DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 MISSISSIPPI Form MDHS-SCSS-1002 Revised 10/31/2016 STATE OF MISSISSIPPI MISSISSIPPI DEPARTMENT OF HUMAN SERVICES SUBGRANT SIGNATURE SHEET P. O. BOX 352 JACKSON, MISSISSIPPI 39205-0352 MDHS FUNDING DIVISION: Workforce Development 1. SUBGRANTEE'S NAME, 2. EFFECTIVE DATE: April 1, 2020 ADDRESS & PHONE NUMBER Mississippi Department of Employment Security 3. AGREEMENT NUMBER: 6018813/6018814 1235 Echelon Parkway Post Office Box 1699 4a. GRANT IDENTIFIER (funding source and year): Jackson, MS 39215 DUN'S NUMBER: 2020 TANF 878193150 b. CATALOG OF FEDERAL DOMESTIC ASSISTANCE (CFDA) #: SUBGRANTEE'S FISCAL YEAR END DATE: 93.558 30-Jun 5. BEGINNING AND ENDING DATES: April 1, 2020 NAME/TITLE OF OFFICERS: (SUBGRANT ENTITY) Jacqueline A. Turner- Deputy Executive Director through September 30, 2020 6. SUBGRANT PAYMENT METHOD: Mary Henery-Workforce Investment Board CURRENT NEEDS/CASH ADVANCE x CONTACT PERSON: COST REIMBURSEMENT Jacqueline A Turner OTHER PHONE NUMBER: EMAIL: jturner@mdes.ms.gov 7. PAGE 1 OF 4 8. THE FOLLOWING FUNDS ARE OBLIGATED: FEDERAL $ STATE $ OTHER $ TOTAL $ 1,462,408.00 ADMINISTRATION $ 146,240.00 - SERVICES $ 1,316,168.00 - OTHER $ TOTAL $ 1,462,408.00 1,462,408.00 9. THE SUBGRANTEE AGREES TO ADMINISTER THIS SUBGRANT IN ACCORDANCE WITH ALL FEDERAL AND/OR STATE PROVISIONS THAT ARE APPLICABLE TO SAID SUBGRANT. THE FOLLOWING DOCUMENTS ARE INCORPORATED HEREIN: a. SUBGRANT SIGNATURE SHEET 3) STANDARD ASSURANCES POLICY b. BUDGET SUMMARY 4) DEBARMENT POLICY c. COST SUMMARY SUPPORT SHEET 5) DRUG FREE WORKPLACE POLICY d. BUDGET NARRATIVE 6) SUBGRANT MANUAL ACCEPTANCE e. SUBGRANT AGREEMENT f. VERIFICATION OF 25% FIDELITY BOND 1) SCOPE OF SERVICES g. COPY OF BOARD RESOLUTION (if applicable) 2) GENERAL TERMS AND PROVISIONS h. COST ALLOCATION PLAN & INDIRECT COST RATES 10. IDENTIFICATION OF OTHER FUNDING (List all other funds requested, anticipated or held over from prior years dedicated to this or similar programs including Federal, State, Local or Private funds. If additional space is needed, please attach typed pages). SOURCE PURPOSE CONTRACT # n/a 11. APPROVED FOR MDHS: AMOUNT $ _______________ _______________ $ _______________ _______________ $ _______________ _______________ $ _______________ 12. APPROVED FOR SUBGRANTEE: 3/17/2020 BY: PERIOD (dates) _______________ DATE: BY: DATE: Jacob Black Jacqueline A. Turner Executive Director\Designee Deputy Executive Director TITLE TITLE 3/16/2020 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 MISSISSIPPI DEPARTMENT OF HUMAN SERVICES BUDGET SUMMARY MISSISSIPPI Form MDHS-BS-1006 Effective 10/31/2016 Page 2 of 4 Pages 1. Applicant Agency: Mississippi Department of Employment Security 2. Agreement Number: 6018813/6018814 3. Grant ID 4. Beginning 5. Ending 2020 TANF April 1, 2020 September 30, 2020 6. Submitted as Part of (check one): a. Funding Request b. Modification ( ) c. Modification (x) Effective Date 7. For MDHS 8. Budget Activity Federal Use Only State Local Funding Sources Program In-Kind Total Administration $ 146,240.00 $ 146,240.00 Program Support $ 1,316,168.00 $ 1,316,168.00 TOTAL $ 1,462,408.00 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 1,462,408.00 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 MISSISSIPPI DEPARTMENT OF HUMAN SERVICES COST SUMMARY SUPPORT SHEET Page Mississippi Form MDHS-CSSS-1007 Revised 10/31/2016 1. Applicant Agency Mississippi Department of Employment Security 2. Agreement Number 3. Grant ID 6018813 2020 TANF 6. Budget Activity Administration 7. For MDHS 8. Budget Category Use Only Federal Indirect Cost 3 of 4. Beginning April 1, 2020 State Local 4 Pages 5. Ending September 30, 2020 9. Budget Program In-Kind $ 146,240.00 Total $ $ TOTAL $ 146,240.00 $ - $ - $ - $ - $ 146,240.00 - 146,240.00 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 MISSISSIPPI DEPARTMENT OF HUMAN SERVICES COST SUMMARY SUPPORT SHEET Page 4 Mississippi Form MDHS-CSSS-1007 Revised 10/31/2016 1. Applicant Agency Mississippi Department of Employment Security 2. Agreement Number 3. Grant ID 6018814 2020 TANF 6. Budget Activity Program Support 7. For MDHS Use Only 8. Budget Category Federal of 4. Beginning April 1, 2020 State Local 4 Pages 5. Ending September 30, 2020 9. Budget Program In-Kind Total Salaries $ 618,337.00 $ 618,337.00 Fringe Benefits $ 240,080.00 $ 240,080.00 Contractual Services $ 432,259.00 $ 432,259.00 Travel $ 22,389.00 $ 22,389.00 Commodities $ 3,103.00 $ 3,103.00 TOTAL $ 1,316,168.00 $ - $ - $ - $ - $ 1,316,168.00 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 STATE OF MISSISSIPPI DEPARTMENT OF HUMAN SERVICES DIVISION OF WORKFORCE DEVELOPMENT SUBGRANT AGREEMENT SUBGRANT AGREEMENT NUMBER: # 6018813/6018814 The MISSISSIPPI DEPARTMENT OF HUMAN SERVICES, DIVISION OF WORKFORCE DEVELOPMENT, hereinafter referred to as "MDHS," and MISSISSIPPI DEPARTMENT OF EMPLOYMENT SECURITY hereinafter referred to as "SUBGRANTEE," by the signatures affixed herein, do hereby make and enter into this Agreement. WHEREAS, pursuant to Section 43-1-2 of the 1972 Mississippi Code Annotated, as amended and 42 U.S.C. '604a, MDHS is authorized to enter into agreements with public and private agencies for the purpose of purchasing certain services for the benefit of eligible individuals under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, hereinafter the "Act"; and WHEREAS, the Subgrantee is eligible for entering into agreements with MDHS for the purpose of providing services for the benefit of certain eligible individuals under the Act; and WHEREAS, the services being contracted for in this Agreement are not otherwise available on a non-reimbursable basis; and WHEREAS, MDHS wishes to purchase such services from Subgrantee; NOW THEREFORE, in consideration of the mutual understandings and agreements set forth, MDHS and Subgrantee agree as follows: SECTION I PURPOSE The purpose of this Agreement is to engage 2020 TANF services of the Subgrantee. SECTION II RESPONSIBILITY OF SUBGRANTEE The Subgrantee shall provide, perform, and complete in a satisfactory manner as determined by MDHS, the services described in Exhibit A, entitled "Scope of Services" which is made a part hereof and incorporated by reference herein. 1 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION III TERM OF AGREEMENT The Subgrantee shall undertake and complete services to be rendered under this Agreement beginning April 1, 2020 and end September 30, 2020. SECTION IV SUBGRANT AMOUNT AND PAYMENT A. SUBGRANT AMOUNT As full and complete compensation for the services to be provided hereunder, total reimbursement by MDHS shall not exceed One Million Four Hundred Sixty Two Thousand Four Hundred Eight Dollars ($1,462,408.00) for the term of this subgrant. These services shall be budgeted in accordance with the Budget Sheets and Budget Narrative attached hereto as Exhibit B and incorporated herein. B. MAXIMUM LIABILITY Irrespective of any other provisions of this Agreement, its attachments, laws and regulations or the obligation of the Subgrantee, the liability of payment by MDHS to Subgrantee of federal and/or state funds shall be limited to an amount not to exceed the sum of One Million Four Hundred Sixty Two Thousand Four Hundred Eight Dollars ($1,462,408.00) in consideration of all the activities and/or services provided pursuant to this Agreement unless specifically increased in accordance with Section XXIII of the Agreement. C. CONSIDERATION AND METHOD OF PAYMENT Payment method is either by Cost Reimbursement as referenced on the Subgrant/Contract Signature Sheet, Item 6. Eligible expenses are outlined