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AG 06-117 - ------------~ ------- - DATE IN: DATE OUT: MENT SCAf\l~" :t:,~- t '.. .. ". REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.IDIY: tv\6 \ 2. ORIGINATING STAFF PERSON: \\NUl \^J~ EXT: d0LtL 3. DATE REQ. BY: ~~ 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D PROFESSIONAL SERVICE AGREEMENT D SECURITY DOCUMENT (E.G. AGREEMENT & D MAINTENANCE/LABOR AGREEMENT PERFIMAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND) D PUBLIC WORKS CONTRACT D CONTRACTOR SELECTION DOCUMENT D SMALL PUBLIC WORKS CONTRACT (E.G., RFB, RFP, RFQ) AG#: 06 -117 (LESS THAN $200,000) D CONTRACT AMENDMENT D PURCHASE AGREEMENT) D CDBG _ ~Y~1V1DXl+- Wsto\ (MATERIALS, SUPPLIES, EQUIPMENT) ~THER lAt\ D REAL ESTATE DOCUMENT 5. PROJECT NAME: Nm-- tiB"YlrY\\Y'lt11.OO :f\g refAY\eYtt- 6. NAME OF CONTRACTOR: \N~' ADDRESS: . TELEPHONE SIGNATURE NAME: TITLE 7. ATTACH ALL EXHIBITS AND CHECK BOXES D SCOPE OF SERVICES D ALL EXHIBITS REFERENCED IN DOCUMENT D INSURANCE CERTIFICATE D DOCUMENT AUTHORIZING SIGNATURE 8. o PLETIONDATE'~ ~ 9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: DYES D NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED DYES D NO IF YES, $ PAID BY: D CONTRACTOR D CITY 10. CONTRACT REVIEW INITIALIDATE APPROVED INITIALIDATE APPROVED D PROJECT MANAGER 7~olo '~IRECTOR ~ D RI8K MAn\GIIMENT 2l \I? lAL- ~w2ltJiDb 11. CONTRACT SIGNATURE ROUTING INITIALIDATE APPROVED INITIAL/DATE APPROVED D LXiv'DE.flAltTMENT @ ~ ~ITY MANAGER ! ~ 2./llolo~ !:l CITY CLBRK >C. ~IGN COPY BACK TO ORGINATlNG DEPT. ~ 1i1/tIt )lCASSIGNEDAG# Ob"'117 D PURCII}.~U>TG: PI P A C::P CJIARCr:: TO. COMMENT~ ~ ~ ~1 lo b W . ~ 07/05 L ------~. --- ~ '\ RECEiVED JUL 3 1 lO06 ~ &iHi~:V at FeUEf1AL 'WAY ilj Washington State Transportation Buil . *' . IC~ ~'I Department of Transportation 310 Maple Park Aven~~ Y4tMGEA'S OFF Douglas B. MacDonald P.O. Box 47300 Secretary of Transportation Olympia, WA 98504-7300 360-705-7000 TTY: 1-800-833-6388 www.wsdot.wa.gov July 17, 2006 CERTIFIED MAIL RECEIPT REQUESTED Mr. Derek Matheson Interim City Manager 33324 8th A venue South Federal Way, WA 98063-9718 Re: Title VI Non-Discrimination Agreement Approval Dear Mr. Matheson: The Washington State Department of Transportation (WSDOT) Office of Equal Opportunity received the City of Federal Way's Non-Discrimination Agreement on April 5, 2006. WSDOT has reviewed the Non-Discrimination Agreement to ensure adherence with Title VI of the Civil Rights Act of 1964 and related federal regulations. The City of Federal Way's Non-Discrimination Agreement is approved as it sufficiently addresses the requirements under Title 23, Code of Federal Regulations (CFR), Part 200 and 49 CFR 21, as well as the provisions of Executive Order 12898 on Environmental Justice and Executive Order 13166 on Limited English Proficiency. Enclosed you will find the signed Non-Discrimination Agreement. WSDOT appreciates your efforts in developing the required document for the implementation of your Title VI Program. The City of Federal Way will be required to submit an Annual Title VI Accomplishment and Update Report each year. The report for Federal Fiscal Year 2006 is due July 31, 2007. There are Title VI compliance areas that will require special attention as you implement the provisions of Title VI. Executive Order 12898 on Environmental Justice and Executive Order 13166 on Limited English Proficiency have identified issues of discrimination on the basis of national origin, which require more specific administrative measures to prevent such forms of discrimination from recipients and sub-recipients of federal funds. '-. Mr. Derek Matheson July 17,2006 Page 2 The implementation of Title VI requires you to incorporate the provisions of Environmental Justice and Limited English Proficiency policies and practices into all aspects of the transportation process. Your update will need to include the following information: . Gather and maintain the most current demographics data on minority, low income and Limited English Proficiency populations in the City of Federal Way's jurisdiction (using a variety of sources such as Office of Financial Management, school districts, and the Washington State Department of Social and Health Services). This information is to be analyzed to develop special outreach for underserved populations impacted by the City of Federal Way's federal-aid highway activities; . How those demographics were obtained and analyzed; . Outline in the Title VI Update and Accomplishment Report the process that was developed for evaluating and documenting the effectiveness of Environmental Justice and Limited English Proficiency public involvement strategies. WSDOT will review the methodologies utilized to maximize public involvement activities. Examples include but are not limited to: 1) Advertising in alternate languages in minority or other publications even though there may not be a minority newspaper of record in the City of Federal Way's jurisdiction, and 2) developing other methods to advise the public of the activities such as notices