HomeMy WebLinkAbout113-02 RESOLUTION• •
RESOLUTION NO. 113-02
A RESOLUTION TO ACCEPT AN ECONOMIC
INFRASTRUCTURE FUND GRANT (EIFG) IN THE AMOUNT OF
ONE HUNDRED TWENTY THOUSAND DOLLARS ($120,000.00)
FROM THE ARKANSAS DEPARTMENT OF ECONOMIC
DEVELOPMENT TO UNDERTAKE PUBLIC WORKS PROJECTS
TO SUPPORT PRIVATE SECTOR JOB GROWTH AT SUPERIOR
INDUSTRIES AND DANAHER TOOL GROUP; AUTHORIZING
CITY STAFF TO PROVIDE SEVEN THOUSAND DOLLARS
($7,000.00) WORTH OF IN-KIND ENGINEERING SERVICES;
AND APPROVING A BUDGET ADJUSTMENT IN THE AMOUNT
OF ONE HUNDRED TWENTY THOUSAND DOLLARS
($120,000.00) FOR SAME.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
FAYETTEVILLE, ARKANSAS•
Section 1. That the City Council of the City of Fayetteville, Arkansas
hereby accepts an Economic Infrastructure Fund Grant (EIFG) in the amount of
One Hundred Twenty Thousand Dollars ($120,000.00) from the Arkansas
Department Of Economic Development to undertake public works projects to
support private sector job growth at Superior Industries and Danaher Tool
Group.
Section 2. That the City Council of the City of Fayetteville, Arkansas
hereby authorizes City Staff to provide Seven Thousand Dollars ($7,000.00)
worth of in-kind engineering services.
Section 3. That the City Council of the City of Fayetteville, Arkansas
hereby approves a Budget Adjustment in the amount One Hundred Twenty
Thousand Dollars ($120,000.00) for same.
PASSED and APPROVED this 16th day of July, 2002.
APPROV
By
D• COODY,Ma
NAME OF FILE:
CROSS REFERENCE:
•
Resolution No. 113-02
(.)
07/16/02
Resolution No. 113-02
Copy of the Economic Infrastructure Fund Grant ($120,000)
06/25/02
Letter to Mayor Coody from Francille Honeycutt, Grants Management
Unit, Arkansas Department of Economic Development
05/23/02
Letter to Francille Honeycutt from Ray M. Boudreaux, Director,
Aviation and Economic Development
07/16/02
Staff Review Form
07/18/02
Memo to Ray Boudreaux, Aviation & Economic Development Director,
from Heather Woodruff, City Clerk
NOTES:
71, le a ye G noaiT ao\t ee
•
ECONOMIC INFR?STRUCTURE FUND GIANT PROGRAM
GRANT AGREEMENT
Grantee: City of Fayetteville
Grant Amount: $120.000
GRANTOR
PART I
Signatory Page
Arkansas Department of Economic Development
One Capitol Mall, Room 4B206
Little Rock, Arkansas 72201
Phone: (501) 682-1211
COPY
Grant Control: #EIF 200214
Activity Type: Multi -Activity
GRANTEE
Name: City of Fayetteville
Address: 113 W. Mountain
Fayetteville, AR 72701
County: Washington
Phone: (479) 521-7700
1. This Grant Agreement, is entered into by the Arkansas Department of Economic Development,
Grantor and the City of Fayetteville, Grantee, for the purpose of providing funds to Grantee to
undertake public works projects which support private sector job creation opportunities pursuant
to Act 1381 of 1999 and its successors. The Grantee agrees to initiate and complete a public
works project in accordance with the terms of this Grant Agreement.
2. The Grantee further warrants it will conduct and administer the grant in accordance with this
Agreement and all applicable State laws and regulations.
ARKANSAS DEPARTMENT OF ECONOMIC
DEVELOPMENT
BY:
Signature
Jim Pickens
Name
Director
Title
Date
FH:dh
CITY OF FAYETTEVILLE
BY:
Signature
Dan Coody
Name
Mayor of Fayetteville
Title
Dateiirri
CI
A.