in the Budget Summary and Cost Summary Support Sheet(s), attached hereto and made a part hereof. For any request for funds to be processed, MDHS must receive required monthly program and fiscal reports as outlined in Section XIX of this Agreement. Any increase, decrease or change in the funding under this Agreement that is authorized by the parties, in compliance with applicable laws and policies, shall require a modification of the amounts listed in the Budget Summary and Cost Summary Support Sheets pursuant to Section XXIII of this Agreement. SECTION V AVAILABILITY OF FUNDS It is expressly understood and agreed that the obligation of MDHS to proceed under this Agreement is conditioned upon the appropriation of funds by the Mississippi State Legislature and/or the receipt of federal and state funds. In the event that the funds anticipated for the fulfillment of this Agreement are, at any time, not forthcoming or are insufficient, either through the failure of the federal government to provide funds, or of the State of Mississippi to appropriate funds, or through the discontinuance or material alteration of the program under which funds were provided, or if 2 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 funds are not otherwise available to MDHS for the performance of this Agreement, MDHS shall have the right to immediately terminate this Agreement, without damage, penalty, cost or expense to MDHS of any kind whatsoever. The ultimate decision as to whether or not funds continue to be available for the performance of this Agreement lies solely with MDHS. SECTION VI RELATIONSHIP OF THE PARTIES A. It is expressly understood and agreed that MDHS enters into this Subgrant with Subgrantee on a purchase of service basis and not on an employer-employee relationship basis. Nothing contained herein shall be deemed or construed by MDHS, the Subgrantee, or any third party as creating the relationship of principal and agent, partners, joint ventures, or any similar such relationship between MDHS and the Subgrantee. Neither the method of computation of fees or other charges, nor any other provision contained herein, nor any acts of MDHS or the Subgrantee hereunder, creates or shall be deemed to create a relationship other than the independent relationship of MDHS and the Subgrantee. B. Subgrantee represents that it has, or will secure, at its own expense, applicable personnel who shall be qualified to perform the duty required to be performed under this Subgrant. C. Any person assigned by Subgrantee to perform the services hereunder shall be the employee of Subgrantee, who shall have the sole right to hire and discharge its employee. MDHS may, however, direct Subgrantee to replace any of its employees under this Subgrant. If Subgrantee is notified within the first eight (8) hours of assignment that the person is unsatisfactory, Subgrantee will not charge MDHS for those hours. The Subgrantee will replace the employee within 5 days after receipt of notice from MDHS. D. It is further understood that the consideration expressed herein constitutes full and complete compensation for all services and performances hereunder, and that any sum due and payable to Subgrantee shall be paid as a gross sum with no withholdings or deductions being made by MDHS for any purpose from said Subgrant sum. E. Subgrantee shall pay when due all salaries and wages of its employees, and it accepts exclusive responsibility for the payment of Federal Income Tax, State Income Tax, Social Security, Unemployment Compensation and any other withholdings that may be required. SECTION VII TERMINATION OR SUSPENSION A. TERMINATION FOR CAUSE If, through any cause, Subgrantee fails to fulfill in a timely and proper manner, as determined by MDHS, its obligations under this Subgrant, or if Subgrantee violates any of the covenants, agreements, or stipulations of this Subgrant, MDHS shall thereupon have the right to terminate the Subgrant by giving written notice to Subgrantee of such termination 3 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 and specifying the effective date thereof at least five (5) days before the effective date of such termination. B. TERMINATION FOR CONVENIENCE This Agreement may be terminated for convenience, in whole or in part, as follows: 1. By MDHS with the consent of the Subgrantee, in which case the two parties shall agree upon the termination conditions, including the effective date, and in the case of partial termination, the portion to be terminated; or 2. By the Subgrantee upon written notification to MDHS, setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. However, if, in the case of a partial termination, MDHS determines that the remaining portion of this subgrant will not accomplish the purposes for which the subgrant was made, MDHS may, without the Subgrantee’s consent, terminate this subgrant in its entirety. C. TERMINATION IN THE BEST INTEREST OF THE STATE This Subgrant may be terminated by the MDHS in whole, or in part, with 15 days’ notice whenever MDHS makes the final determination that such termination is in the best interest of the State of Mississippi. Any such determination will be effected by delivery in writing to the Subgrantee of a notice specifying the extent to which the Subgrant is terminated and the date upon which termination becomes effective. Once the Subgrantee has received notice of termination, Subgrantee shall not make further expenditures for the provision of services under the Subgrant. D. TERMINATION FOR FORCE MAJEURE If either Party is rendered unable, wholly or in part, by reason of strikes, accidents, acts of God, weather conditions or other acts beyond its control and without its fault or negligence, to comply with its obligations under this Subgrant, then such party shall have the option to terminate this Subgrant, in whole or in part, upon giving written notice to the other Party. E. PARTIAL TERMINATION In the event of a partial termination, the Subgrantee shall incur no obligations other than those specifically identified in the agreement or contract governing the partial termination. F. RIGHTS AND REMEDIES UPON TERMINATION OR SUSPENSION In the event of termination or suspension as provided in this Section, Subgrantee shall be entitled to receive just and equitable compensation for unreimbursed obligations or expenses that are reasonably and necessarily incurred in the satisfactory performance, as determined by MDHS, of this Agreement, that were incurred before the effective date of suspension or termination, and that are not in anticipation of termination or suspension. Costs of the Subgrantee resulting from obligations incurred by the Subgrantee during a 4 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 suspension or after termination of this subgrant are not allowable under this Agreement. In no case, however, shall said compensation or payment exceed the total amount of this subgrant as set forth in Section IV. Notwithstanding any provisions of this subgrant, Subgrantee shall be liable to MDHS for damages sustained by MDHS by virtue of any breach of this Agreement by Subgrantee, and MDHS may withhold any payments to Subgrantee for the purpose of set off until such times as the exact amount of damages due to MDHS from Subgrantee are determined. In case of termination or suspension as provided hereunder, all property, finished or unfinished documents, data, studies, surveys, drawings, photographs, manuals and reports or other materials prepared by or for the Subgrantee under this Agreement shall, at the option of MDHS, become the property of MDHS and