August 17, 2021

ADVERTISEMENT FOR BIDS

CDBG Number: CDBG-CV 21-19

Bids for Design-Build Services are being solicited for construction of an Emergency Homeless Shelter in Ozaukee County. Sealed Bids must be delivered to Family Promise of Ozaukee County, 136 W. Grand Avenue, Port Washington, WI 53074, in a sealed envelope, on or before 4:00 pm, Wednesday, September 15, 2021.

For Bid packages go to: www.familypromiseoz.org

For questions contact: Paul Bissett, Homeless Programs Manager, Family Promise of Ozaukee County, 262-268-2723, or paulbfpoz@gmail.com.

There will be a Pre-Submittal Conference on Tuesday, August 31st, 2021, beginning at 5:30 pm at the project site, 1505 Sunset Rd., Port Washington, WI. Interested Contractors are urged to attend.

Public Bid Opening Date: Thursday, September 16, 2021, 10:00 am, at Family Promise of Ozaukee County 136 W. Grand Avenue, Port Washington, WI 53074.

As allowed by the applicable CDBG-CV grant, Family Promise will select the Design-Build firm based on the lowest responsible bidder.

The owner reserves the right to waive any informalities or to reject any or all bids.

Bidders must comply with the requirements and conditions of employment and contracting with the CDBG-CV grant, and Federal and State regulations. All compliance requirements are the responsibility of the Contractor.

The Contract shall be subject to Section 66.0903 of the Wisconsin Statutes about municipal wage scales and Federal Davis-Bacon wage rates.

Attention of bidders are called to conditions of employment and minimum wage rates to be paid under contract, Section 3, Segregated Facility, Section 109 and E.O. 11246.

No bidder may withdraw their bid within 30 days after the actual day of the opening thereof.

Any contract or contracts awarded under this Advertisement for Bids may be funded in part by a grant from the Community Development Block Grant Program.

A bid bond in the amount of 5% of the total bid amount, including sub-contracted work is required. A performance and payment bond of 100% of the complete project cost is required.

Minority and women-owned businesses are encouraged to apply.

END OF ADVERTISEMENT FOR BID

http://www.familypromiseoz.org/

136 W Grand Avenue | Port Washington WI 53074

(262) 268-2723 | www.familypromiseoz.org

Invitation to Submit Bid

PortLight Emergency Shelter Project

Post Date: August 19, 2021

By: Family Promise of Ozaukee County (FPOZ)

Project: PortLight an Emergency Shelter Project in Ozaukee County

Pre-Submittal Meeting: 5:30 PM, Tuesday, August 31, at Project Site - 1505 Sunset St. Port Washington WI, 53074

Bid Due Date: Bid must arrive in the FPOZ office by 4:00 pm, Wednesday, September 15, 2021

Bid Opening Date: Thursday, September 16, 10:00 am at Family Promise of Ozaukee County Office 136 W. Grand Avenue, Port Washington, WI 53074

FPOZ Contact Person: Paul Bissett, Project Manager Phone: 262-268-2723 | Email:

paulbfpoz@gmail.com

Bidder Qualifications: Experience with at least one Community Development Block Grant or other State/Federal grant. Ability to complete the project by May 30, 2022.

Must comply with the requirements and conditions of employment and contracting with the CDBG-CV grant, and Federal and State regulations.

mailto:paulbfpoz@gmail.com

Introduction Ozaukee County, Wisconsin has been awarded federal funding from the Community

Development Block Grant COVID-17 (CDBG-CV) Program and Family Promise of Ozaukee

County (FPOZ) is the sub-grantee for the development of an Emergency Shelter in Port

Washington. FPOZ is seeking bids for Design-Build services relating to the Emergency Shelter

Project.

Grant award amount for Architectural Services is $75,000, Construction/Renovation is $900,000.

The project includes renovating and building an addition onto an existing 1-story building. The renovated and expanded building will be used as an emergency shelter to house the homeless in Ozaukee County. The Shelter will have private guest rooms, each with a sleeping, living, full bathroom, and kitchenette, reception, office, meeting, and food prep space. Design should incorporate safety measures to keep family and female units separate from the male units and limit any visitors to only the reception area.

Contact Information

For Bid packages, all interested persons and firms should go to: www.familypromiseoz.org

Contact Paul Bissett, Homeless Programs Manager, between the hours of 8:30 am to 4:30 pm, Monday-Friday, at 262-268-2723 or paulbfpoz@gmail.com, to ask questions or request additional information, as needed.

Companies that intend to submit a bid should send notification of intent to FPOZ with the person’s/firm’s name and contact information in case of addenda or other changes. Additionally, the Invitation to Bid may be sent to those companies that are included on the FPOZ contact list specifically created for this Solicitation.

