1-Submittal A - Administrative Requirements.pdf

A dm in is tr at iv e

R eq ui re m en ts

Administrative Requirements

Forms and explanatory documents for each of the following administrative requirements are identified below and are included in the respective sections of this package. Also included, as the final section, is a checklist to assist with your proper completion of the required forms prior to bid/proposal submittal. Please note that all documents must be signed by the duly authorized representative of the entity or sole proprietor. In the event of a Joint Venture (JV), officers authorized by each entity must sign and submit a separate set of the following documents:

• Vendor ID Form

• Affidavit of Non-Collusion

• Bidder Contributions CEC Form 56

• Iran Contracting Compliance Affidavit

• Municipal Lobbying Ordinance Bidder Certification CEC Form 50

The following administrative requirements may refer to the Los Angeles City Charter (LACC), Los Angeles Municipal Code (LAMC), or Los Angeles Administrative Code (LAAC).

For further information or assistance regarding all administrative requirements, contact:

Los Angeles World Airports Procurement Services Division P O Box 92216 Los Angeles, CA 90009-2216 Phone: (424) 646-7392 E-mail: sourcing@lawa.org Internet: https://www.lawa.org/en/lawa-businesses/ lawa-administrative-requirements

1. VENDOR ID FORM

The Vendor ID form requires general information about a bidder/proposer’s business as well as the Seller’s Permit and the Business Tax Registration Certificate (BTRC) numbers, Payment Terms, Equal Employment Opportunity Officer contact information, and data on the firm’s City of Los Angeles contracts (if applicable).

• Seller’s Permit Number

The Seller’s Permit Number is required if the vendor is engaged in business in California;

intends to sell or lease tangible personal property that would ordinarily be subject to sales tax if sold at retail; will make sales for a temporary period, normally lasting no longer than 30 days at one or more locations. The enforcing agency for this requirement is the Board of Equalization, the Sales and Use Tax Department. Additional information regarding this requirement can be found at http://www.cdtfa.ca.gov/services/permits-licenses.htm.

• Business Tax Registration Certificate mailto:ProcurementRequirements@lawa.org https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements http://www.boe.ca.gov/sutax/sutprograms.htm http://www.boe.ca.gov/sutax/sutprograms.htm http://www.cdtfa.ca.gov/services/permits-licenses.htm

Pursuant to the LAMC, Chapter 2, Article 1, Section 21.03, persons engaged in any business or occupation within the City of Los Angeles are required to register and pay the required tax.

Businesses, including vendors, subject to this tax are issued a Business Tax Registration Certificate (BTRC) or a Vendor Registration Number (VRN).

Information regarding this requirement may be obtained at Office of Finance, Tax & Permit Division, 200 N. Spring St., Room 101, Los Angeles, CA 90012, Phone: (844) 663-4411, Web:

http://finance.lacity.org.

• Out-of-state Vendors The State of California requires the City of Los Angeles (City) to withhold income taxes from payments to out-of-state vendors for services performed within California unless the vendor submits one of the required forms. The tax withholding rate is seven percent (7%) of payments subject to withholding.

If you are out-of-state vendor, please return one of the following forms to help the City clarify your non-resident tax withholding status:

• Form 590, Withholding Exemption Certificate, certifying exemption from the withholding requirement.

• Form 587, Nonresident Income Allocation Worksheet, which allocates the expected income under the City contract for work completed within and outside of California

• Notice from the CA Franchise Tax Board (CAFTB) that a withholding waiver was authorized (you must first file CA Form 588, Nonresident Withholding Waiver Request to the CAFTB)

• Notice from CAFTB that a reduced withholding request was authorized (you must first file CA Form 589 Nonresident Reduced Withholding Request to CAFTB)

2. AFFIDAVIT OF NON-COLLUSION

Pursuant to the LAAC, Division 10, Chapter 1, Article 2, Section 10.15, each bid/proposal must include the attached affidavit of the Bidder/Proposer that the bid/proposal is genuine, and not a sham or collusive, or made in the interest or on behalf of any person, and that the Bidder/Proposer has not directly or indirectly induced or solicited any other Bidder/Proposer to submit a sham bid, or any other person, firms, or corporation to refrain from bidding, and that the Bidder/Proposer has not sought by collusion to secure for himself/herself an advantage over any other Bidder/Proposer.

Bidders/Proposers must complete, notarize, and submit the attached “Affidavit to Accompany Proposals or Bids” with the bid/proposal.

Failure to include an Affidavit with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

Attachment:

• Affidavit of Non-Collusion http://finance.lacity.org/

3. BIDDER CONTRIBUTIONS CEC FORM 56 (CONTRACT BIDDER CAMPAIGN

CONTRIBUTION AND FUNDRAISING RESTRICTIONS)

Persons who submit a response to this Request for Bid/Proposal/Qualifications are subject to Charter section 470(c)(12) and related ordinances. As a result, bidders/proposers/respondents may not make campaign contributions to and or engage in fundraising for certain elected City officials or candidates for elected City office from the time they submit the response until either the contract is approved or, for successful bidders/proposers/respondents, 12 months after the contract is signed. The bidder's/proposer’s/respondents’ principals and subcontractors performing $100,000 or more in work on the contract, as well as the principals of those subcontractors, are also subject to the same limitations on campaign contributions and fundraising.

