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									                                   SAMPLE of Exhibit I
                            Department of Community Services’             ARRA WE (Y)____
                                  WORK EXPERIENCE                             WIA (Y)____
                            PARTICIPANT WORK SITE PLAN

Worksite: ____THIS IS A SAMPLE – DO NOT FILL IN___________________________

Supervisor: ___________________________________ Phone: ___________________________

Participant’s Name:______________________________________________________________

Position: _____________________________Start Date: __________ End Date:_____________

Pay Per Hour: ________ Hours Per Week: _______ Total Hours: _____Total Cost:_________

Employment Consultant: _____________________________________ Date:_______________

  ____ Exposure to a real working environment.

  ____ Adjustment to work and development of work maturity skills.

  ____ Learn, apply, practice, or enhance job-related skills.

  ____ Exposure to work site language skills and vocabularies (for English as a second
       language participants).

  ____ Assess abilities and/or employability in a similar field.

  ____ Provide the opportunity to obtain references.




Worksite Supervisor                      Participant

________________________________                __________________________________
Signature                   Date                Signature                     Date

Alternate Worksite Supervisor                   DCS Certification
_________________________________               __________________________________
Signature   Date   Signature   Date
                                                   Exhibit II

                             SEXUAL HARASSMENT POLICY
                GENERAL. The contractor must comply with Revised Ordinances of Honolulu (ROH)
section 1-18, on sexual harassment. The contractor shall have and enforce a policy prohibiting sexual
harassment. The contractor's sexual harassment policy must set forth the same or greater protection than
those contained or required by the ordinance. Section 1-18, ROH is on file and available for viewing in the
Purchasing Division. Contractors needing a copy may pick up the copy from the Office of the City Clerk,
Room 203, City Hall, 530 South King Street, Honolulu, Hawaii.
                The ordinance is applicable to the employer's business and includes:
                (1) Prohibitions against an officer's or employee's sexual harassment of the following:
                         (a)        Another officer or employee of the employer;
                         (b)        An individual under consideration for employment with the employer; or
                         (c)        An individual doing business with the employer;
                (2)      A provision prohibiting a management or supervisory officer or employee from
knowingly permitting a subordinate officer or employee to engage in the sexual harassment prohibited under
paragraph (1) above;
                (3)      A prohibition against retaliation towards an officer, employee, or individual who has
complained of sexual harassment, conducted an investigation of a complaint, or acted as witness during an
investigation of a complaint;
                (4)      A prohibition against a malicious false complaint of sexual harassment by an
officer, employee, or individual;
                (5)      Provisions allowing an officer, employee, or individual to make a sexual harassment
complaint to an appropriate management, supervisory, or personnel officer or employee;
                (6)      Procedures for investigating a sexual harassment complaint in an unbiased, fair, and
discreet manner with appropriate safeguards to maintain confidentiality and protection from embarrassment;
                (7)      A provision requiring the use of the "reasonable person of the same gender
standard," to determine if sexual harassment has occurred. Under the standard, sexual harassment shall be
deemed to have occurred if the alleged offender's conduct would be considered sexual harassment from the
perspective of a reasonable person of the same gender as the alleged victim. If the alleged victim is a woman,
the "reasonable person of the same gender standard" shall be equivalent to and may be called the "reasonable
woman standard;"
                (8)      Disciplinary actions which may be imposed on an officer or employee who
committed prohibited act; and
                (9)      For an employer with at least five employees, a provision requiring the annual
viewing of a video on the sexual harassment policy by each management or supervisory officer or employee.
                                               Exhibit III

                                           ARRA Addendum

Required Contract Provision to Implement ARRA Section 902

Section 902 of the American Recovery and Reinvestment Act (ARRA) of 2009 requires that each
contract awarded using ARRA funds must include a provision that provides the U.S. Comptroller
General and his representatives with the authority to:
        (1) to examine any records of the contractor or any of its subcontractors, or any State or local
                 agency administering such contract, that directly pertain to, and involve transactions
                 relating to, the contract or subcontract; and
        (2) to interview any officer or employee of the contractor or any of its subcontractors, or of any
                 State or local government agency administering the contract, regarding such
Accordingly, the Comptroller General and his representatives shall have the authority and rights as
provided under Section 902 of the ARRA with respect to this contract, which is funded with funds
made available under the ARRA. Section 902 further states that nothing in this section shall be
interpreted to limit or restrict in any way any existing authority of the Comptroller General.

Authority of the Inspector General

Section 1515(a) of the ARRA provides authority for any representatives of the Inspector General to
examine any records or interview any employee or officers working on this contract. The Work Site
Host is advised that representatives of the inspector general have the authority to examine any record
and interview any employee or officer of the Work Site Host, its subcontractors or other firms working
on this contract. Section 1515(b) further provides that nothing in this section shall be interpreted to
limit or restrict in any way any existing authority of an inspector general.

Whistle Blower Protection under ARRA Section 1553.
Work Site Host shall not discharge, demote or otherwise discriminate against an employee as a
reprisal for disclosures by the employee of information that the employee reasonably believes is
evidence of: (a) gross mismanagement of a contract or grant relating to ARRA Funds; (b) a gross
waste of ARRA Funds; (c) a substantial and specific danger to public health or safety related to the
implementation or use of ARRA Funds; (d) an abuse of authority related to implementation or use
of ARRA Funds; or (e) a violation of law, rule, or regulation related to a contract, including the
competition for or negotiation of a contract or grant, awarded or issued relating to ARRA Funds.
Work Site Host shall post a notice of the rights and remedies available to employees under ARRA
§1553 in all workplaces where employees perform work that is funded in whole or in part by
money authorized under the ARRA. A sample notice can be found the website,
Work Site Host specifically acknowledges that Work Site Host and its employees are aware of and
shall abide by the provisions of ARRA §1553. Work Site Host shall include the language and
requirements of this subsection ("Whistleblower Protection under §1553 of the ARRA") in all of
its contracts and agreements with employees, subcontractors and anyone else who performs work
on behalf of Work Site Host.
False Claims Act. 31 U.S.C. Sections 3729-3733.
Work Site Host shall refer promptly to an appropriate Federal Inspector General any credible
evidence that a principal, employee, agent, contractor, subgrantee, subcontractor or other person
has committed a false claim under the False Claims Act or has committed a criminal or civil
violation of laws pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct
involving ARRA funds.
Reporting of Fraud, Waste, and Abuse.

Work Site Host shall also report any credible evidence that a principal, employee, agent,
contractor, subgrantee, subcontractor, or other person has committed a criminal or civil violation of
laws pertaining to fraud, waste, and abuse involving ARRA Funds. A report form is available on
the website,

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