shall be disposed of according to MDHS' directives. The rights and remedies of MDHS provided in this Section shall not be exclusive and are in addition to any other rights and remedies provided by law or in equity. G. TERMINATION OR SUSPENSION If the Subgrantee materially fails to comply with any of the covenants, terms or stipulations of this Agreement, whether stated in a federal statute or regulation, an assurance, in the State plan or application, a notice of award, or elsewhere, MDHS may, upon giving written notice to Subgrantee, take one or more of the following actions, as appropriate in the circumstances: 1. Temporarily withhold cash payments pending correction of the deficiency by Subgrantee or more severe enforcement action by MDHS; 2. Disallow (that is, deny both use of funds and, if applicable, matching credit for) all or part of the cost of the activity or action not in compliance; 3. Wholly or partly suspend or terminate the current award for the Subgrantee's program; 4. Withhold further awards for the Subgrantee's program; or 5. Take other remedies that may be legally available. SECTION VIII COMPLAINT RESOLUTION Subgrantee assures that persons requesting or receiving services under this Agreement shall have the right to a complaint resolution procedure regarding any decision relating to this Agreement. Said procedures may be under the Fair Hearing Procedure of the Mississippi Department of Human Services, or under a conciliation process, or that required by the MDHS as authorized by the Mississippi Administrative Procedures Law, Mississippi Code Annotated 1972, as amended, Section 25-43-1 et. seq., or under the complaint procedure of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, whichever is appropriate to the complaint as directed by MDHS. SECTION IX 5 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 COMPLIANCE WITH LAWS, RULES, AND REGULATIONS Subgrantee shall comply with all applicable policies and procedures of MDHS and with all applicable laws, rules and regulations of the federal government and of the State of Mississippi that may affect the performance of services under this Agreement. The Subgrantee shall comply with, among other regulations, the Act; the current MDHS Subgrant Agreement Manual, and the applicable Code of Federal Regulations. If the Subgrantee advertises or prints brochures, flyers or any other material, printed or otherwise, relating to, or promoting, the services which it is providing through this Subgrant, it shall acknowledge that said funding for said Subgrant and for said advertising was provided by MDHS. In executing this Subgrant, Subgrantee shall comply with all federal and/or state statutes or regulations that are made applicable to the grant when properly promulgated and published by the Federal and/or State Government. It is specifically agreed that should additional federal legislation be enacted, or should the U.S. Department of Health and Human Services or other governing federal agencies enacted new regulations or promulgate changes or amendments in existing regulations which require changes in any provision of their grant, then those provisions of this Subgrant affected thereby shall automatically be amended to conform to such federal statute or regulation as of the effective date of their enactment. SECTION X STANDARD ASSURANCES This Agreement is subject to the Subgrant/Contract Signature Sheet, the Budget and Cost Summary Support Sheets, the Scope of Services (Exhibit A), Budget Narrative (Exhibit B), the Standard Assurances, the Certifications Regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements, the Certifications Regarding Monitoring Findings; Audit Findings; and Litigation Occurring within the Last Three Years, the Certification of Adequate Fidelity Bonding (Exhibit C), Board Member=s Notification of Liability, (Exhibit D) Current MDHS Subgrant Agreement Manual Acceptance Form (Exhibit E), Federal Debarment Verification Requirement (Exhibit F) and Partnership Debarment Verification Form (Exhibit G), Minority Vendor Verification (Exhibit H); all of the foregoing being attached hereto and incorporated by reference herein. SECTION XI AGREEMENTS BY SUBGRANTEE A. GENERAL RESPONSIBILITY It is understood and agreed that the Subgrantee may be entering into certain subcontracts with eligible entities (hereinafter referred to as Subgrantee's Contractor/Subcontractor) for the provision of the aforementioned services. Entities currently in a contractual relationship with MDHS to provide the same or similar services are not eligible to enter into a Contract/Subcontract with the Subgrantee. Such subcontracts shall be governed by all of the provisions of this Agreement, and Subgrantee shall be fully responsible for the 6 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 performance of any Subgrantee's Contractor/Subcontractor whatsoever and for any costs disallowed as a result of monitoring of the Subgrantee by MDHS and/or as a result of monitoring the Subgrantee's Contractor/Subcontractor either by MDHS or by the Subgrantee. Copies of all subcontracts and modifications shall be forwarded to MDHS funding division. B. USE OF FUNDS In any Contracts/Subcontracts which Subgrantee enters into with Contractors/Subcontractors for provision of services and/or goods under this Agreement, Subgrantee shall require that the funds obligated under said Contracts/Subcontracts shall be used to support the Contracts/Subcontracts for the provision of only such services authorized under this Agreement. Subgrantee agrees that it shall require all of such Subgrantee's Contractors/Subcontractors/Employees to comply with all local, municipal and county health, safety and other ordinances and requirements and with all applicable federal and state laws, statutes and regulations. C. ADMINISTRATIVE CHARGES Subgrantee agrees that it has not imposed and shall not impose any administrative charges on its subcontractors. SECTION XII ELIGIBILITY FOR SERVICES Subgrantee agrees to provide services only to the target population described in the Scope of Services (Exhibit A). SECTION XIII CONFIDENTIALITY All information regarding applicants for and recipients of services under this Agreement shall be available only to MDHS, Subgrantee, and/or to the appropriate subcontractor and to those persons authorized in writing to receive same by the client, or as otherwise authorized by law. The Subgrantee will guard against unauthorized disclosures. Nothing in this Section, however, shall affect provisions of Section XVIII of this Agreement. SECTION XIV AUDIT A. INTERNAL AUDITING Subgrantee shall conduct internal auditing procedures to ensure that the services provided and the activities performed with funds provided under this Agreement are in compliance with the provisions of this Agreement and with Subgrantee audit policy described in the 7 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 current MDHS Subgrant Agreement Manual and all applicable laws, statutes, rules and regulations. B. INDEPENDENT AUDITING Subgrantee shall comply with the Single Audit Act of 1996, the applicable Office of Management and Budgets (OMB) Circular(s) and the current MDHS Subgrant Agreement Manual. The audit required under the Single Audit Act of 1996 must be performed by an Independent Auditor. C. RESPONSIBILITY OF SUBGRANTEE Subgrantee shall receive, reply to and resolve any audit and/or programmatic exceptions by appropriate state and/or federal audit related to this Agreement and/or any resulting Contract/Subcontract. D. SUPPLEMENTAL AUDIT MDHS retains the right to perform a