Request for Proposal FOR TAX ARBITRAGE REBATE SERVICES ... - ARBITRAGE... · Attached is the OSE...

Request for Proposal

FOR TAX ARBITRAGE REBATE SERVICES

DATE: November 8, 2013

State of Connecticut Health and Educational Facilities Authority

DEADLINE: Friday, December 6, 2013 at 3:00 p.m.

10 Columbus Boulevard Hartford, CT 06106-1978 Tel: 860-520-4700 Fax: 860-520-4706

www.chefa.com

November 8, 2013 To Whom It May Concern: In accordance with the requirements in Connecticut General Statutes, Chapter 187, Section 10a-179h (4), the Connecticut Health and Educational Facilities Authority (the “Authority”) is requesting proposals from qualified firms wishing to provide tax arbitrage rebate services to the Authority and its clients for a period not to exceed three (3) years. The Authority seeks proposals from firms with established expertise in the area of tax-exempt municipal finance generally and specifically for 501(c)(3) healthcare, higher education, private secondary schools, human service providers, early childhood education centers and cultural institutions. Proposals should highlight the recent experience of your firm performing tax arbitrage rebate services for public entities and quasi public agencies similar to the Authority. Responses to the RFP Your firm’s submission relating to this RFP should include a response to the questions and requests for information included in the attached Exhibit A, as well as the materials required by Exhibits B-1, B-2, D and F. Please be sure to include the required undertakings set out on Exhibit A in your response. Proposal Schedule

RFP Issued – November 8, 2013

Proposals are due by no later than December 6, 2013

Notification of Interviews by no later than December 20, 2013

Interviews, if necessary, to be conducted the week of January 6, 2014

Authority Board Action on Selection of Tax Arbitrage Rebate Service Providers by no later than January 22, 2014

The initial term of this Agreement shall be from February 1, 2014 until January 31, 2017.

Tax Arbitrage Rebate Service Provider RFP November 8, 2013 Page 2

Selection Process

The Authority will conduct the selection of the tax arbitrage rebate service providers, with a recommendation for approval to the Board of Directors of a list of providers for the Authority. Evaluation of firms will include, but will not be limited to: the reputation of the firm, the scope of services to be provided, the reputation and experience of the management and staff to be assigned to the Authority, and other value added services that may be provided.

Contractual Relationships with Quasi-Public Agencies

1. Public Act No. 01-184

AN ACT CONCERNING THE PENALTY FOR FALSE STATEMENTS ON APPLICATIONS FOR FINANCIAL ASSISTANCE FROM QUASI-PUBLIC AGENCIES.

Any quasi-public agency, as defined in Section 1-120 of the General Statutes, shall require any application, agreement, financial statement, certificate or other writing submitted to such quasi-public agency with respect to any loan, mortgage, guarantee, investment, grant, lease, tax relief, bond financing or other extension of credit or financial assistance made or provided by such quasi-public agency and that provides information on which the decision of such quasi-public agency was based, to be signed under penalty of false statement as provided in Section 53a-157b of the General Statutes. The Authority requires that proposals in response hereto be provided on the same basis.

2. CHEFA Gift Ban Policy (C.G.S. §§4-250 to 4-252)

The Authority has adopted a gift ban policy which, with very limited exceptions, prohibits the acceptance by Authority employees of anything of value, from parties doing business or seeking to do business with the Authority. In addition, pursuant to the State Code of Ethics, Members of the Board of Directors, as well as employees of the Authority, are subject to strict restrictions on the acceptance of gifts from parties doing business, or seeking to do business, with the Authority. Please complete and sign the Gift and Campaign Certification attached as Exhibit B-1.

Consulting Agreement Affidavit (C.G.S. §4a-81)

Please complete and sign the Consulting Agreement Affidavit attached as Exhibit B-2. Please note that the affidavit must be updated under certain circumstances.

3. State of Connecticut Office of State Ethics (“OSE”) Requirements

Attached is the OSE “Guide to the Code of Ethics for Current or Potential State Contractors” (Exhibit C). This document and the revised statutes effective January 1, 2012 (available on the OSE website) provide your company with a guide to your financial relationship and statutory requirements for conducting


business with a quasi-state agency. By submitting a response to this request for proposal, your firm acknowledges receipt of this information and acceptance of the provisions applicable to organizations doing business with the Authority.

4. Third Party Fee Disclosure

Public Act 00-43 “An Act Concerning Powers and Duties of the Treasurer and the Investment Advisory Council” requires any person or entity entering into a contract for investment services, including investment legal services, with a quasi-public agency to disclose in a sworn affidavit any third party fees (or that there were no third party fees) attributable to such contract. Please complete and sign Exhibit D.

5. State Election Enforcement Commission Campaign Contribution and Solicitation Ban

Section 9-612(g)(1) of the Connecticut General Statutes prohibits “principals” (AND CERTAIN FAMILY MEMBERS) of State contractors and prospective State contractors from donating and soliciting certain campaign contributions. The Authority is required to provide all prospective State contractors with a copy of the Notice to Executive Branch state Contractors and Prospective State Contractors of Campaign Contribution and Solicitation Limitations which has been included as Exhibit E.

6. C.G.S. Sections 4a-60 and 4a-60a

AN ACT CONCERNING CERTAIN STATE CONTRACTING NONDISCRIMINATION REQUIREMENTS

Connecticut General Statutes Sections 4a-60 and 4a-60a, as amended, require an entity or individual entering into a contract with the State or certain of its political subdivisions, including quasi-public agencies, to provide the contracting agency with a written affidavit that certifies the contractor’s compliance with the State’s nondiscrimination agreements and warranties and to periodically update such documentation. (Please refer to the form of the required certification attached as Exhibit F.)

Scope of Services

The Authority will consider each respondent’s ability to provide comprehensive, quality service to the Authority, as well as its reputation and fee structure. At a minimum, the services provided to the Authority by its tax arbitrage rebate service provider will include the following:

For each issue assigned, the selected firms will be required to perform any or all of the following services:

1. Consult with the Authority regarding the nature of the issue and collect all necessary documentation and investment data.


2. Review documentation for special elections and eligibility for spending exceptions. Verify that the issue is subject to the Rebate Requirement.

