HomeMy WebLinkAboutMINUTES - 11071995 - C58 -A
TO: BOARD OF SUPERVISORS
Contra
FROM: s Mark Finucane, Health Services Director
Costa
DATE: October 26, 1995 County
SUBJECT: Approve Standard Agreement #28-538-3 with the State Department of
Health Services for the Pittsburg Active Living Project
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
Approve and authorize the Chair, Board of Supervisors, to execute on
behalf of the County, Standard Agreement #28-538-3 (State #95-23299)
with the State Department of Health Services, in the amount of
$107,800, for- the period from October 1, 1995 through September 30,
1996, for the Pittsburg Active Living Project.
II. FINANCIAL IMPACT:
This Agreement provides $107, 800 of State funding for the final year
of a three year project for the County's Pittsburg Active Living
Project. No County funds are required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
The City of Pittsburg has the highest hospitalization rates for
chronic disease among all Contra Costa cities. The goal of this
Project is to reduce risk factors for circulatory system disorders,
cancer and diabetes among the City of Pittsburg's Latino, African-
American, and Asian/Pacific Islands adult residents.
Seven signed copies of the Standard Agreement and three certified and
sealed copies of the Board Order should be returned to the Contracts
and Grants Unit for submission to the State Department of Health
Services.
CONTINUED ON ATTACHMENT: YES SIGNATURE: 4
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOAR)D COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON �'ts��►np w ��� q g,{ APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
ZUNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD '
Contact: Wendel Brunner, M.D. (313-6712) OF SUPERVISORS ON THE DATE SHOWN.
CC: Health Services (Contracts) ATTESTED
State Dept. of Health Services
Phil Batchelor, Clerk of the Board of
Supoluisprs�Ild County Admin'Isttator -------..__.
w
M882/7-88 BY DEPUTY
• //�7�/ `i9s C .SB
Attochment 1
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
The undersigned certifies,to the best of his or her Rowledge and belbf,that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned,to any person for Influencing or attempting to Influence an officer or employee of an agency
of the United States Government, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with the making, awarding or entering Into of this
Federal contract, Federal grant, or cooperative agreement, and the extension,continuation, renewal,
amendment.or modification of this Federal contract,grant,or cooperative agreement.
(2)If any funds other than Federal appropriated funds have been paid or will be paid to any person
for Influencing or attempting to Influence an officer or employee of any agency of the United States
Government,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with this Federal contract,grant,or cooperative agreement,the undersigned shall
complete and submit Standard Form LLL. 'Disclosure of Lobbying Activities' In accordance with Its
Instructions.
(3) The undersigned shat require that the k3ngu3ge of this certification be included In the award
documents for all subawards at all tiers (including &Ax=troctors,subgrants,and contracts under grants
and cooperative agreements) of $100.000 or more,and that as subrecipients shall certify and disclose
accordingly.
This certification Is a material representation of fact upon which relk3nce was placed when this transaction
was made or entered Into. Submission of this certification Is a prerequisite for making or entering into this
transaction Imposed by Section 1352, Title 31, U. S. Code. any person who falls to file the required
certification shall be subject to a cMi penalty of not less than$10000 and not more than$100,000 for each
such failure.
4-41
Contra Costa County
1ft,..a c nit cw iMrwa d rre,an so,rn
cawoevGar Kn�r aQwAw of ANON so ra oo coo
Chair, Board of Supervisors
oor. tr.
After execution by or on Behalf of Controctaa please return to:
Departrtlent of Health Services
(Name of the DHS program providing the funds)
P.O.Bax 942732
714 P Sheet
Sacramento,CA 94234-7320
04 No.13(10191 -24-
STATE OF CALIFORNIA I - '.I pl C15i °
STANDARD AGREEMENT—
APPROVED GENERBY THEAL CONTRACTNUMBER AM,NO.
ATTORNEY GENERAL
SM.2(REV.5-91) 95-23299 a
TAXPAYERS FEDERAL EMPLOYER IDENTIFICATION NUMBER
THIS AGREEMENT;made and entered into this 1st day of October 19_95 , 94-6000509
in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting
TITLE OF OFFICER ACTING FOR STATE AGENCY
Chief, Program Support Department of Health Services hereafter called the State,and.
CONTRACTOF'S NAME od
Contra Costa- County •� v hereafter called the Contractor.
WITNESSETH: That the Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the.State hereinafter expressed,
does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
lime for performance or completion,and attach plans and specifications,if any.)
I. Term of Contract
Term of this contract shall be from October 1, 1995,through September 30, 1996.
II. Limitation of State Liability
The maximum amount payable under this contract shall not exceed$107,800.
Continued on next page
CONTINUED ON 3 SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER.
The provisions on the reverse side hereof constitute a part of this agreement.
IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date fust above written.
STATE OF CALIFORNIA CONTRACTOR
AGENCY CONTRACTOR(11 other than an individual state whether a corporation,partnership,etc.)
Department of Health Services Contra Costa County
BY(AUTHORIZED SIGNATURE) BY(AUTH 0 SIGNATURE)
D D
PRINTED NAME OF PERSON SIGNING PRINTED NAM ND TITLE OF PERSON SIGNI
Chair, Board of Supervisors
TITLE ADDRESS
Chief, Program Support Branch 651 Pine Street, Martinez CA 94553
AMOUNT ENCUMBERED BY THIS PROGRAWCATEGORY(CODE AND TITLE) FUND TITLE Department of General Services
DOCUMENT
$ 107 800 ClearingAccount _ General Use Only
(OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR
THIS CONTRACT Federal Special Pro sect Funds %is contract exempt frain
ITEM CHAPTER STATUTE FISCAL YEAR
De artment of General
$ -0— 4260-001`001 303/95 1995 95/96 Services ag� royal per
TOTAL AMOUNT ENCUMBERED TO 7"p P
DATE OBJECT OF EXPENDITURE(CODE AND TITLE) Gov't Coda' Section
$ 107,800 95-95282-9522-418-02-93 91S-95 16366.7(b} (FBF)
I hereby certify upon my own personal knowledge that budgeted funds T.B.A.NO. B.R.NO.
are available for the period and purpose of the expenditure stated above.
SIGNATURE OF ACCOUNTING OFFICER DATE
D
F] CONTRACTOR STATE AGENCY DEPT.OF GEN.SER. CONTROLLER
r
STANDARD AGREEMENT
I. The C orttrat for agrecs to indemnify.dcfc!nd i1ndsave harmlessthc SGitt-,its ufficers,agentsand employees
from anN and all claims and losses accruing or resulting to any and all contractors, subcontractors.
inateri.i1mcn,laborers and any other person,firm or corporation furnishing or supplying«•ork services,
materials or supplies in connection Ni'Ith the performance of this contract, in(]from anv and all claims and
tosses accruing or resulting to any person, firm or corporation who may be injured or damaged by the
Contractor in the performance of this contract.
2. The Contractor,and the agents and etnplovces of Contractor,in the performance of the agreement,shall-
act in an independent capacity and not as officers or employees or agents of State of California.
3. The State.may terminate thiisagreententand be relieved ofthe payment ofany consideration to Contractor
should Contractor fail to perforin the covenants herein contained at the time and in the manner herein
provided.. In the event of such termination the State may proceed with the work in any manner deemed
proper by the State. The cost to the State shall be deducted from any sum due:the Contractor under this
agreement,and the balance, if any,shall be paid the Contractor upon demand.
4. Without the written consent of the State,thisagreement is not assignable by Contractor either in whole
or in part.
;. 'Time is of the essence in this agreement.
b. No alteration or variation of the terms of this contract shall be valid unless made in writing and signed by
the parties hereto,and no oral understanding or agreement not incorporated herein,shall be binding on
any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shall be in compensation for all of
Contractor's expenses incurred in the performance hereof, including travel and per diem, unless
otherwise expressly so provided.
91 6tow
Contra Costa County Health Services. ,
Contract Number: 95-23299
Page 2 of 4
III. Termination
This contract may be terminated without cause by either party upon thirty (30) calendar days advance
'written notice to the other party. Such notification shall state the specific date of termination. In the
event of such termination, the Contractor shall take:immediate steps to reduce:.the-incurrence of
- additional"costs. Contractor:shall be entitled to all costs allowable under the terms of this contract,
including non-cancelable obligations incurred prior to the date of receipt of notice of termination, in an
amount not to exceed the maximum payable under Article 2 of this contract.
IV. Additional Provisions/Exhibits
The following attached Exhibits are incorporated herein and made a part hereof by this reference.
1. Exhibit A entitled"Project Workplan,"consisting of seven(7) pages.
2. Exhibit A-1 entititled "Current Contract Year Equipment Purchased with State Funds,"
consisting of one (1)page.
3. Exhibit A(F) entitled"Additional Provisions,"consisting of.twenty-seven (27)pages.
4. Exhibit A(PHHF) entitled "Federal Block Grant Provisions," consisting of one (1) page.
5. Exhibit B entitled "Budget," consisting of one (1)page.
6, Exhibit C entitled"Nondiscrimination Clause,"consisting of one (1) page.
7. Exhibit D entitled"Federal Contract Funds",consisting of one(1) page.
8. Exhibit E entitled"Contract Uniformity,"consisting of one(1)page.
9. Exhibit F entitled "Short-Term Travel Reimbursement Information," consisting of two (2)
pages.
V. Contract Manager
Lisa S. Hershey, M.P.H., is designated as the Contract Manager for the State. The State reserves the
right to change the Contract Manager at any time, and will notify the Contractor of such change within
10 working days.
VI. Address
Invoices, reports, and other communications from the Contractor shall be sent to ON THE MOVE!,
Epidemiology and Health Promotion Section, State Department of Health Services, P.O. Box
942732/601 North 7th Street, MS-675, Sacramento, CA 94234-7320, and shall reference this contract
by number and Contractor's full name.
■
Contra Costa County Health Services.
Contract Number: 95-23299
Page 3 of 4
VII. Contractor's Project Director
Contractor has designated Nancy Baer as their Project Director. The Project Director is responsible for
all programmatic and technical matters under this contract. The State reserves the right to approve any.
-- substitute Project Director.
VIII. Payment Provisions
In consideration of the services described above, performed in a manner acceptable to the State, the
State shall reimburse the Contractor not more frequently than once monthly, in arrears, upon
submission of an invoice for allowable costs incurred. Said invoice shall be submitted in a form and
format prescribed,by the State, and shall be submitted to the address specified in Article VI above.
With written approval of the State, in the form and format of the State, the Contractor may make
changes in any individual line item of allowable cost, provided that such changes in the aggregate as to
any individual line item shall not exceed $10,000. In no event shall the maximum amount payable
under this agreement exceed the amount specified in Article II of this agreement.
IX. Progress Reporting
The Contractor shall submit two progress reports which describe the task accomplishments achieved
during the prior six-month period. The Contractor shall provide the State with one (1) original and
two (2) copies of each report prepared in accordance with a form and format prescribed by the State.
Progress reports are due by the 20th day of the month following the end of the 2nd quarter and within
thirty (30) days following the end of the 4th quarter. Failure to submit timely and acceptable reports
shall be cause for invoice payments to the Contractor to be delayed or disallowed.
X. Progress Reviews
A. The Contractor agrees to cooperate with the State by participating in statewide meetings and site
visits as the State Contract Manager may deem necessary.
B. The Contractor agrees to collect and submit program data in the manner, format, and timeline
prescribed by the State. These data are to include, at a minimum, demographic description of the
population served and items to measure program effectiveness.
C. The Contractor agrees to cooperate with the State by participating in the review and when
appropriate, the field testing of statewide data collection and evaluation instruments and newly
developed educational materials.
D. 'The contractor agrees to abide by the guidelines set for usage of the ON THE MOVE! logo.
Contra Costa County Health'Services.
' Contract Number: 95-23299'
Page 4 of 4
XI. Warranty
Contractor warrants that it is competent and free to enter into and fully perform the terms and
conditions of this contract; that it has,secured or will have secured any and all necessaryright,
- --------- clearness and-licenses with respect to all materials and elements embodied in or used in connection
with the performance of this contract, and that all included materials will neither violate nor infringe
upon the copyright, servicemark, trademark, privacy, creative or other rights of any person, firm,
corporation,or other third party.
XII. Use of Materials
The State reserves the right to use,reproduce, and initially publish all reports and data produced under
this contract,.and reserves the right to authorize others to use and produce such materials.
XIII. Subcontracting
Contractor shall be responsible for performing all requirements.specified in this contract even though
the requirements are carried out pursuant to a subcontractor. No assignment or subcontract which the
Contractor enters into with respect to the performance of agreed-upon work shall in any way relieve
the Contractor of responsibility for performance of contract duties. Subcontracts shall incorporate the
requirements of this contract which are relevant to services provided by the subcontractor. The State
must approve all subcontracts with a cost of$5,000 or more, or agreement exceeding $350 per day,
prior to the Contractor implementing said agreement/subcontract. Contractor shall notify the State
within five(5) working days after termination of any subcontract.
