HomeMy WebLinkAbout _ 4.6(d)--Ratification of Grant Agreement for Adult and Family Literacy Services GI �" Y � F
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REPORT TO THE CITY COUNCIL
MEETING DATE: October 2, 2023 FROM: Kim Niemer, Community
ITEM NO. 4.6(d) Services Director
***APPROVED BY***
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kniemer@cityofredding.org btippin@cityofredding.org
SUBJECT: 4.6(d)--Ratification of Grant Agreement from the California State Library to
Sup ort the Shasta Public Libraries' Libra Literac Services Programs
Recommendation
Approve and authorize the following:
(1) Ratify the acceptance of a grant from the California State Library in the amount of
$64,051 for Library Literacy Services for Fiscal Year 2023-24;
(2) Adopt Resolution approving and adopting the 14th Amendment to City Budget
Resolution No. 2023-060 appropriating said funds; and
(3) Authorize the City Manager, or designee, to execute a11 subsequent documentation and
augmentations relative to the grant.
Fiscal Impact
There is no impact to the General Fund.
Alternative Action
The City Council (Council) could choose not to ratify the acceptance of the $64,051 grant from
the California State Library. This would further limit adult and family literacy services at the
Redding, Anderson, and Burney Libraries. Or, the Council could provide staff with alternate
direction.
Background/Analysis
The California Library Literacy Services (CLLS) campaign was created in 1984 as the first state-
wide, library-based, adult literacy service to help reduce the high level of illiteracy in California
and connect more Californians with public libraries. Adult and family literacy programs through
CLLS reach and support English-speaking adults with low literacy skills who have yet to
succeed in the traditional classroom environment. These no-cost programs help adults improve
their basic reading, writing, math, and speaking skills, connect them to resources, and provide
additional programming to support their families.
Report to Redding City Council September25,2023
Re: 4.6(a')--Ratification of GrantAgreement forAdult and Family Literacy Services Page 2
Shasta Public Libraries currently provides adult and family literacy services at the Redding,
Anderson, and Burney Libraries where adults receive personalized one-on-one tutoring in
reading, writing, math, and finances. The libraries also offer high school equivalency certificate
preparation, assistance with attaining U.S. citizenship, computer literacy and device technology
workshops, and job skills development. Weekly family literacy events round out the program to
create positive associations with learning as a family.
Should the Council accept the funds from the California State Library, the Shasta Public
Libraries will be able to enhance adult and family literacy services at the Redding, Anderson,
and Burney Libraries. Such funding would help residents prepare to achieve their high school
equivalency certificate, improve skills toward employability, establish the value of family
learning, and increase community participation. Weekly family-focused literacy events will
complement the adult literacy programs, thereby creating a positive family learning experience.
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
2023-2024 Award Letter and Agreement
RESOLUTION NO. 2023-
A RESOLUTION OF THE CITY OF REDDING APPROVING AND ADOPTiNG THE
14Tx AMENDMENT TO CITY BUDGET RESOLUTION NO. 2023-060
APPROPRIATING $64,060 FOR THE CALIFORNIA LIBRARY LITERACY SERVICES
GRANT FOR FISCAL YEAR 2023-2024
BE IT RESOL VED BY THE CITY CO UNCIL OF THE CITY OF REDDING
THAT Budget Resolution No. 2023-060 be and is hereby amended as follows:
FUND DNISION DESCRIPTION 1NCREASE DECREASE
181 5301 Library $64,060
THAT account titles and numbers requiring adjustments by this Resolution are as follows:
USE SOURCE
OF FUNDS OF FUNDS
Decrease(Increase)Fund Balance
181-5301-3622604-00000 Adult Literacy State Grant $ 64,060
Increase Expenditures
Adult Literacy Program-
181-5301-6500127-00000 State $ 64,060
Total $ 64,060 $ 64,060
THAT the purpose is to appropriate $64,060 for the California Library Literacy Services grant for
the fiscal year 2023-2024.
I HEREBY CERTIFY that the foregoing resol�ution was introduced at a special meeting of the City
Council of the City of Redding on the 2nd day of October, 2023, and was duly adopted at said
meeting by the following vote:
AYES: COUNCIL MEMBERS:
NOES: COUNCIL MEMBERS:
ABSENT: COUNCIL MEMBERS:
ABSTAIN: COUNCIL MEMBERS:
MIC�IAEL DACQUISTO,Mayor
ATTEST: FORM APPROVAL:
SHARLENE TIPTON, City Clerk BARRY E. DeWALT, City Attorney
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-89BC-OACA8D4689BC
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September 7, 2023
Jared Tolman
Shasta Public Libraries
1100 Parkview Ave.
Redding, CA 96001-3239
Dear Mr. Tolman,
We're pieased to provide funds to support yo�r California Library Literacy
Services program and the important work that you, your staff, and your
volunteers do in your community.
The state budget continues California �ibrary Literacy Services funding at $4.82
million for adult literacy services and $2.5 miilion for family literacy services.
