HomeMy WebLinkAboutE-12 Staff Report - Lunch at the Library Grant Acceptance FY 24-25
CONSENT ITEM
E-12
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
VIA: SERGIO GONZALEZ, CITY MANAGER
FROM: LEILA HASSEN, CITY LIBRARIAN
DATE: FEBRUARY 20, 2024
SUBJECT: ACCEPTANCE OF A LUNCH AT THE LIBRARY GRANT FROM THE
CALIFORNIA STATE LIBRARY
BACKGROUND:
The Azusa Cit y Library has been awarded a grant in the amount of $28,458 from the California
State Library to support Lunch at the Library programming during FY 24/25.
RECOMMENDATIONS:
Staff recommends that the City Council take the following actions:
1) Accept the $28,458 grant award from the California State Library.
ANALYSIS:
The Library is the recipient of the California State Library Lunch at the Library grant. This grant
provides funding for programs and materials related to the Summer Reading Program at Azusa
City Library and pop-up locations in Azusa. Programs are designed to promote learning and
enrichment, independent reading, and volunteer opportunities for high school students. These
funds support programs that coincide with the summer meal distribution program.
Lunch at the Library Grant Acceptance
February 20, 2024
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FISCAL IMPACT:
There is no fiscal impact associated with the recommended actions; upon Council acceptance of
this grant, staff will program the revenues into the Fiscal Year 24/25 budget to support summer
events at the Library and offsite locations in Azusa.
Prepared by: Reviewed and Approved by:
Leila Hassen Sergio Gonzalez
City Librarian City Manager
Attachment:
1. Grant Award Letter
Library – Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
January 23, 2024
Leila Hassen
Azusa City Library
729 N Dalton Ave
Azusa, CA, 91702
Subject: Lunch at the Library Summer 2024
Dear Leila Hassen:
This letter confirms the California State Library’s award of $28,458 to the Azusa City
Library for Lunch at the Library Summer 2024.
The Lunch at the Library program makes it possible for public libraries to:
•Provide free summer meals and programming at library sites,
•Take pop-up libraries to other community-based meal sites,
•Connect children, teens, and families to locally sourced, sustainable food
and provide hands-on food education activities,
•Create volunteer opportunities for teens, and
•Implement innovative solutions to connect more families with nutritious meals
during the summer.
Thank you for being a part of this important work.
Azusa City Library will receive $12,806 of the award upon execution and approval of
the grant agreement, certification, and claim forms. The remaining funding (if
applicable) will be made available according to the payment schedule and upon
the awardee’s completion of the requirements listed in the Grant Agreement and
Certification of Compliance document included with this award packet.
Hard copies of this correspondence will not follow. Therefore, please keep this
correspondence for your files and consider these award materials your original
documents.
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
Attachment 1
2023 Lunch at the Library
LATL23-06A
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Library – Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
This grant is governed by the attached Grant Agreement and Certification of
Compliance, which includes the project period, reporting requirements, payment
schedule, and the proposal outlining the project plan and budget. Within the
DocuSign system, please sign the claim and certification forms included in the
award packet using the DocuSign system. Should you have any questions regarding
using DocuSign please get in touch with your grant monitor.
There are two people assigned to your project. The first is your Grant Monitor.
Contact them regarding compliance and reporting. The Grant Monitor assigned to
your project is Lisa Lindsay. Contact Lisa via email at lisa.lindsay@library.ca.gov.
You are also assigned a Library Programs Consultant for ongoing programmatic
support. The Library Programs Consultant assigned to your project is Kaela Villalobos.
Contact Kaela via email at kaela.villalobos@library.ca.gov.
Please stay in touch with your Grant Monitor and Library Programs Consultant
throughout the award period. Read the enclosed award packet thoroughly and
contact your Grant Monitor if you have any questions.
Best wishes for a successful project.
Respectfully yours,
Greg Lucas
California State Librarian
Enclosures
CC: Gina Iwata
Yesenia Castellon
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
2/1/2024
THE BASICS – YOUR GRANT AWARD
The following provides all the basic information about your grant and managing your grant.
Award #: LATL23-06A
Library/Organization: Azusa City Library
Project Title: Lunch at the Library Summer 2024
Award Amount: $28,458
APPROVED BUDGET CORE PROGRAM
Salaries/Wages/Benefits $0
Consultant Fees $0
Travel $0
Supplies/Materials $21,708
Equipment ($5,000 or more per unit) $0
Services (contracted) $6,750
Project Total $28,458
Indirect Cost $0
APPROVED BUDGET INNOVATION
Salaries/Wages/Benefits $0
Consultant Fees $0
Travel $0
Supplies/Materials $0
Equipment ($5,000 or more per unit) $0
Services (contracted) $0
Project Total $0
Indirect Cost $0
APPROVED BUDGET TOTAL
Grant Total $28,458
Payment Schedule 45%/45%/10%
Start Date: 2/1/2024
End Date: 1/31/2025
Please understand that it can take six to eight weeks to receive a fully executed
claim form with no errors before grant funds are delivered. Therefore, if you have
not received your payment after eight weeks, please contact your grant monitor.
REPORTING
As outlined in the grant terms and conditions, Jurisdiction is required to provide two
financial and narrative reports (first reports due 6/20/2024; second reports due 10/17/2024;
final reports and detailed expenditures due 2/20/2025); and updates upon request. In
addition, the LATL Annual Outputs Survey (reporting on all outputs thus far) must be
submitted by 9/19/2024. Required reports will be available on the State Library’s Lunch at
the Library website under Evaluation.
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Library – Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
PAYMENTS
Please note this clarification regarding payments. Grant payments will be made based on the
payment schedule laid out in the Grant Term and Award Documentation. Ten percent (10%) of
the full grant award is withheld until the end of the project period. It is payable only if the grant
recipient fulfills all project reporting requirements and expends all funds, or returns all unspent
grant funds, by the time specified in the grant terms and conditions.
CONTACT
We want your project to be successful. Please work with the grant monitor and library
programs consultant in implementing your project:
Grant
Monitor
Lisa Lindsay Library Programs
Consultant
Kaela Villalobos
Phone 916.603.6708 Phone 279.399.8977
Email lisa.lindsay@library.ca.gov Email kaela.villalobos@library.ca.gov
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
STATE FUNDED GRANTS
AWARD AGREEMENT AND
CERTIFICATE OF COMPLIANCE
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
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TABLE OF CONTENTS
PROJECT SUMMARY ........................................................ Error! Bookmark not defined.
PROCEDURES and REQUIREMENTS ................................ Error! Bookmark not defined.
A. Term of the Agreement .......................................... Error! Bookmark not defined.
B. Scope of Work .......................................................... Error! Bookmark not defined.
C. Budget Detail .......................................................... Error! Bookmark not defined.
D. Narrative and Financial Reports ........................... Error! Bookmark not defined.
E. Claim Form and Payment ...................................... Error! Bookmark not defined.
EXHIBIT A: TERMS and CONDITIONS ............................... Error! Bookmark not defined.
EXHIBIT B: CERTIFICATION of COMPLIANCE FORM ...... Error! Bookmark not defined.
Certification .................................................................. Error! Bookmark not defined.
EXHIBIT C: STATE REIMBURSABLE TRAVEL EXPENSES ...... Error! Bookmark not defined.
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PROJECT SUMMARY
AWARD AGREEMENT BETWEEN THE STATE LIBRARY and Azusa City Library for the
Lunch at the Library Summer 2024 project.
