HomeMy WebLinkAboutS717-00_initial transmitSTATE OF IDAHO
DEPARTMENT OF
ENVIRONMENTAL QUALITY
1410 North Hilton • Boise, ID 83706 • (208) 373-0502
www.deq.idaho.gov
Brad Little, Governor
Jess Byrne, Director
January 12, 2022
Keith Davison
City of Rexburg
35 N 1st E
Rexburg ID 83440
By Email Transmission: keith.davidson@rexburg.org
RE: S717-00 – Original Subaward
Dear Mr. Davidson:
I have enclosed one proposed original of the DEQ Subaward (#S717) between the City of Rexburg and the Idaho
Department of Environmental Quality (DEQ). The purpose of the subaward is to provide funding for properly
abandon old, hand dug well under city shop.
Upon acceptance of the terms and conditions of this subaward, please return the entire signed copy of the
subaward to me at carrie.champlin@deq.idaho.gov. Please note there are several forms to fill out within this
packet.
If you have any questions or concerns regarding this subaward, please contact Project Officer Curtis Cooper at
curtis.cooper@deq.idaho.gov , or Contracts Manager Carrie Champlin at carrie.champlin@deq.idaho.gov.
Sincerely,
Carrie Champlin
Contracts Manager
cc: Content Manager: 2022AIE10 (1cc Enclosure)
Curtis Cooper, DEQ (1cc Enclosure)
DEQ Subaward Agreement
S717
This Subaward Agreement is entered into by the State of Idaho, Department of Environmental Quality,
hereinafter referred to as the DEPARTMENT, and
hereinafter referred to as the SUBRECIPIENT.
City of Rexburg
Tax Identification 826000250
Subaward Effective Date 1/1/2022 Subaward Expiration Date 12/31/2022
Professional Liability Policy #38A0215810018 Policy Expiration Date 9/30/2022
Check if Exempt/Government Agency
Worker's Compensation Policy #23440 Policy Expiration Date 1/1/2022
Check if Worker's Compensation paid by DEQ
If exempt from Worker's Compensation, note the reason:Government Agency
WITNESSETH: The DEPARTMENT enters into this Subaward Agreement pursuant to authority granted
to it in Title 39, Chapter 1, Idaho Code. The SUBRECIPIENT agrees to undertake performance of this
agreement under the terms and conditions set forth herein.
The SUBRECIPIENT agrees to provide, and the State agrees to accept the services detailed in this
agreement and generally described as follows:
To provide funding for properly abandon old, hand dug well under city shop.
Method of Procurement Subaward RFP Number
Subaward Amount $10,000.00
Subaward #
The following Attachments are checked if applicable and are incorporated by reference and made a part
of this agreement:
SIF Class Code
MBE/WBE Status:DUNS Number:028566750
Attachments
Work Plan / SOW
Conflict of Interest
Grant Application
Program Terms && Conditions
LobbyCertification
Single Audit Act
MBE/WBE Reporting
Page 1 of 3
The terms of this agreement include the Statement of Work, the Budget, the federal agency’s award terms
and conditions, as well as other documents affixed or referred to in this agreement. The SUBRECIPIENT
must comply with the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards (2 CFR Parts 200 and 1500). It is expected that the approved Statement of Work will be
followed in its entirety unless modifications or amendments are agreed to, and approved in writing by the
DEPARTMENT.
The SUBRECIPIENT acknowledges and agrees that changes in legislation may require modification to this
agreement both in program and funding, and that any such changes, which are necessary, shall be
incorporated. The SUBRECIPIENT further agrees that the DEPARTMENT has the right to terminate this
agreement if the SUBRECIPIENT cannot comply with such changes, or meet the requirements originally
outlined in the Statement of Work. The SUBRECIPIENT further acknowledges that all funding is contingent
upon the availability of federal funds, the SUBRECIPIENT’s ability to certify provision of required matching
funds (where applicable), and continued federal authorization of program activities. The SUBRECIPIENT
agrees that the DEPARTMENT has the right to terminate or otherwise modify this agreement if federal
funding or authority is terminated or modified.
