HomeMy WebLinkAboutE-11 Staff Report - CLLS Grant Acceptance FY 2425CONSENT ITEM
E-11
TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL
VIA: SERGIO GONZALEZ, CITY MANAGER
FROM: LEILA HASSEN, CITY LIBRARIAN
DATE: SEPTEMBER 16, 2024
SUBJECT: ACCEPTANCE OF ADULT AND FAMILY LITERACY GRANT FROM
CALIFORNIA LIBRARY LITERACY SERVICES (CLLS)
BACKGROUND:
The Azusa City Library has been awarded grants in the amount of $48,264 from California
Library Literacy Services (CLLS) for Adult Literacy instruction and Family Literacy materials and
programming. This action accepts the grant.
RECOMMENDATION:
Staff recommends that the City Council take the following action:
1)Accept the $48,264 in grant awards from California Library Literacy Services (CLLS) for
Fiscal Year 24/25.
ANALYSIS:
The Azusa City Library is the recipient of Adult and Family Literacy grants through California
Library Literacy Services (CLLS). These grants support Literacy tutoring for adults, family
programs, consultancy services, materials acquisition, and community events at the Library and
offsite locations in Azusa through June 2025. Adult Literacy programs funded through CLLS
include USCIS Citizenship classes, volunteer activities, and digital literacy workshops. Family
Literacy programs funded through CLLS include early learning storyhour, circulating materials
for youths, and commemorative cultural heritage events where multigenerational literacy skills are
promoted. The anticipated benefit of these activities includes an increase in educational
Approved
City Council
September 16, 2024
Acceptance of CLLS Grants
September 16, 2024
Page 2
opportunities for enrolled adult learners, career development, civic engagement, and early literacy
skills.
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 Literacy
programs at the Library and various locations in Azusa.
Prepared by: Reviewed 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
August 22, 2024
Leila Hassen
Azusa City Library
729 N. Dalton Ave
Azusa, CA 91702
Dear Ms. Hassen,
support your California Library Literacy Services program
and the important work that you, your staff, and your volunteers do in your community.
The state budget continues to provide $7.32 million in California Library Literacy Services
funding for Adult Literacy Services and Family Literacy Services.
Your total award amount for the 2024-2025 fiscal year beginning July 1, 2024, is:
Adult Literacy and Family Literacy Services: $48,264
Total Award: $48,264
CLLS programs with Family Literacy Services will receive one award total, referred to as a
-2025 program period. Your library is responsible for allocating
award funds between Adult Literacy Services and Family Literacy Services to respond to
community needs and for adhering to the following requirements:
At least 51 percent of the block grant award must be allocated to Adult Literacy
Services.
At least 26 percent of the block grant award must be allocated to Family Literacy
Services.
Programs who requested a fixed award for Family Literacy Services may adjust their
request by +/- 25 percent. Contact your state team for support.
The block grant model does not apply to English as a Second Language Services funds for
the 2024-2025 and 2025-2026 program periods.
Your award will be claimed in two stages. The claim form included in this award packet will
allow you to request the first 90% of your total award:
Total Initial Award Amount: $43,438
Information about claiming the rest of your award is included in the payment schedule at
the end of your award packet.
You must encumber your funds by June 30, 2025. You must fully expend funds by September
30, 2024, in accordance with your approved budget on file with the State Library.
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
Attachment 1
Library Courts Building 916-323-9759
P.O. Box 942837 csl-adm@library.ca.gov
Sacramento, CA 94237-0001 www.library.ca.gov
and for which a budget has been provided to and approved by the State Library.
Review the California Library Literacy Services Allowable and Unallowable Expenses
guidelines to ensure program expenditures are consistent with the California Library Literacy
Services allowable expenses. If you have questions about expenses or expending award
funds, contact Allyson Jeffredo at CLLS@library.ca.gov.