Bidders/Proposers/Respondents must submit CEC Form 56 (attached) to LAWA with their bid/proposal/Statement of Qualifications. The form requires bidders to identify their principals, their subcontractors performing $100,000 or more in work on the contract, and the principals of those subcontractors. Bidders/Proposers/Respondents must also notify their principals and subcontractors in writing of the restrictions and include the notice in contracts with subcontractors. Responses submitted without a complete CEC Form 56 shall be deemed non-responsive. Bidders/Proposers/Respondents who fail to comply with City law may be subject to penalties, termination of contract, and debarment.

Additional information regarding this requirement may be obtained at:

200 N. Spring Street City Hall, 24th Floor Los Angeles, California 90012

(213) 978-1960

(213) 978-1988 [Fax] ethics.commission@lacity.org Web: http://ethics.lacity.org

Attachments:

• Bidder Contributions CEC Form 56

• Los Angeles City Ethics Commission Special Bulletin, available at http://ethics.lacity.org/pdf/pressrelease/press_042511_New_Charter_Amend_Limits_Bidder_Bulletin.pdf

4. IRAN CONTRACTING ACT OF 2010

Prior to bidding on, submitting a proposal or executing a contract or renewal for a City of Los Angeles contract for goods or services of $1,000,000 or more, a vendor must either: a) certify it is not on the current list of persons engaged in investment activities in Iran created by the California Department of General Services (“DGS”) pursuant to Public Contract Code section 2203(b) ( found at: http://www.documents.dgs.ca.gov/pd/poliproc/Iran%20Contracting%20Act%20List.pdf ) and is not a financial institution extending $20,000,000 or more in credit to another person, for 45 days or more, if that person will use the credit to provide goods or services in the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS; or b) demonstrate it has been exempted from the certification requirement for that solicitation or contract pursuant to Public Contract Code section 2203(c) or (d).

http://ethics.lacity.org/ http://ethics.lacity.org/pdf/pressrelease/press_042511_New_Charter_Amend_Limits_Bidder_Bulletin.pdf http://www.documents.dgs.ca.gov/pd/poliproc/Iran%20Contracting%20Act%20List.pdf

Attachment:

• Iran Contracting Act of 2010 Compliance Affidavit

5. MUNICIPAL LOBBYING ORDINANCE

The City's Municipal Lobbying Ordinance, Los Angeles Municipal Code, Section 48.09 requires certain individuals and entities to register with the City Ethics Commission and requires public disclosure of certain lobbying activities, including money received and spent. Additionally, for all construction contracts, public leases, or licenses of any value and duration; goods or service contracts with a value greater than $25,000 and a term of at least three months, each bidder/proposer must submit with its bid a certification, on a form (CEC Form 50) proscribed by the City Ethics Commission, that the bidder acknowledges and agrees to comply with the disclosure requirements and prohibitions established in the Los Angeles Municipal Lobbying Ordinance, if the bidder qualifies as a lobbying entity.

Failure to submit the Bidder Certification CEC Form 50 with the bid/proposal will render the bid/proposal non-responsive.

Additional information regarding this requirement may be obtained at:

200 N. Spring Street City Hall, 24th Floor Los Angeles, California 90012

(213) 978-1960

(213) 978-1988 [Fax] ethics.commission@lacity.org Web: http://ethics.lacity.org

Attachments:

• Municipal Lobbying Ordinance, available at http://www.lawa.org/welcome_LAWA.aspx?id=586

• Bidder Certification CEC Form 50, available at http://www.lawa.org/welcome_LAWA.aspx?id=586

ADMINISTRATIVE REQUIREMENTS THAT DO NOT REQUIRE FORMS

The following administrative requirements are language only. Submit any questions you may have regarding these ordinances to the LAWA Procurement Services Division at sourcing@lawa.org or at (424) 646-7392.

• Affirmative Action

• Assignment of Anti-Trust Claims

• Child Support Obligations http://ethics.lacity.org/ http://www.lawa.org/welcome_LAWA.aspx?id=586 mailto:ProcurementRequirements@lawa.org

C he ck lis t

Administrative Requirements Checklist

BIDDERS/PROPOSERS (PRIME CONTRACTORS) MUST SUBMIT THE FOLLOWING SIGNED

DOCUMENTS, WITH THEIR PROPOSAL, AS INDICATED

1. VENDOR ID FORM

Is the required Vendor ID Form completed?

Is the BTRC/VRN number provided?

Is the Form enclosed in the Packet?

2. AFFIDAVIT OF NON-COLLUSION

Is the “Affidavit to Accompany Proposals or Bids” completed and signed?

Is the Affidavit notarized?

Is the Affidavit enclosed in the Packet?

Failure to include an Affidavit with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

3. BIDDER CONTRIBUTIONS

Is the required Bidder Contribution CEC Form 56 completed and signed?

Schedule A - Please list all principals on Schedule A.

Schedule B - Please list all subcontractors and their principals on Schedule B (If you check “Yes”) Is the Form enclosed in the Packet?

Failure to include the Bidder Contribution CEC Form 56 with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

4. IRAN CONTRACTING ACT OF 2010 COMPLIANCE AFFIDAVIT

Have you read and checked one of the options?

Is the Affidavit enclosed in the Packet?

5. MUNICIPAL LOBBYING ORDINANCE

Is the required Bidder Certification CEC Form 50 completed and signed?

Is the Form enclosed in the Packet?

