SIGNED BOARD REPORT"�|E���MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: June 14, 2011 Consent AGENDA NO.:
SUBJECT: Approve and authorize the Director of Health to execute on behalf of the County of
Monterey standard agreements, and any amendments thereto, for continued funding
from local, State, and Federal agencies for designated programs.
DEPARTMENT: Health
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health to execute on behalf of the County of Monterey
standard agreements, and any amendments thereto, for continued funding from local, State and
Federal agencies for designated programs.
SUMMARY/DISCUSSION:
The Health Department relies on a variety of local, State, and Federal grants to provide a portion of
the financial support required by the Department for the services it provides in the County. In
preparing the fiscal year FY) 2011-2012 Requested County Budget, the Department has compiled
list of local, State and Federal programs currently providing funding for various programs. These
same programs expect continued funding beyond FY 2011-2012. The State and Federal agencies
responsible for these grants require the Department to submit an application and final agreement to
renew funding for the upcoming fiscal year even though there is an established relationship
between the County and the funding agency in the current fiscal year. In fiscal years 2003 through
2011 the Board of Supervisors BOS) granted approval and authorized the Director of Health to act
on behalf of the County in submitting the application and final agreement to renew grants with the
appropriate funding agency.
Continued support and approval by the BOS for this recommended action would allow the Director
of Health to continue to submit the approved resolution as authority to sign, submit grant
applications and grant agreements to renew funding for those designated programs without having
to request BOS approval for each grant application/agreement. This will significantly reduce the
number of board reports submitted for approval annually and will expedite the process.
The Department will continue to present amendments to the final grant agreement that require
adjustments to the Final County Budget for changes in appropriations, revenues, and/or positions,
to the BOS for approval.
OTHER AGENCY INVOLVEMENT:
County Counsel, Risk Management and the Auditor-Controller agree with the process and will
continue to review each grant agreement before the Department signs and submits the agreement
to the funding agency.
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SIGNED BOARD REPORT"�|E���FINANCING:
The majority of appropriations and revenues related to Attachment A have been included in the
Requested County Budget for FY 2011-2012. Adjustments in appropriations, revenue, and/or
position count will be submitted to the BOS for approval. There will be no new General Fund
Contribution.
Prepared by: Approved by:
usie McKee, Administrative Secretary Ray Bullick, Director of Health
755-4526
Date: 5 a_ 1l
Date: S 3 1
cc: Charles J. McKee, County Counsel
Michael Miller, Auditor-Controller
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COMPLETED BOARD ORDER"�|E���40
Before the Board of Supervisors in and for the
County of Monterey, State of California
Approve and authorize the Director of Health to
execute on behalf of the County of Monterey
standard agreements, and any amendments
thereto, for continued funding from local, State,
and Federal agencies for designated programs....
Upon motion of Supervisor Salinas, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby;
Approved and authorized the Director of Health to execute on behalf of the
County of Monterey standard agreements, and any amendments thereto, for
continued funding from local, State, and Federal agencies for designated
programs.
Agency. Grant/Contract Title
Calif Dept of Alcohol and Drug Beverage Container Recycling & Litter Cleanup Activities
Calif Dept of Alcohol and Drug Comprehensive Drug Court Implementation Grant
Calif Dept of Alcohol and Drug Department of Alcohol and Drug Programs ADP)
Calif Dept of Alcohol and Drug Safe and Drug Free School and Communities
Calif Dept of Alcohol and Drug Substance Abuse and Crime Prevention Act of 2000 Plan
Prop 36)
Calif Dept of Corrections Salinas Valley State Prison, Pathology Service
Calif Dept of Fish and Game Local Assistance Grant For Area Oil Contingency Plan
Calif Dept of Health Care Services California Children's Services Administration
Calif Dept of Health Care Services Child Health and Disability Prevention Program
Calif Dept of Health Care Services Health Care Program for Children in Foster Care
Calif Dept of Health Care Services Medi-Cal Administration Activities MAA)
Calif Dept of Health Care Services Medi-Cal Participation Fee with Host County
Calif Dept of Health Care Services Monterey County Special Education Local Plan Area
SELPA)
Calif Dept of Health Care Services Targeted Case Management TCM)
Calif Dept of Mental Health County/City Performance Contract
Calif Dept of Mental Health Managed Care/Mental Health Plan
Calif Dept of Mental Health Mental Health Services Act MHSA) Agreement
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COMPLETED BOARD ORDER"�|E���40
Calif Dept of Mental Health Mental Health Services Act MHSA) Annual Update
Calif Dept of Mental Health Projects for Assistance in Transition from Homelessness
PATH)
Calif Dept of Mental Health State Hospital Bed Purchase and Usage
Calif Dept of Mental Health Substance Abuse and Mental Health Services
Administration SAMHSA Block)
Calif Dept of Public Health AIDS CARE Early Intervention Services
Calif Dept of Public Health AIDS CARE, Ryan White Treatment Funds Title II
Calif Dept of Public Health AIDS Master Grant
Calif Dept of Public Health Beach Safety Program
Calif Dept of Public Health California Nutrition Network Local Incentive Award
Calif Dept of Public Health Childhood Lead Poisoning Prevention Program
Calif Dept of Public Health Community Challenge Grant/Postpone
Calif Dept of Public Health Comprehensive Tobacco Control Plan
Calif Dept of Public Health Hospital Preparedness Program
Calif Dept of Public Health Immunization Assistance Program
Calif Dept of Public Health Maternal Child Adolescent Health
Calif Dept of Public Health Minority AIDS Initiative
Calif Dept of Public Health Public Health Preparedness Plan/Pan Flu
Calif Dept of Public Health Regional Nutrition Networks for Healthy Active Living
Calif Dept of Public Health State Subvention OHO)
Calif Dept of Public Health STD Community Interventions Program
Calif Dept of Public Health Vital Records, fees
Calif Dept of Public Health Women, Infants and Children WIC) Supplemental
Nutrition Program
Calif Dept of Public Health Beach Act Grant
Calif Dept of Public Health Tuberculosis Prevention and Control Activities
Calif Dept of Rehabilitation County Behavioral Health Cooperative Agreement
Calif Emergency Medical Services
Authority Maddy Fund
Calif Office of Traffic Safety Pedestrian Safety Bike Safety
Calif Office of Traffic Safety Pedestrian Safety Safe Routes to School
Children's Services International Children's and Families Commission Proposition 10)
Dept of Resources Recycling and
Recovery CalRecycle Used Oil Recycling Block Grant
First 5 Monterey County Secure Families/Familias Seguras Grant
Monterey County Office of Ed. Individuals with Disabilities Education Act IDEA)
Monterey County Office of Ed. Through and Beyond
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COMPLETED BOARD ORDER"�|E���40
State Water Resources Control Board Emergency, Abandoned, Recalcitrant EAR)
Substance Abuse and Mental Health Adult Drug Court Grant
Administration SAMHSA) and Bureau
of Justice Assistance BJA)
Substance Abuse and Mental Health Juvenile Drug Court Grant
Administration SAMHSA) Center for
Substance Abuse Treatment CSAT)
PASSED AND ADOPTED on this 14t11 day of June, 2011, by the following vote, to wit:
AYES: Supervisors Armenta, Calcagno, Salinas, Parker, and Potter
NOES: None
ABSENT: None
I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby certify
that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in the minutes
thereof of Minute Book 75 for the meeting on June 14, 2011.
Dated: June 17, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
By
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FULLY EXECUTED AGREEMENT NO. u�/�1
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213 CDPH Rev 2/11)
Check here if additional pages are added:
page(s)
P t lot 2.&) 11
1. This Agreement is entered into between the State Agency and the Contractor named below:
2.
3.
