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Home My WebLink About _ 4.6(a)--Adopt Reso to Accept Library Literacy Services Grant for ESL Services CITY OF REDDING REPORT TO THE CITY COUNCIL Recommendation Authorize and approve the following actions: (1) Adopt Resolution authorizing acceptance of the California State Library’s award of a grant in the amount of $60,188 through the California Library Literacy Services Program to fund the Shasta Public Libraries’ English as a Second Language Services; (2) Authorize the City Manager, or designee, to execute the Award Agreement and all subsequent documentation relative to the grant; and (3) Adopt Resolution approving and adopting the 6th Amendment to City Budget Resolution No. 2023-060 appropriating said funds. Fiscal Impact There is no impact to the General Fund. Alternative Action The City Council could choose not to accept the $60,188 grant from the California State Library. This action would severely limit literacy services and language support available to English learners in the Redding area. Background/Analysis Literacy programs in California’s public libraries transform the lives of thousands of Californians and their families every year. They help adults gain basic literacy skills, achieve learning goals, and use library services effectively. They strengthen communities and help families grow and succeed. Since 1984, California’s librar y literacy programs have helped more than a quarter of a million learners and their families. MEETING DATE: August 1, 2023 ITEM NO. 4.6(a) FROM: ***APPROVED BY*** kniemer@cityofredding.org btippin@cityofredding.org SUBJECT: 4.6(a)--Resolution to Accept Library Literacy Services Grant for English as a Second Language Services and Adopt Budget Resolution Appropriating Funds Kim Niemer, Community Services Director Report to Redding City Council July 26, 2023 Re: 4.6(a)--Adopt Reso to Accept Library Literacy Services Grant for ESL Services Page 2 The California Library Literacy Services (CLLS) is a program of the California State Library. CLLS grant monies provide needed funding for the California Library Literacy and English Acquisition Service Program. This award is the second year in a row that the Shasta Public Library was selected for funding. Should the City Council accept these grant funds, literacy services will continue to be offered at the Redding Library with additional hours and learning resources. Such funding would add capacity to increase the number of students receiving ESL literacy support. ESL tutoring is based on each student’s pace and goals. Outcomes include new fluency in reading, writing, spelling, and conversation, thus enhancing their work opportunities, lifelong learning, family roles, and community participation. The City Attorney’s office has reviewed and approved the proposed language of the agreement. Environmental Review This is not a project defined under the California Environmental Quality Act, and no further action is required. Council Priority/City Manager Goals • Budget and Financial Management – “Achieve balanced and stable 10-year Financial Plans for all funds.” • Government of the 21st Century – “Be relevant and proactive to the opportunities and challenges of today’s residents and workforce. Anticipate the future to make better decisions today.” • Economic Development – “Facilitate and become a catalyst for economic development in Redding to create jobs, retain current businesses and attract new ones, and encourage investment in the community.” Attachments ^Resolution - Grant Acceptance ^Budget Resolution Letter of Intent to Award RESOLUTION NO. 2023-____ A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF REDDING AUTHORIZING THE GRANT ACCEPTANCE AND EXECUTION OF GRANT FUNDS FROM THE CALIFORNIA STATE LIBRARY BUDGET FOR CALIFORNIA LIBRARY LITERACY SERVICES FUNDING FOR ENGLISH AS A SECOND LANGUAGE SERVICES WHEREAS, the California State Library has provided funds for the program shown above; and WHEREAS, the California State Library has been delegated the responsibility for the administration of this grant program, establishing necessary procedures; and WHEREAS, said procedures established by the California State Library require a resolution certifying the approval by the potential grantee’s governing board either before submission of said application(s) to the State or prior to execution of the grant agreement; and WHEREAS, the Applicant/Grantee, if selected, will enter into an agreement with the State of California to carry out the project; and WHEREAS, the City of Redding proposes to implement the Shasta Public Libraries Literacy Services for English as a Second Language Services at the Redding Library; and WHEREAS, the City of Redding has the legal authority and is authorized to enter into a funding agreement with the State of California; and WHEREAS, the City of Redding intends to accept grant funding from the California State Library for the Shasta Public Libraries Literacy Services for English as a Second Language Services at the Redding Library; NOW THEREFORE, BE IT RESOLVED by the City Council of the City of Redding as follows: 1. That pursuant and subject to all of the terms and provisions of the California State Library, the City of Redding City Manager, or designee is hereby authorized and directed to accept the grant funding with the California State Library, and take such other actions necessary or appropriate to maintain grant funding. 2. The City of Redding City Manager, or designee is hereby authorized and directed to execute the funding agreement with the California State Library and any amendments thereto. 3. The City of Redding City Manager, or designee is hereby authorized and directed to submit any required documents, funding requests, and reports required to maintain grant funding. 4. Certifies that the project will comply with any laws and regulations including, but not limited to, the California Environmental Quality Act (CEQA), legal requirements for building codes, health and safety codes, the California Labor Code, disabled access laws, and, that prior to commencement of the project, all applicable permits will have been obtained. I HEREBY CERTIFY that the foregoing resolution was introduced at a regular meeting of the City Council of the City of Redding on the 1st day of August, 2023, and was duly adopted at said meeting by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: __________________________________ MICHAEL DACQUISTO, Mayor ATTEST: FORM APPROVED: _______________________________ __________________________________ SHARLENE TIPTON, City Clerk BARRY E. DeWALT, City Attorney RESOLUTION NO. 2023-___ A RESOLUTION OF THE CITY OF REDDING APPROVING AND ADOPTING THE 6th AMENDMENT TO CITY BUDGET RESOLUTION NO. 2023-060 APPROPRIATING $60,190 FOR THE CALIFORNIA STATE LIBRARY GRANT PROGRAM AWARD FOR ENGLISH AS A SECOND LANGUAGE SERVICES FOR FISCAL YEAR 2023-24 BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF REDDING THAT Budget Resolution No. 2023-060 be and is hereby amended as follows: FUND DIVISION DESCRIPTION INCREASE DECREASE 181 5301 Redding Library $60,190 THAT account titles and numbers requiring adjustments by this Resolution are as follows: USE SOURCE OF FUNDS OF FUNDS Increase (Decrease) Revenue 181-5301-3622603-00000 State Library Grant - Main 60,190$ Increase Expenditures 181-5301-5247501-00000 LSSI Operations 60,190$ Total 60,190$ 60,190$ THAT the purpose is to appropriate $60,190 for the California State Library Grant program award for English as a Second Language Services for fiscal year 2023-24. I HEREBY CERTIFY that the foregoing resolution was introduced at a regular meeting of the City Council of the City of Redding on the 1st day of August, 2023, and was duly adopted at said meeting by the following vote: AYES: COUNCIL MEMBERS: NOES: COUNCIL MEMBERS: ABSENT: COUNCIL MEMBERS: ABSTAIN: COUNCIL MEMBERS: MICHAEL DACQUISTO, Mayor ATTEST: FORM APPROVAL: SHARLENE TIPTON, City Clerk BARRY E. DeWALT, City Attorney Library – Courts Building 916-323-9759 P.O. Box 942837 csl-adm@library.ca.gov Sacramento, CA 94237-0001 www.library.ca.gov July 12, 2023 Jared Tolman Shasta Public Libraries 1100 Parkview Ave. Redding, CA 96001-3239 Dear Mr. Jared Tolman, We’re pleased to provide funds to support your English as a Second Language program and the important work that you, your staff, and your volunteers do for your community through the California Library Literacy Services program. In 2021-2022, the state budget included one-time California Library Literacy Services funding at $15 million for English as Second Language Services. These funds will be allocated over a five-year period. This award letter covers Year 3 of funding between July 1, 2023, and June 30, 2024. Your total award for the 2023-2024 fiscal year beginning July 1, 2023, is: x Total Award: $60,188 Your funds must be fully expended by June 30, 2024, in accordance with your approved budget on file with the State Library. The budget listed in your award packet indicates your original grant request. Your library may have to submit a new budget for review and approval to reflect your 2023-2024 English as a Second Language Services award. To ensure that program expenditures are consistent with the California Library Literacy Services allowable expenses, please review the California Library Literacy Services Allowable and Unallowable Expenses guidelines. If you have any questions about expenses or expending your award funds, please contact Allyson Jeffredo at Allyson.Jeffredo@library.ca.gov. We strongly encourage your program staff to develop and maintain community partners to strengthen your program, attend regular regional library literacy network meetings, participate in your local Adult Education Consortium, and participate in library literacy training opportunities offered by the regional networks and the State Library to meet the CLLS Mission, Values, and Program DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Library – Courts Building 916-323-9759 P.O. Box 942837 csl-adm@library.ca.gov Sacramento, CA 94237-0001 www.library.ca.gov Essentials. Additional California Library Literacy Services resources can also be found on the California Library Literacy Services webpage. The payment process begins when we receive your completed and signed budget modification form (if needed), claim form, certification form, and