Failure to include the Bidder Certification CEC Form 50 with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

THE FOLLOWING REQUIREMENTS DO NOT REQUIRE THE COMPLETION OF FORMS

BUT MAY BE INCORPORATED AS PROVISIONS OF THE CONTRACT:

6. AFFIRMATIVE ACTION

Have you read and agreed with the City of Los Angeles’ Non-discrimination, Equal Employment and Affirmative Action provisions?

7. ASSIGNMENT OF ANTI-TRUST CLAIMS

Have you read and agreed with California Government Code Sections 4550 – 4554?

8. CHILD SUPPORT OBLIGATIONS

Have you read and agreed with Child Support Obligations provisions?

IF YOU ARE AWARDED THE CONTRACT AND PRIOR TO EXECUTION OF THE

CONTRACT:

Prime contractors are required to submit to LAWA forms pertaining to the following requirements:

• Business Tax Registration Certificate

V en do r I de nt ifi ca tio n

Fo rm

VENDOR IDENTIFICATION FORM

ALL FIELDS MUST BE COMPLETED. INCOMPLETE FORMS MAY BE REJECTED AND RESUBMITTED.

GENERAL INFORMATION

Entity type (code)

Individual/Proprietor (I)

Corporation (C or S)

Partnership (P)

BUSINESS ADDRESS

Fax

Airport Concessions Disadvantaged Business Enterprise (ACDBE)

Disadvantaged Business Enterprise (DBE)

Disabled Veteran Business Enterprise (DVBE) (LAWA)

Local Business Enterprise (LBE)

Minority Business Enterprise (MBE)

Minority Women Business Enterprise (M/WBE)

Small Business Enterprise* (Proprietary)

Local Small Business (LSB) (formerly SLB)

Women Business Enterprise (WBE) *Per SBA or DGS criteria verification

CERTIFICATION

The undersigned declares and certifies that all statements on this form are true and correct. I agree to notify Strategic Sourcing Division immediately of any changes to the information contained herein. I have read and agreed with the administrative requirements set for this project and have been provided as a checklist in the bid/proposal package. If selected, I/We will comply with these requirements for the duration of the contract.

DateAuthorized Signature

Title

For instructions and additional information, please click LAWA, call 424-646-7392, or email Los Angeles World Airports Procurement Services Division at sourcing@lawa.org

Form VIF 04082025 LM

For LAWA use only:

Contact Person:

F-590 F-589F-588

BUSINESS CERTIFICATION

(Check all that apply - If required, attach copies of all applicable certifications)

F-587

Phone No:

CALIFORNIA FRANCHISE TAX BOARD (FTB)

Click FTB Publication 1017 for further information

City of Los Angeles Office of Finance (OOF) BTRC/VRN No.

Government

LLC (enter entity code below) BTRC/VRN application pending (attach proof of submission)

An FTB form is required from all vendors with a payment address outside of California. Submit form 587 or 590 or proof of submission of form 588 or 589:

For foreign vendors, click Foreign Entity for related instructions

Legal Name

IRS Taxpayer ID No.

(EIN or SSN)

Doing Business As (DBA)

If applicable:

CA SOS Entity/Registration No.

For further information click Office of Finance

Contact Street

Phone

Email

EIN - Employer Identification number SSN - Social Security Number

Print Name

Submit IRS W9 form (required)

SOS - California Secretary of State VRN - Vendor Registration Number

Zip Code

City

State/ Region

Remittance address:Country

Legend:

BTRC - Business Tax Registration Certificate DTFA - California Department of Tax & Fee Administration

CA DTFA Seller Permit No.

(If different from above)

Is the vendor providing healthcare/medical or legal services?

Requesting Division:

https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements https://www.ftb.ca.gov/forms/misc/1017.html?_sm_au_=isV6qr3j1DZSWN7sFVjLLLQ6vMVN1 https://finance.lacity.org https://www.irs.gov/forms-pubs/about-form-w-9 https://www.irs.gov/forms-pubs/about-form-w-8 https://www.irs.gov/forms-pubs/about-form-w-9 https://www.sos.ca.gov/business-programs/business-entities?adlt=strict https://www.cdtfa.ca.gov/taxes-and-fees/faqseller.htm www.lawa.org/en/lawa-businesses/lawa-administrative-requirements or further information

Vendor ID Form - Attach Back-Up Documents Instructions

If applicable, Attach Forms in Bonfire

IRS W9 Form (Required) California Franchise Tax Board (FTB) Form is required from all vendors with a payment address outside of California.

Copy of Business Tax Registration Certificate or copy of application submitted to the Office of Finance ffi da vi t o f N on -C ol lu si on

ENG. 3--1M--4-59---(R)

AFFIDAVIT TO ACCOMPANY PROPOSALS OR BIDS

STATE OF CALIFORNIA )

) ss.:

COUNTY OF )

being first duly sworn, deposes and says:

(Type or print name) that he or she is the of (Type or print title)

, who submits herewith ( Type or print name of company/firm) to the Board of Airport Commissioners the attached bid/proposal; that he or she is the person whose name is signed to the attached bid/proposal; that said bid/proposal is genuine; that the same is not sham or collusive; that all statements of fact therein are true; and that such bid/proposal was not made in the interest or behalf of any person, partnership, company, association, organization, or corporation not herein named or disclosed.

