HomeMy WebLinkAboutR-2018-080 Financial Assistance Agreement with Missouri DNR and Purchase from Taylormade Co RESOLUTION NO. R-2018-080
A RESOLUTION APPROVING A FINANCIAL ASSISTANCE AGREEMENT WITH
THE MISSOURI DEPARTMENT OF NATURAL RESOURCES AND ALSO
APPROVING A PURCHASE FROM TAYLORMADE COMPANY, ALL RELATED TO
FITNESS COURT SURFACING MATERIAL
WHEREAS, the City of Riverside made application for the 2018 Non-playground Scrap
Tire Material Grant from the Missouri Department of Natural Resources in connection with its
fitness court project; and
WHEREAS,the City has been awarded the grant in the amount of$9,999.36; and
WHEREAS, City Code Section 135.070.B authorizes the City to contract with a vendor
for the purchase of goods or services without utilizing the competitive bidding procedures when,
in the opinion of the Board of Aldermen, the purchase would be in the best interest of the City;
and
WHEREAS, the Board of Aldermen determines that the purchase from TaylorMade
Company for fitness court surfacing without utilizing the competitive bidding procedures is in
the best interest of the City in that i) the City has been awarded a grant from MDNR towards the
purchase of the fitness court surfacing, and ii) TaylorMade's product meets the grant criteria
regarding use of recycled materials.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF ALDERMEN OF
THE CITY OF RIVERSIDE, MISSOURI AS FOLLOWS:
THAT the Board of Aldermen (`Board") approves the Financial Assistance Agreement
in connection with the 2018 Non-playground Scrap Tire Material Grant from the Missouri
Department of Natural Resources, a copy of which is attached hereto and incorporated herein,
and authorizes the Mayor to sign the same on behalf of the City; and
FURTHER THAT the Board approves the purchase from TaylorMade Company of
goods and services related to installation of poured in place fitness court surfacing in the amount
of$13,332.48, and authorizes the Mayor to sign on behalf of the City the Contract, Superseding
Addendum,and the Estimate, all of which are attached hereto and incorporated herein; and
FURTHER THAT the Mayor, the City Administrator, and other appropriate City
officials are hereby authorized to take any and all actions as may be deemed necessary or
convenient to carry out and comply with the intent of this Resolution and to execute and deliver
for and on behalf of the City all certificates, instruments, agreements and other documents, as
may be necessary or convenient to perform all matters herein authorized.
PASSED AND A99PTED by the Board of Aldermen of the City of Riverside,
Missouri,the Z day of 2018.
Mayor Kathleen L. Rose
ATTEST:
Rollin Kincaid, City Clerk
Missouri Department of Natural Resources
4 ® 2018 Non-playground Scrap Tire Material Grant
Financial Assistance Agreement
This agreement is entered into under the authority of and subject to pertinent legislation, regulation, and policies
applicable to 260.200 through 260.345, RSMo.
1. Grantee: 2. Project Number. TNP18024
City of Riverside
2950 NW Vivion Rd. 3. Fiscal Year: 2018
Riverside, MO 64150
Phone: (816) 372-9028 4. Project Period: August 1, 2018—July 31,
2019
5. Grantee Project Manager: Ms.Noel Challis
6. Grantee Authorized Official: Ms. Kathy Rose
7. Project Funding Source: FYI—Solid Waste Management Fund, Scrap Tire Subaccount(0569)
8. State Project Manager&Telephone Number: Mr. Aaron J. Libbert—(573) 751-5401
9. The grantee agrees to administer these funds in accordance with:
a. All applicable current and revised state and federal laws and regulations including but not limited
to 260.200 through 260.345 RSMo, and 10 CSR 80-9.030.
b. General terms and conditions.
c. Grantee application
d. Applicable program guidelines to quarterly/final status reports.
10. Project funding:
Amount Percent
Grant Award Amount $9999.36 75%
Grantee Match $3333.12 25 %
Total Project $13332.48 100%
11. The funding described herein is hereby offered and accepted effective upon signature of authorized
officials and during the period indicated in Part 4 above.
i
Missouri Department of Natural Resources
A
Director Signature Date
City of Riverside
Title Signature Date
SUPERSEDING ADDENDUM TO CONTRACT
1. This superseding addendum is made and entered into this Z day of
2018, by and between the TaylorMade Co, ("Contractor"), and City of Rive de,
Missouri ("Client').
2. This superseding addendum is hereby made a part of the Contract by and between
the Contractor and Client, modifying and superseding where it is inconsistent with
the Contract. All other conditions of the Contract remain unchanged.
3. Section 4.2 is deleted.
4. Prior to commencing work, Contractor shall obtain and maintain for the duration
of the project, commercial general liability insurance coverage, naming the Client
as an additional insured, and providing not less than the following limits:
For all claims arising out of a single accident or occurrence: $1,000,000.00
For any one person in a single accident or occurrence: $1,000,000.00.
5. Pursuant to RSMo 285.530(l), by its sworn affidavit in accordance with the
attached Exhibit, Contractor hereby affirms its enrollment and participation in a
federal work authorization program with respect to the employees working
regarding the contracted services. Furthermore, Contractor affirms that it does
not knowingly employ any person who is an unauthorized alien regarding the
contracted services.
6. This Agreement shall not be deemed to create any third-party benefit hereunder
for any member of the public or to authorize any one, not a party hereto, to
maintain suit pursuant to the terms of this Agreement.