XIV. Publications
Publications prepared by the Contractor as part of the work funded under this contract shall be
submitted to the State and shall require approval by the State, prior to its publication. Oral
presentations, as well as materials developedand printed by the Contractor, as a part of this contract,
shall acknowledge the financial support of the State by including the following: State Department of
Health Services, ON THE MOVE!, Epidemiology and Health Promotion Section, Contract Number
95-23299.
XV. Americans with Disabilities Act
The Contractor shall comply with all requirements established under the Americans with Disabilities
Act, in order to make programs accessible to all participants and to provide equally effective
communications.
1
STATE OF CAL11FORNIA
STANDARD AGREEMENT- APPROVED BYTHE
ATTORNEY GENERAL CONTRACrNUMBER AM.No.
STD.2(1`16-5-91) 95-23299 '
TAXPAYER'S FEDERAL EMPLOYER IDENTIFICATION NUMBER
THIS AGREEMENT,made and entered into this 1st day of October 19 95 94-6000509
in the State of California,by and between State of California,through its duly elected or appointed,qualified and acting
TITLE OF OFFICER ACTING FOR STATE AGENCY
Chief, Program Support Department of Health Services hereafter called the State,and
CONTRACTOR'S NAME
Contra Costa County Health Services hereafter called the Contractor.
-WITNESSETH: That the-Contractor for and in consideration of the covenants,conditions,agreements,and stipulations of the State hereinafter expressed,
does hereby agree to furnish to the State services and materials as follows: (Set forth service to be rendered by Contractor,amount to be paid Contractor,
time for performance or completion,and attach plans and specifications,if any.)
I. Term of Contract
Term of this contract shall be from October 1, 1995,through September 30, 1996.
II. Limitation of State Liability
The maximum amount payable under this contract shall not exceed$107,800.
Continued on next page
CONTINUED ON 3 SHEETS,EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER.
The provisions on the reverse side hereof constitute a part of this agreement.
IN WITNESS WHEREOF,this agreement has been executed by the parties hereto,upon the date first above written.
STATE OF CALIFORNIA CONTRACTOR
AGENCY CONTRACTOR(if other than an individual state whether a corporation,partnership,etc.)
Department of Health Services Contra Costa County Health Services
BY(AUTHORIZED SIGNATURE) BY(AUTHORIZED SIGNATURE)
D D
PRINTED NAME OF PERSON SIGNING PRINTED NAME AND TITLE OF PERSON SIGNING
TITLE ADDRESS
Chief, Program Support Branch 75 Santa Barbara Road, Pleasant Hill, CA 94523
AMOUNT ENCUMBERED BY THIS PROGRAWCATEGORY(CODE AND TITLE) FUND TITLE Department of General Services
DOCUMENT
Clearing Account General use only
$ 107,800 (OPTIONAL USE)
PRIOR AMOUNT ENCUMBERED FOR
THIS CONTRACT Federal Special Pro 'ect Funds
$ —0— ITEM CHAPTER STATUTE FISCAL YEAR
4260-001-001 303/95 1995 95/96
TOTAL AMOUNT ENCUMBERED TO
DATE OBJECT OF EXPENDITURE(CODE AND TITLE)
$ 107,800 95-95282-9522-418-02-93991S-95
!hereby certify upon my own personal knowledge that budgeted funds T.B.A.NO. B.R.NO.
are available for the period and purpose of the expenditure stated above.
SIGNATURE OF ACCOUNTING OFFICER DATE
E] CONTRACTOR STATE AGENCY L1 DEPT.OF GEN.SER. CONTROLLER
STANDARD AGREEMENT
., ... c('Z:Y.'s 91) 1Fi i_VISRsL) .
1. 'fhc('1lntr ,-tor agrees to indemIII fN.defend and save harm If the State,its officers,agenIs-an d enrpIovees
fron) .wv ;tnd all claims and losses accruing or resulting to any and all contractors, subcontractors,
rnatcri<)!III efl..laborers and any other person,firm or corporation furnishing or supplying work services,
materials of supplies in connection NvOli the performance of this contract,and from any and all claims and
losses accruing or resulting to'any.person,firm or corporation who may be injured or damaged by the .
-- —Contraetof in the performance of this contract.
3. The Contractor,and the agents and employees of Contractor,in the performance of the agreement,shall
act in an independent capacity and not as officers or employees or assents of State of California.
3. The State mayterminat.ethisagreementandberelievedofthepaymentofanyconsiderationtoContractor
should Contractor fail to,perform the.covenants herein contained at the time and in the manner herein
provided. In the event of such termination the State may proceed with the work in any manner deemed
proper by the State. The cost to the State shall be deducted from any sum due the Contractor under this
agreement,and the balance,if any,shall be paid the Contractor upon demand.
4. !Without the written consent of the State,this agreement is not assignable by Contractor either in whole
or in part.
5. `rime is of the essence in this agreement.
6. No alteration or variation of the terms of this contract shall be valid unless made in writing and signed by
the parties hereto,and no oral understanding or agreement not incorporated herein,shalt be binding on
any of the parties hereto.
7. The consideration to be paid Contractor, as provided herein, shall be in compensation for all of
Contractor's expenses incurred in the performance hereof, including travel and per diem, unless
otherwise expressly so provided.
1
91 51014
Contra Costa County Health Services, ,
Contract Number: 95-23299
Page 2 of 4
III. Termination
This contract may be terminated without cause by either party upon thirty (30) calendar days advance
..written notice to the other.party. Such notification shall state the specific date of termination..In the
event of such termination, the Contractor shall take immediate steps to reduce the.incurrence of
.additional costs. Contractor shall be entitled to all costs allowable under the terms of this contract,
including non-cancelable obligations incurred prior to the date of.receipt of notice of termination;in an
amount not to exceed the maximum payable under Article 2 of this contract.
IV. Additional Provisions/Exhibits
The following attached Exhibits are incorporated herein and made a part hereof by this reference.
1. Exhibit A entitled"Project Workplan," consisting of seven (7) pages. _
2. Exhibit A-1 entititled "Current Contract Year Equipment Purchased with State Funds,"
consisting of one (1) page.
3. Exhibit A(F) entitled"Additional Provisions," consisting of twenty-seven(27)pages.
4. Exhibit A(PHHF) entitled"Federal Block Grant Provisions," consisting of one (1) page.
5. Exhibit B entitled"Budget," consisting of one(1)page.
6. Exhibit C entitled"Nondiscrimination Clause,"consisting of one (1) page.
7. Exhibit D entitled"Federal Contract Funds", consisting of one(1)page.
8. Exhibit E entitled"Contract Uniformity,"consisting of one (1) page.
9. Exhibit F entitled "Short-Term Travel Reimbursement Information," consisting of two (2)
pages.
V. Contract Manager
Lisa S. Hershey, M.P.H., is designated as the Contract Manager for the State. The State reserves the
right to change the Contract Manager at any time, and will notify the Contractor of such change within
10 working days.
VI. Address
Invoices, reports, and other communications from the Contractor shall be sent to ON THE MOVE!,
Epidemiology and Health Promotion Section, State Department of Health Services, P.O. Box
942732/601 North 7th Street, MS-675, Sacramento, CA 94234-7320, and shall reference this contract
by number and Contractor's full name.
Contra Costa County Health Services..
Contract Number: 95-23299
Page 3 of 4
VII. Contractor's Project Director
Contractor has designated Nancy Baer as their Project Director. The Project Director is responsible for
-all programmatic and technical matters under this contract. The State reserves the right to approve any
substitute Project Director.
VIII. Payment Provisions
In consideration of the services described above, performed in a manner acceptable to the State, the
State shall reimburse the Contractor not more frequently than once,monthly, in arrears, upon
submission of an invoice for allowable costs incurred. Said invoice shall be submitted in a form and
format prescribed by the State, and shall be submitted to the address specified in Article VI above.
With written approval of the State, in the form and format of the State, the Contractor may make
changes in any individual line item of allowable cost, provided that such changes in the aggregate as to
any individual line item shall not exceed $10,000. In no event shall the maximum amount payable
under this agreement exceed the amount specified in Article H of this agreement.
IX. Progress Reporting
The Contractor shall submit two progress reports which describe the task accomplishments achieved
during the prior six-month period. The Contractor shall provide the State with one (1) original and
two (2) copies of each report prepared in accordance with a form and format prescribed by the State.
Progress reports are due by the 20th day of the month following the end of the 2nd quarter and within
thirty (30) days following the end of the 4th quarter. Failure to submit timely and acceptable reports
shall be cause for invoice payments to the Contractor to be delayed or disallowed:
X. Progress Reviews
A. The Contractor agrees to cooperate with the State by participating in statewide meetings and site
visits as the State Contract Manager may-deem necessary.
B. The Contractor agrees to collect and submit program data in the manner, format, and timeline
prescribed by the State. These data are to include, at a minimum, demographic description of the
population served and items to measure program effectiveness.
C. The Contractor agrees to cooperate with the State by participating in the review and when
appropriate, the field testing of statewide data collection and evaluation instruments and newly
developed educational materials.
.D. The contractor agrees to abide by the guidelines set for usage of the ON THE MOVE? logo.
Contra Costa County Health'Services.
Contract Number: 95-2329Y
Page 4 of 4
XI. Warranty
Contractor warrants that it is competent and free to enter into and fully perform the terms and
conditions of this contract; that it has secured or will have secured any and all necessary right,
clearness,-.and.-licenses with respect to all materials and elements embodied in or used in connection
with the performance of this contract, and that all included materials will neither violate nor infringe
upon the copyright, servicemark, trademark, privacy, creative or other rights of any person,.firm,
corporation,or other third party.
XII. Use of Materials
The State reserves the right to use,reproduce, and initially publish all reports and data produced under
this contract, and reserves the'right to authorize others to use and produce such materials.
XIII. Subcontracting
Contractor shall be responsible for performing all requirements.specified in this contract even though
the requirements are carried out pursuant to a subcontractor. No assignment or subcontract which the
Contractor enters into with respect to the performance of agreed-upon work shall in any way relieve
the Contractor of responsibility for performance of contract duties. Subcontracts shall incorporate the
requirements of this contract which are relevant to services provided by the subcontractor. The State
must approve all subcontracts with a cost of$5,000 or more, or agreement exceeding $350 per day,
prior to the Contractor implementing said agreement/subcontract. Contractor shall notify the State
within five (5) working days after termination of any subcontract.
XIV. Publications
Publications prepared by the Contractor as part of the work funded under this contract shall be
submitted to the State and shall require approval by the State, prior to its publication. Oral
presentations, as well as materials developed and printed by the Contractor, as a part of this contract,
shall acknowledge the financial support of the State by including the following: State Department of
Health Services, ON THE MOVE!, Epidemiology and.Health Promotion Section, Contract Number
95-23299.
XV. Americans with Disabilities Act
The Contractor shall comply with all requirements established under the Americans with Disabilities
Act, in order to make programs accessible to all participants and to provide equally effective
communications.
Contract Number: 95-23299 State of California
.Agency Name: Contra Costa County Prevention Program=: DeDartment of Health Services
--Project Title: Pittsburg Active Living Project
Project Period: October 1, 1995 to September 30, 1996 Page 1 of 7
EXHIBIT A
PROJECT WORKPLAN
Goal Statement: The Pittsburg Active Living Project will create a community environment that
encourages and supports regular physical activity among the City of Pittsburg's Latino, African-
American, and Asian/Pacific Islander adult (aged 18 and older) residents.
Related National Year 2000 Objectives:
1.7 overweight persons adopt sound dietary and physical activity practices
1.12 50% of primary providers routinely assess and counsel patients
2.6 increase consumption of complex carbohydrates and fiber
2.21 increase proportion of primary providers who provide nutrition assessment,
counseling, :and referral
8.7 increase employee participation in health promotion activities
8.9 increase discussion of issues related to health promotion
8.10 establish community health promotion programs
8.11 establish culturally and linguistically appropriate community health promotion
programs
15.4 increase persons with high blood pressure under control
15.5 increase persons with high blood pressure taking action to help control blood pressure
Measurable Objective #1: By September 30, 1996, increase the proportion of Pittsburg adults
by at least 25% from baseline estimates who utilize parks, programs and facilities in Pittsburg for
light to moderate physical activity.
