLASSIFICATION ACT. To comply with the Nebraska Employee
Classification Act, each contractor who performs construction or delivery service pursuant to this
contract shall submit to the City an Affidavit For Employee Classification Act (Exhibit 1)
attesting that (1) each individual performing services for such contractor is properly classified
under the Nebraska Employee Classification Act, 2010 LB 563 ("the Act"), (2) such contractor
has completed a federal 1-9 immigration form and has such form on file for each employee
performing services, (3) such contractor has complied with Neb. Rev. Stat. Section 4-114
(federal immigration verification system), (4) such contractor has no reasonable basis to believe
that any individual performing services for such contractor is an undocumented worker, and (5)
as of the time of the contract, such contractor is not barred from contracting with the state or any
political subdivision pursuant to the Act. The contractor shall follow the provisions of the Act.
A violation of the Act by a contractor is grounds for rescission of the contract by the City.
Revised and approved 8/4/2010
-4-
nd defects about which
the Owner or subsequent Owner(s) shall have notified the Contractor at the address stated above
WITHIN ONE YEAR, except for any longer warranty periods specified in the warranty. (Note:.
Contractor to supply extended warranty documents to homeowner(s) at the time of final
inspection)
7. ATTESTATION OF CITIZENSHIP. To comply with Neb. Rev. Stat. 4-108
through 4-114, the Developer/Owner/Subrecipient agrees to comply with the following
requirements:
A. The Developer/Owner/Subrecipient shall include the following language
in all contracts and subcontracts for the physical performance of services:
"The Contractor is required and hereby agrees to use a federal
immigration verification system to determine the work eligibility status of
new employees physically performing services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
9. PARTIES TO CONTRACT: The OWNER and CONTRACTOR agree that they
are the sole parties to this Contract and are solely responsible for its performance. The parties
agree that neither the City nor the United States Department of Housing and Urban Development
(HUD) assumes any liability or responsibility whatsoever for the performance of any terms of
this Contract.
p t, , •
117
0144
dn , )71;7Po // /`
1a . ,47 // t,7/
/ •, O i �' rr��"
. Owner: a Marie Downs / /Date Owner: Edna Marie Downs, AIF for Date
fo /ECoer9w2ef/_/2-- //.4 -(d- ,
Owner: Date Owner: Date
y
Owner: Date Owner: Date
----AO '' '
i AO. .1041 /f/( /d
itness Date
Lamb's Remodeling
Contractor
/7
BY: Thomas Lamb ate
TITLE: Owner
,Z..4.,,,...,...
9/'y/ ,,
ess Date
Approve. by the City on , 20 ,
BY: / 2 )
'ame: James R. Thele
TITLE: Assistant Planning Director
Mailed to CONTRACTOR, and Effective on 1/ (,< , 20 //,
Revised and approved 8/4/2010
-5 -
is
contract shall submit to the City an Affidavit For Employee Classification Act (Exhibit 1)
attesting that (1) each individual performing services for such contractor is properly classified
under the Nebraska Employee Classification Act, 2010 LB 563 ("the Act"), (2) such contractor
has completed a federal 1-9 immigration form and has such form on file for each employee
performing services, (3) such contractor has complied with Neb. Rev. Stat. Section 4-114
(federal immigration verification system), (4) such contractor has no reasonable basis to believe
that any individual performing services for such contractor is an undocumented worker, and (5)
as of the time of the contract, such contractor is not barred from contracting with the state or any
political subdivision pursuant to the Act. The contractor shall follow the provisions of the Act.
A violation of the Act by a contractor is grounds for rescission of the contract by the City.
Revised and approved 8/4/2010
-4-
nd defects about which
the Owner or subsequent Owner(s) shall have notified the Contractor at the address stated above
WITHIN ONE YEAR, except for any longer warranty periods specified in the warranty. (Note:.
Contractor to supply extended warranty documents to homeowner(s) at the time of final
inspection)
7. ATTESTATION OF CITIZENSHIP. To comply with Neb. Rev. Stat. 4-108
through 4-114, the Developer/Owner/Subrecipient agrees to comply with the following
requirements:
A. The Developer/Owner/Subrecipient shall include the following language
in all contracts and subcontracts for the physical performance of services:
"The Contractor is required and hereby agrees to use a federal
immigration verification system to determine the work eligibility status of
new employees physically performing services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
PART II STANDARD TERMS
1. INSURANCE: During the continuance of the work under this Contract, the
Contractor and all subcontractors (as applicable) shall:
A. Maintain, at a minimum, the applicable following classes of coverage which
will provide, at a minimum, the following amount of coverage:
(1) No bid bond or performance bond will be required for a Rehabilitation
Contract in an amount less than the Federal Government's small purchase
threshold under OMB Circular A-110, currently at $100,000. On a case-
by-case basis the Director of the Planning Department can require a bond
if it is in the best interest of the Federal Government and the City of
Omaha. The contractor must be on the Planning Department approved
contractors list.
(2) Contractor's Personal Liability $1,000,000
(3) Combined Bodily Injury and Property Damage $2,000,000
(1,000,000 per occurrence)
(4) Product, Including Completed Operations $1,000,000
(5) Workers' Compensation
These coverages are required to protect the Contractor and the Owner from any
liability or damage from injury to, or death of, any of their employees, other
persons, or property wherever located, resulting from any action or operation
under this Contract, or in connection with the work including liability or
damage which may arise by virtue of any statute or law in force or which may
hereinafter be enacted.
The Contractor agrees to provide evidence to the Owner through the City of
such insurance prior to the commencement of the work. Failure to provide
adequate evidence of insurance, or failure to maintain the insurance as required
by this paragraph, shall be grounds for terminating this Contract at the option of
the Owner.
The City of Omaha shall be named insured on all comprehensive liability
insurance policies.
2. CONTRACT COMPLIANCE CLAUSE: Sec. 10-192. Equal employment
opportunity clause. All contracts hereafter entered into by the City shall incorporate
an equal employment opportunity clause, which shall read as follows:
During the performance of this contract, the Contractor agrees as follows:
Revised and approved 8/4/2010
-6-
d approved 8/4/2010
-4-
nd defects about which
the Owner or subsequent Owner(s) shall have notified the Contractor at the address stated above
WITHIN ONE YEAR, except for any longer warranty periods specified in the warranty. (Note:.
Contractor to supply extended warranty documents to homeowner(s) at the time of final
inspection)
7. ATTESTATION OF CITIZENSHIP. To comply with Neb. Rev. Stat. 4-108
through 4-114, the Developer/Owner/Subrecipient agrees to comply with the following
requirements:
A. The Developer/Owner/Subrecipient shall include the following language
in all contracts and subcontracts for the physical performance of services:
"The Contractor is required and hereby agrees to use a federal
immigration verification system to determine the work eligibility status of
new employees physically performing services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
1 ,
A The Contractor shall not discriminate against any employee or applicant for
employment because of race, religion, color, sex, age, disability or national
origin. The Contractor shall take affirmative action to ensure that applicants are
employed and that employees are treated during employment without regard to
their race, religion, color, sex, age, disability or national origin. As used herein,
the word "treated" shall mean and include, without limitation, the following:
recruited, whether by advertising or by other means; compensated; selected for
training, including apprenticeship; promoted; upgraded; demoted; downgraded;
transferred; laid off; and terminated. The Contractor agrees to and shall post in
conspicuous places, available to employees and applicants for employment,
notices to be provided by the contracting officers setting forth the provisions of
this nondiscrimination clause.
B The Contractor shall, in all solicitations or advertisements for employees placed
by or on behalf of the contractor, state that all qualified applicants will receive
consideration for employment without regard to race, religion, color, sex, age,
disability or national origin.
3. ASSIGNMENT: The Contractor agrees not to assign this Contract without written
consent of the Owner and written concurrence by the City.
4. CHANGE ORDERS: The Contractor agrees not to make any changes to the
Schedule of Work or the Specifications, whether or not requested to do so by the
Owner, without a written change order executed by all parties prior to the
commencement of the work. A written and executed change order is required even if
the modification involves no change in the dollar amount of the Contract.
5. PERMITS AND CODES: The Contractor agrees to secure and pay for all applicable
and necessary permits and licenses required for the Contractor's performance of this
Contract in compliance with applicable requirements, including local building and
housing codes where applicable, whether or not covered by the specifications and
drawings for the work, and further agrees to perform all work in conformance with
the highest standard of all applicable codes and local property rehabilitation
standards.