CONTRACT
THIS CONTRACT(the"Contract"), made this 7�L day of 2018 by and between
TaylorMade Co,(the"Contractor")and City of Riverside. Missouri
THE CLIENT AND THE CONTRACTOR HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. SCOPE OF WORK
1.1 The Contractor hereby agrees that it shall provide all labor and any materials necessary to perform the Services
("Services")for the Client,which Services are more particularly described on Schedule"A"annexed hereto.
2 CONTRACT AMOUNT
2.1 The Client hereby agrees to pay to the Contractor$ 13,332.48 for the
Contractor's performance of the Services(the"Contract Amount")as provided in Schedule"A"attached hereto.
The Contract Amount shall be due NET 30 days following the completion of the services. No retainage shall be
withheld from the Contract Amount. Client agrees to pay all collection cost incurred by Contractor.
2.2 After this Contract is agreed upon by the Contractor and Client,if Client desires a change or modification of the
Services described in Schedule A, Contractor shall be allowed to recompute the Contract Amount to reflect the
Client's request for change. Any changes to the Services provided must be agreed in writing signed by both
Contractor and Client.
2.3 In the event the Contractor discovers circumstances which were not readily apparent when the Contract was
initially executed the Contractor will notify Client of these exigent circumstances. At such time of notification,
the Contractor and Client shall have the option of renegotiating the Contract or cancelling the Contract. In the
event of cancellation pursuant to this clause,Client shall still be responsible for the payment to Contractor for
the Services actually performed by Contractor.
3 PERFORMANCE OF SERVICES
3.1 The Contractor agrees that it shall perform the Services in a thoroughly,first class workmanlike manner under
the direction and to the satisfaction of the Client and in accordance with the scope of the Services contained on
Schedule "A"annexed hereto.
3.2 The Services contemplated on Schedule"A" annexed hereto shall be considered completed upon final approval
by the Client,provided that the Client's approval shall not be unreasonably withheld.
4 DISPUTE RESOLUTION
4.1 Should a dispute arise between the Client and the Contractor regarding the interpretation or construction of,
compliance with or breach of,the Contract,the Client and the Contractor agree that such dispute must be
submitted to mediation.
4.2 In the event that mediation fails to resolve the dispute arising hereunder Client and Contractor agree that such
dispute shall be resolved exclusively through binding arbitration to be conducted in Johnson County,Kansas.
Judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction thereof.
The prevailing party shall be entitled to recover its reasonable attorneys'Contract Amount and costs as
determined by the arbitrator.
4.3 Nothing in this Section shall be deemed to prohibit Contractor from filing a lien for any unpaid Contract Amount.
1
CONTRACTOR:
Taylor MadeC
Wad
President
CLIENT:
City of Riverside,Missouri:
May�br Kathleen L. Rose
ATTEST:
r
Robin Kincaid, City Clerk
•
5.1 This Contract represents the entire agreement regarding the Services to be provided by Contractor to Client.
This Contract supersedes and voids any previous agreements between the Client and Contractor.
5.2 The Contract may be amended from time to time by mutual consent of the Client and the Contractor. All
amendments shall be set forth in writing and signed by both the Client and the Contractor.
5.3 The silence, failure, or delay by the Client or the Contractor in exercising any right hereunder shall under no
circumstances be construed as a waiver of such right by the Client or Contractor and such right and any of the
available remedies required to enforce it shall remain valid until such time as they contractually or legally expire.
5.4 If any provision of this Contract shall be held to be invalid, illegal or unenforceable, the validity, legality and
enforceability of the remaining provisions shall in no way be affected or impaired thereby. This Contract shall be
governed by and construed in accordance with the laws of the State of Kansas.
IN WITNESS WHEREOF the parties have hereunto set their respective signatures as of the date first written
above.
Wade !a yLor; President
TaylorMadeCo
41UjU-4"0;Y-)
',
CII
t
SCHEDULE"A"
Scope of Services to be Performed
Installation of Poured in Place Safety Surface located at 4498 NW High Dr. Riverside, MO 64150
1.5" Depth for 3' Fall Height
Full Color Light Blue top coat
Testing of surface and results once installation is complete
Work to be completed in accordance with Davis Bacon Act
3
uQ TaylormadeCo Estimate
7356 Holliday Drive
surfaClflg
Kansas City, KS 66106 Tel: 913-713-1573 Date Estimate a
Fax: 913-548-0668 6/27/2018 1 s us
Name/Address Ship To
Capital Projects and Parks Fitness Court
City of Riverside.Missouri 4498 NW High Dr
Riverside,MO 64150
Terms Project
Net 30 18148
Description Dry Rate Total
Installation of Poured In Place Safety Surface Full Color Light Blue for 3'Fall 12,332.48 12,332.48
Height(1,5')32'X 32'
Shipping for Material 1,000.00 1,000.00
***3,2001bs of Recycled Material***
***Does not include installation of sub-base and drainage***
This bid is submitted in accordance with the Davis Bacon Act and Certified
payroll will be submitted weekly or sooner if the job is less than a week.
-QUOTE IS VALID FOR 6 MONTHS
-ALL PROJECTS ARE DEPENDENT ON WEATHER.