We strongly encourage your program staff to develop and maintain community partners to
strengthen your program, attend regular regional library literacy network meetings,
participate in your local Adult Education Consortium/a, and participate in library literacy
training opportunities offered by the regional networks and the State Library to meet the
California Library Literacy Services Mission, Values, and Program Essentials. Additional
California Library Literacy Services resources can be found on the California Library Literacy
Services website.
The payment process begins when we receive your completed and signed claim form,
certification form, and State Funded Grants Award Agreement and Certificate of
Compliance included in this packet. All forms should be completed and signed through
DocuSign to be processed for payment.
Our library literacy staff are available to assist you throughout the year. Contact your
Advisor Beverly Schwartzberg and your Grant Monitor Allyson Jeffredo at
CLLS@library.ca.gov with any questions.
Thank you for your willingness to do so much for those in your community. Best wishes for a
successful year.
Respectfully yours,
Greg Lucas
California State Librarian
Cc: Beverly Schwartzberg, beverly.schwartzberg@library.ca.gov
Allyson Jeffredo, allyson.jeffredo@library.ca.gov
State Library Fiscal Office, stategrants.fiscal@library.ca.gov
Regina Arnold, rsells-arnold@AzusaCa.gov
Enc: Re: CLLS24-05: Claim form, certification form, and State Funded Grants Award
Agreement and Certificate of Compliance
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Azusa City Library
THE BASICS YOUR GRANT AWARD
The following provides basic information about your grant and managing your grant.
Award #: CLLS24-05
Library: Azusa City Library
Total Award Amount: $48,264
APPROVED ALS BUDGET
Salary, Wages, and Benefits $35,714
Consultant Fees $ 0
Travel $ 0
Supplies & Materials $ 0
Equipment ($5,000 or more per unit) $ 0
Services $ 0
Subtotal $35,714
Indirect $ 0
Grant Total $35,714
APPROVED FLS BUDGET
Salary, Wages, and Benefits $ 0
Consultant Fees $ 0
Travel $ 0
Supplies & Materials $7,550
Equipment ($5,000 or more per unit) $ 0
Services $5,000
Subtotal $12,550
Indirect $ 0
Grant Total $12,550
Start Date: Upon execution
End Date: June 30, 2025
It can take between eight to ten weeks following the receipt of an error free
claim form before grant funds are delivered. If you have not received your
payment after eight weeks, please contact your grant monitor.
CONTACT
We want your project to be successful. Please work with the program staff listed below
to implement your project:
Literacy Analyst: Allyson Jeffredo
Phone Number: (916) 603-6709
Email Address: allyson.jeffredo@library.ca.gov
Library Programs Consultant: Beverly Schwartzberg
Phone Number: (916) 701-6880
Email Address: beverly.schwartzberg@library.ca.gov
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Azusa City Library
CERTIFICATION
I hereby certify under penalty of perjury: that I am the duly authorized
representative of the claimant herein; that the claim is in all respects
true, correct and in accordance with law and the terms of the
agreement; and that payment has not previously been received for the
amount claimed herein.
The claims the indicated allowance for the purposes of carrying out the
functions stated in its California Library Literacy Services application and
in Sections 18880-18883 of the California Education Code.
729 N. Dalton Ave, Azusa, CA 91702
SIGNED DATE
Signature - Authorized representative
Typed/Printed Name and Title of Authorized Representative
Email address of authorized representative
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9/3/2024
lhassen@AzusaCa.gov
Leila Hassen City Librarian
Azusa City Library
PROJECT INFORMATION:
Invoice #: CLLS24-05
Project Title: California Library Literacy Services
Grantee: Azusa City Library
Funding Start Date: Upon execution
Term Completion: June 30, 2025
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
Azusa City Library
Total Award: $48,264
PAYMENT SCHEDULE:
Libraries receive 90% of their total award amount upon receipt of the award
letter.
Libraries receive the final 10% payment of their total award after successful
completion of the California Library Literacy Services Mid-Year Report form.
