Historic Resource Development Program Grant Application_Mines of SpainMasterpiece on the Mississippi
Dubuque
httil
All-America i r
2007
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Historic Resource Development Program Grant Application for Mines of
Spain Timeline Exhibit
DATE: April 28, 2010
Planning Services Manager Laura Carstens recommends City Council approval of a
Resolution and a $20,500 grant application to the State Historical Society of Iowa for
Historic Resource Development Program (HRDP) grant funds for the Mines of Spain
Interactive Multi -Media Timeline Exhibit. The local match of $20,000 will come from a
$150,000 federal grant the City has received for the Mines of Spain Exhibit and
Education Program.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Laura Carstens, Planning Services Manager
Michael C. Van Milligen
Masterpiece on the Mississippi
TO: Michael Van Milligen, City Manager
FROM: Laura Carstens, Planning Services Manager 'i
SUBJECT: HRDP Grant Application for Mines of Spain Timeline Exhibit
DATE: April 27, 2010
Dubuque
kiftd
All-America lfty
I
2007
Introduction
This memo transmits a resolution and a grant application to the State Historical Society
of Iowa for Historic Resource Development Program (HRDP) grant funds for the Mines
of Spain Interactive Multi -Media Timeline Exhibit, for City Council approval. The exhibit
will be installed in the expanded E.B. Lyons Interpretive Center at the Mines of Spain.
Discussion
The Mines of Spain is owned and managed by the Iowa DNR. The E.B. Lyons
Interpretive Center, owned by the City of Dubuque, serves as a visitor information
center and park office. The Interpretive Center has artifacts on display interpreting the
park's historical sites of farming, prairies, lead mining, Native Americans and wildlife.
These displays are being updated in 2010.
The Interactive Multi -Media Timeline will provide a dynamic exhibit that conveys the
geology and human occupation of the Mines of Spain. This dual timeline will trace the
geologic course of the park on one side, and cultural history on the other side. The
exhibit will include a clear acrylic case with artifacts from prehistoric people, Native
Americans, lead mining, early settlement, and the park today. Four interactive touch
screens on each side will allow the visitor to learn more about the objects in the case,
and the history of the Mines of Spain.
Budget Impact
The estimated project cost is $40,500. The HRDP grant request is for $20,500. The
local match of $20,000 will come from a $150,000 federal grant the City has received for
the Mines of Spain Exhibit and Education Program.
Recommendation
I recommend that the City Council approve the enclosed resolution and HRDP grant
application, and authorize the Mayor to sign them on behalf of the City of Dubuque.
Enclosures
F: \USERS \LCARSTEN \WP\Mines of Spain \HRDP Mines of Spain Exhibits \HRDP Grant MOS Exhibits Memo MVM.doc
Prepared by: Laura Carstens, City Planner Address: City Hall, 50 W. 13th Street Telephone: 589 -4210
RESOLUTION NO. 125-10
RESOLUTION AUTHORIZING GRANT APPLICATION FOR HRDP FUNDS FOR
MINES OF SPAIN INTERACTIVE MULTI -MEDIA TIMELINE EXHIBIT
Whereas, the State Historical Society of Iowa has Historic Resource Development
Program (HRDP) grant funds available for the preservation and interpretation of Iowa's
historic and cultural resources; and
Whereas, the City of Dubuque has an adopted Comprehensive Plan with goals and
objectives for the preservation and interpretation of the community's historic and cultural
resources; and
Whereas, the City of Dubuque owns the E. B. Lyons Interpretive Center at the Mines
of Spain, which includes exhibits for interpretation of the park's historic and cultural
resources.
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
DUBUQUE, IOWA:
Section 1. That the Mayor is hereby authorized to sign the grant application for
HRDP funds to create the Mines of Spain Interactive Multi -Media Timeline Exhibit.
Section 2. That the City of Dubuque agrees to abide by all local, state, and federal
requirements applicable to the proposed project.
