COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�#� NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
COMPLETED BOARD ORDER AND AME�# � NOTEXTPAGE
BIB]
40700-U01
COMPLETED-U02
BOARD-U02
ORDER-U02
AMENDMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO102898-U03
C15-U03
COMPLETED-U03
BOARD-U03
ORDER-U03
6/6/2011-U04
HANCOCKD-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
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$151,556;-U012
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EXECUTED AGREEMENT"�|Ebd�COUNTY OF MONTEREY
AMENDMENT #1 TO AGREEMENT #A-11852
Legal Services for Seniors
This Amendment is made and entered into by and between the County of Monterey, a
political subdivision of the State of California, hereinafter, COUNTY"), and Legal
Services for Seniors hereinafter, CONTRACTOR").
This Amendment modifies the agreement for the provision of legal services to Monterey
County Seniors, between the parties executed on September 22, 2010, hereinafter,
Original Agreement by adding $17,005 for the purchase of computer equipment,
and to fund an increase in the number of service units for the Elder Abuse
Prevention Program, increasing the total contract amount to $151,556. Therefore,
the parties agree:
1. Section 1 of the Original Agreement is amended to read as follows:
1. SERVICES TO BE PROVIDED: The County hereby engages
CONTRACTOR to perform, and CONTRACTOR hereby agrees to perform, the
services described in Exhibits AA, AA-1, A-2, and AA-3, in conformity with the
terms of this Agreement. The services are generally described as follows: Provide
legal services to Monterey County Seniors.
2. Section 2 of the Original Agreement is amended to read as follows:
2. PAYMENTS BY COUNTY: COUNTY shall pay the CONTRACTOR in
accordance with the payment provisions set forth in Exhibits AA, AA-1, A-2, and
AA-3, subject to the limitations set forth in this Agreement. The total amount
payable by COUNTY to CONTRACTOR under this agreement shall not exceed
the sum of $151,556.
3. Section 4 of the Original Agreement is amended to read as follows:
4. ADDITIONAL PROVISIONS/EXHIBITS: The following attached exhibits
are incorporated herein by reference and constitute a part of this agreement:
Exhibit AA Scope of Services/Payment Provisions
AA-1 Title III-B, Scope of Services
A-2 Title III-E, Scope of Services
AA-3 Title VII-B, Scope of Services
Exhibit B DSES Additional Provisions
Program Budgets
CC-1 Title III-B
C-2 Title III-E
CC-3 Title VII-B
Exhibit D-1 Sample Invoice
Exhibit D-2 Sample Annual Closeout Summary
Legal Services for Seniors
Amendment #1 to Agreement #A-11852
Page 1 of 3
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EXECUTED AGREEMENT"�|Ebd�Exhibit D-3 Equipment Acquisition Report
Exhibit D-4 Sample Quarterly Narrative Report
Exhibit D-5 CDA-1022 California Legal Services Quarterly Aggregate
Report Form
Exhibit D-6 CDA Elder Abuse Prevention Quarterly Activity
Report
Exhibit E HIPAA Business Associate Agreement
Exhibit F Elder Abuse & Neglect Reporting Certification
Exhibit G Lobbying Certification
4. Sections 1.02 and 2.01 of Exhibit B of the Original Agreement are amended to
read as follows:
1.02 Allowable Costs: Allowable costs shall be the CONTRACTOR's actual
costs of developing, supervising and delivering the services under this Agreement
as set forth in the budget, attached hereto as Exhibits CC-1, C-2, and CC-3. Only
the costs listed in Exhibits CC-1, C-2, and CC-3 as contract expenses may be
claimed as allowable costs. Any dispute over whether costs are allowable shall be
resolved in accordance with the provisions of 45 Code of Federal Regulations,
Part 74, Sub-Part F and 48 Code of Federal Regulations CFR), Chapter 1, Part 31
2.01 Outcome objectives and performance standards: CONTRACTOR shall,
for the entire term of this Agreement, provide the service outcomes set forth in
Exhibits AA, AA-1, A-2, and AA-3. CONTRACTOR shall meet the contracted
level of service and the specified performance standards described in Exhibits
AA, AA-1, A-2, and AA-3 unless prevented from doing so by circumstances
beyond CONTRACTOR's control including, but not limited to, natural disasters,
fire, theft and shortages of necessary supplies or materials due to labor disputes.