AWARD AGREEMENT NUMBER LATL23-06A
This Award Agreement (“Agreement”) is entered into on 2/1/2024 by and
between the California State Library (“State Library”) and Azusa City Library,
(“Grantee”).
This Award Agreement pertains to Grantee’s State-funded Lunch at the
Library Summer 2024 project.
The Library Development Services Bureau (“LDS”) of the State Library
administers state and federal funds in the form of awards.
The Grantee was selected by the State Library to receive state grant funds
in the amount of $28,458 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:
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PROCEDURES and REQUIREMENTS
A. Term of the Agreement
The Grant term begins on the date of execution of the Agreement by both parties, until
1/31/2025. 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 period ends on
1/31/2025 and all eligible program costs must be incurred by this date.
B. Scope of Work
1. Grantee agrees to perform all activities specifically identified in the Grantee’s
application and submitted to the State Library in response to the Lunch at the
Library Summer 2024 Opportunity.
2. The following activities and deliverables to be performed by the Grantee
include, but are not limited to the following:
• 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
compliance with the purpose of the grant.
• Prepare and submit required narrative and financial reports.
• Procure equipment, and other supplies as needed for the project.
• Issue contracts for services, personnel, and consultants as needed for the
project.
• If applicable, make payments for services, including for hours worked and
travel reimbursements, to consultants and contractors.
• Oversee the implementation of project activities.
C. Budget Detail
The State Library shall provide the Grantee funding for the expenses incurred in
performing the Scope of Work and activities specified in the Grantee’s application. The
Grantee shall request the distribution of grant funding consistent with its proposal and
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the budget worksheet that was included with the application. Under no circumstances
shall payments exceed the total grant amount identified in this Agreement.
D. Narrative and Financial Reports
1. The Grantee shall be responsible for submission of interim and final narrative and
financial reports on the progress and activities of the project, to the California
State Library, using the sample report documents provided by the California
State Library.
2. All the reports must be current, include all required sections and documents, and
must be approved by the Grant Monitor before any payment request can be
processed. Failure to comply with the specified reporting requirements may be
considered a breach of this Agreement and result in the termination of the
Agreement or rejection of the payment request and/or forfeiture by the Grantee
of claims for costs incurred that might otherwise have been eligible for grant
funding. Any problems or delays must be reported immediately to the Grant
Monitor. The financial reports shall reflect the expenditures made by the
Grantee under the Agreement and may be incorporated into the same
reporting structure as the narrative reports.
3. The reports shall be submitted by the following dates:
Reporting Period Report Due Date
2/1/2024 –
5/31/2024
1st Financial and Mid Project Narrative
Report Due
6/20/2024
Summer 2024 LATL Annual Outputs Survey (Reporting on
all outputs thus far)
9/19/2024
6/1/2024 –
9/30/2024
2nd Financial and Mid Project Narrative
Report Due
10/17/2024
10/1/2024 –
1/31/2025
Final Financial Report, Expenditure Detail
Report and Final Narrative Report Due
2/20/2025
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
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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.
6. In addition to the foregoing, the Grantee shall submit to the State Library such
periodic reports, updates, documents and any information as deem necessary
by the State Library to monitor compliance and/or perform program
evaluation. Any requested data or information shall be submitted in electronic
format on a form specified by the State Library.
E. Claim Form and Payment
1. The California State Library shall provide the Grantee payment as outlined in the
payment schedule only if all requirements for claiming the funds as outline in this
document have been met, and only for those activities and costs specified in
the approved award application.
2. The Grantee shall complete, sign, and submit Certification of Compliance form
(Exhibit B) and the Financial Claim form (included in your award packet), to the
California State Library within 14 days of receiving this award packet. These forms
will be issued, signed, and submitted using the online signature and agreement
platform, DocuSign, unless DocuSign is unallowable or inconsistent with practices
and policies of the local jurisdiction. If the use of DocuSign is not acceptable to
your organization, please contact your grant monitor regarding alternate
options.
3. Any of the sums appearing under the categories in the approved budget may
be adjusted with prior authorization from the California State Library Grant
Monitor. This would be to increase the allotment with the understanding that
there will be corresponding decreases in the other allotments so that the total
amount paid by the California State Library to the Grantee under this Agreement
shall not exceed the awarded amount, which shall be expended/encumbered
during the grant period.
4. If the payment amount made by the California State Library exceeds the actual
expenses incurred during the term of this Agreement, as reflected in the financial
reports to be filed by the Grantee, the Grantee shall immediately refund the
excess payment amount to the California State Library.
5. The Award payments will only be made to the Grantee. It is the Grantee’s
responsibility to pay all contractors and subcontractors for purchased goods and
services.
6. The Final Payment of 10% (if applicable) will be withheld and retained by the
California State Library until all conditions agreed upon in this Agreement,
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including submission and grant monitor approval of the interim and final
narrative and financial reports, have been satisfied.
7. Prompt Payment Clause
The California State Library will make payments to the Grantee in accordance
with the Prompt Payment Clause under Government Code, section 927, et. seq.
The Grantee may typically expect payment within 45 days from the date a grant
payment request is properly submitted and approved by the Grant Monitor.
8. Budget Contingency Clause
a. It is mutually agreed that if the Budget Act of the current fiscal year or any
subsequent years covered under this Agreement does not appropriate
sufficient funds for the program, this Agreement shall no longer be in full force
and effect. In this event, the California State Library shall have no liability to
pay any funds whatsoever to the Grantee or to furnish any other
considerations under this Agreement and the Grantee shall not be obligated
to perform any provisions of this Agreement.
b. If funding for any fiscal year is reduced or deleted by the Budget Act for
purposes of this Program, the California State Library shall have the option to
either cancel this Agreement with no liability occurring to itself or offer an
Agreement amendment to the Grantee to reflect the reduced amount.
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EXHIBIT A: TERMS and CONDITIONS
1. Accessibility: The State is responsible for ensuring that public websites are accessible
to both the general public and state employees, including persons with
disabilities. Grantee shall assist the State in meeting its responsibility. Therefore, all
project materials generated by state funded programs must meet the California
Accessibility Standards. Additionally all project materials designed, developed, and
maintained shall be in compliance with the California Government Code, sections
7405 and 11135, and the Web Content Accessibility Guidelines 2.0, or a subsequent
version, as published by the Web Accessibility Initiative of the World Wide Web
Consortium at a minimum Level AA success criteria.
However, if for some reason project material is not generated to be in compliance
to meet these standards, please still submit it to the State Library. When submitting
the material make sure to note that the material is not accessible by including “NOT
ACCESSIBLE” in the file name.
The California State Library reserves the right to post project materials to its website
that are in compliance with these standards.
2. Acknowledgment: The State of California and the California State Library shall be
acknowledged in all promotional materials and publications related to the Lunch at
the Library Summer 2024 Opportunity.
a. Grant award recipients must ensure that the State of California receives full
credit as the source of funds and that the California State Library, likewise, is
acknowledged as the administrator.
b. Publications and information releases about the project must credit the State
of California. An appropriate statement for a publication or project press
release is:
“This [publication/project] was supported in whole or in part by
funding provided by the State of California, administered by the
California State Library.”
Grantees must include the above statement in any publications, vehicle
wraps, and promotional materials, including websites. If space is limited the
State Library logo and the following shortened acknowledgement statement
is acceptable:
“Funding provided by the State of California.”
