RES 2010-0162 - Contract with Siena/Francis House for operation of homeless day shelter JO
• otAxHA,NF
F`,�,a; Planning Department
`ate �►� E ,LI
u , ` v Omaha/Douglas Civic Center
tr ji�!'Z fi,1 n !I r j FED - 1819 Farnam Street,Suite 1100
® ',[ ✓ � !l� E Omaha,Nebraska 68183
°y (402)444-51504
9
op'T U�Q�ro C i " ^ �� Telefax(402)444-6140
ED FEBR O M E' !E... \
� ,] t � °�t R.E.Cunningham,RA,F.SAME
City of Omaha Director
Jim Suttle,Mayor
Honorable President
and Members of the City Council,
•
Submitted for your consideration is a Resolution approving a contract between the City of
Omaha and Siena/Francis House in the amount of$100,000.00.
Siena/Francis House will receive up to $100,000.00 as partial funding for the operation of a
homeless day shelter at 1624 Nicholas Street from January 1, 2010 through December 31, 2010.
Siena/Francis House will seek funding of the remaining cost for such services from sources other
than the City.
The cost of $100,000.00 is payable from the 2010 Omaha/Keno Lottery Fund 12118,
• Organization 126045. Your favorable consideration and adoption of this Resolution is
respectfully requested.
Respectfully submi -d Approved:
. ve441ft4 ' 1111117-419 / ./CrAlelakititeiS- 1/46/0
41 t . Cunningham, RA F. ME Date Human Rights& Relations Dept. Date
Planning Di -ctor
Approved as to Funding: Referred to City Council for Consideration:
6;. 7:4.--5.0 - /--.9-7-/o
Pam Spaccarotella v)ce, Date Mayor s 0 ice Date
Finance Director I\
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State,personally came the above-named officers of the
UNIVERSAL SURETY COMPANY,to me personally known to be the individuals and officers who executed the preceding instrument,
and they acknowledged the execution of said instrument to be the voluntary act and deed of the UNIVERSAL SURETY COMPANY and
their voluntary act and deed as officers of said corporation and that the seal of said corporation was affixed to said instrument by the
authority and direction of said corporation.
Witness my hand and my Notarial seal at Lincoln,Lancaster County,Nebraska this 15th day of April,2008.
JESSICA M.MARS
H
GENERAL NOTARIAL ��,a/ a V �
SEA „/�
L
STATE OF NEBRASKA Je•sica .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
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Revised 10-09
Con-20.3 4
i
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i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
AGREEMENT
THIS CONTRACT is made and entered into this day of January, 2010 by and
between the City of Omaha, a municipal corporation (herein referred to as "the City") and
Siena/Francis House, 1702 Nicholas Street, Omaha, Nebraska 68102 (hereinafter referred to as
"Contractor").
WHEREAS, the City has the statutory authority to contract for services benefiting the
City and its residents through organizations engaged in providing specialized and unique areas of
assistance; and,
WHEREAS, the Contractor will be granted funds to operate homeless day shelter at 1624
Nicholas Street from the January 1, 2010 through December 31, 2010; and,
WHEREAS, the City wishes to contract with the Contractor as described below, to obtain
the Contractor's services in the implementation of this Agreement.
NOW, THEREFORE, in consideration of the mutual covenants and agreements herein
contained, the City and the Contractor mutually undertake and agree as follows:
I.
DUTIES OF THE CONTRACTOR
The Contractor agrees to do the following, along with all other obligations expressed or
implied in this Agreement.
A. The Contractor shall provide services substantially in conformance with the scope of
services attached hereto as Exhibit"A" and incorporated herein by this reference.
B. The Contractor shall comply with all evaluation requirements, as prescribed by the
City of Omaha.
C. The Contractor will be responsible for all aspects, including day-to-day management,
of the Project. The identity of the Chief Executive of the Contractor and any changes
thereof shall be provided to the City.
D. The Contractor shall allow the City to have access to the Contractor's records and
program site for the purpose of financial and/or program audits, as may be required in
the sole discretion of the City or its authorized designee.