Your total award amounts for the 2023-2024 fiscal year beginning July 1, 2023,
qre:
• Adult �iteracy Services: $37,140
• Family Literacy Services: $26,911
• Total Award: $64,051
Please note: This year your Adult Literacy Services award amount differs $ 188
from your projected award amount. You will need to complete a Budget
Modifcation Form to allocate the additional funds.
Your award will be claimed in two stages. The claim form included in this award
packet will allow you to request the first 90� of your Adult Literacy Services
Award and 100% of your Family Literacy Services Award:
• 90� of the Adult Literacy Award: $33,426
• 100�0 of the Family Literacy Award: $26,911
• Total Initial Award Amount: $60,337
Information about claiming the remainder of your award is included in the
payment schedule at the end of your award packet.
Library—Courts Building 916-323-9759
P.O. Box 942$37 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BC-OACASD46B9BC
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Your funds must be encumbered by June 30, 2024, and fully expended, in
accordance with yovr approved budget on file with the State Library, by
December 31, 2024. Encurnbered funds are those that have been deposited in
the grantee's accounting system and for which a budget has been provided to
and approved by the State Library.
To ensure program expenditures are consistent with the California Library
Literacy Services allowable expenses, please review the California Librarv
Literacv Services Allowable and Unallowable Expenses guidelines. If you have
any questions about expenses or expending your award funds, piease contact
Allyson Jeffredo at Allvson.Jeffredo@library.ca.qov.
We strongly encourage your program staff to develop and maintain community
partners to strengthen your program, attend regulcar regional library literacy
network meetings, participate in your local Adult Education Consortium/a, and
participate in library literacy training opport�nities offered by the regional
networks and the State Library to meet the CLLS Mission, Values, and Proctram
Essentials. Additional California Library Literacy Services resources can be found
on the California Librarv Literacy Services website.
The payment process begins when we receive your completed and signed
budget modification form (if neededj, 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 are available to assist you throughout the year. Please
contact your Advisor Beverly Schwartzberg,
beverly.schwartzbergClibrary.ca.gov, and yo�r Grant Monitor Allyson Jeffredo,
Allyson.Jeffredo@library.ca.aov, 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,
CDocuSigned 6y:
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BDA50981C41C416...
Greg Lucas
California State Librarian
Library—Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-89BC-OACA8D46B9BC
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Cc: Beverly Schwartzberg, beverly.schwartzberg@librar .y ca.gov
Allyson Jeffredo, ailyson.ieffredo@librarv.ca.qov
Fiscal Office, stateqrants.fiscal@library.ca.gov
Shae Darling, ShaedCshastalibraries.com
Enc: Re: C�LS23-85: Claim form, certification form, and State Funded Grants
Award Agreement and Certificate of Compliance
Library—Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-69BC-OACA8D46B9BC
Shasta Public Libraries
THE BASICS -YOUR GRANT AWARD
The following provides basic information about your grant and managing your grant.
Award #: CLLS23-85
Libra : Shasta Public Libraries
Total Award Amount: $64,051
APPROVED ALS BUDGET
Sala and Benefits $34,631
Contract Staff $ 0
Operations $1,000
Libra Lifierac Materials $1,200
Small E vipment $ 121
E ui ment $5,000 or more er �nit $ 0
Subtotal $36,952
Indirect $ 0
Award Difference to be Adjusted
induded in rant total belaw $ 188
Grant Total $37,140
APPROVED FlS BUDGET
Sala and Benefits $25,468
Contract Staff $ 0
Operations $ 243
Libra Literac Materiais $1,200
Smail E ui ment $ 0
E uipment $5,000 or more per unit $ 0
Subtotal $26,911
Indirect $ 0
Grant Total $26,911
Start Date: U on exec�tion
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:
Lifierac Analyst: All son Jeffredo
Phone Number: 916 b03-6709
Email Address: all son.�effredo@librar .ca. ov
Libra Pro rams Consultant: Beverl Schwartzber
DocuSign Enveiope ID:4596CAE7-E1CB-4DD7-89BGOACA8D46B9BC
Shasta Public Libraries
Phone Number: 916 701-6880
Email Address: beverl .schwartzber @librar .ca. ov
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BC-OACA8D46B98C
Shasta Public Libraries
CERTIFICATION
I hereby cerfify 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
CDocuSigned by-
�h--- 9/18/2023
AD3178138C6E433_.
Signature - Aufihorized representative
Kim Niemer Director of Community Services
Typed/Printed Name and Title of Authorized Representative
kniemer@cityofredding.org
Email address of avfihorized representative
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
DocuSign Envelope ID:4596CAE7-E1C8-4DD7-B9BC-OACA8D46B9BC
Shasta Pubiic Libraries
PROJECT INFORMATION:
Invoice #: CLLS23-85
Project Title: California Library Literacy Services
Grantee: Shasta Public Libraries
Funding Start Date: Upon execution
Term Completion: June 30, 2024
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-89BC-OACASD46B9BC
Shasfia Public Libraries
Total Award: $64,051
PAYMENT SCHEDUI.E:
Libraries receive 90� of their Adult Literacy Services award and 100% of their
Family Literacy Services award upon receipt of the award lefiter.