NOTE: Libraries have 15 months to spend their California Library Literacy Services
award funds, from July 1, 2024, in which the funds are awarded until September
30 of the following year.
Total award
Initial Payment (90% of total award) $43,438
Final Payment (10% of total award) $4,826
Total: $48,264
REPORTING:
Libraries are required to submit a mid-year financial and narrative report and a
final report. Reminder emails will be sent out beginning six weeks before the
required report is due.
Manage Your Current Grant website. The reporting schedule is detailed below.
Mid-Year Report Due January 31, 2025
Final Report Due September 30, 2025
NOTE: A budget modification form will be required for all budget changes
regardless of amount. Modification forms may be submitted throughout the year
but no later than May 31.
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STATE-FUNDED GRANTS
AWARD AGREEMENT AND
CERTIFICATE OF COMPLIANCE
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Azusa City Library
California Library Literacy Services
2023-2024 CLLS24-05
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TABLE OF CONTENTS
PROJECT SUMMARY 2
PROCEDURES and REQUIREMENTS 3
A. Term of the Agreement 3
B. Scope of Work 3
C. Budget Detail 3
D. Narrative and Financial Reports 4
E. Claim Form and Payment 5
EXHIBIT A: TERMS and CONDITIONS 7
EXHIBIT B: CERTIFICATION of COMPLIANCE FORMS
EXHIBIT C: CALIFORNIA LIBRARY LITERACY SERVICES
GUIDELINES
22
26
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2023-2024 CLLS24-05
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PROJECT SUMMARY
AWARD AGREEMENT BETWEEN THE STATE LIBRARY and Azusa City Library for the
California Library Literacy Services project.
AWARD AGREEMENT NUMBER CLLS24-05
Azusa City Library,
-funded California
Library Literacy Services project.
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 $48,264 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
expenditure date is September 30, 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 June 30, 2025, and all eligible program costs must be incurred by this
date.
B. Scope of Work
1.
application and submitted to the State Library in response to the California
Library Literacy Services project.
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
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Grantee shall request the distribution of grant funding consistent with its proposal and
the budget worksheet that was included with the application. Under no circumstances
shall payments exceed the total grant amount identified in this Agreement.
D. Narrative and Financial Reports
1. The Grantee shall be responsible for submission of interim and final narrative and
financial reports on the progress and activities of the project, to the California
State Library, using the sample report documents provided by the California
State Library.
2. All the reports must be current, include all required sections and documents, and
must be approved by the Grant Monitor before any payment request can be
processed. Failure to comply with the specified reporting requirements may be
considered a breach of this Agreement and result in the termination of the
Agreement or rejection of the payment request and/or forfeiture by the Grantee
of claims for costs incurred that might otherwise have been eligible for grant
funding. Any problems or delays must be reported immediately to the Grant
Monitor. The financial reports shall reflect the expenditures made by the
Grantee under the Agreement and may be incorporated into the same
reporting structure as the narrative reports.
3. The reports shall be submitted by the following dates:
Reporting Period Report Due Date
July 1 - December 31 Mid-Year Report Due January 31, 2025
July 1 - June 30 Final Report Due September 30, 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
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
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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.
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,
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.
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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 current Web Content Accessibility Guidelines, 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 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
California Library Literacy Services project.
a. Grant award recipients must ensure that the State of California receives full
credit as the source of funds and that the California State Library, likewise, is
acknowledged as the administrator.
b. Publications and information releases about the project must credit the State
of California. An appropriate statement for a publication or project press
release is:
[publication/project] was supported in whole or in part by
funding provided by the State of California, administered by the
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:
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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
release form or contact your grant monitor for the State Libra
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
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
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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
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
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
lhassen@AzusaCa.gov
[California State Library]
Allyson Jeffredo
[900 N Street
[Sacramento, CA 95814]
Allyson.jeffredo@library.ca.gov
916-603-6709
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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
contractors and subcontractors is an independent obligation from the
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
e 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
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.