6. HOLD HARMLESS: The Contractor agrees to defend, indemnify and hold the
Owner harmless from any liability or claims for damages because of bodily injury,
death, property damage, sickness, disease, or loss and expense arising from the
Contractor's performance of this Contract. Both parties agree that each Contractor
and Subcontractor is acting in the capacity of an independent contractor with respect
to the Owner. The Contractor further agrees to protect, defend, and indemnify the
Owner form any claims by laborers, subcontractors, or suppliers for unpaid work or
labor performed, or materials supplied in connection with this Contract.
Revised and approved 8/4/2010
-7-
hereby agrees to use a federal
immigration verification system to determine the work eligibility status of
new employees physically performing services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
The Owner and the Contractor agree to hold and save harmless the City of Omaha
from any and all loss, cost, or damages of every kind, nature or description arising
under this Contract.
7. ELIGIBILITY: The Contractor represents that he/she is not listed on the Disbarred
and Suspended Contractor's List of the U.S. Department of Housing and Urban
Development (HUD) or of the City, and further agrees not to hire or utilize as a
subcontractor or supplier or any person or firm that is so listed.
8. CONDITION OF PREMISES: The Contractor agrees to keep the premises broom
clean and orderly and to remove all debris as needed during the course of the work, in
order to maintain work conditions which do not cause health or safety hazards.
9. LEAD BASED PAINT: The Contractor agrees to use no lead-based paint in the
performance of this Contract, including the performance of any subcontractor.
"Lead-based paint" means any paint containing more than six one-hundredths of one
(1) per centum of lead by weight (calculated as lead metal) in the total nonvolatile
content of the paint, or the equivalent measure of lead in the dried film of paint
already applied. The Contractor further agrees to abide by all Federal requirements
regarding lead-based paint poison prevention.
Lead-Based Paint Regulations at 24 CFR 570.608 and 24 CFR Part 35 and in
particular Sub-Part B thereof. Such regulations pertain to all HUD-assisted housing
and require that all owners, prospective owners or tenants or properties constructed
prior to 1978 be properly notified that such properties may include lead-based paint
and require specific treatments according to the amount of HUD funding allocated to
the Project.
10. TERMINATION: The Contractor agrees that the Owner shall have the right to
declare the Contractor in default if the Contractor fails to furnish materials or perform
work in accordance with the provisions of this Contract. In such event, the Owner
shall be responsible for providing written notice to the Contractor by
registered/certified mail of such default. If the Contractor fails to remedy such
default within ten (10) working days of such notice, the Owner shall have the right to
select one or more substitute contractors. If the expense of finishing the work
exceeds the balance not yet paid to the Contractor on this Contract, the Contractor
shall pay the difference to the Owner through the City. The City will assure that all
substitute contractors, subcontractors, suppliers, etc. are paid from the funds received
from the original Contractor. Lien waivers, warranties, etc., shall be obtained just as
though the original Contractor had completed the job. Any funds received from the
original Contractor may be used only to correct/complete items set forth in the
Schedule of Work and may not be used to complete other or extra work desired by the
Owner.
11. INSPECTION: The U.S. Government, the City, and their designees shall have the
right to inspect all rehabilitation work, and the Contractor will take all steps necessary
Revised and approved 8/4/2010
- 8 -
ng services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
to assure that the Government, the City, or their designees are permitted to examine
and inspect the rehabilitation work, and all contracts, materials, equipment, payrolls,
and conditions of employment pertaining to the work, including all relevant data and
records. The U.S. Government and the City by inspecting the premises, records,
suppliers, and equipment assumes no responsibility to the Owner for defective
materials or work in the rehabilitation, or to either party for any breach of this
Contract by the other.
12. INTEREST OF FEDERAL AND CITY OF OMAHA PERSONNEL: The Contractor
agrees that none of the following shall have any interest or benefit, direct or indirect,
in this Contract for any work, supplies, or services, financed in whole or in part under
this Contract:
A. Any member of the governing body of the Locality;
B. Any member of the governing body of the City of Omaha;
C. Any officer or employee of the Locality or the City of Omaha who exercises
any functions or responsibilities in connection with the administration of the
Community Development Block Grant (CDBG) Program;
D. Any member of or delegate to the Congress of the United States;
E. Any Resident commissioner.
13. EQUAL OPPORTUNITY: The Contractor agrees to abide by all Federal, State,
and/or local regulations relative to equal opportunity to all persons, without
discrimination as to race, color, handicap, sex, familial status, age, political, or
religious opinions, affiliations or national origin and status with regard to public
assistance. On agreements of$10,000 or more, the Contractor agrees to abide by the
following provisions of Executive Order 11246, and agrees to incorporate such
language in all contracts for $10,000 or more, which he/she may enter into in
connection with this Contract.
During the course of this contract, the Contractor agrees as follows:
A. The Contractor will not discriminate against any employee or applicant for
employment because of race, color, sex or origin. The Contractor will take
affirmative action to ensure that applicants and/or employees are employed or
treated during employment without regard to their race, color, creed, religion,
national origin, sex, marital status, age, and status with regard to public
assistance or disability. On Agreements of $10,000 or more, the Contractor
agrees to abide by the following provisions of Executive Order 11246, and
agrees to incorporate such language in all contracts for $10,000 or more which
he/she may enter into in connection with this Contract. Such action shall
include but not be limited to, the following: employment, upgrading, demotion
Revised and approved 8/4/2010
-9-
omplete items set forth in the
Schedule of Work and may not be used to complete other or extra work desired by the
Owner.
11. INSPECTION: The U.S. Government, the City, and their designees shall have the
right to inspect all rehabilitation work, and the Contractor will take all steps necessary
Revised and approved 8/4/2010
- 8 -
ng services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
or transfer; recruitment or recruitment advertising; layoff or termination; rates
of pay or other forms of compensation; and selection for training, including
apprenticeship. The Contractor agrees to post in conspicuous places, available
to employees and applicants for employment, notices to be provided by the
locality setting forth the provisions of this nondiscrimination clause.
B. The Contractor will, in all solicitations or advertisements for employees placed
by or on behalf of the Contractor, state that all qualified applicants will receive
consideration for employment without regard to their race, color, religion, sex
or national origin.
C. The Contractor will send to each labor union or representative of workers with
which he/she has a collective bargaining agreement or other contract or
understanding, a notice, to be provided, advising the said labor union or
worker's representative of the Contractor's commitments under this section, and
shall post copies of the notice in conspicuous places available to employees and
applicants for employment.
D. The contractor will comply with all provisions of Executive Order 11246 of
September 24,1965, (or as may be amended) and of the rules, regulations, and
relevant orders of the U. S. Secretary of Labor.
E. The Contractor will furnish all information and reports required by Executive
Order 11246 of September 24, 1965, (or as may be amended) and by the rules,
regulations and orders of the Secretary of Labor and/or the U.S. Secretary of
Housing and Urban Development and will permit access to his/her books,
records, and accounts by the Secretary of Housing and Urban Development, or
his/her designees, and the Secretary of Labor, or his/her designees, for purposes
of investigation to ascertain compliance with such rules, regulations, and orders.
F. In the event of the Contractor's noncompliance with the nondiscrimination
clauses of this Contract, or with any of the said rules, regulations, or orders, this
Contract may be cancelled, terminated, or suspended in whole or in part, and the
Contractor may be declared ineligible for further Government contracts or
Federally-assisted construction contracts in accordance with procedures
authorized in Executive Order 11246 of September 24, 1965; and such other
sanctions may be imposed and remedies invoked as provided in Executive
Order 11246, or by rules, regulations or orders of the Secretary of Labor, or as
otherwise provided by law.
G. The Contractor will include the portion of the sentence immediately preceding
paragraph (A) and the provisions of paragraphs (A) through (G) in every
subcontract or purchase order unless exempted by rules, regulations, or orders
of the Secretary of Labor issued pursuant to Section 204 of Executive Order
11246, so that such provisions will be binding upon each subcontractor or
vendor. The Contractor will take such action with respect to any'subcontract or
Revised and approved 8/4/2010
- 10-
will take all steps necessary
Revised and approved 8/4/2010
- 8 -
ng services within the State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
purchase order which the property owner or the Secretary of Housing and Urban
Development may direct as a means of enforcing such provisions, including
sanctions for noncompliance: Provided, however, that in the event the
Contractor becomes involved in, or is threatened with, litigation by a
subcontractor or vendor as a result of such direction by the property owner or
the Secretary of Housing and Urban Development, the Contractor may request
the United States to enter into such litigation to protect the interest of the
Secretary of Housing and Urban Development of the United States.