3. Verify debt service, original issue discount or premium, sources and uses, and calculate the tax arbitrage yield.

4. Review and confirm prior calculations for the issue, if any.

5. Identify, and separately account for, all "Gross Proceeds" (as that term is defined in the Rebate Requirement) of the bond issue, including those requiring allocation analyses due to "transferred proceeds" and/or "commingled funds" circumstances.

6. Review and analyze the portfolio of investments and the funds and accounts in which the investments are held. Determine whenever necessary the fair market price or present value of investments, as needed.

7. Calculate the issue's excess investment earnings (cumulative rebate liability), taking into account any proceeds that are or have become subject to the yield restriction requirements and all credit and debits required or permitted by the tax regulations.

8. Deliver a comprehensive report detailing the tax arbitrage rebate calculations, the rebate liability and any yield restriction issues as well as an opinion letter regarding the calculations for obligations issued by the Authority, which shall provide, among other things, that such calculations were performed in compliance with federal tax law. Provide an executive summary identifying the methodology employed, major assumptions, conclusions, and any recommendations for changes in the Authority’s recordkeeping and investment policy.

9. Prepare and provide for signing and dating a completed Form 8038T ready for filing with the IRS within 60 days as required.

10. Assist the Authority as requested or necessary in the event of an IRS or other inquiry.

11. Consult if necessary with Authority staff and the Authority’s bond and tax counsel as necessary regarding tax arbitrage-related matters, record keeping and compliance, strategies to maximize investment earnings while complying with tax regulations and changes in tax laws and their effects on outstanding issues and future issuance.

12. Provide annual liability estimates for each June 30 when requested.


RFP Format and Submission Requirements

1. The total length of the response is limited to 15 pages.

2. Please submit a copy of your firm’s response to this RFP via email by no later than Friday, December 6, 2013 at 3:00 p.m. in PDF format to:

Cynthia Peoples [email protected]

The Authority reserves the following rights (without limitation or waiver):

1. To reject any or all proposals.

2. To conduct investigations or request further information relating to the qualifications of any or all respondents.

3. To supplement, modify or cancel this request for proposals without notice or substitution of another such request.

4. To reevaluate a proposal or selection if there are any changes in the substance of the proposal.

Interviews, if necessary, will be held during the week of January 6, 2014. The Authority shall not be liable for any cost incurred in connection with responding to this proposal. Please direct any questions to myself via email at [email protected] or call 860-761-8421.

Sincerely,

Cynthia D. Peoples-H. Cynthia D. Peoples-H. Assistant Director Exhibits Attached

Exhibit A

EXHIBIT A-QUESTIONS-TAX ARBITRAGE REBATE SERVICES PROVIDER RFP PAGE 1 OF 2

TAX ARBITRAGE REBATE SERVICE PROVIDER

REQUEST FOR PROPOSAL

I. General Information:

A. Describe your firm’s experience in providing tax arbitrage rebate compliance services in general, and specifically with regard to transactions issued by State-level entities. Highlight experience with complex tax-exempt structures such as pooled revolving fund issues, advance refundings, etc. in particular. Include at least two examples of work performed at the specific branch office which will have primary responsibility for this engagement. These examples should reflect currently applicable laws, rules and regulations.

B. Provide a brief explanation of circumstances requiring methodological discretion and your recommended approach to addressing such circumstances. Specific examples of how such discretionary measures can impact analyses performed on complex debt issuances are preferred. Examples might include allocation of commingled funds, replacement proceeds, identifying and advising on optional elections available.

C. Identify the individual(s) who would be working on day-to-day activities with Authority staff. Provide a brief description of their experience, office location, and accessibility.

D. Describe in detail the information and assistance you will require from Authority staff. Include your needs for bond issuance and investment information, and any special reporting formats that may be required.

E. Describe the legal expertise available within or to your firm, particularly with regard to the provisions of Section 148(f) of the Internal Revenue Code and Regulations promulgated there under. Describe the assurance you can provide the Authority that work performed is consistent with federal tax and other applicable laws. Explain whether the necessary legal advice will be provided within your firm or by a subcontractor. Describe any legal opinions that may be required to satisfy each tax arbitrage calculation.

F. NOTE: If the requisite legal expertise is available within your firm, describe your firm’s expertise with the relevant provisions of the Internal Revenue Code and applicable rules and regulations. If the legal advice is to be provided outside your firm, identify the source of this expertise and explain the source’s knowledge of the relevant Code and Regulation sections. Explain any mark-ups you will add to the cost for outside legal advice. Provide an estimate of the scope and cost of legal advice, including estimated hours for a typical complex matter and fee rates.

G. Describe your firm’s experience with partial refundings in a program secured by a reserve fund and the issues which are raised in such a circumstance.

H. Describe your firm’s process for adapting to changes in the tax law and the impact on your clients.

I. Describe your firm’s approach to providing the Authority with projected arbitrage rebate liability and payments out five years hence.

J. Describe your firm’s experience with calculating arbitrage rebate with regard to investment in complex Guaranteed Investment Contracts.

Exhibit A

EXHIBIT A-QUESTIONS-TAX ARBITRAGE REBATE SERVICES PROVIDER RFP PAGE 2 OF 2

II. References: Identify three recent clients that we may contact as references. Provide the following information for each reference: name, title, company address, and phone number as well as a brief summary of the services provided and the type of bond issue(s).

III. Connecticut Experience: Discuss your firm’s experience within the State of Connecticut.

IV. Affirmative Action: What is your firm’s Affirmative Action and Equal Employment Policy and what proportion of your firm’s professionals are minorities and women?

V. Pending Litigation: Please disclose any criminal, civil litigation or administrative proceedings involving allegations of securities law violations by your firm or its employees during the last five years.

VI. Potential Conflicts: Are there any other lines of business conducted by your firm that could conflict with your service as financial advisor to the Authority? Please specify how you would propose to resolve any such conflict, including ensuring that there would be no real or apparent compromise of your objectivity as the Authority’s tax arbitrage rebate service provider?

VII. Compensation:

A. Please provide a schedule of compensation for the services identified under Scope of Services. Please state a separate fee for each service. Firms will be compensated based on the actual services provided to the Authority.

B. Indicate any expenses for which you would expect reimbursement.

VIII. Required Undertakings:

Please remember to include the following required undertakings in your response:

A. The information provided herein is submitted by the undersigned firm under penalty of false statement as provided in the Connecticut General Statutes, Section 53a-157b.