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c. This credit line on products of a project, such as materials, is important to
foster support from the public, and state funding sources.
d. California State Library Logo: Use of the California State Library logo, which
can be downloaded on the California State Library website, is required on
any publication, vehicle wrap, or promotional material along with the above
statement(s).
e. Photo Documentation: Digital photos are a great way to document the
happenings of your project. It is recommended that you use a photo release
form when taking photos of the public. You may use your library’s photo
release form, or contact your grant monitor for the State Library’s form.
3. Agency: In the performance of this Agreement the Grantee and its agents and
employees shall act in an independent capacity and not as officers, employees
or agents of the California State Library. The Grantee is solely responsible for all
activities supported by the grant. Nothing in this Agreement creates a
partnership, agency, joint venture, employment, or any other type of relationship
between the parties. The Grantee shall not represent itself as an agent of the
California State Library for any purpose, and has no authority to bind the State
Library in any manner whatsoever.
4. Amendment: No amendment or variation of the terms of this Agreement shall
be valid unless made in writing, signed by the parties, and approved as required.
No oral understanding or agreement not incorporated into this Agreement is
binding on any of the parties. This Agreement may be amended, modified or
augmented by mutual consent of the parties, subject to the requirements and
restrictions of this paragraph.
5. Applicable law: The laws of the State of California shall govern all proceedings
concerning the validity and operation of this Agreement and the performance
of the obligations imposed upon the parties hereunder. The parties hereby
waive any right to any other venue. The place where the Agreement is entered
into and place where the obligation is incurred is Sacramento County, California.
6. Assignment, Successors, and Assigns: The Grantee may not assign this
Agreement or delegate its performance to any third-party person or entity, either
in whole or in part, without the California State Library’s prior written consent. The
provisions of this Agreement shall be binding upon and inure to the benefit of the
California State Library, the Grantee, and their respective successors and assigns.
7. Audit and Records Access: The Grantee agrees that the California State Library,
the Department of General Services, the State Auditor, or their designated
representatives shall have the right to review, audit, inspect and copy any
records and supporting documentation pertaining to the performance of this
Agreement. The Grantee agrees to maintain such records for possible audit for
a minimum of five (5) years after the final payment, or grant term end date,
whichever is later, unless a longer period of records retention is stipulated, or until
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completion of any action and resolution of all issues which may arise as a result
of any litigation, dispute, or audit, whichever is later. The Grantee agrees to
allow the auditor(s) access to such records during normal business hours and to
allow interviews of any employees who might reasonably have information
related to such records. Further, the Grantee agrees to include a similar right of
the State to audit records and interview staff in any subcontract related to
performance of this Agreement.
Examples of audit documentation may include, but not limited to, competitive
bids, grant amendments, if any, relating to the budget or work plan, copies of
any agreements with contractors or subcontractors if utilized, expenditure
ledger, payroll register entries, time sheets, personnel expenditure summary form,
travel expense log, paid warrants, contracts and change orders, samples of
items and materials developed with grant funds, invoices and/or cancelled
checks.
8. Authorized Representative: Grantee and the California State Library mutually
represent that their authorized representatives have the requisite legal authority
to sign on their organization’s behalf.
9. Communication: All communications from either party, including an interim
check-in at any time during the grant term, shall be directed to the respective
grant manager or representative of the California State Library or Grantee. For
this purpose, the following contact information is provided below:
Azusa City Library
Leila Hassen
729 N Dalton Ave
Azusa, CA 91702
626-812-5279
lhassen@azusaca.gov
California State Library
Lisa Lindsay
900 N Street
Sacramento, CA 95814
916.603.6708
lisa.lindsay@library.ca.gov
1. Confidentiality: Grantee will maintain as confidential any material it receives or
produces that is marked Confidential or is inherently confidential or is protected
by privilege. Grantee agrees to alert the State Library to this status in advance,
and State Library agrees to maintain this status in conformity with the Public
Records Act.
2. Contractor and Subcontractors: Nothing contained in this Grant Agreement or
otherwise shall create any contractual relation between the State and any
contractor or subcontractors, and no contract or subcontract shall relieve the
Grantee of his or her responsibilities and obligations hereunder. The Grantee
agrees to be as fully responsible to the State for the acts and omissions of its
contractors, subcontractors, volunteers, student interns and of persons either
directly or indirectly employed by any of them as it is for the acts and omissions
of persons directly employed by the Grantee. The Grantee’s obligation to pay its
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contractors and subcontractors is an independent obligation from the State’s
obligation to make payments to the Grantee. As a result, the State shall have no
obligation to pay or to enforce the payment of any monies to any contractor or
subcontractor.
3. Copyright: Grantee owns and retains titles to any copyrights or copyrightable
material from any original works that it creates within the scope of this
Agreement in accordance with the federal Copyright Act. (17 U.S.C. 101, et
seq.) Grantee is responsible for obtaining any necessary licenses, permissions,
releases or authorizations to use text, images, or other materials owned,
copyrighted, or trademarked by third parties and for extending such licenses,
permissions, releases, or authorizations to the California State Library pursuant to
this section. Also, the California State Library may upload, post or transmit
copyrighted material produced or purchased with grant funds on a California
State Library website for public access and viewing.
4. Discharge of Grant Obligations: The Grantee's obligations under this Agreement
shall be deemed discharged only upon acceptance of the final report by
California State Library. If the Grantee is a non-profit entity, the Grantee’s Board
of Directors shall accept and certify as accurate the final report prior to its
submission to California State Library.
5. Dispute Resolution: In the event of a dispute, Grantee will discuss the problem
informally with the Grant Monitor. If unresolved, the Grantee shall file a written
“Notice of Dispute” with the State Library Grant Monitor within ten (10) days of
discovery of the problem. Within ten (10) days of receipt, the Grant Monitor shall
meet with the Grantee for purposes of resolving the dispute. Any dispute arising
under the terms of this Agreement which is not disposed of within a reasonable
period of time, the Grantee may bring it to the attention of the State Librarian or
the designated representative. The decision of the State Librarian or designated
representative shall be final. Unless otherwise instructed by the Grant Monitor,
the Grantee shall continue with its responsibilities under this Agreement during
any dispute.
6. Drug-free Workplace: The Grantee certifies under penalty of perjury under the
laws of California, that the Grantee will comply with the requirements of the
Drug-Free Workplace Act of 1990 (Gov. Code, § 8350 et. seq.) and will provide a
drug-free workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled substance is
prohibited and specifying actions to be taken against employees for
violations.
b. Establish a Drug-Free Awareness Program to inform employees about all of
the following:
1) The dangers of drug abuse in the workplace.
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2) The Grantee’s policy of maintaining a drug-free workplace;
3) Any available counseling, rehabilitation and employee assistance
programs.
4) Penalties that may be imposed upon employees for drug abuse
violations.
c. Require that every employee who works on the Agreement will:
1) Receive a copy of the Grantee’s drug-free workplace policy
statement.
2) Agrees to abide by the terms of the Grantee’s statement as a
condition of employment on the Agreement.
Failure to comply with these requirements may result in suspension of payments
under the Agreement or termination of the Agreement or both and grantee may
be ineligible for award of any future state agreements if the California State
Library determines that the grantee has made a false certification or violated the
certification by failing to carry out the requirements as noted above.
7. Effectiveness of Agreement: This Agreement is of no force or effect until signed
by both parties.
8. Entire Agreement: This Agreement supersedes all prior agreements, oral or
written, made with respect to the subject hereof and, together with all
attachments hereto, contains the entire agreement of the parties.
9. Exclusive Agreement: This is the entire Agreement between the California State
Library and Grantee.