State Funded Grants Award Agreement and Certificate of Compliance (attached). All forms should be completed and signed through DocuSign to be processed for payment. Our library literacy staff is available to assist you throughout the year. Please contact your Advisor Beverly Schwartzberg, beverly.schwartzberg@library.ca.gov, and your Grant Monitor Allyson Jeffredo, Allyson.Jeffredo@library.ca.gov, with any questions. Thank you for your willingness to do so much for those in your community. Best wishes for a successful year. Respectfully yours, Greg Lucas California State Librarian Cc: Beverly Schwartzberg, beverly.schwartzberg@library.ca.gov Allyson Jeffredo, allyson.jeffredo@library.ca.gov Fiscal Office, stategrants.fiscal@library.ca.gov Shae Darling, Shaed@shastalibraries.com Enc: Re: ESL21-3-46: Claim form, certification form, and State Funded Grants Award Agreement and Certificate of Compliance DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries THE BASICS – YOUR GRANT AWARD The following provides basic information about your grant and managing your grant. Award #: ESL21-3-46 Library: Shasta Public Libraries Total Award Amount: $60,188 ESL GRANT REQUEST Salary and Benefits $55,739 Contract Staff $8,000 Operations $2,500 Library Literacy Materials $7,500 Small Equipment $2,500 Equipment ($5,000 or more per unit) $0 Subtotal $76,239 Indirect $0 Award Difference to be Adjusted (included in grant total below) -$16,051 Grant Total $60,188 Start Date: Upon execution End Date: June 30, 2024 Please understand that it can take between eight to ten weeks following the receipt of an error free claim form before grant funds are delivered. If you have not received your payment after eight weeks, please contact your grant monitor. CONTACT We want your project to be successful. Please work with the program staff listed below to implement your project: Literacy Analyst: Allyson Jeffredo Phone Number: (916) 603-6709 Email Address: allyson.jeffredo@library.ca.gov Library Programs Consultant: Beverly Schwartzberg Phone Number: (916) 701-6880 Email Address: beverly.schwartzberg@library.ca.gov DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries CERTIFICATION I hereby certify under penalty of perjury: that I am the duly authorized representative of the claimant herein; that the claim is in all respects true, correct and in accordance with law and the terms of the agreement; and that payment has not previously been received for the amount claimed herein. The claims the indicated allowance for the purposes of carrying out the functions stated in its CLLS application and in Sections 18880-18883 of the California Education Code. 1100 Parkview Ave., Redding, CA 96001-3239 SIGNED DATE Signature - Authorized representative Typed/Printed Name and Title of Authorized Representative Email address of authorized representative DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 Library DirectorJared Tolman Jared.Tolman@lsslibraries.com 7/19/2023 In Process Shasta Public Libraries PROJECT INFORMATION: Invoice #: ESL21-3-46 Project Title: English as a Second Language Services Grantee: Shasta Public Libraries Funding Start Date: Upon execution Term Completion: June 30, 2024 DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries Total Award: $60,188 PAYMENT SCHEDULE: Libraries receive 100% of their 2023-2024 English as a Second Language Services award upon receipt of the award letter. Note: Libraries have 18 months to spend their 2023-2024 English as a Second Language Services award funds, from July 1, 2023, in which the funds are awarded until December 31, 2024. English as a Second Language Service Award Final Payment $60,188 Total $60,188 REPORTING: For the 2023-2024 program period, libraries will be required to submit a mid-year report and final report. Reminder emails will be sent out beginning six weeks before the required reports are due. All required reporting materials will be located on the California State Library’s website. The reporting schedule is detailed below. Mid-Year Report Due January 31, 2024 Final Report Due September 30, 2024 Note: A budget modification form will be required for all budget changes regardless of amount. Modification forms may be submitted throughout the year but no later than May 31st. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process STATE FUNDED GRANTS AWARD AGREEMENT AND CERTIFICATE OF COMPLIANCE DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 1 of 27 TABLE OF CONTENTSTS PROJECT SUMMARYY 22 PROCEDURES AND REQUIRMENTS A. Term of the Agreement 3 B. Scope of Workrk 3 C. .Budget Detailail 3 D. .Narrative and Financial Reportsts 4 E. Claim Form and Paymentnt 55 EXHIBIT A: TERMS AND CONDITIONSNS 77 EXHIBIT B: CERTIFICATION AND COMPLIANCE FORMM 22 Certification 25 EXHIBIT C: STATE REIMBURSABLE TRAVEL EXPENSESES 27277 DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 2 of 27 PROJECT SUMMARY AWARD AGREEMENT BETWEEN THE STATE LIBRARY and Shasta Public Libraries for the English as a Second Language Services project. AWARD AGREEMENT NUMBER ESL21-3-46 This Award Agreement (“Agreement”) is entered into on July 1, 2023 by and between the California State Library (“State Library”) and Shasta Public Libraries, (“Grantee”). This Award Agreement pertains to Grantee’s State-funded English as a Second Language Services project. The Library Development Services Bureau (“LDS”) of the State Library administers state and federal funds in the form of awards. The Grantee was selected by the State Library to receive state grant funds in the amount of $60,188 through the process adopted by the State Library in administering such grants. The State Library and the Grantee, for the consideration and under the conditions hereinafter set forth in the Grant Agreement, agree as follows: DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 3 of 27 PROCEDURES and REQUIREMENTS A. Term of the Agreement The Grant term begins July 1, 2023, and ends June 30, 2024. The project’s final expenditure date is December 31, 2024. If completion of the project occurs prior to the end of the grant period, this will be the end date of the term of this agreement. Grant eligible program expenditures may begin no earlier than the start date. The project's final encumbrance period ends on June 30, 2024, and all eligible program costs must be expended by December 31, 2024. B. Scope of Work 1. Grantee agrees to perform all activities specifically identified in the Grantee’s application and submitted to the State Library in response to the English as a Second Language Services project. 2. The following activities and deliverables to be performed by the Grantee include, but are not limited to the following: xMaintain and keep records of expenditures related to the grant that are consistent with Generally Acceptable Accounting Practices (GAAP). xMake financial records available to the State Library upon request. xWork with the State Library staff to assure that funds are disbursed in compliance with the purpose of the grant. xPrepare and submit required narrative and financial reports. xProcure equipment, and other supplies as needed for the project. xIssue contracts for services, personnel, and consultants as needed for the project. xIf applicable, make payments for services, including for hours worked and travel reimbursements, to consultants and contractors. xOversee the implementation of project activities. C. Budget Detail The State Library shall provide the Grantee funding for the expenses incurred in performing the Scope of Work and activities specified in the Grantee’s application. The Grantee shall request the distribution of grant funding consistent with its proposal and DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 4 of 27 the budget worksheet that was included with the application. Under no circumstances shall payments exceed the total grant amount identified in this Agreement. D. Narrative and Financial Reports 1. The Grantee shall be responsible for submission of interim and final narrative and financial reports on the progress and activities of the project, to the California State Library, using the sample report documents provided by the California State Library. 2. All the reports must be current, include all required sections and documents, and must be approved by the Grant Monitor before any payment request can be processed. Failure to comply with the specified reporting requirements may be considered a breach of this Agreement and result in the termination of the Agreement or rejection of the payment request and/or forfeiture by the Grantee of claims for costs incurred that might otherwise have been eligible for grant funding. Any problems or delays must be reported immediately to the Grant Monitor. The financial reports shall reflect the expenditures made by the Grantee under the Agreement and may be incorporated into the same reporting structure as the narrative reports. 3. The reports shall be submitted by the following dates: Reporting Period Report Due Date July – December 2023-2024 Mid-Year Report Due January 31, 2024 January – Project End Date 2023-2024 Final Report Due September 30, 2024 4. Failure to submit timely reports with the appropriate documentation by the due date may result in rejection of the payment request and/or forfeiture by the Grantee of claims for costs incurred that might otherwise have been eligible for grant funding. 5. The Grantee agrees to maintain records and supporting documentation pertaining to the performance of this grant, subject to possible audit for a minimum of five (5) years after final payment date or grant term end date, whichever is later. Please refer to Exhibit A, Terms and Conditions, for more information. E. Claim Form and Payment 1. The California State Library shall provide the Grantee payment as outlined in the payment schedule only if all requirements for claiming the funds as outline in this document have been met, and only for those activities and costs specified in the approved award application. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 5 of 27 2. The Grantee shall complete, sign, and submit Certification of Compliance form (Exhibit B) and the Financial Claim form (included in your award packet), to the California State Library within 14 days of receiving this award packet. These forms will be issued, signed, and submitted using the online signature and agreement platform, DocuSign, unless DocuSign is unallowable or inconsistent with practices and policies of the local jurisdiction. If the use of DocuSign is not acceptable to your organization, please contact your grant monitor regarding alternate options. 