INSTALLATION DATES ARE TENTATIVE
-1009/6 FULL PAYMENT DUE IN NET 30 DAYS UPON COMPLETION
-CUSTOMER TO SUPPLY TRASH DUMPSTER
-CUSTOMER TO SUPPLY FENCE AND SECURITY ONCE WORK
BEGINS,UNTIL SURFACE IS DRY
-ADDITIONAL INSURED SUPPLIED AT NO CHARGE
-CUSTOMER RESPONSIBLE FOR COST OF ANY AND ALL CHANGES
TO INSURANCE
Total 513.332.45
E-mail Web Site
Signature kristin@ewturfswfacing.com www.ecoturfsurfacing.com
I
E-Verify,
Company ID Number: 718155
THE E-VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF
UNDERSTANDING FOR E-VERIFY EMPLOYER AGENTS
ARTICLE I
PURPOSE AND AUTHORITY
The parties to this Agreement are the Department of Homeland Security (DHS), and
Tavlormade Co (E-Verify Employer Agent). The purpose of this Agreement is to set forth terms
by which SSA and DHS will provide information to Tavlormade Co (E-Verify Employer Agent)
on behalf of the E-Verify Employer Agent's client (the Employer). This MOU explains certain
features of the E-Verify program and enumerates specific responsibilities of DHS, SSA, the
Employer, and the E-Verify Employer Agent. References to the Employer include the E-Verify
Employer Agent when acting on behalf of the Employer. E-Verify is a program that
electronically confirms an employee's eligibility to work in the United States after completion of
the Employment Eligibility Verification Form (Form 1-9). For covered government contractors, E-
Verify is used to verify the employment eligibility of all newly hired employees and all existing
employees assigned to Federal contracts or to verify the entire workforce if the contractor so
chooses.
The Employer is not a party to this MOU. The E-Verify program requires an initial agreement
between DHS and the E-Verify Employer Agent as part of the enrollment process. After
agreeing to the MOU as set forth herein, completing the tutorial, and obtaining access to E-
Verify as a E-Verify Employer Agent, the E-Verify Employer Agent will be given an opportunity
to add a client once logged into E-Verify. All parties, including the Employer, will then be
required to sign and submit a new MOU. The responsibilities of the parties remain the same in
each MOU.
Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as
amended (8 U.S.C. § 1324a note). Authority for use of the E-Verify program by Federal
contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility
Verification", of the Federal Acquisition Regulation (FAR) (hereinafter referred to in this MOU as
a "Federal contractor with the FAR E-Verify clause") to verify the employment eligibility of
certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive
Order 12989, as amended.
ARTICLE II
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES OF SSA
1. SSA agrees to provide the Employer (through the E-Verify Employer Agent) with available
information that will allow the Employer to confirm the accuracy of Social Security Numbers
Page 1 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-VedFy
Company ID Number: 718155
provided by all employees verified under this MOU and the employment authorization of U.S.
citizens.
2. SSA agrees to provide the Employer and E-Verify Employer Agent appropriate assistance
with operational problems that may arise during the Employer's participation in the E-Verify
program. SSA agrees to provide the E-Verify Employer Agent with names, titles, addresses, and
telephone numbers of SSA representatives to be contacted during the E-Verify process.
3. SSA agrees to safeguard the information provided by the Employer through the E-Verify
program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E-Verify program or such other persons or entities who may be authorized by SSA as governed
by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA
regulations (20 CFR Part 401).
4. SSA agrees to provide a means of automated verification that is designed (in conjunction with
DHS's automated system if necessary) to provide confirmation or tentative nonconfirmation of
U.S. citizens' employment eligibility within 3 Federal Government work days of the initial inquiry.
5. SSA agrees to provide a means of secondary verification (including updating SSA records as
may be necessary) for employees who contest SSA tentative nonconfirmations that is designed
to provide final confirmation or nonconfirmation of U.S. citizens' employment eligibility and
accuracy of SSA records for both citizens and non-citizens within 10 Federal Government work
days of the date of referral to SSA, unless SSA determines that more than 10 days may be
necessary. In such cases, SSA will provide additional verification instructions.
B. RESPONSIBILITIES OF DHS
1. After SSA verifies the accuracy of SSA records for employees through E-Verify, DHS agrees
to provide the Employer(through the E-Verify Employer Agent) access to selected data from
DHS's databases to enable the Employer (through the E-Verify Employer Agent)to conduct, to
the extent authorized by this MOU:
•Automated verification checks on employees by electronic means, and
• Photo verification checks (when available) on employees.
2. DHS agrees to provide to the Employer and E-Verify Employer Agent appropriate assistance
with operational problems that may arise during the Employer's participation in the E-Verify
program. DHS agrees to provide the E-Verify Employer Agent names, titles, addresses, and
telephone numbers of DHS representatives to be contacted during the E-Verify process.
3. DHS agrees to make available to the Employer (through the E-Verify Employer Agent) at the
E-Verify website and on the E-Verify Web browser, instructional materials on E-Verify policies,
procedures and requirements for both SSA and DHS, including restrictions on the use of E-
Verify. DHS agrees to provide training materials on E-Verify.
Page 2 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Veri
fy
Company ID Number: 718155
4. DHS agrees to provide to the Employer (through the E-Verify Employer Agent) a notice,
which indicates the Employer's participation in the E-Verify program. DHS also agrees to
provide to the Employer (through the E-Verify Employer Agent) anti-discrimination notices
issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices
(OSC), Civil Rights Division, U.S. Department of Justice.
5. DHS agrees to issue the E-Verify Employer Agent a user identification number and password
that will be used exclusively by the E-Verify Employer Agent, on behalf of the Employer, to verify
information provided by employees with DHS's databases.
6. DHS agrees to safeguard the information provided to DHS by the Employer (through the E-
Verify Employer Agent), and to limit access to such information to individuals responsible for the
verification of employees'employment eligibility and for evaluation of the E-Verify program, or to
such other persons or entities as may be authorized by applicable law. Information will be used
only to verify the accuracy of Social Security Numbers and employment eligibility, to enforce the
Immigration and Nationality Act (INA) and Federal criminal laws, and to administer Federal
contracting requirements.
