HomeMy WebLinkAboutMINUTES - 12191995 - C85 TO: BOARD OF SUPERVISORS Contra
FROM: JOAN V. SPARKS, DIRECTOR Costa
COMMUNITY SERVICES DEPARTMENT o
County
U
DATE: November 30, 1995
SUBJECT:
APPROVAL OF HEAD START FAMILY CHILD CARE COORDINATOR CONTRACT FOR
THE COMMUNITY SERVICES DEPARTMENT
SPECIFIC REOUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
I. RECOMMENDED ACTION:
APPROVE and AUTHORIZE the Community Services Director or her designee to execute on
behalf of the County, Contract #38-314-2 with Sue W. Mead in the amount of $33,820 to provide
Head Start Family Child Care (FCC) Coordinator services from January 1, 1996 through
December 31, 1996.
II. FINANCIAL EUPACT:
This Contract will use federal funds provided by the Department of Health and Human Services,
Administration for Families and Children (AFC). No County funding is required.
III. REASONS FOR RECOMMENDATIONS/BACKGROUND:
In September, 1994 the County Administrator's Office approved and the Purchasing Agent
executed a contract with Sue W. Mead for Head Start Family Child Care Demonstration Project
services for the period from September 30, 1994 through September 29, 1995. The contract was
amended effective August 1, 1995 to expand the contract services to include duties of the FCC
Demonstration Project Coordinator. On September 12, 1995 the Board approved Contract
Amendment/Extension Agreement #38-314-1 with Sue W. Mead for continuation of contractor's
services through December 31, 1995.
The Community Services Department has since requested continued funding of the FCC services in
its Head Start Grant proposal from the AFC. Standard Contract #38-314-2 continues contractor's
services as FCC Coordinator.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOR COMMITTEE
APPROVE OTHER
SIGNATURES:
ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
CONTACT: Joan Sparks, 313-7350
CC: CAO ATTESTED 9 I
CSD PHIL BATCHELOR,CLERK OF THE BOARD OF
SUPERVISORS AND COUNTY ADMINISTRATOR
C
BY ,DEPUTY
M082 (10/88)
UPAD .
Contra Costa County Number 38-314-2
Standard Form 1/87 STANDARD CONTRACT Fund/Org# 1439
(Purchase of Services) Account #_23 10
1. Contract Identification. Other #
Department: Community Services
Subject: Head Start Family Child Care Coordinator
2. Parties. The County of Contra Costa, California (County),. for its Department named above, and the
following named Contractor mutually agree and promise as follows:
Contractor: SUE W. MEAD
Capacity: Self-employed individual Taxpayer ID # 569-70-5520
Address: 3221 Longview Road, Antioch, California 94509
3. Term. The effective date of this Contract is January 1, 1996 it terminates unless sooner
terminated Decemember 31, 1996 as provided herein.
4. Payment Limit. County's total payments to Contractor under this Contract shall not exceed
$ 33,820
5. County's Obligations. County shall make to the Contractor those payments described in the Payment
Provisions attached hereto which are incorporated herein by reference, subject to all the terms and conditions
contained or incorporated herein.
6. Contractor's Obligations. Contractor shall provide those services and carry out that work described in the
Service Plan attached hereto which is incorporated herein by reference, subject to all the terms and conditions
contained or incorporated herein.
7. General and Special Conditions. This Contract is subject to the General Conditions and Special Conditions
(if any) attached hereto, which are incorporated herein by reference.
8. Project. This Contract implements in whole or in part the following described Project, the application and
approval documents of which are incorporated herein by reference:
9. Legal Authority. This Contract is entered into under and subject to the following legal authorities: California
Government Code: Sections 26227 and 31000.
10. Signatures. These signatures attest the parties' agreement hereto:
COUNTY OF CONTRA COSTA, CALIFORNIA
BOARD OF SUPERVISORS ATTEST: Phil Batchelor, Clerk of the Board of
Supervisors and County Administrator
By
Chairman/Designee Deputy
CONTRACTOR
By By
_\k N, Z' N,
XXA
(Designate business capacity A) esignate bu iness cap ity B)
Note to Contractor: For Corporations(profit or nonprofit), the contract must be signed by two officers. Signature A must be that of the president or vice-president and
Signature B must be that of the secretary or Assistant secretary(Civil Code Section 1190 and Corporations Code Section 313). All signatures must be acknowledged as set forth
o page two.
t
Contra Costa County Standard Form(Rev. 1/95)
APPROVALS/ACKNOWLEDGMENT
Number 38-314-2
APPROVALS
RECOMMENDED BY DEPARTMENT FORM APPROVED
COUNTY COUNSEL
J
By By
Designee Deputy
APPROVED: COUNTY ADMINISTRATOR
By:
Designee
ACKNOWLEDGMENT
STATE OF CALIFORNIA )
ss.