3. Any of the sums appearing under the categories in the approved budget may be adjusted with prior authorization from the California State Library Grant Monitor. This would be to increase the allotment with the understanding that there will be corresponding decreases in the other allotments so that the total amount paid by the California State Library to the Grantee under this Agreement shall not exceed the awarded amount, which shall be expended/encumbered during the grant period. 4. If the payment amount made by the California State Library exceeds the actual expenses incurred during the term of this Agreement, as reflected in the financial reports to be filed by the Grantee, the Grantee shall immediately refund the excess payment amount to the California State Library. 5. The Award payments will only be made to the Grantee. It is the Grantee’s responsibility to pay all contractors and subcontractors for purchased goods and services. 6. The Final Payment of 10% will be withheld and retained by the California State Library until all conditions agreed upon in this Agreement, including submission and grant monitor approval of the interim and final narrative and financial reports, have been satisfied. 7. Prompt Payment Clause The California State Library will make payments to the Grantee in accordance with the Prompt Payment Clause under Government Code, section 927, et. seq. The Grantee may typically expect payment within 45 days from the date a grant payment request is properly submitted and approved by the Grant Monitor. 8. Budget Contingency Clause a. It is mutually agreed that if the Budget Act of the current fiscal year or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall no longer be in full force and effect. In this event, the California State Library shall have no liability to pay any funds whatsoever to the Grantee or to furnish any other considerations under this Agreement and the Grantee shall not be obligated to perform any provisions of this Agreement. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 6 of 27 b. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this Program, the California State Library shall have the option to either cancel this Agreement with no liability occurring to itself or offer an Agreement amendment to the Grantee to reflect the reduced amount. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 7 of 27 EXHIBIT A: TERMS and CONDITIONS 1. Accessibility: The State is responsible for ensuring that public websites are accessible to both the general public and state employees, including persons with disabilities. Grantee shall assist the State in meeting its responsibility. Therefore, all project materials generated by state funded programs must meet the California Accessibility Standards. Additionally all project materials designed, developed, and maintained shall be in compliance with the California Government Code, sections 7405 and 11135, and the Web Content Accessibility Guidelines 2.0, or a subsequent version, as published by the Web Accessibility Initiative of the World Wide Web Consortium at a minimum Level AA success criteria. However, if for some reason project material is not generated to be in compliance to meet these standards, please still submit it to the State Library. When submitting the material make sure to note that the material is not accessible by including “NOT ACCESSIBLE” in the file name. The California State Library reserves the right to post project materials to its website that are in compliance with these standards. 2. Acknowledgment: The State of California and the California State Library shall be acknowledged in all promotional materials and publications related to the English as a Second Language Services project. a. Grant award recipients must ensure that the State of California receives full credit as the source of funds and that the California State Library, likewise, is acknowledged as the administrator. b. Publications and information releases about the project must credit the State of California. An appropriate statement for a publication or project press release is: “This [publication/project] was supported in whole or in part by funding provided by the State of California, administered by the California State Library.” Grantees must include the above statement in any publications, vehicle wraps, and promotional materials, including websites. If space is limited the State Library logo and the following shortened acknowledgement statement is acceptable: “Funding provided by the State of California.” DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 8 of 27 c. This credit line on products of a project, such as materials, is important to foster support from the public, and state funding sources. d. California State Library Logo: Use of the California State Library logo, which can be downloaded on the California State Library website, is required on any publication, vehicle wrap, or promotional material along with the above statement(s). e. Photo Documentation: Digital photos are a great way to document the happenings of your project. It is recommended that you use a photo release form when taking photos of the public. You may use your library’s photo release form, or contact your grant monitor for the State Library’s form. 3. Agency: In the performance of this Agreement the Grantee and its agents and employees shall act in an independent capacity and not as officers, employees or agents of the California State Library. The Grantee is solely responsible for all activities supported by the grant. Nothing in this Agreement creates a partnership, agency, joint venture, employment, or any other type of relationship between the parties. The Grantee shall not represent itself as an agent of the California State Library for any purpose, and has no authority to bind the State Library in any manner whatsoever. 4. Amendment: No amendment or variation of the terms of this Agreement shall be valid unless made in writing, signed by the parties, and approved as required. No oral understanding or agreement not incorporated into this Agreement is binding on any of the parties. This Agreement may be amended, modified or augmented by mutual consent of the parties, subject to the requirements and restrictions of this paragraph. 5. Applicable law: The laws of the State of California shall govern all proceedings concerning the validity and operation of this Agreement and the performance of the obligations imposed upon the parties hereunder. The parties hereby waive any right to any other venue. The place where the Agreement is entered into and place where the obligation is incurred is Sacramento County, California. 6. Assignment, Successors, and Assigns: The Grantee may not assign this Agreement or delegate its performance to any third-party person or entity, either in whole or in part, without the California State Library’s prior written consent. The provisions of this Agreement shall be binding upon and inure to the benefit of the California State Library, the Grantee, and their respective successors and assigns. 7. Audit and Records Access: The Grantee agrees that the California State Library, the Department of General Services, the State Auditor, or their designated representatives shall have the right to review, audit, inspect and copy any records and supporting documentation pertaining to the performance of this Agreement. The Grantee agrees to maintain such records for possible audit for a minimum of five (5) years after the final payment, or grant term end date, DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 9 of 27 whichever is later, unless a longer period of records retention is stipulated, or until completion of any action and resolution of all issues which may arise as a result of any litigation, dispute, or audit, whichever is later. The Grantee agrees to allow the auditor(s) access to such records during normal business hours and to allow interviews of any employees who might reasonably have information related to such records. Further, the Grantee agrees to include a similar right of the State to audit records and interview staff in any subcontract related to performance of this Agreement. Examples of audit documentation may include, but not limited to, competitive bids, grant amendments, if any, relating to the budget or work plan, copies of any agreements with contractors or subcontractors if utilized, expenditure ledger, payroll register entries, time sheets, personnel expenditure summary form, travel expense log, paid warrants, contracts and change orders, samples of items and materials developed with grant funds, invoices and/or cancelled checks. 8. Authorized Representative: Grantee and the California State Library mutually represent that their authorized representatives have the requisite legal authority to sign on their organization’s behalf. 9. Communication: All communications from either party, including an interim check-in at any time during the grant term, shall be directed to the respective grant manager or representative of the California State Library or Grantee. For this purpose, the following contact information is provided below Shasta Public Libraries Jared Tolman 1100 Parkview Ave. Redding, CA 96001-3239 Jared.Tolman@lsslibraries.com (530) 245-7260 California State Library Allyson Jeffredo 900 N Street Sacramento, CA 95814 allyson.jeffredo@library.ca.gov 916-603-6709 10. Confidentiality: Grantee will maintain as confidential any material it receives or produces that is marked Confidential or is inherently confidential or is protected by privilege. Grantee agrees to alert the State Library to this status in advance, and State Library agrees to maintain this status in conformity with the Public Records Act. 11. Contractor and Subcontractors: Nothing contained in this Grant Agreement or otherwise shall create any contractual relation between the State and any contractor or subcontractors, and no contract or subcontract shall relieve the Grantee of his or her responsibilities and obligations hereunder. The Grantee agrees to be as fully responsible to the State for the acts and omissions of its DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 10 of 27 contractors, subcontractors, volunteers, student interns and of persons either directly or indirectly employed by any of them as it is for the acts and omissions of persons directly employed by the Grantee. The Grantee’s obligation to pay its contractors and subcontractors is an independent obligation from the State’s obligation to make payments to the Grantee. As a result, the State shall have no obligation to pay or to enforce the payment of any monies to any contractor or subcontractor. 