7. DHS agrees to provide a means of automated verification that is designed (in conjunction
with SSA verification procedures) to provide confirmation or tentative nonconfirmation of
employees' employment eligibility within 3 Federal Government workdays of the initial inquiry.
8. DHS agrees to provide a means of secondary verification (including updating DHS records as
may be necessary) for employees who contest DHS tentative nonconfirmations and photo non-
match tentative nonconfirmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to DHS, unless DHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions.
C. RESPONSIBILITIES OF THE EMPLOYER
1. The Employer shall display the notices supplied by DHS (through the E-Verify Employer
Agent) in a prominent place that is clearly visible to prospective employees and all employees
who are to be verified through the system.
2. The Employer shall provide to the SSA and DHS the names, titles, addresses, and telephone
numbers of the Employer representatives to be contacted regarding E-Verify.
3. The Employer shall become familiar with and comply with the most recent version of the E-
Verify User Manual. The Employer will obtain the E-Verify User Manual from the E-Verify
Employer Agent.
4. The Employer shall comply with current Form 1-9 procedures, with two exceptions:
• If an employee presents a "List B" identity document, the Employer agrees to only
accept "List B" documents that contain a photo. (List B documents identified in 8 C.F.R. §
Page 3 of 151 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Verify
Company ID Number: 718155
274a.2(b)(1)(B)) can be presented during the Form 1-9 process to establish identity.) If an
employee objects to the photo requirement for religious reasons, the Employer should contact
E-Verify at 1-888-464-4218.
• If an employee presents a DHS Form 1-551 (Permanent Resident Card) or Form 1-766
(Employment Authorization Document) to complete the Form 1-9, the Employer agrees to make
a photocopy of the document and to retain the photocopy with the employee's Form 1-9. The
photocopy must be of sufficient quality to allow for verification of the photo and written
information. The employer will use the photocopy to verify the photo and to assist DHS with its
review of photo non-matches that are contested by employees. Note that employees retain the
right to present any List A, or List B and List C, documentation to complete the Form 1-9. DHS
may in the future designate other documents that activate the photo screening tool.
5. Participation in E-Verify does not exempt the Employer from the responsibility to complete,
retain, and make available for inspection Forms 1-9 that relate to its employees, or from other
requirements of applicable regulations or laws, including the obligation to comply with the
antidiscrimination requirements of section 274B of the INA with respect to Form 1-9 procedures,
except for the following modified requirements applicable by reason of the Employer's
participation in E-Verify: (1) identity documents must have photos, as described in paragraph 4
above; (2) a rebuttable presumption is established that the Employer has not violated section
274A(a)(1)(A) of the Immigration and Nationality Act (INA) with respect to the hiring of any
individual if it obtains confirmation of the identity and employment eligibility of the individual in
good faith compliance with the terms and conditions of E-Verify; (3) the Employer must notify
DHS if it continues to employ any employee after receiving a final nonconfirmation, and is
subject to a civil money penalty between $550 and $1,100 for each failure to notify DHS of
continued employment following a final nonconfirmation; (4) the Employer is subject to a
rebuttable presumption that it has knowingly employed an unauthorized alien in violation of
section 274A(a)(1)(A) if the Employer continues to employ an employee after receiving a final
nonconfirmation; and (5) no person or entity participating in E-Verify is civilly or criminally liable
under any law for any action taken in good faith based on information provided through the
confirmation system. DHS reserves the right to conduct Form 1-9 and E-Verify system
compliance inspections during the course of E-Verify, as well as to conduct any other
enforcement activity authorized by law.
6. The Employer shall initiate E-Verify verification procedures (through the E-Verify Employer
Agent), for new employees within 3 Employer business days after each employee has been
hired (but after the Form 1-9 has been completed), and to complete as many (but only as many)
steps of the E-Verify process as are necessary according to the E-Verify User Manual, or in the
case of Federal contractors with the FAR E-Verify clause, the E-Verify User Manual for Federal
contractors. The Employer is prohibited from initiating verification procedures before the
employee has been hired and the Form 1-9 completed. If the automated system to be queried is
temporarily unavailable, the 3-day time period is extended until it is again operational in order to
accommodate the Employer's attempting, in good faith, to make inquiries during the period of
unavailability. Employers may initiate verification, through the E-Verify Employer Agent, by
notating the Form 1-9 in circumstances where the employee has applied for a Social Security
Number (SSN) from the SSA and is waiting to receive the SSN, provided that the Employer
(through the E-Verify Employer Agent) performs an E-Verify employment verification query
Page 4 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
- eriFy
aw `.,..lilllli
Company ID Number: 718155
using the employee's SSN as soon as the SSN becomes available.
7. The Employer may not use E-Verify procedures for pre-employment screening of job
applicants, in support of any unlawful employment practice, or for any other use not authorized
by this MOU. Employers must use E-Verify (through its E-Verify Employer Agent) for all new
employees, unless an Employer is a Federal contractor that qualifies for the exceptions
described in Article II.D.1.c. Except as provided in Article ILD, the Employer will not verify
selectively and will not verify employees hired before the effective date of this MOU. The
Employer understands that if the Employer uses the E-Verify system for any purpose other than
as authorized by this MOU, the Employer may be subject to appropriate legal action and
termination of its access to SSA and DHS information pursuant to this MOU.
