HomeMy Public PortalAbout2000 Conditions for Donation of Service and SpaceConditions for Donation of Services and SpaLe
1 The common goal of the U S Bureau of the Census and the Donor Organization is to
conduct a complete and accurate Census in //wig/5,4)//VS: ,4t1A,w/ 449 67
A Donation of Services
Under the guidance of the Bureau of the Census the Donor Organization does hereby
agree to provide J (number) Questionnaire Assistance Volunteers, hereinafter called
QAVs for the purpose of helping those persons who request such assistance in order to
complete their Census 2000 questionnaires The names of the QAVs are contained on the
list attached to this agreement
II This donation is subject to the following terms and conditions
1 The QAVs must swear (or affirm) an oath of confidentiality either in wnting or verbally
before an authorized Bureau of the Census official that they will not disclose information
about individual respondents to anyone, not even to the Donor Organization nor use such
informaion for personal gam
2 The Donor Organization will provide questionnaire assistance at the following times and
on the following it deems appropnate TUf5 /7101
25 (the Bureau of the
Census expects peak usage of the questionnaire assistance centers to extend from
gAm to li / m ) and in that the assistance will be provided in
the following language(s) Ltl6tisit 4 S94& I SI-t
3 Questionnaire Assistance Volunteers (QAVs) will direct respondents to return their own
questionnaires by mail in the preaddressed envelopes Also they should ask respondents to
fill out their own queItionnaires
4 The Bureau of the Census will not reimburse the QAV or the Donor Organization for
mileage or any otheriwork related expenses
5 Bureau of Censuslpersonnel will tram the QAVs Locally dunng the times and at
locations to be mutually agreed upon by the Bureau of the Census and the Donor
Organization
6 The Bureau of th� Census personnel will provide each QAV with one (1) manual and
one (1) questionnaire Reference Booklet containing answers to the most frequently asked
questions The Bureau will also provide QAVs with a toll free assistance number that
respondents may call for the answer to questions the QAVs cannot answer
7 The Bureau of the Census and the Donor Organization will jointly publicize in the local
media the dates locations and hours of operation of the Questionnaire Assistance Centers
Conditions for Donation of Services and Space
8 All questionnaire assistance services will be provided without anv charge whatsoever to
the respondent
B Space Occupancy Agreement
The Donor Organization agrees to provide or to arrange for the provision of sufficient
space at the agreed upon sites to accommodate one (1) desk (or table) (2) chairs in which
the QAVs may interview privately and undisturbed, the respondent(s) seeking assistance
The QAV will provide assistance to those respondents who contact or visit the
Questionnaire Assistance Centers
The Bureau of the Census (BOC) will occupy a5 square feet of office space in n -y
4150.41/E U/IMA6S HAIL, at 850 ,C'4wt ,c ST , /X2y 815C/vft4- /cc 33/4/9 for a
period of s u/Ks ,commencing oa/a2,00 through *Woo
The Bureau of Census will occupy the above mentioned space at no cost to the government
The Bureau of Census will provide the Donor Organization with posters to be placed in the
Census Volunteer Questionnaire Assistance Centers which designate these places as
Bureau sanctioned assistance centers
C Liability
In the event that injury or damage is caused by one of our employees while acting within
the scope of his or her authority the incident will be covered under the Federal Tort
Claims Act, Title 28 U S C 2671, et seq
Any injury occuring to one of our employees while acting within the scope of his or her
employment will be covered under the Federal Employees Compensation Act Title 5
U S C 8101 et seq
Conditions for Donation of Services and Space
Because the Federal Government is self insured it is our policy not to purchase or pav for
commercial habdtty insurance Also the Anti Deficiency Act, Title 31 U S C 1341 et seq
prohibits any Federal agency from undertaking contingent and undetermined liability
without funds being appropnated by Congress for such purpose For this reason the
Government cannot agree to a ` hold -harmless clause nor can it waive the right to sue
APP•OVED APPROVED
(Signed) (Signed)
3 a m 03-03-,2000
Date Date
c 5*p,uet letsain46/ bmivA ,Lf Ptx&' -
Name (Please print)
(Agency)
Name (Please print)
Local Census Manager for
Regional Director
Bureau of the Census
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