In the event that this agreement is not executed prior to the first day of the effective period, the late execution
shall provide retroactive approval for expenditures authorized by the agreement and made prior to the date of
execution. This agreement is effective as per the stated agreement effective date. In the event that the last
signature on this agreement pre-dates the stated agreement effective date, the last signature date shall be the
new effective date.
The SUBRECIPIENT agrees to provide notice of the completion of any required audits and any adverse
findings which impact this subaward as required by CFR parts 200.501-200.521, and to provide access to
records as required by parts 200.336, 200.337, and 200.201 as applicable. SUBRECIPIENT agrees to
indemnify and hold harmless the State of Idaho, its agents and its employees from any and all claims, actions,
damages, liabilities and expenses directly or indirectly connected to the SUBRECIPIENT or its agent’s,
employees, contractor’s, or assignee’s actions related to the location, design, construction, operation,
maintenance, repair, failure or deactivation of the project or any part of the project. If the SUBRECIPIENT
is a Public Entity, this indemnification and save harmless obligation shall apply only to the extent permitted
by Idaho Code section 59-1015.
This agreement and related attachments constitute the entire agreement between the parties hereto and shall
supersede all previous proposals, oral or written; negotiations; representations; commitments; and all other
communications between the parties. The agreement may not be released, discharged, changed, extended,
modified, or assigned in whole or in part, and no claim for additional services not specifically provided
herein will be allowed by the DEPARTMENT, except to the extent provided by an instrument in writing
signed by a duly authorized representative of the parties. Any Riders, Appendices, Attachments, and all
other information attached to this agreement serve to supplement the terms and conditions of this agreement,
and do not change or eliminate any provision of this agreement.
EPA
66.468 Capitalization Grants for Drinking Water State Revolving Funds
Federal Award #:FS98003020
Federal Award Name: DWSRF WELLHEAD PROTECTION
Federal Award Information
Subaward
Total Amount of Federal Award to DEQ : $11,011,000.00
DEQ’s Negotiated Indirect Cost Rate: 31.04%
Federal Funds Obligated:
Federal Awarding Agency:
CFDA #:
This Action To Date
$10,000.00$10,000.00
Page 2 of 3
Fiscal Codes - DEQ Use Only
Subrecipient Mailing Address:
Keith Davidson
35 N 1st E
Rexburg ID 83440
Subrecipient Phone Number 208-359-3020
DEQ Contact:
Carrie Champlin, Contracts Manager
1410 N. Hilton
Boise, ID 83706
DEQ Phone Number 208-373-0251
PID OBS CA SubObj WP BE %Grant GT Begin GT End
City of Rexburg
IN WITNESS WHEREOF, the parties have executed this agreement.
AWARDING ENTITY IDAHO DEPARTMENT OF ENVIRONMENTAL QUALITY.
Financial Officer
Signature Title Date
SUBRECIPIENT:
Signature Title Date
SG22 0502 82987 1007499000NPR00 E24003 20 6/30/20257/1/2020
Page 3 of 3
Agreement #S717 Idaho Department of Environmental Quality
Page 1 of 4
1
PROGRAM SPECIFIC TERMS & CONDITIONS
Idaho Source Water Protection (SWP) Grant Program
DEQ Subrecipient: City of Rexburg
I. INTRODUCTION
This Agreement is between the Idaho Department of Environmental Quality (DEQ) and
the City of Pocatello (Subrecipient) for performance under the Idaho Source Water
Protection Grant Program as set forth in the approved Statement of Work. This project is
funded using federal funds from the Environmental Protection Agency (EPA).
II. PROGRAM GUIDANCE & ELIGIBILITY REQUIREMENTS
The Subrecipient shall perform the services set forth in the approved Statement of Work.
All activities covered under this agreement shall be consistent and comply with the
applicable portions of the Section 1452 of the Safe Drinking Water Act, as amended (42
U.S.C. 300j-12), the federal administrative and programmatic conditions as specified and
applicable to subrecipients under EPA Assistance Agreement #FS-98003020, CFDA
#66.468, as well as the requirements outlined in the Source Water Protection Grant
Application Solicitation or Guide.