Libraries receive the final payment of their Adult Literacy Services award affier
successful complefiion of the CLLS Mid-Year Report form.
Note: Libraries have 18 months to spend their California Library Literacy Services
award funds, from July 1, 2023, in which the funds are awarded until December
31 the following year.
Adulfi Literacy Family Literacy Total Allocation
Services Services
Initia) Payment $33,426 $26,911 $60,337
Final Payment $3,714 $3,714
Total: $37,140 $26,911 $64,051
REPORTING:
Libraries will be required to submit a mid-year financiai and narrative report and
a final report. Reminder emails will be sent out beginning six weeks before the
required report is d�e.
All required reporting materials will be located on the California State Library's
website. The reporting schedule is detailed below.
Mid-year Financial and Narrative Due January 31 , 2024
Re ort
Finai Report Due September 30, 2024
Note: A budget modification form will be required for ail budget changes
regardless of amount. Modification forms may be submitted throughout the year
but no later than May 31 St.
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BC-OACA8D46B96C
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STATE FU N DED �RANTS
AWARD AGREEMENT AND
�ERTIFICATE 4F CC�MPLIANCE
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B98C-OACA8D46B9BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CL�S23-85
Page 1 of 27
�
TABLE QF CC)NTENTS
PROJECT SUMMARY 2
PROCEDURES AND REQUIREMENTS
A. Term of the Agreement 3
B. Scope of Work 3
C. Budget Detail 3
D. Narrative and Financiai Reports 4
E. Claim Form and Payment 5
EXHIBIT A: TERMS AND CONDITIONS 7
EXHIBIT B: CERTIFICATION AND COMPLIANCE FORM 22
Certification 25
EXHIBIT C: STATE REIMBURSABI.E TRAVE� EXPEWSES 27
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BGOACA8D4689BC
Shasta Public Libraries
California Library Literacy Se►vices
2023-2024 CLLS23-85
Page 2 of 27
PROJECT SUMMARY
AWARD AGREEMENT BETWEEN THE STATE LIBRARY and Shasta Public Libraries for
the California Library Literacy Services project.
AWARD AGREEMENT NUMBER ClLS23-85
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 Stqte-funded California
Library Literacy Services project.
The Library Development Services Bureau ("LDS") of the State Library
administers state and federc�l funds in the form of awards.
The Grantee was selected by the State Library to receive state grant funds
in the amount of $64,051 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:4596CAE7-E1CB-4DD7-B9BC-OACASD46B98C
Shasta Public Libraries
California Library literacy Services
2023-2024 CLLS23-85
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 ali eligible program costs must
be expended by December 31, 2024.
B. Scope of Work
1. Grantee agrees to perform ail activities specifically identified in the Grantee's
application and submitted to the State Library in response to the California
Library Literacy Services project.
2. The following activities and deliverabies to be performed by the Grantee
inciude, but are not limited to the foliowing:
. Maintain and keep records of expenditures related to the grant that are
consistent with Generally Acceptable Accounting Practices (GAAP).
• Make financial records available to the State Library upon request.
• Work with the State Library staff to assure that funds are disbursed in
compiiance with the purpose of the grant.
• Prepare and submit required narrative and financiai reports.
• Procure equipment, and other supplies as needed for the project.
• Issue contracts for services, personnei, and consultants as needed for the
project.
• If applicable, make payments for services, including for hours worked and
travel reimbursements, to cons�ltants and contractors.
• Oversee the impiementation 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:4596CAE7-E1C6-4DD7-896C-OACA8D46B9BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 4 of 27
the budget worksheet that was included with the appiication. Under no circumstances
shall payments exceed the total grant amount identified in this Agreement.
D. Narrative and Financidl Reports
1. The Grantee shall be responsible for submission of interim and final narrative and
�nancial reports on the progress and activities of the project, to the California
State �ibrary, 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 compiy 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 andlor 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 financiai 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 reporfs shail be submitted by the following dates:
Reporting Period Report Due Date
July 1 - December 31 Mid-Year Report Due January 31, 2024
July 1 -June 30 Final Report D�e 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. Cloim Form and Payment
1. The California State Library shall provide the Grantee payment as outlined in the
payment schedule oniy if ali requiremenfis for claiming the funds as outiine in this
document have been met, and anly for those activities and costs specified in
the approved award application.
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-896C-OACA8D46B98C
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
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
wiil be issued, signed, and submitted using the online signature and agreement
platform, DocuSign, unless DocuSign is unaliowable or inconsistent with practices
and policies of the local j�risdiction. 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 ailotment 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
shail not exceed the awarded amount, which shall be expended/encumbered
during the grant period.
4. If the payment amount made by fihe California State Library exceeds the actual
expenses incurred during the term af 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.
S. The Award payments wili 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% (if applicable) will be withheld and retained by the
California Sfiate Library until aii conditions agreed �pon 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 Stqte 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 mutuaily 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.
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
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-89BC-OACA8046B96C �
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 6 of 27
either cancel this Agreement with no liability occurring to itseif or offer an
Agreement amendment to the Grantee to reflect the reduced amount.