10. Executive Order N-6-22-Russia Sanctions: The Grantee shall comply with
Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia
and Russian entities and individuals. “Economic Sanctions” refers to sanctions
imposed by the U.S. government in response to Russia’s actions in Ukraine, as well
as any sanctions imposed under state law. The EO directs state agencies to
terminate grant agreements with, and to refrain from entering any new grant
agreements with, individuals or entities that are determined to be a target of
Economic Sanctions. Accordingly, should the State determine Grantee is a
target of Economic Sanctions or is conducting prohibited transactions with
sanctioned individuals or entities, that shall be grounds for termination of this
agreement. The State shall provide Grantee advance written notice of such
termination, allowing Grantee at least 30 calendar days to provide a written
response. Termination shall be at the sole discretion of the State.
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
Lunch at the Library Summer 2024 Opportunity. If the Grant Monitor determines
the Grantee has not complied with this Agreement, the Grantee may forfeit the
right to reimbursement of any grant funds not already paid by the California
State Library, including, but not limited to, the ten percent (10%) withhold.
13. Federal and State Taxes: The State Library shall not:
a. Withhold Federal Insurance Contributions Act (FICA) payments from
Grantee’s payments or make FICA payments on the Grantee’s behalf;
or
b. Make Federal or State unemployment insurance contributions on
Grantee’s behalf; or
c. Withhold Federal or State income taxes from Grantee’s payments
Grantee shall pay all taxes required on payments made under this Agreement
including applicable income taxes and FICA.
14. Force Majeure: Neither the California State Library nor the Grantee, its
contractors, vendors, or subcontractors, if any, shall be responsible hereunder for
any delay, default, or nonperformance of this Agreement, to the extent that
such delay, default, or nonperformance is caused by an act of God, weather,
accident, labor strike, fire, explosion, riot, war, rebellion, sabotage, flood, or other
contingencies unforeseen by the California State Library or the Grantee, its
contractors, vendors, or subcontractors, and beyond the reasonable control of
such party.
15. Forfeit of Grant Funds and Repayment of Funds Improperly Expended: If grant
funds are not expended, or have not been expended, in accordance with this
Agreement, the State Librarian or designee, at his or her sole discretion, may
take appropriate action under this Agreement, at law or in equity, including
requiring the Grantee to forfeit the unexpended portion of the grant funds,
including, but not limited to, the ten percent (10%) withhold, and/or to repay to
the California State Library any funds improperly expended.
16. Fringe Benefit Ineligibility: Grantee agrees that neither the Grantee nor its
employees and contract personnel are eligible to participate in any employee
pension, health benefit, vacation pay, sick pay or other fringe benefit plan of the
State of California or the State Library.
17. Generally Accepted Accounting 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 will make reports to the State Librarian in such form and
containing such information as may be required to ensure the proper
used of funds consistent with the grantee’s application and award
agreement. The grantee will keep such records and afford such access as
the California State Library may find necessary to assure the correctness
and verification of such reports.
20. Grantee Accountability: The Grantee is ultimately responsible and accountable
for the manner in which the grant funds are utilized and accounted for and the
way the grant is administered, even if the Grantee has contracted with another
organization, public or private, to administer or operate its grant program. In the
event an audit should determine that grant funds are owed to the California
State Library, the Grantee is responsible for repayment of the funds to the
California State Library.
21. Grantee Funds: It is mutually agreed that the Grantee is responsible for furnishing
funds beyond the grant award that may be necessary to complete the project.
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 fulfilling obligations under this Agreement. Grantee shall furnish
all equipment and materials used to meet its obligations, and complete the
Project. The State Library shall not provide any personnel or other resources
beyond the grant award, and is not required to provide training in connection
with this Agreement.
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 supplies in
connection with the performance of this Agreement, and from any and all
claims and losses accruing or resulting to any person, firm or corporation who
may be injured or damaged by Grantee in the performance of this Agreement.
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24. License to Use: The California State Library reserves a fully paid-up, royalty-free,
nonexclusive, sub-licensable and irrevocable license to reproduce, publish,
prepare derivative works, distribute or otherwise use, and to authorize third
parties to use, any material received or maintained by Grantee in connection
with this Agreement. This includes intellectual property, with or without third-
party rights. All such usages will be for public library and State governmental
purposes:
a. The copyright in any work developed under this grant, sub-grant, or
contract under this grant or sub-grant; and
b. Any rights of copyright to which a Grantee, sub-grantee, or a contractor
purchases ownership with grant support.
25. Limitation of Expenditure: Expenditure for all projects must conform to the
grantee’s approved budget and with applicable State laws and regulations. The
total amount paid by the California State Library to the Grantee under this
agreement shall not exceed $28,458 and shall be expended/encumbered in the
designated award period.
During the award period, the grantee may find that the awarded budget may
need to be modified. Budget changes, requests for additional funds, or requests
for reductions in award funding must be discussed with the assigned State Library
Grant Monitor and a Grant Award Modification may be required to be
submitted according to the instructions. Approval is by the State Librarian or their
designee. Adjustments should be reported on the next financial report. Any
adjustments in approved budgets must be documented and documentation
retained in project accounts.
26. Lobbying: Grantee confirms that the grant funds will not be used for the
purposes of lobbying or otherwise attempting to influence legislation, as those
purposes are defined by the U.S. Internal Revenue Code of 1986.
27. Non-Discrimination Clause: During this grant period, the Grantee and the
Grantee’s contractors, and subcontractors shall not unlawfully discriminate,
harass, or allow harassment against any employee or applicant for employment
because of race, religious creed, color, national origin, ancestry, physical
disability, mental disability, medical condition, genetic information, marital status,
sex, age, sexual orientation, or military and veteran status. Grantee shall insure
that the evaluation and treatment of contractors, employees and applicants for
employment are free from such discrimination and harassment.
Additionally, Grantee, contractors, and subcontractors, if applicable, shall
comply with the provisions of the Fair Employment and Housing Act (Gov. Code
§12900 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2,
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§11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of
the Government Code (Gov. Code §§ 11135-11139.5), and the regulations or
standards adopted by the California State Library to implement such article.
Grantee shall permit access by representatives of the Department of Civil Rights
and the California State Library upon reasonable notice at any time during the
normal business hours, but in no case less than 24 hours’ notice, to such of its
books, records, accounts, and all other sources of information and its facilities as
said Department or the California State Library shall require ascertaining
compliance with this clause. Grantee, and its contractors, and subcontractors
shall give written notice of their obligations under this clause to labor
organizations with which they have a collective bargaining or other agreement.
(See Cal. Code Regs., tit. 2, §11105.) Grantee shall include the non-
discrimination and compliance provisions of this clause in all contracts and
subcontracts to perform work under the Agreement.
28. Notices: All notices and other communications in connection with this
Agreement shall be in writing, and shall be considered delivered as follows:
a. Electronic Mail (E-mail): When sent by e-mail to the last e-mail address
of the recipient known to the party giving notice. Notice is effective
upon transmission.
b. DocuSign (e-signature platform): When sent via DocuSign a notification
will be sent to the last e-mail address of the recipient known to the party
giving notice. Notice is effective upon transmission.
c. Grants Management System: When sent via / uploaded to the California
State Library’s Grants Management System a notification will be sent to
the last e-mail address of the recipient known to the party giving notice.
Notice is effective upon transmission.
d. Personally: When delivered personally to the recipient’s physical address
as stated in this Agreement.
e. U.S. Mail: Five days after being deposited in the U.S. Mail, postage
prepaid, and addressed to recipient’s address as stated in this
Agreement.