AGREEMENT NUMBER
11-10592
STATE AGENCY'S NAME Also referred to as CDPH or the State)
California Department of Public Health
CONTRACTOR'S NAME Also referred to as Contractor)
County of Monterey
The term of this
Agreement is: July 1, 2011 through June 30, 2013
The maximum amount
of this Agreement is: $ 324,546
Three Hundred Twenty-Four Thousand Five Hundred Forty-Six Dollars
4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference made a
part of this Agreement.
Exhibit A Scope of Work
Exhibit B Budget Detail and Payment Provisions
Exhibit B, Attachment I Budget Year 1)
Exhibit B, Attachment II Budget Year 2)
Exhibit C General Terms and Conditions
Exhibit D F) Special Terms and Conditions Attached hereto as part of this agreement)
Exhibit E Additional Provisions
Exhibit F Contractor's Release
Exhibit G Travel Reimbursement information
8 pages
3 pages
2 pages
2 pages
GTC 610
26 pages
2 pages
1 page
2 pages
1-1.11.1
Items shown above with an Asterisk *), are hereby incorporated by reference and made part of this agreement as if attached hereto.
These documents can be viewed at http //www ols das ca aov/Standard+Language.
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
CONTRACTOR'S NAME if other than an individual, state whether a corporation, partnership, etc.)
County of Monterey
BY Authorized Signature)
PRINTED NAMEN6TITLE OF PERSON SIGNING
ROY i?Iiek 11~`rQ +tT
ADDRESS
1270 Natividad der Somas, CA 93906
DEPT OF GENERAL SERVICES
AME AND TITLE OF PERSON SIGNING
Sanrir^ \ntinte Chief, Contracts and Purchasing Services Section
ADDRESS
1501 Capitol Avenue, Suite 71.5178, MS 1802, PO Box 997377
Sacramento, CA 95899-7377
REGISTRATION NUMBER
California Department of
General Services Use Only
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FULLY EXECUTED AGREEMENT NO. u�/�Z
I
S
County of Monterey
11-10592
EXHIBIT A
Scope of Work
1. Service Overview
Contractor agrees to provide to the California Department of Public Health CDPH) the services described
herein:
Sections 120325-120380 of the Health & Safety Code, Chapter 435, require immunizations against
childhood diseases prior to school admittance. Health Officers are required to organize and maintain a
program to make the required immunizations available. This contract assists the Contractor in defraying
costs of the program which supports the State's objectives to control diseases that are preventable by
vaccines. It is the California Department of Public Health's responsibility to provide this assistance to the
local health jurisdictions. The Contractor is to conduct a general immunization program which provides all
Advisory Committee on Immunization Practices ACIP) recommended vaccines to the general public. In
addition, the Contractor identifies target populations in need of immunizations and initiates corrective action
to improve immunization levels.
2 Project Representatives
A. The project representatives during the term of this agreement will be:
California Department of Public Health County of Monterey
Steve Vantine
Telephone: 510) 268-2517
Fax: 510) 268-2111
Email: steve.vantine(crbcdph.ca.gov
Molly Hubbard, MS
Telephone: 831) 755-4683
Fax: 831) 796-8636
Email: hubbardmc@co.monterey.ca.us
B. Direct all inquiries to:
California Department of Public Health
Immunization Branch
Attention: Robina Escalada
850 Marina Bay Pkwy., Bldg. P 2nd Floor
Richmond, CA 94804
County of Monterey
County of Monterey
Attention: Molly Hubbard, MS
1270 Natividad Road
Salinas, CA 93906
Telephone: 510) 620-3729
Fax: 510) 620-3774
E-mail: robina.escalada(aD_cdph.ca.gov
Telephone: 831) 755-4683
Fax: 831) 796-8636
Email: hubbardmc@co.monterey.ca.us
C. Either party may make changes to the information above by giving written notice to the other party.
Said changes shall not require an amendment to this agreement.
3. Services to be Performed Pediatric-IAP-Hepatitis B
The Contractor must agree to the following inclusive objectives and conduct the following activities. Please
note that many of these services to be performed are also objectives and activities required by the Federal
Government and are conditions for funding of the California Immunization Program and/or statutory
requirements of State and local health departments. The level of subvention contract funding to be
awarded is not represented as sufficient for support of all the required activities; a significant amount of
Page 1 of 8
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
local support and funding is expected. Subvention contract funds must not be used to supplant i.e.,
replace) local funds currently being expended for routine immunization services and activities.
A. Objectives:
1) Raise to or maintain) immunization coverage levels to 95% or greater for each immunization
required by law for kindergarten students and child care entrants within the Contractor's jurisdiction.
2) By the end of the year 2013, 90% of two-year-olds within the Contractor's jurisdiction should be
vaccinated with one dose of measles, mumps, and rubella MMR) vaccine, three doses of polio
vaccine, at least four doses of diphtheria, tetanus, and pertussis DTP) vaccine, three doses of
Haemophilus influenzae type b Hib) vaccine, three doses of hepatitis b vaccine, one dose of
varicella vaccine and four doses of pneumococcal conjugate vaccine.
3) Through prevention, surveillance and outbreak control, reduce, or eliminate illness, disability and
death due to vaccine-preventable diseases within the Contractor's jurisdiction.
4) For Fiscal Years 2011 2013 establish and/or maintain an effective reminder/recall system using
the local regional registry.
5) Inform and educate health care providers, school staff, child care community, and the general
public about the need for timely administration of scheduled immunizations of children and adults.
B. Specific Activities:
1) Program Management
a. Contractor agrees to assign one or more staff the responsibility of monitoring each program
activity: 1) Program Management; 2) Vaccine Accountability and Management; 3) Immunization
Information Systems; 4) Provider Quality Assurance; 5) Perinatal Hepatitis B Prevention;
6) Adolescent Immunizations; 7) Adult Immunizations; 8) Education, Information, Training, and
Partnerships; 9) Epidemiology and Surveillance; 10) Population Assessment; and 11) WIC-
Immunization linkage.
b. To ensure that public immunization clinic policies and practices are in compliance with the
current recommendations approved by the U.S. Public Health Service and endorsed by the
American Academy of Pediatrics AAP) as specified in the Revised Standards for Immunization
Practices Child, Adolescent and Adult Immunization, and conduct in-service training for public
clinic staff.
c. Within the health jurisdiction, develop and implement policies and procedures to enhance the
continuity of care including recommended immunizations) through the utilization of a medical
home among medically underserved children, adolescents and adults.
d. Attend/participate in regional, state and local meetings and educational forums related to
immunizations including but not limited to those sponsored by the Immunization Branch and
CDC. Attendance at the yearly CDPH Immunization Branch Coordinator's Meeting is required
for all Immunization Coordinators.
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
2) Vaccine Accountability and Management
The contractor receiving vaccine purchased with State of California/Federal funds, herein called
State purchased vaccines, agrees:
a. To ensure that immunization practices at the local health department for vaccine storage,
handling and administration procedures are consistent with the Revised Standards for
Immunization Practices Child, Adolescent and Adult Immunization.
b. The authorized immunization patient record card or authorized clinic log sheets must be stored
by the local health department in a retrievable file for a minimum of 7 years following the end of
the calendar year in which the vaccine information statement was provided to the vaccine
recipient, parent, or legal representative. In addition, if a notice of a claim or lawsuit has been
made, the record must be retained until after a final disposition has been made.
c. No charge may be made to the patient, parent, guardian or third party payer for the cost of State
purchased vaccine provided to local health departments by the Immunization Branch. In
addition, outside, non-profit providers of immunization services receiving State purchased
vaccine may not charge patients or parents for the cost of vaccine. Charges made by local
health departments to patients for the direct costs incurred for administration or injection of the
vaccine are discouraged but are not specifically prohibited. Should the health department or
outside medical provider receiving state-purchased vaccine establish an administration fee for
an injection of vaccine, information, e.g., sign/poster, must be prominently displayed which
indicates that no one receiving an immunization in a public clinic may be denied vaccine
provided through public funds for failure to pay the administration fee or failure to make a
donation to the provider.
d. The storage and handling of State purchased vaccine within local health department facilities
shall be in accordance with the manufacturers' specifications and Centers for Disease Control
and Prevention CDC) Guidelines. Local health departments may be required to purchase new
refrigerators or freezers if the storage units cannot consistently maintain appropriate
temperatures or have sufficient space to store all vaccines.