Affiant further deposes and says: that the bidder/proposer has not directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interests of the public body which is to award the contract, or of any other bidder/proposer, or anyone else interested in the proposed contract; and that the bidder/proposer has not in any manner sought by collusion to secure for himself/herself/itself/themselves, an advantage over any other bidder/proposer.

Affiant further deposes and says that prior to the public opening and reading of bids/proposals, said bidder/proposer:

(a) did not, directly or indirectly, induce or solicit anyone else to submit a false or sham bid/proposal;

(b) did not, directly or indirectly, collude, conspire, connive or agree with any one else that said bidder/proposer or anyone else would submit a false or sham bid, or that anyone should refrain from bidding or withdraw their bid/proposal;

(c) did not, in any manner, directly or indirectly, seek by agreement, communication or conference with anyone to raise or fix the bid price of said bidder/proposer or of anyone else, or to raise or fix any overhead, profit or cost element of their price or of that of anyone else;

(d) did not, directly or indirectly, submit their bid/proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association organization, bid depository, or to any member or agent, thereof, or to any individual or group of individuals, except to the awarding authority or to any person or person who have a partnership or other financial interest with said bidder/proposer in their business.

Signed:

Name:

Title:

Subscribed and sworn to (or affirmed) before me on this day of , 20 , by

, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.

Notary Public Signature (Notarial Seal)

B id de r C on tri bu tio n C

EC

F or m

ATTENTION:

The following CEC Form 56 must be signed on page 1 and you are required to list all principals on Schedule A. Please refer to the attached instructions.

If you fail to sign the form or if you submit an incomplete CEC Form 56, your proposal/bid may be deemed non-responsive.

Prohibited Contributors (Underwriters)

Los Angeles City

ETHICS COMMISSION

This form must be completed in its entirety and submitted with your bid or proposal to the City department that is awarding the contract. Failure to submit a completed form may affect your bid or proposal. If you have questions about this form, please contact the Ethics Commission at (213) 978-1960.

D Original Filing D Amendment: Date of Signed Original _____ . Date of Last Amendment ____ _

Reference Number (Bid, Contract. or RAMP): _________ Date Bid Submitted: ______ _

Contract Description (Title of the RFP or City contract solicitation and description of the services to be provided):

Awarding Authority (Department awarding the contract): __________________ _

Underwriting Firm Name: -------------------------------

Underwriting Firm Address: ------------------------------

Email Address: __________________ Phone Number: _________ _

Schedule Summary

Please complete all three of the following:

1. SCHEDULE A- Underwriting Firm's Principals (check one) The underwriting firm has one or more PRINCIPALS, as defined in Charter§ 609(e)(3).

At least one principal is required for entities. (if you check "Yes� Schedule A is required.)

2. SCHEDULE B - Subcontractors and Their Principals (check one) The underwriting firm has one or more SUBCONTRACTORS on this bid or proposal with subcontracts worth $100,000 or more. (if you check "Yes", Schedule Bis required.)

3. TOTAL NUMBER OF PAGES SUBMITTED (including this cover page): __

Certification

Yes No

Yes No

I certify that, within the past 12 months, neither the underwriting firm nor its principals made one or more gifts totaling $50 or more, or one or more political contributions totaling $100 or more, to an elected City official, a member of the board of the department whose bonds are the subject of the sale, or a City official having the authority to make or participate in making decisions concerning the sale of the bonds.

I certify the following under penalty of perjury under the laws of the City of Los Angeles and the state of California: A) I understand, will comply with, and have notified my principals and subcontractors of the requirements and restrictions in Los Angeles City Charter§ 609(e) and any related ordinances; B) I understand that I must amend this form within ten business days if any information changes; C) I am the underwriting firm named above or I am authorized to represent the underwriting firm named above, and my name appears below; and D) The information provided in this form is true and complete to the best of my knowledge and belief.

Name

Title

Revised February 2022

Signature

Date

Los Angeles City Charter§ 609(e); Los Angeles Municipal Code §§ 49.7.36(8)(3), (4) ethics.lacity.org

Los Angeles City

ETHICS COMMISSION

Schedule A - Underwriting Firm's Principals

Please identify the names and titles of all of the underwriting firm's principals (attach additional sheets if necessary). Principals include an underwriting firm's parent, subsidiary, or other related business entity; a political action committee controlled or primarily financed by the firm or by a business entity related to the firm as a parent, subsidiary, or other related business entity; the president, chairperson of the board, chief executive officer, or chief operating officer of the firm; a vice president, assistant vice president, or managing director employed in the public finance unit of the firm; an individual who communicates with one or more City officers or employees for the purpose of influencing the City's selection of an underwriter for a particular bond issue; and a person who holds an ownership interest of at least 20 percent in the firm.

Name: ____________________ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ____________________ Title: _______________ _

Address: ____________________________________ _

Name: ____________________ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

D Check this box if additional Schedule A pages are attached.

Revised February 2022 Los Angeles City Charter§ 609(e); Los Angeles Municipal Code §§ 49.7.36(6)(3), (4)

Schedule B - Subcontractors and Their Principals

Los Angeles City

ETHICS COMMISSION

Please identify all subcontractors whose subcontracts are worth $700,000 or more. Separate Schedule B pages are required for each subcontractor who meets the threshold.