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 thereto
b. Terms and Conditions
c. Procedures and Requirements
d. Certificate of Compliance
e. Project Summary
f. Grantee’s Application (including Budget and Activities Timeline)
g. All other attachments hereto, including any that are incorporated by
reference.
30. Payment:
a. The approved Budget, if applicable, is attached hereto and incorporated
herein by this reference and states the maximum amount of allowable
costs for each of the tasks identified in the Project Summary and Activity
Timeline included in the project application. California State Library shall
provide funding to the Grantee for only the work and tasks specified in the
Grantee’s Application at only those costs specified in the Budget and
incurred in the term of the Agreement.
b. The Grantee shall carry out the work described in the Work Plan or in the
Grantee’s Application in accordance with the approved Budget and
shall obtain the Grant Monitor’s written approval of any changes or
modifications to the Work Plan, approved project as described in the
Grantee’s Application, or the approved Budget prior to performing the
changed work or incurring the changed cost. If the Grantee fails to obtain
such prior written approval, the State Librarian or designee, at his or her
sole discretion, may refuse to provide funds to pay for such work or costs.
c. The Grantee shall request funds in accordance with the funding schedule
included in this agreement.
d. Ten percent (10%) will be withheld from the Payment Request (if
applicable) and paid at the end of the grant term, when all reports and
conditions stipulated in this Agreement have been satisfactorily
completed. Failure by the grantee to satisfactorily complete all reports
and conditions stipulated in this Agreement may result in forfeiture of any
such funds withheld.
e. Lodgings, Meals and Incidentals: Grantee’s eligible costs are limited to the
amounts authorized in the California State Administrative Manual (see
Exhibit C or contact the Grant Monitor for more information).
f. Payment will be made only to the Grantee.
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g. Reimbursable 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 all proceedings concerning the validity and operation of this
Agreement and the performance of the obligations imposed upon the parties.
Native American Tribal grantees expressly waive tribal sovereign immunity as a
defense to any and all proceedings concerning the validity and operation of this
Agreement and the performance of the obligations imposed upon the parties.
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
regular job duties, including a proportionate share of any benefits to which the
employee is entitled.
33. Pledge: This Agreement shall not be interpreted to create any pledge or any
commitment by the State Library to make any other or further grants or
contributions to Grantee, or any other person or entity in connection with the
Project. It is mutually agreed that Grantee is responsible for furnishing funds
beyond the grant award that may be necessary to complete outcomes or
deliverables.
34. Privacy Protection: Both parties agree to protect the confidentiality of any non-
public, personal information that may be contained in materials received or
produced in connection with this Agreement, as required by Civil Code, section
1798, et. seq.
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. Public Records Act: Material maintained or used by the California State Library is
considered “public record” under the Public Records Act (PRA) at Government
Code, sections 6250, et. seq. This includes the Interim and Final reports, and any
other written communications between the parties. Grantee agrees to ensure
that all content contained in its written reports are appropriate for publication.
Said material, along with all other reports, documentation and data collected
during the term of the Agreement, will be subject to disclosure unless it qualifies
for exemption under the PRA in whole or in part. Grantee agrees to alert the
State Library as to a basis for exemption, if any exists.
37. Publicity Obligations: Grantee will notify the State Library of any promotional
materials or publications resulting from the grant no later than five (5) days in
advance of distribution, whether they are print, film, electronic, or in any other
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format or medium. Copies of all promotional materials will be provided to the
State Library. Grantee will acknowledge the State Library’s support as noted
above. Grantee agrees that the State Library may include information about
this grant and its outcomes in its own annual reports, with specific reference to
Grantee, and may distribute such information to third parties.
38. Records: Communications, grant related documents, data, original receipts,
and invoices must be maintained by Grantee and shall be made available to
the State Library upon request. Grantee agrees to maintain adequate grant
program records and adequate financial records consistent with generally
accepted accounting practices, and to retain all records for at least five (5)
years after the end-of-term. The State Library may monitor or conduct an onsite
evaluation of Grantee’s operation to ensure compliance with this Agreement,
with reasonable advance notice.
39. Reduction of Waste: In the performance of this Agreement, Grantee shall take
all reasonable steps to ensure that materials purchased or utilized in the course
of the project are not wasted. Steps should include, but not be limited to: the use
of used, reusable, or recyclable products; discretion in the amount of materials
used; alternatives to disposal of materials consumed; and the practice of other
waste reduction measures where feasible and appropriate.
40. Reimbursement Limitations: Under no circumstances shall the Grantee seek
reimbursement pursuant to this Agreement for a cost or activity that has been or
will be paid for through another funding source. The Grantee shall not seek
reimbursement for any costs used to meet cost sharing or matching requirements
of any other California State Library funded program.
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 reporting 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 Library agrees to
reimburse the Library as soon thereafter as State fiscal procedures will
permit.
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d. The final 10% of the grant award (if applicable) is payable only upon
approval of all final reports and receipt of claim form. Failure to provide
timely reports is a serious breach of an award recipient’s administrative
duty under the award.
e. Payment will be provided to cover the expenditures incurred by the
grantee for the project in the following manner:
o $12,806 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 reports and receipt of claim form in the amount of
$12,806
o If applicable, final payment will be made upon approval of all final
reports and receipt of claim form in the amount of $2,846.
42. Self-Dealing and Arm’s Length Transactions: All expenditures for which
reimbursement pursuant to this Agreement is sought shall be the result of arm’s-
length transactions and not the result of, or motivated by, self-dealing on the
part of the Grantee or any employee or agent of the Grantee. For purposes of
this provision, “arm’s-length transactions” are those in which both parties are on
equal footing and fair market forces are at play, such as when multiple vendors
are invited to compete for an entity’s business and the entity chooses the lowest
of the resulting bids. “Self-dealing” is involved where an individual or entity is
obligated to act as a trustee or fiduciary, as when handling public funds, and
chooses to act in a manner that will benefit the individual or entity, directly or
indirectly, to the detriment of, and in conflict with, the public purpose for which
all grant monies are to be expended.
43. Severability: If any part of this Agreement is found to be unlawful or
unenforceable, such provisions will be voided and severed from this Agreement,
but the remainder of the provisions in the Agreement will remain in full force and
effect.
44. Site Visits: The Grantee shall allow the California State Library to access and
conduct site visits, with reasonable notice, at which grant funds are expended
and related work being performed at any time during the performance of the
work and for up to ninety (90) days after completion of the work, or until all issues
related to the grant project have been resolved. A site visit may include, but not
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 thirty (30) days prior to
the effective date of termination. In the event this agreement is terminated, the
Grantee shall deliver to the State Librarian copies of all reports, accounting,
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data, and materials prepared up to the date of termination. The State Librarian
shall determine and pay the Grantee for necessary and appropriate
expenditures and obligations up to the date of termination which have not been
covered by prior installments previously paid to the Grantee. Upon such
termination, the unused portion of the grant award must be returned to the
California State Library within 45 days. If funding has been advanced to the
Grantee, any unobligated balances, as determined by the State Librarian, shall
be returned to the State Library within 45 days of the notice of termination.
46. Timeline: Time is of the essence to this Agreement. It is mutually agreed
between the parties that the grant application and the timeline included therein
are part of the Agreement.
47. Unused Funds: At the end-of-term Grantee agrees to return any unexpended or
unaccounted for funds to the State Library, or to submit a written request for an
extension of the grant period. Funds will be considered unexpended or
unaccounted if they were: (1) not used for their intended purpose, or (2) used
inconsistent with the terms of this Agreement.