Key.Activity QTR 1/2/3/4
1. Maintain and staff Pittsburg Active Living Project Advisory Board (Level 4) 1-4
a. Continue to obtain input from ALP Advisory Board in Project planning
and implementation (Level 1). 1-4
b. Solicit assistance from ALP Advisory Board to identify community
contacts and resources that facilitate project implementation and
sustainability of key Project components (Level 4). 1-4
Pittsburg Active Living Project
Workplan 95-96
Page 2
c. Continue to solicit feedback from the ALP Advisory Board regarding the
ongoing development ofthe culturally and linguistically:appropriate public
information campaign promoting physical activity, using print media and
broadcast media where possible. Specific print media venues will include:
grocery bags, newspapers and the Leisure Services Newsletter (Level 2). 1-4
d. Conduct an evaluation to elucidate the Advisory Board's satisfaction with
Board and project progress via a SWOC analysis (the identification of strengths,
weaknesses, opportunities and challenges) and survey during the
month of March, April or May. The results will serve to give direction
and focus for project implementation and institutionalization of key features
of the project. 2-3
e. Identify a committee member willing to continue to update the Healthy
Cities Steering Committee on physical activity promotion and activities
in the Pittsburg community (Level 4). 1-4
2. Maintain community outreach efforts regarding the promotion of health and physical
activity in Pittsburg's multi-ethnic community (Level 2). 1-4
a. Work with the Community Access Channel to air at least 2 physical
activity health promotion PSA's in spanish and english developed by Project
Vida Sana and San Joaquin County Health Services. We will also work toward
airing two multiethnic physical activity videos entitled: " Nutricise with Melanie
and Buster" and "Nutricise to Energize", developed by U.C. Cooperative
Extension. We plan to air the videos for one year (Level 2). 1-4
b. Identify a community contact who would be responsible for developing a health
piece to include physical activity promotion, every quarter for the Leisure
Services Newsletter starting September 1996. We will explore possible resources
that include: Leisure Services Instructors, Advisory Board Members and HMO's
servicing the Pittsburg area (Level 4). 3-4
c. Community Health Advocates will continue to distribute physical activity
promotion material at various locations in the community to include, for
example, the Marina Community Center, Pittsburg Health Center, Senior Center,
Los Medanos College and the Adult Education Center (Level 2). 1-4
d. Community Health Advocates will continue to make presentations/conduct
workshops and provide referrals to community physical activities and promote
awareness about the Pittsburg Active Living Project (Level 2). 1-4
Pittsburg Active Living Project
Workplan 95-96
Page 3
3. Continue to work toward organizational and environmental changes that support and
sustain regular physical activity in the Pittsburg community (Level 4). 1-4
a. ALPS will collaborate with the Chamber of Commerce to formalize the Seafood
Fun Walk as a regular part of the annual Seafood Festival by helping to
identify a service club/organization and/or community members willing to
coordinate the planning and implementation of the fitness activity
(Level 4). 1-4
b. Pittsburg ALP staff will work with community members, key players and the
Seafood Festival Committee to incorporate the "Fun Walk" as'a regular activity
during the Seafood Festival in September of '96 (Level 5). 1-4
c. Pittsburg ALP in collaboration with other organizations such as Leisure
Services, public housing, apartment complexes, etc., will establish "seed" items
for community organizations. These items could include: volley balls and nets,
soccer balls and nets, baseballs, bats and gloves (Level 4). 1-3
d. ALP staff will provide assistance in the development and maintenance of
regularly scheduled physical fitness activity that will include the use of
volley ball equipment and other sports equipment where feasible (Level 4). 1-3
e. Work toward the establishment of mileage signage in 2-4 sites
designated in the Pittsburg Walking Guide (Level 5). 1-4
f. Apply to the Nike Corporate Giving Program in conjunction with Delta 2000
for the purpose of obtaining funds for items such as "seed items", physical
activity scholarships and mileage signage (Level 4). 1
g. Contact Anne Kletz to explore the SportsBridge mentor program as well as
programs such as Ocean Spray's Wave Program and provide this information to the
to the PTA/Pittsburg Unified School District (Level 4). 1
4. Work with Leisure Services to develop a scholarship program for adult physical
activity programs for families with a limited budget (Level 5). 1-4
a. Conduct research to ascertain what types of scholarship programs exist in
cities in close proximity to the City of Pittsburg. 1
b. Develop policy guidelines for the implementation of the Leisure Services
scholarship program (level 6). 1-2
Pittsburg Active Living Project
Workplan 95-96
Page 4
c. Pittsburg ALP will collaborate with the Healthy Cities Steering Committee
in order to apply for funding through the City's.Community Development Block
Grant for the•_purpose of sustaining the Leisure Services scholarship program
(Level 4). 2
Objective #1 Formative Evaluation: the formative evaluation will be based on the following:
1.1 ALP Advisory Board and subcommittee meetings minutes and correspondence files will be
kept.
1.2 Advisory Board progress will be recorded.
1.3 New collaborators and partners will be documented.
1.4 ALP Advisory board progress will be evaluated and findings will be documented. .
2.1 Document process/methods used to promote health and physical activity in the community.
2.2 Identify and document community partner(s) responsible for sustaining health promotion
piece in the Leisure Services Newsletter.
2.3 Maintain log of the type of organizations, number and type of physical activity related
workshops conducted in the community.
3.1 Document all collaborations and technical assistance provided in the incorporation of a fitness
event related to the Sea Food Festival.
3.2 Document collaborators and methods used to implement mileage signage.
3.3 Maintain log of meetings with PTA and any outcomes as a result of this process.
3.4- All donation/sponsorship/funding requests will be filed and results of such activities will
be documented.
3.5 Document and file all relevant networking opportunities.
4.1 Collect relevant information regarding existing scholarship program structures and
implementation in neighboring communities.
4.2 Policies generated will be maintained in a file.
4.3 The CDBG program grant proposal will be filed and funding decision(s) documented.
Pittsburg Active Living Project
Workplan 95-96
Page 5
Measurable Objective #2: By September 30, 1996, increase the number of Pittsburg Health Center
_physicians; -nurse practitioners and nurses by at least 25% from baseline estimates who routinely
counsel patients on physical activity.
Key Activity QTR 1/2/3/4
1. Continue to work with Pittsburg Health Center health professionals to routinely
counsel their patients concerning physical activity, encourage the use of the Pittsburg Walking
Guide and the multi-lingual exercise fact sheet, and provide referrals to community physical
activities (Level 3). 1-4
a. Implement the prescription pad under the guidance and direction of Dr. Gee
(Level 5). 1
b. Work with Dr. Gee to get exercise information included on the "problem list" form used
by county health professionals so that all providers will routinely ask patients
about involvement in regular exercise (Level 5). 2-3
Objective #2 Formative Evaluation: the formative evaluation is based on the following:
1.1 Maintain a file of all health/exercise materials collected and reviewed for possible
implementation at the Pittsburg Health Center.
1.2 Develop prescription pad for health provider use.
1.3 Document process for getting exercise inquiry included on the "problem list".
Measurable Objective #3: By September 30, 1996, develop a article for publication highlighting
specific program components of the Pittsburg Active Living Project.
Key Activity QTR 1/2/3/4
1. Develop draft of article to be submitted for publication. 1-3
a. Complete draft of introduction 10/95. 1
b. Complete methods section 2/96. 2
c. Results section due 7/96. 3
Pittsburg Active Living Project
Workplan 95-96
Page 6
Pittsburg Active Living Project
Workplan 95-96
Page 6
2. Finalize publication draft. 3
Objective #3 Formative Evaluation: the formative evaluation will be based on the following:
lel Completed draft(s) for publication will be sent to ON THE MOVE and CORE staff
and filed.
1.2 Completion of final draft will be noted and filed, journal and acceptance date noted
and date of publication noted.
Outcome Evaluation
Year
1. Analyze level of change of participant involvement in physical activity and
availability of physical activity resources:
a. Conduct an inventory of available resources for physical activity(e.g. parks,
trails, etc.) at baseline and project end to determine any change in the number
of physical activity resources available. 1-3
b. Conduct inventory at baseline and project end to determine any changes in the number
of walking par courses in the community. 1-3
c. Conduct baseline, second year and project end utilization studies of the use of
walking trails, facilities, etc., at the following sites: Buchanan Park, Stoneman
Park, Los Medanos College and City Park. 1-3
d. Determine. at baseline, six months and project end, walking club participation and assess
any increase or decrease in membership between club start and finish. Core data and follow
up survey data will be collected using Participant Profiles and follow up surveys developed
by the State Department of Health Services.
2. Analyze level of organizational change:
a. Assess changes in health care provider assessment and counseling practices: 1-3
*Phase I: for one month period determine baseline assessment of provider
practices via patient survey.
•Phase II: for a three month period conduct three training sessions to cover the
following areas: the benefits of exercise, indications and contraindications for physical
activity recommendations and personalization of an exercise program.
Pittsburg Active Living Project
Workplan 95-96
Page 7
•Phase III: for one month determine post intervention changes in provider practices
via survey.
- ---- — --- ----- Phase IV (final phase):
♦ Use PACE materials for the purpose of developing a prescription pad for provider
use after obtaining feedback from health center staff in the development of this
material.
♦ Determine use of prescription pads one month, six months and one year after
implementation.
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Exhibit A iPHHS,,
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
Federal Block Grant Provisions
- --.--- —1— FISCAL REPORTING
Pursuant to Chapter 1343, Statutes of.1982, Contractor shall submit to the Sate on a quarterly basis, a Grant
Financial Status Report and a Grant Cash Transactions Report. These reports are due on the 20th calendar day
following the end of each quarter (Oct. 20. Jan. 20, April 20,and July 20),and shall be prepared by Contractor
in a format prescribed by the Sate. These reports must be supported by detailed accounting records watch
Contractor will maintain for a period of three years and make available on request of the Sate.
Reports not submitted in a timely manner will result in appropriate administrative action. Such action may
include but not be limited to disallowance of invoices or cancellation of the contract.
2. AUDITS
Contractor shall be subject to financial and compliance audits not less frequently thin specified by applicable.
federal or state law. Such audits shall be in accordance with guidelines specified by the State and by the United
States General Accounting Office. Audits will be performed by state auditors except that audits approved by the
State Controller's Office consistent with the criteria established by the Office of Management and Budget Circular
A-102 may be performed by qualified local government auditors or by independent public accountanm
3. RESTRICTIONS ON USE OF PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT FUNDS
Contractor shall not use funds provided by this contract to:
L Provide inpatient services,
b. Make cash payments to intended recipients of health services,
C. Purchase or improve land, purchase,construct or permanently improve any building or other facility,
or purchase major medical equipment.
d. Satisfy any requirement for the expenditure of nonfederal funds as a condition for the receipt of
federal funds,
e. Provide financial assistance to any entity other than a public or nonprofit private entity,or
f. Purchase equipment for EMS Systems.
4. PUBLIC PARTICIPATION
Contactor agrees that, in the interest of enhancing public participation and knowledge,meetings of its governing
authority will be open to the public. Meetings which deal with legal or personnel matters shall be exempt. Notice
of each public meeting shall be in a newspaper of general circulation not less than once a week for two
consecutive weeks.
S. NOTIFICATION
Contractor agrees to maintain a mailing list of interested individuals and organizational contacts. If there is a
reduction in federal funds supporting the program under which this contract is financed, the contractor agrees to
inform these individuals and organizational contacts of the funding reduction.
CRU Inetrvcminal Bulletin No.07 f2/B91
' 6d�ff A(fl
MTE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
ADDITIONAL PROVISIONS
(FOR FEDERALLY FUNDED SUBVENTION AIDALOCAL ASSISTANCE
COST REIMBURSEMENT CONTRACTS/GRANTS)
1. Equal Ooportunity Clause
a. The Contractor will .not discriminate against any employee or applicant for
employment because of race, color, religion, sex, national origin, physical or mental
handicap, or age. The Contractor will take affirmative action to ensure that qualified
applicants are employed, and that employees are treated during employment
without regard to their race, color religion, sex, national origin, physical or mental
handicap, or age. Such action shall Include, but not be limited to, the following:
employment, upgrading, demotion or transfer; recruitment or recruitment advertising;
layoff or termination; rates of pay or other.forms of compensation; and career
development opportunities and selection for training;including apprenticeship. The
Contractor agrees to post in conspicuous places, available to employees and
applicants for employment,notices to be provided by the Federal Government or the
State, setting forth the provisions of the Equal Opportunity clause and the
Rehabilitation Act of 1973. Such notices shall state the Contractor's obligation under
the law to take affirmative action to employ and advance in employment qualified
applicants without discrimination based on their race, color, religion, sex, national
origin, physical or mental handicap, or age, and the rights of applicants and
employees.
b. The Contractor will,in bll solicitations or advertisements for employees placed by or on
behalf of the Contractor, state that all qualified applicants will receive consideration
for employment without regard to race,color, religion,sex, national origin, physical or
mental handicap,or age.
c. The Contractor will send to each labor union or representative of workers with which
he or she has a collective bargaining agreement or other contract or understanding a
notice, to be provided by the Federal Government or the State, advising the labor
union or worker's representative of the Contractor's commitments under this Equal
Opportunity clause and shall-post copies of the notice in conspicuous places
available to employees and applicants for employment.
d. The Contractor-will comply with all provisions of the Rehabilitation Act of 1973 and of
the Federal Executive Order No. 11246 as amended,and of the rules,regulations,and
relevant orders of the Secretary of Labor.
e. The Contractor will furnish all information and reports required by Federal Executive
Order No. 11246 as amended and the Rehabilitation Act of 1973, and by the rules,
regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit
access to his books, records, and accounts by the contracting agency and the
Secretary of Labor for purposes of investigation to ascertain compliance with such
rules,regulations and orders.