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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.
2) -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) -free workplace policy
statement.
2)
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
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
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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
must be made in writing and received by the California State Library at least
30 days prior to the final deadline.
12. Failure to Perform: The grant being utilized by the Grantee is to benefit the
California Library Literacy Services project. If the Grant Monitor determines
the Grantee has not 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
behalf; or
b. Make Federal or State unemployment insurance contributions on
c.
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.
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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:
progress and reviewing and approving Grant Payment Requests and other
documents delivered to the California State Library pursuant to this
Agreement. The Grant Monitor may monitor Grantee performance to
ensure Grantee expends grant funds appropriately and, in a manner,
consistent with the terms and conditions contained herein. The Grant
Monitor does not have the authority to approve any deviation from or
revision to the Terms and Conditions (Exhibit A) or the Procedures and
Requirements unless such authority is expressly stated in the Procedures and
Requirements.
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
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-
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
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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.
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
regulations. The total amount paid by the California State Library to the
Grantee under this agreement shall not exceed $48,264 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
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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, §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
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
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:
address as stated in this Agreement.
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e. U.S. Mail: Five days after being deposited in the U.S. Mail, postage
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
-
herein by this reference. In the event of conflict or inconsistency between
the articles, exhibits, attachments, specifications or provisions that constitute
this Agreement, the following order of precedence shall apply:
a. Grant Agreement Coversheet and any Amendments thereto
b. Terms and Conditions
c. Procedures and Requirements
d. Certificate of Compliance
e. Project Summary
f.
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
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
or modifications to the Work Plan, approved project as described in
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.
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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.
to the amounts authorized in the California State Administrative
Manual (see Exhibit C or contact the Grant Monitor for more
information).
f. Payment will be made only to the Grantee.
g. Reimbursable expenses shall not be incurred unless and until the
grantee receives a Notice to Proceed as described in the
Procedures and Requirements.
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.
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36. Public Records Act: Material maintained or used by the California State
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 format or medium. Copies of all promotional
materials will be provided to the State Library. Grantee will acknowledge
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
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.
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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.
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
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 $43,438 upon execution of the agreement and submission of
claim by the grantee organization.
o A second payment will be made after the submission and
approval of the first reports and receipt of claim form in the
amount of $4,826.
42. Self- All expenditures for which
reimbursement pursuant to this Agreement is sought shall be the result of
-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
pur -
both parties are on equal footing and fair market forces are at play, such as
business and
-
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.
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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, 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
t compliance with
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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
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 provide the State Library with copies of all public education and
advertising material produced pursuant to this Agreement.
50.
personnel. If Grantee hires employees to perform services required by this
urance for
them. The Grantee is aware of Labor Code Section 3700, which requires
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 $48,264. This
award will provide library services as set forth in the Project Application as
approved and/or as amended by the California State Librarian.
6. STATEMENT OF COMPLIANCE: Grantee has, unless exempted, complied with
the non-discrimination program requirements. (Gov. Code §12990 (a-f) and
CCR, Title 2, Section 11102).
7. DRUG-FREE WORKPLACE REQUIREMENTS: Grantee will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a
drug-free workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled substance is
prohibited and specifying actions to be taken against employees for
violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
1) the dangers of drug abuse in the workplace;
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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.
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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.
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EXHIBIT C: CALIFORNIA LIBRARY LITERACY SERVICES
GUIDELINES
1. California Library Literacy Services programs shall comply with the
requirements in Sections 18880-18883 of the California Education Code.
2. California Library Literacy Services programs shall train and recruit volunteers
to serve as tutors. Volunteer tutors are the primary instructors for the
program.
3. California Library Literacy Services programs shall seek local government
and community resources and develop cooperative relations with other
local literacy services providers.
4. California Library Literacy Services programs will provide a base level of
local and private fiscal support to be established by the California State
Library.