5. Exhibits A, A-1, A-3, C-1, and C-3 of the Original Agreement, are rescinded and
replaced by Exhibits AA, AA-1, AA-3, CC-1, and CC-3, attached.
6. Exhibit D-6 is added to the Agreement, attached.
Subject to the foregoing amendment, all other terms and conditions of the Original
Agreement shall remain in full force and effect.
this space left blank intentionally)
Legal Services for Seniors
Amendment #1 to Agreement #A-11852
Page 2 of 3
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EXECUTED AGREEMENT"�|Ebd�If there is any conflict or inconsistency between provisions of this amendment and the
Original Agreement, the provisions of this amendment shall control in all respects.
IN WITNESS HEREOF, the parties hereby execute this amendment as follows:
COUNTY O MONTEREY:
By:
Elliott Robinson
Director, DSES
Date:
Approved as to Form:
CONTRACTOR:
Legal Services for Seniors
By:
air, President, Vice-President)
Print Name & Title)
Date: 6-'? 1 f
By: 6 C'A' Ik
7 1, 0, 1 reasurer
f)
q. alkv/
Date: c to
Date: S- 1
Approved as o iscal Pr,pvisions:
11
Legal Services for Seniors
Amendment #1 to Agreement #A-11852
Page 3 of 3
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EXECUTED AGREEMENT"�|Ebd�EXHIBIT AA
SCOPE OF SERVICES/PAYMENT PROVISIONS
LEGAL SERVICES FOR SENIORS
JULY 1, 2010 to JUNE 30, 2011
L CONTACT INFORMATION
Contact Person & Kellie Dunnett Morgantini
Disaster Preparedness Executive Director, Attorney
Coordinator: ed@legalservicesforseniors.org
County Contract Manager: Ethan Hurley, Management Analyst II
Area Agency on Aging
Department of Social and
Employment Services
713 La Guardia Street, Suite A
Salinas, CA 93901
831) 755-3425
Fax: 831) 783-7021
IL OFFICES
Salinas: 21 West Laurel Avenue, Suite 83 93906)
831.442.7700
Seaside: 915 Hilby Avenue, Suite 2 93955)
831.899.0492
Days and Hours of Service:
Monday through Friday, 9:00 a.m. until 5:00 p.m.
III. SERVICES TO BE PROVIDED BY CONTRACTOR
Contractor shall provide the services outlined in Exhibits AA-1, A-2 and AA-3,
attached.
Contractor shall participate in quarterly Aging Services Network meetings to share
program accomplishments and challenges, network, coordinate and collaborate across
AAA funded and community partner agencies.
Services shall be provided throughout the County of Monterey, and Contractor shall
ensure that services are provided to Seniors 60 years of age or older or 55 years of
age or older for the Title III-E Program) in all four regions of Monterey County:
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA-1, and AA-3 Page 1 of 8 v
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EXECUTED AGREEMENT"�|Ebd�Monterey Peninsula Region: Big Sur, Carmel, Carmel Valley, Marina,
Monterey, Pacific Grove, Pebble Beach.
North County Region: Castroville, Moss Landing, Pajaro, and Prunedale.
Salinas Region: City of Salinas and Spreckels.
South County Region: Bradley, Chualar, Gonzales. Greenfield, Jolon, King
City, Lockwood, San Ardo, San Lucas, and Soledad.
IV. TARGETING POLICY
It is the policy of the Area Agency on Aging to assure that services are effectively
targeted and reach people most in need as directed by the Older Americans Act.
The Older Americans Act requires that, with respect to all types of services,
preference be given to serving those in greatest social and economic need, with
particular attention to serving low-income minority individuals, older individuals with
limited English proficiency and older individuals residing in rural areas.
All programs and services shall be targeted toward seniors 60 years of age or older
or 55 years of age or older for the Title III-E Program) in the greatest economic and
social need, with particular attention to serving low-income minority individuals,
older individuals with limited English proficiency, and older individuals residing in
rural areas.