8. The Employer (through the E-Verify Employer Agent) shall follow appropriate procedures
(see Article III. below) regarding tentative nonconfirmations, including notifying employees in
private of the finding and providing them written notice of the findings, providing written referral
instructions to employees, allowing employees to contest the finding, and not taking adverse
action against employees if they choose to contest the finding. Further, when employees
contest a tentative nonconfirmation based upon a photo non-match, the Employer is required to
take affirmative steps (see Article III.B. below) to contact DHS with information necessary to
resolve the challenge.
9. The Employer shall not take any adverse action against an employee based upon the
employee's perceived employment eligibility status while SSA or DHS is processing the
verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(1))
that the employee is not work authorized. The Employer understands that an initial inability of
the SSA or DHS automated verification system to verify work authorization, a tentative
nonconfirmation, a case in continuance (indicating the need for additional time for the
government to resolve a case), or the finding of a photo non-match, does not establish, and
should not be interpreted as evidence, that the employee is not work authorized. In any of the
cases listed above, the employee must be provided a full and fair opportunity to contest the
finding, and if he or she does so, the employee may not be terminated or suffer any adverse
employment consequences based upon the employee's perceived employment eligibility status
(including denying, reducing, or extending work hours, delaying or preventing training, requiring
an employee to work in poorer conditions, refusing to assign the employee to a Federal contract
or other assignment, or otherwise subjecting an employee to any assumption that he or she is
unauthorized to work, or otherwise mistreating an employee) until and unless secondary
verification by SSA or DHS has been completed and a final nonconfirmation has been issued. If
the employee does not choose to contest a tentative nonconfirmation or a photo non-match or if
a secondary verification is completed and a final nonconfirmation is issued, then the Employer
can find the employee is not work authorized and terminate the employee's employment.
Employers or employees with questions about a final nonconfirmation may call E-Verify at 1-
888-464-4218 or OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
10. The Employer shall comply with Title VII of the Civil Rights Act of 1964 and section 2748 of
the INA, as applicable, by not discriminating unlawfully against any individual in hiring, firing, or
recruitment or referral practices because of his or her national origin or, in the case of a
Page 5 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
iE-Veri
',.IIIIIIi
Company ID Number: 718155
protected individual as defined in section 27413(a)(3) of the INA, because of his or her
citizenship status. The Employer shall not engage in such illegal practices as selective
verification or use of E-Verify except as provided in part D below, or discharging or refusing to
hire employees because they appear or sound "foreign" or have received tentative
nonconfirmations. The Employer further understands that any violation of the unfair
immigration-related employment practices provisions in section 274B of the INA could subject
the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII
could subject the Employer to back pay awards, compensatory and punitive damages.
Violations of either section 274B of the INA or Title VII may also lead to the termination of its
participation in E-Verify. If the Employer has any questions relating to the anti-discrimination
provision, it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD).
11. The Employer shall record the case verification number on the employee's Form 1-9 or to
print the screen containing the case verification number and attach it to the employee's Form I-
9.
12. The Employer will use the information it receives from SSA or DHS (through its E-Verify
Employer Agent) pursuant to E-Verify and this MOU only to confirm the employment eligibility of
employees as authorized by this MCU. The Employer agrees that it will safeguard this
information, and means of access to it (such as PINS and passwords) to ensure that it is not
used for any other purpose and as necessary to protect its confidentiality, including ensuring
that it is not disseminated to any person other than employees of the Employer who are
authorized to perform the Employer's responsibilities under this MOU, except for such
dissemination as may be authorized in advance by SSA or DHS for legitimate purposes.
13. The information that the Employer receives through the E-Verify Employer Agent from SSA
is governed by the Privacy Act (5 U.S.C. § 552a(i)(1) and (3)) and the Social Security Act (42
U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses
it for any purpose other than as provided for in this MOU may be subject to criminal penalties.
14. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and
evaluation of E-Verify, including by permitting DHS and SSA, upon reasonable notice, to review
Forms 1-9 and other employment records and to interview it and its employees regarding the
Employer's use of E-Verify, and to respond in a timely and accurate manner to DHS requests
for information relating to their participation in E-Verify.
D. EMPLOYERS THAT ARE FEDERAL CONTRACTORS WITH THE FAR E-VERIFY
CLAUSE
1. If the Employer is a Federal contractor subject to the employment verification terms in
Subpart 22.18 of the FAR, it must verify the employment eligibility of any existing employee
assigned to the contract and all new hires, as discussed in the Supplemental Guide for Federal
Contractors. Once an employee has been verified through E-Verify by the Employer, the
Employer may not reverify the employee through E-Verify.
a. Federal contractors with the FAR E-Verify clause not enrolled at the time of contract
award: An Employer that is not enrolled in E-Verify as a Federal contractor at the time of a
Page 6 of 151 E-Vent'MOU for E-Verify Employer Agentl Revision Date 09/01109
www.dhs.gov/E-Verify
E-Veri Ilk
Company ID Number: 718155
contract award must enroll as a Federal contractor with the FAR E-Verify clause in the E-Verify
program within 30 calendar days of contract award and, within 90 days of enrollment, begin to
use E-Verify to initiate verification of employment eligibility of new hires of the Employer who are
working in the United States, whether or not assigned to the contract. Once the Employer
begins verifying new hires, such verification of new hires must be initiated within 3 business
days after the date of hire. Once enrolled in E-Verify as a Federal contractor with the FAR E-
Verify clause, the Employer must initiate verification of employees assigned to the contract
within 90 calendar days from the time of enrollment in the E-Verify system and selecting which
employees will be verged in E-Verify or within 30 days of an employee's assignment to the
contract, whichever date is later.