Those who FPOZ has sent a Solicitation and those who have provided contact information through a request for a copy of the Solicitation or through a notification of intent will receive all information regarding the Solicitation. The information may include, but is not limited to, any amendments to the Solicitation, answers to inquiries received regarding the Solicitation, or changes to the schedule.

http://www.familyrpomiseoz.org/ http://www.familypromiseoz.org

Questions Regarding This Solicitation to Bid This solicitation contains a description of the project and services required. Interested bidders have the responsibility of understanding what is required by this solicitation. During the review of the solicitation, if the bidder discovers any errors, omissions, or ambiguities within the solicitation, they should identify them in writing and call them to the immediate attention of

Family Promise of Ozaukee County prior to the solicitation submission deadline. Family

Promise of Ozaukee County shall not be held responsible for any person’s/firm’s lack of understanding of the project.

Questions for clarification concerning this Solicitation must be in writing via email to Paul Bissett, Homeless Programs Manager, at paulbfpoz@gmail.com on or before 4:00 pm, September 14, 2021. After this date, questions involving the content or intent of the proposal will not be answered. All questions will be responded to by Paul Bissett, Homeless Programs Manager, in writing via email, and provided to all parties requesting a solicitation for which Family Promise of

Ozaukee County has the contact information and treated as an addendum to the Solicitation packet.

A pre-submittal conference for interested bidders will be held at the proposed site, 1505 Sunset Road, Port Washington, WI, at 5:30 pm on Tuesday, August 31, 2021.

Family Promise of Ozaukee County makes no representations as to the conditions of the project other than those representations made herein, and no employee or any other representative of

Family Promise of Ozaukee County has the authority to make any oral or written representations as to the conditions of the project. Companies should only contact the person designated above regarding this Solicitation and should not contact the Family Promise of

Ozaukee County Chief Executive Officer, Ozaukee County, City of Port Washington members, any committee members, or any other government staff for clarification on this Solicitation.

Addenda Interpretations If it becomes necessary to revise any part of this Solicitation, a written addendum will be provided. Family Promise of Ozaukee County is not bound by any oral clarifications changing the scope of the work for this project. All addenda issued by Family Promise of Ozaukee

County will become part of the official Solicitation and will be emailed to all Bidders of record based upon contact information on record at the original time of issuance or subsequently provided.

Scope of Services & Deliverables The focus of the Design-Build project will be to design and build an Emergency Homeless

Shelter that will include renovation of a 4,800 square foot existing commercial building, and adding approximately 2,000 square feet, for Family Promise of Ozaukee County, Wisconsin.

Family Promise of Ozaukee County Project Area Description:

With the support of CDBG -CV funds, FPOZ plans to purchase an existing commercial building in Port Washington, WI that will provide emergency homeless shelter and services to households with children and households without children. The property is a 4,800 sq. ft.

building on a 1.211-acre lot adjacent to the Ozaukee County Justice Center, at 1505 Sunset Rd, Port Washington, WI. The building, a former daycare, was built in 1995. The property is in good condition and ready for the renovation work needed for emergency shelter operations.

The building should offer space for up to 8 guest rooms, each with a living, sleeping, bath and kitchenette. Additional space for case management office, meeting rooms, food prep, laundry, and storage will be included in the floor plan. Space design will incorporate necessary safety measures to serve multiple household types, keeping the family and female units separate from the male units. All shared spaces will be monitored by staff.

The project is estimated to serve approximately 125 individuals at risk of homelessness annually through direct shelter services. 85% of individuals served by this project will fall within the national objectives of Low and Moderate Income.

Project Background:

Family Promise of Ozaukee County, Inc (FPOZ), in partnership with Ozaukee County, is using the CDBG-CV grant funds to develop a much-needed static site, non-congregate, emergency shelter in the community. The emergency shelter will meet an urgent need in the county for shelter services to single women, single men and families who are homeless.

Prior to COVID-19, the emergency shelter program used area church facilities and volunteers to prepare and serve meals and provide a safe place to sleep overnight for households that were homeless. The pandemic caused two issues. First, the churches closed leaving the organization with no place to shelter people. Second, the number of phone calls increased dramatically from people seeking shelter. Because of COVID-19 the county was left with no shelter and an increased demand for service. FPOZ quickly shifted gears and opened ten rooms at a local motel for emergency shelter services. The Case Manager moved their office to the motel to better serve households in the program. While the motel voucher program is a quick fix, it is not a permanent solution.

The Emergency Shelter project will serve homeless individuals, couples without children, and households with children. These persons are amongst the most vulnerable members of the community, so it is essential that the shelter be designed and built in a way that keeps everyone safe. Guests will reside in the shelter for a minimum of 30 days, and no more than 90 days.