DocuSign Envelope ID:4596CAE7-E1C8-4DD7-B96C-OACA8D46B9BC
Shasta Public Libraries
California library Literacy Services
2023-2024 CLLS23-85
Page 7 of 27
EXHIBIT A: TERMS and CONDITIONS
1. Accessibilitv: The State is responsibie for ensuring that public websites are accessible
to both the general pubiic and state empioyees, including persons with
disabilities. Grantee shall assist the State in meeting its responsibility. Therefore, ail
project materials generated by state funded programs must meet the Californiq
;4ccessibilifiy Standc�rds. Additionaily 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 materiai 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. Acknowledament: The State of California and the California State Library shall be
acknowledged in all promotionai materials and publications related to the
California Library Literacy 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/projectj was supported in whole or in parf by
funding provided by the State of California, administered by fhe
California State Library."
Grantees must include the above statement in any publications, vehicle
wraps, and promotionai materials, including websites. if space is limited the
State Library logo and the following shortened acknowledgement statement
is acceptable:
"Funding provided by the Stafie of California."
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BGOACA8D4689BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 8 of 27
c. This credit line on products of a project, such as materiais, is important to
foster support from the pubiic, and state funding sources.
d. California State Library Logo: Use of fihe 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. Agencv: in the performance of this Agreement the Grantee and its agents and
employees shall act in an independent capacity and not as officers, empioyees,
or agents of the California State Library. The Grantee is solely responsibie 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 shail
be valid unless made in writing, signed by the parties, and approved as required.
No oral understanding or agreemenfi 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 parfies, subject to the requirements and
restrictions of this paragraph.
5. Applicable law: The laws of the State of California shaii 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. Assiqnment, 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, witho�t 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 supporfing 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,
whichever is later, unless a longer period of records retention is stipulated, or until
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B98C-OACA8D46B98C
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 9 of 27
completion of any action and resolution of all issues which may arise as a res�lt
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 parfy, including an interim
check-in at any time during the grant term, shali be directed to the respective
grant manager or representative of the California State Library or Grantee. For
this purpose, the foilowing contact information is provided below:
California State library
Shasta Public �ibraries Allyson Jeffredo
Jared Tolman 900 N Street
1100 Parkview Ave. Sacramento, CA 95814
Redding, CA 96001-3239 Alivson.ieffredo@librarv.ca.qov
Jared.Tolman@Isslibraries.com (916) 603-6709
(530)245-7260
1. Confidentialitv: Grantee wiil 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.
2. Contractor and Subcontractors: Nothing contained in this Grant Agreement or
othen�vise 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
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
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of persons directly employed by the Grantee. The Grantee's obligation to pay its
contractars and subcontractors is an independent obligation from the State's
obligation to make payments to the Grantee. As a resuit, the State shall have no
obligation to pay or to enforce the payment of any monies to any contractor or
subcontractor.
3. Copyriaht: Grantee owns and retains titles to any copyrights or copyrightable
materiai from any origina)works that it creates within the scope of this
Agreement in accordance with the federal Copyright Act. (17 U.S.C. 1 O1, et
seq.) Grantee is responsible for obtaining any necessary licenses, permissions,
releases, or authorizations to use text, images, or other materiais 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 upioad, post, or transmit
copyrighted material produced or purchased with grant funds on a California
State �ibrary website for public access and viewing.
4. Discharae of Grant Obliaations: The Grantee's obligations under this Agreement
shall be deemed discharged only upon acceptance of the finai 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.
5. Dispute Resolution: In the event of a dispute, Grantee will disc�ss the probiem
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.
6. Druq-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 foliowing actions:
a. Publish a statement notifying empioyees thafi 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 all of
the following:
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1) The dangers of drug abuse in the workplace.
2) The Grantee's policy of maintaining a drug-free workplace.
3j Any availabie counseling, rehabilitation, and empioyee assistance
programs.
4) Penaities that may be imposed upon employees for drug abuse
violations.
c. Require that every employee who works on the Agreement wili:
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
cerfification by failing to carry out the requirements as noted above.
7. Effectiveness of Aareement: This Agreement is of no force or effect until signed
by both parties.
8. Entire Aqreement: 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.
9. Exciusive Agreement: This is the entire Agreement between the California State
Library and Grantee.
10. Executive Order N-6-22-Russia Sanctions: The Grantee shali 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. Accordingiy, shouid the State determine Grantee is a
target of Economic Sanctions or is conducting prohibited transactions with
sanctioned individuals or entities, that shail be grounds for termination of this
agreement. The State shall provide Grantee advance,written notice of such
termination, ailowing Grantee at least 30 calendar days to provide a written
response. Termination shall be at the sole discretion of the State.
11. 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
made in writing and received by the California State Library at least 30 days prior
to the final deadline.
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12. Failure to Perform: The grant being utilized by the Grantee is to benefit the
California Library Literacy Services project. if the Grant Monitor determines the
Grantee has not compiied with this Agreement, the Grantee may forfeit the right
fio reimbursement of any grant funds not aiready paid by the California State
Library, including, but not limited to, the ten percent (10�) withhold.