14. TRAINING, EMPLOYMENT, AND BUSINESS OPPORTUNITIES: The Contractor
agrees to abide by the following provisions and to include them in any subcontract
into which the Contractor enters in performance of the Contract.
A. The work to be performed under this Contract is on a project assisted under a
program providing direct Federal financial assistance from the Department of
Housing and Urban Development and is subject to the requirements of Section 3
of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C.
1701 u. Section 13 requires that to the greatest extent feasible, opportunities for
training and employment be given lower income residents of the project area(s)
and contracts for work in connection with the project be awarded to business
concerns which are located in, or owned in substantial part by persons residing
in the area of the project.
B. The parties to this contract will comply with the provisions of said Section 3
and the regulations issued pursuant thereto by the Secretary of Housing and
Urban Development as set forth in 24 CFR Part 135, and all applicable rules and
orders of the Department issued thereunder prior to the execution of this
Contract. The parties to this Contract certify and agree that they are under no
contractual or other disability which would prevent them from complying with
these requirements.
C. The Contractor will send to each labor organization or representative of workers
with which he/she has a collective bargaining agreement or other contract or
understanding, if any, a notice advising the said labor organization or worker's
representative of his/her commitments under this Section 3 clause and shall post
copies of the notice in conspicuous places available to employees and applicants
for employment and/or training.
D. The Contractor will include this Section 3 clause in every subcontract for work
in connection with the project and will, at the direction of the applicant for, or
recipient of, Federal financial assistance take appropriate action pursuant to the
subcontract upon a finding that the subcontractor is in violation of regulations
issued by the Secretary of Housing and Urban Development, 24 CFR Part 135.
The Contractor will not subcontract with any subcontractor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
subcontractor has first provided him/her with a preliminary statement of ability
to comply with the requirements of these regulations.
E. Compliance with the provisions of Section 3, the regulations set forth in 24 CFR
Part 135, and all applicable rules and orders of the Department issued
thereunder prior to the execution of the Contract, shall be a condition of the
Federal financial assistance provided to the project, binding upon the applicant
or recipient for such assistance, its successors, and assigns. Failure to fulfill
these requirements shall subject the applicant or recipient, his/her contractors
and subcontractors, all successors, and assigns to those sanctions specified by
the grant and/or loan agreement or contract through with Federal assistance is
provided, and to such sanctions as are specified by 24 CFR Part 135.
15. MISCELLANEOUS PROVISIONS: The Contractor and Owner agree as follows:
A. That the Owner shall permit the Contractor to use, at no cost, existing utilities
such as light, heat, power, and water necessary to the carrying out and
completion of the work.
B. The parties agree that the reference to "days" in this Contract shall mean
consecutive calendar days; provided, however, that in the event the last
consecutive day of the term shall be on a Sunday or legal holiday, the term shall
then terminate on the next regular day.
C. The parties agree that materials and equipment that have been removed and
replaced as part of the work shall belong to the Contractor unless otherwise
specified by the Owner.
D. The parties agree that should any dispute arise respecting the percentage of
completion, the construction, the meaning of drawings or specifications, or
should any dispute respecting the true value of any omitted or improper
workmanship or materials, or of any loss sustained by the Owner, and if the
manner of estimation is not herein otherwise provided for, the same shall be
determined in the following manner: Either party shall notify the other in
writing that the dispute be submitted to arbitration. Within ten (10) days after
such written notice, each of the parties shall meet with the Director of the
Planning Department, or his/her authorized representative, and both parties
agree to be bound by the decision reached as a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
opportunity provisions of local, state, or federal law and abide by the provisions
of the attached Section 3 clause. The Contractor further agrees to comply with
all requests by the governmental agency for employment records to enforce this
position.
F. The Contractor agrees to comply with affirmative action requirements mandated
by Executive Order 11246 and the regulations promulgated thereunder; and the
civil rights compliance ordinance of the Omaha Municipal Code.
SCHEDULE OF WORK CHECKLIST
1. WORK DESCRIPTION: Each item of work and material must be described in
sufficient detail to provide a standard against which the completed work may be
judged.
2. PRICE: This shall reflect the actual price, including profit and overhead. In no case
shall reimbursement to the Contractor exceed the actual amount of the funds available
under the loan.
3. Schedule for completing work in accordance with payment schedule which will allow
the City and the borrower to monitor actual performance against estimates of what
will be necessary to complete the project on time must be provided.
Revised and approved 8/4/2010
- 13 -
in this Contract shall mean
consecutive calendar days; provided, however, that in the event the last
consecutive day of the term shall be on a Sunday or legal holiday, the term shall
then terminate on the next regular day.
C. The parties agree that materials and equipment that have been removed and
replaced as part of the work shall belong to the Contractor unless otherwise
specified by the Owner.
D. The parties agree that should any dispute arise respecting the percentage of
completion, the construction, the meaning of drawings or specifications, or
should any dispute respecting the true value of any omitted or improper
workmanship or materials, or of any loss sustained by the Owner, and if the
manner of estimation is not herein otherwise provided for, the same shall be
determined in the following manner: Either party shall notify the other in
writing that the dispute be submitted to arbitration. Within ten (10) days after
such written notice, each of the parties shall meet with the Director of the
Planning Department, or his/her authorized representative, and both parties
agree to be bound by the decision reached as a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
• OF014"A'NF,6, Planning Department
��` �`1gr
��>.. Omaha/Douglas Civic Center
z .t1/1,_ i►t Target Area Program 1819 Farnam Street,Suite 1100
�® ' ,ram Omaha,Nebraska 68183
�yA' ry (402)444-5150
o� Q� 3959 NOrth 36th Ave. Telefax(402)444-6140
4/'FO FEBS‘3
Edna Marie Downs R.E. Cunningham,RA,F.SAME
City of Omaha Director
Jim Suttle,Mayor 953-5558
Inspector: Bob P.ickeral
444-1602
The Contract bid documents consist of the following sections:
• General Responsibilities for the Contractor and Occupant.
• Lead Hazard Control Plan, Lead Hazard Reduction Work.
• Non Lead Work.
The Contractor Shall:
• Comply with HUD's "Guidelines for the Evaluation and Control of Lead-
Based Paint
Hazards in Housing". (Copies are available at the Planning Department.)
• Comply with standards called for in the "Construction and Rehabilitation
Specifications, Housing and Community Development Division, City of
Omaha, Nebraska". (Copies are available at the Planning Department.)
• Comply with the State of Nebraska of Nebraska Health and Human
Services Regulation and Licensure, Title 178 Chapter 23 Lead Base paint
regulations.
• Coordinate daily construction schedule with the occupant.
• Submit information cut sheets for all substitutions or approved equals
prior to written approval of the Rehabilitation Inspector.
• Move all furniture and appliances necessary to do required work. Large
furniture left in containment areas may be wrapped with plastic, seal all
joints.
• Repair or replace all items damaged or disturbed during construction.
• At all times keep the site of work and surrounding area free from
accumulations of waste materials or rubbish caused by the work.
• Upon daily completion of work clean up all rubbish, excess material,
equipment, and etc., that is connected with the work, and leave all parts of
the work areas in a neat, sanitary, lead safe and presentable condition.
• Complete this project within 90 calendar days from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
The Occupant Shall:
• Remove, store away and reinstall all effected window coverings.
• Remove and store away pictures, lamps, knick-knacks, valuables, etc out
of the work areas.
• Provide a clean, uncluttered dwelling to work in.
• Allow Final Clearance testing upon substantial completion of work as
determined by the Rehab Inspector.
• Ensure that all household members stay at least ten feet away from all
work areas and also keep all pets at least ten feet away at all times until
the work has been completed and the area has passed a clearance test.
Lead Work
Exterior
1- Scrape, prepare, prime all previously painted surfaces of the exterior of the
house and porches to include the, trim, soffits, porch, walls, and ceilings. All
work must be done using Lead Safe work practices.