Design-Build Services

The selected company will serve as and perform the functions of the Design-Build Contractor for a Community Development Block Grant- CV award, including the following:

● Conduct necessary work to produce the technical documentation including final design criteria, preliminary and final drawings, outline specifications, written description of the project and value-engineering activities. Complete the final design contract documents.

We would defer to the Design Build Architects recommendations for proper code requirements/products for all areas

● Initiate the construction planning including identifying construction sub-contractors and suppliers, providing constructability reviews, develop the construction schedule, and identify long-lead equipment and material purchases. Procure equipment and sub-contractors.

● Prepare a project cost model and provide detailed cost estimates as the design is advanced for the concept of approximately 7,000 sq. ft, including the main section and both wings

● Identify Project permitting requirements and secure necessary permits, including

Occupancy.

● Construct the Project

● Provide operator training

● Provide warranty coverage

● Closeout (punch list documentation and resolution O&M manuals, systems and equipment training, as-built documentation, final inspection, and acceptance.

Bid Solicitation Exhibits This Bid Solicitation document includes the following Exhibits:

Exhibit 1 - Cover Sheet

Exhibit 2 – Disclosure of Potential Conflict of Interest Form

Exhibit 3 – Lobbying Certification Form

Exhibit 4 - Disclosure of Lobbying Activities Form

Exhibit 5 – Affirmative Action Requirements Statement Ozaukee County

Exhibit 6 - Section 3 Contract Language Requirements Clause

Exhibit 7 - Davis-Bacon and Related Acts Clause (DBRA

Exhibit 8 - Federal Labor Standards Provisions (4010)

Exhibit 9 – Equal Opportunity Clause for UGLG Procurement Construction Contracts above

$10,000

Exhibit 10 – Federal Equal Employment Opportunity Clauses Construction Contract

Specifications (EO 11246)

Exhibit 11 – Pre Construction Checklist for Contractors

Exhibit 12 – Wage Determination Schedule

Exhibit 13 – Pre Construction Meeting Items to be discussed

Exhibit 14 - Conceptual Floor Plan

Exhibit 15 - Conceptual Floor Plan Narrative

Exhibit 16– Site Survey

Exhibit 17 – Elevation Plan

Bid State and Federal Regulatory Requirements Bidder’s must comply with the requirements and conditions of employment and contracting with the CDBG-CV grant, and Federal and State regulations. These regulations include:

● Potential Conflict of Interest Disclosure - 24CFR 570.489(h) Conflict of interest Clause

● Lobbying Certification Instructions

● Disclosure of Lobbying Activities Instructions

● Equal Opportunity Clause (EO 11246)

● Section 3 Contract Language Requirements Clause

● Affirmative Action Requirements (EO 11246)

● Federal Equal Employment Opportunity Clauses Construction Contract Specifications

(EO 11246)

● Davis-Bacon and Related Acts Clause (DBRA)

● Federal Labor Standards Provisions (4010)

● Minority Business Enterprise/Woman Business Enterprise Web Resources

Resources for outreach to, contracting with, and certified registration for Minority-Owned

Business Enterprise (MBE), Women-Owned Business Enterprise (WBE) and

Disadvantaged Business Enterprise (DBE) firms:

Department of Administration Certified Minority-Owned Business Enterprise (MBE) and

Women-Owned Business Enterprise (WBE) https://wisdp.wi.gov/search.aspx

City of Madison Targeted Business Enterprise Program Directories:

http://www.cityofmadison.com/dcr/aaTBDir.cfm

Department of Transportation Disadvantaged Business Enterprise (DBE) Program https://wisconsindot.gov/Pages/doing-bus/civil-rights/dbe/default.aspx

● Applicable Davis-Bacon /Federal Wage Decision

All work to be undertaken as part of this proposed program must be in accordance with the

Federal Code of Federal Regulations, including but not limited to 24 CFR, Part 570 and 24 CFR, Part 58; and other applicable State and Federal requirements. The CDBG State and Federal

Regulatory Requirements are listed in the CDBG Implementation Handbook, and Handbook

Chapter Attachments, on the Bureau of Community Development Website at:

https://doa.wi.gov/Pages/LocalGovtsGrants/CDBGImplementationHandbook.aspx

Applicable requirements must be met by the selected entity for this Solicitation, and any entities awarded a contract or subcontract for the CDBG-CV Project.

https://doa.wi.gov/Pages/LocalGovtsGrants/CDBGImplementationHandbook.aspx

Directions for Bid Submission Complete bid packets must be delivered to Family Promise of Ozaukee County, Inc office in a sealed envelope on or before 4:00 pm, Wednesday, September 15, 2021. Bids that arrive in the office after 4:00 pm Wednesday, September 15, 2021 will be rejected.