supplemental audit and review, when MDHS deems the same to be appropriate, of any and all of the Subgrantee’s and/or its Contractor/ Subcontractor's books, records and accounts, and to initiate such audit and to follow any audit trail for a period of three (3) years from expiration date of this Agreement and for such additional time as required to complete any such audit and/or to resolve any questioned costs. E. AUDIT EXCEPTIONS Subgrantee shall pay to MDHS the full amount of any liability to the federal, state or local government resulting from final adverse audit exceptions under this Agreement and/or under any Contract/Subcontract funded hereunder. Audit exceptions may result in accepting a reduction of future amounts by a total equal to the amount disallowed or deferred, and/or by other methods approved by MDHS, including recoupment of funds paid to Subgrantee under this Agreement. SECTION XV RESPONSIBILITY FOR CLAIMS Each party shall be responsible for all claims, demands, liabilities, suits, damages, costs, and expenses of every kind, including court costs and attorney’s fees, arising out of this Agreement and caused by the party’s own, principals, agents, employees, contractors or subcontractors while performing under this Agreement. Further, the parties assume no liability for the actions or omissions of each other’s agents, representatives, employees, contractors, subcontractors, or providers. 8 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION XVI INSURANCE Subgrantee shall maintain Workers' Compensation insurance which shall inure to the benefit of all Subgrantee's personnel performing services under this Agreement, comprehensive general liability insurance and employee fidelity bond insurance in the amount equal to 25% of the funds awarded hereunder. Subgrantee shall furnish MDHS with a certificate of insurance providing the aforesaid coverage, prior to the commencement of performance under this Agreement. In any subcontract into which Subgrantee enters with Subcontractors, there shall be a like insurance provision in which the Subcontractor shall provide the same coverage to and for its personnel. SECTION XVII RECORDS A. MAINTENANCE OF RECORDS Subgrantee shall maintain fiscal and program records, books, documents, and adhere to Generally Accepted Accounting Principles, which sufficiently and properly reflect all direct and indirect costs and cost of any nature expended in the performance of this agreement. Such records shall be subject, at all reasonable times, to inspection, review, audit or the like, by MDHS or by duly authorized federal and state personnel. Fiscal Requirements and Audit. Subgrantee shall establish such fiscal control and fund accounting procedures, including internal auditing procedures, as may be necessary to assure the proper disbursal of and accounting for funds paid under this grant, including but not limited to the Single Audit Act of 1996. Subgrantee shall keep, maintain and present to MDHS, as required, necessary and proper vouchers, documentation and otherwise to support the expenditure of funds and Subgrantee shall adhere to State and Federal guidelines regarding subgrant provisions, financial documentation, and certifications per OMB Circular A-122, Cost Principles for Nonprofit Organizations, OMB A-87, Cost Principles for State, Local and Tribal Governments and OMB A-21, Cost Principles for Educational Institutions. B. ACCESS TO RECORDS Subgrantee agrees that MDHS, the federal grantor agency, the Comptroller General of the United States and/or any of their duly authorized representatives shall have access to any and all books, documents, papers, electronic media or records of the Subgrantee or of the Subgrantee's Contractors/Subcontractors which are pertinent to the program for the purpose of making audits, examinations, excerpts and transcripts of such records. C. RECORDS OF SUBGRANTEE 9 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 Subgrantee agrees that in any Contracts/Subcontracts into which it enters with Contractors/Subcontractors it shall require said Contractors/Subcontractors to maintain fiscal and program records related to Contractor/Subcontractor's work performed under this Agreement, in accordance with MDHS' Records Retention and Access Policy, as set forth in the current MDHS Subgrant Agreement Manual. D. FINANCIAL DOCUMENTS The Subgrantee, by its signature affixed to this Subgrant Agreement, authorizes the release to MDHS of any and all financial documents and records maintained by such financial institutions as may be providing services to the Subgrantee which are pertinent to the services performed under this Subgrant in order to make audit, examination, excerpts, copies, and/or transcripts. Said financial deposits and records shall include, but are not limited to, statements of accounts, statements of deposits and/or withdrawal, cancelled checks and/or drafts. The request for said documents and/or records shall be made in writing by MDHS directly to the Subgrantee providing services. Further, prior to the disbursement of any funds under this Subgrant, the Subgrantee shall provide, in writing, the name and address of the financial institution which shall act as the depository for said funds along with the specific account number(s) which shall be used in the expenditure of the Subgrant funds. SECTION XVIII AVAILABILITY OF INFORMATION Subgrantee shall furnish information and cooperate with all federal and/or state investigations, make such disclosure statements as may be required by the Agreement and other applicable federal and state laws, and federal and state regulations. SECTION XIX REPORTING A. MONTHLY REPORTING Subgrantee shall furnish MDHS written monthly reports of costs incurred and such reports shall contain sufficient data to provide evidence of budget compliance and shall be due ten (10) calendar days after the close of each month. Such reports shall be complete for the period covered and shall contain financial details pertaining to the execution of their subgrant. As may be requested by MDHS, Subgrantee shall review and discuss any of such written reports at such time and in such manner as may be deemed necessary by MDHS. B. TERMINATION REPORTS 10 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 Subgrantee shall furnish MDHS a written termination report within ten (10) days from the termination date unless additional time is granted in writing by MDHS. The termination report shall include information and data required by MDHS to furnish evidence of financial and programmatic compliance. C. FINAL FISCAL REPORT The Subgrantee shall provide a final fiscal report to MDHS within forty-five (45) calendar days after the ending of this Agreement and this, along with the Subgrantee's final fiscal and programmatic report will be used for the purpose of reconciling this Agreement to the actual expenditures for activities and services rendered not to exceed the maximum amount as set forth in Section IV.A of this Agreement. Any funds paid by MDHS to Subgrantee and not expended for activities or services under this Agreement or funds expended in violation of this Agreement, shall be considered MDHS funds and shall be returned to MDHS in full. Where deemed appropriate by MDHS and accepted by the Subgrantee, a reduction may be allowed in future payments under future agreements by a total amount equal to the amount disallowed or deferred, or by other methods approved by MDHS. Proper procedures for closeout of the Subgrant, as detailed in the current MDHS Subgrant Agreement Manual, shall be followed. D. TAX REPORTS Subgrantee