Funds will also be considered unaccounted for, and must be returned, if the
proposal outcomes or deliverables are materially incomplete by the end-of-term
or earlier termination, as determined by the State Library in its sole discretion.
48. Waiver of Rights: California State Library shall not be deemed to have waived
any rights under this Agreement unless such waiver is given in writing and signed
by California State Library. No delay or omission on the part of California State
Library in exercising any rights shall operate as a waiver of such right or any other
right. A waiver by California State Library of a provision of this Agreement shall
not prejudice or constitute a waiver of California State Library’s right otherwise to
demand strict compliance with that provision or any other provision of this
Agreement. No prior waiver by California State Library, nor any course of
dealing between California State Library and Grantee, shall constitute a waiver
of any of California State Library’s rights or of any of grantee’s obligations as to
any future transactions. Whenever the consent of California State Library is
required under this Agreement, the granting of such consent by California State
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
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provide the State Library with copies of all public education and advertising
material produced pursuant to this Agreement.
50. Worker’s Compensation: The State of California will not provide Workers’
Compensation insurance for Grantee or Grantee’s employees or contract
personnel. If Grantee hires employees to perform services required by this
Agreement, Grantee shall provide Workers’ Compensation insurance for them.
The Grantee is aware of Labor Code Section 3700, which requires every
employer to be insured against liability for Workers’ Compensation or to
undertake self-insurance in accordance with the Labor Code, and the Grantee
agrees to comply with such provisions before commencing the performance of
the work of this Agreement.
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EXHIBIT B: CERTIFICATION of COMPLIANCE FORM
1. AUTHORIZED REPRESENTATIVE: I certify that the authorized representative named
below is the legally designated representative of the Grantee for this Grant
Agreement and project and is authorized to receive and expend funds in order
to administer this grant program.
2. I certify that all information provided to the California State Library for review in
association with this award is correct and complete to the best of my
knowledge, and as the authorized representative of the Grantee, I commit to
the conditions of this award, and I have the legal authority to do so.
3. I certify that any or all other participants or contractors in the grant program
have agreed to the terms of the application/grant award and have entered into
an agreement(s) concerning the final disposition of equipment, facilities, and
materials purchased for this program from the funds awarded for the activities
and services described in the attached, as approved and/or as amended in the
application by the California State Librarian.
4. The authorized representative, on behalf of the Grantee, certifies that the
Grantee will comply with all applicable requirements of State and Federal laws,
regulations, and policies governing this program, to include the requirements
listed below in this Certification of Compliance Form.
5. The authorized representative, on behalf of the Grantee, hereby certifies to the
California State Library, for an award of funds in the amount $28,458. This award
will provide library services as set forth in the Project Application as approved
and/or as amended by the California State Librarian.
6. STATEMENT OF COMPLIANCE: Grantee has, unless exempted, complied with the
non-discrimination program requirements. (Gov. Code §12990 (a-f) and CCR,
Title 2, Section 11102).
7. DRUG-FREE WORKPLACE REQUIREMENTS: Grantee will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-
free workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled substance is
prohibited and specifying actions to be taken against employees for
violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
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1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free
workplace;
3) any available counseling, rehabilitation and employee assistance
programs; and,
4) penalties that may be imposed upon employees for drug abuse
violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy
statement; and,
2) agree to abide by the terms of the company's statement as a
condition of employment on the Agreement.
Failure to comply with these requirements may result in suspension of payments
under the Agreement or termination of the Agreement or both and Grantee
may be ineligible for award of any future State agreements if the department
determines that any of the following has occurred: the Grantee has made false
certification or violated the certification by failing to carry out the requirements
as noted above. (Gov. Code § 8350 et. seq.)
8. CONFLICT OF INTEREST: Grantee needs to be aware of the following provisions
regarding current or former state employees. If Grantee has any questions on
the status of any person rendering services or involved with the Agreement, the
California State Library must be contacted immediately for clarification.
Current State Employees (Pub. Contract Code § 10410):
a. No officer or employee shall engage in any employment, activity or
enterprise from which the officer or employee receives compensation or
has a financial interest, and which is sponsored or funded by any state
agency, unless the employment, activity or enterprise is required as a
condition of regular state employment.
b. No officer or employee shall contract on his or her own behalf as an
independent contractor with any state agency to provide goods or
services.
Former State Employees (Pub. Contract Code § 10411):
a. For the two-year period from the date he or she left state employment,
no former state officer or employee may enter into a contract in which he
or she engaged in any of the negotiations, transactions, planning,
arrangements or any part of the decision-making process relevant to the
contract while employed in any capacity by any state agency.
b. For the twelve-month period from the date he or she left state
employment, no former state officer or employee may enter into a
contract with any state agency if he or she was employed by that state
agency in a policy-making position in the same general subject area as
the proposed contract within the 12-month period prior to his or her
leaving state service.
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If Grantee violates any provisions of above paragraphs, such action by Grantee
shall render this Agreement void. (Pub. Contract Code § 10420).
Members of boards and commissions are exempt from this section if they do not
receive payment other than payment of each meeting of the board or
commission, payment for preparatory time and payment for per diem. (Pub.
Contract Code § 10430 (e)).
9. LABOR CODE/WORKERS' COMPENSATION: Grantee needs to be aware of the
provisions which require every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions,
and Grantee affirms to comply with such provisions before commencing the
performance of the work of this Agreement. (Labor Code § 3700).
10. AMERICANS WITH DISABILITIES ACT: Grantee assures the State that it complies
with the Americans with Disabilities Act (ADA) of 1990, which prohibits
discrimination on the basis of disability, as well as all applicable regulations and
guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et. seq.)
11. RESOLUTION: 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)). In particular, the recipient must comply with drug-
free workplace requirements in subpart B of 2 C.F.R. part 3186, which
adopts the Government-wide implementation (2 C.F.R. part 182) of
sections 5152-5158 of the Drug-Free Workplace Act of 1988 (P. L. 100-690,
Title V, Subtitle D; 41 U.S.C. §§ 701-707).
b. This includes but is not limited to: making a good faith effort, on a
continuing basis, to maintain a drug-free workplace; publishing a drug-
free workplace statement; establishing a drug-free awareness program
for the employees; taking actions concerning employees who are
convicted of violating drug statutes in the workplace.
14. ACCESSIBILITY: The organization receiving this award, as listed in the certification
section below, and all program staff, will ensure all project materials will meet
California accessibility standards.
15. NON-DISCRIMINATION: The organization receiving this award, as listed in the
certification section below, and all program staff, agree to comply with all
California non-discrimination laws.
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
Azusa City Library
Lunch at the Library Summer 2024
2023-2024 LATL23-06A
Page 25 of 30
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.
