Addendum No_ 1.pdf

GEFA-1

GEORGIA ENVIRONMENTAL FINANCE AUTHORITY

SUPPLEMENTAL GENERAL CONDITIONS

for

FEDERALLY ASSISTED

STATE REVOLVING FUND

CONSTRUCTION CONTRACTS

May 9, 2014

The following standard language must be incorporated into construction contract documents and in all solicitations for offers and bids for all construction contracts or subcontracts in excess of $10,000 to be funded in whole or in part by the federally-assisted State Revolving Fund in the state of Georgia.

These Supplemental General Conditions shall not relieve the participants in this project of responsibility to meet any requirements of other portions of this construction contract or of other agencies, whether these other requirements are more or less stringent. The requirements in these Supplemental General Conditions must be satisfied in order for work to be funded with the State Revolving Fund.

GEFA-2

TABLE OF CONTENTS

Instructions & General Requirements 3

DBE Compliance Form 4

DBE Compliance Checklist 6

Six Good Faith Efforts 7

Resources for Identifying DBE Subcontractors 8

Certification Regarding Equal Employment Opportunity 9

Certification Regarding Debarment, Suspension, & Other Responsible Matters 10

EPA Form 6100-2 DBE Subcontractor Participation Form 11

EPA Form 6100-3 DBE Subcontractor Performance Form 12

EPA Form 6100-4 DBE Subcontractor Utilization Form 13

Changes to Approved Subcontractors Form 14

DBE Annual Report Form (5700-52A) 15

Special Provisions 16

Equal Employment Opportunity (EEO) Notice 17

EEO Construction Contract Specifications (Executive Order 11246) 18

Davis-Bacon and Related Acts 22

Wage Rate Determination (and links for forms, posters, etc.) 28

Certified Payroll Review Checklist 29

GEFA-3

INSTRUCTIONS & GENERAL REQUIREMENTS

It is the policy of the State Revolving Loan Fund (SRF) to promote a fair share of subcontract, materials, equipment and service awards to small, minority, and women-owned businesses for equipment, supplies, construction, and services. Compliance with these contract provisions is required in order for project costs to be eligible for SRF funding. The fair share objective is a goal, not a quota. Failure on the part of the apparent successful bidder to submit required information to the loan recipient (Owner) may be considered by the Owner in evaluating whether the bidder is responsive to bid requirements.

THE PRIME CONTRACTOR MUST SUBMIT THE FOLLOWING ITEMS TO THE OWNER:

A. Before beginning the work of any contract:

1) DBE Compliance Form and related documentation. The Owner must submit this information to the Georgia Environmental Finance Authority (GEFA) to demonstrate compliance with Disadvantaged Business Enterprise (DBE) requirements. GEFA concurrence is recommended prior to award of the construction contract and is required prior to commencement of any SRF-funded construction. (Pages GEFA-4&5)

2) Certification Regarding Equal Employment Opportunity. This form is required for the Prime Contractor and for all subcontractors. The Prime Contractor form should be submitted with the DBE Compliance Form, and the subcontractor forms should be submitted as the subcontracts are executed. (Page GEFA-9)

3) Certification Regarding Debarment, Suspension, & Other Responsible Matters. This form is required for the Prime Contractor and for all subcontractors. The Prime Contractor form should be submitted with the DBE Compliance Form and the subcontractor forms should be submitted as the subcontracts are executed. (Page GEFA- 10)

4) *EPA Form 6100-2 DBE Subcontractor Participation Form. This form gives a DBE subcontractor the opportunity to describe the work the DBE subcontractor received from the Prime Contractor, how much the DBE subcontractor was paid, and any concerns the DBE subcontractor might have. The Prime Contractor must provide this form to each DBE subcontractor. The DBE subcontractor can, as an option, complete and submit this form to the GEFA DBE Coordinator, who will also forward the form to the EPA DBE Coordinator. (Page GEFA-11)

5) *EPA Form 6100-3 DBE Subcontractor Performance Form. This form captures the description of work to be performed by an intended DBE subcontractor and the price of the work. This form is to be provided by the Prime Contractor to each DBE subcontractor and submitted with the DBE Compliance Form. (Page GEFA-12)

6) *EPA Form 6100-4 DBE Subcontractor Utilization Form. This form captures intended or anticipated use of an identified DBE subcontractor by the Prime Contractor and the estimated dollar amount of the work. This form is to be completed by the Prime Contractor and submitted with the DBE Compliance Form. (Page GEFA-13)

* 6100 FORMS ARE NOT REQUIRED WHEN ALL OF THE WORK IS SELF-PERFORMED BY THE PRIME CONTRACTOR.

B. During the performance of the contract:

7) Changes to Subcontractors Form. If any changes, substitutions, or additions are proposed to the subcontractors included in previous GEFA concurrences, the Owner must submit this information to GEFA for prior concurrence in order for the affected subcontract work to be eligible for SRF funding. (Page GEFA-14)

8) DBE Annual Report. The Owner must submit this information to GEFA no later than October 20th of any year that the construction contract is active. ( Page GEFA-15)

9) Certified Payrolls. These should be submitted to the Owner weekly for the Prime Contractor and all subcontractors.