Subcontractor's Name

Subcontractor's Address

Please check one of the following options:

This subcontractor has one or more principals. D Yes* D No

* Each principa/'s name and title must be identified below. Attach additional sheets if necessary Principals include the firm or individual; the subcontractor's board chair, president, chief executive officer, chief operating officer, and individuals who serve in the function equivalent of one or more of those positions. Principals also include individuals who hold an ownership interest in the subcontractor of at least 20 percent and an individual who communicates with one or more City officers or employees for the purpose of influencing the City's selection of an underwriting firm for a particular bond issue.

Name: ____________________ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ___________________ _ Title: _______________ _

Address: ____________________________________ _

Name: ____________________ Title: _______________ _

Address: ____________________________________ _

D Check this box if additional Schedule B pages are attached.

Revised February 2022 Los Angeles Cit y Charter§ 609(e); Los Angeles Municipal Code §§ 49.7.36(8)(3), (4)

Page3of3

Form 56 Instructions

TABLE OF CONTENTS

INTRODUCTION •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1

CONTACT INFORMATION ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 1

UNDERWRITER RESPONSIBILITIES ••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 2

PAGE 1: COVER PAGE AND UNDERWRITER INFORMATION ••••••••••••••••••••••••••••••••••••••••••••••••• 2

A. Original or Amended Filing

B. Reference Number

C. Date Bid Submitted

D. Contract Description

E. Awarding Authority

F. Underwriter Information

G. Schedule Summary

H. Certification

PAGE 2: SCHEDULE A - UNDERWRITING FIRM'S PRINCIPALS ••••••••••••••••••••••••••••••••••••••••••••• 5

PAGE 3: SCHEDULE B - SUBCONTRACTORS AND THEIR PRINCIPALS •••••••••••••••••••••••••••••••••• 6

Form 56 Instructions I Revised February 2022

INTRODUCTION

Persons who seek selection as underwriting firms in noncompetitive sales of revenue bonds for the Los

Angeles Department of Water and Power (DWP), Los Angeles World Airports (Airports), or the Port of Los

Angeles (Harbor) are subject to gift restrictions and are limited in their ability to financially participate in City elections. They must certify that they have not exceeded specified gift or contribution limits during the 12 months prior to seeking selection as an underwriting firm. They are required to disclose their identities and the identities of their subcontractors and principals, and they and their subcontractors and principals are prohibited from making campaign contributions to and engaging in prohibited fund raising activity for City candidates and officeholders. Form 56 must be used for those purposes, and these instructions provide information about how to complete the form.

CONTACT INFORMATION

All questions about Form 56 and the laws regarding bidders and contractors should be directed to the Los Angeles City Ethics Commission:

Form 56 Instructions I Revised February 2022 ethics.commission@lacity.org

(213) 978-1960 phone

(213) 978-1988 fax Whistleblower Hotline: (800) 824-4825

200 North Spring Street

City Hall 24th Floor, Suite 2410 Los Angeles CA 90012

UNDERWRITER RESPONSIBILITIES

You are an underwriter required to complete Form 56 when both of the following apply:

• You seek selection as an underwriting firm in a noncompetitive sale of revenue bonds; and

• The City department making the selection is Airports, DWP, or Harbor.

Form 56 must be completed when a proprietary City department (Airports, DWP, or Harbor) seeks to enter into an agreement with an underwriter for a sale of revenue bonds and the selection of the underwriter is made on a basis other than competitive bidding (i.e., an agreement for a noncompetitive sale of revenue bonds). Form 56 is also required if an underwriter is responding to a City solicitation to be included on a pre qualified list of underwriters for noncompetitive sales of revenue bonds for Airports, DWP, or Harbor.

Form 56 is used to disclose information about the following individuals and entities:

• You (the underwriter);

• Your principals;

• Your subcontractors with subcontracts valued at $100,000 or more; and

• The principals of those subcontractors.

The gift and campaign finance restrictions and requirements in Los Angeles City Charter§ 609(e) and Los

Angeles Municipal Code§ 49.7.36 apply to all of those individuals and entities. They are subject to those laws because of the positions they hold in relation to a City bid, not because they are disclosed on your Form 56.

See section G for more information.

You are required to do all of the following:

1. Submit a completed Form 56 with your bid or proposal documents to the City department awarding the contract.

2. Amend your Form 56 within 1 0 business days if the information in the form changes after you submit it with your bid.

3. Notify your principals and subcontractors of the campaign finance restrictions and requirements that apply to them.

PAGE 1: COVER PAGE AND UNDERWRITER INFORMATION

You must complete all sections on the cover page.

A. ORIGINAL OR AMENDED FILING

ORIGINAL FILING

Check this box if this is the first time you are submitting a Form 56 in connection with the noncompetitive sale of revenue bonds that you currently seek or have been awarded.

Form 56 Instructions I Revised February 2022 Page 12

AMENDMENT

Check this box if you are making changes to a Form 56 that was previously submitted in connection with the same noncompetitive sale of revenue bonds that you are seeking or have been awarded. For an amended filing, you must provide the later of:

• The date that your original Form 56 submission was signed; or

• The date that your most recent amendment was signed.

Example 1: You submitted a Form 56 last month when responding to a solicitation by the Port of Los

Angeles for a noncompetitive sale of revenue bonds. You are now responding to a solicitation from Los

Angeles World Airports (''Airports") for a different noncompetitive sale. Check the Original Filing box on this Form 56, because this is the first time you are submitting the Form 56 in connection with the contract with Airports.