E. The Contractor will implement and enforce, as to its employees, drug-free workplace
policy substantially similar to the City of Omaha's policy, which is on file with the
Human Resources Department.
nstrument,
and they acknowledged the execution of said instrument to be the voluntary act and deed of the UNIVERSAL SURETY COMPANY and
their voluntary act and deed as officers of said corporation and that the seal of said corporation was affixed to said instrument by the
authority and direction of said corporation.
Witness my hand and my Notarial seal at Lincoln,Lancaster County,Nebraska this 15th day of April,2008.
JESSICA M.MARS
H
GENERAL NOTARIAL ��,a/ a V �
SEA „/�
L
STATE OF NEBRASKA Je•sica .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
II.
COMPENSATION
•The City shall compensate the Contractor in an amount not to exceed, under any
circumstances, $100,000.00 ("Maximum Compensation"). The City will reimburse Contractor
monthly for itemized expenses incurred in the execution of this Agent. All receipts shall be
maintained and made available as requested for auditable evidence by the Contractor. Final
reporting shall be submitted to the City of Omaha Planning Department, Planning Director, 1819
Famam Street, Suite 1111, Omaha,Nebraska 68183.
Any tangible equipment purchased by the Contractor with funds pursuant to this
Agreement shall be property of the Contractor.
In the event that the Contractor breaches any provision of this Agreement, the City may,
at its sole option, and in addition to any other remedies, withhold the payment of any portion of
the Maximum Compensation to the Contractor.
III.
TERM
The Agreement shall become effective on the date of execution and shall terminate on
December 31, 2010. Permissible expenditures under this grant incurred after January 1, 2010 will
be paid as if they occurred after the effective date. Either party may immediately terminate this
Agreement upon mailing prior written notice thereof to the other party, provided, that in the
event of such early termination, the Contractor shall immediately return to the City all
unexpended funds advanced to the Contractor under this Agreement.
IV.
INDEMNITY
To the extend allowed by law, the Contractor covenants and agrees to indemnify and hold
harmless the City, their officers, agents and employees, their successors and assigns, individually
or collectively from and against all liability for any fines, claims, suits, demands, actions or
causes of action of any kind and nature asserted by Contractor or by anyone else, for personal
injury or death, or property damage in any way arising out of or resulting from the acts of the
Contractor's employees or agents pursuant to this Agreement, and the Contractor further agrees
to pay all expenses in defending against any claims made against the City provided, however,
that the Contractor shall not be liable for any injury, damage or loss occasioned by the sole
negligence or willful misconduct of the City, its agents or employees. The Contractor and the
City shall give prompt and timely written notice of any claim made or suit instituted which, in
any way, directly or indirectly, contingently or otherwise affects or might affect the other parties.
V.
EQUAL EMPLOYMENT OPPORTUNITY CLAUSE
L
STATE OF NEBRASKA Je•sica .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
The Contractor has filed the required Annual Contract Compliance Report Form, CC-1,
in the Human Rights and Relations Department. The Equal Employment provisions of this
Agreement are as set forth in the Equal Employment Opportunity clause, which is on file with
the Human Resources Department. Refusal by the Contractor or any subcontractor to comply
with any portion of this program as herein stated and described will subject the offending party
to any or all of the following penalties:
A. Withholding of all future payments under the involved Agreement to the Contractor
until it is determined the Contractor or subcontractor, is in compliance with the
provisions of the Agreement.
B. Refusal of all future bids or Agreements with the City or any of its departments or
divisions until such time as the Contractor or subcontractor, demonstrates that it has
established and shall carry out the policies of the program as herein outlined.
VI.
NONDISCRIMINATION
The Contractor shall not, in the performance of this contract, discriminate or permit
discrimination in violation of federal or state laws or local ordinances because of race, color, sex,
age, disability,political or religious opinions, affiliations or national origin.
VII.
CAPTIONS
Captions used in this contract are for convenience and are not used in the construction of
this contract.
