7-Appendix II.pdf

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Evaluation Services SSCP-000023 JDRC
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Not on record
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Delaware County, Pennsylvania

About this file

This is a Political Contribution Disclosure Form Appendix required by Delaware County, Pennsylvania for contractors bidding on covered contracts subject to County Council approval. The form applies to the Delaware County Department of Juvenile Detention and Rehabilitative Services' request for an academic or research institution to conduct a program impact evaluation supporting the development of a performance-based contracting framework for county-funded, non-residential youth prevention, diversion, and intervention services. Contractors receiving compensation of $50,000 or more under a covered contract must disclose all reportable political contributions made within the past twenty-four months. The disclosure form must be submitted according to instructions in the solicitation documents, or if not specified, at least eight days prior to the County Council meeting where contract approval will be considered. Submissions should be directed to centralpurchasing@co.delaware.pa.us.

For contracts with terms exceeding one year, contractors must provide updated disclosure forms annually by January 30, commencing January 1, 2023, reporting any reportable contributions made in the prior year. Reportable contributions include those made by the contractor, corporate parents or subsidiaries, officers or directors, shareholders or partners with five percent or greater ownership interest, and spouses of these parties to covered candidates, political party committees, or political action committees supporting covered candidates. The disclosure form will be posted on the County website and included in County Council agenda materials prior to contract approval. Failure to provide the required disclosure form within thirty days of written notification from the County Solicitor may result in contract voidance. Contractors who fail to submit the disclosure form or who submit materially inaccurate information may be banned from County contracting for up to three years and/or have their covered contract terminated by majority vote of County Council.

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1-Appendix F.pdf PDF
5-Appendix FF.pdf PDF
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2-Appendix AA FFS CoverSheet.pdf PDF
8-Appendix AA.pdf PDF
4-Appendix EE.pdf PDF
9-Appendix CC.pdf PDF
10-Appendix U.pdf PDF
11-Appendix LL.pdf PDF
3-Appendix DD.pdf PDF
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APPENDIX II

(L:Contracts_2223)Standard_Appendices_AppendixII

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POLITICAL CONTRIBUTION DISCLOSURE

Under Section 6-12.E of the Administrative Code of Delaware County, Contractors under certain Covered Contracts are required to provide this Disclosure Form in connection with consideration of approval of such Covered Contract by County Council.

Definitions of Contractor, Covered Contract, and certain other terms used in this Disclosure Form, as well as additional instructions for its completion, are set forth in Exhibit A attached hereto.

Political Contribution Disclosure: Within the past twenty-four (24) months, Contractor* has:

____NOT made any Reportable Contributions.

____made Reportable Contributions as set forth on Schedule A attached hereto.

*Includes entities and persons related to a Contractor whose contributions are also required to be reported, as further described in the definition of “reportable contribution” on Exhibit A.

Type of Business Entity

Corporation___ LLC___ Sole Proprietorship___ Other: ___(describe)

Limited Partnership ____ Partnership___ LLP___

Certification: In order for this Disclosure Form to be considered validly submitted, it must be properly signed by the Contractor or an officer or employee of the Contractor that is authorized to make this certification. Disclosure Forms that are not properly signed will not be considered as responsive to the requirements of the Delaware County Administrative Code.

By executing below, you:

(1) Declare and certify that you are the Contractor or an employee or officer of the Contractor and duly authorized to execute this Disclosure Form.

(2) Represent and warrant that, to the best of your knowledge after appropriate inquiry, all of the information and disclosures provided are true and contain no material misstatement or omissions.

(3) Acknowledge and agree to comply with the provisions described in Exhibit A.

Name of Contractor: _______________________ _ By: ______________________________________

Name:

Title:

Date:

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Exhibit A Delaware County

Political Contribution and Disclosure Form

Definitions and Instructions

TIMING

Contracts Subject to an RFP/Q, Invitation to Bid or other Solicitation – the Solicitation will have explicit instructions on when and how to submit this Disclosure Form. Please follow those instructions.

Other Contracts – Disclosure Forms must be received by the County at least eight (8) days prior to the County Council meeting at which the approval of a contract will be considered. They should be submitted by e-mail to centralpurchasing@co.delaware.pa.us.

In either case, failure to timely provide this Disclosure Form may delay consideration of your contract by County Council.

PUBLIC POSTING: RIGHT TO KNOW

The Disclosure Form for the selected Contractor is sought will be posted on the County website prior to the County Council meeting at which approval of the Covered Contract will be considered and included in the Agenda materials for such meeting.