in organizations and establishments that provide services or assistance to persons that may be low-income or have Limited English Proficiency. On-line resources regarding Limited English Proficiency and public participation requirements and regulations may be found at the following Internet addresses: http://www.fhwa.dot. gov / civilrights/2004workshops/04Iepsandiego.htm and at http://www.hhs. gov / ocr/lepfina1.htm. The WSDOT Local Agency Guidelines Manual Chapter 28, Appendix 28.73 has a template for the Title VI Annual Accomplishment and Update Report. There is also a template on http://www.wsdot.wa.gov/TA/Operations/LAG/Lagchap.htm as well as on our web site at http://www.wsdot.wa.gov/oeo. The report is available in Microsoft Word@ and in Adobe PDF@ formats. WSDOT is committed to providing any assistance you may need with your Title VI Program implementation process. ------------ Mr. Derek Matheson July 17, 2006 Page 3 If you have any questions concerning your Title VI Program, please contact Liane Carlson, Title VI Coordinator, at (360) 705-7098 or email her at carlsol@wsdot.wa. gov. Sincerely, q)~ 1<. NftMtW~ Brenda R. Nnambi Director, Office of Equal Opportunity Enclosure cc: Dave Mounts, WSDOT Highways and Local Programs File - ---- . . Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Washington State Department of Transportation and Name of Recipient Policy Statement The City of Federal Way . hereinafter referred to as the "Recipient" assures that no person shall on the grounds of race, color, national origin, or sex, as provided by Title VI of the Civil Rights Act of 1964, and the Civil Rights Restoration Act of 1987 (PL 100.259) be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity. The Recipient further assures every effort will be made to ensure non-discrimination in all of its programs and activities, whether those programs and activities are federally funded or not. The Civil Rights Restoration Act of 1987, broadened the scope of Title VI coverage by expanding the definition of terms "programs or activities" to include all programs or activities of Federal Aid recipients, sub-recipients, and contractors/consultants, whether such programs and activities are federally assisted or not (Public Law 100259 (S.557] March 22, 1988.) In the event the Recipient distributes federal aid funds to a sub-recipient, the Recipient will include Title VI language in all written agreements and will monitor for compliance. The Recipient's Human Res~urces Manager is responsible for initi~ng-and monitoring Iitle VI acti,vities, preparing reports and other responsibilities as required by 23 Code of Federal Re~lation(CFR) 200 an f Federal Regulation 21. Interim City Manager <2-/lla IOf; Date ------.- ----.-.---.-- ------- Local Agency Guidelines M 36-63 28-19 April 2005 General Project Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Title VI Program Organization and Staffing Pursuant to 23 CFR 200, the City of Federal Way has appointed a Title VI Specialist who is responsible for Attachment I, which describes the hierarchy for the City of Federal Way's Title VI Program, including an organization's chart illustrating the level and placement of Title VI responsibilities. Assurances 49 CFR Part 21.7 The City of Federal Way hereby gives assurances: l. That no person shall on the grounds of race, color, national origin, and sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity conducted by the recipient regardless of whether those programs and activities are Federally funded or not. Activities and programs which the recipient hereby agrees to carry out in compliance with Title VI and related statutes include but are not limited to: . List all major programs and activities of the recipient and Title VI responsibilities for each one of them. Include information as Attachment 2 to this Nondiscrimination Agreement. 2. That it will promptly take any measures necessary to effectuate this agreement. 3. That each program, activity, and facility as defined at 49 CFR 21.23(b) and (e), and the Civil Rights Restoration Act of 1987 will be (with regard to a program or activity) conducted, or will be (with regard to a facility) operated in compliance with the__ nondiscriminatory requirements imposed by, or pursuant to, this agreement. 4. That these assurances are given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts, property, discounts or other Federal financial assistance extended after the date hereof to the recipient by the Washington State Department of Transportation (WSDOT) under the Federally-Funded Program and is binding on it, other recipients, subgrantees, contractors, sub-contractors, transferees, successors in interest and other participants. The person or persons whose signatures appear below are authorized to sign these assurances on behalf of the Recipient. 