SI
PART H- GRAD GENERAZIERMSAND
CONDITIONS
In consideration of the general terns and conditions hereinafter contained, the Grantor and the Grantee
agree as follows:
1. COMPENSATION AND METHOD OF PAYMENT. The Grantor will utilize a grant
request for payment procedure and will authorize the Grantee to draw up to $120,000
against a Grant Award through the State Treasury, consistent with all fiscal requirements
stipulated herein. The Grantee may request and receive authorized grant funds by
submitting appropriate forms and documentation, subject to approval by the Grantor, for
payments of allowable expenses incurred by the Grantee while undertaking approved
project activities in accordance with this Grant Agreement. These expenses must be
identified by line item categories, which correspond to the line item categories on this
Grant Agreement's Scope of Work -Budget. Requisitions will be mailed to the Grantor, and
the Grantor will review and approve the requisitions before issuing Payment to the
Grantee.
It is expressly understood that Grantor will honor requests for payment and disburse funds
only to the extent that funds have been released to Grantor therefore consistent with the
requirements of the General Accounting and Budgetary Procedures Law, the Revenue
Stabilization Law and any other applicable fiscal control laws and regulations promulgated
by the Department of Finance and Administration.
2. LEGAL AUTHORITY. By signing the Grant Agreement Document's Signatory Sheet,
the Grantee certifies that it possesses legal authority to accept grant funds and to execute
the project described in this Grant Agreement. This act of signing will also certify that the
Grantee will comply with all parts of this Agreement.
3. WAIVERS. No conditions or provisions of this Grant Agreement may be waived unless
approved by the Grantor, in writing.
4. ASSIGNABILITY. The Grantee will not assign any interest in this Grant Agreement and
will not transfer any interest in the same (whether by assignment or novation).
5. SPECIAL CONDITIONS. The Grantee will comply with all special conditions and
attachments incorporated herein to this grant award. Compliance approval and clearance of
special conditions will be given by the Grantor in wasting after receipt and review of
evidence of compliance from the Grantee. Official notification of a special condition and
the Grantor's approval and/or clearance of special conditions must be retained by the
Grantee in its files.
6. FINANCIAL MANAGEMENT AND ACCOUNTING. The Grantee will establish and
maintain a financial management and accounting system, which conforms to generally
accepted accounting principles and complies with all applicable State requirements.
7. ALLOWABLE COSTS. All costs necessary to carry out the eligible activities m the
project must be consistent with and not exceed the limitations imposed by special
conditions, scope of work and budget.
8. AMENDMENTS AND MODIFICATIONS. The Grantor will consider project
amendments if they are necessitated by actions beyond the control of a Grantee. The
Grantee may request or the Grantor may require an amendment or modification of the
Grant Agreement. However, such amendment or modification will not take effect until
approved, in writing. by the Grantor. The Grantee must sign and return the amendment to
the Department of Economic Development within three days The Grantee must request
prior approval for all amendments or modifications. Amendments will not be approved
2
which would materialfilter the circumstances under which thlant was originally
funded.
9. RECORD KEEPING. The Grantee agrees to keep such records as the Grantor may
require. All such records, and other records pertinent to the grant and work undertaken as
part of the project, will be retained by the Grantee for a period of three years after the final
audit of the program.
10. ACCESS TO RECORDS. The Grantor and duly authorized officials of the State will
have full access and the right to examine any pertinent documents, papers, records, and
books of the Grantee and of persons or organizations with which the Grantee may contract,
which involve transactions related to this Grant Agreement. The Grantee's contract with
other persons or organizations must specifically provide for the Grantor's access to
documents as provided herein.
11. REPORTS. The Grantee, at such times and in such forms as the Grantor may require, will
famish the Grantor with such periodic reports as it may request pertaining to the activities
undertaken pursuant to this Grant Agreement, the costs and obligations incurred in
connection therewith, and any other matters covered by this Grant Agreement.
12. OBLIGATIONS REGARDING THIRD PARTY RELATIONSHIPS. The Grantee
will remain fully obligated underet�i provisions of the Grant Agreement notwithstanding
its designation of any third party or parties for the undertaking of all or any part of the
project described herein Any subcontractor who is not the Grantee will comply with all
lawful requirements of the Grantee necessary to ensure that the project is carried out in
accordance with the provisions of this Grant Agreement Failure to comply will result in
sanction upon Grantee, Administrator, Engineer/Architect or Sub Contractor. This
sanction will result m the Department of Economic Development not working with said
persons, for a period of not less than one year or more than five years and/or a suspension
of existing funding.