2- Replace garage door on north side of house with new aluminum door.
Interior
1- Remove and dispose of paneling in family room. Repair/replace drywall on
walls and ceiling as needed. Paint walls and ceiling.
2- Replace all base trim in family room and then paint base and trim.
3- Replace/repair drywall as needed in first floor bedroom, then paint walls,
ceiling, and trim.
4- Strip friction and impact surfaces of the painted door systems using lead safe
practices. Repair all painted doors to function properly. Paint the entire door
systems to match existing colors.
5- Remove all fixtures in first and second floor bathroom. Replace/repair drywall
and trim. Paint walls, ceiling, and trim.
6- Repair/replace drywall in second floor north bedroom closet. Paint closet
walls, ceiling, and trim.
Non Lead Work
Exterior
1- New Roof
a- Remove all shingles and roofing down to the base sheathing on all roofs.
b- Install Weather Watch water and ice barrier by GAF or approved equal.
c- Install new 15# felt and 25 year shingles. (owner to select color)
d- Install all necessary flashing and vents to include style D and gutter apron.
e- Remove existing gutter system.
f- Install new gutter system. To be seamless 6 inch aluminum, downspouts 4x3.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
2- Misc.
a- Replace chimney clean out.
b- Remove broken glass on garage window and replace with new. Re-glaze and
paint window.
c- Replace outside vinyl corner on north side of house.
d- Repair ramp and install sealer on ramp on south side of house.
e- Repair slider exterior door in family room to working order. Install new weather
stripping.
f- Paint all exterior doors and trim. Replace door at entry to basement on south
exterior. Door may not be standard size.
g- Repair/replace concrete filler around house where sidewalk occurs. Caulk where
concrete meets house with Vulcum or equal.
h- Install cap on chimney. Tuck point and seal as necessary.
i- Replace light at garage door.
j- Remove block walls in stairwell to basement that are starting to fall in. Replace
with new, tying into existing walls as needed. Dig out and brace as needed.
Install new stair railing to basement
Interior
1- Electrical
• a- Install smoke detectors throughout the house as per code.
b Install a carbon monoxide/smoke detector in the basement as per code.
c- Install a new exhaust fan with light in the bathrooms, including switch.
d- Install GFI in bathrooms per code.
e- Install new vanity light in each bathroom. Allowance to be $110.00 for both
lights together.
2- HVAC
a- Service existing furnace.
b- Install new AC unit and tie it into the existing furnace.
3- Plumbing
a- Remove all galvanized plumbing lines and replace with new copper or City
approved plastic lines.
b- Remove and cap sink in basement. Cap line closer to where it ties in to other lines.
c- Replace shower on second floor with new fiberglass shower unit with glass door.
Replace bathtub on first floor with new fiberglass tub.
d- Replace existing hose bibs with new, frost free units.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Note: Allowance for all bathroom fixtures, not including fiberglass shower base
and tub, to be $1400.00.
3- Miscellaneous
a- Repair/tighten handrail in basement stairway as per code.
b- Install new underlayment and vinyl floor in bathrooms. Remove existing floor and
underlayment before installing new. Allowance for vinyl to be $16.00 per sq.
yd.
c- Repair any drywall damage and paint bathrooms, including ceiling. Remove all
accessories/hardware and install new when room is finished. Allowance for toilet
paper holder, towel bar, towel ring for both bathrooms and shower curtain
rod in first floor bathroom to be$130.00 total material cost.
d- Repair sub-floor in family room as needed.
e- Install new carpet in family room, and rear bedroom. Allowance for carpet to be
$18.00 per sq. yd.
f- Install new medicine cabinets in both bathrooms. Allowance for medicine
cabinets to be $300.00 total material cost.
g- Repair wall and re-hang stair rail from first floor to basement.
h- Clean any mold in basement and paint all basement walls with Dry-lock or equal.
i- Install active radon unit and test once installed.
J Date
Property Owner
Property Owner Date
uding switch.
d- Install GFI in bathrooms per code.
e- Install new vanity light in each bathroom. Allowance to be $110.00 for both
lights together.
2- HVAC
a- Service existing furnace.
b- Install new AC unit and tie it into the existing furnace.
3- Plumbing
a- Remove all galvanized plumbing lines and replace with new copper or City
approved plastic lines.
b- Remove and cap sink in basement. Cap line closer to where it ties in to other lines.
c- Replace shower on second floor with new fiberglass shower unit with glass door.
Replace bathtub on first floor with new fiberglass tub.
d- Replace existing hose bibs with new, frost free units.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
City of Omaha, Housing and Community Development Division
COST ESTIMATE & CERTIFICATION:
Target Area ® Exterior Project ❑ Special Needs ❑ Barrier Removal ❑
Redevelopment Area:
Address: 3959 North 36th Ave.
Owner(s): Edna Marie Downs, Attorney-In-Fact for Troy E. Colliers, Co-Owner
The estimated cost for the above project is as follows:
Preliminary Revised
Date of Cost Estimate 8/11/2011
General Construction Cost $ 18,133.00
Electrical Cost $ 1,440.00
Plumbing Cost $ 5,520.00
HVAC $ 2,200.00
Overhead/Profit/ NE. Contractor Tax (15%) $ . 3,962.00
Lead Liability Fee
Total Construction Cost Estimate $ 31,255.00
The source for the estimate data is the current addition of Repair & Remodeling Cost Data by
R. S. Means, recent competitive bid pricing for similar work and product and material research.
The Rehabilitation Division has reviewed the project cost estimate, work write-up or plans and
specifications. In our opinion the project cost estimate is accurate.
This estimate is for the use of the City of Omaha, Housing and Community Development Division,
Rehabilitation Section only. The actual c t may vary.
Signed, Construction Specialist Date
_Fici=ak
Initial Inspection Date: _8/8/11 , or riu D te_..._8/19/11 //
Approved, Development Section Mgr. Date f r5 6 1
C: Cheryl
File Rev. 8/29/08
e it into the existing furnace.
3- Plumbing
a- Remove all galvanized plumbing lines and replace with new copper or City
approved plastic lines.
b- Remove and cap sink in basement. Cap line closer to where it ties in to other lines.
c- Replace shower on second floor with new fiberglass shower unit with glass door.
Replace bathtub on first floor with new fiberglass tub.
d- Replace existing hose bibs with new, frost free units.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
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into the existing furnace.
3- Plumbing
a- Remove all galvanized plumbing lines and replace with new copper or City
approved plastic lines.
b- Remove and cap sink in basement. Cap line closer to where it ties in to other lines.
c- Replace shower on second floor with new fiberglass shower unit with glass door.
Replace bathtub on first floor with new fiberglass tub.
d- Replace existing hose bibs with new, frost free units.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
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e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
•
ort AHA,N
4 �j�°�,� Planning Department
, ' Omaha/Douglas Civic Center
1819 Farnam Street,Suite 1100
Omaha,Nebraska 68183
o"
suERNP
ue
(402)'111-5150
FeBR°ram Telefax(402)111-6140
R.E. Cunningham,RA,F.SAME
City of Omaha Director
Jim Suttle,Mayor August 22, 2011
Edna Marie Downs
Omaha, NE 68111
RE: 3959 North 59th Ave.
Dear Ms. Downs:
Pursuant to your application for the Target Area Program, a courtesy inspection of the above-referenced property
was completed on August 8, 2011.
The following violations of the Omaha Municipal Code, Chapter 48 Property Maintenance Code,
Section 48-111, were noted and are hereby brought to your attention:
EXTERIOR
Section
1) 304.13: Windows: Caulk and paint windows. Repair or replace basement screens.
2) 304.10: Decks: Repair and seal handicap ramp.
3) 304.15: Doors: Replace basement exterior door.
INTERIOR
Section
1) 305.1: General: Repair bathroom, lower bedroom, and family room walls and ceilings.
2) 504.1: Plumbing: Replace main stack.
3) 605.2: Receptacles: GFI outlets in bathrooms.
4) 704.4: Smoke Alarms: Install smoke detectors per code.
If you have any questions, please call me at 444-1602.
Since-rely,
//
Robert F. Pickeral ..
Construction Specialist
C: Cheryl
.
,
.
.
. ..
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08. 08.2C)11 T
.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
UNITED STATES CITIZENSHIP ATTESTATION FORM FOR PUBLIC BENEFIT
For the purposes of complying with Neb. Rev. Stat. §§ 4-108 through 4-114, I attest as follows:
I am a citizen of the United States.