Attest:
Passed, approved and adopted this 3rd day of May, 201
. �, /ice_
eanne F. Schneider, City Clerk
F: \USERS \LCARSTEN \WP\Mines of Spain \HRDP Mines of Spain Exhibits \HRDP MOS Exhibits Res.doc
G
Roy D. Buol, Mayor
STATE HISTORICAL SOCIETY OF IOWA
FY2011 REAP /HRDP Grants
Documentary Collections
Part 1: Application Cover Sheet
Applicant Section
Name of Applicant:
Individual
Business
House: 27 & 28
City of Dubuque
Name & Title of Contact Person: Laura Carstens, Planning Services Manager
Address: Planning Services Department, 50 W. 13 St.
City : Dubuque State: I� A� Zip: 52001
Email Address: _ Icarsten(a citvofdubuque.orq
Telephone (daytime) : _(563) 589 - 4210
Type of Applicant:
Nonprofit corporation; unit of government; or American Indian tribe
Applicant Profile: The city of Dubuque is located on the Mississippi River in northeastern Iowa. The
city is approximately 30 square miles in area, with a population of approximately 60,000 persons. The City's
annual operating and capital budget is nearly $100 million and funds a full range of services, including historic
preservation and arts & culture. The City owns the E.B. Lyons Interpretive Center at the Mines of Spain.
Project Section
Project Title: Mines of Spain Interactive Multi -Media Timeline
Project Category
Documentary Collections
Project Summary: The project is to develop an educational and interpretive program using a dynamic
interactive timeline exhibit that conveys the geology and human occupation of the Mines of Spain. This dual
timeline will trace the geologic course of the park on one side, and cultural history on the other side.
County where project is located: Dubuque
Iowa General Assembly /Legislative District Numbers:
U.S. Congressional District: 1
Senate: 14
Ownership Section
Does the Applicant own the historic resource? x Yes No
If the applicant does not own the historic resource, the following
information is required:
Name of Owner:
Address:
City: State: Zip:
Email Address:
Telephone (daytime):
I give my permission for the applicant to carry out the project described
in this REAP /HRDP grant application.
Signature of Owner:
Date:
Public Access
Does the public have access to the historical resource? x Yes No
If yes, how is the historical resource made accessible to the public? (what
are your hours of operation? Is it visible from a public street? Is it
available to view by appointment?)_ The Mines of Spain is open year- round, from 4 a.m. to
10:30 p.m. The E.B. Lyons Interpretive Center is open year- round. It is open Monday - Friday from October -
April with limited hours. During the summer season, April — October, the center is open 7 days a week. Summer
hours are 8 a.m. to 4 p.m. Monday - Friday and noon to 4:30 p.m. on weekends.
If no, how do you plan to make the historical resource accessible to the
public to meet our guidelines? Is there a reason that the historical
resource cannot be made accessible to the public?
STATE HISTORICAL SOCIETY OF IOWA
FY2011 REAP /HRDP Grants
PART 2: Project Description and
Specific Project Scope of Work
Project Description: Within your discussion, be sure to (1)
specifically identify the historical resource and state its significance;
(2) provide an overview of the activities you will complete; and (3)
explain how the proposed actions will assist the historical resource.
Describe how the project will have an impact on the local community
(neighborhood, town, region, or however you choose to define that
community).
Historical Resource & Significance: The Mines of Spain State Recreation Area consists of 1,387 acres of
forest and prairie along the Mississippi River in Dubuque County near the city of Dubuque that is owned and
managed by the Iowa DNR. The E.B. Lyons Interpretive Center serves as a visitor information center and
park office. The Interpretive Center, which is owned by the City of Dubuque, has displays on the park's
historical sites of farming, prairies, lead mining, Native Americans and wildlife. These displays are being
updated in conjunction with an expansion of the Interpretive Center. Trails connect visitors to a farm site,
forests, prairies, archeological sites, and wetlands. The Mines of Spain Area Rural Community Archeological
District, Lead Mining Community Archeological District, and Prehistoric District, and the Dubuque Trading
Post -- Village of Kettle Chief Archeological District were listed in the National Register of Historic Places in
1988. In 1993, the Mines of Spain was designated as a National Historic Landmark. The Mines of Spain
Recreation Area was designated in 2005 as a Silos and Smokestacks National Heritage Area site. The Julien
Dubuque Monument, built in 1897 on the site where Dubuque was buried, sits high above the Mississippi
River and provides the "landmark" for the Mines of Spain. The Julien Dubuque Monument, owned by the
State of Iowa, was listed in the National Register in 1988. It was protected as a City Landmark in 1993.