The Grantee shall secure all such services in accordance with applicable State law and the
provisions of this Grant Agreement, and shall notify the Grantor, in writing, of the method
utilized to secure services, the name and address of the service provider(s), the scope of
work anticipated and the terms of compensation.
13. CONFLICT OF INTEREST. No officer or employee of the Grantor, no member, officer,
or employee File Grantee or its designees or agents, no member of the governing body of
the jurisdiction in which the project is undertaken or located and no other official of such
locality or localities who exercises any fimctions or responsibilities with respect to the
project during his tenure, will have any personal or pecuniary gain or interest, direct or
indirect, in any contract or subcontract, or the proceeds thereof, for work to be performed
m connection with the project assisted under this agreement. The Grantee will incorporate,
or cause to incorporate, in all such contracts or subcontracts a provision prohibiting such
interest pursuant to the purpose of this provision. The Grantor reserves the right to waive
certain provisions of this clause in the event of a situation once justified as unavoidable by
the Grantee, and approved by the Grantor which necessitates such a waiver.
14. POLITICAL ACTIVITY. No portion of the funds provided hereunder will be used for
any partisan political activity or to further the election or defeat of any candidate for public
office or influence the approval or defeat of any ballot issue.
15. NOTICES. The Grantee will comply with all public notices or notices to individuals
required by applicable State laws.
16. PROHIBITION AGAINST PAYMENTS OF BONUS OR COMMISSION. The
assistance provided under this Grant Agreement will not be used in payment of any bonus
or commission for the purpose of obtaining approval of the application for such assistance
or any other approval or concurrence under this Grant Agreement.
3
•
• •
17. TERMINATION BY MUTUAL AGREEMENT. This Grant Agreement may be
terminated, in whole or in part, prior to the completion of project activities when the
Grantor determines that continuation is not feasible or would not produce beneficial results
commensurate with the further expenditure of funds. The Grantee will not incur new
obligations for the terminated portion after the effective date, and will cancel as many
outstanding obligations as possible. The Grantor will make funds available to the Grantee
to pay for allowable expenses incurred before the effective date of termination.
18. TERMINATION FOR CAUSE. If the Grantee fails to comply with the terms of the Grant
Agreement, or fails to use the grant for only those purposes set forth herein, the Grantor
may:
(a) Suspend Grant Payments - After notice to the Grantee, suspend the grant and
withhold any further payment or prohibit the Grantee from incurring additional
obligations of grant funds, pending corrective action by the Grantee or a decision to
terminate by the Grantor.
(b) Terminate in toto - Terminate the grant in whole, or in part at any time before the
final grant payment is made.
The Grantor will promptly notify the Grantee in writing of its determination to terminate,
the reason for such termination, and the effective date of the termination.
Payments made to the Grantee or recoveries by the Grantor will be in accordance with the
legal rights and liabilities of the parties.
19. RECOVERY OF FUNDS. In the event of a default or violation of the teens of the Grant
Agreement by the Grantee, the Grantor may institute actions to recover all or part of the
proper funds paid to the Grantee.
20. DISPUTES. Except as otherwise provided in this agreement, any dispute concerning a
question of fact arising under this agreement which is not disposed of by provision of the
Grant Agreement, will be decided by the Grantor which will reduce its decision to writing
and mail or otherwise furnish a copy thereof to the Grantee The decision of the Grantor
will be final and conclusive. This does not preclude the consideration of questions of law
in connection with decisions provided for in the preceding paragraph, provided that
nothing in this Grant Agreement will be construed as making final the decision of any
administrative official representative, or board on a question of law.
21. INDEMNIFICATION. The Grantee will defend, protect, and save harmless the Grantor
from and against all claims, suits, and actions arising from any act or omission of the
Grantee or any employee or agents of either in the performance of this Grant Agreement.
However, this clause shall not be construed to waive A.C.A. § 21-9-301 (1991 supp.).