5. In response to an expressed and recognized need from the field for specific
program requirements, the California State Library and related stakeholders
created a framework and program essentials. The framework and essentials
describe what constitutes an effective program:
a. California Library Literacy Services programs must use the Roles and
Goals framework to implement and evaluate their literacy services.
b.
regional Library Literacy Network Meetings.
c. Tutor training for volunteers should include, at a minimum, a program
orientation, tutoring basics, and instruction on learner-driven services.
d. California Library Literacy Services programs must align with the
following program values:
i. California Library Literacy Services is library based;
ii. California Library Literacy Services is a core library service;
iii. California Library Literacy Services is learner-driven;
iv. California Library Literacy Services is community-focused;
v. California Library Literacy Services is volunteer-supported;
vi. California Library Literacy Services staff is professionally
engaged; and
vii. California Library Literacy Services supports families.
6. California Library Literacy Services Family Literacy programs (if applicable)
shall provide services to prevent illiteracy through coordinated literacy and
preliteracy services to families. Recruitment of parents not previously
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
Azusa City Library
California Library Literacy Services
2023-2024 CLLS24-05
Page 27 of 29
included in public library literacy programs is a high priority. Family Literacy
programs are implemented and evaluated using the Family Literacy
Evaluation Framework.
Certification
ORGANIZATION
Name: Address (official and complete):
PROJECT COORDINATOR
Name:
Email: Phone:
GRANTTEE AUTHORIZED REPRESENTATIVE
Name: Title:
Email: Phone:
Signature: Date:
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
626-812-5279
Leila Hassen
lhassen@AzusaCa.gov
626-812-5266
9/3/2024
City Librarian
regina.sells-arnold@azusaca.gov
Azusa City Library
Regina Sells-Arnold
729 North Dalton Avenue, Azusa, CA 91702
Azusa City Library
California Library Literacy Services
2023-2024 CLLS24-05
Page 28 of 29
Authorized Representative Signature
ORGANIZATION
Name: Address (official and complete):
AUTHORIZED REPRESENTATIVE
Signature: Date:
Printed Name of Person Signing: Title:
STATE OF CALIFORNIA
Agency Name:California State Library Address: 900 N Street, Sacramento, CA 95814
Signature: Date:
Printed Name of Person Signing: Title: California State Librarian
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
Greg Lucas
9/3/2024
9/3/2024
729 North Dalton Avenue, Azusa, CA 91702
Leila Hassen City Librarian
Azusa City Library
Azusa City Library
California Library Literacy Services
2023-2024 CLLS24-05
Page 29 of 29
20 August 2024
RE: Contractor and Grantee Compliance with Economic Sanctions Imposed in
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.
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,
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: 6406775A-21F4-4106-92B7-AA49E5725FF5
CA LIBRARY LITERACY AND ENGLISH ACQUISITION SERVICES
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: 2024 ITEM NO: 6120-213-0001, Chapter 22, Statutes of 2024
PURCHASING AUTHORITY NUMBER: CSL-6120 REPORTING STRUCTURE: 61202000
COA: 5432000 PROGRAM #: 5312
FAIN: LS or N/A
By Date
(State Library Representative)
Grant Award #: CLLS24-05 Date:
Invoice #:
CLLS24-05-01 PO #:
7552
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: $43,438 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: California Library Literacy Services ☐ AUGMENT
For Period From: upon execution to end of grant period
Docusign Envelope ID: 6406775A-21F4-4106-92B7-AA49E5725FF5
729 North Dalton Avenue, Azusa, CA 91702
Leila Hassen City Librarian
9/3/2024
9/9/2024
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: 6406775A-21F4-4106-92B7-AA49E5725FF5
Ca. State Library
Admin/Accounting
900 N Street
Sacramento 95814 accounting@library.ca.gov
CA
916-603-7157
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: 6406775A-21F4-4106-92B7-AA49E5725FF5