5_ That the Recipient shall insert the following notification in all solicitations for bids for work or material subject to the Regulations and made in connection with all Federally-Funded programs and, in adapted form all proposals for negotiated agreements. The Recipient, in accordance with Title VI of the Civil Rights Act of 1964, 79 Stat. 252,42 U,S.C. 2000d to 2000d-4 and Title 49, Code ofFederaJ Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Nondiscrimination in Federally-assisted programs of the Department of Transportation issued pursuant to such Act, hereby notifies all bidders that it will affirmatively ensure that in any contract entered into pursuant to this advertisement. disadvantaged business enterprises as defined at 49 CFR Part 23 will be afforded full opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, national origin, or sex in consideration for an award. 6. That the Recipient shall insert the clauses of Appendix I of this Agreement in every contract subject to the Act and the Regulations. 7. That the Recipient shall insert the clauses of Appendix 2 of this Agreement, as a covenant running with the land, in any deed from the United States effecting a transfer of real property, structures, or improvements thereon, or interest therein. 8, That the Recipient shall include the appropriate clauses set forth in Appendix 3 of this Agreement, as a covenant running with the land, in any future deeds, leases, permits, licenses, and similar agreements entered into by the Recipient with other parties: (a) for the subsequent transfer of real property acquired or improved under a Federal Aid Program; and (b) for the construction or use of or access to space on, over or under real property acquired, or improved under a Federal Aid Program. 9. The Recipient agrees that the United States has a right to seek judicial enforcement with regard to any matter arising under the Act, the Regulations, and this agreement. --~---,~~-~-------- ____~_..___ _ .___m__.~__.,___.__.______ ~---- ------. 28-20 Local Agency Guidelines M 36-63 April 2005 ____n_______ General Project Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Implementation Procedures This agreement shall serve as the recipient's Title VI plan pursuant to 23 CFR 200 and 49 CFR 21. For the purpose of this agreement, "Federal Assistance" shall include: I. grants and loans of Federal funds, 2, the grant or donation of Federal property and interest in property, 3. the detail of Federal personnel, 4. the sale and lease of, and the permission to use (on other than a casual or transient basis), Federal property or any interest in such property without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public interest to be served by such sale or lease to the recipient, and 5. any Federal agreement, arrangement, or other contract which has as one of its purposes, the provision of assistance. The recipient shall: I. Issue a policy statement, signed by the head of the recipient, which expresses it's commitment to the nondiscrimination provisions of Title VI. The policy statement shall be circulated throughout the recipient's organization and to the general public. Such information shall be published where appropriate in languages other than English. 2. Take affirmative action to correct any deficiencies found by WSDOT or the United States Department of Transportation (US DOT) within a reasonable time period, not to exceed 90 days, in order to implement Title VI compliance in accordance with this agreement. The head of the recipient shall be held responsible for implementing Title VI requirements. 3. Establish a civil rights unit and designate a coordinator who has a responsible position in the organization and easy access to the head of the recipient. This unit shall contain a Title VI Specialist, who shall be responsible for initiating and monitoring Title VI activities and preparing required reports. 4. Adequately staff the civil rights unit to effectively implement the civil rights requirements. 5. Process complaints of discrimination consistent with the provisions contained in this agreement. Investigations shall be conducted by civil rights personnel trained in discrimination complaint investigation. Identify each complainant by race, color, national origin or sex, the nature of the complaint, the date the complaint was filed, the date the investigation was completed, the disposition, the date of the disposition, and other pertinent information. A copy of the complaint, together with a copy of the recipient's report of investigation, will be forwarded to WSDOT's Office of Equal Opportunity (OEO) within 10 days of the date the complaint was received by the recipient. 6. Collect statistical data (race, color, national origin, sex) of participants in, and beneficiaries of the programs and activities conducted by the recipient. 7. Conduct Title VI reviews of the recipient and sub-recipient contractor/consultant program areas and activities. Revise where applicable, policies, procedures and directives to include Title VI requirements. 8, Conduct training programs on Title VI and related statutes. 