12. Copyright: Grantee owns and retains titles to any copyrights or copyrightable material from any original works that it creates within the scope of this Agreement in accordance with the federal Copyright Act. (17 U.S.C. 101, et seq.) Grantee is responsible for obtaining any necessary licenses, permissions, releases or authorizations to use text, images, or other materials owned, copyrighted, or trademarked by third parties and for extending such licenses, permissions, releases, or authorizations to the California State Library pursuant to this section. Also, the California State Library may upload, post or transmit copyrighted material produced or purchased with grant funds on a California State Library website for public access and viewing. 13. Discharge of Grant Obligations: The Grantee's obligations under this Agreement shall be deemed discharged only upon acceptance of the final report by California State Library. If the Grantee is a non-profit entity, the Grantee’s Board of Directors shall accept and certify as accurate the final report prior to its submission to California State Library. 14. Dispute Resolution: In the event of a dispute, Grantee will discuss the problem informally with the Grant Monitor. If unresolved, the Grantee shall file a written “Notice of Dispute” with the State Library Grant Monitor within ten (10) days of discovery of the problem. Within ten (10) days of receipt, the Grant Monitor shall meet with the Grantee for purposes of resolving the dispute. Any dispute arising under the terms of this Agreement which is not disposed of within a reasonable period of time, the Grantee may bring it to the attention of the State Librarian or the designated representative. The decision of the State Librarian or designated representative shall be final. Unless otherwise instructed by the Grant Monitor, the Grantee shall continue with its responsibilities under this Agreement during any dispute. 15. Drug-free Workplace: The Grantee certifies under penalty of perjury under the laws of California, that the Grantee will comply with the requirements of the Drug-Free Workplace Act of 1990 (Gov. Code, § 8350 et. seq.) and will provide a drug-free workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 11 of 27 b. Establish a Drug-Free Awareness Program to inform employees about all of the following: 1) The dangers of drug abuse in the workplace. 2) The Grantee’s policy of maintaining a drug-free workplace; 3) Any available counseling, rehabilitation and employee assistance programs. 4) Penalties that may be imposed upon employees for drug abuse violations. c. Require that every employee who works on the Agreement will: 1) Receive a copy of the Grantee’s drug-free workplace policy statement. 2) Agrees to abide by the terms of the Grantee’s statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and grantee may be ineligible for award of any future state agreements if the California State Library determines that the grantee has made a false certification or violated the certification by failing to carry out the requirements as noted above. 16. Effectiveness of Agreement: This Agreement is of no force or effect until signed by both parties. 17. Entire Agreement: This Agreement supersedes all prior agreements, oral or written, made with respect to the subject hereof and, together with all attachments hereto, contains the entire agreement of the parties. 18. Exclusive Agreement: This is the entire Agreement between the California State Library and Grantee. 19. Executive Order N-6-22-Russia Sanctions: The Grantee shall comply with Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. The EO directs state agencies to terminate grant agreements with, and to refrain from entering any new grant agreements with, individuals or entities that are determined to be a target of Economic Sanctions. Accordingly, should the State determine Grantee is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for termination of this agreement. The State shall provide Grantee advance written notice of such termination, allowing Grantee at least 30 calendar days to provide a written response. Termination shall be at the sole discretion of the State. 20. Extension: The State Librarian or designee may extend the final deadline for good cause. The Grantee’s request for an extension of the grant period must be DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 12 of 27 made in writing and received by the California State Library at least 30 days prior to the final deadline. 21. Failure to Perform: The grant being utilized by the Grantee is to benefit the English as a Second Language Services project. If the Grant Monitor determines the Grantee has not complied with this Agreement, the Grantee may forfeit the right to reimbursement of any grant funds not already paid by the California State Library, including, but not limited to, the ten percent (10%) withhold. 22. Federal and State Taxes: The State Library shall not: a. Withhold Federal Insurance Contributions Act (FICA) payments from Grantee’s payments or make FICA payments on the Grantee’s behalf; or b. Make Federal or State unemployment insurance contributions on Grantee’s behalf; or c. Withhold Federal or State income taxes from Grantee’s payments Grantee shall pay all taxes required on payments made under this Agreement including applicable income taxes and FICA. 23. Force Majeure: Neither the California State Library nor the Grantee, its contractors, vendors, or subcontractors, if any, shall be responsible hereunder for any delay, default, or nonperformance of this Agreement, to the extent that such delay, default, or nonperformance is caused by an act of God, weather, accident, labor strike, fire, explosion, riot, war, rebellion, sabotage, flood, or other contingencies unforeseen by the California State Library or the Grantee, its contractors, vendors, or subcontractors, and beyond the reasonable control of such party. 24. Forfeit of Grant Funds and Repayment of Funds Improperly Expended: If grant funds are not expended, or have not been expended, in accordance with this Agreement, the State Librarian or designee, at his or her sole discretion, may take appropriate action under this Agreement, at law or in equity, including requiring the Grantee to forfeit the unexpended portion of the grant funds, including, but not limited to, the ten percent (10%) withhold, and/or to repay to the California State Library any funds improperly expended. 25. Fringe Benefit Ineligibility: Grantee agrees that neither the Grantee nor its employees and contract personnel are eligible to participate in any employee pension, health benefit, vacation pay, sick pay or other fringe benefit plan of the State of California or the State Library. 26. Generally Accepted Accounting Principles: The Grantee is required to use Generally Accepted Accounting Principles in documenting all grant expenditures. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 13 of 27 27. Grant Monitor: The Grant Monitor’s responsibilities include monitoring grant progress, and reviewing and approving Grant Payment Requests and other documents delivered to the California State Library pursuant to this Agreement. The Grant Monitor may monitor Grantee performance to ensure Grantee expends grant funds appropriately and in a manner consistent with the terms and conditions contained herein. The Grant Monitor does not have the authority to approve any deviation from or revision to the Terms and Conditions (Exhibit A) or the Procedures and Requirements unless such authority is expressly stated in the Procedures and Requirements. 28. Grantee: the government or legal entity to which a grant is awarded and which is accountable to the California State Library for the use of the funds provided. a. The grantee will make reports to the State Librarian in such form and containing such information as may be required to ensure the proper used of funds consistent with the grantee’s application and award agreement. The grantee will keep such records and afford such access as the California State Library may find necessary to assure the correctness and verification of such reports. 29. Grantee Accountability: The Grantee is ultimately responsible and accountable for the manner in which the grant funds are utilized and accounted for and the way the grant is administered, even if the Grantee has contracted with another organization, public or private, to administer or operate its grant program. In the event an audit should determine that grant funds are owed to the California State Library, the Grantee is responsible for repayment of the funds to the California State Library. 30. Grantee Funds: It is mutually agreed that the Grantee is responsible for furnishing funds beyond the grant award that may be necessary to complete the project. 31. Independent Action: Grantee reserves the right to fulfill its obligations under this Agreement in an independent manner, at any location and at any time within the agreed-upon timeline. Grantee’s employees or contract personnel shall perform all services required by this Agreement, but their time need not be devoted solely to fulfilling obligations under this Agreement. Grantee shall furnish all equipment and materials used to meet its obligations, and complete the Project. The State Library shall not provide any personnel or other resources beyond the grant award, and is not required to provide training in connection with this Agreement. 32. Indemnification: Grantee agrees to indemnify, defend and save harmless the State of California, the California State Library and its officers, employees, and agents, from any and all claims, losses, and liabilities accruing or resulting to any and all contractors, subcontractors, suppliers, laborers and any other person, firm DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 14 of 27 or corporation furnishing or supplying work services, materials, or supplies in connection with the performance of this Agreement, and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by Grantee in the performance of this Agreement. 