3) Immunization Information Systems
In coordination with the Senior Field Representatives and Registry Field Staff:
a. Provide assistance to immunization registry user support staff in their jurisdiction.
b. Support activities and strategies to assist in implementation, maintenance, and enhancement of
the California Immunization Registry.
c. Ensure registry participation at the local health department clinic level.
d. Assist and provide referrals as appropriate between local providers and California Immunization
Registry CAIR) staff, including both new and current providers.
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
4) Provider Quality Assurance
a. Provide and/or promote educational/training opportunities and informational materials to ensure
that health care providers within the jurisdiction are knowledgeable and competent regarding
current best practices for immunization services.
b. Utilize AFIX Assessment, Feedback, Incentive, Exchange) annually to assess immunization
coverage rates and adherence to the Standards for Pediatric Immunization Practices at local
health departments.
5) Perinatal Hepatitis B Prevention
Encourage use of the birth dose policy in hospitals within the jurisdiction by:
a. Providing education on the Hepatitis B birth dose recommendations and screening all pregnant
women for HBsAg status.
b. Identifying barriers to implementation of the birth dose.
c. Assuring that delivery hospitals develop written policies, procedures and standing orders for the
administration of the birth dose.
d. Assisting with enrollment of birth hospitals in the Vaccines for Children VFC) Program.
6) Adolescent Immunizations
Working collaboratively with local public and private/nonprofit providers and agencies, and
professional organizations to establish a platform on adolescent immunizations and increase
coverage rates within the jurisdiction through:
a. Enhancing access to all ACIP-recommended vaccines.
b. Promoting public awareness of adolescent immunizations utilizing promotional campaigns,
media and web communications.
c. Increasing awareness of and educating health care providers about adolescent immunization
recommendations.
d. Promoting use of the Immunization Registry for adolescents.
e. Outreach to adolescent service providers and enrollment in the VFC Program.
f. Collaborating with school based health centers, juvenile correctional facilities and social service
agencies to promote coverage.
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
7) Adult Immunizations
a. Working collaboratively with immunization coalitions, community groups, child care providers,
schools, nursing homes, home health agencies and other organizations, develop and implement
a strategy for the promotion of flu immunization within the jurisdiction.
b. To improve immunization coverage rates among adult populations within the jurisdiction,
coordinate program planning and implementation of strategies with local public and
private/nonprofit agencies serving adults.
c. Working collaboratively with the Immunization Registry, develop and implement strategies to
increase the percentage of adult immunizations entered into the registry.
8) Education, Information, Training, and Partnerships
a. Participate in the development, implementation and promotion of outreach activities focused on
children, adolescents, adults and families through partnerships, coalitions, and collaboration
with community groups, child care providers, juvenile justice programs, and culturally
appropriate organizations to reduce ethnic disparities in immunization coverage rates.
b. Collaborate with birthing facilities to develop and implement new mother education programs
regarding immunizations. Collaborate with the Registrar of Births to distribute immunization
educational materials to new mothers.
c. Work collaboratively with immunization coalitions, community groups, child care providers,
schools, nursing homes, home health agencies and other organizations to develop and
implement a strategy for the promotion of influenza vaccination within the jurisdiction.
d. Ensure that providers are knowledgeable about and are using the Vaccine Information
Statement VIS) in accordance with the National Childhood Vaccine Injury Act.
9) Epidemiology and Surveillance
a. Support the maintenance of an effective system for identification and reporting of suspect,
probable and confirmed cases of vaccine preventable diseases VPDs).
b. Support the investigation and follow-up of reported suspect, probable and confirmed VPDs.
c. Ensure that local health departments and public health clinics are knowledgeable about and
utilize the Vaccine Adverse Events Reporting System VAERS) for reporting adverse events
following immunizations in accordance with Immunization Branch guidelines.
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
10) Population Assessment
a. Conduct an immunization assessment of all child care centers and assist schools in completing
an immunization assessment of all kindergarten schools.
b. Conduct selective review site visits to a randomly selected sample of child care centers,
kindergarten, and seventh grade schools.
c. In coordination with Immunization Branch Field Representatives, local health authorities and
local child care center and school authorities, encourage compliance of all child care centers
and schools with existing regulations pertaining to the immunization of children admitted to such
institutions.
d. Implement and maintain immunization clinic reminder/recall systems among all public medical
providers receiving state-supplied vaccines to improve immunization rates among preschool-
age children within the jurisdiction.
e. Develop and implement strategies to increase immunization rates of the 24-35 month old
population in the jurisdiction. Expected improvements as assessed with Clinic Assessment
Software Application CoCASA) for the 4:3:1:3:3 series by provider type are: Public health
clinics PHC) with rates below 40% should achieve a 25% improvement; between 40% and 49%
should achieve a 15% improvement; between 50% and 69% should achieve a 10%
improvement; and between 70% and 85% should achieve a 5% improvement.
11) WIC-Immunization Linkage
a. Promote the use of the immunization registry in WIC sites.
C. Specific Perinatal Hepatitis B Activities only for contractors receiving federal perinatal hepatitis
B funds):
1. Ensure that clinicians are testing pregnant women for HBsAg and that clinicians and laboratories
are reporting patients with positive test results to the local health department.
2. Ensure that hepatitis B vaccine HBV) infected pregnant women are reported to birth hospitals prior
to delivery.
3. Ensure that birth hospitals have a written HBsAg test result for each pregnant woman and that they
test pregnant women with unknown HBsAg status.
4. Ensure that birth hospitals are aware of requirements for post exposure prophylaxis PEP) for
infants born to HBV infected mothers and mothers with unknown HBV infection status.
a. Provide information on developing standing orders and policies and procedures for
administering the birth dose to all infants according to the ACIP recommendations.
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
EXHIBIT A
Scope of Work
5. Ensure that local pediatricians and family physicians caring for infants have a method for identifying
those infants born to HBV infected women and are aware of recommendations for administration of
PEP, for the vaccine series, and for post vaccine serology testing.
6. Provide information to HBSAg-positive women regarding perinatal hepatitis B transmission
and medical care, as well as information on vaccination and testing requirements for the infant.
7. Provide information to HBV infected women and their household and sexual contacts on screening
and vaccination recommendations and provide referrals to medical services as needed.
8. Monitor follow up of infants born to HBV infected mothers, including administration of Hepatitis B
Immune Globulin HBIG) and hepatitis B at birth, completion of the hepatitis B vaccine series and
obtaining post vaccine serologic PVS) testing results.
9. Provide birth hospitals and medical providers written information on screening and reporting
requirements and on the ACIP recommendations for perinatal hepatitis B prevention.
10. Submit case reports for HBV infected pregnant women and their infants to CDPH Immunization
Branch in a timely manner.
D. Required Reports
1) Reports of Local Program Progress and Activities
In accordance with the guidelines and format provided by the CDPH Immunization Branch, the
Contractor shall submit required reports through his/her CDPH Immunization Branch District Field
Representative as identified in paragraph D4), by the 15th of the month following the end of each
quarter, a written quarterly report of progress and activities. In addition to the written report the
Contractor and Project Liaison, or designee, may meet and discuss the above matters in person.
2) Upon completion of the investigation of each probable or confirmed reportable vaccine preventable
disease case, a completed investigation form must be submitted to the CDPH Immunization
Branch.
3) Contractor agrees that itemized personnel positions listed in the Application for Immunization
Project Subvention Funds shall not be subject to Contractor's personnel policy decisions to refrain
from filling vacant positions.