OR
I am a qualified alien under the Federal Immigration and Nationality Act. My
immigration status and alien number as follows:
, and I agree to provide
a copy of my USCIS (United States Citizenship and Immigration Services)
documentation upon request.
I hereby attest that my response and the information provided on this form and any related
application for public benefits are true, complete and accurate and I understand that this
information may be used to verify my lawful presence in the United States.
PRINT NAME:
By:
SIGNATURE:
DATE:
Created and approved 10/26/2009
etter ���ry1
LEAD SAFE HOUSING RULE-APPLICABILITY FORM
Address/location of property: 3959 North 36th Ave..
Activity: remodel
Regulation Eligibility Statements (check all that apply):
_X_Property is receiving Federal Funds.
_X_Unit was built prior to 1978.
Note: If both Eligibility Statements above have been checked, continue with the Exemption Statements below. If not,
the regulation does not apply. Sign and date the form.
Regulation Exemption Statements [24 CFT 35.115] (check all that apply):
Emergency repairs to the property are being performed to safeguard against imminent danger to human life,
health or safety, or to protect the property from further structural damage due to natural disaster, fire or
structural collapse. The exemption applies only to repairs necessary to respond to the emergency.
The property will not be used for human residential habitation. This does not apply to common areas such as
hallways and stairways of residential and mixed use properties.
Housing "exclusively" for the elderly or persons with disabilities, with the provision that children less than
six years of age will not reside in the dwelling unit.
An inspection performed according to HUD standards found the property contained no lead-based paint.
According to documented methodologies, lead-based paint has been identified and removed; and the
property has achieved clearance.
The rehabilitation will not disturb any painted surface.
The property has no bedrooms.
The property is currently vacant and will remain vacant until demolition.
If any of the above Exemption Statements have been checked, the Regulation does not apply. On this basis, sign
and date the form.
I attest that the information above is true and accurate to the best of my knowledge.
Ct
Construction Specialist Date Develop e Section Manager Date
,
. (
1
. ))
08. 08.2C)11 T
.
e- Check hot water heater for proper installation. Correct as needed.
f- Replace all bathroom faucets, toilets, and install pedestal sinks.
g- Replace all shut offs, including those controlling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
I
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lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
L
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City of Omaha, Housing and Community Development Division
BID EVALUATION FORM
Project Owner: Edna Marie Downs, Co-Owner and Attorney-in-Fact for Troy E. Colliers, Co-Owner
Project Address: 3959 North 36th Ave.
Target Area Project X Exterior Project Special Needs Barrier Removal
Funding Source: Block Grant X Home Other
Contractor Planning Dept. Comments
General Conditions:
Demolition: $900.00
Site: $250.00 $445.00
Concrete: $1,450.00
Masonry: $2,500.00
Railings:
Carpentry: $850.00 $1,656.00
Cabinets, Counter Tops:
Roofing and Gutters: $5,547.00 $6,185.00
Insulation:
Siding: $150.00 $308.00
Doors: $1,275.00 $1,200.00
Windows: $100.00 $105.00
Repair & Gyp. Board: $950.00 $1,212.00
Interior Paint: $2,590.00 $1,853.00
Exterior Paint: $900.00 $656.00
Carpet: $1,120.00 $1,728.00
Sheet Vinyl: $990.00 $285.00
Special / Misc: $1,495.00
Plumbing: $4,640.00 $5,520.00
HVAC: $3,640.00 $2,200.00
Electrical: $1,980.00 $1,440.00
Bond.
Overhead & Profit: $800.00 $3,962.00
TOTAL: $29,627.00 $31,255.00
The undersigned has evaluated the bids and proposed construction costs and hereby certifies that the
costs are reasonable.
c �
Construction Specialist: �-- Date: Wlailit
Development Section Manager: Date: 7/f/2-//1
6-7-00
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lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
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onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Housing and Community Development Division
City of Omaha Planning Department
Cost Certification Form
•
Project Name: Target Area
Project Owner: Edna Marie Downs, Co-Owner and Attorney-in-
Fact for Troy E. Colliers, Co-Owner
Project Address: 3959 North 36th Ave.
Certified amount: $29,627.00
The Rehabilitation Division has reviewed the project cost estimate, work write-up or
plans, specifications, &proposal. In our opinion the project cost proposed is reasonable
given the type of work that is to be completed. (See attached)
c,�
Construction Specialist: 'Date: ` 4.�, le
Development Section Manager: Date: 7/ _,,11(
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HOMEOWNER'S ACCEPTANCE FORM
I have reviewed all of the bids submitted for the rehabilitation
of my property located at :
3959 North 366 Ave.
My contractor of choice is: Lamb's Remodeling
Owner's Signature or gc/j../4.Personal Representative:
Date: 9'44//a
cc: Cheryl
File
Certified amount: $29,627.00
The Rehabilitation Division has reviewed the project cost estimate, work write-up or
plans, specifications, &proposal. In our opinion the project cost proposed is reasonable
given the type of work that is to be completed. (See attached)
c,�
Construction Specialist: 'Date: ` 4.�, le
Development Section Manager: Date: 7/ _,,11(
V� ^_ Q N � �HI
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1
9'S-
•
°NAHA,N,
�oF. �,e�,� Planning Department
t.
`',A4 � SECTION 106 REVIEW Omaha/Douglas Civic Center
�r�� nt 1819 Farnam Street,Suite 1100
71 'mow Omaha,Nebraska 68183
°�, ti (402)444 5150
°'P'Te,'_NESP.'RTY OWNER: Edna Marie Downs Telefax(402)444-6140
City of Omaha It.E. Cunningham,HA,F.SAME
Director
Jim s, ,( .TY ADDRESS: 3959 North 36th Ave
TURN-AROUND DATE: 8/18/11
DATE BUILT: _1948 EST. REHAB COST (if applicable):$30,000.
ASSESSED VALUE: $52,100.
DESCRIPTION OF PROPOSED UNDERTAKING:
roof
window trim
drywall repair
doors
Submitted By: Bob Pickeral Program: TAP
Not a Historic Structure
❑ l-Istoric Structure
7 Exempt Activity ,
2 ,S2///s 7,2,'I/
Don Sete, Date
HCD Preservation Officer
ecial / Misc: $1,495.00
Plumbing: $4,640.00 $5,520.00
HVAC: $3,640.00 $2,200.00
Electrical: $1,980.00 $1,440.00
Bond.
Overhead & Profit: $800.00 $3,962.00
TOTAL: $29,627.00 $31,255.00
The undersigned has evaluated the bids and proposed construction costs and hereby certifies that the
costs are reasonable.
c �
Construction Specialist: �-- Date: Wlailit
Development Section Manager: Date: 7/f/2-//1
6-7-00
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lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
•
AFFIDAVIT FOR EMPLOYEE CLASSIFICATION ACT
STATE OF NEBRASKA )
) §
COUNTY OF DOUGLAS )
1, Thomas Lamb, being first duly sworn under oath, state and depose as follows:
1. I am competent to testify to, and have personal knowledge of,the matters stated in this affidavit.
2. I am (a contractor) (the authorized agent of the contractor Lamb's Remodeling). I attest to the
following: (a) each individual performing services for such contractor is properly classified under the Nebraska
Employee Classification Act, 2010 LB 563 ("the Act"), (b) such contractor has completed a federal 1-9 immigration
form and has such form on file for each employee performing services, (c) such contractor has complied with Neb.
Rev. Stat. section 4-114 (federal immigration verification system), (d) such contractor has no reasonable basis to
believe that any individual performing services for such contractor is an undocumented worker, and (e) as of the
time of the contract, such contractor is not barred from contracting with the state or any political subdivision
pursuant to the Act.
FURTHER AFFIANT SAYETH NAUGHT.