shall file timely federal and state tax reports as due and, if requested, shall furnish MDHS a copy of all reports within ten (10) days after filing. SECTION XX DISPUTES Any dispute concerning a question of fact under this Agreement which is not disposed of by agreement of the Parties hereto shall be decided by the Director of the funding division. This decision shall be reduced to writing and a copy thereof mailed or furnished to the Subgrantee and shall be final and conclusive, unless, within thirty (30) days from the date of the decision, Subgrantee mails or furnishes to the Executive Director of the Mississippi Department of Human Services a written request for review. Pending final decision of the Executive Director or his designee, the Subgrantee shall proceed in accordance with the decision of the Director of the funding division. In a review before the Executive Director or designee, the Subgrantee shall be afforded an opportunity to be heard and to offer evidence in support of its position on the question and decision under review. The decision of the Executive Director or designee shall be final and conclusive unless that decision is determined by a court of competent jurisdiction in Jackson, Hinds County, State of Mississippi, to have been fraudulent, capricious or so grossly erroneous as necessarily to imply bad faith, or that it was not supported by substantial evidence. 11 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION XXI WAIVER Failure of either party hereto to insist upon strict compliance with any of the terms, covenants, and conditions of this Agreement shall not be deemed a waiver or relinquishment of any similar right or power hereunder at any subsequent time or of any other provision hereof, nor shall it be construed to be a modification of terms of this Agreement. SECTION XXII PATENTS, COPYRIGHTS, AND RIGHTS IN DATA A. PATENTS Should the activities of Subgrantee or its Contractor/Subcontractor include experimental, developmental or research projects, this Agreement shall be promptly amended to include the standard patent rights clauses as set forth in Public Law 98-620 (1984), 37 CFR 40, Part 401 - Rights to Inventions Made By Nonprofit Organizations and Small Business Firms under Government Grants, Subgrants, and Cooperative Agreements or any other applicable provision required by state and/or federal law, rule or regulation. B. COPYRIGHTS MDHS reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use: C. 1. The copyright in any work developed under this Agreement, or under any subgrant with any Subgrantee or its Contractors/Subcontractors' agreements; and 2. Any rights of copyright to which Subgrantee or its Contractors/Subcontractors purchase ownership with grant support under this Agreement. RIGHTS AND DATA All systems, computer programs, operating instructions, and all other documentation developed for or specifically relating to information processing of any kind under this Agreement, and reports prepared by Subgrantee or its Contractors/Subcontractors will be the property of MDHS and will remain so upon completion or termination of this Agreement. All cards, magnetic tapes, disk packs, or other storage media, temporary and/or permanent, containing programs and/or other information of any kind relating to this Agreement shall be available for inspection by MDHS at any time, and all information thereon shall belong to MDHS, and shall be delivered to MDHS on MDHS' request therefor. Subgrantee shall maintain all master programs and master data files in a completely secure manner, either by storing such programs and files in an appropriate limited access storage area or by duplicating such programs and files and storing the duplicates in a secure 12 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 location in a manner satisfactory to MDHS. Such programs and files shall be identified by program and file name. SECTION XXIII ALTERATION OR MODIFICATION OF AGREEMENT Any alteration, variation, modification, or waiver of provisions of this Agreement shall be valid only when agreed to by both parties hereto, reduced to writing, and duly signed by each Party. SECTION XXIV SEVERABILITY If any term or provision of this Agreement is prohibited by the laws of the State of Mississippi or is declared invalid or void by a court of competent jurisdiction, the remainder of the Agreement shall not be affected thereby, and each term and provision of this Agreement shall be valid and enforceable to the fullest extent permitted by law. SECTION XXV BINDING REPRESENTATIVES AND SUCCESSORS The rights, privileges, benefits, and obligations created by this Agreement and by operation of law, extend to and accrue and are obligatory upon the parties hereto, their personal or real representatives, and successors. SECTION XXVI EQUIPMENT AND SUPPLIES Equipment and supplies purchased with state funds under this Agreement shall be purchased and accounted for in accordance with state law and procedures and in accordance with MDHS Inventory Management Policy within the current MDHS Subgrant Agreement Manual. SECTION XXVII FUNDS USED TO SUPPLEMENT Funds received under this Agreement and any Contract/Subcontract thereunder shall be used only to supplement, not supplant, the amount of federal, state, and/or local funds otherwise expended for the support of services the applicable participants in the Subgrantee's service area. SECTION XXVIII ASSIGNMENT Subgrantee shall not assign or otherwise transfer the obligations or duties imposed pursuant to the terms of this Agreement without the prior written consent of MDHS. Any attempted assignment or transfer of its obligations without such consent shall be wholly void. 13 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION XXIX CONFLICT OF INTEREST Subgrantee must ensure that there exists no direct or indirect conflict of interest in the performance of the Subgrant. Subgrantee must warrant that no part of federal or state money shall be paid directly or indirectly to an employee or official of MDHS as wages, compensation or gifts in exchange for acting as an officer, agent, employee, subcontractor or consultant to the Subgrantee in connection with any work contemplated or pertaining to the Subgrant. MDHS will hold the Subgrantee in strict compliance with the Code of Conduct in the current MDHS Subgrant Agreement Manual. SECTION XXX APPLICABLE LAW This Agreement shall be construed and governed in accordance with the laws of the State of Mississippi. Subgrantee expressly agrees that under no circumstances shall MDHS be obligated to pay attorneys' fees or the cost of legal action to the Subgrantee. SECTION XXXI E-VERIFY Subgrantee represents and warrants that it will ensure its compliance with the Mississippi Employment Protection Act (Senate Bill 2988 from the 2008 Regular Legislative Session) and will register and participate in the status verification system for all newly hired employees. The term "employee" as used herein means any person that is hired to perform work within the State of Mississippi. As used herein, "status verification system" means the Illegal Immigration Reform and Immigration Responsibility Act of 1996 that is operated by the United States Department of Homeland Security, also known as the E-Verify Program, or any other successor electronic verification system replacing the E-Verify Program. Subgrantee agrees to maintain records of such compliance and, upon request of the State, to provide a copy of each such verification to the State. Subgrantee further represents and warrants that any person assigned to perform services hereunder meets the employment eligibility requirements of all immigration laws of the State of Mississippi. Subgrantee understands and agrees that any breach of these warranties may subject Subgrantee to the following: (a) termination of this Agreement and ineligibility for any state or public contract in Mississippi for up to three (3) years, with notice of such cancellation/termination being made public, or (b) the loss of any license permit, certification or other document granted to Subgrantee by an agency, department or governmental entity for the right to do business in Mississippi for up to (1) year, or (c) both. In the event of such termination/cancellation, Subgrantee would also be liable for any additional costs incurred by the State due to contract cancellation or loss of "license or permit." Any Agreement entered into between the Subgrantee and its Contractors/Subcontractors shall contain the E-Verify clause with which said Contractors/Subcontractors shall comply in hiring their employees. 