This is a well abandonment project therefore it does have special provision:
• The well must be abandoned in a manner compliant with IDAPA 37.03.09 Well
Construction Standards Rules. Abandonment must be performed by a well driller licensed
in the State of Idaho per Idaho Code 42-238 unless a waiver has been granted.
III. PROJECT SCOPE OF WORK
The project application as submitted by the Subrecipient and approved by DEQ shall
serve as the approved Statement of Work.
IV. PROJECT MANAGEMENT
a. Time of Performance:
Work under this agreement shall start on the 1st day of January 2022 and end no
later than the 31st day of December 2022.
b. Implementation Schedule:
Agreement #S717 Idaho Department of Environmental Quality
Page 2 of 4
2
Unless amended by mutual written agreement by both parties, the Subrecipient
will perform the described tasks in conformance with the schedule included with
their application.
c. Performance Monitoring:
DEQ will monitor the performance of the Subrecipient against goals and
performance standards required herein. DEQ may terminate the agreement for
failure to ensure reasonable completion of the project within the project period
and in accordance with the implementation schedule herein.
V. PROJECT BUDGET
The total project cost of performing work under this agreement is $11,900; and the total
reimbursable, not to exceed cost is $10,000, as specified in the budget tables below. DEQ
may require a more detailed budget breakdown than the one contained herein. The
Subrecipient shall provide such supplementary budget information in the form and
content prescribed by DEQ. Any amendments to this budget must be approved in writing
by DEQ.
Table 1. Budget Categories
Budget Line Item DEQ Funding Matching Total Budget
Personnel -$ -$ -$
Fringe -$ -$ -$
Travel -$ -$ -$
Equipment -$ -$ -$
Supplies -$ -$ -$
Contractual 10,000$ 1,900$ 11,900$
Other -$ -$ -$
Total Direct 10,000$ 1,900$ 11,900$
Total Indirect -$ -$ -$
TOTAL 10,000$ 1,900$ 11,900$
VI. BILLING PROCEDURES
a. Amount:
DEQ shall reimburse the Subrecipient in an amount not to exceed $10,000 for
costs related to project implementation, as outlined in the approved project scope
of work and budget included as part of this agreement.
b. Requests:
Agreement #S717 Idaho Department of Environmental Quality
Page 3 of 4
3
DEQ shall reimburse the Subrecipient in an amount not to exceed $10,000 for
costs related to this agreement.
Source Documentation and Requests:
The Subrecipient must submit requests for reimbursement to DEQ using the
invoice template. Requests for reimbursement must include:
• Signed Invoice Template (see attached)
• Copy of receipt(s)
c. Submission of Requests:
Reimbursement requests must be submitted electronically via email to DEQ
Project Manager, Curtis Cooper at Curtis.Cooper@deq.idaho.gov AND DEQ
Grants Officer, Douglas McRoberts at Douglas.McRoberts@deq.idaho.gov.
VII. REPORTING REQUIREMENTS
a. Progress Reports:
i. A final report is required 60 days following project completion. The report
must be submitted using the report template included as part of this
agreement.
b. Minority-owned Business Enterprise / Women-owned Business Enterprise
(MBE/WBE) Reporting:
i. The Subrecipient must submit MBE/WBE reports to DEQ annually by
October 20 for the duration of this agreement and according to the
attached MBE/WBE reporting requirements. The final MBE/WBE report
is due 60 days after project completion. The Subrecipient shall use the
report template attached as part of this agreement.
c. Report Submission:
i. All reports should be submitted electronically via email to the DEQ
Project Manager AND Grant Officer:
Project Manager: Curtis Cooper (Curtis.Cooper@deq.idaho.gov)
Grant Officer: Doug McRoberts (Doug.McRoberts@deq.idaho.gov).
ii. Questions regarding reporting requirements may be directed to the DEQ
Grant Officer:
Curtis Cooper
DEQ State Office
1410 N. Hilton
Agreement #S717 Idaho Department of Environmental Quality
Page 4 of 4
4
Boise, ID 83702
Phone: (208) 373-0249
Email: Curtis.Cooper@deq.idaho.gov
Table 5 Reporting Requirements Summary
Reporting Activity Reporting Frequency Reporting Period Report Due Date(s)
Progress Reports Final Report
At Project
Completion
60 days post project
completion
MBE/WBE Reports Annual / Final Oct 1 – Sep 30
October 20 or 60 days
after the end of the
project period
VIII. RECORD RETENTION REQUIREMENTS & ACCESS
The Subrecipient shall retain all financial records, supporting documents, statistical
records and all other records pertinent to this agreement and its associated project(s) for a
minimum of three (3) years from the date of payment of final invoice or from the date of
the publication and approval of the final report, whichever is later.