Afiant
SUBSCRIBED AND SWORN TO before me this a J0day of September,2011.
o Public
•
GENERAL NOTARY.StAte of Nebraska
JOYCE'M.STEVENS
My Comm.Exp.July 29,2014
OPPORTUNITY Approved 6/1/10
asonable.
c �
Construction Specialist: �-- Date: Wlailit
Development Section Manager: Date: 7/f/2-//1
6-7-00
) N (6 O Q fl p Q
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Q c CD
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(U Q
(00 C U
o 0 O G)
J Q O` 0 4)
o 2 0_
N U)
co Q a,._ m
E o
a V Li.
lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
City of Omaha Planning Department
Housing and Community Development Division
Tier II CEST Statutory Checklist (2011-095)
For
Rehabilitation Programs Tier I CEST Statutory.Checklist (2011-002)
Project Name: None
Project Address: 3959 North 36th Avenue
Project Activity: Roof, window trim, drywall repair, and doors
Program: Target Area Program
The Tier I CEST Statutory Checklist requires a Tier II Statutory Checklist the following Impact
Categories:
• Contamination and Toxic Substances
• Explosive and Flammable Operations
• Floodplain Management
• Historic Preservation
• Noise Control
• Floodplain Insurance
The following table presents the Tier II determinations for these categories. An A in the
Status box indicates there are no compliance issues associated with this project and the
project may proceed without further consultation. A B in the Status box indicates there
additional steps are required to address this issue (e.g., removal of hazardous materials). An
Environmental Conditions Form must be completed at the end of the project.
Impact Status
Categories A or B Source Documentation
Lead
Lead-based paint hazards may be present. A risk assessment will
Contamination be conducted, lead safe work practices will be followed, and all
and Toxic A lead hazards will be abated.
Substances The.property is located within the boundary of the Omaha Lead
Superfund Site, according to the EPA (1). The property was
tested for high lead levels in 2003 but did not require clean up.
l p Q
co Z J' a
N M N a) _cp)
N p c Lc) c` o o H
U = W M H Z
C
as , N Na.)
Q c CD
LT_ (X) a I- Q' L.L >'' (NI
O
Z Z a E Z Z
C C 4
(U Q
(00 C U
o 0 O G)
J Q O` 0 4)
o 2 0_
N U)
co Q a,._ m
E o
a V Li.
lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Radon
The City's radon policy states that radon levels will be tested if the
assisted cost of rehabilitation meets or exceeds fifty percent of
the assessed value of the property, and if radon levels exceed 4
picoCuries per Liter, an active radon remediation system will be
installed. According, to the Douglas County Assessor's website,
the assessed value of this property is $52,100 (2). The cost of
rehabilitation is approximately $30,000. Radon testing is
required.
Other Contaminants
A review of an aerial photograph (3) did not identify additional
contamination sources or toxic substances at or near the project
site.
References
(1) EPA Omaha Lead Superfund Site status spreadsheet,
provided to the City of Omaha in July 2011, not attached.
(2) Douglas County Assessor's website,
http://www.dcassessor.org/index.php, accessed 16-
August-2011, not attached.
(3)City of Omaha GIS Records, accessed 16-August-2011, see
map.
A review of an aerial photograph (1) did not identify any explosive
Explosives or flammable operations at or near the project site.
and
Flammable A . References .
Operations (1)City of Omaha GIS Records, accessed 16-August-2011, see
map.
According to the City of Omaha's GIS records (1), the property is
not located within a floodplain. The City's GIS records include
FEMA's flood plain maps and Letters of Map Correction and
Floodplain A Letters of Map Amendments.
Management
References
(1)City of Omaha GIS Records, accessed 16-August-2011, see
map.
The project site is not historic, according to the City of Omaha
Planning Department, Housing and Community Development
Historic A Division's Historic Preservation Officer (1).
Preservation
References
(1)Section 106 Review form for 3959 North 36th Avenue, 15-
m
E o
a V Li.
lling main lines.
h- Replace main stack.Replace any missing or illegal vents or drain lines.
i- Install new floor drain in basement.
from the proceed order.
• Install one dumpster at the beginning of the project for homeowner to
use before construction starts.
a result of this meeting.
If a finding of a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
August-2011, attached.
Noise sources near the project site include one road; Paxton
Boulevard. The HUD Site DNL Calculator (1) was used to
calculate the noise level at the project site using the following
information.
According to the Metropolitan Area Planning Association ("MAPA")
(2), Paxton Boulevard receives approximately 4,800 vehicle trips
per day. MAPA approximates that 2% of all traffic is due to heavy
trucks. They do not have an estimate for medium truck traffic.
Other factors required by the Site DNL Calculator include the road
gradient, distance from the project site, and speed limit.
According to the City of Omaha's GIS records (3);
• Paxton Boulevard is approximately 104 feet from the home,
has a speed limit of 30 miles per hour, and a 0% gradient.
There are no loud or impulsive noise sources in the area (3).
There are no railroad tracks within 3,000 feet (3).
There is an airport within 15 miles of the project site, but no noise
level data (3).
Intervening structures between the noise sources and the project
Noise Control A site are not accounted for in the calculation.
Based upon this information, the calculated Site DNL is 60
decibels, which is within HUD's Acceptable noise level range and
therefore additional noise mitigation is not required.
HUD further requires that a 10-year noise level projection for the
project site. It is unlikely that any of the parameters presented
above will change except for traffic volume. MAPA predicts an
18% population increase over the next 30 years (4). From this it
was concluded that a 6% volume increase will occur over the next
10 years. Using the modified traffic volumes in the Site DNL
calculator generates a Site DNL of 60 decibels. This is also within
HUD's Acceptable noise level range.
Resources
(1) HUD Site DNL Calculator,
http://www.hud.gov/offices/cpd/environment/dnlcalculatort
ool.cfm, accessed 16-August-2011, not attached.
(2)MAPA 2008 Traffic Flow Map,
http://www.mapacog.org/images/stories/2008_traffic_flow
_map.pdf, accessed 16-August-2011, not attached.
(3)City of Omaha GIS Records, accessed 16-August-2011, not
f a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
v
attached.
(4) MAPA 2030 Long Range Transportation Plan, May 2006,
http://www.mapacog.org/2030Irtp.pdf, Accessed 28-
October-2009.
Flood Disaster The project site is not located in a flood plain, see Floodplain
Protection Act A Management, above.
A project-specific Tier II environmental review has been performed at the above location in
compliance with HUD environmental review regulations (24 CFR Part 58) and related laws,
authorities and requirements. The review has been performed prior to the commitment of
HUD or non-HUD funds, as required by §58.22(a) and (c).
This review shall be retained as a component of the City's Environmental Review Record
(ERR). Consult the Tier I CEST Statutory Checklist identified above for information regarding
compliance with other laws and authorities for this HUD-assisted project or program.
Prepared by: X/,4,K/(,i . 4Date: /(-4s,r/ -)u//
Approved b �� r
y Date: JJit/
May 2009
There is an airport within 15 miles of the project site, but no noise
level data (3).
Intervening structures between the noise sources and the project
Noise Control A site are not accounted for in the calculation.
Based upon this information, the calculated Site DNL is 60
decibels, which is within HUD's Acceptable noise level range and
therefore additional noise mitigation is not required.
HUD further requires that a 10-year noise level projection for the
project site. It is unlikely that any of the parameters presented
above will change except for traffic volume. MAPA predicts an
18% population increase over the next 30 years (4). From this it
was concluded that a 6% volume increase will occur over the next
10 years. Using the modified traffic volumes in the Site DNL
calculator generates a Site DNL of 60 decibels. This is also within
HUD's Acceptable noise level range.
Resources
(1) HUD Site DNL Calculator,
http://www.hud.gov/offices/cpd/environment/dnlcalculatort
ool.cfm, accessed 16-August-2011, not attached.
(2)MAPA 2008 Traffic Flow Map,
http://www.mapacog.org/images/stories/2008_traffic_flow
_map.pdf, accessed 16-August-2011, not attached.
(3)City of Omaha GIS Records, accessed 16-August-2011, not
f a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
1
t•J. .. Ta�. • 7:12...
•
't `Paxton • , . .,*, ... ►. f• .. ' - r
as ;
c
• }•
• ...ter _•_ia•,_„. . • ,". :.ems N a••
tY...c t _.Yw:\::-P k.- r .. vat • c''4•�:1 r • --='------
.c.'_ "— ._�. r ' .'l' ' pra ue i.
..``1• N.L h yr, . `- ti - •'t!". •'- •
•
i•
i :1 .:
ri
'',, I - i ir....... .. ‘ ....- ..V.Z:•.:j ,..' . ; !, k . i • •••••., i .