22. SEVERABILITY. If any provision under this Grant Agreement or its application to any
person or circumstances is held invalid by any court of competent junsdiction, this
invalidity does not affect other provisions of the Grant Agreement, which can be given
effect without the invalid provision.
23. PERFORMANCE. The Grantor's failure to insist upon the strict performance of any
provision of this contract or to exercise any right based upon breach thereof or the
acceptance of any performance during such breach, will not constitute a waiver of any
rights under this Grant Agreement.
24. ENFORCEMENT If the Grantor determines that a Grantee's performance fails to meet
the terms and conditions of its Grant Agreement, several courses of action may be pursued
m order to resolve the problem. The Grantor may take any of the following actions,
severally or in combination:
4
• •
(a) Request additional information from the Grantee to verify the nature of inadequate
performance;
Conduct a site visit to examine pertinent records and recommend remedial cause of
action;
(c) Issue a letter of warning, advising the Grantee of the deficiency, recommendations
for corrections, date by which performance must be corrected and notice that more
serious sanctions may be imposed if the situation continues or is repeated;
(d) Suspend funding of questioned activities until remedies are effected;
(e) Establish sanctions upon Grantee, Administrator, Engineer/Architect or Sub
Contractor. This sanction will be for a period of not less than one year but not more
than five years. Require reimbursement of funds improperly spent; or
(f) Refer the matter to the Attomey General of Arkansas with a recommendation that a
civil action be instituted.
25. AUDIT. The Grantee will be responsible for the conduct of a financial and compliance
audit within a reasonable period after completion of project activities Such audit must be
performed by a certified public accountant whose services are secured through procedures
consistent with state law. The Grantor reserves the right to recover any unspent or
questioned balance of grant funds, if any, from the Grantee after final audit.
26. CLOSE-OUT. The Grantor will advise the Grantee to initiate close-out procedures when
the Grantor determines, in consultation with the Grantee, that there are no impediments to
close-out and that the following cnteria have been met or soon will be met:
(a) All costs to be paid with grant funds have been incurred with the exception of any
unsettled third party claims against the Grantee. Costs are incurred when goods and
services are received and/or contract work is performed;
(b) The last required progress report has been submitted. The Grantee's failure to
submit or update will not preclude the Grantor from effecting closeout if it is
deemed to be in the State's interest. Any excess grant amount which may be in the
Grantee's possession will be returned in the event of the Grantee's failure to furnish
or update the report; and
(c) Other responsibilities of the Grantee under this Grant Agreement and any close-out
agreement, and applicable laws and regulations appear to have been carred out
satisfactorily or there is no further State interest in keeping the grant open for the
purpose of securing performance.
27. The Grantee agrees, as a condition of receiving grant assistance, to abide by and adhere to
any policy directives, rules, regulations or other requirements which may be issued from
time to time by the Grantor, and which in the opinion of the Grantor are necessary to
efficient or legal execution of the project.
28. The Grantee agrees to see that all work is performed and completed in a manner consistent
with timelines established at the Grants inception. Failure to meet these timelines without
acceptable justification may result in sanction and or deobligation of funding to Grantee
and/or Sub Contractors.
(b)
5
• •
PART III SCOPE OF WORK, SPECIAL CONDITIONS,
BUDGET, AND PROJECT SCHEDULE
SECTIONA - SCOPE OF WORK
Grantee: City of Fayetteville Amendment # N/A
Control # EIF 200214 Amendment Date N/A
The project described more fully herein consists of a grant to the Grantee for the purpose of the
construction of a new parking lot and sidewalk. The Grantee will provide $20,000 in grant funds
allowing the Danaher Tool Group to construct a sidewalk as part of a warehouse expansion project and
Superior Industries to construct a new parking lot to support the company's expansion. The location of
all improvements is shown on the project map, which is attached hereto and incorporated herein by
reference.
Job Creation
Superior Industries commits to creating 136 new, full time jobs within 24 months of project
completion.
Danaher Tool Group will create 43 new, full-time fobs as a result of the project.
Audit
Upon completion of this project, the Grantee is responsible for securing an independent, certified
public accountant to perform an audit, which tracks the expenditure of the grant funds.