Direct submissions to:

Family Promise of Ozaukee County, Inc.

ATTN: FPOZ Emergency Shelter Project, CDBG-CV Design-Build Project Solicitation Review Committee

136 W. Grand Ave.

Port Washington, WI, 53074

Family Promise of Ozaukee County reserves the right to reject any and all bids not meeting the requirements of this bid solicitation for design-build services.

Persons requesting ADA assistance accommodations for hearing and speech impaired may contact Paul Bissett, Homeless Programs Manager at 262-268-2723 or paulbfpoz@gmail.com.

Individuals/firms interested in being considered for this project must submit a bid detailing qualifications, technical expertise, management, and staff capabilities, related prior experience, and a detailed cost estimate for the Scope of Services described above. The objective of the sealed bid process is to objectively select the lowest responsible bidder.

Bid Contents

1. Exhibit 1 - Proposal Cover Sheet

2. Bidder’s compliance with the requirements and conditions of employment and contracting with the CDBG-CV grant, and Federal and State regulations. State and

Federal Forms.

a. Exhibit 2 - Disclosure of Potential Conflict of Interest Form

b. Exhibit 3 - Lobbying Certification Form

c. Exhibit 4 - Disclosure of Lobbying Activities Form

3. Bidder’s profile and a clear concise statement with:

a. Examples indicating past performance and familiarity with the type of work detailed in the Solicitation.

b. Provide 3 written references from previous clients with similar projects and all references give excellent response on quality of service. (Attach references and contact information)

4. Project team statement indicating the professional and technical qualifications of the key persons who will be assigned to the project and their responsibilities within the Scope of

Services.

5. Project work plan indicating mechanisms proposed to coordinate the work effort with

FPOZ.

6. Project scope statement describing the work to be undertaken, include the services outlined in the Solicitation, any modifications or expansion of the scope provided to deliver the Design-Build service, and any value engineering/cost effective components.

7. Detailed cost estimate for Architectural services.

8. Detailed cost estimate for Construction project, broken down by division and subdivision.

Bid Format The proposal must be submitted in typed format with the items to be included in the proposal placed in the same order as described in above. The Bid Cover Sheet must be signed by the submitter or authorized representative and dated. The pages of the Bid must be numbered in consecutive order and should not exceed the maximum sheet size of 8.5” x 11.”

Other Conditions of Bid Submittal

1. Only one Bid will be accepted from any person, firm, or entity.

2. No Bid will be accepted from any person, firm or entity that is in arrears for any obligation to Family Promise of Ozaukee County, is debarred from contracting for federally funded projects, or that otherwise may be deemed irresponsible or unresponsive by the elected officials of Ozaukee County, Wisconsin.

3. All Bids submitted become public information and may be reviewed by anyone requesting to do so at the conclusion of the evaluation process.

4. Requirements and conditions of employment and contracting to be observed for compliance with Conflict of Interest, Lobbying, and Section 3: Affirmative Action, Equal

Opportunity, Minority-Business Enterprise/Women Business Enterprise (MBE/WBE), Federal Labor Standards, and Davis-Bacon and Related Acts (DBRA) regulations apply to this project. For a listing of State and Federal Regulatory Requirements visit https://doa.wi.gov/Pages/LocalGovtsGrants/CDBGImplementationHandbook.aspx https://doa.wi.gov/Pages/LocalGovtsGrants/CDBGImplementationHandbook.aspx

Qualifications and Selection

● FPOZ will consider bids from contractors with experience completing projects funded by

Community Development Block Grants or similar state/federally funded projects.

● Responsible bidders will demonstrate the ability to complete the project by May 30, 2022. Time is of the essence. Currently, FPOZ is paying $14,000 per month for 10 motel rooms to shelter guests. The sooner the emergency shelter project is complete, the sooner the agency can terminate services at the local motel.

● Contractor must comply with the requirements and conditions of employment and contracting with the CDBG-CV grant, and Federal and State regulations.

Final selection of the design-build contractor will be based on the lowest responsible bidder. Bids shall be opened publicly on Thursday, September 16th, 2021, at Family Promise of Ozaukee County, 136 West Grand Ave, Port Washington, WI at 10:00am. If awarded, a firm fixed-price contract award shall be made in writing to the lowest responsible bidder. FPOZ can, however, decide not to make the award to any of the bidders. FPOZ may re-bid the project under certain conditions (i.e., bids are not responsible, or the proposals do not contain information necessary to evaluate the bids).