B. With regard to a State contract as defined in P.A. 07-1 having a value in a calendar year of $50,000 or more or a combination or series of such agreements or contracts having a value of $100,000 or more, the authorized signatory to this submission in response to the Authority’s solicitation expressly acknowledges receipt of the State Elections Enforcement Commission’s notice, Exhibit E, advising prospective State contractors of State campaign contribution and solicitation prohibitions, and will inform its principals of the contents of the notice.

OPM Ethics Form 1 Exhibit B-1Rev. 11-29-11

Page 1 of 2

STATE OF CONNECTICUT GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION

Written or electronic certification to accompany a State contract with a value of $50,000 or more in a calendar or fiscal year, pursuant to C.G.S. §§ 4-250 and 4-252(c); Governor M. Jodi Rell’s Executive Orders No. 1, Para. 8, and No. 7C, Para. 10; and C.G.S. §9-612(g)(2)

INSTRUCTIONS:

Complete all sections of the form. Attach additional pages, if necessary, to provide full disclosure about any lawful campaign contributions made to campaigns of candidates for statewide public office or the General Assembly, as described herein. Sign and date the form, under oath, in the presence of a Commissioner of the Superior Court or Notary Public. Submit the completed form to the awarding State agency at the time of initial contract execution and if there is a change in the information contained in the most recently filed certification, such person shall submit an updated certification either (i) not later than thirty (30) days after the effective date of such change or (ii) upon the submittal of any new bid or proposal for a contract, whichever is earlier. Such person shall also submit an accurate, updated certification not later than fourteen days after the twelve-month anniversary of the most recently filed certification or updated certification.

CHECK ONE: Initial Certification 12 Month Anniversary Update (Multi-year contracts only.)

Updated Certification because of change of information contained in the most recently filed certification or twelve-month anniversary update.

GIFT CERTIFICATION:

As used in this certification, the following terms have the meaning set forth below:

1) “Contract” means that contract between the State of Connecticut (and/or one or more of it agencies orinstrumentalities) and the Contractor, attached hereto, or as otherwise described by the awarding Stateagency below;

2) If this is an Initial Certification, “Execution Date” means the date the Contract is fully executed by, andbecomes effective between, the parties; if this is a twelve-month anniversary update, “Execution Date”means the date this certification is signed by the Contractor;

3) “Contractor” means the person, firm or corporation named as the contactor below;4) “Applicable Public Official or State Employee” means any public official or state employee described in

C.G.S. §4-252(c)(1)(i) or (ii);5) “Gift” has the same meaning given that term in C.G.S. § 4-250(1);6) “Principals or Key Personnel” means and refers to those principals and key personnel of the Contractor,

and its or their agents, as described in C.G.S. §§ 4-250(5) and 4-252(c)(1)(B) and (C).

I, the undersigned, am a Principal or Key Personnel of the person, firm or corporation authorized to execute this certification on behalf of the Contractor. I hereby certify that, no gifts were made by (A) such person, firm, corporation, (B) any principals and key personnel of the person firm or corporation who participate substantially in preparing bids, proposals or negotiating state contracts or (C) any agent of such, firm, corporation, or principals or key personnel who participates substantially in preparing bids, proposals or negotiating state contracts, to (i) any public official or state employee of the state agency or quasi-public agency soliciting bids or proposals for state contracts who participates substantially in the preparation of bid solicitations or request for proposals for state contracts or the negotiation or award of state contracts or (ii) any public official or state employee of any other state agency, who has supervisory or appointing authority over such state agency or quasi-public agency.

I further certify that no Principals or Key Personnel know of any action by the Contractor to circumvent (or which would result in the circumvention of) the above certification regarding Gifts by providing for any other Principals, Key Personnel, officials, or employees of the Contractor, or its or their agents, to make a Gift to any Applicable Public Official or State Employee. I further certify that the Contractor made the bid or proposal for the Contract without fraud or collusion with any person.

OPM Ethics Form 1 Exhibit B-1 Rev. 11-29-11 Page 2 of 2 CAMPAIGN CONTRIBUTION CERTIFICATION: I further certify that, on or after December 31, 2006, neither the Contractor nor any of its principals, as defined in C.G.S. § 9-612(g)(1), has made any campaign contributions to, or solicited any contributions on behalf of, any exploratory committee, candidate committee, political committee, or party committee established by, or supporting or authorized to support, any candidate for statewide public office, in violation of C.G.S. § 9-612(g)(2)(A). I further certify that all lawful campaign contributions that have been made on or after December 31, 2006 by the Contractor or any of its principals, as defined in C.G.S. § 9-612(g)(1), to, or solicited on behalf of, any exploratory committee, candidate committee, political committee, or party committee established by, or supporting or authorized to support any candidates for statewide public office or the General Assembly, are listed below: Lawful Campaign Contributions to Candidates for Statewide Public Office: Contribution Date Name of Contributor Recipient Value Description

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________ Lawful Campaign Contributions to Candidates for the General Assembly: Contribution Date Name of Contributor Recipient Value Description

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________ Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement. __________________________________ _________________________________________ Printed Contractor Name Printed Name of Authorized Official ___________________________________ Signature of Authorized Official Subscribed and acknowledged before me this ______ day of __________________, 20___.

___________________________________________ Commissioner of the Superior Court (or Notary Public)

Exhibit B-2

OPM Ethics Form 5 Rev. 10-01-11

STATE OF CONNECTICUTCONSULTING AGREEMENT AFFIDAVIT

Affidavit to accompany a bid or proposal for the purchase ofgoods and services with a value of $50, 000 ormore in a calendar or fiscal year, pursuant to Connecticut General Statutes § 4a8l(a) and 4a-81’b). Forsole source or no bid contracts the form is submitted at time ofcontract execution.

INSTRUCTIONS:

If the bidder or vendor has entered into a consulting agreement, as defined by ConnecticutGeneral Statutes § 4a-81(b)(1): Complete all sections of the form. If the bidder or contractor hasentered into more than one such consulting agreement, use a separate form for each agreement. Sign anddate the form in the presence of a Commissioner of the Superior Court or Notary Public. If the bidder orcontractor has not entered into a consulting agreement, as defined by Connecticut GeneralStatutes § 4a-81(b)(1): Complete only the shaded section of the form. Sign and date the form in thepresence of a Commissioner of the Superior Court or Notary Public.