4) All reports, other than those required to be directed to the Field Representatives, invoices, and
other written communications are to be addressed and delivered to the address identified in Exhibit
A 2B.
5) The State reserves the right to use and reproduce all reports and data produced and delivered
pursuant to this Contract and reserves the right to authorize others to use or reproduce such
materials, provided that the confidentiality of patient information and records are protected pursuant
to California State laws and regulations.
6) It is agreed by the Contractor that in the event that a significant portion of the Contract objectives for
the initial 4 months of the Contract are not met by that time; and in the event that the State
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FULLY EXECUTED AGREEMENT NO. u� /�County of Monterey
11-10592
EXHIBIT A
Scope of Work
4.
determines from quarterly invoices, performance reports, and other sources of information that the
Contractor will not perform the total quantity of services contracted for; and that therefore, the total
budget allocation will not be depleted; the State and/or Contractor may make an equitable
adjustment in the original Contract budget and Contract objectives in order to decrease the total
quantity of services and commensurate Contract amount. Any adjustment shall be by amendment
only and duly executed by both parties and approved by the Department of General Services if
applicable).
Glossary of Acronyms
Abbreviation Definition
ACIP Advisory Committee on Immunization Practices
CDPH California Department of Public Health
HBsAg Hepatitis B Surface Antigen
HBV Hepatitis B Vaccine
VPDs Vaccine Preventable Disease(s)
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FULLY EXECUTED AGREEMENT NO. u�
/�County of Monterey
11-10592
Exhibit B
Budget Detail and Payment Provisions
1. Invoicing and Payment
A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to
compensate the Contractor for actual expenditures incurred in accordance with the budget(s) attached
hereto.
B. Invoices shall include the Agreement Number and shall be submitted in triplicate not more frequently
than quarterly in arrears to:
California Department of Public Health
Immunization Branch
Attn: Robina Escalada
850 Marina Bay Pkwy., Bldg. P, 2h1d Floor
Richmond, CA 94804
C. Invoices shall:
1) Be prepared on Contractor letterhead. If invoices are not on produced letterhead invoices must be
signed by an authorized official, employee or agent certifying that the expenditures claimed
represent actual expenses for the service performed under this contract.
2) Bear the Contractor's name as shown on the agreement.
3) Identify the billing and/or performance period covered by the invoice.
4) Itemize costs for the billing period in the same or greater level of detail as indicated in this
agreement. Subject to the terms of this agreement, reimbursement may only be sought for those
costs and/or cost categories expressly identified as allowable in this agreement and approved by
CDPH.
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered
under this agreement does not appropriate sufficient funds for the program, this agreement shall be of
no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to
Contractor or to furnish any other considerations under this agreement and Contractor shall not be
obligated to perform any provisions of this agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the
State shall have the option to either cancel this agreement with no liability occurring to the State, or
offer an agreement amendment to Contractor to reflect the reduced amount.
3. Prompt Payment Clause
Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5,
commencing with Section 927.
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/�County of Monterey
11-10592
Exhibit B
Budget Detail and Payment Provisions
4. Amounts Payable
A. The amounts payable under this agreement shall not exceed:
1) $162,273 for the budget period of 07/01/11 through 06/30/12.
2) $162,273 for the budget period of 07/01/12 through 06/30/13.
B. Reimbursement shall be made for allowable expenses up to the amount annually encumbered
commensurate with the state fiscal year in which services are performed and/or goods are received.
C. The Contractor must maintain records reflecting actual expenditures for each state fiscal year
covered by the term of this agreement.
5. Timely Submission of Final Invoice
A. A final undisputed invoice shall be submitted for payment no more than sixty 60) calendar days
following the expiration or termination date of this agreement, unless a later or alternate deadline is
agreed to in writing by the program contract manager. Said invoice should be clearly marked Final
Invoice", thus indicating that all payment obligations of the State under this agreement have ceased
and that no further payments are due or outstanding.
B. The State may, at its discretion, choose not to honor any delinquent final invoice if the Contractor fails
to obtain prior written State approval of an alternate final invoice submission deadline. Written State
approval shall be sought from the program contract manager prior to the expiration or termination date
of this agreement.
C. The Contractor is hereby advised of its obligation to submit, with the final invoice, a completed copy of
the Contractor's Release Exhibit F)".
6. Expense Allowability I Fiscal Documentation
A. Invoices, received from a Contractor and accepted and/or submitted for payment by the State, shall not
be deemed evidence of allowable agreement costs.
B. Contractor shall maintain for review and audit and supply to CDPH upon request, adequate
documentation of all expenses claimed pursuant to this agreement to permit a determination of
expense allowability.
C. If the allowability or appropriateness of an expense cannot be determined by the State because invoice
detail, fiscal records, or backup documentation is nonexistent or inadequate according to generally
accepted accounting principles or practices, all questionable costs may be disallowed and payment
may be withheld by the State. Upon receipt of adequate documentation supporting a disallowed or
questionable expense, reimbursement may resume for the amount substantiated and deemed
allowable.
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11-10592
Exhibit B
Budget Detail and Payment Provisions
D. If travel is a reimbursable expense, receipts must be maintained to support the claimed expenditures.
For more information on allowable travel and per diem expenses and required documentation, see
Exhibit G entitled, Travel Reimbursement Information".
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FULLY EXECUTED AGREEMENT NO. u�
/� County of Monterey
11-10592
Exhibit B, Attachment I
Budget Year 1)
07/01/11 through 06/30/12)
% of time or Monthly salary range
1. Personnel hours on project or hourly rate Total
1 Chronic Dis Prev Coord/IZ Coord 100% $4,679 $6,416 $76,987.00
1 Deputy Health Officer Prog Mngr 5% $10,394- $14,198 $8,519.00
1 Public Health Nurse III 7% $5,487 $7,535 $6,329.00
1 Office Assistant I I I 30% $2,537 $3,464 $12,470.00
Total Personnel $104,305.00
II. Fringe Benefits 38% of Personnel) $39,636.00
Ill. Operating Expenses or General Expenses
Office Supplies
$0.00
Health Education Materials $1,000.00
Printing $1,500.00
Other $14,632.00
IV. Equipment $0.00
V. Travel* $1,200.00
*The contractor shall be reimbursed for the actual claimed and invoiced)
VI. Subcontracts $0.00
VII. Other Costs $0.00
VIII. Indirect Costs 0%) 0.00
Total Budget $162,273.00
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FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
Exhibit B, Attachment I
Budget Year 1)
07/01 /11 through 06/30/12
*Health Education Materials $1,000:
Translation costs for Language Line to translate flyers and brochures for medical providers and
community members: $500
Purchase of Health Education Materials. Health Education Materials will be supplemented by
the purchase of material from outside vendors as needed. $500
**Printing $1,500: Printing of flyers and brochures. This information will be utilized to help support local
vaccine topics and vaccine educational campaigns.