COUNTY OF CONTRA COSTA )
On , before me,
(insert name and title of the officer), personally appeared
personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s)
whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the
instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the
instrument.
WITNESS MY HAND AND OFFICIAL SEAL.
(Seal)
Signature
ACKNOWLEDGMENT(by Corporation,Partnership,or Individual)
(Civil Code§1189)
Contra Costa County PAYMENT PROVISIONS Standard Form 6/90
(Fee Basis Contracts)
Number 38-314-2
1, Payment Amounts. Subject to the Payment Limit of this Contract and subject to the following
Payment Provisions, County will pay Contractor ,the following fee as full compensation for all
services, work, expenses or costs provided or incurred by Contractor:
[Check one alternative only.]
[ ] a. $ monthly, or
[X] b. $ 16.00 per unit, as defined in the Service Plan (see Paragraph II), or
[ ] c. $ after completion of all obligations and conditions herein.
2. Payment Demands. Contractor shall submit written demands. Said demands shall be made on
County Demand Form D-15 and in the manner and form prescribed .by County. Contractor shall
submit said demands for payment no later than 30 days from the end of the month in which the
contract services upon which such demand is based were actually rendered. Upon approval of said
payment demands by the head of the County Department for which this Contract is made, or his
designee, County will make payments as specified in Paragraph 1. (Payment Amounts) above.
3. Penalty for Late Submission. When Contractor. fails to submit to County a timely demand for
payment as specified in Paragraph 2. (Payment Demands) above, and as a result of Contractor's late
submission the County is unable to obtain reimbursement from the State of California or otherwise; to
the extent the County's recovery of funding is prejudiced, County shall not pay Contractor for such
services, even though such services were fully provided.
4. Right to Withhold. County has the right to withhold payment to the Contractor when, in the opinion
of the County expressed in writing to the Contractor, (a) the Contractor's performance, in whole or in
part, either has not been carried out or is insufficiently documented, (b) the Contractor has neglected,
failed or refused to furnish information or to cooperate with any inspection, review or audit of its
program, work or records, or (c) Contractor has failed to sufficiently itemize or document its
demand(s) for payment.
5. Audit Exceptions. Contractor agrees to accept responsibility for receiving, replying to, and/or
complying with any audit exceptions by appropriate County, State or Federal audit agencies occurring
as a result of its performance of this Contract. Contractor also agrees to.pay_to the County within 30
days of demand by County the full amount of the County's obligation, if any, to the State and/or
Federal government resulting from any audit exceptions, to the extent such are attributable to the
Contractor's failure to perform properly any of its obligations under this Contract.
Initials:
Contractor County
SERVICE PLAN
Number 38-314-2
I. Contractor's Obligations.
A. Contractor's Qualifications. Contractor hereby certifies and assures that she is
specially trained, experienced, and competent to perform special Head Start
Family Child Care (FCC) Program services, including consultation, technical
assistance, and training. Contractor shall render such special services for County
at certain times and locations specified by the head of the County Department
for which this contract is made, or his/her designee as stated herein.
B. Service Activities. Under the supervision of the Head Start Assistant Program
Manager, Contractor shall provide FCC Program Coordinator services for the
Head Start Family Child Care Program. In providing services hereunder,
Contractor shall:
1. Recruit Head Start Family Child Care providers, families, and children
for the program;
2. Plan, implement, and/or coordinate the training of Head Start Family
Child Care providers;
3. Visit each Head Start Family Child Care home weekly to monitor
services and provide technical assistance and support;
4. Coordinate the delivery of Head Start services by maintaining
communications with the Head Start Family Child Care Providers and
relevant Head Start program staff;
5. Attend scheduled meetings regarding the Head Start Family Child Care
Demonstration Program Grant;
6. Prepare required quarterly reports;
7. Prepare and submit Grant Application documents, as required; and
8. Perform other duties as required.
C. Progress Reports. Contractor shall submit periodic progress reports, written or
oral, upon request to County's Head Start Program Manager or her designee,
detailing Contractor's accomplishments in providing services hereunder.