The Owner must maintain payroll records and make these available for inspection. Use Department of Labor form WH-347 or a similar form that contains all of the information on the Department of Labor.

THE OWNER MUST SUBMIT INFORMATION FOR GEFA REVIEW AND CONCURRENCE TO:

Georgia Environmental Finance Authority Attention: DBE Compliance Coordinator

233 Peachtree Street, N.E.

Harris Tower, Suite 900 Atlanta, Georgia 30303

(404)584-1000; (404)584-1069 (fax) dbe_compliance@gefa.ga.gov mailto:dbe_compliance@gefa.ga.gov

GEFA-4

DBE COMPLIANCE FORM

ALL INFORMATION OUTLINED ON THIS FORM IS REQUIRED FOR DBE COMPLIANCE REVIEW. THE PROPOSED PRIME CONTRACTOR AND OWNER SHOULD ENSURE THAT THIS INFORMATION IS COMPLETE PRIOR TO SUBMITTAL.

Loan Recipient __________________________ SRF Loan Number ______________________________

PRIME CONTRACTOR’S AND OWNER‘S CERTIFICATIONS:

I certify that the information submitted on and with this form is true and accurate and that this firm has met and will continue to meet the conditions of this construction contract regarding DBE solicitation and utilization. I further certify that criteria used in selecting subcontractors and suppliers were applied equally to all potential participants and that EPA Forms 6100-2 and 6100-3 were distributed to all DBE subcontractors.

________________________________________ Date___________________ (Prime Contractor signature)

(Printed name and title)

I certify that I have reviewed the information submitted on and with this form and that it meets the requirements of the Owner's State Revolving Fund loan contract.

________________________________________ Date__________________ (Signature of Owner or Owner's representative)

(Printed name and title)

CONTACT INFORMATION

Owner contact _________________________________________________________________________________________________

Owner phone number & email ____________________________________________________________________________________

Consulting Engineer contact _____________________________________________________________________________________

Consulting Engineer phone number & email ________________________________________________________________________

Proposed Prime Contractor ______________________________________________________________________________________

Prime Contractor contact ________________________________________________________________________________________

Prime Contractor phone number & email ___________________________________________________________________________

Proposed total contract amount $ _____________________________________________________________________________

Proposed total MBE participation $ ______________________________ Percentage _________ Goal: 4.0 percent

Proposed total WBE participation $ ______________________________ Percentage _________ Goal: 4.0 percent

CONTINUED ON NEXT PAGE

GEFA-5

Please submi t the fo l lowing wi th the DBE Compl iance Form:

1) List of all committed and uncommitted subcontractors by trade, including company name, address, telephone number, contact person, dollar amount of subcontract, and DBE/MBE/WBE status.

2) Indicate in writing if no solicitations were made because the Prime Contractor intends to use only its own forces to accomplish the work.

3) Proof of certification by EPA, SBA, DOT (or by state, local, Tribal, or private entities whose certification criteria match EPA criteria) for each subcontractor listed as a DBE, MBE, or WBE.

4) Documentation of solicitation efforts for prospective DBE firms, such as fax confirmation sheets, copies of solicitation letters and e-mails, printout of online solicitations, printouts of online search results and copies and affidavits of publication in newspapers or other publications. (see also, “Six Good Faith Efforts”, page GEFA-7).

a. The Prime Contractor shall use the necessary resources to identify and directly solicit no less than 3 certified MBE firms and 3 certified WBE firms to bid in each expected subcontract trade or area. If a diligent and documented search of the recommended directories does not identify 3 potential certified MBE firms and 3 potential certified WBE firms, then the Prime Contractor shall post an advertisement in the Owner’s local legal organ, the Owner’s official website, a regional newspaper in a larger community in the proximity, the Prime Contractor’s website, or some other appropriate resource.

b. The Prime Contractor is encouraged to follow-up each written, fax, or e-mail solicitation with at least 1 logged phone call.

c. Whenever possible, post solicitations for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date.

5) Written justification for not selecting a certified DBE subcontractor that submitted a low bid for any subcontract area.

6) Certification By Proposed Prime Contractor or Subcontractor Regarding Equal Employment Opportunity (GEFA-9)

7) Certification By Proposed Prime or Subcontractor Regarding Debarment, Suspension, and Other Responsible Matters.

(GEFA-10)

8) *EPA Form 6100-3 DBE Subcontractor Performance Form for all DBE subcontracts. (GEFA-12)

9) *EPA Form 6100-4 DBE Subcontractor Utilization Form for all DBE subcontracts. (GEFA-13)

*6100 forms are not required when all of the work is self-performed by the prime contractor.