If any litigation, claim, or audit is initiated prior to the expiration of the three (3) year
period, the Subrecipient shall retain the records until all litigation, claims, or audit
findings involving the records have been resolved and final action taken.
Records for any equipment acquired through funding provided to the Subrecipient
through this agreement shall be retained for three (3) years after final disposition.
The Subrecipient agrees to provide the DEQ Director, or his/her authorized agents, access
to all files, records, accountings and books relating to the management and accountability
of this sub-award.
IX. SUBAWARD CLOSEOUT INSTRUCTIONS
This sub-award will be considered closed once the Subrecipient submits all invoices,
reports, and any other requested documentation to DEQ, AND these documents have
been paid / approved by DEQ. This includes the final invoice and the final report.
X. TITLE OF EQUIPMENT
Title of any equipment purchased under this agreement will conditionally vest with the
Subrecipient in accordance with 2 CFR 200.313.
Please Sign and Return this Form with the Signed Agreement
City of Rexburg
Acknowledgement of Federal Audit Requirements
for Federal Subrecipients
Subaward grant funds disbursed per this Agreement are considered federal financial assistance per the
Single Audit Act (SAA) of 1984, as amended by the Single Audit Act Amendments of 1996 (SAA), 31
U.S.C. §§7501-7507 (2000) and moved and incorporated in 2014 into the Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards located at 2 CFR Part 200,
Subpart F – Audit Requirements. If a Subrecipient expends more than $750,000 of federal funds
(including, but not limited to those received as part of this agreement) in their fiscal year 2016 or later;
then, the Subrecipient must have a single or program-specific audit conducted for that year in accordance
with Subpart F of the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for
Federal Awards (§200.500-200.500.521). In such case, the Subrecipient must:
•Procure or otherwise arrange for the required audit in accordance with 200.509 Auditor selection,
and ensure it is properly performed and submitted when due;
•Prepare appropriate financial statements, including the schedule of expenditures of Federal
awards in accordance with §200.510 Financial statements;
•Properly submit audit report in a timely fashion (§200.512):
o The audit must be submitted within thirty (30) calendar days after the receipt of the
auditor’s report OR nine (9) months after the end of the audit period, which is generally
the Subrecipient’s fiscal year end.
o The auditee must ensure timely submission of the data collection form and reporting
package to the Federal Audit Clearinghouse (FAC) as described in §200.512 paragraphs
(b)and (c) respectively.
o Subrecipient must keep one copy of the data collection form and one copy of the
reporting package on file for three (3) years from the date of submission to the FAC.
•Promptly follow up and take corrective action on audit findings, including preparation of a
summary schedule of prior audit findings and a corrective action plan in accordance with
§200.511, Audit findings follow-up, paragraph (c), respectively (as appropriate);
•Provide the auditor with access to personnel, accounts, books, records, supporting documentation,
and other information as needed for the auditor to perform the audit required by Subpart F.
The Subrecipient recognizes that it is responsible for determining if the $750,000 threshold is reached, as
appropriate, and if a SAA audit is required. Additionally, the Subrecipient must inform the Department, in
writing, of any findings or recommendations pertaining to this agreement contained in any audits
conducted by the Subrecipient. In such cases, the Subrecipient must also provide the Department with a
copy of the audit.