13. Federal and State Taxes: The State Library shall not:
a. Withhold Federal Insurance Contributions Act (FICAj 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 appiicable income taxes and FICA.
14. Force Majeure: Neither the California State �ibrary nor the Grantee, its
contractors, vendors, or subcontractors, if any, shali 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, expiosion, riot, war, rebellion, sabotage, flood, or other
contingencies �nforeseen by the California State Library or the Grantee, its
contractors, vendors, or subcontractors, and beyond the reasonable control of
such party.
15. Forfeit of Grant Funds and Repavment of Funds Im�roperiy 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 Agreernent, at law or in equity, including
requiring the Grantee to forfeit the unexpended portion of the grant funds,
inciuding, but not limited to, the ten percent (10%) withhold, and/or to repay to
the California State Library any funds improperly expended.
16. Fringe Benefit Ineliaibilit� 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 Califomia or the State Library.
17. Generallv Accepted Accountin_ Principles: The Grantee is required to use
Generally Accepted Accounting Principles in documenting all grant
expenditures.
18. 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.
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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.
19. 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 wiil 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.
20. Grantee Accountabiiitv: 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.
21. Grantee Funds: it is mutually agreed that the Grantee is responsibie for furnishing
funds beyond the grant award that may be necessary to complete the project.
22. 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 fuifilling obligations under this Agreement. Grantee shall furnish
ail eq�ipment and materiais used to meet its obligations and complete the
Project. The State Library shali not provide any personnel or other resources
beyond the grant award and is not required to provide training in connection
with this Agreement.
23. 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
or corporation furnishing or supplying work services, materials, or suppiies in
connection with the performance of this Agreement, and from any and all
claims and losses accruing or resuiting to any person, firm or corporation who
may be injured or damaged by Grantee in the performance of this Agreement.
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24. License to Use: The California State Library reserves a fully paid-up, royalty-free,
nonexclusive, sub-licensabie and irrevocable license to reproduce, pubiish,
prepare derivative works, distribute, or otherwise �se, and to authorize third
parties to use, any material received or maintained by Grantee in connection
with this Agreement. This inciudes intellectuai praperfy, 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.
25. Limitation of Expendit�re: 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 $64,051 and shali 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. Approvai is by the State Librarian or their
designee. Adjustments should be reported on the next financiai reporf. Any
adjustments in approved budgets must be documented and documentation
retained in project accounts.
26. Lobbyinq: 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.
27. Non-Discrimination Clause: During this grant period, the Grantee and the
Grantee's contractors, and subcontractors shall not unlawfuily 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, genefiic information, marital status,
sex, age, sexuai orientation, or military and veteran stat�s. 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 subcontrdctors, if applicabie, shail
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,
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§1 1000 et seq.), the provisions of Arficle 9.5, Chapter 1, Parf 1, Division 3, Title 2 of
the Government Code (Gov. Code §§ 1 1 1 35-1 1 1 39.5), and the regulations or
standards adopted by the California State Library to implement such arficle.
Grantee shall permit access by representatives of the Deparfment of Civii Rights
and the California State Library upon reasonable notice at any time during the
normai business hours, but in no case less than 24 hours' notice, to such of its
books, records, accounts, and ail other sources of information and its facilities as
said Department or the California State Library shall require ascertaining
compliance with this ciause. Grantee, and its contractors, and subcontractors
shall give written notice of their obligations under this clause to labor
organizations with which they have a coliective bargaining or other agreement.
(See Cal. Code Regs., tit. 2, §11105.) Grantee shaii include the non-
discrimination and compliance provisions of this clause in ail contracts and
subcontracts to perform work under the Agreement.
28. Notices: All nofiices and other communications in connection with this
Agreement shali be in writing, and shail be considered delivered as follows:
a. Electronic Mail (E-mail): When sent by e-mail to the last e-maii address
of the recipient known to the parfy 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.
29. Order of Precedence: The performance of this Agreement shall be conducted
in accordance with the Terms and Conditions, Procedures and Requirements,
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
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provisions that constitute this Agreement, the following order of precedence shall
apply:
a. Grant Agreement Coversheet and any Amendments thereta
b. Terms and Conditions
c. Procedures and Requirements
d. Certificate of Compiiance
e. Project Summary
f. Grantee's Application (including Budget and Activities Timeline)
g. All other attachments hereto, including any that are incorporated by
reference.
30. Payment:
a. The approved Budget, if applicable, is attached hereto and incorporated
herein by this reference and states fihe maximum amount of aliowable
costs for each of fihe tasks identified in the Project Summary and Activity
Timeline included in the project application. California State Library shail
provide funding to the Grantee for oniy 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 Appiication in accordance with the approved Budget and
shall obtain the Grant Monitor's written approvai 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 writfien 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
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, Meais 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.
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g. Reimbursabie expenses shall not be incurred unless and until the grantee
receives a Notice to Proceed as described in the Procedures and
Requirements.
31. Personal Jurisdiction: The Grantee consents to personal jurisdiction in the State of
California for ali 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.