END OF DBE COMPLIANCE FORM

GEFA-6

D B E C O M P L I A N C E C H E C K L I S T THE PRIME CONTRACTOR MUST SUBMIT THE FOLLOWING ITEMS TO THE OWNER BEFORE THE WORK BEGINS:

Loan Recipient _______________________________ SRF Loan Number _______________________________

I n c l u d e i n P a c k a g e S u b m i t t a l

1. DBE Compliance Form. The Owner must sign and submit this information to the Georgia Environmental Finance Authority (GEFA) to demonstrate compliance with DBE requirements. GEFA concurrence is recommended prior to award of the construction contract and is required prior to commencement of any SRF-funded construction. (Pages GEFA-4&5)

2. Certification Regarding Equal Employment Opportunity. This form is required for the Prime Contractor and for all subcontractors. The Prime Contractor’s form should be submitted with the DBE Compliance Form and the subcontractors’ forms should be submitted as the subcontracts are executed. (Page GEFA-9)

3. Certification Regarding Debarment, Suspension, & Other Responsible Matters. This form is required for the Prime Contractor and for all subcontractors. The Prime Contractor’s form should be submitted with the DBE Compliance Form and the subcontractors’ forms should be submitted as the subcontracts are executed. (Page

GEFA-10)

4. EPA Form 6100-2 DBE Subcontractor Participation Form. This form gives a DBE subcontractor the opportunity to describe the work the DBE subcontractor received from Prime Contractor, how much the DBE subcontractor was paid, and any other concerns the DBE subcontractor might have. The Prime Contractor must provide this form to each DBE subcontractor.

The DBE subcontractor can, as an option, submit this form to the GEFA DBE Coordinator, who will forward the form to the EPA DBE Coordinator. (Page GEFA-11)

5. EPA Form 6100-3 DBE Subcontractor Performance Form. This form captures an intended DBE subcontractor’s description of work to be performed for the Prime Contractor and the price of the work. This form is to be provided by the Prime Contractor to each DBE subcontractor and submitted with the DBE Compliance Form. (Page GEFA-12)

6. EPA Form 6100-4 DBE Subcontractor Utilization Form. This form captures the Prime Contractor’s intended use of an identified DBE subcontractor and the estimated dollar amount of the work. This form is to be completed by the Prime Contractor and submitted with the DBE Compliance Form (Page GEFA-13)

U n c o m m i t t e d T r a d e s

D o c u m e n t a t i o n o f G o o d F a i t h E f f o r t s

PRIME CONTRACTOR ONLY TOTAL CONTRACT

AMOUNT

ALL SUBCONTRACTORS, INCLUDING DBE FIRMS TRADE AMOUNT

ALL SUBCONTRACTORS, INCLUDING DBE FIRMS Trade Amount TRADE AMOUNT

DBE SUBCONTRACTORS ONLY TRADE AMOUNT

DBE SUBCONTRACTORS ONLY TRADE AMOUNT

PRIME CONTRACTOR ONLY (Not applicable if self-performing all work, with no subcontracting)

Newspaper ads Internet Websites Fax Confirmation

Copies of Solicitation Emails/letters

Copies of phone logs

PROOF OF CERTIFICATION FOR EACH SUBCONTRACTOR LISTED AS A

DBE, MBE, OR WBE

GEFA-7

SIX GOOD FAITH EFFORTS

These good faith efforts are required methods to ensure that DBEs have the opportunity to compete for procurements funded by EPA financial assistance dollars. Such good faith efforts are described as follows:

1. Ensure DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities.

This will include placing DBEs on solicitation lists and soliciting them whenever there are potential sources.

2. Make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules, where the requirements permit, in a way that encourages and facilitates participation by DBEs in the competitive process.

This includes, whenever possible, posting solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date.

3. Consider in the contracting process whether firms competing for large contracts could subcontract with DBEs. This will include dividing total requirements when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the competitive process.

4. Encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually.

5. Use the resources, services, and assistance of the Department of Transportation (DOT), Small Business Administration (SBA), and the Minority Business Development Agency of the Department of Commerce (MBDA).

6. If the Prime Contractor awards subcontracts, it must take the steps described in items (1) through (5) listed above.

Please note that DBEs, MBEs, and WBEs must be certified by EPA, SBA, or DOT (or by state, local, Tribal, or private entities whose certification criteria match EPA’s). DBEs must be certified in order to be counted toward the Prime Contractor’s MBE/WBE goals. “Self-certified” DBE subcontractors will not be counted toward the Prime Contractor’s MBE/WBE goals.

Depending upon the certifying agency, a DBE may be classified as a DBE, a Minority Business Enterprise (MBE), or a Women’s Business Enterprise (WBE).

The Prime Contractor must employ and document the Six Good Faith Efforts for all subcontracts, even if the Prime Contractor has achieved the fair share objectives.

The documentation of solicitations for the Six Good Faith Efforts must be detailed in order to allow for satisfactory review.

Such documentation might include fax confirmation sheets, copies of solicitation letters/emails, printouts of the online solicitations, printouts of online search results and affidavits of publication in newspapers or other publiccations. The Prime Contractor is encouraged to follow up each written, fax, or e-mail solicitation with at least 1 logged phone call.

The Prime Contractor should attempt to identify and solicit DBEs in the geographic proximity of the project before soliciting those located farther away.

If a DBE subcontractor fails to complete work under the subcontract for any reason, the Prime Contractor must notify the Owner in writing prior to any termination and must employ the Six Good Faith Efforts described above if using a replacement subcontractor. Any proposed changes from the approved DBE subcontractor list must be reported to the Owner and to GEFA on the Changes to Approved Subcontractors Form (GEFA-14) prior to initiation of the action. EPA Forms Nos. 6100-3 and 6100-4 must also be submitted to GEFA for new DBE subcontracts.