Signature of Authorized Representative: _________________________ Date: ________________
Questions? Contact DEQ Grants Manager, Doug McRoberts Ph: (208) 373-0497
Email: Douglas.McRoberts@deq.idaho.gov S717
CONFLICT OF INTEREST CERTIFICATION
Subgrant #: Subrecipient Name:
A conflict of interest (COI) is defined as an actual or potential situation that undermines, or may undermine, the
impartiality of an individual or non -federal entity because their self -interest conflicts, or may conflict with their
duty and obligations to the public in performing a federally funded financial assistance agreement. COI also
includes situations that create, or may create, an unfair competitive advantage, or the appearance of such, for an
applicant or contractor in competing for federal financial assistance.
Situations Requiring Disclosure: (1) Any COI described at 2 CFR 200.318(c)(1) including consulting fees or
other compensation paid to employees, officers, agents of the subrecipient and/or members of their immediate
families paid by procurement contractors or other subrecipients receiving federal funding under a subaward. (2)
Any organizational COI described at 2 CFR 200.318(c)(2) between the subrecipient and procurement contractors
or other subrecipients receiving federal funding under a subaward.
Timing & Content of Disclosure: Subrecipients must disclose any COI related to this agreement within 10
calendar days of discovery to DEQ ’s Project Manager . All disclosures must be in writing preferably through
email communication. In addition to describing the COI, subrecipients must also provide any information
regarding measures to eliminate, neutralize, mitigate or otherwise resolve the conflict.
Subrecipient Point of Contact (POC): This is the person designated to disclose and resolve any COI that may
arise related to this subaward agreement. The Subrecipient POC must be an employee or officer of the
Subrecipient or another entity (e.g. consultant or attorney) expressly authorized by the Subrecipient to speak on its
behalf.
Name: _________________________________________ Phone: _______________________
Title: ____________________________________________________________________________
Please check one of the following:
□The subrecipient has implemented a written policy of financial COI that is consistent with feder al general
procurement standards referenced herein. I certify that all individuals responsible for the application, design,
implementation, administration, and/or monitoring of this agreement have made the required disclosures to DEQ
in accordance with the subrecipient’s policy.
□The subrecipient has not implemented a written policy of financial COI. I certify that all individuals
responsible for the application, design, implementation, administration, and/or monitoring of this agreement have
made the required disclosures to DEQ in accordance with the situtations, timing, and content of disclosure
requirements listed above.
I certify that the information listed above is true, complete and accurate to the best of my knowledge, and that I
am an Authorized Organizational Official for the subrecipient.
Signature: Email:
Date: Name: Title:
City of RexburgS717
Questions? Contact DEQ Grants Manager, Doug McRoberts Ph: (208) 373-0497
Email: Douglas.McRoberts@deq.idaho.gov S717
Please Sign and Return this Form with the Signed Agreement
45 CFR Part 604 – New Restrictions on Lobbying
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The applicant certifies, to the best of his or her knowledge and belief, that:
(1)No Federal appropriated funds have been paid or will be paid, by or on behalf of the
applicant, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with the awarding
of any Federal contract, the making of any Federal grant, the making of any Federal
loan, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement.
(2)If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the applicant shall complete and submit Standard Form-
LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
(3)The applicant shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants,
and contracts under loans, and cooperative agreements) and that all subrecipients
shall certify and disclosure accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is
prerequisite for making or entering into this transaction imposed by Section 1352, Title
31, U.S. Code. Any person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
__________________________________ Signature
__________________________________
Title/Institution
City of Rexburg
Questions? Contact DEQ Grants Manager, Doug McRoberts Ph: (208) 373-0497
Email: Douglas.McRoberts@deq.idaho.gov S717
attach MBE/WBE 1:
Subaward #:
MBE/WBE UTILIZATION UNDER STATE OF IDAHO DEQ
PART I. (Reports are required even if no procurements are made during the reporting period.)
1A. FEDERAL FISCAL YEAR
201_
1B. REPORTING PERIOD (Check ALL appropriate boxes)
Annual (October – September)
1C. REVISION OF A PRIOR REPORT?
Y or N
Year: _________
Quarter: _________
BRIEFLY DESCRIBE THE REVISIONS YOU ARE MAKING:
2A. FINANCIAL ASSISTANCE OFFICE ADDRESS
Fiscal Office
Department of Environmental Quality
1410 North Hilton Street
Boise, Idaho 83706-1255
3A. RECIPIENT NAME AND ADDRESS
2B. Agency Contact
Name: Doug McRoberts
E-mail:
Douglas.McRoberts@deq.idaho.gov
2C. PHONE:
208-373-0 497
3B. RECIPIENT REPORTING CONTACT:
Name:
E-mail:
3C. PHONE:
4A. Check and skip to Block No. 7 if no
procurements and accomplishments were
made this reporting period.