Submit completed form to the awarding State agency with bid or proposal. For a sole source award, submitcompleted form to the awarding State agency at the time of contract execution.

This affidavit must be amended if there is any change in the information contained in the most recently filedaffidavit not later than (i) thirty days after the effective date of any such change or (ii) upon the submittal ofany new bid or proposal, whichever is earlier.

AFFIDAVIT: [Number of Affidavits Sworn and Subscribed On This Day:

_____

I, the undersigned, hereby swear that I am a principal or key personnel of the bidder or contractor awardeda contract, as described in Connecticut General Statutes § 4a-81(b), or that I am the individual awardedsuch a contract who is authorized to execute such contract. I further swear that I have not entered into anyconsulting agreement in connection with such contract, except for the agreement listed below:

Consultant’s Name and Title Name of Firm (if applicable)

Start Date End Date Cost

Description of Services Provided:

_________________________________________________________________

Is the consultant a former State employee or former public official? YES NO

If YES:

____________________________________ ___________________________

Name of Former State Agency Termination Date of Employment

Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement.

Printed Name of Bidder or Contractor Signature of Principal or Key Personnel Date

Printed Name (of above) Awarding State Agency

Sworn and subscribed before me on this

________

day of

_____________

20...........

Commissioner of the Superior Courtor Notary Public

Exhibit C

Guide to the Code of EthicsFor Current or Potential

State Contractors

2010

ExhbitC

Guide for Current or Potential State Contractors

INTRODUCTION

The Connecticut Office of State Ethics (OSE) is an independent regulatory agency for thestate of Connecticut, charged with administering and enfoming the Connecticut Codes ofEthics, located in the Connecticut General Statutes, Chapter 10.

The Ethics Codes under the OSE’s jurisdiction are comprised of:• The Code of Ethics for Public Officials (Part I);• The Code of Ethics for Lobbyists (Part II); and• Limited jurisdiction over Ethical Considerations Concerning Bidding and State

Contracts (Part IV).

This guide provides general information only. The descriptions of the law and the OSEin this guide are not intended to be exhaustive. Please review the Advisory Opinions andDeclaratory Rulings on our website or contact the Legal Division of the OSE with anyquestions regarding interpretation of the law.

For more information on the subjects discussed in this guide, call, write or visit:

Connecticut Office of State Ethics ON

%uite20Striet

Haitford Cl 06106 k

860/263240()wwetgov/ethics

Citizen ‘s Ethics Advisorj Board:

G. Kenneth Bernhard, Chairperson (through September 2011)Thomas H. Dooley, Vice Chairperson (through September 2012)Ernest Abate (through September 2011)Kathleen F. Bornhorst (through September 2012)Rebecca M. Doty (through September 2011)General David Gay, (ret.) (through September 2013)Dennis Riley (through September 2013)Winthrop Smith, Jr. (through September 2013)Shawn T. Wooden (through September 2013)

2

Exhibit C


CONTENTS

Introduction 2

Office of State Ethics 4

The Big Picture 4

Benefits to State PersonnelGifts 5Necessary Expenses 7Fees/Honorariums 7

Hiring State PersonnelPost-state Employment 8Outside Employment 9

Other ProvisionsProhibited Activities 10Affidavits 10Investment Services 10Registering as a Lobbyist 10Contribution Ban for

Communicator Lobbyists 10Sessional Ban for Client

Lobbyists 11Public Act 05-2 87 11Executive Orders 11

Additional Information 12

3

Exhibit C


THE OFFICE OF STATE ETHICS (OSE)

The Connecticut Office of State Ethics (0 SE) was officially created on July 1, 2005, byPublic Act 05-183. The governing body of the OSE is the Citizen’s Ethics AdvisoryBoard (CEAB), nine members appointed by the Governor and legislative leadership. TheCEAB holds monthly meetings that are open to the public and that are often covered byCT-N. A schedule of CEAB meeting dates, times and locations is available on the OSE’sWeb site, www.ct.gov/ethics.

The OSE is an independent watchdog agency for the state of Connecticut that administersConnecticut General Statutes, Chapter 10, Parts I and II, with limited jurisdiction overPart IV.

Simply put, the OSE educates all those covered by the law (the “regulated community”);provides information to the public; interprets and applies the codes of ethics; andinvestigates potential violations, and otherwise enforces the codes.

The OSE is made up of the following components:• Citizen’s Ethics Advisory Board• Executive Director• Legal Division• Enforcement Division

THE BIG PICTURE

All state officials and employees (except judges) are covered by Part I of the Code ofEthics for Public Officials (henceforth, Part I, or the Code). It is important to rememberthat certain provisions of the Code also apply to public officials and state employees afterthey leave state service.

As you read through this guide, be aware that these laws were enacted to preventindividuals from using their public position or authority for personal, financial benefit.

Each state agency also has its own ethics policy, which in nian easesmay be more restrictive than what follows. Be sure to obtain, a copy ofthe agency’s policy before you attempt to provide any benefit to anagency official or employee.

4

Exhibit C


GIVING BENEFITS TO STATE PERSONNEL rTh

GiftsAs a current or potential state contractor, you are presumably doing business with orseeking to do business with a state agency, and are therefore considered to be a restricteddonor. In general, public officials, state employees and candidates for public office maynot accept gifts from restricted donors.

Restricted DonorsRestricted donors include:

• Registered lobbyists (a list is available on the OSE’s Web site) or a lobbyist’srepresentative;

• Individuals or groups doing business with a state department or agency;• Individuals or groups seeking to do business with a state department or agency;• Individuals or groups engaged in activities regulated by a state department or

agency; or• Contractors pre-qualified by the Connecticut Department of Administrative

Services (Conn. Gen. Stat. § 4a-100).

A g ft is defined as anything of value that is directly and personally received by a publicofficial or state employee (or sometimes family members of those two categories) unlessconsideration of equal or greater value is provided. Conn. Gen. Stat. § 1-79 (e).

Gift ExceptionsThere are, however, certain exceptions to this definition of gift. Not all exceptions arecovered below; see Conn. Gen. Stat. § 1-79 (e) (1) —(17) for the complete list.