GEFA-8

RESOURCES FOR IDENTIFYING DBE SUBCONTRACTORS

RESOURCES FOR IDENTIFYING DBE SUBCONTRACTOR’S FOR DIRECT SOLICITATION:

Georgia Department of Transportation (GDOT) Disadvantaged Business Enterprise Program

(404) 631-1972 https://gdotbiext.dot.ga.gov/analytics/saw.dll?Dashboard&PortalPath=%2Fshared%2FExternal%2F_portal% 2FUCP%20Directory&Page=UCP%20Directory&Action=Navigate&Syndicate=true&anon=1

City of Atlanta, Georgia Office of Contract Compliance (404) 330-6010 https://www.atlantaga.gov/government/mayor-s-office/executive-offices/office-of-contract-compliance

DeKalb County, Georgia Office of Purchasing and Contracting

(404) 371-4730 http://dekalblsbe.info/wordpress1/wp-content/uploads/2016/05/DeKalbCountyCertifiedVendorsListMay10-2016-Final2.pdf

Fulton County, Georgia Purchasing and Contract Compliance

(404) 612-5800 http://www.fultoncountyga.gov/fcpccd-local-business-directory

Metropolitan Atlanta Rapid Transit Authority (MARTA) Disadvantaged Business Enterprise Program

(404) 848-4656 https://marta.diversitysoftware.com/FrontEnd/VendorSearchPublic.asp?XID=8663&TN=marta

United States Environmental Protection Agency http://www.epa.gov/osbp/dbe_team.htm Teree Henderson National DBE Program Coordinator

(202) 566-2222 henderson.teree@epa.gov

NOTES:

(1) The Prime Contractor shall use the necessary resources to identify and directly solicit no less than 3 certified MBE firms and 3

WBE firms to bid in each expected subcontract area or trade.

(2) If a diligent and documented search of the recommended directories does not identify 3 potential certified MBE firms and 3 potential certified WBE firms, then the Prime Contractor shall post an advertisement in the Owner’s local legal organ, the Owner’s official website, a regional newspaper in a larger community in the proximity, the Prime Contractor’s website, or some other appropriate resource. Whenever possible, post solicitation for bids or proposals for a minimum of 30 calendar days before the bid or proposal closing date.

(3) Expenditures to a DBE that acts merely as a broker or passive conduit of funds, without performing, managing, or supervising the work of its subcontract in a manner consistent with normal business practices may not be counted.

(4) The Prime Contractor should attempt to identify and first solicit DBEs in the geographic proximity of the project before soliciting those located farther away.

(5) Contact GEFA Program Managers at (404) 584-1000 or dbe_compliance@gefa.ga.gov for further assistance or resources.

For more information about DBE compliance, contact:

dbe_compliance@gefa.ga.gov http://tomcat2.dot.state.ga.us/ContractsAdministration/uploads/rptDBE_Directory_CA_New.pdf http://pro.prismcompliance.com/ http://www.co.dekalb.ga.us/purchasing/pdf/supplierList.pdf http://www.fultoncountyga.gov/plugins/content/external_links/frameset.php?url=http%3A%2F%2Fwww.occfultoncountyga.com%2FDirectory%2FMFBEDirectoryExternal.aspx http://www.fultoncountyga.gov/plugins/content/external_links/frameset.php?url=http%3A%2F%2Fwww.occfultoncountyga.com%2FDirectory%2FMFBEDirectoryExternal.aspx http://www.itsmarta.com/vendor-opportunities.aspx http://www.epa.gov/osbp/dbe_team.htm mailto:henderson.teree@epa.gov http://www.gefa.ga.gov/ mailto:dbe_compliance@gefa.ga.gov

GEFA-9

CERTIFICATION BY PROPOSED PRIME CONTRACTOR OR SUBCONTRACTOR

REGARDING

EQUAL EMPLOYMENT OPPORTUNITY

Proposed Prime Contractor

Proposed Subcontractor

This certification is required pursuant to Executive Order 11246, Part II, Section 203 (b), (30 F.R. 12319-25). Any bidder or prospective prime contractor, or any of the proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.

Where the certification indicated that the prime or subcontractor has not filed a compliance report due under applicable instruction, such contractor shall be required to submit a compliance report.

(1) Bidder has participated in a previous contract or subcontract subject to the Equal Opportunity Clause.

YES _____ NO _____

(2) Compliance Reports were required to be filed in connection with such contract or subcontract.

YES _____ NO _____ (If YES, state what reports were filed and with what agency.)

(3) Bidder has filed all compliance reports due under applicable instructions, including SF-100 (EEO-1 Report).

YES _____ NO _____ (If NO, please explain in detail.)

The information above is true and complete to the best of my knowledge and belief. (A willfully false statement is punishable by law – U.S. Code, Title 18, Section 1001.)