9. Prepare a yearly report of Title VI accomplishments for the last year and goals for the next year. a) Annual Work Plan Outline Title VI monitoring and review activities planned for the coming year; state by which each activity will be accomplished and target date for completion. b) Accomplishment Report List major accomplishments made regarding Title VI activities. Include instances where Title VI issues were identified and discrimination was prevented. Indicate activities and eff0l1s the Title VI Specialist and program area personnel have undertaken in monitoring Title VI. Include a description of the scope and conclusions of any special reviews (internal or external) conducted by the Title VI Specialist. List any major problem(s) identified and corrective action taken. Include a summary and status report on any Title VI complaints filed with the recipient. . ~------_._--------_._--------- --------_.~~,--._._-_._~---- .._--~-- --~------_._---- -- - .-.. -------~-._~-- Local Agency Guidelines M 36-63 28-21 April 2005 - --- ----- General Project Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Discrimination Complaint Procedure l. Any person who believes that he or she, individually, as a member of any specific class, or in connection with any disadvantaged business enterprise, has been subjected to discrimination prohibited by Title VI of the Civil Rights Act of 1964, the American with Disabilities Act of 1990, Section 504 of the Vocational Rehabilitation Act of 1973 and the Civil Rights Restoration Act of 1987, as amended, may file a complaint with the recipient. A complaint may also be filed by a representative on behalf of such a person. All complaints will be referred to the recipient's Title VI Specialist for review and action, 2. In order to have the complaint consideration under this procedure, the complainant must file the complaint no later than 180 days after; a) The date of alleged act of discrimination; or b) Where there has been a continuing course of conduct, the date on which that conduct was discontinued. In either case, the recipient or hislher designee may extend the time for filing or waive the time limit in the interest of justice, specifying in writing the reason for so doing. 3. Complaints shall be in writing and shall be signed by the complainant and/or the complainant's representative. Complaints shall set forth as fully as possible the facts and circumstances surrounding the claimed discrimination. In the event that a person makes a verbal complaint of discrimination to an officer or employee of the recipient, the person shall be interviewed by the Title VI Specialist. If necessary, the Title VI Specialist will assist the person in reducing the complaint to writing and submit the written version of the complaint to the person for signature. The complaint shall then be handled according to the recipient's investigative procedures. 4. Within 10 days, the Title VI Specialist will acknowledge receipt of the allegation, inform the complainant of action taken or proposed action to process the allegation, and advise the complainant of other avenues of redress available, such as WSDOT and USDOT. 5. The recipient will advise WSDOT within 10 days of receipt of the allegations. Generally, the following information will be included in every notification to WSDOT; a) Name, address, and phone number of the complainant. b) Name(s) and address(es) of alleged discriminating official(s). c) Basis of complaint (i.e.; race, color, national origin or sex) d) Date of alleged discriminatory act(s). e) Date of complaint received by the recipient. f) A statement ofthe complaint. g) Other agencies (state, local or Federal) where the complaint has been filed, h) An explanation of the actions the recipient has taken or proposed to resolve the issue raised in the complaint. 6, Within 60 days, the Title VI Specialist will conduct an investigation of the allegation and based on the information obtained, will render a recommendation for action in a report of findings to the head of the recipient. The complaint should be resolved by informal means whenever possible. Such informal attempts and their results will be summarized in the report of findings. 7. Within 90 days of receipt of the complaint, the head of the recipient will notify the complainant in writing of the final decision reached, including the proposed disposition of the matter. The notification will advise the complainant ofhis/her appeal rights with WSDOT, or USDOT, if they are dissatisfied with the final decision rendered by the Recipient. The Title VI Specialist will also provide WSDOT with a copy of this decision and summary offindings upon completion of the investigation. ~--~---~-----------------_.-._. --.--- ---------_..---- - --- ----.------.----..-------.--.------ 28-22 Local Agency Guidelines M 36-63 April 2005 General Project Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 8. Contacts for the different Title VI administrative jurisdictions are as follows: Washington State Department of Transportation Office of Equal Opportunity, Title VI Program PO Box 47314 Olympia, WA 98466 (360) 705-7098 Federal Highway Administration Washington Division Office 711 Capitol Way South, Suite 501 Olympia, WA 98501 (360) 534-9325 Sanctions In the event the recipient fails or refuses to comply with the terms ofthis agreement, the WSDOT may take any or all of the following actions: 1. Cancel, terminate, or suspend this agreement in whole or in part; 2. Refrain from extending any further assistance to the recipient under the program from which the failure or refusal occurred until satisfactory assurance of future compliance has been received from the recipient. 