• Thken items — Restricted donors such as current or potential state contractors mayprovide any item of value that is not more than $10 (such as a pen, mug, orinexpensive baseball cap) to a public official or state employee, provided that theannual aggregate of such items from a single source is $50 or less. Conn. Gen.Stat. § 1-79 (e) (16).

• frood and Be’ierage Restricted donors may also provide less than $50 worth offood and beverage in a calendar year to a public official or state employee,provided that the restricted donor or his/her representative is in attendance whenthe food and/or beverage is being consumed. Conn. Gen. Stat. § 1-79 (e) (9).

• Trai)izng Vendors may provide public officials and state employees withtraining for a product purchased by a state or quasi-public agency provided suchtraining is offered to all customers of that vendor. Conn. Gen. Stat. § 1-79 (e)(17).

5

Exhibit C


• (;t1s to rho State Restricted donors may provide what are typically referred to as“gifts to the state.” These gifts are goods and services provided to a state agencyor quasi-public agency for use on state or quasi-public agency property or thatsupport an event, and which facilitate state or quasi-public action or functions.Conn. Gen. Stat. § 1-79 (e) (5).

• Other Exeeprion. There are a total of 17 separate gift exceptions in the Code.Also exempt from the definition of gift are items such as informational materialsgermane to state action, ceremonial plaques or awards costing less than $100, orpromotional items, rebates or discounts also available to the general public. SeeConn. Gen. Stat. § 1-79 (e) (1)— (17).

Note: The popularly-cited exception for major life events does not apply to those whoare regulated by, doing business with or seeking to do business with a state agency. Theonly restricted donor that can make use of this very narrow exception is a registeredlobbyist.

Gift ProvisionsExample: You are in the pic ofsubmitting acontracrrng bid to a state ilgene. You pro i’ide the auic’ncJ’l,ea( wit/i a gift certificate for S-iS to a popular WestHartford eatery for her to use on her own.. You have notpreviously given anyrhing of value to this indivithal.

Eveii thong/i you are under the permissible S49 99 foodand he.’erage limit, this gift is not allowed because yoi oryour representative will not be in attendance while thefood and beverage is being oi,sumed.

Renorting RequirementsShould you or your representative give something of $10 or more in value to a publicofficial or state employee, you must, within 10 da, give the gift recipient and the headof that individual’s department or agency a written report stating:

7• Name of the donor;• Description of item(s) given;• Value of such item(s); and /

• Total cumulative value of all items to date given to that recipient during thecalendar year.

This helps both you and the state employee keep track of the gift exceptions noted above,so that permissible limits are not exceeded. Conn. Gen. Stat. § 1-84 (o). A courtesy formis available for this notification on the OSE’s Web site, in the “Forms” section.

6

Exhibft C


Necessary ExpensesYou may provide necessary expenses to a public official or state employee only if theofficial or employee, in his/her official capacity, is actively participating in an event bygiving a speech or presentation, running a workshop, or having some other activeinvolvement.

Necessary expenses are limited to:• Travel (coach or economy class);• Lodging (standard cost of room for the nights before, of, and immediately

following the event);• Meals; and• Related conference expenses.

Conn. Gen. Stat. § 1-79 (9).

Entertainment costs (tickets to sporting events, golf outings, night clubs, etc.) are nornecessary expenses. Necessary expense payments also do not include payment ofexpenses for family members or other guests.

Fees/HoioanumsPublic officials and state employees may not accept fees or honorariums for an article, *appearance, speech or participation at an event in their official capacity.

Fees or honorariums for such activities, if offered based solely on expertise and withoutany regard to official capacity, may be acceptable. Contact the OSE before offering suchpayment to an official or employee. Conn. Gen. Stat. § 1-84 (k).

4eeessar Expenses. Fees and IlonorariunisExample: You invite a state employee to travel to \‘ew York Cityto give a speech to your liutnagers on issues surroundingcontracuiig wit/i a state agency. You provide 4 intrak fare for theemployee as well as his spouse, who will spend the da in thecity. The evening ofthe speech, you will treat the ‘niployee andhis sy,ozise with caiiiplimentctrr tickets to a Broadway show inlieu ofa cpeaki,,gfie.

)ou may provide coach class travel expenses only to the stateemployee who is actively participatilig in an event. In this case.you may only provide 1nitrakfirefir the employee giving thespeech. liar hi spouse. Entertainwent costs, such as tickets to ashow, are nat considered necessarj expenses and maj’ not beprovided. Additionally, state employees may nut accept fees orhonorariums fiir a speech given in their official capacity.

7

Exhibit C


HIRING STATE PERSONNEL

Post-state Employment (Revolving Door)If you are considering hiring aformer state employee, you should be aware of the Code’spost-state employment, or revolving door, provisions.

Lifetime Bans• Former state employees may never disclose any confidential information they

learned during the course of their state service for anyone’s financial gain. Conn.Gen. Stat. § l-84a.

• A former state official or employee may never represent anyone other than thestate regarding a particular matter in which he or she was personally orsubstantially involved while in state service and in which the state has asubstantial interest. This prevents side-switching. Conn. Gen. Stat. § 1 -84b (a).

One-year Bans• If you hire or otherwise engage the services of a former state official or employee,

he or she may not represent you before his or her former agency for a period ofone ‘. after leaving state service. Conn. Gen. Stat. § l-84b (b). (SeeAdvisoryOpinion 2003-3, which provides a limited exception to this provision if the employee is providingpurely technical expertise to help implement a previously-awarded contract. This exceptionapplies to extremely limited circumstances; contact the OSE for guidance.)

• You are prohibited from hiring a former state official or employee for a period ofone year after he or she leaves state service if that individual was substantiallyinvolved in, or supervised, the negotiation or award of a contract (that you or yourbusiness was a party to) valued at $50,000 or more, and the contract was signedwithin his or her last year of state service. Conn. Gen. Stat. § l-84b (f).

• Employees who held certain specifically-designated positions (with significantdecision-making or supervisory responsibility) at certain state regulatory agenciesare prohibited from seeking or accepting employment with any business subject toregulation by the individual’s agency within one ear of leaving the agency.Likewise, such businesses may not hire those employees. Note that there is anexception for ex-officio board or commission members. Conn. Gen. Stat. § 1 -84b(c).