33. License to Use: The California State Library reserves a fully paid-up, royalty-free, nonexclusive, sub-licensable and irrevocable license to reproduce, publish, prepare derivative works, distribute or otherwise use, and to authorize third parties to use, any material received or maintained by Grantee in connection with this Agreement. This includes intellectual property, with or without third- party rights. All such usages will be for public library and State governmental purposes: a. The copyright in any work developed under this grant, sub-grant, or contract under this grant or sub-grant; and b. Any rights of copyright to which a Grantee, sub-grantee, or a contractor purchases ownership with grant support. 34. Limitation of Expenditure: Expenditure for all projects must conform to the grantee’s approved budget and with applicable State laws and regulations. The total amount paid by the California State Library to the Grantee under this agreement shall not exceed $60,188 and shall be expended/encumbered in the designated award period. During the award period, the grantee may find that the awarded budget may need to be modified. Budget changes, requests for additional funds, or requests for reductions in award funding must be discussed with the assigned State Library Grant Monitor and a Grant Award Modification may be required to be submitted according to the instructions. Approval is by the State Librarian or their designee. Adjustments should be reported on the next financial report. Any adjustments in approved budgets must be documented and documentation retained in project accounts. 35. Lobbying: Grantee confirms that the grant funds will not be used for the purposes of lobbying or otherwise attempting to influence legislation, as those purposes are defined by the U.S. Internal Revenue Code of 1986. 36. Non-Discrimination Clause: During this grant period, the Grantee and the Grantee’s contractors, and subcontractors shall not unlawfully discriminate, harass, or allow harassment against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 15 of 27 sex, age, sexual orientation, or military and veteran status. Grantee shall insure that the evaluation and treatment of contractors, employees and applicants for employment are free from such discrimination and harassment. Additionally, Grantee, contractors, and subcontractors, if applicable, shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12900 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Gov. Code §§ 11135-11139.5), and the regulations or standards adopted by the California State Library to implement such article. Grantee shall permit access by representatives of the Department of Fair Employment and Housing and the California State Library upon reasonable notice at any time during the normal business hours, but in no case less than 24 hours’ notice, to such of its books, records, accounts, and all other sources of information and its facilities as said Department or the California State Library shall require ascertaining compliance with this clause. Grantee, and its contractors, and subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. (See Cal. Code Regs., tit. 2, §11105.) Grantee shall include the non-discrimination and compliance provisions of this clause in all contracts and subcontracts to perform work under the Agreement. 37. Notices: All notices and other communications in connection with this Agreement shall be in writing, and shall be considered delivered as follows: a. Electronic Mail (E-mail): When sent by e-mail to the last e-mail address of the recipient known to the party giving notice. Notice is effective upon transmission. b. DocuSign (e-signature platform): When sent via DocuSign a notification will be sent to the last e-mail address of the recipient known to the party giving notice. Notice is effective upon transmission. c. Grants Management System: When sent via / uploaded to the California State Library’s Grants Management System a notification will be sent to the last e-mail address of the recipient known to the party giving notice. Notice is effective upon transmission. d. Personally: When delivered personally to the recipient’s physical address as stated in this Agreement. e. U.S. Mail: Five days after being deposited in the U.S. Mail, postage prepaid, and addressed to recipient’s address as stated in this Agreement. 38. Order of Precedence: The performance of this Agreement shall be conducted in accordance with the Terms and Conditions, Procedures and Requirements, DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 16 of 27 Certificate of Compliance, Project Summary, Activities Timeline, and Budget, of this Agreement, or other combination of exhibits specified on the Grant Agreement Coversheet attached hereto (collectively referred to as “Terms”). Grantee’s California State Library-approved Application (Grantee’s Application) is hereby incorporated herein by this reference. In the event of conflict or inconsistency between the articles, exhibits, attachments, specifications or provisions that constitute this Agreement, the following order of precedence shall apply: a. Grant Agreement Coversheet and any Amendments thereto b. Terms and Conditions c. Procedures and Requirements d. Certificate of Compliance e. Project Summary f. Grantee’s Application (including Budget and Activities Timeline) g. All other attachments hereto, including any that are incorporated by reference. 39. Payment: a. The approved Budget, if applicable, is attached hereto and incorporated herein by this reference and states the maximum amount of allowable costs for each of the tasks identified in the Project Summary and Activity Timeline included in the project application. California State Library shall provide funding to the Grantee for only the work and tasks specified in the Grantee’s Application at only those costs specified in the Budget and incurred in the term of the Agreement. b. The Grantee shall carry out the work described in the Work Plan or in the Grantee’s Application in accordance with the approved Budget and shall obtain the Grant Monitor’s written approval of any changes or modifications to the Work Plan, approved project as described in the Grantee’s Application, or the approved Budget prior to performing the changed work or incurring the changed cost. If the Grantee fails to obtain such prior written approval, the State Librarian or designee, at his or her sole discretion, may refuse to provide funds to pay for such work or costs. c. The Grantee shall request funds in accordance with the funding schedule included in this agreement. d. Ten percent (10%) will be withheld from the Payment Request (if applicable) and paid at the end of the grant term, when all reports and conditions stipulated in this Agreement have been satisfactorily DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 17 of 27 completed. Failure by the grantee to satisfactorily complete all reports and conditions stipulated in this Agreement may result in forfeiture of any such funds withheld. e. Lodgings, Meals and Incidentals: Grantee’s eligible costs are limited to the amounts authorized in the California State Administrative Manual (see Exhibit C or contact the Grant Monitor for more information). f. Payment will be made only to the Grantee. g. Reimbursable expenses shall not be incurred unless and until the grantee receives a Notice to Proceed as described in the Procedures and Requirements. 40. Personal Jurisdiction: The Grantee consents to personal jurisdiction in the State of California for all proceedings concerning the validity and operation of this Agreement and the performance of the obligations imposed upon the parties. Native American Tribal grantees expressly waive tribal sovereign immunity as a defense to any and all proceedings concerning the validity and operation of this Agreement and the performance of the obligations imposed upon the parties. 41. Personnel Costs: Any personnel expenditures to be paid for with grant funds must be computed based on actual time spent on grant-related activities and on the actual salary or equivalent hourly wage the employee is paid for their regular job duties, including a proportionate share of any benefits to which the employee is entitled. 42. Pledge: This Agreement shall not be interpreted to create any pledge or any commitment by the State Library to make any other or further grants or contributions to Grantee, or any other person or entity in connection with the Project. It is mutually agreed that Grantee is responsible for furnishing funds beyond the grant award that may be necessary to complete outcomes or deliverables. 43. Privacy Protection: Both parties agree to protect the confidentiality of any non- public, personal information that may be contained in materials received or produced in connection with this Agreement, as required by Civil Code, section 1798, et. seq. 44. Prohibited Use: The expenditure under this program shall not be used to supplant Grantee efforts in other grant programs provided by the California State Library. 45. Public Records Act: Material maintained or used by the California State Library is considered “public record” under the Public Records Act (PRA) at Government Code, sections 6250, et. seq. This includes the Interim and Final reports, and any other written communications between the parties. Grantee agrees to ensure that all content contained in its written reports are appropriate for publication. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 18 of 27 Said material, along with all other reports, documentation and data collected during the term of the Agreement, will be subject to disclosure unless it qualifies for exemption under the PRA in whole or in part. Grantee agrees to alert the State Library as to a basis for exemption, if any exists. 