3. Take such other action that may be deemed appropriate under the circumstances, until compliance or remedial action has been accomplished by the recipient. 4. Refer the case to the Department of Justice for appropriate legal proceedings. WASHINGTON STATE DEPARTMENT OF TRANSPORTATION: q3~ g. N~~ Signature Director of the Office of Equal Opportunity Title Date 7/!7/DG ~:;:n~ Derek Matheson Interim City Manager 2-/110 ( 010 Date. { -~---~~----~___.__ ____._____._u,_. _. ____.___... --~-----'~-~--------------,--,--- .. Local Agency Guidelines M 36-63 28-23 April 2005 --, General Project Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Appendix 1 During the performance of this contract, the contractor/consultant, for itself, its assignees and successors in interest (hereinafter referred to as the "contractorfl) agrees as follows: 1. Compliance with Regulations The contractor shall comply with the Regulations relative to non-discrimination in federally assisted programs of United States Department of Tmnsportation (USDOT), Title 49. Code of Federal Regulations, part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorpomted by reference and made a part of this contract, 2. Non-discrimination The contractor, with regard to the work performed by it during the contract, shall not discriminate on the grounds of race, color, sex, or national origin in the selection and retention of sub-contractors, including procurement of materials and leases of equipment. The contmctor shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. 3. Solicitations for Sub-contracts, Including Procurement of Materials and Equipment In all solicitations either by competitive bidding or negotiations made by the contractor fur work to be pertbimed under a sulK:ontract, including procurement of materials or leases of equipment, each potential sub-contractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to nolNfiscrimination on the grounds of race, color, sex, or naliona. origin. 4. Information and Reports The contractor shall prQvide all information and reports required by the Regulations or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the contracting agency or the appropriate federal agency to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to fIlmisb this information, the contractor shall so certify to WSDOT or the USDOT as appropriate, and shall set forth what efforts it has made to obtain the information. 5. Sanctions for Non-compliance In the event of the contractor's non-compliance with the non-discrimination provisions of this contract, the contracting agency shall impose such contract sanctions as it or the USOOT may determine to be appropriate, including, but not limited to: . Withholding of payments to the contractor under the contract until the contractor complies. and/or; . Cancellation, termination, or suspension of the contract, in whole or in part 6. Incorporation of Provisions The contractor shall include th.e provisions of paragraphs (I) through (5) in every sulK:ontract, including procurement of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any sub-contractor or procurement as the Contracting agency or USDOT may direct as a mean.s of enforcing such provisions including sanctions for non-compliance. Provided, however, that in the event a contractor becomes involved in, or is threatened with. litigation with a sub-contractor or supplier as a result of such direction, the contractor may request WSDOT cnt<< into such litigation to protect the interests of the state and, in addition, the contractor may request the USOOT enter into such litigation to protect the interests of the United States. -_.~- 28-24 Locat Ag<imcy Guidelines M 36-63 Apnl 2005 - General Proje<;t Development Appendix 28.72 Non-Discrimination Agreement Population Under 100,000 Appendix 2 The following clauses shall be included in any and all deeds affecting or recording the transfer of real property, structures or improvements thereon, or interest therein from the United States. GRANTING CLAUSE NOW TIiEREFORE, Department of Transportation, as authorized by law. and upon the condition that the state of Washington will accept title to the lands and maintain the project constructed thereon, in accordance with Title 23, United States Code, the Regulations for the Administration QfFederal Aid for Highways and the policies and procedures prescribed by the United States Department of Transportation and, also in accordan.ce with and in compliance with all requirements imposed by or pursuant to TItle 49, Code of Federal Regulations, Department of Transportation, Subtitle A, the Department ofTransportation WSDOT (hereinafter referred to as the