If you have any questions regarding this Request for Proposals, please contact:

Paul Bissett, Homeless Programs Manager | paulbfpoz@gmail.com | 262-268-2723 mailto:paulbfpoz@gmail.com

EXHIBIT 1

Cover Sheet – Bidder Information

COMPANY NAME

ADDRESS

PHONE WEBSITE

PRIMARY

CONTACT

CONTACT

PHONE

PRIMARY

CONTACT

POSITION

CONTACT

EMAIL

General Questions Y/ N If no, please explain

1. Does company have experience with at least one CDBG or another federal/state program?

2. Is your estimated project completion date on or before May 30, 2022?

3. Has the company completed 1 or more previous, similar type projects within the proposed time frame and budget?

4. Does the company have the capacity to comply with the requirements and conditions of employment and contracting with the CDBGCV grant, and Federal and State Regulations?

5. Is the company a Minority or Women Business Enterprise, Disadvantaged Business Enterprise, or Section 3/LMI Firm?

6. Is the company able to provide a bond for this project?

7. Does the bid include 1 or more value engineering/cost effective components?

BID $ ESTIMATE EVALUATION Y/N EXPLAIN

Architectural Services:

Does the architectural bid fit within the Architecture Budget?

Construction

Does the Bid fit within the Construction Budget?

Authorized Signature: Date:

Print Name: Title:

Division of Energy, Housing and Community Resources (DEHCR) Community Development Block Grant – Potential Conflict of Interest Disclosure

Potential Conflict of Interest Disclosure Page 1 Revised: August 31, 2017

EXHIBIT 2

POTENTIAL CONFLICT OF INTEREST DISCLOSURE

Emergency Shelter Project Ozaukee County, Wisconsin

Do you have family or business ties to any of the people listed below?

Yes ☐ No ☐

If yes, please check the box next to the name(s) of the individual(s) and describe the relationship in the space provided below:

OZAUKEE COUNTY ELECTED OFFICIALS:

☐ Julianne Winkelhorst, Ozaukee County Clerk

☐ Adam Gerol, Ozaukee County District Attorney

☐ Ronald Voigt, Ozaukee County Register of Deeds

☐ Mary Lou Mueller, Ozaukee County Clerk of Courts

☐ Joshua Morrison, Ozaukee County Treasurer

☐ Dan Becker, Supervisor

☐ Janette Braverman, Supervisor

☐ Barbara Jobs, Supervisor

☐ Patrick Marchese, Supervisor

☐ Paul Melotik, Supervisor

☐ Richard Nelson, Supervisor

☐ Thomas Richart, Supervisor

☐ Bruce Ross, Supervisor

☐ Lee Schlenvogt, Supervisor

☐ Gus ‘Sandy’ Wirth Jr, Supervisor

OZAUKEE COUNTY ADMINISTRATION, DEPARTMENT HEADS AND LEGAL COUNSEL:

☐ Jason Dzwinel, Ozaukee County Administrator

☐ Jason Wittek, Ozaukee County Policy and Budget Analyst

FAMILY PROMISE OF OZAUKEE COUNTY BOARD MEMBERS AND STAFF:

☐ Barb Janssen, Chair

☐ Connie Pukaite, Vice Chair

☐ Errol Barnett, Treasurer

☐ Stephen Knowles, Secretary

Division of Energy, Housing and Community Resources (DEHCR) Community Development Block Grant – Potential Conflict of Interest Disclosure

Potential Conflict of Interest Disclosure Page 2 Revised: August 31, 2017

☐ Allen Boyle, Board of Directors

☐ David Schlageter, Board of Directors

☐ Jeff Lambie, Board of Directors

☐ Jim Hoffman, Board of Directors

☐ Kathy Nordberg, Board of Directors

☐ Patricia Stark, Board of Directors

☐ Rev. Scott Samuelson, Board of Directors

☐ Suzy Frazier, Board of Directors

☐ Greg Bachrach, Board of Directors

☐ Kathleen Christenson Fisher, Chief Executive Officer

☐ Paul Bissett, Manager

Description of Relationship(s):

Please Note: The name of any bidder with a potential conflict of interest will be disclosed at the Ozaukee County Human Services Board meeting in which bids are discussed. Potential conflicts of interest will be reviewed in accordance with 24 CFR 570.489(h).

Printed Name of Individual

Title Signature

Name of Business/Firm/Company Date Signed [MM/DD/YYYY]

Division of Energy, Housing and Community Resources Lobbying Certification

Lobbying Certification Revised: August 31, 2017

GRANTEE/UGLG NAME: Ozaukee County, Wisconsin

DEHCR GRANT AGREEMENT #: CDBG-CV 21-19

LOBBYING CERTIFICATION

FROM THE

Municipality/UGLG: ___________________

Contractor/Sub-Contractor

Other: ______________________________

The undersigned certifies, to the best of his/her knowledge and belief, that:

1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including sub-contracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Name of Municipality/UGLG/Business/Firm

Signature of the Chief Elected Official, Owner, or Chief Executive Officer Title Date Signed

Printed Name of the Chief Elected Official, Owner, or Chief Executive Officer

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046

(See reverse for public burden disclosure.)