PRINTED NAME & TITLE OF AUTHORIZED REPRESENTATIVE OF CONTRACTOR OR SUBCONTRACTOR

SIGNATURE OF AUTHORIZED REPRESENTATIVE DATE

GEFA-10

CERTIFICATION BY PROPOSED PRIME CONTRACTOR OR SUBCONTRACTOR

REGARDING

DEBARMENT, SUSPENSION, AND OTHER RESPONSIBLE MATTERS

Proposed Prime Contractor

Proposed Subcontractor

Under Executive Order 12549 individuals or organizations debarred from participation in Federal Assistance Programs may not receive an assistance award under federal program or sub-agreement there under for $25,000 or more. Accordingly each recipient of a State loan or a contract (engineering or construction) awarded under a loan must complete the following certification (see 40 CFR 32.510).

The prospective participant certifies to the best of its knowledge and belief that it and its principals;

(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency.

(b) Have not within a three year period preceding this proposal been convicted of or had a civil judgement rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(c) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and

(d) Have not within a three year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause of default.

I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of the award. (A willfully false statement is punishable by law – U.S. Code, Title 18, Section 1001.)

PRINTED NAME & TITLE OF AUTHORIZED REPRESENTATIVE OF CONTRACTOR OR SUBCONTRACTOR

SIGNATURE OF AUTHORIZED REPRESENTATIVE DATE

_____ I am unable to certify to the above statements. My explanation is as follows:

GEFA-11

EPA FORM 6100-2 (DBE Subcontractor Participation Form)

OMB Control No: 2090-0030 Approved: 8/13/2013

Approval Expires: 8/31/2015

Disadvantaged Business Enterprise (DBE) Program DBE Subcontractor Participation Form

An EPA Financial Assistance Agreement Recipient must require its prime contractors to provide this form to its DBE subcontractors. This form gives a DBE1 subcontractor2 the opportunity to describe work received and/or report any concerns regarding the EPA-funded project (e.g., in areas such as termination by prime contractor, late payments, etc.). The DBE subcontractor can, as an option, complete and submit this form to the EPA DBE Coordinator at any time during the project period of performance.

Subcontractor Name Project Name

Bid/ Proposal No. Assistance Agreement ID No. (if known) Point of Contact

Address

Telephone No. Email Address

Prime Contractor Name Issuing/Funding Entity:

Contract Item

Number

Description of Work Received from the Prime Contractor Involving Construction, Services , Equipment or Supplies

Amount Received by Prime

Contractor

1 A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certifications as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202.

2 Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance.

GEFA-12

OMB Control No: 2090-0030 Approved: 8/13/2013

Approval Expires: 8/31/2015

Disadvantaged Business Enterprise (DBE) Program DBE Subcontractor Performance Form

EPA FORM 6100-3 (DBE Subcontractor Performance Form)

This form is intended to capture the DBE1 subcontractor’s2 description of work to be performed and the price of the work submitted to the prime contractor. An EPA Financial Assistance Agreement Recipient must require its prime contractor to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package.

Subcontractor Name Project Name

Bid/ Proposal No. Assistance Agreement ID No. (if known) Point of Contact

Address

Telephone No. Email Address

Prime Contractor Name Issuing/Funding Entity:

Contract Item Number Description of Work Submitted to the Prime Contractor Involving Construction, Services , Equipment or Supplies

Price of Work Submitted to the Prime Contractor

DBE Certified By: DOT SBA

Other:

Meets/ exceeds EPA certification standards?

YES NO Unknown

1 A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certifications as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202.

2 Subcontractor is defined as a company, firm, joint venture, or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance.

GEFA-13 EPA FORM 6100-4 (DBE Subcontractor Utilization Form)

I have identified potential DBE certified subcontractors YES NO

If yes, please complete the table below. If no, please explain:

Subcontractor Name/ Company Name

Company Address/ Phone/ Email Est. Dollar Amt

Currently

DBE

Certified?

OMB Control No: 2090-0030 Approved: 8/13/2013

Approval Expires: 8/31/2015

Disadvantaged Business Enterprise (DBE) Program DBE Subcontractor Utilization Form

This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract.

An EPA Financial Assistance Agreement Recipient must require its prime contractors to complete this form and include it in the bid or proposal package.

Prime contractors should also maintain a copy of this form on file.

Prime Contractor Name Project Name

Bid/ Proposal No. Assistance Agreement ID No. (if known) Point of Contact

Address

Telephone No. Email Address

Issuing/Funding Entity:

Continue on back if needed 1 A DBE is a Disadvantaged, Minority, or Woman Business Enterprise that has been certified by an entity from which EPA accepts certifications as described in 40 CFR 33.204-33.205 or certified by EPA. EPA accepts certifications from entities that meet or exceed EPA certification standards as described in 40 CFR 33.202.

GEFA-14

CHANGES TO APPROVED SUBCONTRACTORS FORM

Loan Recipient ___________________________________ SRF Loan Number ____________________________

CERTIFICATIONS:

I certify that the information submitted on and with this form is true and accurate and that this firm has met and will continue to meet the conditions of this construction contract regarding DBE solicitation and utilization. I further certify that criteria used in selecting subcontractors and suppliers were applied equally to all potential participants.