Regulations) pertaining to and effectuating the provisions of TItle VI of the Civil Rights Act of 1964 (78 Stat. 252: 42 USC 2000d to 2000d - 4) does hereby remise, release, quitclaim, and coovey unto the state of Washington all the righ.t, title, and interest of the Department of Transportation in and to said land described in Exhibit A attached hereto and made a part thereof. HABENDUM CLAUSE TO HAVE AND TO HOLD said lands and interests therein unto the state of Washington, and its successors forever, subject, however, to the covenants. conditiQns, restrictions and reservations herein contained as foHows, which will remain in effect for the period during which the real property or structures are used for a purpose for which the federal financial assistance is extended or for another purpose involving the provisiQIlS of similar services or benefits and shall be binding on the state of Washington, its successors, and assigns. The state of Washington. in consideration of the conveyance of said lands and interests in lands, does hereby covenant and agree as a covenant running with the land for itself. its successors and assigns, that (I) no person shall on the grounds of race, color, sex or nationaJ origin, be exciuded from participation in, be denied tbe benefits of. or be otherwise subject to discrimination with regard to any facility located wholly or in part on, over, or under such lands hereby oonveyed (,)(and)* (2) that the state of Washington. shall use the lands and interests in lands so conveyed, in compliance with all requirements imposed by or pursuant to TItle 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, part 21, Non-discrimination of federally assisted programs of the Department of Transportation. Effectuation of TItle VI of the Civil Rights Act of 1964, and as said Regulations may be amended (.) and (3) that in the event of breach of any of the above mentioned non-discrimination conditions, the department shall have a right to reenter said lands and facilities on said land, and the above described land and facilities shall thereon revert to and vest in and become the absolute property of the Department of Transportation and its assigns as such interest existed. prior to this instruction. Local Agency GuIdelines M 36-63 211-26 April 2005 ~ . General Project Development Appendix 28.72 Non.Discrimlnatlon AglWmeot Population Under 100,000 Appendix 3 The following clauses shaU be included in all deeds, licenses, leases, penults, or similar instruments entered into by (Recipient) pursuant to the provisions of Assurance 8, The LESSEE, for himself or herself, his or hcr heirs, personal representatives, successors ill interest, and assigns, as a part of the consideration hereof. does hereby covenant and agree as a covenant running with the land that in the event facilities are constructed, maintained, or otherwise operated on the said property described in this lease, for a purpose of which a Department of Transportation program or activity is extended or for another purpose involving the provision of similar services or bene1its, the LESSEE shall maintain and opemle such fucilities and services in compliance with all other requirements imposed pursuant to TItle 49, Code of Federal Regulations, Department of Transportation. Subtitle A, Office of the Secretary, part 21, Non-discrimination in federally assisted programs of the Department ofTram;portation - Effectuation of Title VI of the Civil Rights Act of 1964, as said Regulations may be amended. That in the event of breach of any of the above non-discrimination covenants, the STATE shall have the right to terminate the lease, and to reenter and repossess said land and the facilities thereon, and hold the same as if said lease has never been made or issued. The following shall be included in all deeds, licenses, leases, permits, orsirnilar agreements entered illto by the Washington State Department ofTransportation pursuant to the provisions of Assurance 8. The LESSEE, or himself or herself: his or her personal representatives, successors in interest, and assigns, as a part of the consideration hereof, does hereby COvenant and agree as a covenant running with the land that (I) no person. on the grounds of race, color, sex, or national origin, shall be excluded from participation in, be denied the benefits of, or be otherwise subjected todiscrimination in the use of said facilities, (2) that in the construction of any improvements on, over or under such land and furnishing of services thereon, no person on the grounds of race, color, sex, and national origin shall be excluded from participation in, denied the benefits ot; or otherwise be subjected to discrimination, (3) that the LESSEE shall use the premises in compliance with all requirements imposed by or pursuant to Title 49, Code ofFedera1 Regulations, Department of Transportation, Subtitle A. Office of the Secretary, part 21, Non..discrimination in federally assisted programs of the Department of Transportation - Effectuation of Title VI of the Civil Rights Act of 1964, and as said Regulations may be