Initials:
Contractor County
D. Automobile Liability Insurance. During the entire term of this contract and
any extension or modification thereof, Contractor shall keep in effect a policy or
policies of motor vehicle liability insurance for use Contractor makes of a
private automobile in the performance of this contract, as required by the State,
and shall provide suitable evidence (e.g., copy of policy declarations page) of
such coverage.
II. Payment and Expenses. For the purpose of payment to the Contractor, one service
unit shall be defined as one (1) hour of work. Contractor's fee, as set forth in
Paragraph 1 of the Payment Provisions, includes full compensations for all services and
work. In addition, County shall reimburse Contractor for the reasonable cost of
allowable expenses actually incurred in the provision of services hereunder for needed
supplies, approved conference and training fees, and for the daily use of a private
automobile following arrival at the work site at the rate of$0.30 per mile, but not to
exceed a total of$540 for such allowable expenses.
Initials:
Contractor County
Contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
1. Compliance. with Law. Contractor shall be subject to and comply with all Federal, State and local
laws and regulations applicable with respect to its performance under this Contract, including but not
limited to, licensing, employment and purchasing practices; and wages, hours and conditions of
employment, including nondiscrimination.
2. Inspection. Contractor's performance, place of business and records pertaining to this Contract are
subject to monitoring, inspection, review and audit by authorized representatives of the County, the
State of California, and the United States Government.
3. Records. Contractor shall keep and make available for inspection and copying by authorized
representatives of the County, the State of California, and the United States Government, the
Contractor's regular business records and such additional records pertaining to this Contract as may be
required by the County.
a. Retention of Records. The Contractor shall retain all documents pertaining to this Contract
for five years from the date of submission of Contractor's final payment demand or final Cost
Report; for any further period that is required by law; and until all Federal/State audits are
complete and exceptions resolved for this contract's funding period. Upon request, Contractor
shall make these records available to authorized representatives of the County, the State of
California, and the United States Government.
b. Access to Books and Records of Contractor, Subcontractor. Pursuant to Section
1861(v)(1) of the Social Security Act, and any regulations promulgated thereunder, Contractor
shall, upon written request and until the expiration of four years after the furnishing of services
pursuant to this Contract, make available to the Secretary of Health and Human Services or to
the Comptroller General, or any of their duly authorized representatives, this Contract and
books, documents, and records of Contractor that are necessary to certify the nature and extent
of all costs and charges hereunder.
Further, if Contractor carries out any of the duties of this Contract through a subcontract with a value
or cost of$10,000 or more over a twelve-month period, such subcontract shall contain a clause to the
effect that upon written request and until the expiration of four years after the furnishing of services
pursuant to such subcontract, the subcontractor shall make available, to the County, to the Secretary,
or to-the Comptroller General, or any of their duly authorized representatives, the subcontract and
books, documents, and records of the subcontractor that are necessary to verify the nature and extent
of all costs and charges thereunder.
This special condition is in addition to any and all other terms regarding the maintenance or retention
of records under this Contract and is binding on the heirs, successors, assigns and representatives of
Contractor.
Initials:
Contractor County
Contra Costa County Standard Form 1187
GENERAL CONDITIONS
(Purchase of Services)
4. Reporting Requirements. Pursuant to Government Code Section 7550, Contractor shall include in
all documents or written reports completed and submitted to County in accordance with this Contract,
a separate section listing the numbers and dollar amounts of all contracts and subcontracts relating to
the preparation of each such document or written report. This section shall apply only if the payment
limit under this Contract exceeds $5,000.
5. Termination.
a. Written Notice. This Contract may be terminated by either party, at their sole discretion,
upon thirty-day advance written notice thereof to the other, and may be cancelled immediately
by written mutual consent.
b. Failure to Perform. The County, upon written notice to Contractor, may immediately
terminate this Contract should the Contractor fail to perform properly any of its obligations
hereunder. In the event of such termination, the County may proceed with the work in any
reasonable manner it chooses. The cost to the County of completing Contractor's performance
shall be deducted from any sum due the Contractor under this Contract, without prejudice to
the County's rights otherwise to recover its damages..