b. Federal contractors already enrolled in E-Verify at the time of a contract award but are
not enrolled in the system as a Federal contractor with the FAR E-Verify clause: Employers
enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a contract award
must use E-Verify to initiate verification of employment eligibility for new hires of the Employer
who are working in the United States, whether or not assigned to the contract, within 3 business
days after the date of hire. Employers enrolled in E-Verify as other than a Federal contractor
with the FAR E-Verify clause, must update E-Verify to indicate that they are a Federal contractor
with the FAR E-Verify clause within 30 days after assignment to the contract. If the Employer is
enrolled in E-Verify as a Federal contractor for 90 calendar days or less at the time of contract
award, the Employer must, within 90 days of enrollment, begin to use E-Verify to initiate
verification of new hires of the contractor who are working in the United States, whether or not
assigned to the contract. Such verification of new hires must be initiated within 3 business days
after the date of hire. An Employer enrolled as a Federal contractor with the FAR E-Verify
clause in E-Verify must initiate verification of each employee assigned to the contract within 90
calendar days after date of contract award or within 30 days after assignment to the contract,
whichever is later.
c. Institutions of higher education, State, local and tribal governments and sureties:
Federal contractors with the FAR E-Verify clause that are institutions of higher education (as
defined at 20 U.S.C. 1001(a)), State or local governments, governments of Federally recognized
Indian tribes, or sureties performing under a takeover agreement entered into with a Federal
agency pursuant to a performance bond may choose to only verify new and existing employees
assigned to the Federal contract. Such Federal contractors with the FAR E-Verify clause may,
however, elect to verify all new hires, and/or all existing employees hired after November 6,
1986. The provisions of Article Il, part D, paragraphs 1.a and 1.b of this MOU providing
timeframes for initiating employment verification of employees assigned to a contract apply to
such institutions of higher education, State, local and tribal governments, and sureties.
d. Verification of all employees: Upon enrollment, Employers who are Federal
contractors with the FAR E-Verify clause may elect to verify employment eligibility of all existing
employees working in the United States who were hired after November 6, 1986, instead of
verifying only new employees and those existing employees assigned to a covered Federal
contract. After enrollment, Employers must elect to do so only in the manner designated by DHS
and initiate E-Verify verification of all existing employees within 180 days after the election.
Page 7 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Verify �_
Company ID Number: 718155
e. Form 1-9 procedures for existing employees of Federal contractors with the FAR E-
Verify clause: A Federal contractor with the FAR E-Verify clause may choose to complete new
Forms 1-9 for all existing employees other than those that are completely exempt from this
process. Federal contractors with the FAR E-Verify clause may also update previously
completed Forms 1-9 to initiate E-Verify verification of existing employees who are not
completely exempt as long as that Form 1-9 is complete (including the SSN), complies with
Article II.C.4, the employee's work authorization has not expired, and the Employer has
reviewed the information reflected in the Form I-9 either in person or in communications with the
employee to ensure that the employee's stated basis in section 1 of the Form 1-9 for work
authorization has not changed (including, but not limited to, a lawful permanent resident alien
having become a naturalized U.S. citizen). If the Employer is unable to determine that the Form
1-9 complies with Article II.C.4, if the employee's basis for work authorization as attested in
section 1 has expired or changed, or if the Form 1-9 contains no SSN or is otherwise incomplete,
the Employer shall complete a new 1-9 consistent with Article II.C.4, or update the previous 1-9
to provide the necessary information. If section 1 of the Form 1-9 is otherwise valid and up-to-
date and the form otherwise complies with Article II.C.4, but reflects documentation (such as a
U.S. passport or Form 1-551) that expired subsequent to completion of the Form 1-9, the
Employer shall not require the production of additional documentation, or use the photo
screening tool described in Article II.C.4, subject to any additional or superseding instructions
that may be provided on this subject in the Supplemental Guide for Federal contractors. Nothing
in this section shall be construed to require a second verification using E-Verify of any assigned
employee who has previously been verified as a newly hired employee under this MOU, or to
authorize verification of any existing employee by any Employer that is not a Federal contractor
with the FAR E-Verify clause.
2. If the Employer is a Federal contractor with the FAR E-Verify clause, its compliance with this
MOU is a performance requirement under the terms of the Federal contract or subcontract, and
the Employer consents to the release of information relating to compliance with its verification
responsibilities under this MOU to contracting officers or other officials authorized to review the
Employer's compliance with Federal contracting requirements.
E. RESPONSIBILITIES OF E-VERIFY EMPLOYER AGENT
1. The E-Verify Employer Agent agrees to provide to the SSA and DHS the names, titles,
addresses, and telephone numbers of the E-Verify Employer Agent representatives who will be
accessing information under E-Verify.
2. The E-Verify Employer Agent agrees to become familiar with and comply with the E-Verify
User Manual and provide a copy of the manual to the Employer so that the Employer can
become familiar with and comply with E-Verify policy and procedures
3. The E-Verify Employer Agent agrees that any E-Verify Employer Agent Representative who
will perform employment verification queries will complete the E-Verify Tutorial before that
individual initiates any queries.
A. The E-Verify Employer Agent agrees that all E-Verify Employer Agent representatives
Page 8 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
- erg y
NI
Company ID Number: 718155
will take the refresher tutorials initiated by the E-Verify program as a condition of continued use
of E-Verify, including any tutorials for Federal contractors if the Employer is a Federal contractor
with the FAR E-Verify clause.
B. Failure to complete a refresher tutorial will prevent the E-Verify Employer Agent and
Employer from continued use of the program.
4. The E-Verify Employer Agent agrees to obtain the necessary equipment to utilize E-Verify.
5. The E-Verify Employer Agent agrees to provide the Employer with the notices described in
Article 11.6.4 above.