14 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION XXXII TRANSPARENCY This contractual agreement, including any accompanying exhibits, attachments, and appendices, is subject to the “Mississippi Public Records Act of 1983", codified as section 25-61-1 et seq., Mississippi Code Annotated and exceptions found in Section 79-23-1 of the Mississippi Code Annotated (1972, as amended). In addition, this Agreement, is subject to the provisions of the Mississippi Accountability and Transparency Act of 2008 (MATA) codified as Section 31-7-13 of the Mississippi Code Annotated (1972, as amended). Unless exempted from disclosure due to a court-issued protective order, this contract is required to be posted to the Department of Finance and Administration’s independent agency contract website for public access. Prior to posting the Agreement to the website, any information identified by the Independent Contractor as trade secrets, or other proprietary information including confidential vendor information, or any other information which is required confidential by state or federal law or outside the applicable freedom of information statutes will be redacted. SECTION XXXIII INCLUSION OF ALL TERMS AND CONDITIONS This Agreement and any and all documents attached hereto or incorporated by reference herein, including the Subgrant Signature Sheet, constitute the entire agreement of the parties with respect to the subject matter contained herein and supersede and replace any and all prior negotiations, understandings and agreements, written or oral, between the parties relating thereto. No other understanding regarding the subject matter of this Agreement shall be deemed to exist or bind any of the parties hereto. 15 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Revised 10/15/2019 SECTION XXXIV NOTICE Notice as required by the terms of this Subgrant shall be certified United States mail, postage prepaid, to the Parties at their respective usual business addresses, or Notice may be hand-delivered to that respective Party whose signature appears on this Subgrant as MDHS or Subgrantee. The Parties agree to promptly notify each other of any change of address. For the faithful performance of the terms of this Agreement, the parties hereto have caused this Agreement to be executed by their undersigned authorized representatives. Mississippi Department of Human Services Mississippi Department of Employment Services By: ________________________________ Authorized Signature By: ________________________________ Authorized Signature Printed Name: Jacob Black Printed Name: Jacqueline A. Turner________ Title: Executive Director or Designee Title: Deputy Executive Director 3/17/2020 3/16/2020 Date: _______________________________ Date: ______________________________ 16 DocuSign DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 37C45611-1756-4AD5-BAD2-06F53C46DF45 EXHIBIT A Scope of Work DocuSign DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 37C45611-1756-4AD5-BAD2-06F53C46DF45 DocuSign DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 37C45611-1756-4AD5-BAD2-06F53C46DF45 DocuSign DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 37C45611-1756-4AD5-BAD2-06F53C46DF45 DocuSign Envelope ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 EA26F57A-6134-4674-8AE5-EE32C478FE29 Exhibit B Budget Narrative DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 089D94A5-9047-4005-923A-E4BBA3ED6E29 3/17/2020 3/16/2020 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 EXHIBIT C MDHS Subgrant/Agreement Manual – (Revised 11/2/2016) Page 1 STANDARD ASSURANCES AND CERTIFICATIONS Section 4 OVERVIEW Each Subgrantee and any lower-tier subrecipient must assure compliance with the regulations, policies, guidelines, and requirements imposed by the Federal grantor agency and MDHS. The assurances listed in this section may not be applicable to a particular project or program, and there may be additional assurances required by certain Federal awarding agencies. Therefore, all subgrantees are responsible for knowing the specific requirements of their awards. Templates for required certifications are available online through subgrantees’ MDHS employee account at www.mdhs.ms.state.us. In addition, each subgrantee must certify in writing that it will comply with the following regulations:  Lobbying;  Suspension and Debarment;  Drug-Free Workplace;  Unresolved Monitoring and Audit Findings; and  Fidelity Bond Coverage. STANDARD ASSURANCES The Subgrantee assures that it: 1. Has the legal authority to apply for and receive the subgrant; that a resolution, motion, or similar action has been duly adopted or passed as an official act of the subgrantee's governing body, authorizing the subgrant, including all understandings and assurances contained therein, and directing and authorizing the person identified as the official representative of the Subgrantee to act in connection with the subgrant and to provide such additional information as may be required; 2. Shall give MDHS, the State Auditor's Office, the Federal grantor agency, and the Comptroller General, or any other appropriate authorized state or Federal representatives, access to and the right to examine and copy all records, books, papers, documents, or items related to the subgrant for as long as these records are required to be retained; 3. Shall establish and maintain both fiscal and program controls and accounting procedures in accordance with Generally Accepted Accounting Principles and Federal grantor agency and MDHS directives; and will keep and maintain such books and records for audit by MDHS, by the Federal grantor agency, by the State Auditor, or by their authorized representatives; and will maintain either electronic or paper files of all such records, books, papers, documents, or items for a period of at least three (3) years from the date of submission of the final Claim Support Sheet, or, if any litigation, claim, audit, or action has begun before the expiration of the three-year period, will retain all such items until the completion of the action and resolution of all issues involved or until the end of the regular three-year period, whichever is later, and will obtain written approval from the MDHS Division of Program Integrity or Funding Division Director prior to destroying any such items as described above upon the expiration of the above-stated period. The request shall be completed by submission of the DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 MDHS Subgrant/Agreement Manual – (Revised 11/2/2016) Page 2 STANDARD ASSURANCES AND CERTIFICATIONS