amended. That in the event of breach of any of the above non..discrimination covenants, the STATE shall have the right to terminate the lease, and to reenter and repossess said land and the facilities thereon, and hold the same as if said lease had never been made or issued. I Reverter Clause and related language to be used only when it is determined that such a clause is necessary in order to effectuate the purpose of Title VI of the Civil Rights Act of 1964. Z8-2G Local Agency GuidelInes M 36-63 April 2005 i .. Appendix 28.73 Annual Title VI Update Questionnaire ANNUAL TITLE VI UPDATE ACCOMPLISHMENT REPORT In responding to this questionnaire, the agency is to only identify changes that have occurred since they submitted their previous questionnaire or since their Title VI Plan or Nondiscrimination Agreement was approved. The questionnaire is to be submitted by the due date each year to the Region Local Programs Engineer for transmittal to Highways and Local Programs (H&LP) for submittal to WSDOT's Office of Equal Opportunity (OEO). I. POLICY STATEMENT Describe any changes to your approved policy statement that have resulted from changes in legislation, local ordinances, etc., or a change in Chief Executive Officer. Submit a copy of the policy statement with the new CEO's signature. II. ORGANIZATION, STAFFING, STRUCTURE a. Organization: Describe any changes in the agency's organization that modify the Title VI Program reporting relationship of the Title VI Coordinator to the CEO. b. Staffing: Provide all changes in descriptions of duties, names, race and gender of the support staff responsible for Title VI compliance monitoring. c. Structure: Provide all changes in supervisory staff (their names, race and gender) responsible for Title VI compliance for each of the agency's program areas (e.g., Planning, Design, Construction, Maintenance, etc.). III. TITLE VI MONITORING AND REVIEW PROCESS Describe actions that have been taken to promote internal (within the agency) and external (sub recipient of the agency's federal funds) compliance with Title VI. List any Title VI compliance reviews the agency has conducted and the results and/or conclusion of each review. IV. COMPLAINTS Describe each Title VI complaint, if any, its basis (race, gender, etc.), and its resolution. Provide a copy of the investigative report(s). V. ACCOMPLISHMENT REPORT FOR EACH PROGRAM AREA 05-18-06 I --- . , Appendix 28.73 Annual Title VI Update Questionnaire A. Planning 1) How many consultant projects for planning were awarded and their dollar value? 2) Describe efforts made to utilize minority and female consultants and subcontractors in federally funded contracts. 3) Describe any studies conducted to provide data relative to minority persons, neighborhoods, income levels, physical environments, and travel habits. What assistance did the Title VI Coordinator provide to ensure that Title VI considerations were included in the planning stage? 4) Identify the number of planning hearings held. Describe efforts to ensure citizen participation in the hearings, particularly by minorities and women. How many minorities and women both individually and through their organizations were represented, and their role(s) in the citizen participation effort? B. Research (Generally not a local agency reporting area) 1) How many research projects are currently underway? 2) List of universities and/or consultants currently conducting research projects. a) Universities b) Consultants c) Federal 3) Provide a summary of actions taken to encourage universities to utilize minority and women students to participate on highway research projects. 4) Provide a summary of actions taken to increase minority and women consultant firms in obtaining research projects. 5) List any significant actions to be taken during the ensuing year. c. Location 05-18-06 2 ------ ---------- , Appendix 28.73 Annual Title VI Update Questionnaire 1) Describe complaints filed, if any, resulting from the choice of highway location decisions, or the procedure used for arriving at the decisions. 2) Identify the titles, ethnicity and gender of employees, and any vacancies, in the Location Program area. Describe efforts of the Title VI Coordinator to increase the representation of minorities and women if they are under-represented. Describe efforts to encourage adequate representation of minorities and women on boards and committees involved in the development of transportation projects. 3) How many Environmental Impact Statements were reviewed? Summarize comments provided on the EIS about adverse impacts on minority, handicapped, elderly, etc., communities. 4) How many consultants currently have contracts involving project development activities and their dollar value? How many are minority consultants and their dollar value? Where minorities and women participation is low, describe efforts to increase their participation. 5) How many project location public hearings were held? Describe how these hearings were advertised, including efforts to provide notification to minorities. 