Program Description

The Home energy Assistance Program has two components, Subsidy and Crisis.

The Subsidy component provides benefits in the form of fuel or payment toward a utility bill for all households that are income eligible and that are responsible for home energy cost either directly or as an undesignated portion of their rent.

The Crisis component requires that eligible households also meet the Crisis definition:

• the household is without heat if coal, wood or kerosene is the heat source; or
• the household is within 4 days of running out of fuel if propane or fuel oil is the heat source; or
• the household has received a past due or disconnect notice if natural gas or electric is the heat source; or
• the household requires a heating system repair to obtain adequate heat; or
• the household's home heating costs are included as an undesignated portion of the rent, and the household has received
       an eviction notice for non-payment of rent; or

Emergency programs may be authorized during the summer.

Each vendor needs to be aware of and understand these basic program requirements before signing this agreement.

For bulk fuels, I understand that I must have the consumers signature, certifying the delivery of the fuel, to receive payment.

Vendor Responsibilities
As a vendor for this program, I understand and agree to comply with the non-discrimination provisions which requires that I

• Charge the LIHEAP household, in the normal billing process, the difference between the actual cost of home energyand the amount of the payment approved from the program;
• Not treat households adversely because of the receipt of LIHEAP benefits;
• Not discriminate, either in the cost of the goodssupplied or the services provided against the eligible household for whom         payment is being made;
• Reconnect utilities and/or deliver fuel upon certification of payment; and
• Not increase the household's rent on the basis of the receipt of the payment.

I further agree to

• Allow agency and/or other authorized officials to inspect records upon request;
• Maintain records of financial transactions regarding LIHEAP for a period of three (3) years;
• Provide information to the agency on any instances where I may be aware that a household has been approved for benefits by misrepresentation of the household's situation;
• Comply with the Equal Employment Opportunity standards;
• Comply with the billing procedures established by the agency and included in this agreement as Attachment A; and
• Provide fuel as specified and at the price quoted in this agreement as Attachment B,
• Submit all vouchers to the local CAA within 60 days of issuance or May 15, whichever comes first.

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                     Business Name                                                                 Telephone Number

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                    Business Address

Revised 9/30/99