Section 4 Request to Dispose of Records form (MDHS-DPI-001); 4. Shall comply with the Single Audit Act Amendments of 1996; 5. Shall comply with the OMB Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards; 6. Shall provide, in a timely manner, written disclosure, all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the subgrant; 7. Shall establish safeguards to prohibit employees from using their positions for a purpose that involves nepotism, or constitutes, or presents the appearance of any other personal or organizational conflict of interest, or personal gain; 8. Shall comply with all Federal and State statutes relating to discrimination, including, but not limited to: Title VI of the Civil Rights Act of 1964, prohibiting discrimination on the basis of race, color, or national origin; Title VII of the Civil Rights Act of 1964, relating to non-discrimination in matters of recruitment, hiring, promotion, and other employment practices; Title VIII of the Civil Rights Act of 1968, as amended, relating to non-discrimination the sale, rental, or financing of housing; Title IX of the Education Amendments of 1972, as amended, prohibiting discrimination on the basis of gender in federally assisted education programs and activities; Age Discrimination Act of 1975, prohibiting discrimination on the basis of age; Section 504 of the Rehabilitation Act of 1973, prohibiting discrimination on the basis of handicaps; Subtitle A, Title II of the Americans with Disabilities Act (ADA) (1990); Omnibus Reconciliation Act of 1981, prohibiting discrimination on the basis of race, color, religion, sex, national origin, age, and handicap; Drug Abuse Office and Treatment Act of 1972, as amended, relating to non-discrimination on the basis of drug abuse; Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, as amended, relating to non-discrimination on the basis of alcohol abuse or alcoholism; DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 MDHS Subgrant/Agreement Manual – (Revised 11/2/2016) Page 3 STANDARD ASSURANCES AND CERTIFICATIONS Section 4 Sections 523 and 527 of the Public Health Service Act of 1912, as amended, relating to confidentiality of alcohol and drug abuse patient records; and Any other non-discrimination provisions in the specific statute(s) under which these monies will be granted or awarded and the requirements of any other non-discrimination statute(s) which may apply to this subgrant or award. 9. Shall ensure that buildings and facilities owned, occupied, or financed by the United States government are accessible to and usable by physically handicapped persons in accordance with the Architectural Barriers Act of 1968; 10. Shall comply with the requirements of the provisions of the Uniform Relocation Assistance and Real Property Acquisition Act of 1970, which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal and federally assisted programs. These provisions apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases; 11. Shall comply with the provisions of the Hatch Act, as amended, which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds; 12. Shall comply, as applicable, with the provisions of the Davis-Bacon Act, the Copeland Act, and the Contract Work Hours and Safety Standards Act, regarding labor standards for federally assisted construction subagreements; 13. Shall conform with Executive Order (EO) 11246, entitled "Equal Employment Opportunity," as amended by EO 11375, and as supplemented in Department of Labor regulations (41 CFR Part 60) and will incorporate an equal opportunity clause in federally assisted construction contracts and subcontracts; 14. Shall comply with the minimum wage and maximum hours provisions of the Federal Fair Labor Standards Act; 15. Shall comply with the Intergovernmental Personnel Act of 1970 relating to prescribed standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration; 16. Shall comply, if applicable, with Section 102(a) of the Flood Disaster Protection Act of 1973, which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more; 17. Shall comply with the Lead-Based Paint Poisoning Prevention Act, which prohibits the use of lead-based paint in construction or rehabilitation of residence structures; DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 MDHS Subgrant/Agreement Manual – (Revised 11/2/2016) Page 4 STANDARD ASSURANCES AND CERTIFICATIONS Section 4 18. Shall assist the Federal grantor agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended; EO 11593; and the Archaeological and Historic Preservation Act of 1974; 19. Shall comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 and EO 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in flood plains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972; (f) conformity of Federal actions to State (Clean Air) Implementation Plans under Section 176 of the Clean Air Act of 1955, as amended; (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended; (h) protection of endangered species under the Endangered Species Act of 1973, as amended; (I) Section 6002 of the Resource Conservation and Recovery Act; and (j) the Coastal Barriers Resources Act; 20. Shall comply with the Wild and Scenic Rivers Act of 1968 related to protecting components or potential components of the national wild and scenic rivers system; 21. Shall comply with Public Law (PL) 93-348 regarding the protection of human subjects involved in research, development and related activities supported by this subgrant; 22. Shall comply with the Laboratory Animal Act of 1966 pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this subgrant; 23. Shall comply with Federal regulations regarding criteria for cost sharing or matching contributions; 24. Shall assure all funds received shall be used only to supplement services and activities that promote the purposes for which the grant is awarded, and not supplant, unless specifically authorized by the program regulations and the appropriate MDHS Division; 25. Shall provide certification regarding lobbying to comply with Section 319, PL 101-121 (31 USC 1352); 26. Shall provide the required certification regarding their exclusion status and that of their principal’s prior to the award in accordance with EOs 12549 and 12689 Debarment and Suspension; 27. Shall provide certification to comply with the Drug-Free Workplace Act of 1988; 28. Shall comply with The Privacy Act of 1974 (5 USC §552a) related to gathering and disclosure of information and documentation maintained on individuals; DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 MDHS Subgrant/Agreement Manual – (Revised 11/2/2016) Page 5 STANDARD ASSURANCES AND CERTIFICATIONS Section 4 29. Shall comply with all applicable requirements of all other Federal and State laws, Executive Orders, regulations, and policies governing the program(s) for which these monies are provided and with the terms and conditions of the Subgrant Agreement, including but not limited to all documentation/information required by the MDHS funding divisions for federal reporting purposes. 30. Shall comply with all requirements of the Federal Funding Accountability and Transparency Act (FFATA). This includes providing the grantor a DUNS number and other information such as executive compensation data when required so the grantor can meet the reporting requirements of FFATA. 