Project Overview: The Interactive Multi -Media Timeline project will provide an educational and interpretive
program using a dynamic interactive timeline exhibit that conveys the geology and human occupation of the
Mines of Spain. It will offer visitors an interpretive media and object -based exhibit that is both engaging and
educational. This dual timeline will trace the geologic course of the park on one side, and cultural history on
the other side. The exhibit will include a clear acrylic case with artifacts from prehistoric people, Native
Americans, lead mining, early settlement, and the park today. Four interactive touch screens on each side will
allow the visitor to learn more about the objects in the case, and the history of the Mines of Spain. Lighting
will be used to highlight the artifacts, and interactive media programming will aid in telling the story of the
area. It's imagined as an exhibit that conveys high -end interpretation of the Mines of Spain and the local
region by using an installation of objects that are evocative of the rich cultural, geological, and natural history
alongside a four - screen, touch - activated dynamic media experience. There, visitors can "drill down" and
discover the content and educational storyline, all of which is tied to a chronological interpretation of the
region. Artifacts from the Mines of Spain collection will be used in the Interactive Multi -Media Timeline.
Project Impact: There is no exhibit or facility in the local or regional museums or interpretive centers that
tells this story of where Iowa's history began. This Interactive Multi -Media Timeline exhibit will help people
understand the unique geologic history of this area and the complex cultural history of the Mines of Spain. Its
unique interactive storylines about Dubuque's natural and cultural history will be accessible to visitors of all
ages. The exhibit will be open free to the public when the park's Interpretive Center is open throughout the
year. The exhibit will allow us to increase the number and kind of programs that are provided to the public
and to schools and other youth organizations about the geologic and cultural history of the Dubuque area.
The grant would also increase the number of schools utilizing the park for field trips since we will be able to
provide new and higher level of interpretation and education for them. More and different programs would
also increase the park's visitation and attendance to the center.
Using this same format, continue on additional sheets as necessary.
Specific Project Scope of Work:
This section is a critical part of the application. Provide a step -by-
step description of how the project will be carried out. Each major work
element should clearly relate to budget line items. Include a timeline
for each major work element.
Interpretive displays about the Mines of Spain's natural, historic, and cultural resources are being updated in
conjunction with an expansion of the E.B. Lyons Interpretive Center at the Mines of Spain. Experience
Design, out of Boston, Massachusetts, is the exhibit design firm hired to update these displays and develop
the new exhibit and educational program at the Mines of Spain. Experience Design has created exhibits at
museums and interpretive centers across the country. Experience Design has indicated that development of
the Interactive Multi -Media Timeline Exhibit involves the following steps:
1. Media design July 2010
2. Media production August 2010
3. Media hardware September 2010
4. Case October 2010
5. Exhibit cabinetry November 2010
Experience Design will install the Interactive Multi -Media Timeline Exhibit. Artifacts from the Mines of Spain
collection will be used in the Interactive Multi -Media Timeline.
Using this same format, attach additional sheets as necessary.
STATE HISTORICAL SOCIETY OF IOWA
FY2011 REAP /HRDP Grants
PART 2, continued: Digitization Projects
If your project involves digitization or scanning, please
consider and answer the following questions. If your project
does not involve digitization or scanning, please move on to
Part 3: Budget Form.
1. What standards are being followed for digitization?
2. How will the digital masters be protected and preserved?
3. How have you provided for long -term enduring access to the digital
files and metadata? Possibilities include a combination of
refreshing the data, migrating it to a new environment, and
replication.
Using this same format, continue on additional sheets as necessary.