.K• r Y- .na>•:r .-- 1.. ,c �'; 'tom �ti�i-�' _� i s
%
••f . •t ems'' ii— •.+`Y• �.•• ''f ` •• , A .--•'�..
e .. ' t.ii, .- • i In :;ter ;� yJ .s
•bf *S•S`=t -. :.-.-.L-:.•Y'iS7t.4 '_t 41...."::s a+•-Jk• .•w — �• �' [.'� • t ,
t 4
.._ i
• -. ..1... . . 4, r:,-7.;:f... ..
•, I . Q —�• 'F' �. ..... ` 1 • :ter ermi _ti . I »•r-• _
3959 North 36th Avenue
Target Area Program
Legend N
3959 North 36th Street
Streets 0 50 100 200 - 300
//�// Zoning-100-Year Flood IIMNI IIIMIIIMII Feet
Douglas North NRS• .•
Omaha
South NRSA
ion for the
project site. It is unlikely that any of the parameters presented
above will change except for traffic volume. MAPA predicts an
18% population increase over the next 30 years (4). From this it
was concluded that a 6% volume increase will occur over the next
10 years. Using the modified traffic volumes in the Site DNL
calculator generates a Site DNL of 60 decibels. This is also within
HUD's Acceptable noise level range.
Resources
(1) HUD Site DNL Calculator,
http://www.hud.gov/offices/cpd/environment/dnlcalculatort
ool.cfm, accessed 16-August-2011, not attached.
(2)MAPA 2008 Traffic Flow Map,
http://www.mapacog.org/images/stories/2008_traffic_flow
_map.pdf, accessed 16-August-2011, not attached.
(3)City of Omaha GIS Records, accessed 16-August-2011, not
f a formal dispute resolution finds that the Contractor must be paid,
and if the Owner refuses to give his or her approval, the City must authorize the
disbursement and process for payment without the Owner's signature, noting the
reasons for doing so on the pay request and in the rehabilitation file.
E. As governmental funds are being used, the Contractor agrees that he/she and
his/her subcontractors will obey all civil rights and equal employment
Revised and approved 8/4/2010
- 12 -
actor where he/she has
notice or knowledge that the latter has been found in violations of regulations
under 24 CFR Part 135, and will not let any subcontract unless the
Revised and approved 8/4/2010
- 11 -
State of
Nebraska. A federal immigration verification system means the electronic
verification of the work authorization program authorized by the Illegal
Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C.
Revised and approved 8/4/2010
-3 -
e each adult member of the household applying for a
benefit under this agreement execute a United States Citizenship Attestation Form for Public Benefit
(Exhibit"A")verifying eligibility status for the purposes of receiving a public benefit.
-3- Revised and approved 7/16/2010
.
:"Signature / � _
':Title " ice~`- Telephone Number ��10-'=?Z�S •�
Eit le or Corporate vane ,.-2 ., c.3 ..s.4._
r-• Date of Signing /.D---/j'
Address 4 4(7 j
vt ( JJ
.,
r?
• c6--, ._.,tre, .i.
3 .
onths from the date received by the Human.Relations Department Any questions regarding the Contract Compliance
Ordinance or PBE/DEB Listings should be directed to the Huma .elations epartment at 402-444-5055.
4.r r(Please Print Legibly or Type) Firm O t s -� �� Incarporat•. in
•
Name_f �,' fi'� h. �->/ Signature j / `
Title Phone 1023' Fax
7 Fax ` , 7-337--7
.2 1 - f r- r c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
09/26/2011 16:06 4029385090 NP DODGE INSURANCE PAGE 01
V
OP ID: BH
'�
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOMIYI)09/26/11
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
• CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(Ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s). CONTACT
PRODUCER 402-938-5008 NAMEA
NP Dodge Insurance Agency,Inc PHONE FAX
I ,Nod;
g g y, 402-938-5090 _aC o ExI):
1 Z002 Pacific St :MAIL
gppaess:
Omaha,NE 68154-3507 7aa6ucER LAMBS-1
cusToMeg.1p x: —r—
JOhn E.Bush INSURERS)AFFORDING COVERAGE NAIL S
INSURED Lambs Remodeling INSURER A:IOwa Mutual Group 14338 —
Thomas F Lamb D/B/A INSURER B:
21210 Welsh Road INSURER c:
Elkhorn, NE 68022 INSURER D:
INSURER E: - —
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.
NOTWITHSTANDING CONDITIONCONTRACT
DOCUMENT
Nl WITH RESPECT TO
WHICH THIS
CERTIFICATE A E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
•- ASDL SUER POLICY EFF POLICY EXF- LIMITS
IL TYPE OF INSURANCE INSR SAND POLICY NUMBER (MMIDD/YYYY1 (MwporvYYYI 1 OOO,OOO
GENERAL LIABILITY EACH OCCURRENCE S
10l10111 10/10/12 DAMAGE I O RER1 I:O 100,000
A X COMMERCIAL GENERAL LIABILITY X A0278630LPREMISES(Ea occvrrencnl
CLAIMS-MADE F.i1 OCCUR MED EXP(Any one person) S 5,000
PERSONAL a ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GEML AGGREGATE LIMIT APPLIES PER:
PRODUCTS.COMP/OP AGG S 2,000,000
O- S
7 POLICY 17 JF PRCT fl LOC COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY S 1,000,000
(Eo occident)
A ANY AUTO A027863BA 10110111 10/10/12
—
BODILY INJURY(Par por:on)
ALL OWNED AUTOS BODILY INJURY(Per occldont) $
_ SCHEDULED AUTOS PROPERTY DAMAGE S
X HIRED AUTOS (Per eccidonl)
$X NON-OWNED AUTOS
S
UMBRELLA UAB OCCUR EACH OCCURRENCE S
EXCESS LIAB� CLAIMS-MADE AGGREGATE S ,•
_ $
_ DEDUCTIBLE
s
_ RETENTION S VYC STATU- OTM-
WOR)tERS COMPENSATION X I WEYTATU- _
AND EMPLOYERS'LIABILITY 1 O/10/11 10110I12 EL, 100,000
A ANY PROPRIETORIPARTNER/EXECUTIVE Y N A027863WC ,EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED? N/A EL,DISEASE-EA EMPLOYEE`$ 100,00
(Mandatory In NH) 500 00
If yes,descrlbp under E.L.DISEASE-POLICY LIMIT $
_ DESCRIPTION OF OPERATIONS below _
U
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD tut,Additional Remarks Schedule,If more epaco Is required)
City of Omaha is added as additional Insured on the General Liability
Policy.
CERTIFICATE HOLDER CANCELLATION
CIT2001
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Omaha ACCORDANCE WITH THE POLICY PROVISIONS.
Planning Department
Cheryl Williams AUTHORIZED REPRESENTATIVE
1819 Farnam Room 1111 John E.Bush •
Omaha,NE 68183
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD
c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
Housing and Community Development Division
City of Omaha Planning Department
Contractor Eligibility Form
Project Name: . Target Area
Project Owner: Edna Marie Downs-Co-Owner, and Attorney-in-Fact for Co-Owner Troy
E. Colliers
Project Address: 3959 North 36th Avenue •
Contractor: Lamb's Remodeling
Based on the review of the current"List of Parties Excluded from Federal
Procurement and Nonprocurement Programs"a government publication.
_X Contractor is eligible
Contractor is not eligible
7/W
onstruction Sped 'st Date I
ei(P
7/1-2-1 I(
Development Sectio ger Date
ion Manager: Date: 7/ _,,11(
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acluded Parties List System Page 1 of 1
I
i IL, I excluded 1?arties.list System
, # 711.1 W\ ,1 tigNatartanteri ,
Search-Current Exclusions EPLS Search Resources
Results
>Advanced Search >Search Help
>Multiple Names Search Results for Parties >Advanced Search Tips
>Exact Name and SSN/TIN Excluded by >Public User's Manual
>MyEPLS Firm,Entity, >FAQ
or Vessel :Lamb's Remodeling
>Recent Updates As of 13-Sep-2011 9:06 AM EDT >Acronyms
>Browse All Records Save to MyEPLS >Privacy Act Provisions
>News
View Cause and Treatment Code System for Award Management
Descriptions Your search returned no results. >(SAM)
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>For Help:Federal Service Desk
https://www.epls.gov/epls/search.do 9/13/2011
-L
E: - —
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.