________________________________________ Date____________ (Prime Contractor signature)

(Printed name and title)

I certify that I have reviewed the information submitted on and with this form and that it meets the requirements of the Owner's State Revolving Fund loan contract.

________________________________________ Date____________ (Signature of Owner or Owner's representative)

(Printed name and title)

GENERAL INFORMATION:

1) If an approved subcontractor is terminated or replaced, please identify this company and briefly state reason.

Subcontractor Name:: Trade

Reason Terminated or Replaced

2) For new or additional subcontractors, list name, trade, address, telephone number, contact person, dollar amount of subcontract, and DBE status.

New Subcontractor Name and Contact Person Trade

Address Telephone Number

Dollar Amount DBE Status

1) Attach proof of certification by EPA, SBA, DOT (or by state, local, Tribal, or private entities whose certification criteria match EPA’s) for each subcontractor listed as a DBE, MBE, or WBE.

2) Attach documentation of Six Good Faith Efforts solicitation effort for all new subcontracts.

3) Provide justification for not selecting any certified DBE subcontractor that submitted a low bid for any subcontract area.

4) For each subcontractor, attach certifications regarding Equal Employment Opportunity (GEFA-9) and certifications regarding Debarment, Suspension, and Other responsible Matters (GEFA-10)

GEFA-15

DBE ANNUAL REPORT

FORM (5700-52A)

This form must be completed by recipients of federal financial assistance for procurement of supplies, equipment, construction or services. SRF loan recipients are required to submit this report to GEFA by the 20th of October for the previous period of October 1 through September 30. Please submit a “negative” report even if $0 is the amount paid to MBE/WBE subcontractors during the reporting period.

ANNUAL REPORT FORM (5700-52A)

1. PRIME CONTRACTOR 2. REPORTING PERIOD (Complete date using current year.)

Period Ending (September 30, ________)

3. SUBMIT TO:

Georgia Environmental Finance Authority Attention: DBE Compliance Coordinator 233 Peachtree Street, N.E.

Harris Tower, Suite 900 Atlanta, Georgia 30303 dbe_compliance@gefa.ga.gov

4. LOAN RECIPIENT (Name, Address and Telephone)

5. LOAN RECIPIENT (OWNER)

REPORTING CONTACT

PHONE: 6. TYPE OF FEDERAL FINANCIAL

ASSISTANCE PROGRAM (Check one)

CWSRF ___________ DWSRF__________

7. SRF LOAN NUMBER

8. CONTRACTOR NAME & TOTAL CONSTRUCTION

CONTRACT AMOUNT

9. ACTUAL DOLLAR AMOUNT PAIDTO MBE/WBE

SUBCONTRACTORS THIS PERIOD

$ MBE____________ $ WBE____________ NEGATIVE REPORT ($0) ___

10. RECIPIENT’S MBE/WBE GOALS

MBE 4.0 % WBE 4.0 %

11. TOTAL DOLLARS SPENT THIS PERIOD

MBE $___________________

WBE $___________________

NON MBE/WBE $___________________

TOTAL $ ___________________

12. NAME & TITLE OF AUTHORIZED

REPRESENTATIVE OF LOAN RECIPIENT

(OWNER).

13. SIGNATURE OF AUTHORIZED

REPRESENTATIVE OF LOAN RECIPIENT.

14. DATE

MBE/WBE PAYMENTS MADE DURING PERIOD

NAME & ADDRESS of DBE (SUB)CONTRACTOR (indicate if MBE or WBE firm) TOTAL DOLLAR AMOUNT PAID & DATE PAID

$______________________ DATE_____________

GEFA-16

SPECIAL PROVISIONS

(a) The Prime Contractor is required to pay its subcontractors in accordance with the Georgia Prompt Payment Act

(OCGA 13-11).

(b) The Prime Contractor is required to insert the entirety of the Davis Bacon contract requirements into all subcontracts

(c) Sewer line and water line crossing of all roads and streets shall be done in accordance with the Georgia Department of Transportation (D.O.T.) Policies and Procedures and must comply with the Ga. D.O.T. Standard Specifications, Construction of Roads and Bridges, 1993 Edition.

(c) Construction shall be carried out so as to prevent bypassing of wastewater flow and to prevent interruption of drinking water treatment during construction. EPD must receive written notification prior to any reduction in the level of treatment and must approve all temporary modifications to the treatment process prior to the activity.

(d) Erosion and Sedimentation Control shall be accomplished in accordance with the Georgia Erosion and Sedimentation Control Act of 1975 as currently amended and NPDES General Permits (Storm Water from Construction Sites). See also www.gaepd.org and www.gaswcc.georgia.gov for information regarding permits.

(e) Use of Chemicals: All chemicals used during project construction or furnished for project operation, whether herbicide, pesticide, disinfectant, polymer reactant or of other classification, must show approval of either EPA or USDA. Use of all such chemicals and disposal of residues shall be in conformance with State and local regulations as appropriate.

(f) It is the duty of the Prime Contractor, the Owner and the Engineer to ensure the construction of the project, including the letting of contracts in connection therewith, shall comply with all applicable laws and regulations and requirements of the United States of America or any agency thereof, the state of Georgia or any agency thereof, territorial, or any local government laws or political subdivision and ordnances to the extent that such requirements do not conflict with Federal laws and this subchapter.