C. Cessation of Funding. Notwithstanding Paragraph 5.a. above, in the event that Federal,
State, or other non-County funding for this Contract ceases, this Contract is terminated without
notice.
6. Entire Agreement. This Contract contains all the terms and conditions agreed upon by the parties.
Except as expressly provided herein, no other understanding, oral or otherwise, regarding the subject
matter of this Contract shall be deemed to exist or to bind any of the parties hereto.
7. Further Specifications for Operating Procedures. Detailed specifications of operating procedures
and budgets required by this Contract, including but not limited to, monitoring, evaluating, auditing,
billing, or regulatory changes, may be developed and set forth in a written Informal Agreement
between the Contractor and the County. Such Informal Agreements shall be designated as such and
shall not be amendments to this Contract except to the extent that they further detail or clarify that
which is already required hereunder. Such Informal Agreements may not enlarge in any manner the
scope of this Contract, including any sums of money to be paid the Contractor as provided herein.
Informal Agreements may be approved and signed by the head of the County Department for which
this Contract is made or his designee.
8. Modifications and Amendments.
a. General Amendments. This Contract may be modified or amended by a written document
executed by the Contractor and the Contra Costa County Board of Supervisors or, after Board
approval, by its designee, subject to any required State or Federal approval.
Initials:
Contractor County
Contra Costa County Standard Form 1%87
GENERAL CONDITIONS
(Purchase of Services)
b. Administrative Amendments. Subject to the Payment Limit, the Payment Provisions and the
Service Plan may be amended by a written administrative amendment executed by the
Contractor and the County Administrator or his designee, subject to any required State or
Federal approval, provided that such administrative amendments may not materially change
the Payment Provisions or the Service Plan.
9. Disputes. Disagreements between the County and Contractor concerning the meaning, requirements,
or performance of this Contract shall be subject to final determination in writing by the head of the
County Department for which this Contract is made or his designee or in accordance with the
applicable procedures (if any) required by the State or Federal Government.
10. Choice of Law and Personal Jurisdiction.
a. ' This Contract is made in Contra Costa County and shall be governed and construed in
accordance with the laws of the State of California.
b. Any action relating to this Contract shall be instituted and prosecuted in the courts of Contra
Costa County, State of California.
11. Conformance with Federal and State Regulations and Laws. Should Federal or State regulations
or laws touching upon the subject of this Contract be adopted or revised during the term hereof, this
Contract shall be deemed amended to assure conformance with such Federal or State requirements.
12. No Waiver by County. _ Subject to Paragraph 9. (Disputes) of these General Conditions, inspections
or approvals, or statements by any officer, agent or employee of the County indicating the
Contractor's performance or any part thereof complies with the requirements of this Contract, or
acceptance of the whole or any part of said performance, or payments therefor, or any combination of
these acts, shall not relieve the Contractor's obligation to fulfill this Contract as prescribed; nor shall
the County be thereby estopped from bringing any action for damages or enforcement arising from
any failure to comply with any of the terms and conditions of this Contract.
13. Subcontract and Assignment. This Contract binds the heirs, successors, assigns and representatives
of Contractor. The Contractor shall not enter into subcontracts for any work contemplated under this
Contract and shall not assign this Contract or monies due or to become due, without the prior written
consent of the County Administrator or his designee, subject to any required State or Federal
approval.
14. Independent Contractor Status. This Contract is by and between two independent contractors and
is not intended to and shall not be construed to create the relationship between the parties of agent,
servant, employee, partnership, joint venture or association.
Initials:
Contractor County
Contra Costa County Standard Form 1%87
GENERAL CONDITIONS
(Purchase of Services)
15. Conflicts of.Interest. Contractor, its officers, partners, associates, agents, and employees, shall not
make, participate in making, or in any way attempt to use the position afforded them by this Contract
to influence any governmental decision in which he or she knows or has reason to know.that he or she
has a financial interest under California Government Code Sections 87100, et seq., or otherwise.
16. Confidentiality. Contractor agrees .to comply and to require its officers, partners, associates, agents
and employees to comply with all applicable State or Federal statutes or regulations respecting
confidentiality, including but not limited to, the identity of persons served under this Contract, their
records, or services provided them, and assures that:
a. All applications and records concerning any individual made or kept by Contractor or any
public officer or agency in connection with the administration of or relating to services
provided under this Contract will be confidential, and will not be open to examination for any
purpose not directly connected with the administration of such service.
b. No person will publish or disclose or permit or cause to be published or disclosed, any list of
persons receiving services, except as may be required in the administration of such service.