6
SECTIO B - SPECIAL CONDITIONS
Grantee: City of Fayetteville
Control #: EIF 200214
1. Any construction costs in excess of $100,000 on the Superior Industries project and $20,000 on
the Danaher Tool Group will be paid by the city or company.
2. The Grantee shall ensure that all Requests for Payments are accompanied by pay estimates,
which have been approved by the Grantee. Pay estimate must accompany Request for Payment
before the Grantor will honor the Request.
3. The Grantee is responsible for having an audit of the expenditure of the grant funds at project's
completion.
4. The Grantee must receive from the Companies, job creation information at the end of the
project. Job creation information is to include, at a minimum:
a. Total number of jobs on the company payroll at the start of the project.
b. Total number of jobs on the company payroll at the end of the project.
c. General categories of jobs that were created as a result of the project.
7
•
SEIPTION C - BUDGET
•
Grantee: City of Fayetteville Amendment: #
Grant Control #EIF 200214
Category:
Housing Economic Development Community Facility Planning
Activity: Multi -Activity
ource of Funds
8
•
Cost
Sub -Costs
Classification
Arkansas
Department
Economic
of
Development
Cost
Classification
Total
Construction
$120,000
S120,000
Totals
S120,000
$120,000
8
•
.JUN -05-2002.WED 09'40 AM FAY. MIJN, AIRPORT
•
4797187646
P. 03
•
Indusldal Park Land
e._ Occupied
Available
City Owned Property
0
.a
w
CO
Danaher Tool croup
Superior Industries
For Further knwmntion Contact
•1.. Squdreal)x , Director
is Development
Clyo) Fayetteville
4500 8. School Ave., Suite F
Fayetteville, N. 72701
(478) 718.7642
email: rboudreeur areyettevil4.r.w
Fayetteville Industrial Park Land
1000
0
1000
2000. Feet
February 28, 2002
•
•
Form W-9
(Rev. December 1996)requester.
Departmentof the Treuvy
Request for Taxpayer -
Identification Number and Certification
Give .form to the
Do NOT
send to the IRS.
Internal
@
Novenae Santo
Name (If a pint account
or you changed your name, see Specific Instrections on page 2.)
F
0
Business name, it different from above. (See Specific Instructions on page 2.)
S
■
Corporation
■
Partnership
•
Other P
•
Individual/Sole proprietor
a
Check appropriate box:
i
m
Address (number, street, and
apt. or suite no.)
Requester's name end address (optional)
O.
City, state, and ZIP code
List account number(s) here (optional)
Part 1
Taxpayer
Identification
Number
(TIN)
11N in the appropriate box. For
En er your
Ind vlduals, this Is your social security number
(SSN). However. If you are a resident alien OR a
Social
security
11
number
i•
2.
sole proprietor, see the Instructions on page
Is
Part 11
For Payees Exempt From Backup
For other entities, it your employer
identification number (EIN). If you do not have a OR
Withholding (See the instructions
number, see How To Get a TIN on page 2.
Employer Identification number
on page 2.)
Note: If the account Is In m than one name, on whose I
1 1-
1
1
1 1
1
1
see the chart on page 2for
number ro enter..
Part 111
Certification
Under penalties of perjury, I certify that: •
1. The number shown on this form Is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) i have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding.
Certification Instructions.—You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply.
For mortgage Interest paid, acquisition or abandonment of secured property, cancellation not required debt,
t. contributionstib
to an oNficetionidual retirement
you must
arrangement (IRA), and generally, payments other than interest and dividends, you
provide your correct 11N. (See the Instructions on page 2.)
Sign
Here Signature 0 -
Purpose
Purpose of Form.—A person who is
required o file an information retum with
the IRS must get your correct taxpayer
identifica Ion number (TiN) to report, for
example, Income paid to you, real estate
transactions, mortgage Interest you paid,
acquisition or abandonment of secured
property, cancellation of debt, or
contributions you made to an IRA.
Use Form W-9 to give your correct TIN
to the person requesting it (the requester)
and, when applicable, to:
1. Certify the TIN you are giving Is
correct (or you are waiting for a number to
be Issued),
2. Certify you are not subject to backup
withholding, or
3. Claim exemption from backup
withholding if you are an exempt payee.
Note: If a requester gives you a form other
than a W-9 to request your TIN, you must
use the requester's form if It Is substantially
similar to this Form W-9.