CARS A MucNa bAeAn Na 02 01/Dp
f. In the event of the Contractor's noncompliance with the requirements of this Equal
Opportunity clause or with any federal rules, regulations, or orders which are
referenced in this clause, this contract may be canceled, terminated, or suspended in
whole or in port and the Contractor may be declared ineligible for further federal or
state contracts in accordance with procedures authorized in Federal Executive Order
No. 11246 as amended and such other sanctions may be imposed and remedies
Invoked as provided in Federal Executive Order No. 11246 as amended, or by rule,
regulation, or order of the Secretary of Labor, or as otherwise provided by law.
g. The Contractor will Include the provisions of paragraphs [a] through [g] in every
subcontract or purchase order unless exempted by rules, regulations, or orders of the
Secretary of Labor issued pursuant to Federal Executive Order No. 11246 as amended,
or Section 503 of the rehabilitation Act of 1973,.so that such provisions will be binding
upon each subcontractor or vendor. The Contractor will take such action with
respect to any subcontract or purchase order as the Director of the Office of Federal
Contract Compliance Programs or the State may direct as a means of enforcing such
provisions including sanctions for noncompliance-provided, however that in the event
the Contractor becomes Involved in, or Is threatened with, litigation with a
subcontractor or vendor as a result of such direction by the State, the Contractor may
request in writing to the State, who, in turn, may request the United States to enter Into
such litigation to protect the Interests of the State and of the United States.
2. Travel and Per Mom
Any reimbursement for necessary traveling and per diem shall be at rates not to exceed
those amounts paid to the State's represented employees under collective bargaining
agreements currently in effect. No travel outside the State of California shall be reimbursed
unless prior written authorization Is obtained from the State.
3. Procurement Requirement
a. Prior authorization in writing by the State will be required before the Contractor will be
reimbursed for any purchase order or subcontract exceeding $2,500 for any articles,
supplies, equipment, or services or for any fee, or other payment, for consultation of
three hundred fifty dollars ($350) or more per day. The Contractor must provide In its
request for authorization all particulars necessary for evaluation of the necessity or
desirability of Incurring such cost, and as to the reasonableness of the price or cost.
For purchases of any said articles, supplies, equipment, services, or for consultant fees
exceeding such minimum amount, three competitive quotations must be submitted
with the request, or the absence of bidding must be adequately justified.
b. If other than the lowest bidder or a sole-source provider is selected, all documents
used In contractor selection must be presented in writing to the State for prior
approval before awarding any contract, and maintained for possible future audit as
specified In paragraph 7 below.
c. The terms 'purchase order" and 'subcontract as used in the above paragraph 3a
only, excludes: (a) purchase orders not exceeding $2,500, and (b) subcontracts or
purchase orders for public utility services at rates established for uniform applicability
to the general public.
-2-
Ed"A(F)
4. Standards of work
The Contractor agrees that the performance- of work and services pursuant to the
requirements of this contract shall confirm to high professional standards.
5. Fumishina of Property by the State or Purchase of Procertv with State or federal Funds
a. (1) All equipment, material, supplies, or property of any kind purchased from funds
- -- -- - - advanced or reimbursed or furnished by the State under the terms of this
contract and not fully consumed In the performance of the contract shall be the
property of the State and shall be.subject to the provisions of this paragraph (a),
as well as paragraphs(b),(c),and(d)below.
If the Equipment Line item in the budget or In any other paragraph of this
contract,exceeds S 10,000 or more,the provisions of subparagraph b shall apply.
(2) Inventory and Disposition
(a) Contractor shall, at the request of the State, submit an inventory of
equipment furnished or purchased under the terms of this contract. Such
Inventory will be required not more frequently than annually.
(b) At the termination of this contract, the Contractor shall provide a final
Inventory to the State and shall at that time query the State as to the State's
requirements, Including the manner and method, in returning said
equipment to the State. Rnal disposttlon of such equipment shall be at state
expense in accordance with instructions from the State to be issued
immediately after receipt of the final inventory.
(3) Motor Vehicles
(a) If,under the provisions of paragraph (2) above,any part of such property is
motor vehicles, the State Office of Procurement shall purchase said motor
vehicles for and on behalf of the Contractor. The provisions of clause (5b)
below are applicable to this paragraph concerning motor vehicles.
(b) If, under the provisions of paragraphs (2) or (3) above, any part of such
property Is motor vehicles..the State authorizes the Contractor to use said
motor vehicles under the terms and conditions of this contract for purposes
of this contract only, and in accordance with the provisions of
subparagraphs (c)through (f) below.
(c) It is mutually understood that the State of California shall be the legal owner
of said vehicles and the Contractor shall be the registered owner.
(d) Upon return of such motor vehicles to the State, Contractor shall deliver to
State all necessary documents of title to enable proper transfer of
marketable title to the State.
(e) Contractor agrees that all operators of motor vehicles listed in said
agreement shall hold a valid State of California driver's license. In the event
12 or more passengers are to be carried in any one vehicle listed in said
agreement,a Class 2 driver's license will also be required.
(f) Contractor shall furnish to the State a certificate of insurance stating that
there is liability insurance presently in effect for the Contractor of not less
than $500=per occurrence for bodily injury and property damage liability
combined.
-3-
The certificate of insurance must include provisions(D and M,stating that:
(D The insurer will not cancel the Insured's coverage without 30 days prior
written notice to the State.
(Ii) The State of California,Its officers,agents,employees,and servants are
Included as additional Insureds, but only insofar as the operations
under this contract are concerned.
Contractor agrees that the bodily Injury liability insurance herein provided
for shall be In effect at all times during the term of this contract. In the event
said Insurance coverage expires at any time or times during the term of this
contract, Contractor agrees to provide at least thirty (30) days prior to sold
expiration date a new certificate of Insurance evidencing insurance
coverage as provided for herein for not less than the remainder of the term
of the contract, or for a period of not less than one (1) year. New
certificates of insurance are subject to the approval of said Department of
General Services, and Contractor agrees that no work or services shall be
performed prior to the giving of such approval. In the event Contractor fails
to keep in effect at all times insurance coverage as herein provided, State
may, In addition to any other remedies it may have,terminate this contract
upon the occurrence of such event.
b. if the Equipment line item budget In this contract is $10,000 or more, the State shall
purchase said equipment through its Office of Procurement. The cost of the
procurement of equipment will be deducted from the contract amount. Contractor
shall submit to the State a separate list of the equipment specifications. State will pay
vendor directly for equipment purchases and title to the equipment will remain with
the State. The equipment will be delivered either to the Contractor's address as
stated In the contract unless notified by the Contractor in writing.
c. (1) Title to state property shall not be affected by the Incorporation or attachment
thereof to any property not owned by the State, nor shall such state property, or
any part thereof, be or become a fixture or lose its identity as personality by
reason of affixation to any reatty.
(Z Unless otherwise provided herein, the State shall not be under any duty or
obligation to restore or rehabilitate. or to pay the cost of the restoration or
rehabilitation of the Contractor's facility or any portion thereof which is affected
by removal of any state property.
(3) The Contractor shall maintain and administer,In accordance with sound business
practice, a program for the utilization, maintenance, repair, protection, and
preservation of state property so to assure its full availability and usefulness for the
performance of this contract. The Contractor shall take all reasonable steps to
comply with all appropriate directions and Instructions which the State may
prescribe as reasonably necessary for the protection of state property.
d. For equipment only. Before equipment purchases made by the Contractor are
reimbursed by the State,the Contractor must submit paid vendor receipts identifying
the purchase price, description of the Item, serial number, model number, and
location where equipment will be used during the term of this agreement. Said paid
receipts will be attached to Contractors invoices submitted to the State.
-4-
E~AM
6. Income Restrictions
TheContractoragrees that any refunds, rebates, credits, or other amounts (including any
interest thereon) accruing to or received by the Contractor under this contract shall be
paid by the Contractor to the State, to the extent that they are properly allocable to costs
for which the Contractor has been reimbursed by the State under this contract.
7,`Examination of Accounts. Audit. Records. and Subcontract Language
a. The Contractor shall maintain books, records, documents, and other evidence,
accounting procedures, and practices, sufficient to reflect property all direct and
indirect costs of whatever nature claimed to have been incurred in the performance
of this contract, including any matching costs and expenses. The foregoing
Constitutes"records"for the purpose of this clause.
b. The Contractor's facility or office or such part thereof as may be engaged in the
performance of this contract and his records shall be subject at all.reasonable times
to inspection, audit, and reproduction by the State or any of its duly authorized
representatives, including the Comptroller General of the United States.
c. The Contractor shall preserve and make available his records (t) for a period of three
years from the date of final payment under this contract, and (11) for such longer
period, If any, as is required by applicable statute, by any other clause of this contract,
or by subparagraphs (1) or (2) below.
(1) If this contract Is completely or partially terminated, the records relating to the
work terminated shall be preserved and made available for a period of three
years from the date of any resulting final settlement.
(2) If any litigation, claim, negotiation, audit, or other action involving the records
has been started before the expiration of the three-year period, the records shalt
be retained until completion of the action and resolution of all Issues which arise
from It, or until the end of the regular three-year period, whichever is later.
d. The Contractor further agrees to Include In all his subcontracts hereunder a written
agreement with sold subcontractor or vendor,the following clause:
"(Name of Vendor or Subcontractor) agrees to maintain and preserve, until three
years after termination of (Contractor's name) agreement or contract with the State
of California, and to permit the State or any of Its duly authorized representatives,
including the Comptroller General of the United States, to have access to and
examine and audit any pertinent books, documents, papers, and records of (name of
subcontractor or vendor) related to this(purchase order or subcontract).'
8. Covenant Against Contingent Fees
The Contractor warrants that no person or selling agency has been employed or retained
to solicit or secure this .controct upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide
established commercial or selling agencies maintained by the Contractor for the purpose
of securing business. for breach or violation of this warranty, the State shall have the right
to annul this contract without liability or in its discretion to deduct from the contract price or
consideration, or otherwise recover, the full amount of such commission, percentage,
brokerage, or contingent fee.
-5-
9. inspection
The State, through any authorized representatives, has the right at all reasonable times to
inspect or otherwise evaluate the work performed or being performed hereunder including
subcontract supported activities and the premises In which it Is being performed. if any
Inspection or evaluation Is made by the State of the_premises of the Contractor or a
subcontractor, the Contractor shall provide and shall require his subcontractors to provide
all reasonable facilities and assistance for the safety and convenience of the state
representatives in the performance of their duties. All inspections and evaluations shall be
performed in such a manner as will not unduly delay the work.
10. Nondiscrimination In Services_ Benefits. and Facilities
a. The Contractor will not discriminate in the provision of services because of race, color,
creed, national origin, sex, age, or physical or mental handicap as provided by state
and federal law.
b. For the purpose of this contract, distinctions on the grounds of race, color, creed,
national origin, sex, age, or physical or mental handicap Include, but are not limited
to, the following: denying a participant any service or providing a benefit to a
participant which Is different, or is provided in a different manner or at a different time
from that provided to other participants under this contract; subjecting a participant
to segregation or separate treatment in any matter related to his receipt of any
service; restricting'a participant in any way in the enjoyment of any advantage or
privilege enjoyed by others receiving any service or benefit; treating a participant
differently from others in determining whether he satisfied any admission, enrollment
quota, eligibility, membership, or other requirement or condition which individuals must
meet In order to be provided any service or benefit; the assignment of times or places
for the provision of services on the basis of the race, color, creed, or national origin of
the participants to be served.
c. The Contractor will take affirmative action to ensure that Intended beneficiaries are
provided services without regard to race, color, creed, national origin, sex, age, or
physical or mental handicap.
d. The Contractor agrees that complaints alleging discrimination in the delivery of
services by the Contractor or his or her subcontractor because of race, color, national
origin, creed, sex, age, or physical of mental handicap will be resolved by the State
through the Department of Health Services' Affirmative Action/Discrimination
Compliant Process.
e. The Contractor shall, subject to the approval of the Department of Health Services,
establish procedures under which service participants are Informed of their rights to file
a complaint alleging discrimination or a violation of their civil rights with the
Department of Health Services.
f. The Contractor shall operate the program or activity in such a manner that It Is readily
accessible to and usable by mentally or physically handicapped persons pursuant to
45 Code of Federal Regulations, Parts 84,Sections 84.21 and 84.22.
g. The Contractor shall keep records, submit required compliance reports, and permit
state access to records In order that the State can determine compliance with the
nondiscrimination requirements pursuant to 45 Code of Federal regulations, Parts 80,
84, and 90, Sections 80.6, 84.61, and 90.42.
-6-
E~A(n
11. Einal Invoice—Final Report—Retention of Funds
If a final report is required by this.contract, 10 percent of the face amount of the contract
or 50 percent of the final invoice, whichever is the larger amount, but not to exceed $3,000,
shall be withheld until after receipt by the State of a report satisfactory to the State.