.
4B. TOTAL PROCUREMENT AMOUNT THIS REPORTING PERIOD
(ONLY include amount not in any prior reporting period and procurements made by Program
Subrecipients)
4C. ACTUAL MBE/WBE PROCUREMENT ACCOMPLISHED THIS REPORTING PERIOD BY RECIPIENT, SUB -RECIPIENTS, AND PRIME
CONTRACTORS.
Construction Equipment Services Supplies Total
$MBE: ____________ _____________ _ _ _____________ ________________
$WBE: ____________ ______________ ___________ _____________ ________________
5. COMMENTS:
6. NAME OF RECIPIENT’S AUTHORIZED REPRESENTATIVE
TITLE
7. SIGNATURE OF RECIPIENT’S AUTHORIZED REPRESENTATIVE
DATE
S717
DWSRF WELLHEAD PROTECTION
City of Rexburg
Keith Davidson
35 N 1st E
Rexburg ID 83440
attach MBE/WBE 2:
S717
attach MBE/WBE Instructions:
INSTRUCTIONS
MBE/WBE UTILIZATION UNDER STATE OF IDAHO
FEDERAL SUBAWARD PROGRAM
A. General Instructions
MBE/WBE utilization is based on Executive Orders
11625, 12138, 12432, P.L. 102-389 and EPA
Regulations Part 30 and 31. EPA Form 5700-52A
must be completed by recipients of Federal grants,
cooperative agreements or other Federal financial
assistance which involves procurement of supplies,
equipment, construction or services to accomplish
Federal assistance Programs.
Recipients are required to report to EPA within one
month following the end of each Federal fiscal quarter,
semi-annually or annually as in the agreement.
B. Definitions
Procurement is the acquisition through order,
purchase, lease or barter of supplies, equipment,
construction or services needed to accomplish Federal
assistance programs.
A contract is a written agreement between an EPA
recipient and another party (other than another public
agency) and any lower tier agreement for equipment,
services, supplies or construction necessary to
complete a project. Includes personal and professional
services, agreements with consultants, and purchase
orders.
A minority business enterprise (MBE) is a business
concern that is (1) at least 51 percent owned by one or
more minority individuals, or, in case of a publicly
owned business, at least 51 percent of the stock is
owned by one or more minority individuals; and (2)
whose daily business operations are managed and
directed by one or more of the minority owners.
U.S. citizenship is required. Recipients shall presume
that minority individuals include Black Americans,
Hispanic Americans, Native Americans, Asian Pacific
Americans, or other groups whose members are found
to be disadvantaged by the Small Business Act or by
the Secretary of Commerce under section 5 of
Executive order 11625. The reporting contact at EPA
can provide additional information.
A woman business enterprise (WBE) is a business
concern that is, (10 at least 51 percent owned by one
or more women, or in the case of a publicly owned
business at least 51 percent of the stock is owned by
one or more women and (2) whose daily business
operations are managed and directed by one or more
of the women owners.
Business firms which are 51 percent owned by
minorities or women, but are in fact managed and
operated by non-minority individuals do not qualify for
meeting MBE/WBE procurement goals.
C. Instructions for Part 1
1a. Complete Federal fiscal year
1b. Check applicable reporting box quarterly.
(Federal fiscal year runs October 1 through
September 30.)
1c. Indicate if this is a change to a previous year or
other reporting period. (Highlight items to be
revised and provide explanation in Block #5-
Comments)
3a-c. Identify the agency, state authority, university or
other organization which the recipient of the
Federal financial assistance and the person to
contact concerning this report.
4a. Self-explanatory
4b. Total contacts/procurement awarded during the
reporting period (quarter, semi-annual, or
annual). For example: Actual dollars for
procurement from the procuring office: actual
contracts let from the contracts offices, actual
goods, services, supplies, etc., from other
sources including the central
purchasing/procurement centers.