NOTWITHSTANDING CONDITIONCONTRACT
DOCUMENT
Nl WITH RESPECT TO
WHICH THIS
CERTIFICATE A E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
•- ASDL SUER POLICY EFF POLICY EXF- LIMITS
IL TYPE OF INSURANCE INSR SAND POLICY NUMBER (MMIDD/YYYY1 (MwporvYYYI 1 OOO,OOO
GENERAL LIABILITY EACH OCCURRENCE S
10l10111 10/10/12 DAMAGE I O RER1 I:O 100,000
A X COMMERCIAL GENERAL LIABILITY X A0278630LPREMISES(Ea occvrrencnl
CLAIMS-MADE F.i1 OCCUR MED EXP(Any one person) S 5,000
PERSONAL a ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GEML AGGREGATE LIMIT APPLIES PER:
PRODUCTS.COMP/OP AGG S 2,000,000
O- S
7 POLICY 17 JF PRCT fl LOC COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY S 1,000,000
(Eo occident)
A ANY AUTO A027863BA 10110111 10/10/12
—
BODILY INJURY(Par por:on)
ALL OWNED AUTOS BODILY INJURY(Per occldont) $
_ SCHEDULED AUTOS PROPERTY DAMAGE S
X HIRED AUTOS (Per eccidonl)
$X NON-OWNED AUTOS
S
UMBRELLA UAB OCCUR EACH OCCURRENCE S
EXCESS LIAB� CLAIMS-MADE AGGREGATE S ,•
_ $
_ DEDUCTIBLE
s
_ RETENTION S VYC STATU- OTM-
WOR)tERS COMPENSATION X I WEYTATU- _
AND EMPLOYERS'LIABILITY 1 O/10/11 10110I12 EL, 100,000
A ANY PROPRIETORIPARTNER/EXECUTIVE Y N A027863WC ,EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED? N/A EL,DISEASE-EA EMPLOYEE`$ 100,00
(Mandatory In NH) 500 00
If yes,descrlbp under E.L.DISEASE-POLICY LIMIT $
_ DESCRIPTION OF OPERATIONS below _
U
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD tut,Additional Remarks Schedule,If more epaco Is required)
City of Omaha is added as additional Insured on the General Liability
Policy.
CERTIFICATE HOLDER CANCELLATION
CIT2001
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Omaha ACCORDANCE WITH THE POLICY PROVISIONS.
Planning Department
Cheryl Williams AUTHORIZED REPRESENTATIVE
1819 Farnam Room 1111 John E.Bush •
Omaha,NE 68183
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD
c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
C-25A CITY OF OMAHA
LEGISLATIVE CHAMBER
Omaha,Nebraska
RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA:
WHEREAS, the City annually receives Community Development Block Grant (CDBG) funds
under Title 1 of the Housing and Community Development Act of 1974, as amended, for the purpose of benefiting
low- and moderate-income residents, eliminating slum and blight and for other urgent community development
needs;and,
WHEREAS, the Mayor recommended various projects in the 2011 Consolidated Submission for
Community Planning and Development Programs(Consolidated Plan);and,
WHEREAS, the City Council approved the 2011 Consolidated Plan on December 14, 2010 by
Resolution No. 1356,which included the North NRSA Single-Family Target Area Rehabilitation Program;and,
WHEREAS, this property is located in the North NRSA CDBG Single-Family Target Area
Rehabilitation Program;and,
WHEREAS,the best bid was received in an amount of$29,627.00 from Lamb's Remodeling,Tom
Lamb, Owner, to perform rehabilitation work and lead reduction work when applicable, at the property owned by
Edna Marie Downs and Troy E. Colliers and occupied by Edna Marie Downs, and located at 3959 North 36th
Avenue,Omaha,Nebraska 68111;and,
WHEREAS,the total project cost is$29,627.00;and,
WHEREAS, this project is in the best interest of the residents of the City of Omaha and those
residing therein.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
OMAHA:
THAT, the attached Grant Agreement, as recommended by the Mayor, to provide a Community
Development Block Grant (CDBG) in the amount of$29,627.00 for the rehabilitation and lead reduction work,
when applicable, at the property owned by Edna Marie Downs and Troy E. Colliers and occupied by Edna Marie
Downs, located at 3959 North 36th Avenue, Omaha, Nebraska 68111, is hereby approved. The contract is to be
awarded to Lamb's Remodeling, Thomas Lamb, Owner. Funds in the amount of$29,627.00 shall be paid from
North Neighborhood Revitalization Strategy Area (NRSA) CDBG Single-Family Target Area Rehabilitation
Program,Fund No. 12186,Organization No. 129114.
APPROVED A TO FORM:
C ATTORNEY DAT
Xrif
pinlsf1602-res
.
BY!- • cilmember
Adopted ,PV ' 8.:2.011
C' Clerk l/9 1/
Approved
Mayor
I:O 100,000
A X COMMERCIAL GENERAL LIABILITY X A0278630LPREMISES(Ea occvrrencnl
CLAIMS-MADE F.i1 OCCUR MED EXP(Any one person) S 5,000
PERSONAL a ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GEML AGGREGATE LIMIT APPLIES PER:
PRODUCTS.COMP/OP AGG S 2,000,000
O- S
7 POLICY 17 JF PRCT fl LOC COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY S 1,000,000
(Eo occident)
A ANY AUTO A027863BA 10110111 10/10/12
—
BODILY INJURY(Par por:on)
ALL OWNED AUTOS BODILY INJURY(Per occldont) $
_ SCHEDULED AUTOS PROPERTY DAMAGE S
X HIRED AUTOS (Per eccidonl)
$X NON-OWNED AUTOS
S
UMBRELLA UAB OCCUR EACH OCCURRENCE S
EXCESS LIAB� CLAIMS-MADE AGGREGATE S ,•
_ $
_ DEDUCTIBLE
s
_ RETENTION S VYC STATU- OTM-
WOR)tERS COMPENSATION X I WEYTATU- _
AND EMPLOYERS'LIABILITY 1 O/10/11 10110I12 EL, 100,000
A ANY PROPRIETORIPARTNER/EXECUTIVE Y N A027863WC ,EACH ACCIDENT S
OFFICER/MEMBER EXCLUDED? N/A EL,DISEASE-EA EMPLOYEE`$ 100,00
(Mandatory In NH) 500 00
If yes,descrlbp under E.L.DISEASE-POLICY LIMIT $
_ DESCRIPTION OF OPERATIONS below _
U
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD tut,Additional Remarks Schedule,If more epaco Is required)
City of Omaha is added as additional Insured on the General Liability
Policy.
CERTIFICATE HOLDER CANCELLATION
CIT2001
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Omaha ACCORDANCE WITH THE POLICY PROVISIONS.
Planning Department
Cheryl Williams AUTHORIZED REPRESENTATIVE
1819 Farnam Room 1111 John E.Bush •
Omaha,NE 68183
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD
c�
Address /�.6 FU A 000 �L 6-��il•rA /U 6d 0 �6
I Street'P.O.Box ' -o ty State � Zip
�t E-Mali Address D��a�' �C �/�C�
ntal units or agencies not identified by OMB will be determined based on the Federal agency
providing the largest amount of Federal funds.In these cases,a governmental unit must develop an indirect cost
proposal in accordance with the requirements of this Circular and maintain the proposal and related supporting
documentation for audit.These governmental units are not required to submit their proposals unless they are
specifically requested to do so by the cognizant agency.Where a local government only receives funds as a sub
recipient,the primary recipient will be responsible for negotiating and/or monitoring the sub recipient's plan.
c. Each Indian tribal government desiring reimbursement of Indirect costs must submit its indirect cost proposal to the
Department of the Interior(its cognizant Federal agency).
d. Indirect cost proposals must be developed(and,when required,submitted)within six months after the close of the
governmental unit's fiscal year,unless an exception is approved by the cognizant Federal agency.If the proposed
central service cost allocation plan for the same period has not been approved by that time,the indirect cost
http://www.whitehouse.gov/omb/circulars_a087_2004/ - 10/24/2011
10/24/2011
e would result in a more
equitable allocation of the costs,or that a more readily available base would not increase the costs charged to
sponsored awards.The results of special cost studies(such as an engineering utility study)shall not be used to
determine and allocate the indirect costs to sponsored awards.
http://www.whitehouse.gov/omb/circularsal 22_2004/ 10/26/2011
1
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