What Is Backup Withholding?—Persons
making certain payments to you must
withhold and pay to the IRS 31 % of such
payments under certain conditions. This Is
called "backup withholding." Payments
that may be subject to backup withholding
Date ►
5. You do not certify your TIN when
required. See the Part III Instructions on
page 2 for details.
Certain payees and payments are
exempt from backup withholding. See the
Part II Instructions and the separate
Instructions for the Requester of Form
Include interest, dividends, broker and
barter exchange transactions, rents,
royalties, nonemployee pay, and certain
payments from fishing boat operators. Real
estate transactions are not subject to •
backup withholding.
If you give the requester your correct
11N, make the proper certifications, and
report all your taxable Interest and
dividends on your tax return, payments
you receive w it not be subject to backup
withholding. Payments you receive will be
subject to backup withholding if:
1. You do not furnish your 11N to the
requester, or
2. The IRS tells the requester that you
furnished an Incorrect TIN, or
3. The IRS tells you that you are subject
to backup withholding because you did not
report all your Interest and dividends on
your tax return (for reportable Interest and
dividends only), or
4. You do not certify to the requester
that you are not subject to backup
withholding under 3 above (for reportable
Interest and dividend accounts opened
after 1983 only), or
Penalties
Failure To Furnish TIN.—If you fail to .
furnish your correct TIN to a requester, you
are subject to a penalty of $50 for each
such failure unless your failure is due to
reasonable cause and not to willful neglect.
Civil Penalty for False Information With
Respect to Withholding.—If you make a
false statement with no reasonable basis
that results In no backup withholding, you
are subject to a $500 penalty.
Criminal Penalty for Falsifying
Information.— Willfully falsifying '
certifications or affirmations may subject
you to criminal penalties including fines
and/or Imprisonment.
Misuse, of TINs.—If the requester
discloses or uses TINs in violation of
Federal law, the requester may be subject
to civil and criminal penalties.
•
Cat No. 10231%
Form W-9 (Rev. 12-96)
•
• (6/99)
Attachment 3 (Continued)
Arkansas Direct Deposit System
General Expense Direct Deposit Authorization Form
Agency Code: EIF 200214 Agency Title: Arkansas Date: //,
Department of Economic
Development
Contact Person: Dana Heatley
Telephone Number: (501) 682-1211
CHECK WHERE APPLICABLE:
New Enrollment Complete entire form and sign.
Change of present financial information. Complete entire form and sign.
Cancel participation. Sign form.
I hereby authorize the Arkansas Direct Deposit System (ADDS) to deposit to my account indicated
below the net amount I am due as if a warrant had been delivered to me for that amount. I also
authorize the financial institution indicated below to credit the net amount to the account. Should an
incorrect entry be made, ADDS is authorized to initiate debit entries to my account necessary to
correct the incorrect credit entries.
X
Financial Institution Name:
City:
State:
Checking Account: X Savings Account:
(Select One)
Zip:
This authority is to remain in full effect until ADDS has received written notification from me of its
termination. I understand that by having my payment deposited in this manner, a direct deposit advice
notification will be available and that there will be no charge.
Social Security Number: Federal ID #:
Vendor Number: Suffix:
Grantee Name:
Address:
City/State/Zip:
Date: Signature:
ATTACH A VOIDED CHECK OR PERSONALIZED DEPOSIT SLIP WITH THIS FORM
On
Page 2 of 2
Bank Routing Number
Account Number
Account Type
1
Page 2 of 2
• •
Attachment 3
Arkansas Direct Deposit System
General Expense Direct Deposit Authorization Form
Instructions for completing forms required for direct deposit.
Arkansas Direct Deposit System Form
Complete only those blanks with an "X" beside them.
Bank Name:
City/State/Zip:
(6/99)
Enter the name of the bank authorized and able to
accept direct deposits for the project.
Enter the city, state and zip code of the bank.
Name (In Box): Enter the name of the Grantee.
Address. Enter the complete address of the Grantee.
Date and Signature. The Grantee's Chief Executive Officer must sign
and date the form.
W-9 Form
Name: Identify the Grantee as "City of " or
{{ County"
Address: Enter the complete address of the City or County.