6) Describe efforts to identify minority leaders and encourage them to provide suggestions and ask questions about the location of highways. 7) Was there a need to utilize bilingual advertisements, announcements, notices, etc.? D, Design 1) How many consultant firms currently have design contracts and their dollar value? How many of these are held by minority and women owned firms and their dollar value? 2) Describe efforts to increase minority and female participation in consultant contracts. Does the agency maintain a list of minority and woman consultants? If so, how many firms are on the list? How many are receiving contracts? 05-18-06 3 .. Appendix 28.73 Annual Title VI Update Questionnaire 3) How many highway design phase public hearings were held? Describe minority individuals, groups and organizations that participated in the hearings, including efforts to involve them. Provide a summary of concerns and issues raised, if any, related to minority communities. Describe actions taken by the Title VI Coordinator to facilitate and/or address these concerns. 4) Identify the Design Program employees by title, ethnicity, and gender, and identify any vacant positions. Describe efforts to increase minority and female representation where it is low. 5) Identify Title VI complaints filed, if any, in the Design Program area. Provide a summary of each with basis, status, actions proposed and actions taken. 6) Identify any significant Title VI problem areas, accomplishments, and actions to take during the ensuing year. E. Right of Way 1) Identify the number of civil rights complaints filed, if any, in each of the following Right-of-Way functional areas: a) Appraisals b) Negotiations c) Relocation Assistance and Payments d) Property Management 2) How many appraisers were utilized and how many were minority and women? What efforts were made by the Title VI Coordinator to increase minority and women representation if they were low? 3) Identify the number of negotiations. Does the negotiator's log reflect any disparity in negotiations with minorities as compared to non-minorities? 4) Explain concerns, if any, raised by minorities or women about their options in the negotiation phase. 5) Identify the number of relocations. 6) Describe concerns, if any, raised by minorities or women on replacement housing, referral housing and advisory services. 05-18-06 4 . , Appendix 28.73 Annual Title VI Update Questionnaire 7) Identify the number of contracts awarded for providing relocation assistance, the opportunities given to minorities and women to obtain these, and how many they received. 8) Describe special efforts made to comply with Title VI regulations? 9) Identify Right-of-Way staff by name, job title, race and gender. F. Construction and Maintenance 1) Describe civil right complaints, if any, the agency received on their competitive bidding procedures, and the corrective action, if any was needed, that the agency has taken. Provide a summary of any concerns raised by MWBE about licensing, pre-qualifications, lack of sub-contracting opportunities, etc. 2) Summarize the efforts of the Title VI Coordinator to encourage the use of minority individuals, firms, or agencies for maintenance agreements or construction contracts. 3) Describe any agency procedures that were reviewed to assure Title VI compliance in subcontract agreements, first and second tier, material supply and equipment lease agreements. 4) List any significant accomplishment goals and/or action items to be taken during the ensuing year. G. Education and Training 1) Describe efforts made to encourage participation by minorities and women in National Highway Institute (NHI) educational and training program(s). 2) Identify the types of NHI programs the agency staff attended, whether the agency sponsored or co-sponsored the programs, the number of agency staff that attended, and how many of these were minorities and women. 3) Identify agency staff responsible for training by job title, ethnicity and gender. 4) Describe civil rights complaints filed, if any, concerning training and educational opportunities, and the corrective actions. Provide a summary of concerns raised, complaints filed, status, etc. 05-18-06 5 1-- -------- ------ ----- . , Appendix 28.73 Annual Title VI Update Questionnaire H. Administration 1) Provide a summary list of employees by ethnicity, gender and title in each of the Title VI program areas. 2) Describe activities undertaken to assure Title VI compliance with contractors and by contractors. (Title VI requirements are to be included in all contracts, subcontracts, and consultant agreements.) Describe reviews made to ensure contractors and consultants are apprised of Title VI requirements and to ensure that contractors and/or consultants are adhering to Title VI requirements. 3) Describe Title VI training, if any, that was provided, and how many participants attended, their titles, etc. Describe participation in any other kind of civil rights training (e.g., title and course content), and provide a list of participants by job title (e.g. supervisor, manager, etc.) 05-18-06 6