PROJECTED COSTS
REAP /HRDP
GRANT
REQUEST
APPLICANT'S MATCH
CASH IN -KIND
ROW TOTALS
Media design
$ 1,500
$ 1,500
$ 3,000
Media production
$ 5,000
$ 5,000
$10,000
Media hardware
$ 7,500
$ 7,500
$15,000
Case
$ 3,500
$ 3,500
$ 7,000
Exhibit cabinetry
$ 2,500
$ 2,500
$ 5,000
TAN*
$500
$500
STATE HISTORICAL SOCIETY OF IOWA
FY2011 REAP /HRDP Grants
Part 3: Budget Form
$20,500
REAP /HRDP
GRANT
Cash
In -Kind
$20,000 $
APPLICANT MATCH
$40,500
TOTAL PROJECT
COST
*A $500 line is provided for TAN (Technical Advisory Network). It is included as part of your grant,
should the need for technical assistance arise during the project. If the $500 is not used for TAN during
the project, the $500 reverts to the State Historical Society and shall not be used to fund another portion
of your project. Please include this line and document match for it even if you do not foresee using it.
Matching requirements for each one dollar of grant request are as follows:
Units of govt., tribes, & non - profit corporations — fifty cents, of which at least twenty -five cents must be in cash.
Individuals — seventy -five cents, of which at least fifty cents must be in cash.
Businesses — one dollar, of which at least seventy -five cents must be in cash.
For further explanation please see MATCHING FUNDS in the grant guidelines.
Part 3, continued: Budget Explanation
Part 4: Photographs
Attach Labeled Photographs on Separate Sheet
Part 5: Minority Impact Statement
Pursuant to 2008 Iowa Acts, HF 2393, Iowa Code Section 8.11, all grant
applications submitted to the State of Iowa which are due beginning January 1,
2009 shall include a Minority Impact Statement. This is the state's mechanism
to require grant applicants to consider the potential impact of the grant
project's proposed programs or policies on minority groups. See the following
page for definitions.
Please choose the statement(s) that pertains to this grant application. Complete
all the information requested for the chosen statement(s).
x The proposed grant project programs or policies could have a disproportionate
or unique positive impact on minority persons.
Describe the positive impact expected from this project:
Name:
Title:
Indicate which group is impacted:
Women
x Persons with a Disability
Blacks
Latinos
Asians
Pacific Islanders
American Indians
Alaskan Native Americans
Other
❑ The proposed grant project programs or policies could have a disproportionate
or unique negative impact on minority persons.
Describe the negative impact expected from this project:
Present the rationale for the existence of the proposed program or
Policy:
Provide evidence of consultation of representatives of the minority
groups impacted
Indicate which group is impacted:
Women
Persons with a Disability
Blacks
Latinos
Asians
Pacific Islanders
American Indians
Alaskan Native Americans
Other
❑ The proposed grant project programs or policies are not expected to have a
disproportionate or unique impact on minority persons.
Present the rationale for determining no impact.
I hereby certify that the information on this form is complete and accurate, to
the best of my knowledge:
Minority Impact Questionnaire Definitions
"Minority Persons ", as defined in Iowa Code Section 8.11, mean individuals
who are women, persons with a disability, Blacks, Latinos, Asians or
Pacific Islanders, American Indians, and Alaskan Native Americans.
"Disability ", as defined in Iowa Code Section 15.102, subsection 5,
paragraph "b ", subparagraph (1):
b. As used in this subsection:
(1) "Disability" means, with respect to an individual, a
physical or mental impairment that substantially limits one or more
of the major life activities of the individual, a record of physical
or mental impairment that substantially limits one or more of the
major life activities of the individual, or being regarded as an
individual with a physical or mental impairment that substantially
limits one or more of the major life activities of the individual.
"Disability" does not include any of the following:
(a) Homosexuality or bisexuality.
(b) Transvestism, transsexualism, pedophilia, exhibitionism,
voyeurism, gender identity disorders not resulting from physical
impairments or other sexual behavior disorders.
(c) Compulsive gambling, kleptomania, or pyromania.
(d) Psychoactive substance abuse disorders resulting from
current illegal use of drugs.