32. 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
regularjob duties, including a proportionate share of any benefits to which the
employee is entitled.
33. Piedae: This Agreement shall not be interpreted to creafie 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.
34. Privacv 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.
35. 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.
36. P�blic Records Act: Material maintained or used by the California State l.ibrary 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.
Said material, along with ail 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.
37. Pubiicitv Obligations: Grantee wiil 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
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format or medium. Copies of all promotional materials wiii 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 annuai reports, with specific reference to
Grantee, and may distribute such information to third parties.
38. Records: Communications, grant related documents, data, originai 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.
39. Reduction of Waste: In the performance of this Agreement, Grantee shaii take
all reasonable steps to ensure that materials purchased or utilized in the course
of the project are not wasted. Steps shouid inciude, but not be limited to: the use
of used, reusabie, or recyclabie 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 appropriafie.
40. Reimbursement Limitations: Under no circumstances shail 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.
41. 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 reporfing schedule detailed in the Procedures
and Requirements section.
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 �ibrary agrees to
reimburse the �ibrary as soon thereafter as State fiscal procedures wiil
permit.
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d. The final 10� of the grant award (if applicabie) 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 $60,337 upon execution of the agreement and submission of claim by
the grantee organization.
o If applicable, second payment will be made after the submission and
approval of the first reporfs and receipt of claim form in the amount of
$3,714.
42. Self-Dealina and Arm's Lenath 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, seif-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 parfies are on
equal footing and fair market forces are at piay, such as when mulfiiple 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 individuai 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.
43. Severabilitv: If any parf 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.
44. Site Visits: The Grantee shall ailow the California State Library to access and
cond�ct 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, b�t not
be limited to, monitoring the use of grant funds, provide technical assistance
when needed, and to visit the State funded project.
45.Termination: The Agreement shall be subject to termination by the State
Librarian or designee upon notice to the Grantee at least thirfy (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 �ibrarian
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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 granfi award must be returned to the
California State �ibrary 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.
46. Timeline: Time is of the essence to this Agreement. It is mutually agreed
between the parfies that the grant application and the timeline included therein
are part of the Agreement.
47. Unused F�nds: 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 J not used for their intended purpose, or (2) used
inconsistent with the terms of this Agreement.
Funds wiil also be considered unaccounted for, and must be returned, if the
proposai outcomes or deliverables are materially incornplete by the end-of-term
or earlier termination, as determined by the State Library in its sole discretion.
48. Waiver of Riqhts: California State Library shall not be deemed to have waived
any righfis 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 shail 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 compiiance with that provision or any other provision of this
Agreement. No prior waiver by California State Library, nor any course of
dealing beiween 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 �nder this Agreement, the granting of such consent by California State
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.
49. 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
materiai produced pursuant to this Agreement.
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BC-OACA8D46B9BC
Shasta Public Libraries
Califomia Library Literacy Services
2023-2024 CL�S23-85
Page 21 of 27
50. Worker's Compensation: The State of California will not provide Workers'
Compensation insurance for Grantee or Grantee's empioyees 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 l.abor Code, and the Grantee
agrees to comply with such provisions before commencing the performance of
the work of this Agreement.
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-B9BC-OACA8D4669BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 22 of 27
EXHIBIT B: CERTIFICATI4N 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 ali other parficipants ar 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 wiil comply with ail appiicable requirements of State and Federal laws,
regulations, and policies governing this program, to inciude 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$64,051. 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 1 1102).
7. DRU6-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 foilowing 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:
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B96C-OACA8D46B96C
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 23 of 27
1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free
workpiace;
3J any available counseling, rehabilitation and employee assistance
programs; and,
4j penalties that may be imposed upon empioyees 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 ciarification.
Current State Employees (Pub. Contract Code § 10410):
a. No officer or employee shail 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. Conhact 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 empioyee 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 generai subject area as
the proposed contract within the 12-month period prior to his or her
leaving state service.
DocuSign Envelope ID:4596CAE7-E1C8-4DD7-B9BC-OACASD4669BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
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)j.
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 compiy with such provisions before commencing the
performance of the work of this Agreement. (Labor Code § 3700).
10. AMERICANS WITH DISABILITIES ACT: Grantee ass�res 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
g�idelines issued pursuant to the ADA. (42 U.S.C. 12101 et. seq.)
11. RESO�UTION: For awards totaling $350,000 or more, 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)j. In particular, the recipient must comply with drug-
free workpiace 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 empioyees; 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 fihis award, as listed in fhe
cerfification section below, and all program staff, agree to comply with all
California non-discrimination laws.
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B98C-OACA8D4689BC
Shasta Public Libraries
California �ibrary Literacy Services
2023-2024 CLLS23-85
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
Nqme• Kimberly A. Niemer Address (official and complete):
�irector of community Services
PROJECT COORDINATOR
Name: �ared Tolman
Emall: jaredt@shastalibraries.org Phone: 530-806-8489
GRANTEE AUTHORIZED REPRESENTATIVE
Name: K;m Niemer Tltle: pirector of community services
Email: kniemer@cityofredding.org Phone: 530-225-4085
DowSignetl by:
Signature: �i1w,� Date: g�18/2023
AD7779138C6E433...