12.__.Officials Not to Benefit
No member of or delegate to Congress or the State Legislature shall be admitted to any
share or part of this contract, or to any benefit that may arise therefrom; but this provision
shall not be construed to extend to this contract if made with a corporation for its general
benefit.
13. Rights in Data
a. Subject Data. As used in this clause, the term "Subject Data" means writings, sound
recordings, pictorial reproductions, drawings, designs or graphic representations,
procedural manuals, forms, diagrams, work flow charts, equipment descriptions, data
files and data processing or computer programs, and works of any similar nature
(whether or not copyrighted Or copyrightable) which are first produced or developed
under this contract. The term does not include financial reports, cost analyses, and
similar Information incidental to contract administration.
b. Federal Government and State Rights. Subject only to the provisions of "c" below, the
Federal Government and State may use, duplicate, or disclose in any manner and for
any purpose whatsoever, and have or permit others to do so, all Subject Data
delivered under this contract.
c. License to Copyrighted Data. In addition to the Federal Government and State rights
as provided in [b] above, with respect to any subject data which may be
copyrighted; the Contractor agrees to and does hereby grant to the Federal
Government and State a royalty-free, nonexclusive and Irrevocable license
throughout the world to use, duplicate, or dispose of such data In any manner for
State or Federal Government purposes and to have or permit others to do so.
Provided, however, that such license shall be only to the extent that Contractor now
has, or prior to completion or final settlement of this contract may acquire, the right to
grant such license without becoming liable to pay compensation to others solely
because of such grant.
d. Relation to Patents. The State reserves a license on patent rights in any contract
Involving research or developmental, experimental, or demonstration work with
respect to any discovery or Invention which arises under this contract.
e. Marking and Identification. The Contractor shall mark all Subject Data with the
number of this contract and the name and address of the contractor or
subcontractor who generated the data. The Contractor shall not affix any restrictive
markings upon any Subject Data, and if such markings are affixed, the Federal
Government or State shall have the right at any time to modify, remove, obliterate, or
Ignore any such markings.
f. Subcontractor Data. Whenever any Subject Data Is to be obtained from a
subcontractor under this contract, the Contractor shall use this same clause In
subcontract without alteration, and no other clause shall be used to enlarge or
diminish the Federal Government's or State's rights in the subcontractor Subject Data.
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g. Deferred Ordering and Delivery of Data. The Federal Government or State shall have
the right to order, at any time during the performance of this contract, or within two
years from either acceptance of all Items (other than data) to be delivered under this
contract or termination of this contract, whichever is later, any Subject Data and any
data not called for in the schedule of this contract but generated in performance of
the contract, and the Contractor shall promptly prepare and deliver such data as is
ordered. if the principal investigator is no longer associated with the Contractor, the
Contactor shall exercise Its best efforts to prepare and deliver such data as is ordered.
The Federal Government's or State's right to use data delivered pursuant to this
paragraph (g) shall be the same as the rights In Subject Data as provided in "b"
above. The Contractor shall be relieved of obligation to furnish data pertaining to an
item obtained from a subcontractor upon the expiration of two years from the.date
he accepts such items. When data, other than Subject Data, Is delivered pursuant to
this paragraph (g), payment shall be made, by equitable adjustment or otherwise,for
converting the data Into the prescribed form, reproducing It or preparing it for
delivery. The terms of such payment shall be agreed upon-In writing by the
Contractor and the State and/or Federal Government, whichever ordered the
production of the data.
14. Disabled Veterans and Veterans of the Vietnam Era
a. The Contractor will not discriminate against any employee or applicant for
employment because he or she is a disabled veteran or veteran of the Vietnam era in
regard to any position for which the employee or applicant for employment is
qualified. The Contractor agrees to take affirmative action to employ, advance In
employment, and otherwise treat qualified disabled veterans and veterans of the
Vietnam era without discrimination based upon their disability or veterans status In all
employment practices such as the following: employment upgrading, demotion or
transfer, recruitment, advertising, layoff or termination, rates of pay or other forms of
compensation, and selection for training, Including apprenticeship.
b. The Contractor agrees that all suitable employment openings of the Contractor which
exist at the time of the execution of this contract and those which occur during the
performance of this contract, including those not generated by this contract and
Including those occurring at an establishment of the Contractor other than the one
wherein the contract is being performed but excluding those of Independently
operated corporate affiliates,shall be listed at an appropriate local office of the state
employment service system wherein the opening occurs. The Contractor further
agrees to provide such reports to such local office regarding employment openings
and hires as may be required.
State and local government agencies holding federal contracts of $10,000 or more
shall also list all their suitable openings with the appropriate office of the state
employment service, but are not required to provide those reports set forth In
paragraphs*d*and"e".
c. Listing of employment openings with the employment service system pursuant to this
clause shall be made at least concurrently with the use of any other recruitment
source or effort and shall Involve the normal obligations which attach to the placing
of bona fide job order, including the acceptance of referrals of veterans and
nonveterans. The listing of employment openings does not require the hiring of any
particular job applicant or from any particular group of job applicants, and nothing
herein Is intended to relieve the Contractor from any requirements In Executive Orders
or regulations regarding nondiscrimination In employment.
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Fctft"A(F)
d. The reports required by paragraph "b" of this clause shall include, but not be limited to,
periodic reports which shall be filed at least quarterly with the appropriate local office
or, where the Contractor has more than one hiring location in a State, with the central
office of that state employment service. Such reports shall indicate for each hiring
location (1) the number of individuals hired during the reporting period, (2) the
number of nondisabled veterans of the Vietnam era hired, (3) the number of disabled
-
---------------veterans of the Vietnam era hired, and (4) the total number of disabled veterans
hired. The reports should include covered veterans hired for the on-the-job training
under 39 U.S.C. 1787. The Contractor shall submit a report within 30 days after the end
of each reporting period wherein any performance is made on this contract
identifying data for each hiring location. The Contractor shall maintain at each hiring
location copies of the reports submitted until the expiration of one year after final
payment under the contract, during which time these reports and related
documentation shall be made available, upon request, for examination by any
authorized representatives of the Federal Contracting Officer, the State, or the
Secretary of Labor. Documentation would include personnel records respecting Job
openings, recruitment, and placement.
e. Whenever the Contractor becomes contractually bound to the listing provisions of this
clause, it shall advise the employment service system in each state where it has
establishments of the name and location of each hiring location in the state. As long
as the Contractor is contractually bound to these provisions and has so advised the
state system, there Is no need to advise the state system of subsequent contracts. The
Contractor may advise the state system when it is no longer bound by this contract
clause.
f. This clause does not apply to the listing of employment openings which occur and are
filled outside the 50 states, the District of Columbia, Puerto Rico, Guam, and the
Virgin Islands.
g. The provisions of paragraphs 'b", 'c', "d', and 'e' of this clause do not apply to
openings which the Contractor proposes to fill from within his own organization or to fill
pursuant to a customary and traditional employer-union hiring arrangement. This
exclusion does not apply to a particular opening once an employer decides to
consider applicants outside of his own organization or employer-union arrangement
for that opening.
h. As used in this clause:
(1) 8AI1 suitable employment openings' Includes, but Is not limited to, openings which
occur in the following job categories: production and nonproduction: plant and
office; laborers and mechanics; supervisory and nonsupervisory; technical and
executive, administrative, and professional openings that are compensated on a
salary basis of less than $25,000 per year. This term includes full-time employment,
temporary employment of more than three days' duration, and part-time
employment. It does not include openings which the Contractor proposes to fill
from within his own organization or to fill pursuant to a customary and traditional
employer-union hiring arrangement nor openings in an educational Institution
which are restricted to students of that institution. Under the most compelling
circumstances, an employment opening may not be suitable for listing, including
such situations where the needs of the Federal Government cannot reasonably
be otherwise supplied, where listing would be contrary to national security, or
where the requirement of listing would otherwise not be for the best Interest of
the Federal Government.
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(2) 'Appropriate office of the state employment service system' means the local
office of the federal/state national system of public employment offices with
assigned responsibility for serving the area where the employment opening is to
be filled, Including the District of Columbia, Guam, Puerto Rico, and the
Virgin Islands.
(_3) 'Openings which the Contractor proposes to fill from within his own organization"
means employment openings for which no consideration will be given to persons
outside the Contractor's organization (including any affiliates, subsidiaries, and
the parent companies) and includes any openings which the Contractor
proposes to fill from regularly established'recall'lists.
(4) 'Openings which the Contractor proposes to fill pursuant to a customary and
traditional employer-union hiring arrangement" means employment openings
which the contractor proposes to fill from union halls which is part of the
customary and traditional hiring relationship which exists between the Contractor
and representatives of his'employees.
1. The Contractor agrees to comply with the rules, regulations,..and relevant orders of the
Federal Secretary of Labor Issued pursuant to the Act.
J. In the event of the Contractor's noncompliance with the requirements of this clause,.-
actions
lause,.actions for noncompliance may be taken in accordance with the rules, regulations,
and relevant orders of the Federal Secretary of Labor issued pursuant to the Act.
k. The Contractor agrees to post In conspicuous places available to employees and
applicants for employment notices in a form to be prescribed by the Director of the
Office of Federal Contract Compliance Programs, provided by or through the
contracting Officers or State. Such notices shall state the Contractor's obligation
under the law to take affirmative action to employ and advance In employment
qualified disabled veterans and veterans of the Vietnam era for employment, and the
rights of applicants and employees.
I. The Contractor will notify each labor union or representative of workers with which It
has a collective bargaining agreement or other contract understanding that the
Contractor is bound by terms of the Vietnam Era Veteran's Readjustment Assistance
Act and Is committed to take affirmative action to employ and advance In
employment qualified disabled veterans and veterans of the Vietnam era.
m. The Contractor will include the provisions of this clause in every subcontract or
purchase order of $10,000 or more unless exempted by rules, regulations, or orders of
the Federal Secretary of Labor issued pursuant to the Act, so that such provisions will
be binding upon each subcontractor or vendor. The Contractor will take such action
with respect to any subcontract or purchase order as the Director of the Office of
Federal Contract Compliance Programs may direct to enforce such provisions,
Including action for noncompliance.
15, Glean Air and Water
a. (Applicable only if the contract Is not with a sole source vendor of products or
services, or if it exceeds$5,000.)
The Contractor agrees under penalty of perjury (it,he,she) is not In violation of any
order or resolution which Is not subject to review promulgated by the State Air
Resources Board or an air pollution district.
•10-
Ex WU A(F)
The Contractor agrees under penalty or perjury (it, he,she) is not subject to cease and
desist order which is not subject to review Issued pursuant to Section 13301 of the
Water Code for violation of waste discharge requirements or discharge prohibitions, or
Is not finally determined to be in violation of provisions of federal law relating to air or
water pollution.
(Applicable only If the contract or subcontract exceeds $100,000 or the contract is not
otherwise exempt under 40 CFR 15.5.)
The Contractor agrees as follows:
(i) To comply with all the requirements of Section 114 of the Clean Air act as
amended (42 U.S.C. 7401 et seq., as amended by Public Law 95-95), and section
308 of the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq., as
amended by Public Law 92-500),respectively, relating to Inspection, monitoring,
entry, reports, and information, as well as all other requirements specified in
Section 114 and Section 308 of the Air Act and the Water Act, respectively, and
all regulations and guidelines issued to implement those Acts before the award of
this contract.
(2) That no portion of the work required by this contract will be performed in a facility
listed on the Environmental Protection Agency List of Violating Facilities on the
date when this contract was awarded unless and until the Environmental
Protection Agency eliminates the name of such facility or facilities from such
listing.
(3) To use his best efforts to comply with clean air standards and clean water
standards at the facility In which the contract Is being performed. The terms used
In this paragraph have the following meanings:
(a) The term 'clean air standards' means any enforceable rules, regulations,
guidelines standards, limitations, orders, controls, or prohibitions or other
requirements which are contained in, Issued under, or adopted pursuant to
the Clean Air Act.
(b) The term'clean water standards' means any enforceable limitation, control,
condition, prohibition, standard, or another requirement which is
promulgated pursuant to the Clean Water Act or contained In a permit
Issued to a discharger-by EPA or by the State under an approved program
as authorized by Section 402 of the Clean Water Act (33 U.S.C. 1342), or by
a local government to ensure compliance with pretreatment regulations as
required by Section 307 of the Clean Water Act (33 U.S.C. 1317), and
regulations Issued pursuant thereto.
(c) In addition to compliance with clean air and water standards, the term
compliance shall also mean compliance with a schedule or plan ordered or
approved by a court of competent jurisdiction, the Environmental Protection
Agency, or an air or water pollution control agency in accordance with the
requirements of the Clean Air Act and the Federal Water Pollution Control
Act.
(4) As a condition for the award of a contract the applicant or contractor shall notify
the State of the receipt of any communication from the Assistant Administrator
for Enforcement, U.S. EPA Indicating that a facility to be utilized for the contract Is
under consideration to be listed on the EPA List of Violating Facilities. Prompt
notification shall be required prior to contract award.