Post-state EmploineiitLvainple: iou run a hospital regulated by the Office ofHeubli care4cces (OIIc,i). You would like to of/kr ajob to the fiwmerconin,issioner of 011(‘A, who has heeii out ofstate .cei’viee for 5 months.

Because the hospital is regulated by a stare agemicv whose Can,mnInieris specifically designated in I —84b (c,), the fanner head of ct,cli areiic

would not be peruntred to accept einployi,ieiit wit/i ron/or one full yearafter leaving state service. See tdi’isaiy_Opinion 20(13-19.

8

Exhibit C


Outside Employment for Current Public Officials

and State EmployeesIf you are considering hiring a current state employee, especially from a state agencywith which you do business or by which you are regulated, you should be aware of thefollowing rules regarding the employment of current state employees.

• A current state employee may not accept outside employment that impairs his orher independence ofjudgment regarding his or her state duties, or that encourageshim or her to disclose confidential information learned in his or her state job.Conn. Gen. Stat. § 1-84 (b).

• A current state employee may not use his or her state position for his or her ownfinancial gain or the gain of his or her family (spouse, child, child’s spouse,parent, brother or sister) or an associated business, however inadvertent that usemaybe. Conn. Gen. Stat. § 1-84 (c).

Other ConsiderationsBusiness entities engaged in Indian gaming activities in the state should be aware ofspecific provisions that apply to present or fonner Gaming Policy Board or Division ofSpecial Revenue public officials or employees. See Conn. Gen. Stat. § 1-84b (d) and(e).

\/

JI

Outside EmploymentExample: Your sinai! business occasionally receives grants orcontracts front Ageiiçi X You know rhat aparticular contractmanager ii’ith Agency X has the skith you need to help you growrour busijiess. This employee has expressed interest in. earning

a little extra money for bin,self, while helping you with yourbu%iness in the evenitigs amid on weekends.

It would c’mstituie an impermis.%ihle impairment ofjudgment farthe employee of. 1gency X, who has contract managementreci)onsibi!#tes, to accept outside employment with your busi,,ess— a business that receives grants or camitracts from,, Igency X.

9

Exhibit C


OTHER PROVISIONS

Prohibited Activities for Consultants or Independent ContractorsIf you are hired by the state as a consultant or independent contractor, you are prohibitedfrom the following:

• Using your authority under the contract or any confidential information acquiredduring the course of the contract for your financial gain or the financial gain ofyour immediate family;

• Accepting another state contract that would impair your independence ofjudgment or your performance in your existing state contract; and

• Accepting anything of value based on the understanding that your actions onbehalf of the state would be influenced.

Conn. Gen. Stat. § l-86e (1)— (3); see also Conn. Gen. Stat. § l-lOlnn.

Gift and/or Campaign Contribution CertficatkmsContractors seeking large state contracts must provide certifications 4regarding gifis and/or campaign contributions made to certain stateemployees or public officials in the two-year period prior to thesubmission of a bid or proposal. Copies of these certifications andother updated information regarding state contractors can be found onthe Web sites of the Department of Administrative Services (www.das.state.ct.us) and theOffice of Policy and Management (www.opm.state.ct.us).

Investment Services and the Office of the TreasurerIf you or your business provides investment services, as defined in the Code, and youmake a political contribution to the State Treasurer’s campaign, you may be prohibitedfrom contracting with the Office of the Treasurer. See Conn. Gen. Stat. § 1-84 (n).

Registering as a LobbyistIf you or your business spends or receives over $2,000 in a calendaryear for activities that constitute lobbying under Part II of the Codeof Ethics (whether to affect legislation or the actions of anadministrative state agency), you/your business may have to registeras a lobbyist with the Office of State Ethics. Lobbyist registrationinformation is available at www.ct. gov/ethics.

Contribution Ban for Communicator Lobbyists (Conn. Gen. Stat. § 9-610(g)and(h).)Registered communicator lobbyists, their affiliated political action committees (PACs),as well as members of their immediate families are banned from soliciting or donatingpolitical campaign contributions. Please contact the State Elections EnforcementCommission at 860-256-2940 for more information.

10

Exhibit C


Sessional Contribution Ban for Client Lobbyists (Conn. Gen. Stat. § 9-610 (e).)Registered lobbyists and their affiliated political action committees (PACs) are bannedfrom soliciting or donating political campaign contributions. Specifically, there is atemporary ban while the General Assembly is in session that applies to all registeredclient lobbyists and their affiliated PACs. Please contact the State Elections EnforcementCommission at 860-256-2940 for more information.

Public Act 05-287Public Act 05-287 prohibits anyone who is a party (or seeking to become a party) to alarge state construction, procurement, or consultant services contract over $500,000 from:

• Soliciting information from a public official or state employee that is not availableto other bidders for that contract, with the intent to obtain a competitiveadvantage;

• Intentionally or recklessly charging a state agency for work not performed orgoods or services not provided;

• Falsif’ing invoices or bills; or• Intentionally violating or circumventing state competitive bidding and ethics laws.

This Act also requires any prospective state contractor to affirm in writing that he or shehas received a summary of the state’s ethics laws and that his or her key employees haveread and understood the summary and agree to comply with the applicable provisions.Conn. Gen. Stat. § l-lOlqq.

An affirmation form is available through the Connecticut Office of Policy andManagement.

Executive OrdersExecutive Order 3Under this Order, the Department of Administrative Services established and maintainson its Web site the State Contracting Portal for purposes of posting all contractingopportunities with state agencies and providing information on contracting processes andprocedures.

Executive Order 7CThis Order covers the State Contracting Standards Board, established to conduct acomprehensive review of existing procurement and contracting laws and prepare auniform code to govern all aspects of procurement and contracting.

The full text of these Executive Orders can be found on the Governor’s Web site,www.ct.gov/governorrell/site/default.asp.

11

Exhibit C


FOR MORE INFORMATION

This guide provides general information only. The descriptions of the law and the OSEin this guide are not intended to be exhaustive. For more information regarding the Codeof Ethics as it pertains to current or potential state contractors, please contact the LegalDivision of the Office of State Ethics, Monday — Friday, 8:30 a.m. to 5:00 p.m.