Part I (Taxpayer ID #): Enter the nine digit city or county tax identification
number. The City Clerk or County Treasurer will
know this number.
Date and Signature: The Grantee's Chief Executive Officer must sign
and date the form.
Page 1 of 2
• •
(6/99)
Attachment 2
Request for Payment (RFP) Signature Card
A. ACEDP Control #: EIF 200214
B. Grantee Name and Address:
City of Fayetteville, 113 W. Mountain, Fayetteville, Arkansas 72701:
C. I certify that the signatures below are of the individuals authorized to request
ACEDP grant funds, and that (select the appropriate option below):
■
■
only one signature is required to sign Requests for Payment.
two signatures are required to sign & countersign Requests for Payment.
D. Signature of Chief Executive Officer:
Typed Name: Date:
E. Signatures of Individuals Authorized to Sign Requests for Payment:
1. Signature:
Typed Name:
2. Signature:
Typed Name:
3. Signature:
Typed Name:
4. Signature:
Typed Name:
F. Arkansas Department of Economic Development Approval:
Grants Manager:. Date:
•
• •
(6/99)
Attachment 2
Request for Payment (RFP) Signature Card
A. ACEDP Control #: EIF 200214
13. Grantee Name and Address:
City of Fayetteville, 113 W. Mountain, Fayetteville, Arkansas 72701:
C. I certify that the signatures below are of the individuals authonzed to request
ACEDP grant funds, and that (select the appropriate option below):
■
■
only one signature is required to sign Requests for Payment.
two signatures are required to sign & countersign Requests for Payment.
D. Signature of Chief Executive Officer:
Typed Name: Date:
E. Signatures of Individuals Authorized to Sign Requests for Payment:
1. Signature:
Typed Name:
2. Signature:
Typed Name:
3. Signature:
Typed Name:
4. Signature:
Typed Name:
F. Arkansas Departmentof•Economic Development Approval:
Grants Manager: Date:
•
(6/99)
Instructions for Completing the
Bank Designation and Check Signature Form
Section I
1. Enter the Grantee's name, permanent address and zip code.
2. Enter the name, street address and zip code of the bank that will receive direct
deposits of ACEDP funds.
3. Enter the name and number of the bank account established to receive ACEDP
funds.
4. Enter the ACEDP control number identified in the grant agreement.
5. Enter the typed names and signatures of all individuals authonzed to sign bank
account checks. At least two signatures must be provided. Such individuals
cannot be authorized to sign Requests for Payment forms The Statement of
Grantee section must be signed by the same official that signed the grant
agreement.
Section II
All sections must be completed to provide specific information regarding the bank, which
will receive ACEDP funds.
Each item is self-explanatory.
• •
Attachment 1 -
Bank Designation and Check Signature Form
SECTION I (To be Completed by Grantee)
City of Fayetteville, 113 W Mountain, Fayetteville, Arkansas 72701:
Name, Street Address and Zip Code ofACH or ACH-capable Bank to receive deposits:
(6/99)
has been designated as the depository for all grant funds to be received directly from the State of Arkansas for deposit to a non-interest
bearing account,
(3) Enter name and number of account in the proceeding blank.
resulting from Grant Control Number # EIF 200214,
(4) Grant Control Numberfrom grant agreement in the proceeding blank.
executed with the Arkansas Department of Economic Development.
(5) Typed names and Signatures (Note J)
of Persons Authorized to Sign Checks
(Typed Name/Signature)
(Typed Name/Signature)
(Typed Name/Signature)
(Typed Name/Signature)
Statement of Grantee
I/We understand that disbursements from the
Account may be made only for authorized
costs of the project.
(Signature/Title of Chief Executive Officer)
(Date)
SECTION II (To be Completed by the Bank Official)
A non-interest bearing account identified in Section I has been established with this bank. All necessary documentation, including a
power of attorney (where necessary), which will legally enable this depository to receive State of Arkansas warrants for deposit to
Bank Account Number/Name
without the payee's endorsement has been received and is in this depository's custody. This bank is a member of the FDIC.