46. Publicity Obligations: Grantee will notify the State Library of any promotional materials or publications resulting from the grant no later than five (5) days in advance of distribution, whether they are print, film, electronic, or in any other format or medium. Copies of all promotional materials will be provided to the State Library. Grantee will acknowledge the State Library’s support as noted above. Grantee agrees that the State Library may include information about this grant and its outcomes in its own annual reports, with specific reference to Grantee, and may distribute such information to third parties. 47. Records: Communications, grant related documents, data, original receipts, and invoices must be maintained by Grantee and shall be made available to the State Library upon request. Grantee agrees to maintain adequate grant program records and adequate financial records consistent with generally accepted accounting practices, and to retain all records for at least five (5) years after the end-of-term. The State Library may monitor or conduct an onsite evaluation of Grantee’s operation to ensure compliance with this Agreement, with reasonable advance notice. 48. Reduction of Waste: In the performance of this Agreement, Grantee shall take all reasonable steps to ensure that materials purchased or utilized in the course of the project are not wasted. Steps should include, but not be limited to: the use of used, reusable, or recyclable products; discretion in the amount of materials used; alternatives to disposal of materials consumed; and the practice of other waste reduction measures where feasible and appropriate. 49. Reimbursement Limitations: Under no circumstances shall the Grantee seek reimbursement pursuant to this Agreement for a cost or activity that has been or will be paid for through another funding source. The Grantee shall not seek reimbursement for any costs used to meet cost sharing or matching requirements of any other California State Library funded program. 50. Reports and Claims: It is the responsibility of the grantee make the required reports and claims to the California State Library. a. The grantee shall be responsible for submitting to the State Library Narrative Reports detailing progress and activities. The reports are due on the dates specified in the reporting schedule detailed in the Procedures and Requirements section. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 19 of 27 b. The grantee shall be responsible for submitting to the State Library Financial Reports reflecting grantee expenditure activity. The reports are due on the dates specified in the reporting schedule detailed in the Procedures and Requirements section. c. To obtain payment hereunder the grantee shall submit authorized claims provided by the State Library for that purpose, on each of the following mentioned dates for payment, and the California State Library agrees to reimburse the Library as soon thereafter as State fiscal procedures will permit. d. The final 10% of the grant award (if applicable) is payable only upon approval of all final reports and receipt of claim form. Failure to provide timely reports is a serious breach of an award recipient’s administrative duty under the award. e. Payment will be provided to cover the expenditures incurred by the grantee for the project in the following manner: o $60,188 upon execution of the agreement and submission of claim by the grantee organization. 51. Self-Dealing and Arm’s Length Transactions: All expenditures for which reimbursement pursuant to this Agreement is sought shall be the result of arm’s- length transactions and not the result of, or motivated by, self-dealing on the part of the Grantee or any employee or agent of the Grantee. For purposes of this provision, “arm’s-length transactions” are those in which both parties are on equal footing and fair market forces are at play, such as when multiple vendors are invited to compete for an entity’s business and the entity chooses the lowest of the resulting bids. “Self-dealing” is involved where an individual or entity is obligated to act as a trustee or fiduciary, as when handling public funds, and chooses to act in a manner that will benefit the individual or entity, directly or indirectly, to the detriment of, and in conflict with, the public purpose for which all grant monies are to be expended. 52. Severability: If any part of this Agreement is found to be unlawful or unenforceable, such provisions will be voided and severed from this Agreement, but the remainder of the provisions in the Agreement will remain in full force and effect. 53. Site Visits: The Grantee shall allow the California State Library to access and conduct site visits, with reasonable notice, at which grant funds are expended and related work being performed at any time during the performance of the work and for up to ninety (90) days after completion of the work, or until all issues related to the grant project have been resolved. A site visit may include, but not DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 20 of 27 be limited to, monitoring the use of grant funds, provide technical assistance when needed, and to visit the State funded project. 54. Termination: The Agreement shall be subject to termination by the State Librarian or designee upon notice to the Grantee at least thirty (30) days prior to the effective date of termination. In the event this agreement is terminated, the Grantee shall deliver to the State Librarian copies of all reports, accounting, data, and materials prepared up to the date of termination. The State Librarian shall determine and pay the Grantee for necessary and appropriate expenditures and obligations up to the date of termination which have not been covered by prior installments previously paid to the Grantee. Upon such termination, the unused portion of the grant award must be returned to the California State Library within 45 days. If funding has been advanced to the Grantee, any unobligated balances, as determined by the State Librarian, shall be returned to the State Library within 45 days of the notice of termination. 55. Timeline: Time is of the essence to this Agreement. It is mutually agreed between the parties that the grant application and the timeline included therein are part of the Agreement. 56. Unused Funds: At the end-of-term Grantee agrees to return any unexpended or unaccounted for funds to the State Library, or to submit a written request for an extension of the grant period. Funds will be considered unexpended or unaccounted if they were: (1) not used for their intended purpose, or (2) used inconsistent with the terms of this Agreement. Funds will also be considered unaccounted for, and must be returned, if the proposal outcomes or deliverables are materially incomplete by the end-of-term or earlier termination, as determined by the State Library in its sole discretion. 57. Waiver of Rights: California State Library shall not be deemed to have waived any rights under this Agreement unless such waiver is given in writing and signed by California State Library. No delay or omission on the part of California State Library in exercising any rights shall operate as a waiver of such right or any other right. A waiver by California State Library of a provision of this Agreement shall not prejudice or constitute a waiver of California State Library’s right otherwise to demand strict compliance with that provision or any other provision of this Agreement. No prior waiver by California State Library, nor any course of dealing between California State Library and Grantee, shall constitute a waiver of any of California State Library’s rights or of any of grantee’s obligations as to any future transactions. Whenever the consent of California State Library is required under this Agreement, the granting of such consent by California State DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 21 of 27 Library in any instance shall not constitute continuing consent to subsequent instances where such consent is required and in all cases such consent may be granted or withheld in the sole discretion of California State Library. 58. Work Products: Grantee shall provide California State Library with copies of all final products identified in the Work Plan and Application. Grantee shall also provide the State Library with copies of all public education and advertising material produced pursuant to this Agreement. 59. Worker’s Compensation: The State of California will not provide Workers’ Compensation insurance for Grantee or Grantee’s employees or contract personnel. If Grantee hires employees to perform services required by this Agreement, Grantee shall provide Workers’ Compensation insurance for them. The Grantee is aware of Labor Code Section 3700, which requires every employer to be insured against liability for Workers’ Compensation or to undertake self-insurance in accordance with the Labor Code, and the Grantee agrees to comply with such provisions before commencing the performance of the work of this Agreement. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 22 of 27 EXHIBIT B: CERTIFICATION of COMPLIANCE FORM 1. AUTHORIZED REPRESENTATIVE: I certify that the authorized representative named below is the legally designated representative of the Grantee for this Grant Agreement and project and is authorized to receive and expend funds in order to administer this grant program. 2. I certify that all information provided to the California State Library for review in association with this award is correct and complete to the best of my knowledge, and as the authorized representative of the Grantee, I commit to the conditions of this award, and I have the legal authority to do so. 3. I certify that any or all other participants or contractors in the grant program have agreed to the terms of the application/grant award and have entered into an agreement(s) concerning the final disposition of equipment, facilities, and materials purchased for this program from the funds awarded for the activities and services described in the attached, as approved and/or as amended in the application by the California State Librarian. 4. The authorized representative, on behalf of the Grantee, certifies that the Grantee will comply with all applicable requirements of State and Federal laws, regulations, and policies governing this program, to include the requirements listed below in this Certification of Compliance Form. 5. The authorized representative, on behalf of the Grantee, hereby certifies to the California State Library, for an award of funds in the amount $60,188. This award will provide library services as set forth in the Project Application as approved and/or as amended by the California State Librarian. 