Office of State Ethics18-20 Trinth: StreetHartford. CT 06106-1660

T: 860/263-2400F: 860/263-2402www.cl.go’/cthics

Specific Contacts:Questions or advice regarding the Ethics Codes: [email protected] ILobbyist filing/reporting questions: [email protected] -

Public official filing/reporting questions: [email protected] questions: [email protected] other inquiries: [email protected]

January 2010

12

Exhibit D

EXHIBIT D – THIRD PARTY FEE DISCLOSURE

AFFIDAVIT OF DISCLOSURE REGARDING THIRD PARTY FEES

STATE OF ) ) SS: COUNTY OF ) Pursuant to Section 3-13j of the Connecticut General Statutes I, [a duly authorized officer of _______________________________], a person or entity entering into a contract for investment services with the CONNECTICUT HEALTH AND EDUCATION FACILITIES AUTHORITY, being duly sworn, hereby depose and say: that all third party fees1 attributable to such contract are as follows:

NAME OF PAYEE

DOLLAR AMOUNT PAID OR VALUE OF NON-CASH

COMPENSATION AND DATE

FEE ARRANGEMENT

SPECIFIC SERVICES PERFORMED BY

PAYEE

[if none, state none] In witness whereof I have hereunto set my hand and seal. Witness: Name: Title:

Subscribed and sworn to before me this _____ day of _________, 20___ Notary Public My commission expires:

1 “Third party fees” include, but are not limited to, management fees, placement agent fees, solicitation fees, referral fees, promotion fees, introduction or matchmaker fees, and due diligence fees.

Exhibit E

CONNECTICUT STATE ELECTIONS ENFORCEMENT COMMISSIONRev. 1/11Page 1 of2

Notice to Executive Branch State Contractors and Prospective StateContractors of Campaign. Cóñfributión áñd Solicitation LimitatiOns

This notice is provided under the authority of Connecticut General Statutes §9-612(g)(2), as amended by P.A. 10-1, and is forthe purpose of informing state contractors and prospective state contractors of the following law (italicized words are defined onthe reverse side of this page).

CAMPAIGN CONTRIBUTION AND SOLICITATION LIMITATIONS ‘ ,

No state contractor, prospective state contractor, principal ofa state contractor or principal ofa prospective state contractor, with regardto a state contract or state contract solicitation with or from a state agency in the executive branch or a quasi-public agency or a holder, orprincipal of a holder of a valid prequalification certificate, shall make a contribution to (i) an exploratory committee or candidate committeeestablished by a candidate for nomination or election to the office of Governor, Lieutenant Governor, Attorney General, State Comptroller,Secretary of the State or State Treasurer, (ii) a political committee authorized to make contributions or expenditures to or for the benefit ofsuch candidates, or (iii) a party committee (which includes town committees).

In addition, no holder or principal of a holder of a valid prequalification certificate, shall make a contribution to (i) an exploratorycommittee or candidate committee established by a candidate for nomination or election to the office of State senator or Staterepresentative, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) aparty committee.

On and after January 1, 2011, no state contractor, prospective state contractor, principal of a state contractor or principal of a prospectivestate contractor, with regard to a state contract or state contract solicitation with or from a state agency in the executive branch or aquasi-public agency or a holder, or principal of a holder of a valid prequalification certificate, shall knowingly solicit contributions fromthe state contractor’s or prospective state contractor’s employees or from a subcontractor or principals ofthe subcontractor on behalf of (i)an exploratory committee or candidate committee established by a candidate for nomination or election to the office of Governor,Lieutenant Governor, Attorney General, State Comptroller, Secretary of the State or State Treasurer, (ii) a political committee authorized tomake contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee.

r ) 1 D1_JTi TO INFORM I

State contractors and prospective state contractors are required to inform their principals of the above prohibitions, as applicable, and thepossible penalties and other consequences of any violation thereof.

‘‘ PENALTIES FOR VIOIATIO1’IS I

Contributions or solicitations of contributions made in violation of the above prohibitions may result in the following civil and criminalpenalties:

Civil penalties—Up to $2,000 or twice the amount of the prohibited contribution, whichever is greater, against a principal or a contractor.Any state contractor or prospective state contractor which fails to make reasonable efforts to comply with the provisions requiring notice toits principals of these prohibitions and the possible consequences of their violations may also be subject to civil penalties of up to $2,000 ortwice the amount of the prohibited contributions made by their principals.

Criminal penalties—Any knowing and willful violation of the prohibition is a Class D felony, which may subject the violator toimprisonment of not more than 5 years, or not more than $5,000 in fmes, or both.

CONTRACT CONSEQUENCES II1

In the case of a state contractor, contributions made or solicited in violation of the above prohibitions may result in the contract beingvoided.

In the case of a prospective state contractor, contributions made or solicited in violation of the above prohibitions shall result in the contractdescribed in the state contract solicitation not being awarded to the prospective state contractor, unless the State Elections EnforcementCommission determines that mitigating circumstances exist concerning such violation.

The State shall not award any other state contract to anyone found in violation of the above prohibitions for a period of one year after theelection for which such contribution is made or solicited, unless the State Elections Enforcement Commission determines that mitigatingcircumstances exist concerning such violation.

Additional information may be found on the website of the State Elections Enforcement Commission, www.ct.gov/seec. Click on the linkto “LobbyistJContractor Limitations.”

Exhibit E

CONIECTICUT STATE ELECTIONS ENFORCEMENT COMMISSIONRev. 1/11Page 2 of 2

DEFINITIONS

“State contractor” means a person, business entity or nonprofit organization that enters into a state contract. Such person, business entity or nonprofitorganization shall be deemed to be a state contractor until December thirty-first of the year in which such contract terminates. “State contractor” does notinclude a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or politicalsubdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch ofstate government or a quasi-public agency, whether in the classified or unclassified service and full or part-time, and only in such persons capacity as a stateor quasi-public agency employee.

“Prospective state contractor” means a person, business entity or nonprofit organization that (i) submits a response to a state contract solicitation by the state,a state agency or a quasi-public agency, or a proposal in response to a request for proposals by the state, a state agency or a quasi-public agency, until thecontract has been entered into, or (ii) holds a valid prequalification certificate issued by the Commissioner of Administrative Services under section 4a-100.“Prospective state contractor” does not include a municipality or any other political subdivision of the state, including any entities or associations dulycreated by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employeein the executive or legislative branch of state government or a quasi-public agency, whether in the classified or unclassified service and full or part-time, andonly in such person’s capacity as a state or quasi-public agency employee.