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-B9BC-OACA8D46696C
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 26 of 27
Authorized Representative Signature
ORGANIZATION
Name: Kimberly A. Niemer Address (official and completeJ:
777 Cypress Avenue, Redding, CA 96001
AUTHORIZED REPRESENTATIVE
Signature:��`"$ro"'°'� Date:
K,�.� 9J18/2023
AD3f]B138CBE433...
Printed Name of Person Signing: Title: pirector of Community serv;ces
Kim Niemer
STATE OF CALIF(�RNIA
Agency Name: California State Libra��y Address: 900 N Street, Sacramento, CA 95814
Signature:��'°"� Date: 9/812023
6DR50901GiCJ16...
Printed Name of Person Signing: Title: California Staie �ibrariar�
Greg Lucas
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-69BC-OACA8D46B9BC
Shasta Public Libraries
California Library Literacy Services
2023-2024 CLLS23-85
Page 27 of 27
EXHIBIT C: 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.qov/employeeslpaqes/travel-reimbursements.aspx
Mileage: $0.585 per mile-approved business/travel expense
Rate subject to change
Meals: $7.00- Breakfast
Receipts are required $1 1.00- 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: $ 90.00 plus tax for all counties/cities not listed below
Receipts are required $ 95.00 plus tax for Napa, Riverside, and Sacramento
and MUST have a zero Counties
balance. $ 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
Ciara 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 uotes.
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: Actual reasonable fees pertaining to airline travel will be
itinerary and receipts are reimbursed. Business, First Class, or Early Bird Check-in fee
re uired is not an a roved reimbursabie ex ense. '
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-69BGOACA8D4689BC
�` �_ . �,
w... � � ��-
� �� ST°�TE LI��A6�1r
24 August 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 (EOJ
regarding sanctions in response to Russian aggression in Ukraine. The EO is located
at https�//www.gov.ca. ov/w�-contentiuploads/2Q22/03/3.4.22-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 compiy with existing economic sanctions imposed
by the U.S. government in response to Russia's actions in Ukraine, as weli as any
sanctions imposed under state law.
This correspondence serves as a notice under the E4 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
federai executive orders identified in the EO and the sanctions identified on the
U.S. Department of the Treasury website (https://home.treasury.qovJ�olicy-
issues/financial-sanctions/sanctions-programs-and-countrv-information/ukraine-
russia-related-sanctions). Failure to comply may result in the termination of
contracts or grants, as applicable.
Piease 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:4596CAE7-E1C8-4DD7-B9BC-OACA8D46B98C
�
CALIFORNIA LIBRARY LITERACY AND ENGLISH ACQUISITION SERVICES
FINANCIAL CLAIM
1St PAYMENT
Grant Award#: CLLS23-85 Date: 9/18/2023
invoice#: CLLS23-85-01 PO#: 6700
Payee Name: City of Redding
(Legal name of authorized agency to receive,disburse and account for funds")
Compiete Address: ��� Cypress Avenue, Redding, ca 96001
Street Address,City,State,Zip Code(Warrant will be mailed to this address)
Amount Claimed: $60,337 Type of Payment:
(Payable Upon Execution of Agreement) � PROGRESS
Grantee Name: Shasta Pubiic Libraries ❑ FINAL
(Name on Award Letter and Agreement) ❑ IN FU�L
Project Title: California Library Literacy Services ❑ AUGMENT
For Period From: upon execution to end of grant period
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.
DocuSigned 6y:
B� �AD�6E4�
(Signature of the Authorized Representative)
Kim Niemer Director of Community Services
(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 andlor address may cause delay in payment. If you need to change payee name and/or address,
please contact Fiscal Services at stateqrants.fiscal(c�library.ca.qov.
State of California, State Library Fiscal Office
ENY: 2023 ITEM NO: 6120-213-0001, Chapter 12, Statutes of 2023
PURCHASING AUTHORITY NUMBER: CSL-6120 REPORTING STRUCTURE: 61202000
COA: 5432000 PROGRAM#: 5312
FAIN: N/A
gy Date
(State Library Representative)
P�Fo� Reset Form
DocuSign Envelope ID:4596CAE7-E1CB-4DD7-69BC-OACA8D46896C
- - - - - _ __ -- __.. ___--
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)
Sectian'1 —Payee Infarmatian
NAME(This is required. Do not leave this line blank. Must match the payee's federal tax return)
City of Redding
BUSINESS NAME, DBA fdAilAE or DISREGARDED SINGLE MEMBER LLC NAME(If different from above)
Shasta Public Libraries
MAI�ING ADDRESS(number,street,apt.or suite no.) (See instructions on Page 2)
777 Cypress Avenue
CITY,STATE,ZIP CODE E-MAIL ADDRESS
Redding kniemer@cityofredding.org
Sectio�2-=En#i'ty Type
Check one 1 box onl that matches the entit t e of the Pa ee listed in Section 1 above. See instructions on a e 2
❑ SOLE PROPRIETOR/INDIVIDUAL CORPORATION(see instructions on page 2)
❑ SINGL.E MEMBER LLC Disregarded Entiry owned by an individual � MEDICAL(e.g., dentistry, chiropractic,etc.)