Contractor agrees to inform all employees, agents and partners of the above provisions, and
that any person knowingly and intentionally disclosing such information other than as
authorized by law may be guilty of a misdemeanor.
17. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract shall
be available to all qualified persons regardless of age, sex, race, religion, color, national origin, or
ethnic background, or handicap, and that none shall be used, in whole or in part, for religious
worship or instruction.
18. Indemnification. The Contractor shall defend, indemnify, save, and hold harmless the County and
its.officers and employees from any and all claims, costs and liability for any damages, sickness,
death, or injury to person(s) or property, including without limitation all consequential damages, from
any cause whatsoever arising directly or indirectly from or connected with the operations or services
of the Contractor or its agents, servants, employees or subcontractors hereunder, save and except
claims or litigation arising through the sole negligence or sole willful misconduct of the County or its
officers or. employees. Contractor will reimburse the County for any expenditures, including
reasonable attorneys' fees, the County may make by reason of the matters that are the subject of this
indemnification, and if requested by the County will defend any claims or litigation to which this
indemnification provision applies at the sole cost and expense of the Contractor.
19. Insurance. During the entire term of this Contract and any extension or modification thereof, the
Contractor shall keep in effect insurance policies meeting the following insurance requirements unless
otherwise expressed in the Special Conditions:
Initials:
Contractor County
Contra Costa County Standard Form 1%87
GENERAL CONDITIONS
(Purchase of Services)
a. Liability Insurance. The Contractor shall provide comprehensive liability insurance,
including coverage for owned and non-owned automobiles, with a minimum combined single
limit coverage of $500,000 for all damages, including consequential damages, due to bodily
injury, sickness or disease, or death to any person or damage to or destruction of property,
including the loss of use thereof, arising from each occurrence. Such insurance shall be
endorsed to include the County and its officers and employees as additional insureds as to all
services performed by Contractor under this agreement. Said policies shall constitute primary
insurance as to the County, the State and Federal Governments, and their officers, agents, and
employees, so that other insurance policies held by them or their self-insurance program(s)
shall not be required to contribute to any loss covered under the Contractor's insurance policy
or policies.
b. Workers' Compensation. The Contractor shall provide workers' compensation insurance
coverage for its employees.
C. Certificate of Insurance. The Contractor shall provide the County with (a) certificate(s) of
insurance evidencing liability and worker's compensation insurance as required herein no later
than the effective date of this Contract. If the Contractor should renew the insurance
policy(ies) or acquire either a new insurance policy(ies) or amend the coverage afforded
through an endorsement to the policy at any time during the term of this Contract, then
Contractor shall provide (a) current certificate(s) of insurance.
d. Additional Insurance Provisions. The insurance policies provided by the Contractor shall
include a provision for thirty (30) days written notice to County before cancellation or material
changes of the above specified coverage.
20. Notices. All notices provided for by this Contract shall be in writing and may be delivered by deposit
in the United States mail, postage prepaid. Notices to the County shall be addressed to the head of
the County Department for which this Contract is made. Notices to the Contractor shall be addressed
to the Contractor's address designated herein. The effective date of notice shall be the date of deposit
in the mails or of other delivery, except that the effective date of notice to the County shall be the date
of receipt by the head of the County Department for which this Contract is made.
21. Primacy of General Conditions. Except for Special Conditions which expressly supersede General
Conditions, the Special Conditions (if any) and Service Plan do not limit any term of the General
Conditions.
22. Nonrenewal. Contractor understands and agrees that there is no representation, implication, or
understanding that the services provided by Contractor under this Contract will be purchased by
County under a new contract following expiration of termination of this Contract, and waives all
rights or claims to notice or hearing respecting any failure to continue purchase of all or any such
services from Contractor.
Initials:
Contractor County
Contra Costa County Standard Form 1187
GENERAL CONDITIONS
(Purchase of Services)
231 Possessory Interest. If this Contract results in the Contractor having possession of, claim to or right
to the possession of land or improvements, but does not vest ownership of the land or improvements
in the same person, or if this Contract results in the placement of taxable improvements on tax exempt
land (Revenue & Taxation Code Section 107), such interest or improvements may represent a
possessory interest subject to property tax, and Contractor may be subject to the payment of property
taxes levied on such interest. Contractor agrees that this provision complies with the .notice
requirements of Revenue & Taxation Code Section 107.6, and waives all rights to further notice or to
damages under that or any comparable statute.