The Older Americans Act, Amendments of 2006 defines the term Greatest Economic
Need as the need resulting from an income level at or below the poverty line. The
term Greatest Social Need means the need caused by:
Physical and mental disabilities
Language barriers
Isolation caused by cultural, racial or ethnic status
Social or geographic isolation
Additional Target populations required by the OAA include:
Older Native Americans
Isolated, abused, neglected and or exploited older individuals
Frail older individuals
Older individuals with limited English-speaking ability
Older individuals with Alzheimer's disease or related disorders with
neurological and organic brain dysfunction and their caregivers
Older individuals with disabilities
Caregivers as defined in Title IIIE
Lesbian, Gay, Bisexual, and Transgender Seniors
Leizal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA- 1, and AA-3 Page 2 of 8
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EXECUTED AGREEMENT"�|Ebd�V. GETCARE LICENSES
COUNTY will pay for one 1) GetCare license each month. Any additional licenses
shall be the financial responsibility of CONTRACTOR. To obtain additional
licenses, contact Laura Emery at RTZ, 510) 986-6700 x202, or via e-mail at
Laura@RTZAssociates.com. Licenses will be issued to individuals. When there is a
change in staff, CONTRACTOR must notify COUNTY in writing within 15 days.
VI. AUDIT PROVISIONS
CONTRACTOR is required to provide an audit as per the terms in Exhibit B, Section
III. Additionally, CONTRACTOR shall ensure that State-Funded expenditures are
displayed along with the related federal expenditures in the Single Audit report
Schedule of Expenditures of Federal Awards" SEFA) under the appropriate Catalog
of Federal Domestic Assistance CFDA) number as referenced in Exhibits AA-1,
A-2 and AA-3.
VII. PAYMENT SUMMARY
Exhibit AA-1, Title III B: $123,236
Exhibit A-2, Title III-E: $22,308
Exhibit AA-3, Title v-H-B: $6,012
TOTAL: $151,556
Claims for payment shall be submitted electronically, in the form provided on
the GetCare website: https://ca.getcare.com/caprovider/index.jsp. Claims for
payment shall be submitted simultaneously with program data.
In the event, in any reporting month the GetCare System is unusable, for any reason,
for reporting purposes, CONTRACTOR will provide COUNTY with the equivalent
reporting data in hardeopy and electronic form as agreed-upon by the parties. This
provision in alternate form will assure CONTRACTOR shall be paid for the claims
submitted regardless of the availability of the GetCare on-line reporting system.
CONTRACTOR shall comply with the appropriate benchmark requirements for service
units to be delivered in order to draw down contract funds in accordance with the terms
of this Agreement. The applicable benchmark for each type of service is identified under
Section II, Performance Reporting and Section IV, Invoice/Payment Provisions contained
in Exhibits AA-1, A-2 and AA-3.
The total amount to be paid by COUNTY to CONTRACTOR under this agreement
shall not exceed one hundred fifty-one thousand, five hundred and fifty-six
dollars $151,556) for the period July 1, 2010 to June 30, 2011.
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA-1, and AA-3 Page 3 of 8
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EXECUTED AGREEMENT"�|Ebd�EXHIBIT AA-1
TITLE III-B CFDA #93.044)
LEGAL ASSISTANCE/COMMUNITY EDUCATION
SCOPE OF SERVICES
1. SERVICES TO BE PROVIDED
CONTRACTOR shall provide legal assistance and community education for seniors
60 years of age or older. Services shall be provided in accordance with the California
Code of Regulations, Title 22, Social Security, Division 1.8, California Department of
Aging.
1. Service:
Legal Assistance NAPIS 11)
Unit of Service Definition:
Legal advice, counseling and/or representation by an attorney or other
person acting under the supervision of an attorney.
Unit of Service Measurement:
1 Hour
Estimated Service Units to be delivered:
12,000
Cost per Unit of Service: $8.50 12,000 x $8.50 $102,000)
Benchmark of Service Units to be delivered:
by September 30th: 2,400 Units 20%)
by December 31St: 6,000 Units 50%)
by March 31St: 9,000 Units 75%)
by June 30th: 12,000 Units 100%)
2. Service:
Community Education NAPIS 15-Other)
Unit of Service Definition:
Educating groups of older persons, their families, friends, and
community organizations/facility staff on rights, benefits, entitlements,
and health and wellness information for older persons either residing at
home, or in an institutional setting.