Example 2: You submitted a Form 56 last week when responding to an RFQ from the Department of

Water and Power (DWP) for selection to a pre-qualified list of underwriting firms for the noncompetitive sale of revenue bonds. Your response to the RFQ is still pending with DWP. This week, your firm moved its offices to a new location. You are required to update your contact information by filing a new Form

56 and checking the Amendment box, because you are submitting an updated version of the Form 56 that was submitted in connection with the same RFQ with DWP.

B. REFERENCE NUMBER

If applicable, provide the bid number, contract number, RAMP ID, or other identifying number or code assigned to the bid or contract that you seek. You can usually find this number on the City solicitation package (e.g., the RFP or RFQ documents). However, not all solicitations have a reference number.

If there is no reference number for the bid or contract, enter "N/ A" in this box.

C. DATE BID SUBMITTED

Enter the date that you submit your bid or response documents to the City department that will be making the selection.

D. CONTRACT DESCRIPTION

Provide the following information in this section:

• Title of the RFP or RFQ, as listed on the City solicitation documents; and

• Description of the contract.

A brief description of the contract is usually given in the RFP, RFQ, or solicitation documents. If you cannot find one, describe what will be performed under the contract.

Form 56 Instructions I Revised February 2022 Pagel3

E. AWARDING AUTHORITY

Provide the name of the City department that will be selecting one or more underwriting firms.

F. UNDERWRITER INFORMATION

Provide all of the following information:

• Underwriter's full legal name;

• Underwriter's business address;

• Underwriter's phone number; and

• Underwriter's email address.

The email address and telephone number provided in this section will be used to contact you if there are questions about the information provided in your Form 56.

Remember to amend your Form 56 to keep this information current.

G. SCHEDULE SUMMARY

ITEM 1: UNDERWRITING FIRM'S PRINCIPALS

Indicate whether you have one or more principals. Check only one box ("Yes" or "No").

A principal is any of the following:

• Underwriter's parent, subsidiary, or other related business entity;

• A political action committee controlled or primarily financed by the underwriter or by a business entity related to the underwriter as a parent, subsidiary, or other related business entity;

• Underwriter's President, Board Chair, Chief Executive Officer, or Chief Operating Officer;

• A Vice President, Assistant Vice President, or Managing Director employed in the public finance unit of the underwriter;

• An individual who communicates with one or more City officers or employees to influence the

City's selection of an underwriter for a particular bond issue; and

• A person who holds an ownership interest of at least 20% in the underwriter.

Example 1: You are putting together a proposal in response to a solicitation from DWP on behalf of your employer, Underwriting Professionals, Inc. and must complete a Form 56. Because Underwriting

Professionals, Inc. is an entity, you must check the ''Yes" box and disclose Underwriting Professionals, lnc.'s principals on attached Schedule A pages.

All underwriters who are entities are required to complete Schedule A. Most underwriters are entities, so most underwriters must check the "Yes" box and attach Schedule A pages to the cover page.

Attach to the cover page as many Schedule A pages as necessary to identify all of your principals.

Form 56 Instructions I Revised February 2022 Page 14

ITEM 2: SUBCONTRACTORS AND THEIR PRINCIPALS

Indicate whether you have one or more subcontractors with subcontracts valued at $100,000 or more on the City contract you seek. Check only one box ("Yes" or "No").

Example 1: You are submitting a response to a solicitation from the Port of Los Angeles and must submit a Form 56. For the proposed sale of revenue bonds, you expect to have a subcontract with Banking Company worth $500,000, and Investments Corporation as another subcontractor that will provide $25,000 worth of services. Check the "Yes" box and attach Schedule B pages to disclose Banking Company and its principals.

Example 2: You are submitting a response to an RFQ with Airports and must submit a Form 56. For the proposed bond sale, you expect to subcontract with Bankers, Inc., which will perform $75,000 worth of consulting services, and with Investors Plus Company, which will perform $50,000 worth of accounting services. You do not anticipate having any other subcontractors. Check the "No" box, indicating that you do not have subcontractors with subcontracts valued at $100,000 or more.

Attach to the cover page as many Schedule B pages as necessary to identify all of your subcontractors and their principals.

ITEM 3: TOTAL NUMBER OF PAGES SUBMITTED

Enter the total number of Form 56 pages that you are submitting, including the cover page and all attached Schedule A and B pages.

H. CERTIFICATION

Form 56 must be signed by an authorized representative of the underwriter. By signing this section, you are certifying under penalty of perjury all of the following:

• In the past 12 months, neither you nor your principals have made one or more gifts totaling $50 or more, or one or more political contributions totaling $100 or more, to any of the following:

o An elected City official;

o A member of the board of the department whose bonds are the subject of the sale; or o A City official with the authority to make or participate in making decisions concerning the sale of the bonds.

• You understand and will comply with the requirements and restrictions under Los Angeles City

Charter§ 609(e) and Los Angeles Municipal Code§ 49.7.36;

• You have notified your principals and subcontractors of the requirements and restrictions; and

• The information you provided in the Form 56 and all attached pages is true and complete to the best of your knowledge and belief.

PAGE 2: SCHEDULE A - UNDERWRITING FIRM'S PRINCIPALS

You must complete this section to if you have principals. If you are an entity, this section is required. You must disclose the name, title, and business address of each principal. For a definition of "principal", see the instructions for Page 1, Section G.

Form 56 Instructions I Revised February 2022 Page I 5

If you need more space, mark the box indicating that you are attaching additional Schedule A pages. You may attach as many additional Schedule A pages as necessary to disclose all of your principals.