24. No Third-Party Beneficiaries. Notwithstanding mutual recognition that services under this Contract
may provide some aid or assistance to members of the County's population, it is not the intention of
either the County or Contractor that such individuals occupy the position of intended third-party
beneficiaries of the obligations assumed by either party to.this Contract.
25. Copyrights and Rights in Data. Contractor shall not publish or transfer any materials produced or
resulting from activities supported by this agreement without the express written consent of the
County Administrator. If any material is subject to copyright, the County reserves the right to
copyright such and the Contractor agrees not to copyright such material. If the material is
copyrighted, the County reserves a royalty-free, nonexclusive, and irrevocable license to reproduce,
publish, and use such materials, in whole or in part, and to authorize others to do so.
26. Endorsements. Contractor shall not in its capacity as a contractor with Contra Costa County publicly
endorse or oppose the use of any particular brand name or commercial product without the prior
approval of the Board of Supervisors. In its County contractor capacity, Contractor shall not publicly
attribute qualities or lack of qualities to a particular brand name or commercial product in the absence
of a well-established and widely-accepted scientific basis for such claims or without the prior approval
of the Board of Supervisors. In its County contractor capacity, Contractor shall not participate or
appear in any commercially-produced advertisements designed to promote a particular brand name or
commercial product, even if Contractor is not publicly endorsing a product, as long as the
Contractor's presence in the advertisement can reasonably be interpreted as an endorsement of the
product by or on behalf of Contra Costa County. Notwithstanding the foregoing, Contractor may
express its views on products to other contractors, the Board of Supervisors, County officers, or
others who may be authorized by the Board of Supervisors or by law to receive such views.
27. Required Audit. If Contractor is funded by $25,000 or more in federal grant funds in any fiscal year
from any source, Contractor shall provide to County at Contractor's expense an audit conforming to
the requirements set forth in the most current version of Office of Management and Budget Circular
A-133. If Contractor is funded by $25,000 to $100,000 in federal grant funds in any fiscal year from
any source, Contractor shall arrange for.conduct of the federally-required audit biennially and shall
submit the audit to County in the time, form, and manner required by the most current version of
Office of Management and Budget Circular A-133 and by County. If Contractor is funded by
Initials:
Contractor County
Contra Costa County Standard Form 1/87
GENERAL CONDITIONS
(Purchase of Services)
$100,000 or,more in federal grant funds in any fiscal year from any source, Contractor shall arrange
for the federally-required audit annually and shall submit the audit to the County in the time, form,
and manner required by the most current version of Office of Management and Budget Circular A-133
and by County. Contractor is solely responsible for arranging for the conduct of the audit, and for its
cost, and County may withhold the estimated cost of the audit or 10 percent of the contract amount,
whichever is larger, or the final payment, from Contractor until County receives the audit from
Contractor.
Initials:
Contractor County
SPECIAL CONDITIONS
Number 38-314-2
I. Provision of Federally-Funded Contract.
A. 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 this Contract were executed after that
determination was made.
B. This Contract is valid and enforceable only if sufficient funds are made
available to the County by the United.States Government for the purposes of
this Contract. 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.
C. It is mutually agreed that if the Congress does not appropriate sufficient funds
for this program, this Contract shall be amended to reflect such reduction.
D. The County has the option to void this Contract under the thirty-day
cancellation clause set forth in Paragraph 5 (Termination) of General Conditions
or to amend this Contract to reflect any reduction of funds.
Initials:
Contractor County
QUESTIONNAIRE FOR DETERMINING INDEPENDENT
CONTRACTOR PAYMENT METHOD
All new or renewal independent contractor agreements that do not meet IRS criteria for independent
contract status must be paid through the payroll system so that withholding taxes and Social Security
can be deducted (note: this does not.apply in the case of contracts with corporations, temporary help
agencies, partnerships or established businesses with Taxpayer Identification number).