Unit of Service Measurement:
1 Activity
Estimated Units of Service to be delivered:
25
Cost per Unit of Service: $188 25 x $188 $4,700)
Benchmark of Service Units to be delivered:
by September 30th: 6 Units 25%)
by December 31St: 12 Units 50%)
by March 31St: 18 Units 75%)
by June 30th: 25 Units 100%)
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA- 1, and AA-3 Page 4 of 8
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EXECUTED AGREEMENT"�|Ebd�H. PERFORMANCE REPORTING
CONTRACTOR shall enter data monthly into the new AAA GetCare System by the
10'x' of the month following the month of service. This is a non-registered service.
CONTRACTOR shall provide a CDA-1022, California Legal Services Quarterly
Aggregate Report Form to the COUNTY describing the progress of services by
October 20, 2010, January 20, 2011, April 20, 2011 and July 20, 2011. The
California Legal Services Quarterly Aggregate Report Form shall be in the form of
CDA-1022, Exhibit D-5.
CONTRACTOR shall provide a quarterly narrative report to the COUNTY
describing the progress of services by October 10, 2010, January 10, 2011, April 10,
2011 and July 10, 2011. The Narrative Report shall be in the form of Exhibit D-4.
COUNTY has an expectation that a certain number of services are delivered within
each reporting period. The benchmark is determined by dividing the service units
into the number of months within the contract term quarterly if it is a quarterly
function). The COUNTY has expectations that CONTRACTOR will deliver the
contracted service units within 20% of the benchmark.
If CONTRACTOR falls below the required benchmark percentage for two 2)
consecutive quarters, CONTRACTOR will provide a corrective action plan to the
AAA describing the reason for the occurrence and a plan to meet the benchmark, and
reimbursement may be limited as per Section IV. Invoice/Payment Provisions.
M. MATCH REQUIREMENTS
Title III-B requires a local cash/in-kind match of 10.53%. The required match is
calculated by taking the total budgeted costs less program income and non-matching
contributions, multiplied by the matching requirement percentage.
IV. INVOICE/PAYMENT PROVISIONS
If CONTRACTOR delivers less than the benchmark of service units for two 2)
consecutive quarters, COUNTY's payment to CONTRACTOR may be limited to an
amount of grant funds based on the percentage of services provided year to date. The
benchmark is identified in Section II, Performance Reporting, and a 20% variance is
allowed. This restriction will be lifted by the County Contract Manager once
CONTRACTOR meets acceptable performance outcomes.
The maximum amount of grant funds allowed to be drawn down per month cannot
exceed 10% of the overall grant, unless approved in writing by the County Contract
Manager.
COUNTY shall pay CONTRACTOR in accordance with Article 6, Payment
Conditions of this Agreement. Claims for payment shall be submitted in the form set
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA- 1, and AA-3 Page 5 of 8
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd �forth in Exhibit D-l, Sample Invoice, by the 10`h of the month for services rendered in
the previous month.
Exhibit D-2, Annual Closeout Summary, shall be submitted by CONTRACTOR to
COUNTY no later than July 10, 2011.
Exhibit D-3, Equipment Acquisition Report, shall accompany CONTRACTOR's
invoice to COUNTY as appropriate. Equipment must be received by June 30,
2011 for expenses to be claimed against this Agreement. CONTRACTOR, a
provider of senior legal services with a duty to maintain attorney-client
confidentiality, is required to and shall request approval from the AAA for the
return or disposition of property when CONTRACTOR services no longer
continue. Measures to protect confidential information shall be included in the
approved property disposition plan. The following pertains to disposition of
computer hardware; hardware may be retained as property by the
CONTRACTOR with AAA approval, or hardware shall be wiped clean of
confidential data with costs born by Legal Services for Seniors, or
CONTRACTOR may purchase the hard drive from the AAA.