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(5) To report violations to the State and to the Assistant Administrator for
Enforcement: -
(6) , To Insert the substance of the provisions of paragraph [b] Into any nonexempt
subcontract, Including this paragraph [b6], and to take such action as the
Federal Government may direct as a means of enforcing such provisions.
16. Utilization of Small Business and Minority and Women Owned Business Enterprise
a. It is a federal policy to award a fair share of contracts to small, minority, and women
owned business firms. The State Legislature has declared that a fair proportion of the
total purchases and contracts or subcontracts for property and services for the State
be placed with small minority and women owned business enterprises.
b. A firm shall qualify as a small business If it meets the requirements specified In
Government Code Section 14837. -
c. The Contractor hereby agrees to carry out this policy in the awarding of subcontracts
to the fullest extent consistent with efficient contract performance. As used In this
contract, the term 'minQrity business enterprise" means a business concern (1) which Is
at least 51 percent owned by one or more minority group members or women, or In
the case of publicly owned business, at least 51 percent of the stock of which is
owned by one or more minority group members or women; and (2) whose
management and dally business operations are controlled by one or more such
individuals. A minority group member Is a person who is Black, Aslan, Hispanic, Filipino,
Polynesian, American Indian, or Alaskan Native. 'Control,'as used in this clause, means
exercising the power to make policy decisions.
d. Contractors acting in good faith may rely on written representations by their
subcontractors regarding their status as minority business enterprises in lieu of an
Independent investigation.
17. printing
If Printing or other reproduction work of more than an incidental and minor dollar amount Is
a reimbursable item in this contract, It shall be printed or produced by the State Printer. The
State Printer may, at his sole option, elect to forego said work and delegate the work to the
private sector. If the State Printer prints or produces said work, or the State obtains the
printing or other work through the Office of State Procurement, the cost will be deducted
from said contract amount. This requirement does not apply to normal in-house copying
necessary for routine business matters of the Contractor.
18. prior Approval of Training Seminars_Workshops. r Conferences
Contractor shall obtain prior state approval over the location, costs, dates, agenda, instructors.
Instructional materials,and attenclees at any reimbursable training seminar, workshop or conference,
and over any reimbursable publicity oreducational materials to be made avallable for distribution.
The Contractor shall acknowledge the support of the State whenever public zing the work under the
contract in any media. This paragraph does not apply to necessary staff meetings to conduct routine
business matters.
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EatMDN A(i)
19.
a. The Contractor and his or her employees agents, or subcontractors shall protect from
unauthorized disclosure names and other identifying information concerning persons
either receiving services pursuant to this contract or persons whose names or
Identifying information become available or are disclosed to the Contractor, his/her
------employees, agents, or subcontractors as a result of services performed under this
contract, except for statistical information not identifying any such person.
b. The Contractor, his/her employees, agents, or subcontractors shall not use such
identifying Information for any purpose other than carrying out the Contractor's
obligations under this contract.
C. The Contractor, his/her employees, agents, or subcontractors shall promptly transmit
to the State all requests for disclosure of such identifying information not emanating
from the client or person.
d. The Contractor shall not disclose, except as otherwise specifically permitted by this
contract or authorized by the client, any such Identifying information to anyone other
than the State without prior written authorization from the State.
e. For purposes of this paragraph, identity shall Include, but not be limited to, name,
identifying number, symbol, or other identifying particular assigned to the individual,
such as finger or voice print or a photograph.
20. National Labor Relations Board Certification
(not applicable if Contractor is a public entity.)
Contractor, by signing this agreement, does swear under penalty of perjury that no more
than one final unappealable finding of contempt of court by a federal court has been
Issued against Contractor within the immediately preceding two-year period because of
the Contractor's failure to comply with an order of a federal court which orders the
Contractor to comply with an order of the National Labor Relations Board.
21. Documents and Written Reports
Any document or written report prepared as a requirement of this agreement shall contain,
In a separate section preceding the main body of the document, the number and dollar
amounts of all contracts and subcontracts relating to the preparation of such document or
report, If the total cost for work by nonemployees of the State exceeds$5.,000.
22. Resolution of Direct Service Contract Disputes
a. If the Contractor believes there Is a dispute or grievance between the Contractor and
the State, the procedures set forth in Chapter 2.1, Sections 20201 through 20205, of
Title 22, of the California Code of Regulations, shall be followed.
b. If the Contractor wishes to appeal the decision of the Deputy Director for Public
Health or his/her designee, the Contractor shall follow the procedures set forth In
Division 25.1 (commencing with Section 38050) of the Health and Safety Code and
the regulations adopted thereunder. (Title 1, Subchapter 2.5 commencing with
Section 251, California Code of Regulations.)
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c. Disputes arising out of an audit or examination of a contract not covered by subdivision
(a)of Section 20204,of Chapter 2.1,Title 22,of the California Code of Regulations, and
for which no procedures for appeal are provided In statute, regulation or the contract
shall be handled in accordance with the procedures identified in Sections 51016
through 51047,Title 22,California Code of Regulations.
2V 1 financial and Compliance Audit of Nonprofit Entitles
- - -(Applicable only If Contractor Is a private,nonprofit-entity)-
a. Definitions within this paragraph are defined in Section 38040 of the Health and Safety
Code,which,by this reference,is made a part hereof.
b. Contractor agrees to obtain an annual single, organization wide, financial and
compliance audit. The audit shall be conducted In accordance with the requirements
specified in the Federal Office of Management and the Budget (OMB) Circular A-133,
'Audits of institutions of Higher Education and Other Nonprofit Organizations.'
c. References to 'Federal' In OMB Circular A-133 shall be considered to man 'Federal
and/or State' in contracts where State funds are present either alone or in conjunction
with Federal funds.
d. The audit shall be completed by the 15th day of the fifth month following the end of the
Contractors fiscal year. Two copies of the audit report shall be delivered to the State
program funding this contract. The report shall be due within 30 days after the
completion of the audit.
e. If the contractor receives less than S25A00 per year from the State, the audit shall be
conducted biennially, unless there Is evidence of fraud or other violation of state law in
connection with this contract. This requirement takes precedence over the OMB A-1 33
section which exempts from Federal audit requirements any nonprofit institution
receiving less than $25,000 per year.
f. The cost of such audit may be included in the funding for this contract up to the
proportionate amount this contract represents of the Contractor's total revenue.
g. The State, or Its authorized designee including the Auditor-General, is responsible for
conducting contract performance audits which are not financial and compliance
audits.
h. Nothing in this contract limits the State's responsibility or authority to enforce State law or
regulations,procedures,or reporting requirements arising pursuant thereto.
1. Nothing In this paragraph limits the authority of the State to make audits of this contract,
provided however, that If independent audits arranged for by Contractor meet
generally accepted governmental auditing standards, the State shall rely on those
audits and any additional audit work shall build upon the work already done.
J. The State may, at its option,direct its own auditors to perform the single audit described
In OMB Circular A-133. The State's auditors shall meet the independence standards
specified in Government Auditing Standards. The audit shall be conducted in
accordance with OMB Circular A 133 so as to satisfy all State and Federal requirements
for a single organization wide audit.
24. Contract Amendments
a. This contract may be amended by mutual agreement between the parties and, If
required by Government Code, Section 11010.5, or Public Contract Code, Section
10355,the amendment shall be subject to the approval of the Department of General
Services,unless otherwise exempted. ,
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E■ndt A(F)
b. If any amendment to this contract has the effect of increasing the monetary amount
of the contract or an agreement by the State to Indemnify or save harmless the
Contractor, his agents or employees, the amendment shall be approved by the
Department of General Services, unless otherwise exempted.
25. Evaluation of Contractors
The Contractor's performance under-this contract shall be evaluated at the conclusion of
the term of this contract. The evaluation shall include, but not be limited to:
a. Whether the contracted work or services were completed as specified in the contract
and reasons for and amount of any cost overruns.
b. Whether the contracted.work or services met the quality standards specified In the
contract.
c. Whether the.Contractor,fulfilled all requirements of the contract.
d. Factors outside the control of the Contractor which caused difficulties in. Contractor
performance. The evaluation of the Contractor shall not be a public record.
26. Conflict of Interest—Current and Former State Employees
a. Current State Officers and Employees
(1) Contractor shall not utilize In the performance of this contract any state officer or
employee in the state civil service or other appointed state official unless the
employment, activity, or enterprise is required as a condition of the officer or
employee's regular state employment. Employee In the state civil service Is
defined to be any person legally holding a permanent or Intermittent position in
the state civil service.
(2) If any state officer or employee is utilized or employed in the performance of this
contract, Contractor shall first obtain written verification from the State that the
employment, activity, or enterprise is required as a condition of the officer's,
employee's, or official's regular state employment and shall keep sold verification
on file for three years after the termination of this contract.
(3) Contractor may not accept occasional work from any currently employed state
officer, employee, or official.-
(4)
fficial.(4) If Contractor accepts volunteer work from any currently employed State officer,
employee, or official, Contractor may not reimburse, or otherwise pay or
compensate, such person for expenses incurred, including, without limitation,
travel expenses, per diem, or the like. In connection with volunteer work on
behalf of contractor.
(5) Contractor shall not employ any state officers, employees, or officials who are on
paid or unpaid leave of absence from their regular state employment.
(6) Contractor or anyone having a financial Interest In this contract may not
become a state officer, employee, or official during the term of this contract.
Contractor shall notify each of Its employees, and any other person having a
financial interest in this contract that It Is unlawful under Public Contract Code,
Section 10410 for such person to become a state officer, employee, or official
during the term of this contract unless any relationship with the Contractor giving
rise to a financial Interest, as an employee or otherwise, is first terminated.
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(7) Occasional or one-time reimbursement of a state employee's travel expenses Is
not acceptable.
(Citation: Public Contract Code, Section 10410)
b. Former State Officers and Employees
_(1)_—Contractor shall not utilize In the performance of this contract any formerly
employed person of any state agency or department that was employed under
the state civil service, or otherwise appointed to serve in the State Government, If
that person was engaged in any negotiations, transactions, planning,
arrangement, or any part of the decision-making process relevant to the
contract while employed in any capacity by any state agency or department.
This prohibition shall apply for a two-year period beginning on the date the
person left state employment.
(2) Contractor shall not utilize within 12 months from the date of separation of
services, a former employee of the contracting state agency or department if
that former employee was employed In a policy making position in the some
general subject area as the proposed contract within the. 12-month period prior
to the employee leaving state service.
(Citation: Public Contract Code,Section 10411)
c. Failure to Comply with Subparts'a'or'b'
(1) If Contractor violates any provision of Subparts 'a' or 'b' above, such action by
Contractor shall render this contract void, unless the violation is technical or
nnnsuhstantive_
(Citation: Public Contract Code,Section 10420)
27. Single audit act of 19U (applicable only if Contractor Is a governmental entity)
In accordance with Public Law 98-502 and OMB Circular A-128, it Is stipulated between the
parties hereto that:
a. The cost of the single audit will be charged to the federal assistance program
providing funds for this agreement on a 'Fair Share' basis. The amount-chargeable to
federal assistance programs for the cost of the single audit Is calculated based on the
ratio of federal expenditures to total expenditures of the Contractor. The State's share
of the single audit cost under this contract is based upon the ratio of federal funds
received under this agreement to total federal funds received by the Contractor
each fiscal year.
b. The Contractor shall Include a clause in any contract the Contractor enters Into with
the audit firm doing the single audit to provide access by the State or Federal
Government to the working papers of the Independent auditor who prepares the
single audit for the Contractor.
c. Federal or State auditors shall have 'expanded scope auditing' authority to conduct
specific program audits during the same period in which_ a single audit is being
performed, but the audit report has not been Issued. The federal or state auditors
shall review and have access to the current audit work being conducted and will not
apply any testing or review procedures which have not been satisfied by previous
audit work that has been completed.
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&SCM A(�
The term 'expanded scope auditing' is applied and defined in the U.S. General
Accounting Office (GAO) Issued Standards for Audit of Governmental Organizations,
Programs,Activities and Functions,better known as the'yellow book.'
28.
Contractor shall provide written notice to the State at least 30 days prior to any changes to
the Contractor's current legal name.
29. NoycffiQD
If the Contractor proposes any novation agreement,the State shall act upon the proposal
within 60 days after receipt of the written proposal. The State may review and consider the
proposal,consult and negotiate with the Contractor,and accept or reject all or part of the
proposal. Acceptance or rejection may be made orally within the 60 day period, and
confirmed In writing within five days.
30. Drug-Free Workplace
Contractor certifies to the State that it will provide a drug-free workplace by doing all of
the following:
a. Publishing a statement notifying employees that the unlawful manufacture,
distribution, dispensation, possession, or use of a controlled substance Is prohibited in
the person's or organization's workplace and specifying the actions that will be taken
against employees for violations of the prohibition.
b. Establishing a drug-free awareness program to Inform employees about all of the
following:
(1) The dangers of drug abuse in the workplace.