***Other $14,632:
Meeting expenses: Costs of hosting educational meetings for the community. Costs include but
aren't limited to location rental fees, presenter fees and meeting supplies:
o Monterey County Immunization Coalition. Quarterly meetings that will cost approximately
$400 each: $1600
o Annual Immunization Update: $4,500
o Storage & Handling trainings. Annual training for medical providers: $500
o Parents' Open House. A meeting for parents that would address parent concerns,
vaccine safety and vaccine myths: $300
Postage charges for Childcare mailing and other immunization related mailings: $523
Telecommunications for the year, including business phone line, information line and fax line
for the Immunization Coordinator only): $1,506
Internet charges and computer support for the Immunization Coordinator only): $3,577
Software upgrade to office 2010 for the Immunization Coordinator only): $355
Upgrade to dual monitors for the Immunization Coordinator only): $550
Electronic payroll and finance services support for the Immunization Coordinator only): $1,221
****Travel $1,200
In-State travel:
Travel to and from the Annual Immunization Branch Coordinator's Meeting in Emeryville for one
local immunization staff. Total cost includes mileage, food, incidentals and lodging. $420
Within County travel for clinic visits, presentations and trainings.
o 4 trips to and from King City $0.555 x 100 miles $55.50 each): $222.00
o 4 trips to and from the Peninsula based on averaged distance to Seaside, Pacific Grove
and Marina) $0.555 x 23 miles $ 25.53 each): $102
o 10 trips in Salinas $0.555 x 6 miles $3.33 each): $33
Travel to and from the Annual California Immunization Coalition Summit in Sacramento for one
local immunization staff. Total cost includes mileage, food, incidental and lodging. $425
Page 2 of 2
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
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AI102677-U03
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C5-U03
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1/24/2012-U04
BOYDA-U04
16616-U05
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411-HEALTH-U08
MCKEE-U09
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6/1/2011-U011
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AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/� County of Monterey
11-10592
Exhibit B, Attachment II
Budget Year 2)
07/01/12 through 06/30/13)
% of time or Monthly salary range
1. Personnel hours on project or hourly rate Total
1 Chronic Dis Prev Coord/IZ Coord 100% $4,679 $6,416 $76,987.00
1 Deputy Health Officer Prog Mngr 5% $10,394 $14,198 $8,519.00
1 Public Health Nurse III 7% $5,487 $7,535 $6,329.00
1 Office Assistant III 30% $2,537 $3,464 $12,470.00
Total Personnel $104,305.00
II. Fringe Benefits 38% of Personnel) $39,636.00
Ill. Operating Expenses or General Expenses
Office Supplies
$0.00
Health Education Materials $1,000.00
Printing $1,500.00
Other $14,632.00
IV. Equipment $0.00
V. Travel* $1,200.00
*The contractor shall be reimbursed for the actual claimed and invoiced)
VI. Subcontracts $0.00
VII. Other Costs $0.00
VIII. Indirect Costs 0%) $0.00
Total Budget $162,273.00
Page 1 of 2
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
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FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/�County of Monterey
11-10592
Exhibit B, Attachment II
Budget Year 2)
07/01/12 through 06/30/13
*Health Education Materials $1,000:
Translation costs for Language Line to translate flyers and brochures for medical providers and
community members: $500
Purchase of Health Education Materials. Health Education Materials will be supplemented by
the purchase of material from outside vendors as needed. $500
**Printing $1,500: Printing of flyers and brochures. This information will be utilized to help support local
vaccine topics and vaccine educational campaigns.
***Other $14,632:
Meeting expenses: Costs of hosting educational meetings for the community. Costs include but
aren't limited to location rental fees, presenter fees and meeting supplies:
o Monterey County Immunization Coalition. Quarterly meetings that will cost approximately
$400 each: $1600
o Annual Immunization Update: $4,500
o Storage & Handling trainings. Annual training for medical providers: $500
o Parents' Open House. A meeting for parents that would address parent concerns,
vaccine safety and vaccine myths: $300
Postage charges for Childcare mailing and other immunization related mailings: $523
Telecommunications for the year, including business phone line, information line and fax line
for the Immunization Coordinator only): $1,506
Internet charges and computer support for the Immunization Coordinator only): $3,577
Software upgrade to office 2010 for the Immunization Coordinator only): $355
Upgrade to dual monitors for the Immunization Coordinator only): $550
Electronic payroll and finance services support for the Immunization Coordinator only): $1,221
****Travel $1,200
In-State travel:
Travel to and from the Annual Immunization Branch Coordinator's Meeting in Emeryville for one
local immunization staff. Total cost includes mileage, food, incidentals and lodging. $420
Within County travel for clinic visits, presentations and trainings.
o 4 trips to and from King City $0.555 x 100 miles $55.50 each): $222.00
o 4 trips to and from the Peninsula based on averaged distance to Seaside, Pacific Grove
and Marina) $0.555 x 23 miles $ 25.53 each): $102
o 10 trips in Salinas $0.555 x 6 miles $3.33 each): $33
Travel to and from the Annual California Immunization Coalition Summit in Sacramento for one
local immunization staff. Total cost includes mileage, food, incidental and lodging. $425
Page 2 of 2
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
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AS99894-U03
AI102677-U03
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1/24/2012-U04
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BEHALF-U07
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COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
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411-HEALTH-U08
MCKEE-U09
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MCKEES-U10
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AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health
Exhibit D(F)
Special Terms and Conditions
For federally funded service contracts or agreements and grant agreements)
The use of headings or titles throughout this exhibit is for convenience only and shall not be used to interpret or to
govern the meaning of any specific term or condition.
The terms contract", Contractor" and Subcontractor" shall also mean, agreement", grant", grant agreement",
Grantee" and Subgrantee" respectively.
The terms California Department of Public Health" and CDPH" shall have the same meaning and refer to the
California State agency that is a party to this Agreement.
This exhibit contains provisions that require strict adherence to various contracting laws and policies. Some
provisions herein are conditional and only apply if specified conditions exist i.e., agreement total exceeds a certain
amount, agreement is federally funded, etc.). The provisions herein apply to this Agreement unless the provisions
are removed by reference on the face of this Agreement, the provisions are superseded by an alternate provision
appearing elsewhere in this Agreement, or the applicable conditions do not exist.
Index of Special Terms and Conditions
1. Federal Equal Employment Opportunity 17. Human Subjects Use Requirements
Requirements
18.
Novation Requirements
2 Travel and Per Diem Reimbursement
19. Debarment and Suspension Certification
3 Procurement Rules
20. Smoke-Free Workplace Certification
4 Equipment Ownership / Inventory / Disposition
21. Covenant Against Contingent Fees
5 Subcontract Requirements
22. Payment Withholds
6 Income Restrictions
23. Performance Evaluation
7 Audit and Record Retention
24. Officials Not to Benefit
8 Site Inspection
25. Four-Digit Date Compliance
9 Federal Contract Funds
26. Prohibited Use of State Funds for Software
10 Intellectual Property Rights
27. Use of Small, Minority Owned and Women's
11. Air or Water Pollution Requirements Businesses
12. Prior Approval of Training Seminars, Workshops 28. Alien Ineligibility Certification
or Conferences
29.
Union Organizing
13. Confidentiality of Information
30. Contract Uniformity Fringe Benefit Allowability)
14 Publications
and Written Reports
Documents
31. Lobbying Restrictions and Disclosure Certification
15. Dispute Resolution Process
16. Financial and Compliance Audit Requirements
CDPH Exhibit D(F) 8/10) Page 1 of 26
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EXECUTED-U02
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
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THE-U07
DIRECTOR-U07
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ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions Exhibit D F)
1. Federal Equal Opportunity Requirements
Applicable to all federally funded agreements entered into by the California Department of Public Health
CDPH) formerly known as California Department of Health Services CDHS).)