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
Azusa City Library
Lunch at the Library Summer 2024
2023-2024 LATL23-06A
Page 26 of 30
Certification
ORGANIZATION
Name: Azusa City Library Address (official and complete): 729 N Dalton Ave,
Azusa, CA, 91702
PROJECT COORDINATOR
Name: Elizabeth Ram
Email: eram@azusaca.gov Phone: 626-812-5146
GRANTEE AUTHORIZED REPRESENTATIVE
Name: Leila Hassen Title: Library Services Manager
Email: lhassen@azusaca.gov Phone: 626-812-5279
Signature: Date:
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
2/1/2024
Azusa City Library
Lunch at the Library Summer 2024
2023-2024 LATL23-06A
Page 27 of 30
Authorized Representative Signature
ORGANIZATION
Name: Azusa City Library Address (official and complete): 729 N Dalton Ave,
Azusa, CA, 91702
AUTHORIZED REPRESENTATIVE
Signature: Date:
Printed Name of Person Signing: Leila
Hassen
Title: Library Services Manager
STATE OF CALIFORNIA
Agency Name: California State Library Address: 900 N Street, Sacramento, CA 95814
Signature: Date:
Printed Name of Person Signing: Greg
Lucas
Title: California State Librarian
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
2/1/2024
2/1/2024
Azusa City Library
Lunch at the Library Summer 2024
2023-2024 LATL23-06A
Page 28 of 30
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.gov/employees/pages/travel-reimbursements.aspx
Mileage:
Rate subject to change
$0.67 per mile – approved business/travel expense
Meals:
Receipts are required
$7.00 – Breakfast
$11.00 – Lunch
$23.00 – Dinner
$5.00 - Incidentals
Meals Note: Lunch can only be claimed if travel is more than 24 hours. Incidental
charge may be claimed once for every 24-hour period and should cover incidental
expenses, such as but not limited to, tip, baggage handling, etc.
Hotel:
Receipts are required
and MUST have a zero
balance.
$ 90.00 plus tax for all counties/cities not listed below
$ 95.00 plus tax for Napa, Riverside, and Sacramento
Counties
$ 110.00 plus tax for Marin County
$ 120.00 plus tax for Los Angeles, Orange, and Ventura
Counties, and Edwards AFB. Excluding the city of Santa
Monica
$ 125.00 plus tax for Monterey and San Diego Counties
$ 140.00 plus tax for Alameda, San Mateo and Santa
Clara Counties
$ 150.00 plus tax for the City of Santa Monica
$ 250.00 plus tax for San Francisco County
Out of State: Prior authorization must be obtained, as well
as three print-out hotel quotes. Actual receipt must be
included with authorization and additional quotes.
Hotel Note: If the above approved reimbursable hotel rates cannot be secured, please
contact your grant monitor to obtain an excess lodging form. This form must be
approved prior to actual travel.
AIRLINE TICKETS:
Itinerary and receipts are
required
Actual reasonable fees pertaining to airline travel will be
reimbursed. Business, First Class, or Early Bird Check-in fee
is not an approved reimbursable expense.
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
April 25, 2022
RE: Contractor and Grantee Compliance with Economic Sanctions Imposed in
Response to Russia’s Actions in Ukraine
Dear Grantee,
You are receiving this notification because you currently have an active grant through the California
State Library.
On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding
sanctions in response to Russian aggression in Ukraine. The EO is located at
https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf.
The EO directs all agencies and departments that are subject to the Governor’s authority to take
certain immediate steps, including notifying all contractors and grantees of their obligations to
comply with existing economic sanctions imposed by the U.S. government in response to Russia's
actions in Ukraine, as well as any sanctions imposed under state law.
This correspondence serves as a notice under the EO that as a contractor or grantee, compliance
with the economic sanctions imposed in response to Russia’s actions in Ukraine is required,
including with respect to, but not limited to, the federal executive orders identified in the EO and the
sanctions identified on the U.S. Department of the Treasury website
(https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-
information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of
contracts or grants, as applicable.
Please note that for any agreements or grants valued at $5 million or more, a separate notification
will be sent outlining additional requirements specified under the EO.
Annly Roman
California State Library
900 N Street
Sacramento, CA 95814
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
LUNCH AT THE LIBRARY PROGRAM
FINANCIAL CLAIM
1st PAYMENT
CERTIFICATION
I hereby certify under penalty of perjury: that I am the duly authorized representative of the claimant herein;
that this claim is in all respects true, correct and in accordance with law and the terms of the agreement; and
that payment has not previously been received for the amount claimed herein.
By
(Signature of the Authorized Representative)
(Print Name) (Title)
*Legal payee name must match the payee’s federal tax return. Warrant will be made payable to payee name. Payee
discrepancies in name and/or address may cause delay in payment . If you need to change payee name and/or address,
please contact Fiscal Services at stategrants.fiscal@library.ca.gov.
State of California, State Library Fiscal Office
ENY: 2023 ITEM NO: 6120-140-0001, Chapter 12, Statutes of 2023
PURCHASING AUTHORITY NUMBER: CSL-6120 REPORTING STRUCTURE: 61202000
COA: 5432000 PROGRAM #: 5312
FAIN: N/A
By Date
(State Library Representative)
Grant Award #: LATL23-06A Date:
Invoice #:
LATL23-06A-001 PO #:
7166
Payee Name: Azusa City Library
(Legal name of authorized agency to receive, disburse and account for funds *)
Complete Address:
Street Address, City, State, Zip Code (Warrant will be mailed to this address)
Amount Claimed: $12,806 Type of Payment:
(Payable Upon Execution of Agreement) ☒ PROGRESS
Grantee Name: Azusa City Library ☐ FINAL
(Name on Award Letter and Agreement) ☐ IN FULL
Project Title: Lunch at the Library Summer 2024 ☐ AUGMENT
For Period From: upon execution to end of grant period
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
City Librarian
729 North Dalton Avenue, Azusa, CA 91702
Leila Hassen
2/1/2024
2/6/2024
STATE OF CALIFORNIA – DEPARTMENT OF FINANCE PAYEE DATA RECORD
(Required when receiving payment from the State of California in lieu of IRS W-9 or W-7)
STD 204 (Rev. 03/2021)
Section 1 – Payee Information
NAME (This is required. Do not leave this line blank. Must match the payee’s federal tax return)
BUSINESS NAME, DBA NAME or DISREGARDED SINGLE MEMBER LLC NAME (If different from above)
MAILING ADDRESS (number, street, apt. or suite no.) (See instructions on Page 2)
CITY, STATE, ZIP CODE E-MAIL ADDRESS
Section 2 – Entity Type
Check one (1) box only that matches the entity type of the Payee listed in Section 1 above. (See instructions on page 2)
CORPORATION (see instructions on page 2)☐ SOLE PROPRIETOR / INDIVIDUAL
☐ MEDICAL (e.g., dentistry, chiropractic, etc.)☐ SINGLE MEMBER LLC Disregarded Entity owned by an individual
☐ PARTNERSHIP
☐ ESTATE OR TRUST
☐ LEGAL (e.g., attorney services)
☐ EXEMPT (e.g., nonprofit)
☐ ALL OTHERS
Section 3 – Tax Identification Number
Enter your Tax Identification Number (TIN) in the appropriate box. The TIN must
match the name given in Section 1 of this form. Do not provide more than one (1) TIN.
The TIN is a 9-digit number. Note: Payment will not be processed without a TIN.
•
•
•
•
•
•
For Individuals, enter SSN.
If you are a Resident Alien, and you do not have and are not eligible to get an
SSN, enter your ITIN.
Grantor Trusts (such as a Revocable Living Trust while the grantors are alive) may
not have a separate FEIN. Those trusts must enter the individual grantor’s SSN.
For Sole Proprietor or Single Member LLC (disregarded entity), in which the
sole member is an individual, enter SSN (ITIN if applicable) or FEIN (FTB
prefers SSN).
For Single Member LLC (disregarded entity), in which the sole member is a
business entity, enter the owner entity’s FEIN. Do not use the disregarded
entity’s FEIN.