VIII.
APPLICABLE LAW
Parties to this contract shall conform to all existing and applicable city ordinances,
resolutions, state laws, federal laws, and all existing and applicable rules and regulations
Nebraska law will govern the terms and the performance under this contract.
IX.
CONFLICT OF INTEREST
A. No elected official nor any officer or employee of the City shall, during their tenure
and one year thereafter, have a financial interest, direct or indirect, in this Agreement
or in any funds transferred hereunder. Any violation of this section shall render the
Agreement voidable by the City or the Contractor.
B. The Contractor coverrants that it presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict with the performance required to be
sole
negligence or willful misconduct of the City, its agents or employees. The Contractor and the
City shall give prompt and timely written notice of any claim made or suit instituted which, in
any way, directly or indirectly, contingently or otherwise affects or might affect the other parties.
V.
EQUAL EMPLOYMENT OPPORTUNITY CLAUSE
L
STATE OF NEBRASKA Je•sica .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
•
performed under this Agreement, it further covenants that, in the performance of this
Agreement, no person having any such interest shall be employed.
X.
WARRANTY AS TO COMMISSIONS
Contractor warrants that it has not employed any person to solicit or secure the
Agreement upon any agreement for commission,percentage,brokerage, or contingent fee.
XI.
MERGER
This Agreement shall not be merged into any other oral or written contract, lease or deed
of any type. This is the complete and full agreement of the parties.
XII.
MODIFICATION
This Agreement contains the entire agreement of the parties. No representations were
made or relied upon by either party other than those that are expressly set forth herein. No agent,
employee or other representative of either party is empowered to alter any of the terms hereof
unless done in writing and signed by an authorized officer of the respective parties.
XIII.
ASSIGNMENT
Neither party may assign its rights under this Agreement without the express prior written
consent of the other party.
XIV.
CONTRACT DOCUMENTS
Contractor is responsible for review of and compliance with each of the terms of this
Agreement. The parties agree that this Agreement shall include, as if fully set forth herein, the
Proposal which is attached hereto.
XV.
AUTHORIZED REPRESENTATIVE
In further consideration of the mutual covenants herein contained, the parties hereto
expressly agree that for purposes of notice, include legal service of process, during the term of
this Agreement and for the period of any applicable statute of limitations thereafter, the
following named individuals shall be authorized representative of the parties:
City shall, during their tenure
and one year thereafter, have a financial interest, direct or indirect, in this Agreement
or in any funds transferred hereunder. Any violation of this section shall render the
Agreement voidable by the City or the Contractor.
B. The Contractor coverrants that it presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict with the performance required to be
sole
negligence or willful misconduct of the City, its agents or employees. The Contractor and the
City shall give prompt and timely written notice of any claim made or suit instituted which, in
any way, directly or indirectly, contingently or otherwise affects or might affect the other parties.
V.
EQUAL EMPLOYMENT OPPORTUNITY CLAUSE
L
STATE OF NEBRASKA Je•sica .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
' A. City of Omaha
R.E. Cunningham, RA F.SAME, Planning Director
Planning Department
1819 Farnam Street, Suite 1111
Omaha,NE 68183
(402)444-5405
B. Sienna/Francis House
Mike Saklar, Executive Director
1702 Nicholas Street
Omaha,NE 68102
(402) 341-1821
EXECUTED this 3" ay ofreinggi_, 2009, by the City of Omaha,Nebraska.
ATTEST: - CITY OF OMAHA,NEBRASKA
Z2 _ -:'. '7;4 4/ ./V-.
.v4 ' _...., . , .. _ _ ie
usterErown, City Clerk` - Date Jir u e, t%Oror Date
SIENA/FRANCIS HOUSE
.
Mike Saklar Date
APPROVED AS TO FORM:
a c„,,At / --/,zw
Dep City Attorney Date
P:\LAW—CITY COUNCIL DOCUMENTS\2010\50012s1w.doc
013. Resume
is attached.
Revised 03/99
C
Approved..