1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. contract a. bid/offer/application a. initial filing

b. grant b. initial award b. material change

c. cooperative agreement c. post-award For Material Change Only:

d. loan year _________ quarter _________

e. loan guarantee date of last report ______________

f. loan insurance

4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime:

Tier ______, if known :

Congressional District, if known : Congressional District, if known :

6. Federal Department/Agency: 7. Federal Program Name/Description:

CFDA Number, if applicable: _____________

8. Federal Action Number, if known : 9. Award Amount, if known :

10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if ( if individual, last name, first name, MI): different from No. 10a )

(last name, first name, MI ):

11. Signature:

Print Name:

Title:

Telephone No.: _______________________

Authorized for Local Reproduction

Standard Form LLL (Rev. 7-97)

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be available for public inspection.

required disclosure shall be subject to a not more than $100,000 for each such failure.

Prime Subawardee

Federal Use Only:

Date:

who fails to file the Any person $10,000 and than civil penalty of not less

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employeeof any agency, a Member of Congress, an officer or employeeof Congress, or an employeeof a Member of Congress in connectionwith a coveredFederalaction. Completeall items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriateclassification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, State and zip code of the reporting entity. Include CongressionalDistrict, if known. Check the appropriateclassification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizationallevel below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance

(CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number;

Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503.

Affirmative Action Requirements (EO 11246)

Affirmative Action Requirements (EO 11246) Revised: August 31, 2017

AFFIRMATIVE ACTION REQUIREMENTS (EO 11246)

(Applicable to construction contracts/sub-contracts exceeding $10,000)

1. The Offeror's or Bidder's attention is called to the "Equal Opportunity Clause" and the

"Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth herein.

2. The goals and timetables 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 Women = 6.9 percent (this goal applies nationwide)

Goals for minority participation = ______8.0____ (this goal applies county-wide) (Insert goals – see next page)

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. If the contractor performs construction work in a geographic area located outside of the covered area, it shall apply the goals established for such geographic area where the work is actually performed.

The contractor is also subject to the goals for both its federal and nonfederal construction.

3. The contractor's compliance with the Executive Order and the regulations in 41 CFR 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 minorities 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 of the contract, the Executive Order, and the regulations in 41 CFR 60-4. Compliance with the goals will be measured against the total work hours performed.

4. The contractor shall provide written notification to the Director of the Office of Federal

Contract Compliance Programs within 10 working days of award of any construction sub-contract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation. The notification shall list the name, address, and telephone number of the sub-contractor; employer identification number; estimated dollar amount of the sub-contract; estimated starting and completion dates of the sub-contract; and the geographical area in which the contract is to be performed.

As used in this notice, and in the contract resulting from this solicitation, the "covered area" is a description of the geographical areas where the contract is to be performed indicating the state, county and city, if any.

Affirmative Action Requirements (EO 11246)

Affirmative Action Requirements (EO 11246) Revised: August 31, 2017

GOALS FOR WOMEN AND MINORITY UTILIZATION IN CONSTRUCTION

These goals apply to all federally assisted construction contracts and sub-contracts in excess of $10,000 (EO 11246). All hours of work (federal and non-federal) in each trade, regardless of the location of work, are subject to these goals.

Directions: Use the applicable county percentage below to fill in the "Goals for minority participation" on the previous page.

A. Goals for Women--6.9 percent (this goal applies nationwide).

B. Minority Goals--percentage listed for each county:

Adams 1.7 Iowa 1.7 Polk 2.2 Ashland 1.2 Iron 1.2 Portage .6 Barron .6 Jackson .6 Price .6 Bayfield 1.2 Jefferson 7.0 Racine 8.4 Brown 1.3 Juneau .6 Richland 1.7 Buffalo .6 Kenosha 3.0 Rock 3.1 Burnett 2.2 Kewaunee 1.0 Rusk .6 Calumet .9 La Crosse .8 St. Croix 2.9 Chippewa .5 Lafayette .5 Sauk 1.7 Clark .6 Langlade .6 Sawyer .6 Columbia 1.7 Lincoln .6 Shawano 1.0 Crawford .5 Manitowoc 1.0 Sheboygan 7.0 Dane 2.2 Marathon .6 Taylor .6 Dodge 7.0 Marinette 1.0 Trempealeau .6 Door 1.0 Marquette 1.7 Vernon .6 Douglas 1.0 Menomonie 1.0 Vilas .6 Dunn .6 Milwaukee 8.0 Walworth 7.0 Eau Claire .5 Monroe .6 Washburn .6 Florence 1.0 Oconto 1.0 Washington 8.0 Fond du Lac 1.0 Oneida .6 Waukesha 8.0 Forest 1.0 Outagamie .9 Waupaca 1.0 Grant .5 Ozaukee 8.0 Waushara 1.0 Green 1.7 Pepin .6 Winnebago .9 Green Lake 1.0 Pierce 2.2 Wood .6