"State Agency ", as defined in Iowa Code Section 8.11, means a department,
board, bureau, commission, or other agency or authority of the State of
Iowa.
Part 6: Contract
The contract appears on the next five pages. Fill in the highlighted
areas and print two copies.
Then have the legally- authorized representative of the applicant sign
and date both copies. We need two contracts with original signatures
included with the application submittal.
Contract Number:
Agency:
Grant Recipient:
Grant Amount:
Effective Dates:
HISTORICAL RESOURCE DEVELOPMENT PROGRAM
STATE HISTORICAL SOCIETY OF IOWA
GRANT PROJECT
FUNDED THROUGH THE RESOURCE ENHANCEMENT AND PROTECTION PROGRAM ACT
[Number to be assigned by State].
STATE HISTORICAL SOCIETY OF IOWA
City of Dubuque
$ 20,500
JULY 1, 2010 — NOVEMBER 30, 2012
IDENTIFICATION OF PARTIES (Article 1.0)
• This contract is entered into by and between the State Historical Society of
Iowa (hereafter referred to as "State" or "SHSI ") and City of Dubuque
(hereafter referred to as "Grantee ").
• The SHSI Public Trust administrator or designee is the State official
designated to execute any changes in the terms or conditions specified in this
contract.
• The Planning Services Manager is designated to execute any changes in the
terms or conditions specified in this contract, on behalf of the Grantee.
• "HRDP" means Historical Resource Development Program as defined in Iowa Code
Chapter 303.16, and Iowa Administrative Code [223] Chapter 49.
STATEMENT OF PURPOSE (Article 2.0)
• The purpose of the Historical Resource Development Program is to provide
grants to preserve, conserve, interpret, educate the public about and enhance
the historical resources of the state.
• SHSI has been designated by the Iowa General Assembly to administer REAP /HRDP,
and the grantee has been approved for funding.
CONTRACTUAL REQUIREMENTS (Article 3.0)
• REAP /HRDP monies are to be expended according to Iowa Administrative Code
[223] Chapter 49 and FY2011 grant guidelines (version published January 2010).
• The Grantee must:
• Give preference to Iowans and Iowa products and services in carrying out
this grant.
• Refrain from using REAP /HRDP funds to influence legislation or for any
lobbying function.
• Follow all local, state, and federal laws which bar discrimination
against any employee, applicant for employment, or any person
participating in a sponsored program, on the basis of race, creed,
color, national origin, religion, sex, age, or physical or mental
disability, and require compensation for employment at no less than
minimum wage requirements, and provide safe and sanitary working
conditions. These laws include, but are not limited to, Title VI and
VII of the Civil Rights Act of 1964, as amended, and the Rehabilitation
Act of 1973, as amended.
• Comply with applicable Americans with Disabilities Act (ADA) provisions.
ADA is a civil rights law that prohibits discrimination on the basis of
physical or mental impairment (the definition of disability). The
project must comply with ADA, unless (1) the property is a religious
entity, a private club or private residence and not used as a place of
public accommodation; (2) the property is an owner - occupied bed -and-
breakfast with five or fewer rooms; or (3) the repair work is something
like reroofing, masonry repointing, painting or wallpapering, or changes
to mechanical and electrical systems that do not affect the usability of
the property. If you can make minor adjustments in your project that
would eliminate barriers in a way that meets the Secretary of the
Interior's Standards and Guidelines for Archeology and Historic
Preservation, you should do so. If your proposed work is an alteration
that affects the "primary function area" of your property, ADA
accessibility standards also apply to the path from accessible parking
to and through an entrance. Building owners are not required to spend
more than 20%% of the total cost of altering the primary function area to
make the path of travel to that area accessible. (There are also
alternative requirements for those historic properties that cannot be
made accessible without threatening or destroying their significance.
Contact the State Historical Society if you believe this is your
situation.)