For all other entities including LLC that is taxed as a corporation or partnership,
estates/trusts (with FEINs), enter the entity’s FEIN.
Social Security Number (SSN) or
Individual Tax Identification Number (ITIN)
___ ___ ___ -___ ___ -___ ___ ___ ___
OR
Federal Employer Identification Number
(FEIN)
___ ___ -___ ___ ___ ___ ___ ___ ___
Section 4 – Payee Residency Status (See instructions)
☐ CALIFORNIA RESIDENT – Qualified to do business in California or maintains a permanent place of business in California.
☐ CALIFORNIA NONRESIDENT – Payments to nonresidents for services may be subject to state income tax withholding.
☐No services performed in California
☐Copy of Franchise Tax Board waiver of state withholding is attached.
Section 5 – Certification
I hereby certify under penalty of perjury that the information provided on this document is true and correct.
Should my residency status change, I will promptly notify the state agency below.
NAME OF AUTHORIZED PAYEE REPRESENTATIVE TITLE E-MAIL ADDRESS
SIGNATURE DATE TELEPHONE (include area code)
Section 6 – Paying State Agency
Please return completed form to:
STATE AGENCY/DEPARTMENT OFFICE UNIT/SECTION
MAILING ADDRESS FAX TELEPHONE (include area code)
CITY STATE ZIP CODE E-MAIL ADDRESS
Print Form Reset FormDocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9
95814
accounting@library.ca.gov
Sacramento CA
CA State Library
916-603-7157
900 N Street
Accounting
STATE OF CALIFORNIA – DEPARTMENT OF FINANCE PAYEE DATA RECORD
(Required when receiving payment from the State of California in lieu of IRS W-9 or W-7)
STD 204 (Rev. 03/2021)
GENERAL INSTRUCTIONS
Type or print the information on the Payee Data Record, STD 204 form. Sign, date, and return to the state agency/department office address shown in Section 6.
Prompt return of this fully completed form will prevent delays when processing payments.
Information provided in this form will be used by California state agencies/departments to prepare Information Returns (Form1099).
NOTE: Completion of this form is optional for Government entities, i.e. federal, state, local, and special districts.
A completed Payee Data Record, STD 204 form, is required for all payees (non-governmental entities or individuals) entering into a transaction that may lead to a
payment from the state. Each state agency requires a completed, signed, and dated STD 204 on file; therefore, it is possible for you to receive this form from
multiple state agencies with which you do business.
Payees who do not wish to complete the STD 204 may elect not to do business with the state. If the payee does not complete the STD 204 and the required
payee data is not otherwise provided, payment may be reduced for federal and state backup withholding. Amounts reported on Information Returns (Form 1099)
are in accordance with the Internal Revenue Code (IRC) and the California Revenue and Taxation Code (R&TC).
Section 1 – Payee Information
Name – Enter the name that appears on the payee's federal tax return. The name provided shall be the tax liable party and is subject to IRS TIN matching (when
applicable).
• Sole Proprietor/Individual/Revocable Trusts – enter the name shown on your federal tax return.
• Single Member Limited Liability Companies (LLCs) that is disregarded as an entity separate from its owner for federal tax purposes - enter the name of the
individual or business entity that is tax liable for the business in section 1. Enter the DBA, LLC name, trade, or fictitious name under Business Name.
• Note: for the State of California tax purposes, a Single Member LLC is not disregarded from its owner, even if they may be disregarded at the Federal level.
• Partnerships, Estates/Trusts, or Corporations – enter the entity name as shown on the entity’s federal tax return. The name provided in Section 1 must match
to the TIN provided in section 3. Enter any DBA, trade, or fictitious business names under Business Name.
Business Name – Enter the business name, DBA name, trade or fictitious name, or disregarded LLC name.
Mailing Address – The mailing address is the address where the payee will receive information returns. Use form STD 205, Payee Data Record Supplement
to provide a remittance address if different from the mailing address for information returns, or make subsequent changes to the remittance address.
Section 2 – Entity Type
If the Payee in Section 1 is a(n)… THEN Select the Box for…
Individual ● Sole Proprietorship ● Grantor (Revocable Living) Trust disregarded for federal tax purposes Sole Proprietor/Individual
Limited Liability Company (LLC) owned by an individual and is disregarded for federal tax purposes Single Member LLC-owned by an individual
Partnerships ● Limited Liability Partnerships (LLP) ● and, LLC treated as a Partnership Partnerships
Estate ● Trust (other than disregarded Grantor Trust) Estate or Trust
Corporation that is medical in nature (e.g., medical and healthcare services, physician care, nursery
care, dentistry, etc. ● LLC that is to be taxed like a Corporation and is medical in nature
Corporation-Medical
Corporation that is legal in nature (e.g., services of attorneys, arbitrators, notary publics involving legal
or law related matters, etc.) ● LLC that is to be taxed like a Corporation and is legal in nature
Corporation-Legal
Corporation that qualifies for an Exempt status, including 501(c) 3 and domestic non-profit corporations. Corporation-Exempt
Corporation that does not meet the qualifications of any of the other corporation types listed above ● LLC
that is to be taxed as a Corporation and does not meet any of the other corporation types listed above
Corporation-All Other
Section 3 – Tax Identification Number
The State of California requires that all parties entering into business transactions that may lead to payment(s) from the state provide their Taxpayer
Identification Number (TIN). The TIN is required by R&TC sections 18646 and 18661 to facilitate tax compliance enforcement activities and preparation of
Form 1099 and other information returns as required by the IRC section 6109(a) and R&TC section 18662 and its regulations.
Section 4 – Payee Residency Status
Are you a California resident or nonresident?
• A corporation will be defined as a "resident" if it has a permanent place of business in California or is qualified through the Secretary of State to do business in
California.
• A partnership is considered a resident partnership if it has a permanent place of business in California.
• An estate is a resident if the decedent was a California resident at time of death.
• A trust is a resident if at least one trustee is a California resident.
o For individuals and sole proprietors, the term "resident" includes every individual who is in California for other than a temporary or transitory purpose and
any individual domiciled in California who is absent for a temporary or transitory purpose. Generally, an individual who comes to California for a purpose
that will extend over a long or indefinite period will be considered a resident. However, an individual who comes to perform a particular contract of short
duration will be considered a nonresident.
For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below:
Withholding Services and Compliance Section: 1-888-792-4900 E-mail address: wscs.gen@ftb.ca.gov
For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb.ca.gov
Section 5 – Certification
Provide the name, title, email address, signature, and telephone number of individual completing this form and date completed. In the event that a SSN or ITIN is
provided, the individual identified as the tax liable party must certify the form. Note: the signee may differ from the tax liable party in this situation if the signee can
provide a power of attorney documented for the individual.
Section 6 – Paying State Agency
This section must be completed by the state agency/department requesting the STD 204.
Privacy Statement
Section 7(b) of the Privacy Act of 1974 (Public Law 93-579) requires that any federal, state, or local governmental agency, which requests an individual to
disclose their social security account number, shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory or other authority
such number is solicited, and what uses will be made of it. It is mandatory to furnish the information requested. Federal law requires that payment for which the
requested information is not provided is subject to federal backup withholding and state law imposes noncompliance penalties of up to $20,000. You have the
right to access records containing your personal information, such as your SSN. To exercise that right, please contact the business services unit or the
accounts payable unit of the state agency(ies) with which you transact that business.
All questions should be referred to the requesting state agency listed on the bottom front of this form.
DocuSign Envelope ID: B8CC1943-0E88-4921-AA61-242F3CC197B9