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HomeMy WebLinkAbout564261 ENERGY OUTREACH COLORADO - CONTRACT - AGREEMENT MISC - ENERGY OUTREACH COLORADO1 SERVICES AGREEMENT THIS AGREEMENT, effective this 21 day of December, 2015, is made by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City", and ENERGY OUTREACH COLORADO, a Colorado non-profit corporation, hereinafter referred to as "Service Provider". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. Service Provider agrees to provide services in accordance with the statement of work attached hereto as Exhibit "A", consisting of two (2) pages and incorporated herein by this reference. 2. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within five (5) days following execution of this Agreement. Services shall be completed no later than December 31, 2016. Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 3. Contract Period. This Agreement shall commence January 1, 2016, and shall continue in full force and effect until December 31, 2016, unless sooner terminated as herein provided. In addition, at the option of City, the Agreement may be extended for additional one year periods not to exceed four (4) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. Written notice of renewal shall be provided to Service Provider and mailed no later than ninety (90) days prior to contract end. 4. Delay. If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause. To the extent the performance is actually prevented, Service Provider must provide written notice to City of such condition within fifteen (15) days from the onset of such condition. 5. Early Termination by City; Notice; City Representative. a. Notwithstanding the time periods contained herein, City may terminate this Agreement at any time without cause by providing written notice of termination to Service Provider. Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice, unless otherwise agreed in writing by the parties. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 2 b. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: City: City of Fort Collins Attn: Purchasing PO Box 580 Fort Collins, CO 80522 Copy to: City of Fort Collins Utilities Attn: Pete Iengo PO Box 580 Fort Collins, CO 80522 Service Provider: Energy Outreach Colorado 225 E. 16th Ave, Suite 200 Denver, CO 80203 In the event of early termination by City, Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of Service Provider's obligations under this Agreement. Such payment shall be Service Provider's sole right and remedy for such termination. c. City designates the Utilities Payment Assistance Program Coordinator as its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement. All requests concerning this agreement shall be directed to the City Representative at the address provided in subsection b. and as follows: Peter Iengo, Program Coordinator; 970-221-6847; piengo@fcgov.com 6. Contract Sum. City shall disburse funds to the Service Provider for the performance of this Contract, as set forth in Exhibit “A”. 7. Independent Service Provider. The services to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins. City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose. 8. Personal Services. It is understood that City enters into the Agreement based on the special abilities of Service Provider and this Agreement shall be considered as an agreement for personal services. Accordingly, Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of City. 9. Acceptance Not Waiver. City approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to City hereunder or cause of action arising out of performance of this Agreement. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 3 10. Warranty. a. Service Provider warrants all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature. b. Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City. c. Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City-furnished materials, equipment and labor, against defects/nonconformances in design, materials and workman/womanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any subcontractor. Upon receipt of written notice from City of any such defect/nonconformances, the affected item/part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City. 11. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof. 12. Remedies. In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non- defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 13. Indemnity; Insurance. a. Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder. b. Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property. c. Without limiting any of Service Provider's obligations hereunder, Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and with the limits specified within Exhibit DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 4 “B”, consisting of one (1) page, attached hereto and incorporated herein by this reference. Service Provider before commencing services hereunder shall deliver to the City's Director of Purchasing and Risk Management, P.O. Box 580 Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City. 14. Entire Agreement. This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties, and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. Covenants or representations not contained in this Agreement shall not be binding on the parties. 15. Law/Severability. The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 16. Prohibition against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et seq., Service Provider represents and agrees that: a. As of the date of this Agreement: i. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and ii. Service Provider. will participate in either thee-Verify program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108 th Congress, as amended, administered by the United States Department of Homeland Security (the "e-Verify Program") or the Department Program (the "Department Program"), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement. c. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 5 i. Notify such subcontractor and City within three days that Service Provider has actual knowledge that the subcontractor is employing or contracting with an illegal alien; and ii. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien; except that Service Provider shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. e. Service Provider shall comply with any reasonable request by the Colorado Department of Labor and Employment (the "Department") made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17.5-102 (5), C.R.S. f. If Service Provider violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17.5-102, C.R.S. City may terminate this Agreement. If this Agreement is so terminated, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider's violation of Subsection 8-17.5-102, C.R.S. g. City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and City terminates the Agreement for such breach. 17. Amendment 54 To the extent that this Agreement may constitute a "sole source government contract" within the meaning of Section 2(14.4) of Article XXVIII of the constitution of the State of Colorado, about which the City makes no representation, Section 15 of said Article XXVIII, which reads as follows, is hereby incorporated into this Agreement and made a part hereof. Section 15. Because of a presumption of impropriety between contributions to any campaign and sole source government contracts, contract holders shall contractually agree, for the duration of the contract and for two years thereafter, to cease making, causing to be made, or inducing by any means, a contribution, directly or indirectly, on behalf of the contract holder or on behalf of his or her immediate family member and for the benefit of any political party or for the benefit of any candidate for any elected office of the state (of Colorado) or any of its political subdivisions. 18. Red Flags Rules. Service Provider must implement reasonable policies and procedures to detect, prevent and mitigate the risk of identity theft in compliance with the Identity Theft Red Flags Rules found at 16 Code of Federal Regulations part 681, including appropriate incident response times relative to the nature of the issues identified. Further, Service Provider must take appropriate steps to mitigate identity theft if it occurs with one or more of City's covered accounts. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 6 19. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit “C” - Confidentiality, consisting of one (1) page, attached hereto and incorporated herein by this reference. IN WITNESS WHEREOF, the parties hereto have executed this Agreement of understanding as of the date written above. CITY OF FORT COLLINS, COLORADO A municipal corporation By: ___________________________ Gerry S. Paul Director of Purchasing ATTEST: ________________________ City Clerk Approved as to form: Assistant/City Attorney ENERGY OUTREACH COLORADO A non-profit corporation By: ___________________________ Jennifer Gremmert Deputy Director Direct Line: 303-226-5052 Cell Phone: 720-937-8659 Fax: 303-825-0765 jgremmert@energyoutreach.org ATTEST: ________________________ Rose Reed Administrative Services Director rreed@energyoutreach.org DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 EXHIBIT A STATEMENT OF WORK The City of Fort Collins Utilities (Utilities) began the Payment Assistance Fund (PAF) in 2004. The PAF program is designed to assist any customer, including our low income customers, with service interruption associated with an account balance delinquency. The PAF is funded through customer solicited donations on a monthly or lump sum basis. On average, for the past 11 years, approximately $35,000 annually is donated by our utility customers into this fund. Energy Outreach Colorado (EOC) was established in 1989 as the only non-profit, 501(c)3 in the state that raises funds to help thousands of low-income Coloradans afford home energy and remain warm and safe in their homes. With the help of partner assistance organizations and subcontractors across the state, they provide utility bill assistance, emergency home furnace repair and grants to improve the energy efficiency of non-profit and affordable housing facilities. Utilities and EOC will partner through this Agreement to increase funding available to Utilities customers. EOC will match PAF funds transferred to EOC, dollar for dollar. Funds will be dispersed to qualified customers through EOC’s qualified Home Energy Assistance Grant agencies to help eligible residential customers remain current with their Utilities account and avoid service interruption. Payment Assistance Fund Guidelines  Funding received by Energy Outreach Colorado from Utilities is to be allocated for the benefit of Utilities customers only;  Customer must have an active, past-due account in the customer’s name in order to receive assistance;  Customer may be eligible for assistance once within the 12-month grant administration cycle (Oct 1-Sept 30);  Deposit will not be included in the assistance benefit provided to a customer;  Assistance is available for both electric and water usage; and  Program participation will be subject to available funds. Agreement Guidelines  EOC will match Utilities funds dollar for dollar.  Utilities will transfer funds to EOC within the first 14 days of each calendar quarter.  All funds Utilities allocates to EOC will be reserved for Utilities customers’ assistance to be distributed in accordance with program administration requirements, in substantially the form as attached hereto as “Attachment 1”.  EOC will not pay administrative fees to grant agencies with Utilities funds; all Utilities-allocated funding will be reserved for direct customer assistance.  If Utilities-allocated funds are not spent within EOC’s fiscal period, they will be rolled over into the next period to be used for the same purpose.  Utilities administrative staff will have access to EOC data as it pertains to Utilities customers, and may request from EOC periodic customer participation reports. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 Administration EOC administrative grant agencies will receive Payment Assistance Fund applications and screen applicants through EOC’s existing programs and processes, including processing applications within EOC’s existing program time periods, but at no time longer than twenty one (21) days after the application date. In conjunction with Utilities staff, EOC grant agencies will determine need and award assistance according to “Home Energy Assistance Grant Administration Requirements” (Attachment 1) and the terms within this agreement. EOC grant agencies will sign a program “Certification Form” in substantially the form attached hereto as ”Attachment 2” before the agency is eligible to administer funds. EOC will submit to Utilities all revisions and modifications to the grant administration requirements and certification criteria no later than October 1 of each year during the term of the Agreement. EOC is responsible to pay each administrative grant agency an administrative fee for funds administered, with such fees being paid from EOC-supplied funds. Budget Utilities will solicit donations from ratepayers to fund the City’s allocation to the Payment Assistance Fund. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 EXHIBIT B INSURANCE REQUIREMENTS 1. The Service Provider will provide, from insurance companies acceptable to City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement: “The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins.” In case of the breach of any provision of the Insurance Requirements, City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. City, its officers, agents and employees shall be named as additional insureds on the Service Provider's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement. 2. Insurance coverages shall be as follows: a. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement: i. Workers' Compensation insurance with statutory limits as required by Colorado law. ii. Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee. B. Commercial General & Vehicle Liability. b. The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a "broad form" basis. The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance. c. Errors & Omissions. The Service Provider shall maintain errors and omissions insurance in the amount of $1,000,000. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 EXHIBIT C CONFIDENTIALITY CONFIDENTIALITY IN CONNECTION WITH SERVICES provided to the City of Fort Collins (the “City”) pursuant to this Agreement (the “Agreement”), the Service Provider hereby acknowledges that it has been informed that the City has established policies and procedures with regard to the handling of confidential information and other sensitive materials. In consideration of access to certain information, data and material (hereinafter individually and collectively, regardless of nature, referred to as “information”) that are the property of and/or relate to the City or its employees, customers or suppliers, which access is related to the performance of services that the Service Provider has agreed to perform, the Service Provider hereby acknowledges and agrees, on behalf of its officers, employees, agents, successors and assigns, as follows: That information that has or will come into its possession or knowledge in connection with the performance of services for the City may be confidential and/or proprietary. The Service Provider agrees to treat as confidential (a) all information that is owned by the City, or that relates to the business of the City, or that is used by the City in carrying on business, and (b) all information that is proprietary to a third party (including but not limited to customers and suppliers of the City). The Service Provider shall not disclose any such information to any person not having a legitimate need-to-know for purposes authorized by the City. Further, the Service Provider, including any of its officers, employees, agents, successors or assigns, shall not use such information to obtain any economic or other benefit for itself, or any third party, except as specifically authorized in writing by the City. The foregoing to the contrary notwithstanding, the Service Provider understands that it shall have no obligation under this Agreement with respect to information and material that (a) becomes generally known to the public by publication or some means other than a breach of duty of this Agreement, or (b) is required by law, regulation or court order to be disclosed, provided that the request for such disclosure is proper and the disclosure does not exceed that which is required. In the event of any disclosure under (b) above, the Service Provider shall furnish a copy of this Agreement to anyone to whom it is required to make such disclosure and shall promptly advise the City in writing of each such disclosure. In the event that the Service Provider ceases to perform services for the City, or the City so requests for any reason, the Service Provider shall promptly return to the City any and all information described hereinabove, including all copies, notes and/or summaries (handwritten or mechanically produced) thereof, in its possession or control or as to which it otherwise has access. The Service Provider understands and agrees that the City’s remedies at law for a breach of the Service Provider’s obligations under this Confidentiality Agreement may be inadequate and that the City shall, in the event of any such breach, be entitled to seek equitable relief (including without limitation preliminary and permanent injunctive relief and specific performance) in addition to all other remedies provided hereunder or available at law. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 Home Energy Assistance Grant Recipient Organization Certification Form As a recipient of Energy Outreach Colorado (EOC) funds, made available for the period October 1, 2015 through September 30, 2016 and as the duly authorized representative of ____________________________________________________________________________________ (Name of Agency) I certify that my organization: • Is nonprofit or governmental and will provide immediate written notification of any change in the organization’s tax-exempt status • Has the capability to provide emergency utility services • Will use funds to supplement and extend existing resources and only to provide utility assistance • Has an accounting system or fiscal agent who will verify documentation required by EOC • Conducts an annual audit or annual review • Has a non-discrimination policy that includes race, ethnicity, gender, sexual orientation and religion. Agencies with religious affiliations will not engage in religious proselytizing in the utility program funded by EOC • Has read, understands and will follow the documents titled Home Energy Assistance Grant Application Guidelines and Home Energy Assistance Grant Administration Requirements • Using the Cash Assistance Database, agencies will track the information detailed in the Utility Assistance Application. Applicants who were denied EOC assistance for