One Time Only Funding:
$16,536 for the purchase of computers, computer equipment, computer
accessories, and computer software, to support baseline services.
The maximum amount to be paid by COUNTY to CONTRACTOR for Title III-B for
the period July 1, 2010 to June 30, 2011 shall not exceed one hundred twenty-three
thousand, two hundred and thirty-six dollars $123,236).
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA-1, and AA-3 Page 6 of 8
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd
�TITLE VII-B CFDA #93.041)
ELDER ABUSE PREVENTION
SCOPE OF SERVICES
I. SERVICES TO BE PROVIDED
EXHIBIT AA-3
CONTRACTOR shall provide Elder Abuse Prevention, Education, and Training.
Services shall be provided in accordance with the California Code of Regulations,
Title 22, Social Security, Division 1.8, California Department of Aging.
Service:
Elder Abuse Prevention, Education and Training NAPIS 15)
Unit of Service Definition:
Public education and training of professionals to develop, strengthen, and
carry out programs for the prevention, detection, assessment, and treatment of,
intervention in, investigation of, and response to elder abuse, neglect, and
exploitation including financial exploitation). This includes training for Title
III E caregivers.
Unit of Service Measurement:
1 Session
Estimated Service Units to be delivered:
109
Cost per Unit of Service: $55.1559 109 x $55.1559 $6,012*)
* Rounded to nearest dollar
Benchmark of Service Units to be delivered:
by September 30th:
by December 31St:
by March 31St:
by June 30th:
25 Units 25%)
50 Units 50%)
75 Units 75%)
109 Units 100%)
H. PERFORMANCE REPORTING
CONTRACTOR shall enter data monthly into the new AAA GetCare System by the
10th of the following month. This is a non-registered service.
CONTRACTOR shall provide a quarterly narrative report to the COUNTY
describing the progress of services by October 10, 2010, January 10, 2011, April 10,
2011 and July 10, 2011. The Narrative Report shall be in the form of Exhibit D-4.
CONTRACTOR shall provide a California Elder Abuse Prevention Quarterly
Activity Report Form to the COUNTY describing the progress of services by
April 10, 2011 and July 10, 2011. The California Elder Abuse Prevention
Quarterly Activity Report shall be in the form of Exhibit D-6.
COUNTY has an expectation that a certain number of services are delivered within
each reporting period. The benchmark is determined by dividing the service units
into the number of months within the contract term quarterly if it is a quarterly
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA-1, and AA-3 Page 7 of 8 v
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd
�function). The COUNTY has expectations that CONTRACTOR will deliver the
contracted service units within 20% of the benchmark.
If CONTRACTOR falls below the required benchmark percentage for two 2)
consecutive quarters, CONTRACTOR will provide a corrective action plan to the
AAA describing the reason for the occurrence and a plan to meet the benchmark, and
reimbursement may be limited as per Section IV. Invoice/Payment Provisions.
IH. MATCH REQUIREMENTS
There is no local cash/in-kind match for Title VII-B.
IV. INVOICE/PAYMENT PROVISIONS
If CONTRACTOR delivers less than the benchmark of service units for two 2)
consecutive quarters, COUNTY's payment to CONTRACTOR may be limited to an
amount of funds based on the percentage of services provided year to date. The
benchmark is identified in Section II, Performance Reporting, and a 20% variance is
allowed. This restriction will be lifted by the County Contract Manager once
CONTRACTOR meets acceptable performance outcomes.
COUNTY shall pay CONTRACTOR in accordance with Article 6, Payment
Conditions of this Agreement. Claims for payment shall be submitted in the form set
forth in Exhibit D- 1, Sample Invoice, by the 100' of the month for services rendered in
the previous month.
Exhibit D-2, Annual Closeout Summary, shall be submitted by CONTRACTOR to
COUNTY no later than July 10, 2011.