• Consult with the State Historical Society if your project involves any
disturbance of the ground including, but not limited to, moving in any
large equipment or uprooting plants. After you have consulted with the
State Historical Society and the Society has given written permission
for you to proceed, make sure that any excavation work at your project
is carefully observed by you or your contractors. If, during
construction, the project work uncovers an item or items which might be
of archaeological, historical, or architectural interest - -or if
important new archaeological, historical, or architectural data come to
light in the project area, you must stop work immediately and notify the
State Historical Society. Make reasonable efforts to avoid or minimize
harm to the materials until the significance of the discovery can be
determined by a professionally - qualified archaeologist. Contact the
State Historical Society with any questions and for instructions.
• Include the following statement in any printed lists of contributors,
and in any promotions, publicity, or advertising:
"This project is supported in part by the State
Historical Society of Iowa, Historical Resource
Development Program."
• Post signs provided by the State in a conspicuous place at
the project area where grant funds are used. The sign must
remain in place for no less than 36 months after the
contract has been completed.
• Write your state legislators within thirty (30) days of receiving your
signed contract to tell them about the project. Copies of the letters
must be sent to Grants Manager, State Historical Society of Iowa, 600
East Locust Street, Des Moines, Iowa 50319 -0290.
FINANCIAL RECORDS
• Retain all financial records, reporting documents, and all other records
pertinent to the HRDP program for a period of three calendar years
beyond the end of the grant contract.
• Provide, at no charge, and make accessible to the State and to the State
Auditor's office, all books, documents, account information, facilities,
12
or other property belonging to or in use by the Grantee concerning the
receipt of funds under this program.
COPYRIGHT
• Choose to copyright any books, publications, films, or other material
developed because of grant activities, unless otherwise specified in the
award notice or scope of work. The State reserves the right to borrow
or use, without payment of a royalty fee, any materials developed
through grant projects.
PROFESSIONAL STANDARDS
• Comply with all applicable federal and state laws, regulations,
guidelines, and technical standards, including nationally accepted
documentary collection and museum standards and the Secretary of the
Interior's Standards and Guidelines for Archeology and Historic
Preservation. The Secretary of the Interior's Standards and Guidelines
for Archeology and Historic Preservation were published in the Federal
Register on September 29, 1983, and revised in 1990.
• If your project includes work on real property that is listed on or
eligible for the National Register of Historic Places, you must include
the following clause in all construction contracts and project
specifications:
"All work on this project will be done in accordance with the
recommended practices as stated in the 1990 edition of The Secretary
of Interior's Standards for Rehabilitating Historic Buildings."
SCOPE OF WORK AND BUDGET
• Follow the Scope of Work and Budget as presented in the Grant
Application and as approved by the State Historical Society.
DAMAGES
• Hold the State harmless from damages in any action arising from the
performance of work described in this contract.
PHOTOGRAPHS
• Provide photographs of the project work. Photographs must be taken at
the beginning of the project, at various stages during work, and at the
project's conclusion to document the nature of the work. Good
quality, original, photographs should be mounted or printed on 8 x 11"
paper. If digital photographs are submitted, please include a CD or DVD
containing the images, as well as the printed copies. Along with the
final report and request for reimbursement, the Grantee must provide at
least five (5) color photographs of the project from its beginning to
its end.
FINDING OF NON - COMPLIANCE (Article 4.0)
• The State may, for cause, find that the Grantee is not in compliance with the
requirements of the HRDP program or the terms of this contract pursuant to
Iowa Code 303.16, Iowa Administrative Code [223] Chapter 49, and published
grant guidelines. At the State's discretion, remedies for non - compliance
include suspension or return of HRDP grant funds.
CANCELLATION DUE TO NON - APPROPRIATION (Article 5.0)
• If funds anticipated for the continued fulfillment of this contract are at any
time cancelled or insufficient either through the failure of the State of Iowa
to appropriate funds, or through discontinuance or material alteration of the
program for which funds were provided, the State shall have the right to
cancel this contract without penalty by giving written notice of not less than
13
thirty (30) days documenting the lack of funding, discontinuance or program
alteration. In the event of termination of this contract due to non -
appropriation, discontinuance, or program alteration, the exclusive, sole, and
complete remedy of the Grantee shall be payment for services rendered prior to
the termination.