��' Mayor
-
577.85
Exhibit A SIENA/FRANCIS HOUSE
HOMELESS DAY SHELTER OPERATIONS PLAN
January 1,2010
Submitted by: Siena/Francis House
Address: 1702 Nichols Street
Omaha,NE 68102
Telephone: 402.341.1821
402.341.5270 (Fax)
Email: msaklar@sienafrancis.org
The Siena/Francis House Day Shelter program will operate as follows:
A. Facility. The Siena/Francis House Homeless Day Shelter program is located at
1624 Nicholas Street in a commercial building that was purchased and partially
renovated by the City of Omaha and transferred to the Siena/Francis House. This
facility was opened for business on December 1, 2008.
The facility is comprised of approximately 4,460 gross square feet of space with
an approximately 2,040 square foot "meeting hall". There is also a 550 square
foot secondary room along with storage areas, restrooms and showers, reception
area and six offices. This facility can accommodate up to 172 persons at a time.
The Siena/Francis House also offers homeless day shelter services at its main
facilities at 1702 Nicholas Street and 1111 North 17th Street, as appropriate, to
homeless men, women, and families. The primary location for serving women
and families will be at these locations. All sites will be appropriately staffed.
B. Staffing. The Siena/Francis House will staff the homeless day shelter program
utilizing seven salaried employees and nine employees from its employment
training program. Salaried professionals and employment training employees,
covering various eight-hour work schedules, will be on site at all times. In
addition, other staff will be conducting outreach services.
The Siena/Francis House currently has six salaried employees and nine
employment training employees assigned to its Homeless Day Shelter Program.
The Homeless Day Shelter Director is Mr. Rod Bauer who has been an employee
of the Siena/Francis House since April 2003. Mr. Bauer has a Masters Degree
and is a Provisionally Licensed Mental Health Practioner and a Licensed Alcohol
and Drug Addiction Counselor. Other Day Shelter staff consists of two Licensed
Alcohol and Drug Addiction Counselors, two Master Degree level social workers,
and a driver. One additional professional level employee will be hired in 2010.
The nine employment training program staff are assigned to the homeless day
shelter program based on their individual abilities. The employment training
program is comprised of men and women who are clients in the Siena/Francis
House chemical addictions treatment program.
1
ca .Marsh,Notary Public
MY COMMISSION EXPIRES
MARCH 24, 2010
�/� f)1 sie,^ /4:/e _ 5�Shit
d ' day of March ,20 10 Universal Surety Company
surety
.S.ASP LT did
4eyinLtL
Principal(Signature) Jacqueline L. Drey ✓
Attorney-in-Fact(Printed Name)
Principal(PrintedName) Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
SIENA/FRANCIS HOUSE
HOMELESS DAY SHELTER OPERATIONS PLAN
January 1,2010
The Siena/Francis House has conducted a day services program since October
2005 and has provided a multitude of services to hundreds of homeless men,
women and families. The Siena/Francis House, and its staff, has essential
experience is working with actively addicted, mentally ill, chronically homeless
persons.
C. Population. The Siena/Francis House accepts all persons, unconditionally,
regardless of whether they are active in their addictions, have a severe mental
illness, are severely disabled, and/or severely dysfunctional. Thus, we have
developed our emergency shelter program to effectively serve and work with this
population. We have no requirements such as attending religious programs or
entering our chemical addictions program in order to stay in our shelter. As such,
our program is specifically designed to assist and work with homeless persons
who are active in their addictions and who may have a mental illness. The
Siena/Francis House has over thirty years of experience in working with this
specific homeless population.
Siena/Francis House staff, and the agency as a whole, has developed specific
skills in working with the actively addicted, mentally ill, chronically homeless
while, at the same time, creating a safe environment for all. The Siena/Francis
House is the only emergency shelter program in the Omaha Metropolitan Area
that serves the actively addicted, mentally ill, chronically homeless population.