(g) EPD, EPA, and GEFA shall have access to the site and the project work at all times.

BONDS

Bonding requirements for Contracts of $100,000 or less are contained in the General Conditions. Bond requirements of contracts in excess of $100,000 are:

1. Bid guarantee equivalent to five percent of the bid price. The bid guarantee shall consist of a firm commitment such as a certified check or bid bond submitted with the bid.

2. Performance bond equal to 100 percent of the contract price and;

3. Payment bond equal to 100 percent of the contract price. Bonds must be obtained from companies holding Certificates of Authority as acceptable sureties, issued by the U.S. Treasury.

SPECIAL NOTICE TO BIDDERS

By the submission of this bid, each bidder acknowledges that he understands and agrees to be bound by the equal opportunity requirements of EPA regulations (40 CFR Part 8, particularly Section 8.4 (b)), which shall be applicable throughout the performance of work under any contract awarded pursuant to this solicitation. Each bidder agrees that if awarded a contract, it will similarly bind contractually each subcontractor. In implementation of the foregoing policies, each bidder further understands and agrees that if awarded a contract, it must engage in affirmative action directed at promoting and ensuring equal employment opportunity in the workforce used under the contract (and that it must require contractually the same effort of all subcontractors whose subcontracts exceed $10,000.00). The bidder understands and agrees that “affirmative action” as used herein shall constitute a good faith effort to achieve and maintain minority employment in each trade in the on-site workforce used on the project.

http://www.gaepd.org/ http://www.gaswcc.georgia.gov/

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EQUAL EMPLOYMENT OPPORTUNITY NOTICE

NOTICE OF REQUIREMENT FOR AFFIRMATIVE ACTION TO ENSURE EQUAL OPPORTUNITY

(EXECUTIVE ORDER 11246)

1. The Offeror’s or Bidder’s attention is called to the Equal Opportunity Clause which is included in the nondiscrimination Provision and Labor Standards, EPA Form 5720-4 and the Standard Federal Equal Employment Opportunity (EEO) Construction Contract Specifications set forth herein.

2. The goals for minority and female participation, expressed in percentage terms for the Contractor’s aggregate workforce in each trade on all construction work in the covered area, are as follows:

Goals for minority participation for each trade 4.0 percent

Goals for female participation for each trade 4.0 percent

These goals are applicable to all the Contractor’s construction work (whether or not it is Federal or federally assisted) performed in the covered area.

The Contractor’s compliance with the Executive Order and the regulations in 41 CFR Part 60-4 shall be based on its implementation of the Equal Opportunity Clause, specific affirmative action obligations required by the specifications set forth in 41 CFR 60-4.3(a), and its efforts to meet the goals established for the geographical area where the contract resulting from this solicitation is to be performed. The hours of minority and female employment and training must be substantially uniform throughout the length of the contract, and in each trade, and the contractor shall make a good faith effort to employ minority and women evenly on each of its projects. The transfer of minority or female employees or trainees from Contractor to Contractor or from project to project for the sole purpose of meeting the Contractor’s goals shall be a violation to the contract, the Executive Order and the regulations in 41 CFR Part 60-4.

Compliance with the goals will be measured against the total work hours performed.

3. The contractor shall not discriminate on the basis of race, color, national origin or sex in the performance of this contract. The contractor shall carry out applicable requirements of 40CFR Part 33 in the award and administration of contracts awarded under EPA financial assistance agreements. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result in the termination of this contract.

4. As used in this Notice, and in the contract resulting from this solicitation, the “covered area” is (insert description of the geographical area where the contract is to be performed giving the state, county and city, if any).

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EEO Construction Contract Specifications (Executive Order 11246)

EEO Specifications:

1. As used in these specifications:

a. “Covered area” means the geographical area described in the solicitation from which this contract resulted;

b. “Director” means Director, Office of Federal Contract Compliance Program, United States Department of Labor, or any person to whom the Director delegates authority;

c. “Employer identification number” means the Federal Social Security number used on the Employer’s Quarterly Federal Tax Return, U.S. Treasury Department Form, 941.

d. “Minority” includes:

(i) Black (all persons having origins in any of the Black African racial groups not of Hispanic origin);

(ii) Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish Culture or origin, regardless of race);

(iii) Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands);

and

(iv) American Indian or Alaskan Native (all persons having origins in any of the original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification).

2. Whenever the contractor, or any subcontractor at any tier, subcontracts a portion of the work involving any construction trade, it shall physically include in each subcontract in excess of $10,000 the provisions of these specifications and the Notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted.

3. If the Contractor is participating (pursuant to 41 CFR 60-4.5) in a Hometown Plan approved by the U.S.

Department of Labor in the covered area either individually or through an association, its affirmative action obligations on all work in the Plan area (including goals and timetables) shall be in accordance with that Plan for those trades which have unions participating in the Plan. Contractors must be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each Contractor or Subcontractor participating in an approved Plan is individually required to comply with its obligations under the EEO clause, and to make a good faith effort to achieve each goal under the Plan in each trade in which it has employees. The overall good faith performance by other Contractors or Subcontractors toward a goal in an approved Plan does not excuse any covered Contractor’s or Subcontractor’s failure to take good faith efforts to achieve the Plan goals and timetables.