PAYMENT (Article 6.0)
• The State will issue a payment for fifty percent (50 %) of the grant at the
time of award.
• At the conclusion of the project, the grantee must submit documentation of all
project work and all expenditures to the State. Upon approval of all project
work and all documentation, the State will provide final payment of grant
funds. The grantee's request for reimbursement must be submitted with
documentation proving project completion, documentation of expenditure of
grant funds, and documentation of cash and in -kind match, as outlined in the
contract budget.
• The final report provided by the Grantee must include photographs of work
completed and an explanation of how the work meets the standards established
in the museum, historic preservation, or documentary collections category.
The final report must be made on forms supplied by the State Historical
Society, and must include all information and documentation as outlined on the
form.
CHANGES IN OWNERSHIP (Article 7.0)
If a change of ownership
completion of the grant,
the State.
• If a change of ownership
the grant, fifty (50) percent of the grant shall be
•
when the
• of real property occurs within 24 months after the
the entire amount of the grant shall be returned to
occurs within 25 to 60 months after the completion of
returned to the State.
If the Grantee i g
is a government unit or a non - profit organization, the sale of
property is exempt from payback provisions sale places the property
on tax rolls.
• In the event of death of an individual owner, this provision shall not apply.
TIME OF PERFORMANCE (Article 7.0)
• All claims for HRDP funds shall be received by November 30, 2012.
14
SIGNATURES
• Grant Applicants must sign and date two copies of this document as part of the
REAP /HRDP FY2011 grant application process. This document becomes a legally -
binding contract upon signature by the State Historical Society of Iowa's
authorized representative.
For the Grantee:
Signature of Grant Applicant's Legally Authorized Representative
Roy D. Buol, Mayor
Typed Name and Title of Above Representative
May 3, 2010
Date Signed by Grantee
For the State:
Jerome Thompson, Administrator,
State Historical Society of Iowa
Date Signed by State
15
Part 7: SUBSTITUTE W 9/VENDOR UPDATE FORM
(Please print or type except for signature)
In order for the State of Iowa to pay you the amount that is due to you and to comply with the IRS
regulations on reporting these payments, we are requesting the following information. Failure to
provide this information will result in withholding of payment.
Box A
Are you/Your Business YES NO
Individual [ I ]
Or Sole Proprietor [ S ]
Phone 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1 1 1 1 1 1 1 1 1 1 1 1
Fax
If the answer to both was no, please complete Box B
If you answeredYes to either item, please provide
your Social Security number (Sole Proprietors may enter
their EIN, however, the IRS prefers you use your SSN):
SSN 1 1 1 1 L_LJ 1 1 1 1 1
OR EIN LJ 1 1 1 1 1 1 1 1
AND Complete the name and address below
Last Name
1111111111111111
First Name
11111 11111111111
Doing Business as
11111111111111111 1 1 I I 1 1 11
Address:
1 1 1 1 i 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Address:
H I I I I I I I I I I I I I I I I I I I I I H
City:
I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
State: Zip:
J 1 1 1 1 1 1 -1 1 1 1
Box B
Is your business
Corporation
Partnership
Estate or Trust
Government
Other
Please Explain
Please provided us with your
Federal Employer Identification Number:
LJJ 11111111
Phone:
Fax :
From
Dept.
Contact
Phone #:
[C]
[P1
[E]
[G]
AND
Complete the Name and Address below:
Firm:
YES NO
I J o m I g LJustness [ I I I as: 1 1 1 1 1 1 I I I I I 1 1 1 11
IAo IJI ess I I I I I I I I I I I I I I I I I I I I
1 try 1 : 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
1 1111111111111111 1 1 1 .
State: Zip:
J 1 1 1 1 1 1 1 1 1 1 1
Certification Must Be Signed By Vendor
Certification — Under penalties of perjury, I certify that:
(1) The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
(2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subjected to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
notified me that I am no longer subject to backup withholding.
Signature Date
For Office Use Only (Refer to Procedure 270.450 for more details)
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