(2) The person's or organization's policy of maintaining a drug-free workplace.
(3) Any available drug counseling, rehabilitation, and employee assistance
programs.
(4) The penalties that may be Imposed upon employees for drug abuse violations.
c. Requiring that each employee engaged in the performance of the contract or grant
be given a copy of the statement required by subdivision(a)and that,as a condition
of employment on the contract or grant,the employee agrees to abide by the terms
of the statement.
d. Contractor agrees this contract may be subject to suspension of payments or
termination of this contract,or both,and the contractor may be subject to debarment,
In accordance with the requirements of the Government Code Section 8350,et seq.,If
the Department determines that any of the following has occurred:
(1) The contractor or grantee has made a false certification.
(2) The contractor violates the certification by failing to carry out the requirements of
subdivisions(a)through(c)above.
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• 31. Debarment-and Suspension Requirements
Contractor agrees to comply with the debarment and suspension requirements as found in
7 Code of Federal Regulations,Part 3017,or as amended.
32. LIMITATIONS ON PAYMENTS TO INFLUENCE
CERLAIN FEDERAL ACTIONS AND RELATED DI_=LOSURES
(a) Definitions. As used in this Exhibit.
- J 'Agency; as defined in 5 U.S.C. 552(f), Includes Federal executive departments and
agencies as well as independent regulatory commissions and Government
"corporations,as defined in 31 U.S.C. 9101(1).
'Covered Federal action'means any of the following Federal actions:
(1) The awarding of any Federal Contract;
(2) The.making of any Federal grant,
(3) The making of any Federal ban.
(4) . The entering into of any cooperative agreement; and
(5) The extension, continuation, renewal, amendment, or modification of any
Federal contract.grant,loan,or cooperative agreement.
Covered Federal action does not include receiving from an agency a commitment
providing for the United States to insure of guarantee a loan.
'Indian tribe' and `tribal organization' have the meaning provided in section 4 of the
Indian Setf-Determination and Education Assistance Act (25 U.S.C. 45013). Alaskan
Natives are included under the definitions of Indian tribes in the Act.
'Influencing or attempting to influence' means making, with the intent to influence,
any communication to or appearance before an officer or employee of any agency,
a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress,in connection with any covered Federal action.
'Local government' means a unit of government in a State and, if chartered,
established,or otherwise recognized by a State for the performance of a government
duty. including a local public authority, a special district, an intrastate district, a
council of governments, a sponsor group representative organization, and any other
instrumentality of a local government.
'Officer or employee of an agency' Includes the following individuals who are
employed by an agency:
(1) An individual who is appointed to a position In the Government under title 5.
U. S. Code,including a position under a temporary appointment,
(2) A member of the uniformed services as defined in section 101(3), title 37,
U. S. Code;
(3) A special government employee as defined in section 202, title 18, U. S. Code;
and
(4), An individual who is a member of a Federal advisory committee, as defined by
the Federal Advisory Committee Act,title 5,U.S. Code,Appendix 2.
-18-
'Person' means an individual, corporation, company, association, authority, firm,
partnership,society,State, and local government, regardless of whether such entity is
operated for profit or not for profit. This term excludes an Indian tribe, tribal
organization,or any other Indian organization with respect to expenditures specifically
permitted by other Federal law.
'Reasonable compensation' means,with respect to a regularly employeed officer or
employee of any person, compensation that is consistent with the normal
compensation for such officer or employee for work that is not furnished to, not
--- - funded-by,-or not furnished in cooperation with the Federal Government.-
'Reasonable
overnment:'Reasonable payment' means, with respect to professional and other technical
services, a payment in an amount that is consistent with the amount normally paid for
such services in the private sector.
'Recipient' includes the Contractor or Grantee,and all subcontractors or subgrantees
at any tier in connection with a Federal contract, grant, or other Federally funded
activity. The term excludes an Indian tribe, tribal or gan¢ation, or any other Indian
organization with respect to expenditures specifically permitted by other Federal law.
'Regularly employed' means, with respect to an officer or employee of a person
requesting or receiving a Federal contract, an officer or employee who is employed
by such person for at least 130 working days within 1 year immediately preceding the
date of the submission that initiates agency consideration of such person for receipt of
such contract. An officer or employee who is employed by such person for less than
130 working days within 1 year immediately preceding the date of the submission that
initiates agency consideration of such person shall be considered to be regulartr
employed as soon as he or she is employed by such person for 130 working days.
'State' means a State of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, a territory or possession of the United States, an
agency or Instrumentality of a State, and a multi-State, regional, or interstate entity
having governmental duties and powers.
b Prohibition.
(1) Section 1352 of title 31, U. S. Code provides in part that no appropriated funds
may be expended by the recipient of a Federal contract, grant, loan, or
cooperative agreement to pay any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in
connection with any of the following covered Federal actions: The awarding of
any Federal contract, the making of any Federal grant, the making of any
Federal loan, entering Into of any cooperative agreement, and the extension.
continuation, renewal, amendment, or modification of any Federal contract,
grant,loan,or cooperative agreement.
(2) The prohibition does not apply as follows:
(i) Agency and legislative Raison by Own Employees.
(A) The prohibition on the use of appropriated funds, in paragraph (b)(1),
does not apply in the case of a payment of reasonable compensation
made to an officer or employee of a person requesting or receiving a
Federal contract If the payment is for agency and legislative liaison
activities not directly related to a covered Federal action.
-19- -
(B) For purposes of paragraph (b)(2)(1)(A), providing any information
specifically requested by an agency or Congress is allowable at any
time.
(C) For purposes of paragraph (b)(2)(1)(A) of this section, the following
agency and legislative liaison activities are allowable at any time only
where they are not related to a specific solicitation for any covered
Federal action:
(1) Discussing with any agency (including.individual demonstrations)
the qualities and characteristics of the person's products or
services,conditions or terms of sale,and service capabilities;and,
(0) Technical discussions and other activities regarding the
application or adaptation of the person's products or services for
an agency's use.
(D) For purposes of paragraph (b)(2)(i)(A) of this section, the following
agency and legislative Ikiison activltles are allowable only where they
are prior to formal solicitation of any covered Federal action:
(t) Providing any information not specifically requested but necessary
for an agency to make an informed decision about initiation of a
covered Federal action;
(ID Technical discussions regarding the preparation of an unsolicited
proposal prior to its official submission;and,
(iii) Capability presentations by persons seeking awards from an
agency pursuant to the provisions of the Small Business Act, as
amended by Public Law 95-507 and other subsequent
amendments.
(Q Only those activities expressly authorized by paragraph (b)(2)(i) are
allowable under paragraph(b)(2)(i).
Professional and technical services by Own Employees.
(A) The prohibttion on the use of appropriated funds, in paragraph (b)(1),
does not apply in the case of any reasonable payment of reasonable
compensation made to an officer or employee of a person requesting
or receiving a Federal contract or an extension, continuation, renewal,
amendment, or modification of a Federal contract if payment is for
professional or technical services rendered directly in the preparation,
submission or negotiation of any bid, proposal, or application for that
Federal contract or for meeting requirements imposed by or pursuant
to law as a condition for receiving that Federal contract.
-20-
(B) For purposes of paragraph (b)(2)(11)(A), 'professional and technical
services' shall be limited to advice an analysis directly applying any
professional or technical discipline. For example, drafting of a legal
document accompanying a bid or proposal by a lawyer is allowable.
Similarly, technical advice provided by an engineer on the
performance or operational, capability of a piece of equipment
rendered directly in the negotiation of a contract is allowable.
However, communications with the intent to influence made -by a
professional (such as a licensed lawyer) or a technical person (such as
a licensed accountant)are not allowable under this section unless they
provide advice and analysis directly applying their professional or
technical expertise and unless the advice or analysis is rendered
directly and solely in the preparation,submission or negotiation of a
covered Federal action. thus, for example, communications with the
intent to influence made by a lawyer that do not provide legal advice
and analysis directly and solely related to the legal aspects of his or her
client's proposal, but generally advocate one proposal over another
are not allowable under this section because the lawyer is not
providing professional legal services. Similarly,communications with the
intent to influence made by an engineer providing an engineering
analysis prior to the preparation or submission of a bid or proposal are
not allowable under this section since the engineer is providing
technical services but not directly in the preparation, submission or
negotiation of a covered Federal action.
(C) Requirements imposed by or pursuant to law as a condition for
receiving a covered Federal award Include those required by law or
regulation,or reasonably expected to be required by law or regulation,
and any other requirements In the actual award documents.
(D) Only those services expressly authorized by paragraph (b)(2)(ii) are
allowable under paragraph(b)(2)Cu).
(iii) Reporting for Own Employees.
No reporting is required with respect to payments of reasonable
compensation made to regularly employed officers or employees of a
person.
(iv) Professional and technical services by Other than Own Employees.
(A) The prohibition on the use-of appropriated funds, in paragraph (b)(1),
does not apply in the case of any reasonable payment to a person,
other than an officer or employee of a person requesting or receiving a
covered Federal action, If the payment is for professional or technical
services rendered directly In the preparation,submission,or negotiation
of any bid, proposal, or application for that Federal contract or for
meeting requirements imposed by or pursuant to law as a condition for
receiving that Federal contract.
-21-
(B) For purposes of paragraph (b)(2)(iv)(A), 'professional and technical
services' shall be limited to advice and analysis directly applying any
professional or technical discipline. For example, drafting of a legal
document accompanying a bid or proposal by a lawyer is allowable.
Similarly, technical advice provided by an engineer on the
performance or operational capability of a piece of equipment
rendered directly in the negotiation of a contract Is allowable.
However, communications with the intent to influence made by a
professional (such as a licensed lawyer) or a technical person-(such as
a licensed accountant)are not allowable under this section unless they
provide advice and analysis directly applying their professional or
technical expertise and unless the advice or analysis is rendered
directly and solely in the preparation, submission or negotiation of a
covered Federal action. Thus, for example, communications with the
intent to influence made by a lawyer that do not provide legal advice
or analysis directly and solely related to the legal aspects of his or her
client's proposal, but generally advocate one proposal over another
are not allowable under this section because the lawyer is not
providing professional legal services. Similarly,communications with the
intent to Influence made by an engineer providing an engineering
analysis prior to the preparation or submission of a bid or proposal ore
not allowable under this section since the engineer is providing
technical services but not directly in the preparation, submission or
negotiation of a covered Federal action.
(C) Requirements imposed. by or pursuant to law as a condition for
receiving a covered Federal award include those required by low or
regulation,or reasonably expected to be required by law or regulation,
and any other requirements in the actual award documents.
(D) Persons other than officers or employees of a person requesting or
receiving.a covered Federal action include consultants and trade
associations.
(E) Only those services expressly authorized by paragraph (b)(2)(ty) of this
section are allowable under paragraph(bXZ00.
(v) The prohibition on use of Federal appropriated funds does not apply to
influencing activities not in connection with a specific covered Federal
action. These activities include those related to legislation and regulations
for a program versus a specific covered Federal action.
(55 Fed. Reg. 24542 (June 15, 1990).)
(c) Certification and Disclosure.
(1) Each person (or recipient) who requests or receives a contract, subcontract,
grant,or subgront,which Is subject to section 1352 of title 31,United States Code,
and which exceeds $100.000 at any tier, shall file a certification (in the form set
forth in Attachment 1, consisting of one page, entitled 'Certification Regarding
Lobbing ) that the recipient has not made, and will not make, any payment
prohibited by paragraph(b)of this Exhibit.
-22-
(2) Each recipient shall file a disclosure (in the form set forth in Attachment 2
consisting of three pages, entitled 'Standard Form-LLL-'Disclosure of Lobbying
Activities') if such recipient has made or has agreed to make any payment using
nonappropriated funds (to include profits from any covered Federal action) in
connection with a contract or grant or any extension or amendment of that
contract or grant, which would be prohibited under paragraph (b) of this Exhibit
If paid for with appropriated funds.
(3) Each recipient shall file a disclosure form at the end of each calendar quarter in
which there occurs any event that requires disclosure or that materially affects -
the accuracy of the information contained in any disclosure form previously filed
by such person under-paragraph (c)(2). An event that materially affects the
accuracy of the Information reported includes:
(i) A cumulative increase of $25.000 or more in the amount paid or expected
to be paid for influencing or attempting to influence a covered.Federal
action; or
(ii) A change in the person(s) or individual(s) influencing or attempting to
influence a covered Federal action; or,
(ii0 A change in the officer(s), employee(s), or Member(s) contacted for the
purpose of influencing or attempting to Influence a covered Federal action.
(4) Each person (or recipient) who requests or receives from a person referred to in
paragraph (c)(1) of this section a contract, subcontract, grant, or subgrant
exceeding $100,000 at any tier under a contract or grant shall file a certification,
and a disclosure form,If required,to the next tier above.
(5) All disclosure forms(but not certifications)shall be forwarded from tier to tier until
received by the person referred to in paragraph (1) of this section. That person
shall forward all disclosure forms to the State agency.
