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PROPOSITION K L.A. FOR KIDS PROGRAM

10th Cycle Request for Proposals

TITLE PAGE AND ASSURANCES

|Legal Name of Agency Submitting Proposal: |

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|Address (Street, City, State, Zip Code): |

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|Phone #: |Fax#: |Email Address: |

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|Agency’s Authorized Representative: |Address (if different than above): |

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|Project Name: |

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|Project Location / Address: (Street, City, State, Zip Code): |

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|Project Description: |

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|Recreational Services to be provided for youth as repayment of Proposition K Grant: |

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|Los Angeles Business Tax Registration Certificate Number: |Federal Employer ID Number: |

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|City Council District: |Census Tract Number: |

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|Project Category: |

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ASSURANCES

1. It is understood and agreed by the undersigned that:

a. The proposer states that no person who is presently employed by the City of Los Angeles has any personal, financial, or economic interest, direct or indirect, in any agreement resulting from this offer and will not have such interest for a period of one (1) year following their employment with the City of Los Angeles.

b. Audit and Inspection of Records:

The proposer will permit the authorized representatives of the City of Los Angeles to inspect and audit all data and records relating to its proposal and performance under the contract or grant award.

c. Expenditure of Grant Funds:

Funds granted as a result of this Request for Proposals are to be expended for the purpose set forth herein and in accordance with all applicable laws, regulations, policies, and procedures of the City of Los Angeles, and, where applicable, the State and Federal governments.

2. City of Los Angeles Prevailing Wage:

Recipients of City grant funds must further comply with City, or State Prevailing Wages requirements.

3. City of Los Angeles Equal Benefits Ordinance:

Recipients of City grant funds must further comply with Equal Benefits requirements.

4. City of Los Angeles Americans with Disabilities Act:

Recipients of the City of Los Angeles grant funds under this Request for Proposals must ensure that their project will be designed in accordance with the requirements of the Americans with Disabilities Act, as amended.

5. City of Los Angeles Living Wage Ordinance/Service Contractor Worker Retention Ordinance requirements.

Recipients of City grant funds must comply with Living Wage Ordinance/Service Contractor Worker Retention requirements.

6. City of Los Angeles Affirmative Action Program Requirements:

Recipients of City grant funds their contractors must comply with the Affirmative Action Program Requirements as provided for in Division 10, Chapter 1, and Article 1 of the Los Angeles Administrative Code.

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Signature of Person Legally Authorized

To Sign for Agency

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Type or Print Name

_______________________________

Title

_______________________________

Date

Affix Corporate Seal

Seal must bear the same title under which this application is being submitted (if the agency does not have a Corporate Seal, a current copy of the Articles of Incorporation must be attached).

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