4. The Contractor shall implement the specific affirmative action standards provided in paragraphs 7(a) through (p) of these specifications. The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the Contractor should reasonably be able to achieve in each construction trade in which it has employees in the covered area. The Contractor is expected to make substantially uniform progress toward its goals in each craft during the period specified.

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5. Neither the provisions of any collective bargaining agreement, nor the failure by a union with whom the Contractor has a collective bargaining agreement, to refer either minorities or women shall excuse the Contractor’s obligations under these specifications, Executive Order 11246, or the regulations promulgated pursuant thereto.

6. In order for the non-working training hours of apprentices and trainees to be counted in meeting the goals, such apprentices and trainees must be employed by the Contractor during the training period, and the Contractor must have made a commitment to employ the apprentices and trainees at the completion of their training, subject to the availability of employment opportunities. Trainees must be trained pursuant to training programs approved by the U.S. Department of Labor.

7. The Contractor shall take specific affirmative actions to ensure equal employment opportunity. The evaluation of the Contractor’s compliance with these specifications shall be based upon its effort to achieve maximum results from its actions. The Contractor shall document these efforts fully, and shall implement affirmative action steps at least as extensive as the following:

a. Ensure and maintain a working environment free of harassment, intimidation, and coercion at all sites, and in all facilities at which the Contractor’s employees are assigned to work. The Contractor, where possible, will assign two or more women to each construction project. The Contractor shall specifically ensure that all foremen, superintendents, and other on-site supervisory personnel are aware of and carry out the Contractor’s obligation to maintain such a working environment, with specific attention to minority or female individuals working at such sites or in such facilities.

b. Establish and maintain a current list of minority and female recruitment sources, provide written notification to minority and female recruitment sources and to community organizations when the Contractor or its unions have employment opportunities available, and maintain a record of the organizations responses.

c. Maintain a current file of the names, addresses and telephone numbers of each minority and female off-the-street applicant and minority or female referral from a with respect to each such individual. If such individual was sent to the union hiring hall for referral and was not referred back to the Contractor by the union or, if referred, not employed by the Contractor, this shall be documented in the file with the reason therefore, along with whatever actions the Contractor may have taken.

d. Provide immediate written notification to the Director when the union or unions with which the Contractor has a collective bargaining agreement has not referred to the Contractor a minority person or woman sent by the Contractor, or when the Contractor has other information that the union referral process has impeded the Contractor’s efforts to meet its obligations.

e. Develop on-the-job training opportunities and/or participate in training programs for the area which expressly include minorities and women, including upgrading programs and apprenticeship and trained programs relevant to the Contractor’s employment needs, especially those programs funded or approved by the Department of Labor. The Contractor shall provide notice of these programs to the sources complied under 7(b) above.

f. Disseminate the Contractor’s EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the Contractor in meeting its EEO obligations by including it in any policy manual and collective bargaining agreement; by publicizing it in the company newspaper, annual report, etc.; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work is performed.

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g. Review, at least annually, the company’s EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination or other employment decisions including specific review of these items with on-site supervisory personnel such as Superintendents, General Foremen, etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings, persons attending, subject matter discussed, and disposition of the subject matter.

h. Disseminate the Contractor’s EEO policy externally by including it in any advertising in the news media, specifically including minority and female news media, and providing written notification to and discussing the Contractor’s EEO policy with other Contractors and Subcontractors with whom the Contractor does or anticipates doing business.

i. Direct its recruitment efforts, both oral and written, to minority, female and community organizations, to schools with minority and female students and to minority and female recruitment and training organizations serving the Contractor’s recruitment area and employment needs. Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment source, the Contractor shall send written notification to organizations such as the above, describing the openings, screening procedures, and tests to be used in the selection process.

j. Encourage present minority and female employees to recruit other minority persons and women and, where reasonable, provide after school, summer and vacation employment to minority and female youth both on the site and in other areas of a Contractor’s workforce.

k. Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60-3.

l. Conduct, at least annually, an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for, through appropriate training, etc., such opportunities.

m. Ensure that seniority practices, job classifications, work assignments and other personnel practices, do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO policy and the Contractor’s obligations under these specifications are being carried out.

n. Ensure that all facilities and company activities are non-segregated except that separate or single-user toilet and necessary changing facilities shall be provided to assure privacy between the sexes.

o. Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations.

p. Conduct a review, at least annually, of all supervisors’ adherence to and performance under the Contractor’s EEO policies and affirmative action obligations.

8. Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their affirmative action obligations 7(a) through (p). The efforts of a contractor association, joint contractor-union, contractor-community, or other similar group of which the contractor is a member and participant may be asserted as fulfilling any one or more of its obligations under 7(a) through (p) of these Specifications provided that the contractor actively participates in the group, makes every effort to assure that the group has a positive impact on the employment of minorities and women in the industry, ensures that the concrete benefits of the program are reflected in the Contractor’s minority and female workforce participation, makes

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a good faith effort to meet its individual goals and timetables, and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the Contractor.