Remember to include all Schedule A pages in the total page count on your cover page and attach them to the cover page.

PAGE 3: SCHEDULE B - SUBCONTRACTORS AND THEIR PRINCIPALS

You must complete this section if you will have subcontractors with subcontracts worth $100,000 or more.

You must disclose the names and business addresses of those subcontractors and the names, titles, and business addresses of their principals. "Principal" is defined differently for your subcontractors than it is for you as the bidding underwriter.

A principal of a subcontractor includes any of the following:

• The subcontracting firm or individual;

• Subcontractor's Board Chair;

• Subcontractor's President;

• Subcontractor's Chief Executive Officer;

• Subcontractor's Chief Operating Officer;

• An individual who serves in the functional equivalent of any of the above positions;

• An individual who holds an ownership interest in the subcontractor of 20% or more; and

• An individual who communicates with one or more City officers or employees for the purpose of influencing the City's selection of an underwriter for a particular bond issue.

You must submit at least one Schedule B page for each subcontractor. Provide the name and business address of the subcontractor, and then mark the appropriate box to indicate whether the subcontractor has principals.

If a subcontractor has more principals than will fit on one page-or if you have multiple subcontractors to disclose-mark the box indicating that you are attaching additional Schedule B pages. You may attach as many additional Schedule B pages as necessary to disclose all of your subcontractors with subcontracts worth $100,000 or more and all of their principals.

Remember to include all Schedule 8 pages in the total page count on your cover page and attach them to the cover page.

Form 56 Instructions I Revised February 2022 Page I 6

I ra n C on tra ct in g C om pl ia nc e Af fid av it

IRAN CONTRACTING ACT OF 2010 COMPLIANCE AFFIDAVIT

(California Public Contract Code Sections 2200-2208)

The California Legislature adopted the Iran Contracting Act of 2010 to respond to policies of Iran in a uniform fashion (PCC § 2201(q)). The Iran Contracting Act prohibits bidders engaged in investment activities in Iran from bidding on, submitting proposals for, or entering into or renewing contracts with public entities for goods and services of one million dollars ($1,000,000) or more (PCC § 2203(a)). A bidder who “engages in investment activities in Iran” is defined as either:

1. A bidder providing goods or services of twenty million dollars ($20,000,000) or more in the energy sector of Iran, including provision of oil or liquefied natural gas tankers, or products used to construct or maintain pipelines used to transport oil or liquefied natural gas, for the energy sector of Iran; or

2. A bidder that is a financial institution (as that term is defined in 50 U.S.C. § 1701) that extends twenty million dollars ($20,000,000) or more in credit to another person, for 45 days or more, if that person will use the credit to provide goods or services in the energy sector in Iran and is identified on a list created by the California Department of General Services (DGS) pursuant to PCC § 2203(b) as a person engaging in the investment activities in Iran.

The bidder shall certify that at the time of submitting a bid for new contract or renewal of an existing contract, the bidder is not identified on the DGS list of ineligible businesses or persons and that the bidder is not engaged in investment activities in Iran in violation of the Iran Contracting Act of 2010.

California law establishes penalties for providing false certifications, including civil penalties equalto the greater of $250,000 or twice the amount of the contract for which the false certification was made; contract termination; and three-year ineligibility to bid on contracts (PCC § 2205).

To comply with the Iran Contracting Act of 2010, the bidder shall provide its vendor or financial institution name, and City Business Tax Registration Certificate (BRTC) if available, in completing ONE of the options shown below.

OPTION #1: CERTIFICATION

I, the official named below, certify that I am duly authorized to execute this certification on behalf of the bidder or financial institution identified below, and that the bidder or financial institution identified below is not on the current DGS list of persons engaged in investment activities in Iran and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another person or vendor, for 45 days or more, if that other person or vendor will use the credit to provide goods or services in the energy sector in Iran and is identified on the current DSG list of persons engaged in investment activities in Iran.

Vendor Name/Financial Institution (printed)

BTRC (or n/a)

By (Authorized Signature)

Print Name and Title of Person Signing

Date Executed

City Approval (Signature) (Print Name)

OPTION #2: EXEMPTION

Pursuant to PCC § 2203(c) and (d), a public entity may permit a bidder or financial institution engaged in investment activities in Iran, on a case-by-case basis, to be eligible for, or to bid on, submit a proposal for, or enter into, or renew, a contract for goods and services. If the bidder or financial institution identified below has obtained an exemption from the certification requirement under the Iran Contracting Act of 2010, the bidder or financial institution shall complete and sign below and attach documentation demonstrating the exemption approval.

Vendor Name/Financial Institution (printed)

BTRC (or n/a)

By (Authorized Signature)

Print Name and Title of Person Signing

Date Executed

City Approval (Signature) (Print Name)

B id de r C er tif ic at io n

C

EC

F or m

M un ic ip al

L ob by in g O rd in an ce

ATTENTION:

The following CEC Form 50 must be filled out completely and signed.

If you fail to sign the form or if you submit an incomplete CEC Form 50, your proposal/bid may be deemed non-responsive.

Revised Los Angeles Municipal Code § 48.09(H), Los Angeles Administrative Code § 10.40.1 Page 1 of 1

This form must be submitted with your bid or proposal to the City department that is awarding the contract noted below. If you have questions about this form, please contact the Ethics Commission at (213) 978-1960.