Exhibit D-3, Equipment Acquisition Report, shall accompany CONTRACTOR's
invoice to COUNTY as appropriate. Equipment must be received by June 30,
2011 for expenses to be claimed against this Agreement. CONTRACTOR, a
provider of senior legal services with a duty to maintain attorney client
confidentiality, is required to and shall request approval from the AAA for the
return or disposition of property when CONTRACTOR services no longer
continue. Measures to protect confidential information shall be included in the
approved property disposition plan. The following pertains to disposition of
computer hardware; hardware may be retained as property by the
CONTRACTOR with AAA approval, or hardware shall be wiped clean of
confidential data with costs born by Legal Services for Seniors, or
CONTRACTOR may purchase the hard drive from the AAA.
The maximum amount to be paid by COUNTY to CONTRACTOR for Title VII-B
for the period July 1, 2010 to June 30, 2011 shall not exceed six thousand and
twelve dollars $6,012).
Legal Services for Seniors Amendment #1 to Agreement #11852
Exhibits AA, AA-1, and AA-3 Page 8 of 8
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd
�Monterey County AAA Budget Certification Report
Legal Services for Seniors Title III-B Legal Servcies
ExpCat Budget Cash
Salaries / Vol IK 100,778
Payroll Taxes 7,705
Employee Benefits 13,597
Volunteer Reimbursements
Travel / Vol Travel 4,800
Conference / Trainings / Meetings 1,000
Professional Fees: Acctg/Legal/DP 18,000
Equipment Purchase 12,000
Equipment Rental / Maintenance 3,000
Occupancy 41,727
Insurance Not Vech / Occ) 3,600
Utilities / Communications 6,600
Postage / Shipping 1,200
Printing / Publication 950
Public Relations / Advertising 1,000
Subs / Membership Dues 5,400
Supplies 7,536
Food / Food Service
Vehicle Operation
Overhead 8% limit)
Awards / Events
Low Income Subsidy
Federal Mental Health
Low Income Subsidy
Depreciation
Nutrition Education
Bank Service Fees
Subcontractor
Miscellaneous
Expense Totals 228,893
AAA Grant NSIP Grant
106,700 / OTO Grant
16,536
Project Income CNonMatch IKNonMatch CashMatch
24,000 81,657
I certify that the amounts displayed
are accurate and correct.
Budget InKind
21,360
21,360
Fiscal Year 2010-2011
250,253
IKMatch GRTotal Required Match
21,360 250,253 23,824
Provider Signature
Approved by
AAA Fiscal Officer
Approved by
Date
Date AlleFleo/l
Revision Date
EXHIBIT CC-1
4/18/2011
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
CONTRACT-U012
AMOUNT,-U012
DO-U012
SIGNIFICANTLY-U012
CHANGE-U012
THE-U012
SCOPE-U012
OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd
�Monterey County AAA Budget Certification Report EXHIBIT CC-3
Legal Services for Seniors Title 7B Elder Abuse Prevention
ExpCat Budget Cash Budget InKind
Salaries / Vol IK 8,194
Payroll Taxes 627
Employee Benefits 1,561
Volunteer Reimbursements
Travel / Vol Travel
Conference / Trainings / Meetings
Professional Fees: Acctg/Legal/DP
Equipment Purchase 469
Equipment Rental / Maintenance
Occupancy
Insurance Not Vech / Occ)
Utilities / Communications
Postage / Shipping
Printing / Publication
Public Relations / Advertising
Subs / Membership Dues
Supplies
Food / Food Service
Vehicle Operation
Overhead 8% limit)
Awards / Events
Low Income Subsidy
Federal Mental Health
Low Income Subsidy
Depreciation
Nutrition Education
Bank Service Fees
Subcontractor
Miscellaneous
Expense Totals 10,851
AAA Grant NSIP Grant
5,543 OTO Grant
469
Project Income CNonMatch IKNonMatch CashMatch IKMatch
4,839
I certify that the amounts displayed
are accurate and correct.