any reason will be tracked separately from the database with documentation outlining the reason for denial • Will spend all funds and close out the program by September 30, 2016 and return any unused funds to EOC by October 15, 2016 • Will allow the EOC Board of Directors, the EOC Executive Director and any other duly authorized EOC representative, including but not limited to an outside auditor, to have access to all pertinent books, documents, papers and records of the recipient organization to make audits examinations, excerpts and transcripts • Will allow EOC and/or any of their duly authorized representatives to conduct an agency site visit at any time • Will allow EOC to review and approve the text of any proposed publicity concerning this grant prior to its release • Recognizes EOC shall not be responsible in the event of any dispute between the applicant and the agency and indemnifies and holds EOC harmless from any liability (including attorney fees) arising out of this grant, any activities conducted by the agency and any claims by any applicant • Agrees not to assist any staff member, volunteer, or any other persons associated with the agency with EOC funds NAME: _______________________________________ _____________________________________ Signature Print Name TITLE: _______________________________________ DATE: _______________________________ (Acceptable signatures: Executive Director, Chair or Vice Chair of the Board, Secretary or Treasurer) DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 225 East 16th Ave: Suite 200: Denver: CO 80203: Phone 303-825-8750: Fax: 303-825-0765 Home Energy Assistance Grant Administration Requirements Purpose Energy Outreach Colorado’s Home Energy Assistance Grant helps limited-income individuals and families afford the cost of home energy fuels. The qualifying fuels are: natural gas, electricity, propane, oil, kerosene, firewood, solid fuel pellets and coal. Guidelines • Clients must complete an application, which includes all of the information requested in the Cash Assistance Database client application. • Applicants must be directly responsible for the energy bill; however, the applicant does not have to be the account holder. • Payments to the vendors must be enough to guarantee service for at least 30 additional days from the date funds were committed. • Payments must be for actual amounts owed. The assistance cannot create a credit in the applicant’s account. • Payments will not be made to individuals or landlords. The payments must go to fuel vendors. • Applicants may receive Energy Outreach Colorado (EOC) funds only once during the grant year (October 1, 2015 through September 30, 2016), and they cannot exceed the maximum of $1000.00. • Payments cannot be used to pay any fee that may be returned to the client, such as deposits. • Your organization must offer energy saving/efficiency information and/or counsel to applicants who receive assistance. • During the Low-Income Energy Assistance Program (LEAP) season (November 1 - April 30) applicants are required to apply for LEAP before receiving EOC funds. Your agency is required to obtain written verification of application for LEAP. If your agency knows that the applicant is over the income limits for LEAP and/or does not pay for heating, then the applicant does not need to apply for LEAP. Eligibility Electricity and Natural Gas: • Applicant must provide the most recent bill for an active utility account showing that their account is at least one day in arrears and it must show a past due balance. • Applicant must sign the Confidentiality Agreement and Consent to Disclose Customer Data form. This is a combination of the former EOC Confidentiality Agreement and PUC Consent form. • Applicant must disclose income information. Pre-paid Electricity: • Applicant must provide proof of having a low balance or being out of funds in their account. • Applicant must sign the Confidentiality Agreement and Consent to Disclose Customer Data form. • Applicant must disclose income information. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23 Propane and Fuel Oil: • Applicant must provide a written statement of running low on fuel or being out of fuel in their tanks. • Applicant must sign the Confidentiality Agreement and Consent to Disclose Customer Data form. • Applicant must disclose income information. All Other Fuels: • Applicant must provide a written statement that they are running low on fuel and vendor contact information. • Applicant must sign the Confidentiality Agreement and Consent to Disclose Customer Data form. • Applicant must disclose income information. Payments Electricity and Natural Gas: • If the bill is $1000 or less you can pay the entire bill or just pay the overdue portion of the bill. • If the maximum of $1000 will not restore service or continue service for 30 days do not approve. Pre-paid Electricity: • Multiply the average usage of the applicant by six and pay that amount, up to $500. Propane and Fuel Oil: • Call vendor to find out how much fuel is needed to fill the tank, up to $1000. All Other Fuels: • Call vendor to find out how much fuel is needed to maintain constant fuel in the applicant’s home for a period of at least 30 days, up to $1000. Documentation All applicant files should contain at a minimum: • A completed application. • The bill that was paid or documentation of need for fuels that do not have an account. • Signed Confidentiality Agreement and Consent to Disclose Customer Data form. • Copy of a form of ID • The LEAP letter of approval or denial or written proof of application if during LEAP season. • A copy of the check to the utility vendor. If your office does not write the checks, a copy of the check must be available for an audit. Exemptions, Exceptions and Anomalies • For clients with two different utilities/fuels your agency can help them once with each fuel within the grant year, as long as the total assistance does not exceed $1000, the payments do not need to be made on the same day. • Your agency staff and volunteers cannot be assisted with EOC money by your agency; they must be referred to another agency for assistance. • In a roommate situation, we can only authorize one payment per energy account • If a situation arises that is not covered in this document or clarification is needed, contact the EOC program manager or program assistant. DocuSign Envelope ID: A2994AAD-EA60-4CFF-B719-74B25ED92D23