31. Shall comply with the Pilot program for enhancement of contractor employee whistleblower protections (48 CFR 3.908-3, 48 CFR 52.203-17 and 41 U.S.C. 4712). Specifically, the subgrantee/lower-tier subrecipient shall provide written notification to all employees, of the subgrantee/lower-tier subrecipient, of employee whistleblower rights and protections under 41 U.S.C. 4712, as described in 48 CFR 3.908 of the Federal Acquisition Regulation. Subgrantees shall also include in each agreement with lower-tier subrecipients the required whistleblower provisions, as mandated in 48 CFR 52.203-17. 32. Shall ensure that it will require any lower-tier subrecipients to comply with the above listed regulations and any other applicable requirements of all other Federal and State laws, Executive Orders, regulations, and policies governing the program(s) for which these monies are provided and with the terms and conditions of the Subgrant Agreement, including but not limited to all documentation/information required by the MDHS funding divisions for federal reporting purposes. As a duly authorized representative of the subgrantee, I hereby assure and certify compliance with the above mentioned provisions and all other applicable Federal and state statutes, regulations, policies, guidelines, and requirements of the Subgrant/Agreement Manual, as well as the specific terms and conditions of the Subgrant/Agreement. SUBGRANTEE NAME AND ANY OTHER NAMES UNDER WHICH THE SUBGRANTEE HAS DONE BUSINESS: MS Department of Employment Security SUBGRANTEE ADDRESS AND ANY OTHER ADDRESSES THE SUBGRANTEE HAS USED: 1235 Echelon Parkway Jackson, MS 39213 TYPED NAME AND TITLE OF THE SUBGRANTEE'S AUTHORIZED REPRESENTATIVE: Jacqueline A. Turner SIGNATURE OF SUBGRANTEE’S AUTHORIZED REPRESENTATIVE AND DATE: 12/23/2019 DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 EXHIBIT E MDHS SUBGRANT/AGREEMENT MANUAL ACCEPTANCE FORM Revised February 1, 2017 MDHS Subgrant/Agreement Manual Acceptance Form Subgrant/Contract Manual Coordinator Each Subgrantee should designate a Mississippi Department of Human Services Subgrant/Contract Manual coordinator who is familiar with the agency’s operations. The coordinator’s name, address, and telephone number should be sent directly to the Director, Office of Monitoring, Mississippi Department of Human Services, by the beginning of each contract period. The subgrantee should only notify the Director, Office of Monitoring, MDHS, in writing of any change in assignment. MS Department of Employment Security As duly authorized representative of the____________________________________________ ______________________________ , I certify that said organization will comply with the above provisions and that I have accessed as of this date, a copy of the current Mississippi Department of Human Services Subgrant/Agreement Manual. 12/23/2019 Signature Executive Director Title Date MS Department of Employment Security Organization DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 EXHIBIT F Federal Debarment Verification Form Revised April 5, 2016 MISSISSIPPI DEPARTMENT OF HUMAN SERVICES FEDERAL DEBARMENT VERIFICATION FORM Please Print/Type Clearly in Blue Ink Subgrantee’s/Contractor’s Name Authorized Official’s Name DUNS Number Address Phone Number Are you currently registered with www.sam.gov (Respond Yes or No) Registration Status (Type Active or Inactive) Active Exclusions (Type Yes or No) MS Department of Employment Security Jacqueline A. Turner 878193150 1235 Echelon Parkway Jackson, MS 601-321-6000 39213 yes active no MS Department of Employment Security I hereby certify that _________________________________ is not on the list for federal debarment on Subgrantee’s Name/Contractor’s Name www.sam.gov –System for Award Management. __________________________________________ Signature of Authorized Official 12/23/2019 ___________________ Date DocuSign EA26F57A-6134-4674-8AE5-EE32C478FE29 DocuSign Envelope Envelope ID: ID: 0DB3175D-3A0A-4480-859C-662A983A3EB2 3D90ACED-82FB-44E0-9434-42CB87ABFAF9 EXHIBIT G Partnership Debarment Verification Form Revised April 5, 2016 MISSISSIPPI DEPARTMENT OF HUMAN SERVICES PARTNERSHIP DEBARMENT VERIFICATION FORM Please Print/Type Clearly in Blue Ink Subgrantee’s/Contractor’s Name Authorized Official’s Name DUNS Number Address Phone Number MS Department of Employment Security Jacqueline A. Turner 878193150 1235 Echelon Parkway Jackson, MS 39213 601-321-6000 I hereby certify that all entities who are in partnership with MDHS (subcontractors, subrecipients, et al.) are not on the federal debarment list on www.sam.gov – System for Award Management. Proof of documentation of partnership verification with SAM shall be kept on file and the debarment status shall be checked prior to submission of every contract/subgrant and modification to MDHS. __________________________________________ Signature of Authorized Official 12/23/2019 ___________________ Date Certificate Of Completion Envelope Id: 0DB3175D3A0A4480859C662A983A3EB2 Status: Completed Subject: Please DocuSign: MS Department of Employment Security 2020 TANF Subgrant for signatures.pdf Source Envelope: Document Pages: 39 Signatures: 6 Envelope Originator: Certificate Pages: 5 Initials: 0 Carla Conyers AutoNav: Enabled 1860 Michael Faraday Drive, Suite 100 EnvelopeId Stamping: Enabled Reston, VA 20190 Time Zone: (UTC-08:00) Pacific Time (US & Canada) carla.conyers@mdhs.ms.gov IP Address: 69.60.35.160 Record Tracking Status: Original 3/16/2020 4:19:32 PM Signer Events Holder: Carla Conyers Location: DocuSign carla.conyers@mdhs.ms.gov Signature Timestamp Jacqueline A. Turner Sent: 3/16/2020 4:25:52 PM jturner@mdes.ms.gov Viewed: 3/16/2020 7:24:34 PM Security Level: Email, Account Authentication (None) Signed: 3/16/2020 7:25:36 PM Signature Adoption: Drawn on Device Using IP Address: 107.77.234.23 Signed using mobile Electronic Record and Signature Disclosure: Accepted: 3/16/2020 7:24:34 PM ID: 61f57e32-741a-4b24-9417-28b425050ac4 Jacob Black Sent: 3/16/2020 7:25:38 PM Jacob.Black@mdhs.ms.gov Viewed: 3/17/2020 7:52:00 AM Deputy Executive Signed: 3/17/2020 7:52:30 AM Mississippi Department of Human Services Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 69.60.35.160 Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Bryan Wardlaw Bryan.Wardlaw@mdhs.ms.gov Chief Procurement Officer MDHS – Budgets and Accounting Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Sent: 3/17/2020 7:52:32 AM Carbon Copy Events Status Timestamp Accepted: 7/16/2018 10:32:32 AM ID: b90984c8-b81b-4a64-a9f3-53535db31601 Laketha Gilmore Sent: 3/17/2020 7:52:33 AM Laketha.Gilmore@mdhs.ms.gov Division Director MDHS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 7/27/2017 7:57:07 AM ID: 59bb9e0d-1235-4301-95e0-6dd6b2e9c19f George Pender Sent: 3/17/2020 7:52:33 AM George.Pender@mdhs.ms.gov Viewed: 3/17/2020 8:22:52 AM Bureau Director II MDHS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign jonathan Evans Sent: 3/17/2020 7:52:34 AM jonathan.evans@mdhs.ms.gov Fiscal Officer I MDHS - PI Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Gloria Sanders Sent: 3/17/2020 7:52:34 AM gloria.sanders@mdhs.ms.gov STAFF OFFICER I MDHS Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 3/17/2020 7:52:34 AM Certified Delivered Security Checked 3/17/2020 7:52:34 AM Signing Complete Security Checked 3/17/2020 7:52:34 AM Completed Security Checked 3/17/2020 7:52:34 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 10/2/2015 8:48:16 AM Parties agreed to: Jacqueline A. Turner, Bryan Wardlaw, Laketha Gilmore ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Carahsoft Technology Corp.-Partner (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through your DocuSign, Inc. (DocuSign) Express user account. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. 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