6. STATEMENT OF COMPLIANCE: Grantee has, unless exempted, complied with the non-discrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 11102). 7. DRUG-FREE WORKPLACE REQUIREMENTS: Grantee will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug- free workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish a Drug-Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 23 of 27 2) the person's or organization's policy of maintaining a drug-free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations. c. Every employee who works on the proposed Agreement will: 1) receive a copy of the company's drug-free workplace policy statement; and, 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Grantee may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Grantee has made false certification or violated the certification by failing to carry out the requirements as noted above. (Gov. Code § 8350 et. seq.) 8. CONFLICT OF INTEREST: Grantee needs to be aware of the following provisions regarding current or former state employees. If Grantee has any questions on the status of any person rendering services or involved with the Agreement, the California State Library must be contacted immediately for clarification. Current State Employees (Pub. Contract Code § 10410): a. No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest, and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment. b. No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services. Former State Employees (Pub. Contract Code § 10411): a. For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency. b. For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 24 of 27 If Grantee violates any provisions of above paragraphs, such action by Grantee shall render this Agreement void. (Pub. Contract Code § 10420). Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code § 10430 (e)). 9. LABOR CODE/WORKERS' COMPENSATION: Grantee needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Grantee affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code § 3700). 10. AMERICANS WITH DISABILITIES ACT: Grantee assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et. seq.) 11. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement. 12. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all Grantees that are not another state agency or other governmental entity. 13. DRUG FREE WORKPLACE: a. Continue to provide a drug-free workplace by complying with the requirements in 2 C.F.R. part 3186 (Requirements for Drug-Free Workplace (Financial Assistance)). In particular, the recipient must comply with drug- free workplace requirements in subpart B of 2 C.F.R. part 3186, which adopts the Government-wide implementation (2 C.F.R. part 182) of sections 5152-5158 of the Drug-Free Workplace Act of 1988 (P. L. 100-690, Title V, Subtitle D; 41 U.S.C. §§ 701-707). b. This includes but is not limited to: making a good faith effort, on a continuing basis, to maintain a drug-free workplace; publishing a drug- free workplace statement; establishing a drug-free awareness program for the employees; taking actions concerning employees who are convicted of violating drug statutes in the workplace. 14. ACCESSIBILITY: The organization receiving this award, as listed in the certification section below, and all program staff, will ensure all project materials will meet California accessibility standards. 15. NON-DISCRIMINATION: The organization receiving this award, as listed in the certification section below, and all program staff, agree to comply with all California non-discrimination laws. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 25 of 27 16. ACKNOWLEDGEMENT: The organization receiving this award, as listed in the certification section below, and all program staff, agree to comply with California State Library acknowledgement requirements. Certification ORGANIZATION Name: Address (official and complete): PROJECT COORDINATOR Name: Email: Phone: GRANTTEE AUTHORIZED REPRESENTATIVE Name: Title: Email: Phone: Signature: Date: DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 Library Director Shae Darling 7/19/2023 Shasta Public Libraries 530 245 7237 Jared.Tolman@lsslibraries.com ShaeD@shastalibraries.org 530 245 7255 1100 Parkview Ave, Redding, CA 96001 Jared Tolman In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 26 of 27 Authorized Representative Signature ORGANIZATION Name: Address (official and complete): AUTHROIZED REPRESENTATIVE Signature: Date: Printed Name of Person Signing: Title: STATE OF CALIFORNIA Agency Name: California State Library Address: 900 N Street, Sacramento, CA 95814 Signature: Date: Printed Name of Person Signing: Title: California State Librarian DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 Greg Lucas 7/18/2023 7/19/2023 1100 Parkview AVE, Redding, CA 96001Shasta Public Libraries Library DirectorJared Tolman In Process Shasta Public Libraries English as a Second Language Services 2023-2024 ESL21-3-46 Page 27 of 27 EXHIBIT B: STATE REIMBURSABLE TRAVEL EXPENSES Rates are subject to change per State of California, Department of Human Resources Please Check State of California, Department of Human Resources Website for updated expenses: http://www.calhr.ca.gov/employees/pages/travel-reimbursements.aspx Mileage: Rate subject to change $0.56 per mile – approved business/travel expense Meals: Receipts are required $7.00 – Breakfast $11.00 – Lunch $23.00 – Dinner $5.00 - Incidentals Meals Note: Lunch can only be claimed if travel is more than 24 hours. Incidental charge may be claimed once for every 24-hour period and should cover incidental expenses, such as but not limited to, tip, baggage handling, etc. Hotel: Receipts are required and MUST have a zero balance. $ 90.00 plus tax for all counties/cities not listed below $ 95.00 plus tax for Napa, Riverside, and Sacramento Counties $ 110.00 plus tax for Marin County $ 120.00 plus tax for Los Angeles, Orange, and Ventura Counties, and Edwards AFB. Excluding the city of Santa Monica $ 125.00 plus tax for Monterey and San Diego Counties $ 140.00 plus tax for Alameda, San Mateo and Santa Clara Counties $ 150.00 plus tax for the City of Santa Monica $ 250.00 plus tax for San Francisco County Out of State: Prior authorization must be obtained, as well as three print-out hotel quotes. Actual receipt must be included with authorization and additional quotes. Hotel Note: If the above approved reimbursable hotel rates cannot be secured, please contact your grant monitor to obtain an excess lodging form. This form must be approved prior to actual travel. AIRLINE TICKETS: Itinerary and receipts are required Actual reasonable fees pertaining to airline travel will be reimbursed. Business, First Class, or Early Bird Check-in fee is not an approved reimbursable expense. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process 5 June 2023 RE: Contractor and Grantee Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine Dear Grantee, You are receiving this notification because you currently have an active grant through the California State Library. On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions in response to Russian aggression in Ukraine. The EO is located at https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf. The EO directs all agencies and departments that are subject to the Governor’s authority to take certain immediate steps, including notifying all contractors and grantees of their obligations to comply with existing economic sanctions imposed by the U.S. government in response to Russia's actions in Ukraine, as well as any sanctions imposed under state law. This correspondence serves as a notice under the EO that as a contractor or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury website (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country- information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants, as applicable. Please note that for any agreements or grants valued at $5 million or more, a separate notification will be sent outlining additional requirements specified under the EO. Annly Roman California State Library 900 N Street Sacramento, CA 95814 DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process California Library Literacy and English Acquisition Services FINANCIAL CLAIM PAYMENT IN FULL CERTIFICATION I hereby certify under penalty of perjury: that I am the duly authorized representative of the claimant herein; that this claim is in all respects true, correct and in accordance with law and the terms of the agreement; and that payment has not previously been received for the amount claimed herein. By (Signature of the Authorized Representative) (Print Name) (Title) *Legal payee name must match the payee’s federal tax return. Warrant will be made payable to payee name. Payee discrepancies in name and/or address may cause delay in payment. If you need to change payee name and/or address, please contact Fiscal Services at stategrants.fiscal@library.ca.gov. State of California, State Library Fiscal Office ENY: 2021 ITEM NO: 6120-2131-0001, Chapter 240, Statutes of 2021 PURCHASING AUTHORITY NUMBER: CSL-6120 REPORTING STRUCTURE: 61202000 COA: 5432000 PROGRAM #: 5312 By Date (State Library Representative) Grant Award #: Date: Invoice #: PO #: Payee Name: ESL21-3-46 ESL21-3-46-01 City of Redding (Legal name of authorized agency to receive, disburse and account for funds*) Complete Address: Street Address, City, State, Zip Code (Warrant will be mailed to this address) Amount Claimed: $60,188 Type of Payment: (Payable Upon Execution of Agreement) ☐PROGRESS Grantee Name: Shasta Public Libraries ☐FINAL (Name on Award Letter and Agreement) ☒IN FULL Project Title: English as a Second Language ☐AUGMENT For Period From: upon execution to end of grant period DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 7/19/2023 Jared Tolman Library Director 777 Cypress Ave FLOOR 3rd Redding, CA 96001 In Process STATE OF CALIFORNIA – DEPARTMENT OF FINANCE PAYEE DATA RECORD (Required when receiving payment from the State of California in lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021) Section 1 – Payee Information NAME (This is required. Do not leave this line blank. Must match the payee’s federal tax return) BUSINESS NAME, DBA NAME or DISREGARDED SINGLE MEMBER LLC NAME (If different from above) MAILING ADDRESS (number, street, apt. or suite no.) (See instructions on Page 2) CITY, STATE, ZIP CODE E-MAIL ADDRESS Section 2 – Entity Type Check one (1) box only that matches the entity type of the Payee listed in Section 1 above. (See instructions on page 2) CORPORATION (see instructions on page 2)☐ SOLE PROPRIETOR / INDIVIDUAL ☐ MEDICAL (e.g., dentistry, chiropractic, etc.)