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, disability, age or status as a disabled
veteran or veteran of the Vietnam era. 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, disability, age or status as a
disabled veteran or veteran of the Vietnam era. 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 CDPH, setting forth the provisions of the Equal Opportunity clause, Section 503 of the
Rehabilitation Act of 1973 and the affirmative action clause required by the Vietnam Era Veterans'
Readjustment Assistance Act of 1974 38 U.S.C. 4212). 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, disability, age or status as a disabled veteran or veteran of the Vietnam era and the
rights of applicants and employees.
b. The Contractor will, in all solicitations or advancements 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, disability, age or status as a
disabled veteran or veteran of the Vietnam era.
c. The Contractor will send to each labor union or representative of workers with which it 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 workers' representative of the Contractor's
commitments under the provisions herein 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 and furnish all information and reports required by
Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Era Veterans' Readjustment
Assistance Act of 1974 38 U.S.C. 4212) and of the Federal Executive Order No. 11246 as amended,
including by Executive Order 11375, Amending Executive Order 11246 Relating to Equal Employment
Opportunity,' and as supplemented by regulation at 41 CFR part 60, Office of the Federal Contract
Compliance Programs, Equal Employment Opportunity, Department of Labor," 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, including by Executive Order 11375, Amending Executive Order 11246 Relating to Equal
Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60, Office of the Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of Labor," 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 its books, records, and accounts by the State and its
designated representatives and the Secretary of Labor for purposes of investigation to ascertain
compliance with such rules, regulations, and orders.
f. In the event of the Contractor's noncompliance with the requirements of the provisions herein or with any
federal rules, regulations, or orders which are referenced herein, this Agreement may be cancelled,
terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further
federal and 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, including by Executive Order 11375, Amending
Executive Order 11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation
at 41 CFR part 60, Office of the Federal Contract Compliance Programs, Equal Employment
CDPH Exhibit D(F) 8/10) Page 2 of 26
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40963-U01
FULLY-U02
EXECUTED-U02
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NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
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THE-U07
DIRECTOR-U07
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ON-U07
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OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
9.
Exhibit D F)
Opportunity, Department of Labor," or by rule, regulation, or order of the Secretary of Labor, or as
otherwise provided by law.
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, including by Executive Order 11375, Amending
Executive Order 11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation
at 41 CFR part 60, Office of the Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor," or Section 503 of the Rehabilitation Act of 1973 or 38 U.S.C. 4212)
of the Vietnam Era Veteran's Readjustment Assistance 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 or CDPH 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 by a subcontractor or
vendor as a result of such direction by CDPH, the Contractor may request in writing to CDPH, 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 Diem Reimbursement
Applicable if travel and/or per diem expenses are reimbursed with agreement funds.)
Reimbursement for travel and per diem expenses from CDPH under this Agreement shall, unless otherwise
specified in this Agreement, be at the rates currently in effect, as established by the California Department of
Personnel Administration DPA), for nonrepresented state employees as stipulated in CDPH's Travel
Reimbursement Information Exhibit. If the DPA rates change during the term of the Agreement, the new
rates shall apply upon their effective date and no amendment to this Agreement shall be necessary.
Exceptions to DPA rates may be approved by CDPH upon the submission of a statement by the Contractor
indicating that such rates are not available to the Contractor. No travel outside the State of California shall be
reimbursed without prior authorization from CDPH. Verbal authorization should be confirmed in writing.
Written authorization may be in a form including fax or email confirmation.
3. Procurement Rules
Applicable to all agreements in which equipment, property, commodities and/or supplies are furnished by
CDPH or expenses for said items are reimbursed with state or federal funds.)
a. Equipment definitions
Wherever the term equipment /property is used, the following definitions shall apply:
1) Major equipment/property: A tangible or intangible item having a base unit cost of $5,000 or more
with a life expectancy of one 1) year or more and is either furnished by CDPH or the cost is
reimbursed through this Agreement. Software and videos are examples of intangible items that meet
this definition.
2) Minor equipment/property: A tangible item having a base unit cost of less than $5.000 with a life
expectancy of one 1) year or more and is either furnished by CDPH or the cost is reimbursed
through this Agreement.
b. Government and public entities including state colleges/universities and auxiliary organizations),
whether acting as a contractor and/or subcontractor, may secure all commodities, supplies, equipment
and services related to such purchases that are required in performance of this Agreement. Said
procurements are subject to Paragraphs d through h of Provision 3. Paragraph c of Provision 3 shall also
apply, if equipment purchases are delegated to subcontractors that are nonprofit organizations or
commercial businesses.
c. Nonprofit organizations and commercial businesses, whether acting as a contractor and/or
subcontractor, may secure commodities, supplies, equipment and services related to such purchases for
performance under this Agreement.
1) Equipment purchases shall not exceed $50,000 annually.
CDPH Exhibit D(F) 8/10) Page 3 of 26
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MG99866-U03
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
To secure equipment above the annual maximum limit of $50,000, the Contractor shall make
arrangements through the appropriate CDPH Program Contract Manager, to have all remaining
equipment purchased through CDPH's Purchasing Unit. The cost of equipment purchased by or
through CDPH shall be deducted from the funds available in this Agreement. Contractor shall submit
to the CDPH Program Contract Manager a list of equipment specifications for those items that the
State must procure. The State may pay the vendor directly for such arranged equipment purchases
and title to the equipment will remain with CDPH. The equipment will be delivered to the Contractor's
address, as stated on the face of the Agreement, unless the Contractor notifies the CDPH Program
Contract Manager, in writing, of an alternate delivery address.
2) All equipment purchases are subject to Paragraphs d through h of Provision 3. Paragraph b of
Provision 3 shall also apply, if equipment purchases are delegated to subcontractors that are either a
government or public entity.
Nonprofit organizations and commercial businesses, shall use a procurement system that meets the
following standards:
3)
a) Maintain a code or standard of conduct that shall govern the performance of its officers,
employees, or agents engaged in awarding procurement contracts. No employee, officer, or
agent shall participate in the selection, award, or administration of a procurement, or bid contract
in which, to his or her knowledge, he or she has a financial interest.
b) Procurements shall be conducted in a manner that provides, to the maximum extent practical,
open, and free competition.
c) Procurements shall be conducted in a manner that provides for all of the following:
1] Avoid purchasing unnecessary or duplicate items.
2] Equipment solicitations shall be based upon a clear and accurate description of the technical
requirements of the goods to be procured.
3] Take positive steps to utilize small and veteran owned businesses.
d. Unless waived or otherwise stipulated in writing by CDPH, prior written authorization from the appropriate
CDPH Program Contract Manager will be required before the Contractor will be reimbursed for any
purchase of $5,000 or more for commodities, supplies, equipment, and services related to such
purchases. The Contractor must provide in its request for authorization all particulars necessary, as
specified by CDPH, for evaluating the necessity or desirability of incurring such costs. The term
purchase" excludes the purchase of services from a subcontractor and public utility services at rates
established for uniform applicability to the general public.
e. In special circumstances, determined by CDPH e.g., when CDPH has a need to monitor certain
purchases, etc.), CDPH may require prior written authorization and/or the submission of paid vendor
receipts for any purchase, regardless of dollar amount. CDPH reserves the right to either deny claims for
reimbursement or to request repayment for any Contractor and/or subcontractor purchase that CDPH
determines to be unnecessary in carrying out performance under this Agreement.
f. The Contractor and/or subcontractor must maintain a copy or narrative description of the procurement
system, guidelines, rules, or regulations that will be used to make purchases under this Agreement. The
State reserves the right to request a copy of these documents and to inspect the purchasing practices of
the Contractor and/or subcontractor at any time.
g.
For all purchases, the Contractor and/or subcontractor must maintain copies of all paid vendor invoices,
documents, bids and other information used in vendor selection, for inspection or audit. Justifications
supporting the absence of bidding i.e., sole source purchases) shall also be maintained on file by the
Contractor and/or subcontractor for inspection or audit.
h. CDPH may, with cause e.g., with reasonable suspicion of unnecessary purchases or use of
CDPH Exhibit D(F) 8/10) Page 4 of 26
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FEDERAL-U012
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions Exhibit D F)
inappropriate purchase practices, etc.), withhold, cancel, modify, or retract the delegated purchase
authority granted under Paragraphs b and/or c of Provision 3 by giving the Contractor no less than 30
calendar days written notice.
4. Equipment Ownership / Inventory / Disposition
Applicable to agreements in which equipment and/or property is furnished by CDPH and/or when said items
are purchased or reimbursed with state or federal funds.)
a. Wherever the terms equipment and/or property are used in Provision 4, the definitions in Provision 3,
Paragraph a, shall apply.
1)
Unless otherwise stipulated in this Agreement, all equipment and/or property that are
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this Agreement
shall be considered state equipment and the property of CDPH.