For completion by Department Personnel:
YES NO
a. Do I, as the employer, have the right to
control not only the result of the work,
but also the way in which it is done? [X] [ ]
b. Am I setting the independent contractor's
hours? [X] [
c. Is the independent contractor restricted
from taking jobs from other businesses at
the same time they are working for me? [X] [ ]
d. Do I or other departments have employee(s)
with similar duties as the independent
contractor? [X] [ ]
e. Does the County supply assistants to the
contractor? [X] [ ]
f. Is the duration of employment for a
specific period of time rather than a
specific job? [X] [ ]
g. Does the County furnish training, tools,
or equipment to the contractor? [X] [ ]
A "yes" answer to any of the above questions will constitute justification for paying the contractor
through the payroll system.
CONTRACTOR CERTIFICATION PREPARED BY:
I certify that the answers to
the above questions accurately X
reflect the anticipated working
relationship. REVIEWED AND APPROVED BY:
X X
Department Head/Authorized Designee
INDEPENDENT CONTRACT EMPLOYEE MASTER FILE
W-4 ATTACHED [ ]
OATH ATTACHED [ ]
ORIGINAL IN PAYROLL FILE [ ]
CONTRACT EMPLOYEE FOR THE COMMUNITY SERVICES DEPARTMENT
BUDGET UNIT 1439 ORG 2310 LOCATION CODE
CONTRACT EMPLOYEE'S NAME SUE W. MEAD
SOCIAL SECURITY NUMBER 569-70-5520
CONTRACT DURATION FROM JANUARY 1, 1996 THRU December 31, 1996
TYPE OF PAYMENT FIXED MONTH AMOUNT
FIXED HOURLY RATE $16.00
OTHER (Insurance) $540
TOTAL AUTHORIZED CONTRACT AMOUNT $33,820
CONTRACT REFERENCE NUMBER 38-314-2
PLEASE INDICATE: NEW [ X ]
RENEWAL [ ]
MODIFICATION [ ]
SIGNATURE OF APPOINTING AUTHORITY
FOR PAYROLL USE ONLY
EMPLOYEE NUMBER
CLASS CODE
INSURANCE COVERAGE THRU
(INDEPEN.CON)
Contra Costa County Standard Form 1/91
WITHHOLDING AND FICA DEDUCTIONS ADDENDUM
Withholding and FICA Deductions. Notwithstanding Paragraph 14. of the General
Conditions (Paragraph 10. [Independent Contractor Status] of the Short Form Service
Contract), for purposes of withholding State and Federal taxes and Social Security only from
payments due, the Auditor-Controller will make deductions for these purposes as if Contractor
was an employee. Contractor agrees that for all other purposes, Contractor is not a County
employee and remains an independent Contractor. Contractor further agrees that the County
has no obligation to provide, and Contractor will not be provided, with Workers'
.Compensation Insurance, and fringe benefits, including but not limited to, vacation, sick
leave, retirement, and health plan coverage.
Initials:
Contractor County
CONTRA COSTA COUNTY
INDEPENDENT CONTRACTOR—SUBJECT TO WITHHOLDING
QUESTIONNAIRE
DEPARTMENT USE ONLY
1. Contract Reference #: 38-314
2. Please Indicate: New Contract 38-314-2 Renewal #
3. Total Authorized Amount: $ 33,820
4. Independent Contractor's Name: SUE W. MEAD
5. Department: COMMUNITY SERVICES Org. # 1439
6. Identification Number: 569-70-5520
7-Contract Period From: January 1, 1996 To: December 31, 1996
Month/Day/Year Month/Day/Year
8. Project/Program: Head Start Family Child Care Position: Family Child Care Coordinator
INDEPENDENT CONTRACTOR
Contra Costa County is surveying the number of independent contractors with whom it does business to
measure its affirmative action progress with independent contractors. Please answer all questions by placing
an "X" in the appropriate box. This information is voluntary and will be kept separate and confidential.
A. ARE YOU: * B. ARE YOU:
1. _ White I. _ Male
2. — Black 2. _ Female
3. — Hispanic
4. — Asian C. ARE YOU OVER 40 YEARS OLD?
5. — Filipino 1._ Yes
6. — American Indian 2._ No
7. — Pacific Islander
D. Date of Birth:
Month/Day/Year
* Only one box may be marked. Persons of mixed races"should classify according to the race/ethnic group
with which they identify. Definitions are on the reverse side of this questionnaire.
Independent Contractor's Signature Date
Received and Accepted By:
Department Head/Authorized Agent
Return completed forms to: Human Resources Department-
651 Pine Street, 2nd Floor, Martinez, CA 94553