GRTotal
Fiscal Year 2010-2011
10,851
Required Match
10,851 10,851
11.6*...1 +
Revision Date
Provider Signature
Approved by
Date
L./ 1
AAA Fiscal Officer
Approved by
Date
yl?z/2o,//
4/18/2011
BIB]
40953-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99716-U03
MG99791-U03
AS99817-U03
AS99819-U03
AI101976-U03
DO109655-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16515-U05
3-U06
A.-U07
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
THE-U07
DEPARTMENT-U07
OF-U07
SOCIAL-U07
&-U07
EMPLOYMENT-U07
SERVICES,-U07
OR-U07
HIS-U07
DESIGNEE,-U07
TO-U07
SIGN-U07
511-DSS-U08
OLDS-U09
ANNA-U09
OLDSAM-U10
5/12/2011-U011
AMENDMENT-U012
NO.-U012
1-U012
TO-U012
AGREEMENT-U012
NO.-U012
A-11852-U012
LEGAL-U012
SERVICES-U012
SENIORS-U012
THE-U012
PROVISION-U012
OF-U012
SERVICES-U012
TO-U012
MONTEREY-U012
COUNTY-U012
SENIORS-U012
THE-U012
PERIOD-U012
JULY-U012
1,-U012
2010-U012
TO-U012
JUNE-U012
30,-U012
2011,-U012
ADDING-U012
$17,005,-U012
INCREASING-U012
THE-U012
TOTAL-U012
CONTRACT-U012
AMOUNT-U012
TO-U012
$151,556;-U012
B.-U012
AUTHORIZE-U012
THE-U012
DIRECTOR-U012
OF-U012
THE-U012
DEPARTMENT-U012
OF-U012
SOCIAL-U012
&-U012
EMPLOYMENT-U012
SERVICES,-U012
OR-U012
HIS-U012
DESIGNEE,-U012
TO-U012
SIGN-U012
UP-U012
TO-U012
THREE-U012
3)-U012
AMENDMENTS-U012
TO-U012
AGREEMENT,-U012
THE-U012
TOTAL-U012
AMENDMENTS-U012
DO-U012
EXCEED-U012
TEN-U012
PERCENT-U012
10%)-U012
OF-U012
THE-U012
ORIGINAL-U012
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AMOUNT,-U012
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OF-U012
WORK.-U012
EXECUTED AGREEMENT"�|Ebd�e t
STATE OF CALIFORNI
CALIFORNIA DEPARTMENT OF AGING
ELDER ABUSE PREVENTION
QUARTERLY ACTIVITY REPORT
REV 10/2010)
EXHIBIT D-6
AAA Name: PSA Number:
Person Completing Report: Telephone No:
Email Address: Date Submitted:
Reporting Quarter: Quarterly Reporting Period:
Units of Service: The Area Agency on Aging must perform at least one activity from the table below.
# of Sample Topics:
Public Education Sessions Sessions:
# of Sample Topics:
Training Sessions for Professionals Sessions:
Training Sessions for Caregivers # of Sample Topics:
Served by Title III E Sessions:
Hours Spent Developing a Coordinated # of Hours: Sample Activities:
System to Respond to Elder Abuse
# of Sample Materials:
Educational Materials Distributed Materials:
The Area Agency on Aging must indicate how many individuals were served by the above activities.
# of
Individuals Reached through Activities Individuals:
INSTRUCTIONS
AAA Name: Enter the name of the Area Agency on Aging.
PSA Number: Enter your Planning and Service Area PSA) number.
Person Completing Report: Enter the name of the person completing this form.
Telephone No: Enter the telephone number of the person completing this form.
Email Address: Enter the email address of the person completing this form.
Date Submitted: Enter the date the report is submitted.
Reporting Quarter: Enter 1St 2nd 3rd or 4th Quarter
Quarterly Reporting Period: Enter the months, days and the year of the reporting quarter, e.g., July 1 to September 30, 2010.
UNITS OF SERVICE: The Area Agency on Aging must perform at least one activity from the Units of Service listed on
the form.
Public Education Sessions, Training Sessions for Professionals, and Training Sessions for Caregivers Served by
Title III-E: Indicate the number of sessions and topic(s) discussed.
Hours Spent Developing a Coordinated System to Respond to Elder Abuse: Indicate the number of hours and describe
the types of activities in which the Area Agency on Aging was involved.
Educational Materials Distributed: Indicate the number and describe the type(s) of materials distributed.
INDIVIDUALS REACHED THROUGH ACTIVITIES: Indicate the number of individuals served by this program during the
reporting quarter who were reached through any of the activities funded by this program.
Please email the completed form to stateombnaaging.ca.gov.
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