CDPH requires the reporting, tagging and annual inventorying of all equipment and/or property that is
furnished by CDPH or purchased/reimbursed with funds provided through this Agreement.
Upon receipt of equipment and/or property, the Contractor shall report the receipt to the CDPH
Program Contract Manager. To report the receipt of said items and to receive property tags,
Contractor shall use a form or format designated by CDPH's Asset Management Unit. If the
appropriate form i.e., Contractor Equipment Purchased with CDPH Funds) does not accompany this
Agreement, Contractor shall request a copy from the CDPH Program Contract Manager.
2) If the Contractor enters into an agreement with a term of more than twelve months, the Contractor
shall submit an annual inventory of state equipment and/or property to the CDPH Program Contract
Manager using a form or format designated by CDPH's Asset Management Unit. If an inventory
report form i.e., Inventory/Disposition of CDPH-Funded Equipment) does not accompany this
Agreement, Contractor shall request a copy from the CDPH Program Contract Manager. Contractor
shall:
a) Include in the inventory report, equipment and/or property in the Contractor's possession and/or
in the possession of a subcontractor including independent consultants).
b) Submit the inventory report to CDPH according to the instructions appearing on the inventory
form or issued by the CDPH Program Contract Manager.
c) Contact the CDPH Program Contract Manager to learn how to remove, trade-in, sell, transfer or
survey off, from the inventory report, expired equipment and/or property that is no longer wanted,
usable or has passed its life expectancy. Instructions will be supplied by CDPH's Asset
Management Unit.
b. Title to state equipment and/or property shall not be affected by its incorporation or attachment to any
property not owned by the State.
c. Unless otherwise stipulated, CDPH shall be under no obligation to pay the cost of restoration, or
rehabilitation of the Contractor's and/or Subcontractor's facility which may be affected by the removal of
any state equipment and/or property.
d. The Contractor and/or Subcontractor shall maintain and administer a sound business program for
ensuring the proper use, maintenance, repair, protection, insurance and preservation of state equipment
and/or property.
1) In administering this provision, CDPH may require the Contractor and/or Subcontractor to repair or
replace, to CDPH's satisfaction, any damaged, lost or stolen state equipment and/or property.
Contractor and/or Subcontractor shall immediately file a theft report with the appropriate police
agency or the California Highway Patrol and Contractor shall promptly submit one copy of the theft
report to the CDPH Program Contract Manager.
CDPH Exhibit D(F) 8/10) Page 5 of 26
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
e. Unless otherwise stipulated by the program funding this Agreement, equipment and/or property
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this Agreement,
shall only be used for performance of this Agreement or another CDPH agreement.
f. Within sixty 60) calendar days prior to the termination or end of this Agreement, the Contractor shall
provide a final inventory report of equipment and/or property to the CDPH Program Contract Manager
and shall, at that time, query CDPH as to the requirements, including the manner and method, of
returning state equipment and/or property to CDPH. Final disposition of equipment and/or property shall
be at CDPH expense and according to CDPH instructions. Equipment and/or property disposition
instructions shall be issued by CDPH immediately after receipt of the final inventory report. At the
termination or conclusion of this Agreement, CDPH may at its discretion, authorize the continued use of
state equipment and/or property for performance of work under a different CDPH agreement.
g. Motor Vehicles
1)
3)
Applicable only if motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH
under this Agreement.)
If motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, within thirty 30) calendar days prior to the termination or end of this
Agreement, the Contractor and/or Subcontractor shall return such vehicles to CDPH and shall deliver
all necessary documents of title or registration to enable the proper transfer of a marketable title to
CDPH.
2) If motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, the State of California shall be the legal owner of said motor vehicles and
the Contractor shall be the registered owner. The Contractor and/or a subcontractor may only use
said vehicles for performance and under the terms of this Agreement.
The Contractor and/or Subcontractor agree that all operators of motor vehicles,
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this
Agreement, shall hold a valid State of California driver's license. In the event that ten or more
passengers are to be transported in any one vehicle, the operator shall also hold a State of California
Class B driver's license.
4) If any motor vehicle is purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, the Contractor and/or Subcontractor, as applicable, shall provide, maintain,
and certify that, at a minimum, the following type and amount of automobile liability insurance is in
effect during the term of this Agreement or any extension period during which any vehicle remains in
the Contractor's and/or Subcontractor's possession:
Automobile Liability Insurance
a) The Contractor, by signing this Agreement, hereby certifies that it possesses or will obtain
automobile liability insurance in the amount of $1,000,000 per occurrence for bodily injury and
property damage combined. Said insurance must be obtained and made effective upon the
delivery date of any motor vehicle, purchased/reimbursed with agreement funds or furnished by
CDPH under the terms of this Agreement, to the Contractor and/or Subcontractor.
b) The Contractor and/or Subcontractor shall, as soon as practical, furnish a copy of the certificate
of insurance to the CDPH Program Contract Manager. The certificate of insurance shall identify
the CDPH contract or agreement number for which the insurance applies.
c) The Contractor and/or Subcontractor agree that bodily injury and property damage liability
insurance, as required herein, shall remain in effect at all times during the term of this Agreement
or until such time as the motor vehicle is returned to CDPH.
d) The Contractor and/or Subcontractor agree to provide, at least thirty 30) days prior to the
expiration date of said insurance coverage, a copy of a new certificate of insurance evidencing
continued coverage, as indicated herein, for not less than the remainder of the term of this
CDPH Exhibit D(F) 8/10) Page 6 of 26
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FEDERAL-U012
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions Exhibit D F)
f)
g)
Agreement, the term of any extension or continuation thereof, or for a period of not less than one
1) year.
e) The Contractor and/or Subcontractor, if not a self-insured government and/or public entity, must
provide evidence, that any required certificates of insurance contain the following provisions:
1]
The insurer will not cancel the insured's coverage without giving thirty 30) calendar days
prior written notice to the State California Department of Public Health CDPH)).
2] The State of California, its officers, agents, employees, and servants are included as
additional insureds, but only with respect to work performed for the State under this
Agreement and any extension or continuation of this Agreement.
3]
The insurance carrier shall notify CDPH, in writing, of the Contractor's failure to pay
premiums; its cancellation of such policies; or any other substantial change, including, but not
limited to, the status, coverage, or scope of the required insurance. Such notices shall
contain a reference to each agreement number for which the insurance was obtained.
The Contractor and/or Subcontractor is hereby advised that copies of certificates of insurance
may be subject to review and approval by the Department of General Services DGS), Office of
Risk and Insurance Management. The Contractor shall be notified by CDPH, in writing, if this
provision is applicable to this Agreement. If DGS approval of the certificate of insurance is
required, the Contractor agrees that no work or services shall be performed prior to obtaining
said approval.
In the event the Contractor and/or Subcontractor fails to keep insurance coverage, as required
herein, in effect at all times during vehicle possession, CDPH may, in addition to any other
remedies it may have, terminate this Agreement upon the occurrence of such event.
5. Subcontract Requirements
Applicable to agreements under which services are to be performed by subcontractors including independent
consultants.)
a. Prior written authorization will be required before the Contractor enters into or is reimbursed for any
subcontract for services costing $5,000 or more. Except as indicated in Paragraph a(3) herein, when
securing subcontracts for services costing $5,000, the Contractor shall obtain at least three bids or justify
a sole source award.
1) The Contractor must provide in its request for authorization, all information necessary for evaluating
the necessity or desirability of incurring such cost.
2) The State may identify the information needed to fulfill this requirement.