BCD CDBG Implementation Handbook

Chapter 6: Equal Opportunity, Fair Housing & Section 3 Page 15 Revised: October 2020

ATTACHMENT 6-B: SECTION 3 CONTRACT LANGUAGE REQUIREMENTS

Include the following language in all contracts and sub-contracts funded with CDBG dollars**:

1. Section 3 of the Housing and Urban Development Act of 1968. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (Section 3). The purpose of Section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing.

2. The parties to this contract agree to comply with HUD's regulations in 24 CFR 135, which implement Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the part 135 regulation.

3. The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this Section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the Section 3 preference, shall set forth minimum number and job titles subject to hire, availability of apprenticeship, and training positions, the qualifications for each; and the name and location of the person(s) taking applications for each of the positions; and the anticipated date the work shall begin.

4. The contractor agrees to include this Section 3 clause in every sub-contract subject to compliance with regulations in 24 CFR 135, and agrees to take appropriate action, as provided in an applicable provision of the sub-contractor in this Section 3 clause, upon a finding that the sub-contractor is in violation of the regulations in 24 CFR 135. The contractor will not sub-contract with any sub-contractor where the contractor has notice or knowledge that the sub-contractor has been found in violation of the regulations in 24 CFR 135.

5. The contractor will certify that any vacant employment positions, including training positions, that are filled

(1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR 135.

6. Non-compliance with HUD's regulations in 24 CFR 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts.

7. With respect to work performed in connection with Section 3 covered Indian housing assistance, Section 7(b) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450e) also applies to the work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible: (i) preference and opportunities for training and employment shall be given to Indians; and (ii) preference in the award of contracts and sub-contracts shall be given to Indian organizations and Indian-Owned Economic Enterprises. Parties to this contract that are subject to the provisions of Section 3 and Section 7(b) agree to comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with section 7(b).

** This language is only required for those contracts and sub-contracts regarding project activities that are funded with CDBG dollars. However, it is strongly recommended that this language be included in ALL contracts regardless of the funding source to avoid any unnecessary problems later in the project cycle.

Page 22 Chapter 7: Labor Standards Revised: October 2020

ATTACHMENT 7-B: DAVIS-BACON AND RELATED ACTS (DBRA)

A. Force Account - Under most Davis-Bacon statutes, only employees of contractors or sub-contractors are subject to Davis-Bacon wage requirements. In some instances, rather than contracting or sub-contracting out construction work, a grant recipient performs the construction in-house, with its own "force account" employees. Such force account work is not subject to Davis- Bacon wage requirements under statutes that cover only employees of contractors and sub-contractors. Furthermore, the USDOL does not consider a state or local government to be a contractor, even if it enters into a contract to perform construction work (see 29 CFR Section 5.2(h)). However, under the Housing and Community Development Act of 1974, a private firm that receives federal assistance funds indirectly from a recipient pursuant to a written procurement contract of sub-grant agreement that provides for the performance of construction work is considered a contractor or sub-contractor, and the force account exception does not apply to construction activity performed by employees of such a firm.

Laborers and mechanics employed by a local or state agency PHA (Public Housing Authority only), even though not employed by a contractor, are subject to Davis-Bacon when performing development work financed by the U.S. Housing Act of 1937, as amended. Davis-Bacon federal wage requirements are not applicable where such employees are used in work defined as major repairs (deferred maintenance) pursuant to 24 CFR 868.3 and 868.9(h), which constitute project operation rather than development.

B. Compliance and Certification Parameters - HUD policy clearly affords federal wage protection for all laborers and mechanics, regardless of contractual relationship. There is no exception to this protection for self-employed laborers or mechanics, including owners of businesses, sole proprietors, partners, corporate officers, or others. Laborers and mechanics may not certify to the payment of their own federal wages except where the laborer or mechanic is the owner of a business working on the site of the work with his/her own crew.