6. The E-Verify Employer Agent agrees to initiate E-Verify procedures on behalf of the Employer
in accordance with the E-Verify Manual and E-Verify Web-Based Tutorial. The E-Verify
Employer Agent will query the automated system using information provided by the Employer
and will immediately communicate the response back to the Employer. If the automated system
to be queried is temporarily unavailable, the 3-day time period is extended until it is again
operational in order to accommodate the E-Verify Employer Agent's attempting, in good faith, to
make inquiries on behalf of the Employer during the period of unavailability. In all cases, the E-
Verify Employer Agent will use the SSA verification procedures first, and will use DHS
verification procedures only as directed by the SSA verification response.
7. The E-Verify Employer Agent agrees to cooperate with DHS and SSA in their compliance
monitoring and evaluation of E-Verify, including by permitting DHS and SSA, upon reasonable
notice, to review Forms 1-9 and other employment records and to interview it and its employees
regarding the use of E-Verify, and to respond in a timely and accurate manner to DHS requests
for information relating to their participation in E-Verify.
ARTICLE III
REFERRAL OF INDIVIDUALS TO SSA AND DHS
A. REFERRAL TO SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print
the tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation.
2. The Employer will refer employees to SSA field offices only as directed by the automated
system based on a tentative nonconfirmation, and only after the Employer records the case
verification number, reviews the input to detect any transaction errors, and determines that the
employee contests the tentative nonconfirmation. The Employer (through the E-Verify Employer
Agent), will transmit the Social Security Number to SSA for verification again if this review
indicates a need to do so. The Employer will determine whether the employee contests the
tentative nonconfirmation as soon as possible after the Employer receives it.
Page 9 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Veri
Company ID Number: 718155
3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide the
employee with a system-generated referral letter and instruct the employee to visit an SSA
office within 8 Federal Government work days. SSA will electronically transmit the result of the
referral to the Employer (through the E-Verify Employer Agent) within 10 Federal Government
work days of the referral unless it determines that more than 10 days is necessary. The
Employer agrees to check the E-Verify system regularly for case updates.
4. The Employer shall not ask the employee to obtain a printout from the Social Security
Number database (the Numident) or other written verification of the Social Security Number
from the SSA.
B. REFERRAL TO DHS
1. If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must print
the tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation.
2. If the Employer finds a photo non-match for an employee who provides a document for which
the automated system has transmitted a photo, the employer must print the photo non-match
tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or she will contest the finding.
3. The Employer shall refer individuals to DHS only when the employee chooses to contest a
tentative nonconfirmation received from DHS automated verification process or when the
Employer issues a tentative nonconfirmation based upon a photo non-match. The Employer will
determine whether the employee contests the tentative nonconfirmation as soon as possible
after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer shall
provide the employee with a referral letter and instruct the employee to contact DHS through its
toll-free hotline (as found on the referral letter)within 8 Federal Government work days.
5. If the employee contests a tentative nonconfirmation based upon a photo non-match, the
Employer will provide the employee with a referral letter to DHS. DHS will electronically transmit
the result of the referral to the Employer within 10 Federal Government work days of the referral
unless it determines that more than 10 days is necessary. The Employer agrees to check the E-
Verify system regularly for case updates.
6. If an employee contests a tentative nonconfirmation based upon a photo non-match, the
Employer shall send a copy of the employee's Form 1-551 or Form 1-766 to DHS for review by:
• Scanning and uploading the document, or
• Sending a photocopy of the document by an express mail account (furnished and paid
for by
DHS).
Page 10 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Veri
fy
Company ID Number: 718155
7. If the Employer(through the E-Verify Employer Agent) determines that there is a photo non-
match when comparing the photocopied List B document described in Article II.C.5 with the
image generated in E-Verify, the Employer (through the E-Verify Employer Agent) must forward
the employee's documentation to DHS using one of the means described in the preceding
paragraph, and allow DHS to resolve the case.
ARTICLE IV
SERVICE PROVISIONS
The SSA and DHS will not charge the Employer or the E-Verify Employer Agent for verification
services performed under this MOU. DHS is not responsible for providing the equipment needed
to make inquiries. A personal computer with Internet access is needed to access the E-Verify
System.
ARTICLE V
PARTIES
A. This MOU is effective upon the signature of the parties, and shall continue in effect for as
long as the SSA and DHS conduct the E-Verify program unless modified in writing by the mutual
consent of all parties, or terminated by any party upon 30 days prior written notice to the others.
Any and all system enhancements to the E-Verify program by DHS or SSA, including but not
limited to the E-Verify checking against additional data sources and instituting new verification
procedures, will be covered under this MOU and will not cause the need for a supplemental
MOU that outlines these changes. DHS agrees to train employers on all changes made to E-
Verify through the use of mandatory refresher tutorials and updates to the E-Verify User
Manual, the E-Verify User Manual for Federal Contractors or the E-Verify Supplemental Guide
for Federal Contractors. Even without changes to E-Verify, DHS reserves the right to require E-
Verify Employer Agents to take mandatory refresher tutorials. An E-Verify Employer Agent for
an Employer that is a Federal contractor with the FAR E-Verify clause may terminate this MOU
when the Federal contract that requires the Employers participation in E-Verify is terminated or
completed. In such a circumstance, the E-Verify Employer Agent must provide written notice to
DHS. If the E-Verify Employer Agent fails to provide such notice, that Employer will remain a
participant in the E-Verify program on behalf of the Employer, will remain bound by the terms of
this MOU that apply to participants that are not Federal contractors with the FAR E-Verify
clause, and will be required to use the E-Verify procedures to verify the employment eligibility of
all the Employer's newly hired employees.