☐ SINGLE MEMBER LLC Disregarded Entity owned by an individual ☐ PARTNERSHIP ☐ ESTATE OR TRUST ☐ LEGAL (e.g., attorney services) ☐ EXEMPT (e.g., nonprofit) ☐ ALL OTHERS Section 3 – Tax Identification Number Enter your Tax Identification Number (TIN) in the appropriate box. The TIN must match the name given in Section 1 of this form. Do not provide more than one (1) TIN. The TIN is a 9-digit number. Note: Payment will not be processed without a TIN. • • • • • • For Individuals, enter SSN. If you are a Resident Alien, and you do not have and are not eligible to get an SSN, enter your ITIN. Grantor Trusts (such as a Revocable Living Trust while the grantors are alive) may not have a separate FEIN. Those trusts must enter the individual grantor’s SSN. For Sole Proprietor or Single Member LLC (disregarded entity), in which the sole member is an individual, enter SSN (ITIN if applicable) or FEIN (FTB prefers SSN). For Single Member LLC (disregarded entity), in which the sole member is a business entity, enter the owner entity’s FEIN. Do not use the disregarded entity’s FEIN. For all other entities including LLC that is taxed as a corporation or partnership, estates/trusts (with FEINs), enter the entity’s FEIN. Social Security Number (SSN) or Individual Tax Identification Number (ITIN) ___ ___ ___ -___ ___ -___ ___ ___ ___ OR Federal Employer Identification Number (FEIN) ___ ___ -___ ___ ___ ___ ___ ___ ___ Section 4 – Payee Residency Status (See instructions) ☐ CALIFORNIA RESIDENT – Qualified to do business in California or maintains a permanent place of business in California. ☐ CALIFORNIA NONRESIDENT – Payments to nonresidents for services may be subject to state income tax withholding. ☐No services performed in California ☐Copy of Franchise Tax Board waiver of state withholding is attached. Section 5 – Certification I hereby certify under penalty of perjury that the information provided on this document is true and correct. Should my residency status change, I will promptly notify the state agency below. NAME OF AUTHORIZED PAYEE REPRESENTATIVE TITLE E-MAIL ADDRESS SIGNATURE DATE TELEPHONE (include area code) Section 6 – Paying State Agency Please return completed form to: STATE AGENCY/DEPARTMENT OFFICE UNIT/SECTION MAILING ADDRESS FAX TELEPHONE (include area code) CITY STATE ZIP CODE E-MAIL ADDRESS Print Form Reset FormDocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 900 N Street CA Admin/Accounting accounting@library.ca.gov 916-603-7157 Ca. State Library 95814Sacramento In Process STATE OF CALIFORNIA – DEPARTMENT OF FINANCE PAYEE DATA RECORD (Required when receiving payment from the State of California in lieu of IRS W-9 or W-7) STD 204 (Rev. 03/2021) GENERAL INSTRUCTIONS Type or print the information on the Payee Data Record, STD 204 form. Sign, date, and return to the state agency/department office address shown in Section 6. Prompt return of this fully completed form will prevent delays when processing payments. Information provided in this form will be used by California state agencies/departments to prepare Information Returns (Form1099). NOTE: Completion of this form is optional for Government entities, i.e. federal, state, local, and special districts. A completed Payee Data Record, STD 204 form, is required for all payees (non-governmental entities or individuals) entering into a transaction that may lead to a payment from the state. Each state agency requires a completed, signed, and dated STD 204 on file; therefore, it is possible for you to receive this form from multiple state agencies with which you do business. Payees who do not wish to complete the STD 204 may elect not to do business with the state. If the payee does not complete the STD 204 and the required payee data is not otherwise provided, payment may be reduced for federal and state backup withholding. Amounts reported on Information Returns (Form 1099) are in accordance with the Internal Revenue Code (IRC) and the California Revenue and Taxation Code (R&TC). Section 1 – Payee Information Name – Enter the name that appears on the payee's federal tax return. The name provided shall be the tax liable party and is subject to IRS TIN matching (when applicable). • Sole Proprietor/Individual/Revocable Trusts – enter the name shown on your federal tax return. • Single Member Limited Liability Companies (LLCs) that is disregarded as an entity separate from its owner for federal tax purposes - enter the name of the individual or business entity that is tax liable for the business in section 1. Enter the DBA, LLC name, trade, or fictitious name under Business Name. • Note: for the State of California tax purposes, a Single Member LLC is not disregarded from its owner, even if they may be disregarded at the Federal level. • Partnerships, Estates/Trusts, or Corporations – enter the entity name as shown on the entity’s federal tax return. The name provided in Section 1 must match to the TIN provided in section 3. Enter any DBA, trade, or fictitious business names under Business Name. Business Name – Enter the business name, DBA name, trade or fictitious name, or disregarded LLC name. Mailing Address – The mailing address is the address where the payee will receive information returns. Use form STD 205, Payee Data Record Supplement to provide a remittance address if different from the mailing address for information returns, or make subsequent changes to the remittance address. Section 2 – Entity Type If the Payee in Section 1 is a(n)… THEN Select the Box for… Individual ● Sole Proprietorship ● Grantor (Revocable Living) Trust disregarded for federal tax purposes Sole Proprietor/Individual Limited Liability Company (LLC) owned by an individual and is disregarded for federal tax purposes Single Member LLC-owned by an individual Partnerships ● Limited Liability Partnerships (LLP) ● and, LLC treated as a Partnership Partnerships Estate ● Trust (other than disregarded Grantor Trust) Estate or Trust Corporation that is medical in nature (e.g., medical and healthcare services, physician care, nursery care, dentistry, etc. ● LLC that is to be taxed like a Corporation and is medical in nature Corporation-Medical Corporation that is legal in nature (e.g., services of attorneys, arbitrators, notary publics involving legal or law related matters, etc.) ● LLC that is to be taxed like a Corporation and is legal in nature Corporation-Legal Corporation that qualifies for an Exempt status, including 501(c) 3 and domestic non-profit corporations. Corporation-Exempt Corporation that does not meet the qualifications of any of the other corporation types listed above ● LLC that is to be taxed as a Corporation and does not meet any of the other corporation types listed above Corporation-All Other Section 3 – Tax Identification Number The State of California requires that all parties entering into business transactions that may lead to payment(s) from the state provide their Taxpayer Identification Number (TIN). The TIN is required by R&TC sections 18646 and 18661 to facilitate tax compliance enforcement activities and preparation of Form 1099 and other information returns as required by the IRC section 6109(a) and R&TC section 18662 and its regulations. Section 4 – Payee Residency Status Are you a California resident or nonresident? • A corporation will be defined as a "resident" if it has a permanent place of business in California or is qualified through the Secretary of State to do business in California. • A partnership is considered a resident partnership if it has a permanent place of business in California. • An estate is a resident if the decedent was a California resident at time of death. • A trust is a resident if at least one trustee is a California resident. o For individuals and sole proprietors, the term "resident" includes every individual who is in California for other than a temporary or transitory purpose and any individual domiciled in California who is absent for a temporary or transitory purpose. Generally, an individual who comes to California for a purpose that will extend over a long or indefinite period will be considered a resident. However, an individual who comes to perform a particular contract of short duration will be considered a nonresident. For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below: Withholding Services and Compliance Section: 1-888-792-4900 E-mail address: wscs.gen@ftb.ca.gov For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb.ca.gov Section 5 – Certification Provide the name, title, email address, signature, and telephone number of individual completing this form and date completed. In the event that a SSN or ITIN is provided, the individual identified as the tax liable party must certify the form. Note: the signee may differ from the tax liable party in this situation if the signee can provide a power of attorney documented for the individual. Section 6 – Paying State Agency This section must be completed by the state agency/department requesting the STD 204. Privacy Statement Section 7(b) of the Privacy Act of 1974 (Public Law 93-579) requires that any federal, state, or local governmental agency, which requests an individual to disclose their social security account number, shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory or other authority such number is solicited, and what uses will be made of it. It is mandatory to furnish the information requested. Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and state law imposes noncompliance penalties of up to $20,000. You have the right to access records containing your personal information, such as your SSN. To exercise that right, please contact the business services unit or the accounts payable unit of the state agency(ies) with which you transact that business. All questions should be referred to the requesting state agency listed on the bottom front of this form. DocuSign Envelope ID: 67CC1724-9F4E-4C9A-9117-FE74009B9157 In Process