Accordingly, HUD and program participants responsible for labor standards administration and enforcement may not accept certified payrolls reporting single or multiple owners (e.g., partners) are certifying that they have paid to themselves the prevailing wage for their craft. A sole proprietor may not submit a payroll reporting himself or herself as simply "Owner" signing the certification as to his/her own wage payment from "draws" or other payment methods. Nor may several mechanics submit a payroll reporting themselves as "partners" with one or more certifying as to the payment of their wages or salaries. Such mechanics must instead be carried on the certified payroll of the contractor or sub-contractor for whom they are working and with whom they have executed a "contract" for services.

In these cases, maintenance of an accurate accounting of weekly work hours including any overtime hours for such mechanics is essential. Whatever method of compensation computation is utilized (piecework, weekly contract draw performance), the amount of weekly compensation divided by the actual hours of work performed for that week must result in an "effective" hourly wage rate for that week that is not less than the prevailing hourly rate for the type of work involved.

This computation must take into account overtime pay rates (i.e., one and one-half) for all hours worked in excess of 40 hours per week, pursuant to the CWHSSA, where applicable, and pursuant to the Fair Labor Standards Act where CWHSSA is not applicable.

The name, work classification, actual hours of work, effective hourly wage rate, and wage payment for each such mechanic and laborer must be reported and certified on the responsible employer's weekly payroll. Note that the effective hourly wage rate for such mechanics and laborers may fluctuate from week to week. However, the effective hourly wage rate may not be less than the minimum prevailing wage rate for the respective craft.

In any case, where the effective rate falls below the corresponding craft prevailing wage rate, the responsible employer must compensate the mechanic at no less than the prevailing wage rate on the wage determination for the craft.

Chapter 7: Labor Standards Page 23 Revised: October 2020

C. Business Owners Working with Their Crew - Owners of businesses working with their crew on the same HUD-assisted job site may certify to the payment of their own federal wages in conjunction with the prevailing wages paid to their employees. This exception to compliance standards does not suggest that such owners are not likewise entitled to prevailing wages for their labor. Rather, it accepts the wage payment certification on weekly payroll reports by the owner of his/her own wages as that certification accompanies the certification offered for payment of prevailing wages to his/her employees. On weekly payroll reports, include the owner's name, identifying him/her as "owner," and the daily and total hours worked on the covered project for the week. Omit the Rate of Pay and Amount Earned.

D. Owner-operators of Power Equipment - Frequently, owner-operators of power equipment (e.g., backhoes, front-end loaders) will contract for services at a rate for both "man and machine." In these cases, the owner-operator includes liability, equipment maintenance, and salary in an hourly or contract rate for services. Because of the prevalence of such practice and the inherent difficulty in ascribing costs for liability and maintenance costs verses hourly labor salary, HUD and its program clients may accept a combined ("man and machine") hourly rate on the responsible contractor's certified payroll provided that such hourly rate may not be less than the rate on the wage determination for the respective power equipment operator. Note: Owner-operators of power equipment, like self-employed mechanics, may not submit their own payrolls certifying to the payment of their own wage but must be carried on the responsible contractor's certified payroll report. Include the name, work classification, and actual hours worked. Upon completion of the contract, verify the pay by taking the amount paid to the sub-contractor (documented with copies of all invoices identified for this job) and divide by the hours reported on the certified payrolls.

Compare the actual hourly wage rate with the rate in the Wage Determination. If the actual hourly wage is less than the Davis-Bacon Wage Rate, collect and disburse the wage underpayments.

E. "Owner Operator" Truck Drivers - A USDOL administration policy excludes bona fide owner-operators of trucks who are independent contractors from Davis-Bacon/CWHSSA provisions concerning their own hours of work and rate(s) of pay. These truck "owner-operators" can certify to their own weekly payrolls but the payrolls do not need to show the hours worked or rates allegedly paid - only the notation "Owner-operator." Note that any laborers or mechanics, including truck drivers, employed by the owner-operator/independent contractor are subject to Davis- Bacon/CWHSSA provisions in the usual manner.

This policy does not pertain to owner-operator of other equipment such as backhoes, bulldozers, cranes and scrapers (i.e., power equipment as noted in the paragraph titled "Owner-operators of Power Equipment,” above).

"Contractor's" Truck Drivers Based on the decision made in the Midway Excavating trial, (Building and Construction Trades Department, AFL-CIO vs. USDOL Wage Appeals Board "Midway") truck drivers employed by contractors are only covered by federal wage requirements when they are performing labor on the site of the work. (e.g. if the UGLG is building a highway and the truck driver is loading, unloading, spreading, or driving back and forth on the site, then the truck driver is covered). Hauling materials to or from the site, if not performed on the site, is not covered time.

HUD has advised that they currently believe unloaded are likewise not covered.

F. Determining Proper Classification for Various Work - Questions as to the proper classification of a laborer or mechanic for various types of work are resolved by making an area-practice determination.