D. Services. The Siena/Francis House proposes to provide a full array of services
ranging from basic daily needs to case management. Basic daily needs will
consist of a safe place to stay during the day, public restrooms, showers, storage
of personal property, emergency clothing, personal hygiene products, daily
supplies, food and drink. Food will not be prepared on site. The Siena/Francis
House will work with the various sack lunch programs to provide lunches at the
day shelter location.
In addition, the Siena/Francis House will provide a) mental health screening and
referral, b) substance abuse assessment, education and referral, c) needs
assessment, case management and referral, d) job training and employment
assistance, e) housing assistance, f) social services including assistance with
Social Security, Veterans Administration, General Assistance, Health and Human
Services, and Workforce Development, g) transportation assistance, h) financial
assistance, and i) physical health assessment and referral. In addition to providing
direct services, the Siena/Francis House will partner with other agencies that will
also provide services including the Visiting Nurse Association, the Charles Drew
Health Center, Community Alliance, The Salvation Army, Heartland Family
Services and the YWCA Women in Violence Program.
2
Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
SIENA/FRANCIS HOUSE
HOMELESS DAY SHELTER OPERATIONS PLAN
January 1,2010
E. Community Outreach and Monitoring of Criminal Activity. Siena/Francis House
staff will go into the surrounding neighborhoods in order to seek out homeless
persons and to monitor for any criminal activity that might be perpetrated by
homeless individuals. The objectives of this outreach and monitoring effort are to
reach out to homeless persons and to bringthem to Siena/Francis House facilities
to receive services. Staff will report any noted criminal activity to the Omaha
Police Department. Such monitoring will be focused in a one-half mile radius of
the Siena/Francis House campus but will extend beyond this radius into other
areas where the homeless may be found.
F. Noncommercial Day Shelter Advisory Committee. The Siena/Francis House will
meet with the Noncommercial Day Shelter Advisory Committee whenever it
wishes to convene.
G. Quarterly Reports. The Siena/Francis House will provide quarterly reports to the
Office of the Mayor and City Planning Department detailing the accomplishments
of its day services program.
H. Budget. The 2010 budget is attached.
I. Hours of Operation. The Siena/Francis House Day Shelter will conduct services
between the hours of 7:00 AM and 7:00 PM, seven days a week.
The Siena/Francis House will not discriminate or permit discrimination in
violation of federal or state laws or local ordinances because of race, color, sex,
age, or disability, or because of political or religious opinions, affiliations or
national origin. The Siena/Francis House reserves the right to remove or bar
individuals from the premises or program due to violent or disruptive behavior,
threat of violent behavior, carrying of fire arms or other weapons, using illegal
drugs or alcohol on or in its premises, bringing illegal drugs, alcohol or weapons
onto or into its premises, or any other disruptive behavior that might cause harm
to staff or guests. The Siena/Francis House also reserves the right to remove or
bar specific individuals who are known to be violent based on past involvement
with our programs. A list of such violent persons is maintained at the
Siena/Francis House administrative offices.
Respectfully submitted by:
A L. L' '
Mike Saklar
Executive Director
Siena/Francis House
3 ,
curity, Veterans Administration, General Assistance, Health and Human
Services, and Workforce Development, g) transportation assistance, h) financial
assistance, and i) physical health assessment and referral. In addition to providing
direct services, the Siena/Francis House will partner with other agencies that will
also provide services including the Visiting Nurse Association, the Charles Drew
Health Center, Community Alliance, The Salvation Army, Heartland Family
Services and the YWCA Women in Violence Program.