B. Notwithstanding Article V, part A of this MOU, DHS may terminate access to E-Verify if it is
deemed necessary because of the requirements of law or policy, or upon a determination by
SSA or DHS that there has been a breach of system integrity or security by the E-Verify
Employer Agent or the Employer, or a failure on the part of either to comply with established
procedures or legal requirements. The E-Verify Employer Agent understands that if the
Employer is a Federal contractor with the FAR E-Verify clause, termination of this MOU by any
Page 11 of 15 I E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Veri
_Jllllli ,
Company ID Number: 718155
party for any reason may negatively affect the Employer's performance of its contractual
responsibilities.
C. Some or all SSA and DHS responsibilities under this MOU may be performed by
contractor(s), and SSA and DHS may adjust verification responsibilities between each other as
they may determine necessary. By separate agreement with DHS, SSA has agreed to perform
its responsibilities as described in this MOU.
D. Nothing in this MOU is intended, or should be construed, to create any right or benefit,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the E-Verify Employer Agent, the Employer, or their
agents, officers, or employees.
E. Each party shall be solely responsible for defending any claim or action against it arising out
of or related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom,
including (but not limited to) any dispute between the E-Verify Employer Agent or the Employer
and any other person or entity regarding the applicability of Section 403(d) of IIRIRA to any
action taken or allegedly taken by the E-Verify Employer Agent or the Employer.
F. Participation in E-Verify is not confidential information and may be disclosed as authorized or
required by law and DHS or SSA policy, including but not limited to, Congressional oversight, E-
Verify publicity and media inquiries, determinations of compliance with Federal contractual
requirements, and responses to inquiries under the Freedom of Information Act (FOIA).
G. The foregoing constitutes the full agreement on this subject between DHS and the E-Verify
Employer Agent.
Page 12 of 15 I E-Verify MOU for E-Verify Employer Agent!Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Verify
Company ID Number: 718155
The individuals whose signatures appear below represent that they are authorized to enter into
this MOU on behalf of the E-Verify Employer Agent and DHS respectively. If you have any
questions, contact E-Verify at 1-888-464-4218.
Approved by:
Employer Taylormade Co
Wade Taylor
Name(Please Type or Print) Title
Electronically Signed 10/21/2013
Signature Date
Department of Homeland Security—Verification Division
USCIS Verification Division
Name(Please Type or Print) Title
Electronically Signed 10/21/2013
Signature Date
Information Required for the E-Verify Program
Information relating to your Company:
Company Name: aylormade Co
Company Facility Address:7356 Holliday or
Kansas City, KS 66106
Company Alternate
Address:
Page 13 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www,dhs.gov/E-Verify
E-Verify
Company ID Number: 718155
County or Parish: WYANDOTTE
Employer Identification
Number: 451874049
North American Industry
Classification Systems
Code: 238
Administrator:
Number of Employees:1 to 4
Number of Sites Verified
for:
Are you verifying for more than 1 site? If yes, please provide the number of sites verified for
in each State:
KANSAS 1 site(s)
Information relating to the Program Administrator(s) for your Company on policy
questions or operational problems:
Name: Lauren C Harris
Page 14 of 15 i E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
E-Verify .
Company ID Number: 718155
Telephone Number: (913)713-1573 Fax Number: (913)548-0668
E-mail Address: lauren@playgroundpeople.com
Name: Wade A Taylor
Telephone Number: (913)226-4135 Fax Number: (913)548-0668
E-mail Address: tmci@playgroundpeople.com
Page 15 of 15 1 E-Verify MOU for E-Verify Employer Agentl Revision Date 09/01/09
www.dhs.gov/E-Verify
Work Authorization Affidavit
STATE OF KANSAS )
) ss.
COUNTY OF 11 )
As used in this Affidavit,the following terns shall have the following meanings:
EMPLOYEE: Any person performing work or service of any kind or character for hire
within the State of Missouri.
FEDERAL WORK AUTHORIZATION PROGRAM: Any of the electronic verification
of work authorization programs operated by the United States Department of Homeland
Security or an equivalent federal work authorization program operated by the United
States Department of Homeland Security to verify information of newly hired employees,
under the Immigration Reform and Control Act of 1986(IBCA), P.L. 99-603.
KNOWINGLY: A person acts knowingly or with knowledge, (a) with respect to the
person's conduct or to attendant circumstances when the person is aware of the nature of
the person's conduct or that those circumstances exist; or (b) with respect to a result of
the person's conduct when the person is aware that the person's conduct is practically
certain to cause that result.
UNAUTHORIZED ALIEN: An alien who does not have the legal right or authorization
under federal law to work in the United States, as defined in 8 U.S.C. 1324a(h)(3).
BEFORE ME, the undersigned authority, personally appeared Y4 Sctj-� mance
e
who,being duly swom, states on his oath or affirmation as follows:
1. My name is 11\0.nc.e and I am currently the } YYwroQeY'
of TaylorMade Co(hereinafter"Contractor"),and I am authorized to make 's Affidavit.
I am of sound mind and capable of making this Affidavit, and I am personally acquainted
with the facts stated herein.
3. Contractor is enrolled in and participates in a federal work authorization program with
respect to the employees working regarding the services contracted between Contractor
and the City of Riverside.
4. Contractor does not knowingly employ any person who is an unauthorized alien
regarding the contracted services set forth above.
Affiant Printed Name
to before me this day 18.
"F•t"'• SUEBOWORE
i"iO_9"•• ' My Appoinvent Expires
Notary Public