“Principal of a state contractor or prospective state contractor” means (i) any individual who is a member of the board of directors of, or has an ownershipinterest of five per cent or more in, a state contractor or prospective state contractor, which is a business entity, except for an individual who is a member ofthe board of directors of a nonprofit organization, (ii) an individual who is employed by a state contractor or prospective state contractor, which is a businessentity, as president, treasurer or executive vice president, (iii) an individual who is the chief executive officer of a state contractor or prospective statecontractor, which is not a business entity, or if a state contractor or prospective state contractor has no such officer, then the officer who duly possessescomparable powers and duties, (iv) an officer or an employee of any state contractor or prospective state contractor who has managerial or discretionaryresponsibilities with respect to a state contract, (v) the spouse or a dependent child who is eighteen years of age or older of an individual described in thissubparagraph, or (vi) a political committee established or controlled by an individual described in this subparagraph or the business entity or nonprofitorganization that is the state contractor or prospective state contractor.

“State contract” means an agreement or contract with the state or any state agency or any quasi-public agency, let through a procurement process orotherwise, having a value of fifty thousand dollars or more, or a combination or series of such agreements or contracts having a value of one hundredthousand dollars or more in a calendar year, for (i) the rendition of services, (ii) the furnishing of any goods, material, supplies, equipment or any items ofany kind, (iii) the construction, alteration or repair of any public building or public work, (iv) the acquisition, sale or lease of any land or building, (v) alicensing arrangement, or (vi) a grant, loan or loan guarantee. “State contract” does not include any agreement or contract with the state, any state agency orany quasi-public agency that is exclusively federally funded, an education loan, a loan to an individual for other than commercial purposes or any agreementor contract between the state or any state agency and the United States Department of the Navy or the United States Department of Defense.

“State contract solicitation” means a request by a state agency or quasi-public agency, in whatever form issued, including, but not limited to, an invitation tobid, request for proposals, request for information or request for quotes, inviting bids, quotes or other types of submittals, through a competitive procurementprocess or another process authorized by law waiving competitive procurement

“Managerial or discretionary responsibilities with respect to a state contract” means having direct, extensive and substantive responsibilities with respect tothe negotiation of the state contract and not peripheral, clerical or ministerial responsibilities.

“Dependent child” means a child residing in an individual’s household who may legally be claimed as a dependent on the federal income tax of suchindividual.

“Solicit” means (A) requesting that a contribution be made, (B) participating in any fund-raising activities for a candidate committee, exploratorycommittee, political committee or party committee, including, but not limited to, forwarding tickets to potential contributors, receiving contributions fortransmission to any such committee or bundling contributions, (C) serving as chairperson, treasurer or deputy treasurer of any such committee, or (D)establishing a political committee for the sole purpose of soliciting or receiving contributions for any committee. Solicit does not include: (i) making acontribution that is otherwise permitted by Chapter 155 of the Connecticut General Statutes; (ii) informing any person of a position taken by a candidate forpublic office or a public official, (iii) notifying the person of any activities of, or contact information for, any candidate for public office; or (iv) serving as amember in any party committee or as an officer of such committee that is not otherwise prohibited in this section.

“Subcontractor” means any person, business entity or nonprofit organization that contracts to perform part or all of the obligations of a state contractor’sstate contract. Such person, business entity or nonprofit organization shall be deemed to be a subcontractor until December thirty first of the year in whichthe subcontract terminates. “Subcontractor” does not include (i) a municipality or any other political subdivision of the state, including any entities orassociations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter,or (ii) an employee in the executive or legislative branch of state government or a quasi-public agency, whether in the classified or unclassified service andfull or part-time, and only in such person’s capacity as a state or quasi-public agency employee.

“Principal of a subcontractor” means (i) any individual who is a member of the board of directors of, or has an ownership interest of five per cent or more in,a subcontractor, which is a business entity, except for an individual who is a member of the board of directors of a nonprofit organization, (ii) an individualwho is employed by a subcontractor, which is a business entity, as president, treasurer or executive vice president, (iii) an individual who is the chiefexecutive officer of a subcontractor, which is not a business entity, or if a subcontractor has no such officer, then the officer who duly possesses comparablepowers and duties, (iv) an officer or an employee of any subcontractor who has managerial or discretionary responsibilities with respect to a subcontractwith a state contractor, (v) the spouse or a dependent child who is eighteen years of age or older of an individual described in this subparagraph, or (vi) apolitical committee established or controlled by an individual described in this subparagraph or the business entity or nonprofit organization that is thesubcontractor.

Exhibit F

Form C07-08-2009

STATE OF CONNECTICUT4 NONDISCRIMINATION CERTIFICATION — Affidavit

By EntityFor Contracts Valued at $50,000 or More

Documentation in the form ofan affidavit signed under penalty of false statement by a chief executiveofficer, president, chaimperson, member, or other corporate officer duly authorized to adopt corporate,company, or partnership policy that certifies the contractor complies with the nondiscriminationagreements and Warranties under Connecticut General Statutes §‘ 4a-60(a)(]) and 4a-60a(a)(1), asamended

INSTRUCTIONS:

For use by an entity (corporation, limited liability company, or partnership) when entering into any contracttype with the State of Connecticut valued at $50,000 or more for any year of the contract. Complete allsections of the form. Sign form in the presence of a Commissioner of Superior Court or Notary Public,Submit to the awarding State agency prior to contract execution.

AFFIDAVIT:

I, the undersigned, am over the age of eighteen (18) and understand and appreciate the obligations of

an oath. am

___________________________

of

__________________________________

, an entitySignatory’s Title Name of Entity

duly formed and existing under the laws of

________________________________________

Name of State or Commonwealth

I certify that I am authorized to execute and deliver this affidavit on behalf of

____________________________________

and that

____________________________________

Name of Entity Name of Entity

has a policy in place that complies with the nondiscrimination agreements and warranties of Connecticut

General Statutes § 4a-60(a)(1)and 4a-60a(a)(1), as amended.

Authorized Signatory

Printed Name

Sworn and subscribed to before me on this

______

day of

____________,

20.,,,.

Commissioner of the Superior Court! Commission Expiration DateNotary PubJic

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