Certification

I certify the following on my own behalf or on behalf of the entity named above, which I am authorized to represent:

A. I am applying for one of the following types of contracts with the City of Los Angeles:

1. A goods or services contract with a value of more than $25,000 and a term of at least three months;

2. A construction contract with any value and duration;

3. A financial assistance contract, as defined in Los Angeles Administrative Code § 10.40.1(h), with a value of at least $100,000 and a term of any duration; or

4. A public lease or license, as defined in Los Angeles Administrative Code § 10.40.1(i), with any value and duration.

B. I acknowledge and agree to comply with the disclosure requirements and prohibitions established in the Los Angeles Municipal Lobbying Ordinance if I qualify as a lobbying entity under Los Angeles Municipal Code § 48.02.

I certify under penalty of perjury under the laws of the City of Los Angeles and the state of California that the information in this form is true and complete.

Name Signature

Title Date

Original Filing Amendment: Date of Signed Original ________________. Date of Last Amendment _________________.

Email Address Phone Number

Address

Reference Number (Bid, Contract, or ) Awarding Authority (Department awarding the contract)

Bidder Name

FORM

Bidder Certification

Administrative Requirements (Language Only)

Sec. 10.8. Mandatory Provisions Pertaining to Non-discrimination in Employment in the Performance of City Contracts.

The City of Los Angeles, in letting and awarding contracts for the provision to it or on its behalf of goods or services of any kind or nature, intends to contract only with those contractors that comply with the non-discrimination and affirmative action provisions of the laws of the United States of America, the State of California and the City of Los Angeles. The City and each of its awarding authorities shall therefore require that any person, firm, corporation, partnership or combination thereof that contracts with the City for services, materials or supplies, shall not discriminate in any of its hiring or employment practices, shall comply with all provisions pertaining to non- discrimination in hiring and employment, and shall require Affirmative Action Programs in contracts in accordance with the provisions of this Code. The awarding authority and/or Office of Contract Compliance of the Department of Public Works shall monitor and inspect the activities of each contractor to determine that they are in compliance with the provisions of this chapter.

Although in accordance with Section 22.359 of this Code, the Board of Public Works, Office of Contract Compliance, is responsible for the administration of the City’s Contract Compliance Program, accomplishing the intent of the City in contract compliance and achieving non- discrimination in contractor employment shall be the continuing responsibility of each awarding authority. Each awarding authority shall use only the rules, regulations and forms provided by the Office of Contract Compliance to monitor, inspect or investigate contractor compliance with the provisions of this chapter.

Each awarding authority shall provide immediate notification upon award of each contract by that awarding authority to the Office of Contract Compliance. Each awarding authority shall call upon the Office of Contract Compliance to review, evaluate and recommend on any contractual dispute or issue of noncompliance under the provisions of this chapter. The Office of Contract Compliance shall be notified by each awarding authority of any imminent announcement to bid, to allow the Office of Contract Compliance the opportunity to participate with the awarding authority in the monitoring, review, evaluation, investigation, audit and enforcement of the provisions of this chapter in accordance with the rules, regulations and forms promulgated to implement the City's Contract Compliance, Equal Employment Practices Program.

SECTION HISTORY

Based on Ord. No. 132,533, Eff. 7-25-66.

Amended by: Ord. No. 147,030, Eff. 4-28-75; Ord. No. 173,186, Eff. 5-22-00; In Entirety, Ord. No. 184,292, Eff. 6-27-16.

Sec. 10.8.1. Definitions.

Except for Section 10.8.2.1, the following definitions shall apply to the following terms used in this article:

“Awarding Authority” means any Board or Commission of the City of Los Angeles, or any authorized employee or officer of the City of Los Angeles, including the Purchasing Agent of the City of Los Angeles, who makes or enters into any contract or agreement for the provision of any goods or services of any kind or nature whatsoever for, or on behalf of, the City of Los Angeles.

“Contract” means any agreement, franchise, lease or concession, including agreements for any occasional professional or technical personal services, for the performance of any work or service, the provision of any materials or supplies, or the rendition of any service to the City of Los Angeles or to the public, which is let, awarded or entered into with, or on behalf of, the City of Los Angeles or any Awarding Authority thereof. Contracts where the provisions of this article would conflict with federal or state grant funded contracts, or conflict with the terms of the grant or subvention, as determined by the DAA, are exempt.

“Contractor” means any person, firm, corporation, partnership or any combination thereof, who enters into a contract with any Awarding Authority of the City of Los Angeles.

“Designated Administrative Agency (DAA) ” means the Department of Public Works, Office of Contract Compliance created by Article X of Chapter 13 of Division 22 of the Los Angeles Administrative Code. That office is also known as the Department of Public Works, Bureau of Contract Administration.

“Domestic Partners” means, for purposes of this article, any two adults, of the same or different sex, who have registered with a governmental entity pursuant to state or local law authorizing this registration or with an internal registry maintained by an employer of at least one of the domestic partners.

“Employment Practices” means any solicitation of, or advertisement for, employees, employment, change in grade or work assignment, assignment or change in place or location of work, layoff, suspension or termination of employees, rate of pay or other form of compensation including vacation, sick and compensatory time, selection for training, including apprenticeship programs, any and all employee benefits and activities, promotion and upgrading, and any and all actions taken to discipline employees for infractions of work rules or employer requirements.

“Minority” is defined to…