10-28-2024 CC Agenda Packet - Laserfiche WebLink

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AFMN Community Grant Application with Assurances (GK203)20 data created, collected, received, stored, used, maintained, or disseminated by Grantee in performing its duties under this grant. 9. Data Disclosure Under Minnesota Statutes, section 270C.65, subdivision 3 (https://www.revisor.mn.gov/statutes/cite/270C.65#stat.270C.65.3), and other applicable laws, the Grantee consents to disclosure of its SWIFT Supplier ID Number (formally known as SWIFT Vendor ID), Social Security number, federal employer tax identification number and/or Minnesota tax identification number, already provided to the State, to federal and state tax agencies and State personnel involved in the payment of State obligations. These numbers may be used in the enforcement of federal and State tax laws which could result in action requiring the Grantee to file State tax returns and pay delinquent State tax liabilities, if any. 10.Insurance requirements Grantee shall not begin work under the Contract until it has obtained all the insurance described below and State has approved such insurance. Grantee shall maintain the insurance in force and effect throughout the term of the contract. Grantee is required to maintain and furnish satisfactory evidence of the following insurance policies. a. Worker’s Compensation Grantee certifies that it is in compliance with Minnesota Statutes, section 176.181, subdivision 2 (https://www.revisor.leg.state.mn.us/statutes/?id=176.181), pertaining to workers’ compensation insurance coverage. The Grantee’s employees and agents will not be considered state employees. Any claims that may arise under the Minnesota Workers’ Compensation Act on behalf of these employees and any claims made by any third party as a consequence of any act or omission on the part of these employees are in no way the state’s obligation or responsibility. Minimum insurance limits are as follows: $100,000 – Bodily Injury by Disease per employee $500,000 – Bodily Injury by Disease aggregate $100,000 – Bodily Injury by Accident If Minn. Stat. § 176.041 exempts GRANTEE from Workers’ Compensation insurance mandates, including if Grantee has no employees in the State of Minnesota, Grantee must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Grantee from the Minnesota Workers’ Compensation requirements. Grantee’s employees and agents will not be considered employees of State. Any claims that may arise under the Minnesota Workers’ Compensation Act on behalf of these employees or agents and any claims made by any third party as a consequence of any act or omission on the part of these employees or agents are in no way State’s obligation or responsibility. 113