❑ PARTNERSHIP O LEGAL(e.g.,attorneyservices)
❑ ESTATE OR TRUST ❑ EXEMPT(e.g.,nonprofit)
�ALL OTHERS
Secfiion�-=T�x lclent��catia�Nur»b�r
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. Social Security Number(SSN)or
The TIN is a 9-digit number. Note: Payment wili not be processed without a TIN. �ndividual Tax Identification Number(ITIN)
• For Individuais,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 Revocabie Living Trust while the grantors are alive)may OR
not have a separate FEIN. Those trusts must enter the individuai grantor's SSN.
• For Sole Proprietor or Singie Member LLC(disregarded entity), in which the Federal Empioyer ldentification Number
sole member is an individual,enter SSN(ITIN if applicable)or FEIN(FTB (FEIN)
prefers SSN).
• For Singie Member LLC (disregarded entity), in which the sole member is a -���-04�-------
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.
Secti�sn 4=Payee Res�dency S#atus{See instructic+ns
2�1 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 Califomia
❑Copy of Franchise Tax Board waiver of state withholding is attached.
SBC#�ii11�-CaE1 ti�Cattt�l'!
l hereby certify under penalty of perjury that the information provided on fhis documenf is true and correct.
Should m residenc status chan e,l will rom tl noti the stafe a enc betow.
NAME OF AUTHORIZED PAYEE REPRESENTATIVE TITLE E-MAIL ADDRESS
Kimberly A. Niemer Director of Community Servic �niemer@cityofredding.org
SIGNATURE �_ DATE TELEPHONE (include area code)
�, .
5302254085
�.A03�Y8138GBE433,,; ., �; � � �8C�1�111��:^P��t�I1�a��'�#3� Pr�IC�. �.�,'; . , , � �.
Please return com leted form to:
STATE AGENCY/DEPARTMENT OFFICE UNIT/SECTION
California Admin/Accounting
MAILING ADDRESS FAX TELEPHONE(include area code)
777 Cypress Avenue 916-603-7157
CITY STATE ZIP CODE E-MAIL ADDRESS
Redding CA 95814 accounting@library.ca.gov
DocuSign Envelope ID:4596CAE7-E1C6-4DD7-B9BC-OACA8D46898C
_ _ _... __ _.. __ _ _. ._ _-
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)
GENERALINSTRUCTIONS
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 Govemment 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 Retums(Form 1099)
are in accordance with the Internal Revenue Code(IRC)and the Califomia Revenue and Taxation Code(RBTC).
Section 1 —Payee InformaEian
Name-Enter the name that appears on the payee's federal tax retum. The name provided shall be the tax liable party and is subject to IRS TIN matching(when
applicable).
• Sole Proprietor/lndividual/Revocable Trusts-enter the name shown on your federal tax retum.
• 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,�LC 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 retums,or make subsequent changes to the remittance address.
s@CtICl1t`�i-Et'itl � E.'
If the Pa ee in Sectian 1 is a n ... THEN Select the Bax for...
Individual•Sole Pro rietorshi •Grantor Revocable Livin Trust disre arded for federal tax u oses Sole Pro rietoriindividual
Limited liabili Com an LLC owned b an individual and is disre arded for federal tax ur oses Sin le Member LLC-owned b an individual
Partnershi s•Limited Liabilit Partnershi s LLP •and,LLC treated as a Partnershi Partnershi s
Estate•Trust other than disre arded Grantor Trust Estate or Trust
Corporation that is medical in nature(e.g.,medical and healthcare services,physician care,nursery Corporation-Medical
care,dentist ,etc.•�LC that is to be taxed like a Cor oration and is medical in nature
Corporation that is legal in nature(e.g.,services of attorneys,arbitrators,notary publics involving legal Corporation-legal
or law related matters,etc. •LLC that is to be taxed like a Cor oration and is le al in nature
Cor oration that ualifies for an Exem t status,inciudin 501 c 3 and domestic non- rofit cor orations. Cor oration-Exem t
Corpo�ation that does not meet the qualifications of any of the other corporation types listed above•LLC Corporation-All Other
that is to be taxed as a Co oration and does not meet an of the other co oration es Iisted above
Sectian 3-Tax Identif�cation 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 RBTC section 18662 and its regulations.
Sectiart 4-Payee Residency S#atus;
Are you a California resident or nonresident?
. A corporation will be defined as a"residenY'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 partne�ship if it has a permanent place of business in Califomia.
. 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 Califomia 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 Califomia for a purpose
that wili extend over a iong 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.qov
' Section 5-Cert�ficafion
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 attomey documented for the individual.
Section'6—Paying State Agency ;
This section must be completed by the state agency/department requesting the STD 204.
PI'�YaCy Statet'tleCtt
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 federai backup withhoiding 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.