Name of Bank
Telephone Number of Bank
Mailing Address of Bank
City, State and Zip Code of Bank
Title of Authorized Bank Official Signature of Authorized Bank Officer
Date
Note 1: Must have a minimum of two and a maximum of four signatures of individuals authorized to make disbursements (write
checks). The County Judge cannot sign county checks. Individuals signing disbursement checks cannot sign RFPs.
•
•
Attachment 1 -
Bank Designation and Check Signature Form
SECTION I (To be Completed by Grantee)
City of Fayetteville, 113 W. Mountain, Fayetteville, Arkansas 72701:
(2) Name, Street Address and Zip Code ofACH or ACH-capable Bank to receive deposits:
(6/99)
has been designated as the depository for all grant funds to be received directly from the State of Arkansas for deposit to a non-interest
bearing account,
(3) Enter name and number of account in the proceeding blank.
resulting from Grant Control Number # EIF 200214
(4) Grant Control Number from grant agreement in the proceeding blank
executed with the Arkansas Department of Economic Development.
(5) Typed names and Signatures (Note /)
of Persons Authorized to Sign Checks
(Typed Name/Signature)
(Typed Name/Signature)
(Typed Name/Signature).
(Typed Name/Signature)
Statement of Grantee
1/We understand that disbursements from the
Account may be made only for authorized
costs of the project.
(Signature/Title of Chief Executive Officer)
(Date)
d
A non-interest bearing account identified in Section 1 has been established with this bank. All necessary ocumentatimcl
on, udmg a
power of attorney (where necessary), which will legally enable this depository to receive State of Arkansas warrants for deposit to
Bank Account Number/Name
without the payee's endorsement has been received and is in this depository's custody. This bank is a member of the FDIC.
Name of Bank
Telephone Number of Bank
Mailing Address of Bank
City, State and Zip Code of Bank
Title of Authorized Bank Official Signature of Authorized Bank Officer
Date
Note 1: Must have a minimum of two and a maximum of four signatures of individuals authorized to make disbursements (write
checks). The County Judge cannot sign county checks. Individuals signing disbursement checks cannot sign RFPs.
SECTION
IT
(Tobe Completed by the Bank Official)
d
A non-interest bearing account identified in Section 1 has been established with this bank. All necessary ocumentatimcl
on, udmg a
power of attorney (where necessary), which will legally enable this depository to receive State of Arkansas warrants for deposit to
Bank Account Number/Name
without the payee's endorsement has been received and is in this depository's custody. This bank is a member of the FDIC.
Name of Bank
Telephone Number of Bank
Mailing Address of Bank
City, State and Zip Code of Bank
Title of Authorized Bank Official Signature of Authorized Bank Officer
Date
Note 1: Must have a minimum of two and a maximum of four signatures of individuals authorized to make disbursements (write
checks). The County Judge cannot sign county checks. Individuals signing disbursement checks cannot sign RFPs.
•
City of Fayetteville, Arkansas
Budget Adjustment Form
. Rea. 113-02
Budget Year Department Sales Tax Capital Improvement Fund
2002 Division:
Program: Economic Development Grant Matches
'Project or Item Requested:
Recognition of a state economic development grant award and
establishing the expenditure budget to use the grant is
requested.
Date Requested
July 1, 2002
Adjustment #
Project or Item Deleted:
None. Recognition of a state grant is the primary revenue
funding this request.
COPY,
Justification of this Increase.
The State of Arkansas has awarded a grant to the City to aid
Danaher Tools, Inc. and Superior Industries, Inc. in expanding
their operations in Fayetteville.
Justification of this Decrease:
Increase Expense (Decrease Revenue)
Account Name Amount Account Number Project Number
Economic Development Grant M: 120,000 4470 9470
5315 00 02050 1
Decrease Expense (Increase Revenue)
•
Account Name Amount Account Number Project Number
State Grants 120,000
4470 0947 4302 00
Approval Signatures
Req ed By
deet ager
Date
Date
Department Director Date
Admin. Serviceq Director Date
/
77/7/62---
-
Mayor Date
1.,/ 61 i
Budget Office Use Only
Type: A B C
Date of Approval
Posted to General Ledger
Posted to Project Accounting
Entered in Category Log
Blue . ' Budget .0 Roconrrl / whir.. r ....• o_—.__.�
Budget
E