(d) Agreement. In accepting any contract,grant,subcontractor subgrant subject to this
Exhibit,the recipient(and any person submitting an offer for such a contract or grant)
agrees not to make any payment prohibited by law or this Exhibit.
(e) Penalties.
(1) Any person who makes an expenditure prohibited under paragraph (b) of this
Exhibit shall be subject to a civil penalty of not less than $10,00.0 and not more
than$100A00 for each such expenditure.
(2) Any person who fails to file or amend the disclosure form to be filed or amended
It required by this Exhibit,shall be subject to a civil penalty of not less than $10A00
and not more than$100,000 for each such failure.
(3) Recipients may rely without liability on the representations made by their
subcontractors or subgrantees in the certification and disclosure form.
(f) Cost allowability. Nothing in this Exhibit Is to be interpreted to make allowable or
reasonable any costs which would be unallowable or unreasonable in accordance
with Part 31 of the Federal Acquisition Regulation. Conversely,costs made specifically
unallowable by the requirements in this Exhibit will not be made allowable under any
of the provisions of Part 31 of the Federal Acquisition Regulation.
-23-
Aftaahrndnt`l
STATE OF CALIFORNIA
DEPARTMENT OF HEALTH SERVICES
CERTIFICATION REGARDING LOBBYING
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned,to any person for Influencing or attempting to Influence an officer or employee of an agency
of the United States Government, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress In connection with the making, awarding or entering Into of this
Federal contract, Federal grant, or cooperative agreement, and the extension, continuation, renewal,
amendment,or modification of this Federal contract,grant,or cooperative agreement.
(2) If any funds other than Federal approprlated.funds have been paid or will be paid to any person
for Influencing or attempting to Influence an officer or employee of any agency of the United States
Government,a Member of Congress,an officer or employee of Congress,or an employee of a Member of
Congress in connection with this Federal contract,grant,or cooperative agreement,the undersigned shall
complete and submit Standard Form LLL, 'Disclosure of Lobbying Activities' In accordance with Its
Instructions.
(3) The undersigned shaft require that the language of this certification be Included in the award
documents for all subawards at all tiers (inciuding subcontractors,subgrants,and contracts under grants
and cooperative agreements) of $100A00 or more;and that all subreciplents shall certify and disclose
accordingly.
This certification Is a material representation of fact upon which reliance was placed when this transaction
was made or entered Into. Submission of this certification Is a prerequisite for making or entering into this
transaction Imposed by Section 1352,Title 31, U. S. Code. any person who fails to file the required
certification shall be subject to,a civil penalty of not less than$10=and not more than$100.000 for each
such failure.
No"a Co oda P;i Nom•of F*= sgnr,v fa Ca*octa
CW*0Cl/G0N Nunbw for cortat«
tet• m.
After execution by or on Behalf of Contractor,please return to:
Department of Health Services
(Name of the DHS program providing the funds)
P.O.Banc 942732
714 P Street
Sacramento,CA 94234-7320
CIA raftuoftne Moen No.13(10/91) -24-
Contract#: 95-23399
Agency Name: Contra Costa Prevention Program
Exhibit B. Budget.
Oct. 1, 1995 to Sept. 30, 1996
PerceMlonthIy..Salary Requested
Time Range Amount
A. Personnel Expenses
1. Chronic Disease Coord. 20%$3045-3701 $7,770.00
2. Student Worker 10%$6-7/hr. $2,000.00
3. Sr.Clerk 407.$2044-2609 $12,160.00
4. Health Ed. Specialist 100%$2434-2959 $33,440.00
5. Public Info. Specialist 30%$1529-2906 $9,450.00
6. Admin. Interns 50%$11-12/hr. $9,000.00
Subtotal County Salaries & Wages $73,820.00
Fringe Benefits Perm. $18,762.00
10.84%-31%
Total Personnel Expenses $92,582.00
B. Indirect Exps (10% alad) 10.00% $9,258.00
C. Operating Expenses
General Expenses
Communications (includes Voice Mail) $150.00
Duplicating/Printing/Production Costs $700.00
Incentives $500.00
Travel $1,200.00
Contractual $2,610.00
Supplies $800.00
Total Operating Expenses $5,960.00
Grand Total $107,800.00
STATE OF CALIFORNIA
NONDISCRIMINATION CLAUSE (OCP-1) Exhibit C ,
STD.17A(REV.2-93)
1. During the performance of this contract,contractor and its subcontractors shall not unlawfully discriminate,
harass or allow harassment,against any employee or applicant for employment because of sex,race,color,
ancestry, religious creed,national origin,physical disability(including HIV and AIDS),mental disability,
-- --- - -medical-condition-(cancer), age (over 40),marital status, and-denial of family care leave. Contractors and
subcontractors shall insure that the evaluation and treatment of their employees and applicants for
employment are free from such discrimination and harassment.Contractor and subcontractors shall comply
with the provisions of the Fair Employment and Housing Act(Government Code,Section 12900 et seq.)and
the applicable regulations promulgated thereunder(California Code of Regulations,Title 2,Section 7285.0
et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing
Government Code,Section 12990(a-f),set forth in Chapter 5 of Division 4 of Title 2 of the California Code
of Regulations are incorporated into this contract by reference and made a part hereof as if set forth in full.
Contractor and its subcontractors shall give written notice of their obligations under this clause to labor
organizations with which they have a collective bargaining or other agreement.
2. This contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the contract.
_ e .
' StvnL of CUV-4o 1 W h.and Wotfoe Ae.—Y DepartnerA of HedRh Sw Acft
Exhibit: D
FEDERAL CONTRACT FUNDS
1 It is mutually understood between the parties that this contract may have
been written before ascertaining the availability of congressional
appropriation of funds for the mutual benefit of both parties in order to
avoid program and fiscal delays which would occur if the contract were
executed after that determination was made.
2. This contract is valid and enforceable only if sufficient funds are made
available to the States by the United States Government for the Fiscal Year
.1995-96 for the purposes of this program. In addition, this contract is subject
to any additional restrictions, limitations, or conditions enacted by the
Congress or any statute enacted by the Congress which may affect the
provisions, terms, or funding of this contract in any manner.
3. It is mutually agreed that if the Congress does not appropriate sufficient
funds for the program, this contract shall be amended to reflect any
reduction in funds.
4. The Department has the option to void the contract with 30-days written
notice onto amend the contract to reflect any reduction of funds.
C" �D_"t,NO.UdOA5>
State of California—Health and Welfare Agency Department of Health Services
Contract Management Section
Exhibit E
Contract Uniformity
(Applicable to nonprofit organizations only)
Pursuant to the provisions of Article 1.8 (commencing with Section 242)of Chapter 2 of Part 1 of Division 1 of the
Health and Safety Code, the Department of Health Services, an agency of the State of California, sets forth the
following policies,procedures,and guidelines:regarding fringe benefits in direct-service (subvention)contracts.
1. As used in this agreement, fringe benefits shall mean an employment benefit given by one's employer to an
employee—in addition to one's regular or normal wages or salary. As used herein, pension plan costs shall be
construed as a fringe benefit.
2. As used herein,fringe benefit does not include:
a. Compensation for personal services paid currently or accrued by the Contractor for services of employees
rendered during the"term of this agreement which is identified as regular or normal salaries and wages
b. Director's and executive committee member's fees
c. Incentive awards
d. Allowances for off-site pay
e. Incentive pay
f. Location allowances
g. Hardship pay
h. Cost-of-living differentials
3. To be an allowable fringe benefit,it is agreed the cost must meet the following criteria:
a. Be necessary and reasonable for the performance of the contract
b. Be determined in accordance with generally accepted accounting principles
c. Be consistent with policies that apply uniformly to all activities of the Contractor
4. Specific allowable fringe benefits are identified as:
a. Fringe benefits representing regular compensation paid to employee for vacation,sick leave,jury duty,
military training,and the like provided they are absorbed by all organizational activities in proportion to
the relative amount of time or effort actually devoted to each
b. Fringe benefits in the form of employer contributions for payroll taxes, employee health and
unemployment insurance, worker's compensation, and employer's share of pension plans provided they
are granted in accordance with established written organization policies
5. It is agreed by both parties that any and all fringe benefits shall be at cost.
CMS instructional Bulletin No. 11 (5/88)
xhibit F
4 -Department of Health Services
Contract Management Unit
SHORT-TERM TRAVEL REIMBURSEMENT INFORMATION _
EFFECTIVE JULY 1, 1993
1. The following rate policy is to be applied for reimbursing the travel expenses of persons under contract:
a, Short Term Travel is defined as a 24-hour period, and less than 31 consecutive days. Starting time is
either one hour prior to takeoff time or from the time a person leaves his or her home, whichever is
earlier.
b. Contractors on travel status for more than one 24-hour period and less than 31 consecutive days may
claim a fractional part of a period of more than 24 hours. Consult the chart appearing on page 2 of
this bulletin to determine the reimbursement allowance.
(1) Lodging: Statewide Rate (no receipts) $24.99
Statewide Rate (with receipts) Actual costs up to $79.00 plus tax.
Reimbursement for actual lodging expenses exceeding the above amounts may be allowed with
the advance written approval of the Deputy Director of the Department of Health Services or his
or her designee. Receipts are required.
(2) Meals/Supplemental Expenses (with or without receipts):
Breakfast $5.50 Dinner $17.00
Lunch 9.50 Incidentals 5.00
c. Out-of-state travel.may only be reimbursed if such travel has been stipulated in the contract and has
been approved in advance by the program with which the contract is held. For out-of-state travel,
contractors may be reimbursed actual lodging expenses, supported by a receipt, and may be
reimbursed for meals and supplemental expenses each 24-hour period computed at the rates Fisted In
b(2) above.
d. In computing allowances for continuous periods of travel of less than 24 hours, consult the chart
appearing on page 2 of this bulletin.
e. No meal or lodging expenses will be reimbursed for any period of travel that occurs within normal
working hours.
2. If any of the reimbursement rates stated herein change by law, an amendment to the contract must be
entered Into to incorporate the new rates. The effective date of any new rates will be determined by the
effective date of the contract amendment.
3. For transportation expenses, the contractor must retain receipts for parking; taxi, airline, bus, or rail tickets;
car rental; or any other travel receipts pertaining to each trip for attachment to an Invoice as
substantiation for reimbursement. Reimbursement may be requested for commercial carrier fares; private.
car mileage; parking fees; bridge tolls; taxi, bus, or streetcar fares; and auto rental fees when
substantiated by a receipt.
4. Note on.Use of Autos: If a contractor uses his or her car for transportation, the rate of pay will be 24 cents
per mile. if, however, the contractor claims that his or her actual cost Is over 24 cents per mile, the
contractor may claim up to 30 cents per mile provided the contractor types on an Invoice and certifies
the following: "1 certify that the actual cost of operating my vehicle was equal to or greater than the rate
1 have claimed." If a contractor uses his or her car "in Ileu of" air fare, the air coach fare will be the
maximum paid by the state. The contractor must provide a cost comparison upon request by the state.
Gasoline and routine automobile repair expenses are not reimbursable. Amounts claimed in excess of
24 cents per mile may be reported to the Internal Revenue Service.
5. The contractor may be required to furnish details surrounding each period of travel. Travel detail may
include but not be limited to: departure and return times, destination points, miles driven, mode of
transportation, etc.
6. Contractors are to consult with the program with which the contract is held to obtain specific Invoicing
procedures.
CMU Bulletin No.01 01/93) 1 of 2
q • . r
SHORT-TERM TRAVEL REIMBURSEMENT GUIDE
IF LENGTH OF TRAVEL IS IF THIS CONDITION EXISTS CONTRACTOR MAY CLAIM
Less than 24 hours Travel period began,at least one Breakfast
hour before the regularly scheduled
work day began:
Example: A contractor may claim breakfast If, during a period of travel,
he or she begins their travel at 7:00 a.m. or earlier and their normal
working day was scheduled to begin at 8:00 a.m.
Less than 24 hours --------------------------------------------------- No lunch
Less than 24 hours Travel period ends at least one Dinner
hour after the regularly scheduled
work day ends.
24 hours A contractor is on travel status for Breakfast, lunch, and dinner
a full 24-hour period (determined
begin and end times).
Last fractional part of Return at or after 9:00 a.m. Breakfast
more than 24 hours
Example: if a contractor returns the last day of a trip of more than 24 hours
at or after 9:00 a.m., a breakfast allowance may be claimed.
Last fractional part of Return at or after 2:00 p.m. I Lunch
more than 24 hours.
Example: If a contractor returns the last day of a trip of more than 24 hours
at or after 2:00 p.m., a lunch allowance may be claimed.
Last fractional part of Return at or after 7:00 p.m. I Dinner
more than 24 hours.
Example: if a contractor returns the last day of a trip of more than 24 hours
at or after 7:00 p.m., a dinner allowance may be claimed.
CMU Bulletin No.01 (1/93) 2 of 2