4c. Dollar amount of all MBE/WBE procurements
amounts awarded under this reporting period by
the loan recipients, sub-recipients, and prime
contractors.
5. Additional comments or explanations. Please
refer to specific item number(s) if appropriate.
INSTRUCTIONS MBE/WBE UTILIZATION UNDER STATE OF IDAHO FEDERAL SUBAWARD PROGRAM A. General Instructions MBE/WBE utilization is based on Executive Orders 11625, 12138, 12432, P.L. 102-389 and EPA Regulations Part 30 and 31. EPA Form 5700-52A must be completed by recipients of Federal grants, cooperative agreements or other Federal financial assistance which involves procurement of supplies, equipment, construction or services to accomplish Federal assistance Programs. Recipients are required to report to EPA within one month following the end of each Federal fiscal quarter, semi-annually or annually as in the agreement. B. Definitions Procurement is the acquisition through order, purchase, lease or barter of supplies, equipment, construction or services needed to accomplish Federal assistance programs. A contract is a written agreement between an EPA recipient and another party (other than another public agency) and any lower tier agreement for equipment, services, supplies or construction necessary to complete a project. Includes personal and professional services, agreements with consultants, and purchase orders. A minority business enterprise (MBE) is a business concern that is (1) at least 51 percent owned by one or more minority individuals, or, in case of a publicly owned business, at least 51 percent of the stock is owned by one or more minority individuals; and (2) whose daily business operations are managed and directed by one or more of the minority owners. U.S. citizenship is required. Recipients shall presume that minority individuals include Black Americans, Hispanic Americans, Native Americans, Asian Pacific Americans, or other groups whose members are found to be disadvantaged by the Small Business Act or by the Secretary of Commerce under section 5 of Executive order 11625. The reporting contact at EPA can provide additional information. A woman business enterprise (WBE) is a business concern that is, (10 at least 51 percent owned by one or more women, or in the case of a publicly owned business at least 51 percent of the stock is owned by one or more women and (2) whose daily business operations are managed and directed by one or more of the women owners. Business firms which are 51 percent owned by minorities or women, but are in fact managed and operated by non-minority individuals do not qualify for meeting MBE/WBE procurement goals. C. Instructions for Part 1 1a. Complete Federal fiscal year 1b. Check applicable reporting box quarterly. (Federal fiscal year runs October 1 through September 30.) 1c. Indicate if this is a change to a previous year or other reporting period. (Highlight items to be revised and provide explanation in Block #5-Comments) 3a-c. Identify the agency, state authority, university or other organization which the recipient of the Federal financial assistance and the person to contact concerning this report. 4a. Self-explanatory 4b. Total contacts/procurement awarded during the reporting period (quarter, semi-annual, or annual). For example: Actual dollars for procurement from the procuring office: actual contracts let from the contracts offices, actual goods, services, supplies, etc., from other sources including the central purchasing/procurement centers. 4c. Dollar amount of all MBE/WBE procurements amounts awarded under this reporting period by the loan recipients, sub-recipients, and prime contractors. 5. Additional comments or explanations. Please refer to specific item number(s) if appropriate.
6. Name and title of official administrator or
designated reporting official.
7. Signature and month, day, and year report
submitted.
D. Instructions for Part II
For each MBE/WBE procurement made under
this assistant agreement during the reporting
period, provide the following information.
1. Check whether this is a first tier
procurement made directly by Federal
financial assistance recipient or other
second tier procurement made by
recipient’s sub-grantee or prime contractor.
Include all qualifying second tier
purchases executed this reporting
period regardless of when the first tier
procurement occurred.
2. Check MBE or WBE
3. Dollar value of procurement
4. Date of award, show month, day, and year.
Date of award is defined as the date the
contract or procurement was awarded, not
the date the contractor received payment
under the awarded contract or
procurement, unless payment occurred the
date of award.
5. Using codes at the bottom of the form,
identify type of product or services
acquired through this procurement (e.g.,
enter 1 if construction, 2 if supplies, etc).
6. Name, address, and telephone number of
MBE/WBE business.