2
Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
2010 Siena/Francis House
Day Services Budget
Description 2010 budget 2009 Actual 2009 Budgeted ,
Legal and Accounting $2,400.00 $2,400.00 $2,400.00
Management and General $12,500.00 $12,500.00 $12,500.00
Property/Liability Insurance $1,800.00 $1,773.00 $1,800.00
Utilities $9,850.00 $9,500.00 $11,760.00
Maintenance and Repairs $25,000.00 $50,039.00 $7,500.00
Food Purchases $3,000.00 $999.00 $30,000.00
Supplies $5,000.00 $3,346.00 $6,825.00
Other(Trash, Fuel, Vehicle Exp) $0.00 not determined $12,700.00
Personal Care Items $0.00 not determined $1,200.00
Records Assistance $5,000.00 $4,570.00 $6,000.00
Local Transportation $5,820.00 $5,350.00 $5,820.00
Out of Town Transportation $1,200.00 $1,554.00 $1,200.00
Office Expenses $0.00 not determined $2,640.00
Telephones**(US Cellular) $6,384.00 $3,841.00 $5,328.00
Internet Service, Telephones, Cabl $4,250.00 $3,542.00 $780.00
' Cable Television $0.00 included above $480.00
Employment Training Stipends $31,200.00 $29,200.00 $20,400.00
Salaries and Wages $218,850.00 $157,115.00 $183,000.00
Employee Healthcare Plan $39,690.00 $20,379.00 $48,000.00
Retirement Benefits $6,565.00 $666.00 $5,490.00
Employer Taxes $18,900.00 $13,241.00 $15,190.00
Workman's Compensation $4,380.00 $2,920.00 $6,040.00 •
Mileage Reimbursement $0.00 not determined $7,200.00
Total Expenses $401,789.00 $322,935.00 $394,253.00
1/8/2010
gin. The Siena/Francis House reserves the right to remove or bar
individuals from the premises or program due to violent or disruptive behavior,
threat of violent behavior, carrying of fire arms or other weapons, using illegal
drugs or alcohol on or in its premises, bringing illegal drugs, alcohol or weapons
onto or into its premises, or any other disruptive behavior that might cause harm
to staff or guests. The Siena/Francis House also reserves the right to remove or
bar specific individuals who are known to be violent based on past involvement
with our programs. A list of such violent persons is maintained at the
Siena/Francis House administrative offices.
Respectfully submitted by:
A L. L' '
Mike Saklar
Executive Director
Siena/Francis House
3 ,
curity, Veterans Administration, General Assistance, Health and Human
Services, and Workforce Development, g) transportation assistance, h) financial
assistance, and i) physical health assessment and referral. In addition to providing
direct services, the Siena/Francis House will partner with other agencies that will
also provide services including the Visiting Nurse Association, the Charles Drew
Health Center, Community Alliance, The Salvation Army, Heartland Family
Services and the YWCA Women in Violence Program.
2
Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
C-25A CITY OF OMAHA
LEGISLATIVE CHAMBER
Omaha,Nebraska
RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA:
WHEREAS, Siena/Francis House has signed a contract with the City. of Omaha,
which is attached hereto as Exhibit"A",to provide certain specified services; and,
WHEREAS, pursuant to such contract, Siena/Francis House will operate a
homeless day shelter at 1624 Nicholas Street from January 1, 2010 through December 31, 2010;
and,
WHEREAS, as recommended by the Mayor, the sum of One Hundred Thousand
Dollars ($100,000.00) has been allocated to Siena/Francis House for partial funding of such
project from the Omaha/Keno Lottery Fund 12118, Organization 126045; and,
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF OMAHA:
THAT, the contract between the City of Omaha and Siena/Francis House for the
operation of a homeless day shelter at 1624 Nicholas Street, attached hereto as Exhibit "A" and
incorporated herein by this reference, and partial funding of such project in the amount of
$100,000.00, is hereby approved.
FURTHER THAT, the Finance Director is authorized to provide payment of
$100,000.00 from Omaha/Keno Lottery Fund 12118, Organization 126045, City Contributions
46111 in accordance with the contract terms.
APPROVED AS TO FORM:
afra., /0/ 7d
De y City Attorney Date
P:\LAW-CITY COUNCIL DOCUMENTS\2010\50011s1w.doc
AVe/LNA00041.
By 047
Councilmember
Adopted idetroEB...2..3..2010 6-0
''A‘
ity Clera(/k,, f ,5/4)
v �
Approved..