The County will also provide copies of Disclosure Forms (whether or not the Contractor is awarded a Covered Contract) in response to requests under the Pennsylvania Right to Know Law.

ONGOING REPORTING

By January 30 each year, commencing January 1, 2023, each Covered Contractor under a Covered Contract with a term exceeding one year is required to provide the County Clerk with an updated Disclosure form showing any reportable contributions in the prior year indicating that are none. If a Contractor does not provide the required disclosure form within thirty (30) days of written notification from the County Solicitor of its failure to timely provide such form, the applicable Covered Contract is subject to being voided by County Council.

PENALTIES

Any Contractor which fails to provide the Disclosure Form or which submits a Disclosure Form which is materially inaccurate may be banned as a contractor or subcontractor to the County for a period of up to three (3) years, and/or, to the extent legally permitted, the covered contract in question may be terminated, in each case, by a majority vote of County Council following such investigation and consideration of such evidence as County Council deems appropriate or by action of such other entity or body as may be designated by resolution of County Council.

DEFINITIONS

“Contractor” means any non-governmental person, corporation, partnership, association or other entity, whether or not for profit, and includes any subcontractor which is reasonably anticipated to receive compensation of $50,000 or more under the applicable Covered Contract.

See the definition of “Reportable Contribution” below for entities and persons related to a contractor whose contributions are also required to be reported.

mailto:centralpurchasing@co.delaware.pa.us

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“Covered Candidate” means any individual who seeks nomination or election to the following offices by vote of the electorate (whether or not such individual is nominated or elected): (1) County Council, District Attorney, Sheriff, Controller or Register of Wills in Delaware County; (2) Judge of the Court of Common Pleas of Delaware County or the Magisterial District Courts of Delaware County; (3) any seat in the Pennsylvania General Assembly which represents residents of Delaware County; or (4) any state-wide office in Pennsylvania (non federal).

An individual shall be deemed to be seeking nomination or election to an office if such individual has:

(1) received a contribution or made an expenditure or given consent for any other person or committee to receive a contribution or make an expenditure for the purpose of influencing his nomination or election to such office, whether or not the individual has announced the specific office for which he will seek nomination or election at the time the contribution is received, or the expenditure is made; or

(2) taken the action necessary under the laws of Pennsylvania to qualify for nomination or election to such office.

The term shall include individuals nominated or elected as write-in candidates unless they resign such nomination or elected office within 30 days of having been nominated or elected.

“Covered Contract” means any contract, agreement, memorandum of understanding or other arrangement which is (i) required to be approved by County Council and (ii) under which a Covered Contractor provides or leases goods, supplies, materials, equipment, consulting, professional or other services, and/or property to the County, whether or not payments under the Covered Contract are anticipated to be made from general revenues or another specified source of funds, but does not include grant agreements under which the County is the grantee.

“Political contribution” means any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, pledge, purchase of a ticket to a testimonial or similar fund-raising affair, or subscription of contract, agreement, promise or other obligations, whether or not legally enforceable, to make a political contribution.

“Reportable Contribution” means a political contribution, to:

(A) A covered Candidate.

(B) Any Pennsylvania state committee of a political party, any County committee of a political party or any committee of a political party established at the municipal level for a municipality in the County.

(C) A contribution to a political action committee with the intent or expectation that some or all of such contribution will be directed to a covered candidate. This intent shall be presumed if a political action committee only supports one or more covered candidates.

(D) A contribution to a political action committee controlled by a person or entity described in clauses (1) through (5) below.

Reportable contributions include contributions by: (1) a Contractor; (2) any corporate parent, subsidiary or other affiliate of a Contractor; (3) an officer or director of a

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Contractor; (4) a shareholder or partner of a Contractor with a 5% or greater ownership interest; and (5) the spouse of any person or entity listed in the preceding clauses; and shall also include any contribution reimbursed by a person or entity listed in the clauses

(1) through (5).

QUESTIONS

Questions regarding the Disclosure Form may be directed to centralpurchasing@co.delaware.pa.us.

Schedule A

DELAWARE COUNTY

mailto:centralpurchasing@co.delaware.pa.us

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POLICITICAL CONTRIBUTION FORM

Reportable Contributions within Past 24 months

Name of Contractor: ____________________

Date: __________________

Contributor*

Candidate

Date

Amount

Relationship of Contributor to Contractor

*Reporting required for Contractor and all other entities and persons related to Contractor whose contributions are also required to be reported, as further described in the definition of “reportable contribution” on Exhibit A.

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