Mayor
9
es the right to remove or bar
individuals from the premises or program due to violent or disruptive behavior,
threat of violent behavior, carrying of fire arms or other weapons, using illegal
drugs or alcohol on or in its premises, bringing illegal drugs, alcohol or weapons
onto or into its premises, or any other disruptive behavior that might cause harm
to staff or guests. The Siena/Francis House also reserves the right to remove or
bar specific individuals who are known to be violent based on past involvement
with our programs. A list of such violent persons is maintained at the
Siena/Francis House administrative offices.
Respectfully submitted by:
A L. L' '
Mike Saklar
Executive Director
Siena/Francis House
3 ,
curity, Veterans Administration, General Assistance, Health and Human
Services, and Workforce Development, g) transportation assistance, h) financial
assistance, and i) physical health assessment and referral. In addition to providing
direct services, the Siena/Francis House will partner with other agencies that will
also provide services including the Visiting Nurse Association, the Charles Drew
Health Center, Community Alliance, The Salvation Army, Heartland Family
Services and the YWCA Women in Violence Program.
2
Constructors Bonding Company
Agency/Business Name
11636 W. Center Road
Omaha, NE 68144
Agency.Business Address
402-333-3232
Phone Number
• APPROVED AS TO FORM:
DEPUTY CITY ATTORNEY
3
Revised 10-09
Con-20.3
entage,and that all moneys payable to him/her hereunder
are free from obligation to any other person for services rendered,or supposed to have been rendered,in the procurement of this
contract.He/She further agrees that any breach of this warranty shall constitute adequate cause for the annulment of this contract
I
by the party of the first part and that the said party of the first part may retain for its own use,from any sums due or to become r
due hereunder,an amount equal to any brokerage,commission,or percentage,so paid or agreed to be paid. 1
s
That the party of the second part further agrees to pay all laborers and mechanics for labor that shall be performed and 'l
pay for all material, supplies and equipment which is used or rented in performing the contract, and pay to the Unemployment I1
Compensation Fund of the State of Nebraska the unemployment contributions and interest due under provisions of the Nebraska �,
Employment Security Law on wages paid to individuals employed in the performance of this contract.
C
All work required in carrying out this contract shall be performed in compliance with the laws of the State of Nebraska. 14
i
The party of the second part further agrees to perform the work under the supervision of the Owner. The administrator lX
of the Federal Highway Administration or his/her authorized agent, including the State of Nebraska,Department of Roads shall i
have the right at all times,but not the duty,to inspect the work for eligibility for federal funding in accordance with the.laws of
the State of Nebraska, and the rules and regulations of the Administrator of the Federal Highway Administration of the United
States,for the purpose of carrying out the provisions of Title 23,United States Code,as amended and supplemented(Federal Aid
Highway Acts). Ifs
That in consideration of the foregoing,the parties understand that when the Owner authorizes payment(s)the Owner I-I
will see that prompt payment is made by the State of Nebraska, Department of Roads on behalf of the Owner and the Federal
1 y
l..
Revised 10-09
Con-20.3 4
i
J
0
i'
uthority
copy of Form 17 and a Nebraska Resale or Exempt Sale Certificate, must be signed by the owner, partner, corporate officer, or other
Form 13, with Section C, Part 2, completed. The subcontractor will individual authorized to sign by a power of attorney on file with the
retain these forms in his or her records, and will not charge the Nebraska Department of Revenue.
•
NDOR www.revenue.ne.gov, (800)742-7474(toll free in NE and IA), (402) 471-5729
6-139-1970 Rev.4-2009 Supersedes 6-139-1970 Rev.2-2008
p
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cc4 O ccn N . N .O-•,
_ _ ie
usterErown, City Clerk` - Date Jir u e, t%Oror Date
SIENA/FRANCIS HOUSE
.
Mike Saklar Date
APPROVED AS TO FORM:
a c„,,At / --/,zw
Dep City Attorney Date
P:\LAW—CITY COUNCIL DOCUMENTS\2010\50012s1w.doc
013. Resume
is attached.
Revised 03/99
C
Approved..
��' Mayor
-
577.85