3) Subcontracts performed by the following entities or for the service types listed below are exempt from
the bidding and sole source justification requirements:
a)
b)
c)
d)
e)
f)
g)
h)
A local governmental entity or the federal government,
A State college or university from any State,
A Joint Powers Authority,
An auxiliary organization of a California State University or a California community college,
A foundation organized to support the Board of Governors of the California Community Colleges,
An auxiliary organization of the Student Aid Commission established under Education Code
69522,
Entities of any type that will provide subvention aid or direct services to the public,
Entities and/or service types identified as exempt from advertising in State Contracting Manual
5.80. View this publication at the following Internet address:
htt //www,ols.d s.ca. ov/Contract+Manual/Cha ters4throu h6.htm.
CDPH Exhibit D(F) 8/10) Page 7 of 26
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FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
b. CDPH reserves the right to approve or disapprove the selection of subcontractors and with advance
written notice, require the substitution of subcontractors and require the Contractor to terminate
subcontracts entered into in support of this Agreement.
1) Upon receipt of a written notice from CDPH requiring the substitution and/or termination of a
subcontract, the Contractor shall take steps to ensure the completion of any work in progress and
select a replacement, if applicable, within 30 calendar days, unless a longer period is agreed to by
CDPH.
c. Actual subcontracts i.e., written agreement between the Contractor and a subcontractor) of $5,000 or
more are subject to the prior review and written approval of CDPH. CDPH may, at its discretion, elect to
waive this right. All such waivers shall be confirmed in writing by CDPH.
d. Contractor shall maintain a copy of each subcontract entered into in support of this Agreement and shall,
upon request by CDPH, make copies available for approval, inspection, or audit.
e. CDPH assumes no responsibility for the payment of subcontractors used in the performance of this
Agreement. Contractor accepts sole responsibility for the payment of subcontractors used in the
performance of this Agreement.
f. The Contractor is responsible for all performance requirements under this Agreement even though
performance may be carried out through a subcontract.
g.
The Contractor shall ensure that all subcontracts for services include provision(s) requiring compliance
with applicable terms and conditions specified in this Agreement.
h. The Contractor agrees to include the following clause, relevant to record retention, in all subcontracts for
services:
Subcontractor Name) agrees to maintain and preserve, until three years after termination of
Agreement Number) and final payment from CDPH to the Contractor, to permit CDPH or any
duly authorized representative, to have access to, examine or audit any pertinent books,
documents, papers and records related to this subcontract and to allow interviews of any
employees who might reasonably have information related to such records."
i. Unless otherwise stipulated in writing by CDPH, the Contractor shall be the subcontractor's sole point of
contact for all matters related to performance and payment under this Agreement.
j�
Contractor shall, as applicable, advise all subcontractors of their obligations pursuant to the following
numbered provisions of this Exhibit: 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 17, 19, 20, 24, and 31 or other
numbered provisions herein that deemed applicable.
6. Income Restrictions
Unless otherwise stipulated in this Agreement, the Contractor agrees that any refunds, rebates, credits, or
other amounts including any interest thereon) accruing to or received by the Contractor under this
Agreement shall be paid by the Contractor to CDPH, to the extent that they are properly allocable to costs for
which the Contractor has been reimbursed by CDPH under this Agreement.
7. Audit and Record Retention
Applicable to agreements in excess of $10,000.)
a. The Contractor and/or Subcontractor shall maintain books, records, documents, and other evidence,
accounting procedures and practices, sufficient to properly reflect all direct and indirect costs of whatever
nature claimed to have been incurred in the performance of this Agreement, including any matching costs
and expenses. The foregoing constitutes records" for the purpose of this provision.
b. The Contractor's and/or subcontractor's facility or office or such part thereof as may be engaged in the
performance of this Agreement and his/her records shall be subject at all reasonable times to inspection,
CDPH Exhibit D(F) 8/10) Page 8 of 26
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FEDERAL-U012
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions Exhibit D F)
audit, and reproduction.
c. Contractor agrees that CDPH, the Department of General Services, the Bureau of State Audits, or their
designated representatives including the Comptroller General of the United States shall have the right to
review and to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to allow the auditor(s) access to such records during normal business
hours and to allow interviews of any employees who might reasonably have information related to such
records. Further, the Contractor agrees to include a similar right of the State to audit records and
interview staff in any subcontract related to performance of this Agreement. GC 8546.7, CCR Title 2,
Section 1896).
d. The Contractor and/or Subcontractor shall preserve and make available his/her records 1) for a period of
three years from the date of final payment under this Agreement, and 2) for such longer period, if any, as
is required by applicable statute, by any other provision of this Agreement, or by subparagraphs 1) or 2)
below.
1) If this Agreement 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 shall 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.
e. The Contractor and/or Subcontractor shall comply with the above requirements and be aware of the
penalties for violations of fraud and for obstruction of investigation as set forth in Public Contract Code
10115.10, if applicable.
f. The Contractor and/or Subcontractor may, at its discretion, following receipt of final payment under this
Agreement, reduce its accounts, books and records related to this Agreement to microfilm, computer
disk, CD ROM, or other data storage medium. Upon request by an authorized representative to inspect,
audit or obtain copies of said records, the Contractor and/or Subcontractor must supply or make available
applicable devices, hardware, and/or software necessary to view, copy and/or print said records.
Applicable devices may include, but are not limited to, microfilm readers and microfilm printers, etc.
9.
The Contractor shall, if applicable, comply with the Single Audit Act and the audit reporting requirements
set forth in OMB Circular A-133.
8. Site 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 of the
premises of the Contractor or Subcontractor, the Contractor shall provide and shall require Subcontractors to
provide all reasonable facilities and assistance for the safety and convenience of the authorized
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.
9. Federal Contract Funds
Applicable only to that portion of an agreement funded in part or whole with federal funds.)
a. It is mutually understood between the parties that this Agreement 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 Agreement were executed after that
determination was made.
b. This agreement is valid and enforceable only if sufficient funds are made available to the State by the
United States Government for the fiscal years covered by the term of this Agreement. In addition, this
CDPH Exhibit D(F) 8/10) Page 9 of 26
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
Agreement 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 Agreement
in any manner.
c. It is mutually agreed that if the Congress does not appropriate sufficient funds for the program, this
Agreement shall be amended to reflect any reduction in funds.
d. CDPH has the option to invalidate or cancel the Agreement with 30-days advance written notice or to
amend the Agreement to reflect any reduction in funds.
10. Intellectual Property Rights
a. Ownership
1) Except where CDPH has agreed in a signed writing to accept a license, CDPH shall be and remain,
without additional compensation, the sole owner of any and all rights, title and interest in all
Intellectual Property, from the moment of creation, whether or not jointly conceived, that are made,
conceived, derived from, or reduced to practice by Contractor or CDPH and which result directly or
indirectly from this Agreement.
2) For the purposes of this Agreement, Intellectual Property means recognized protectable rights and
interest such as: patents, whether or not issued) copyrights, trademarks, service marks, applications
for any of the foregoing, inventions, trade secrets, trade dress, logos, insignia, color combinations,
slogans, moral rights, right of publicity, author's rights, contract and licensing rights, works, mask
works, industrial design rights, rights of priority, know how, design flows, methodologies, devices,
business processes, developments, innovations, good will and all other legal rights protecting
intangible proprietary information as may exist now and/or here after come into existence, and all
renewals and extensions, regardless of whether those rights arise under the laws of the United
States, or any other state, country or jurisdiction.
a) For the purposes of the definition of Intellectual Property, works" means all literary works,
writings and printed matter including the medium by which they are recorded or reproduced,
photographs, art work, pictorial and graphic representations and works of a similar nature, film,
motion pictures, digital images, animation cells, and other audiovisual works including positives
and negatives thereof, sound recordings, tapes, educational materials, interactive videos and any
other materials or products created, produced, conceptualized and fixed in a tangible medium of
expression. It includes preliminary and final products and any materials and information
developed for the purposes of producing those final products. Works does not include articles
submitted to peer review or reference journals or independent research projects.
3) In the performance of this Agreement, Contractor will exercise and utilize certain of its Intellectual
Property in existence prior to the effective date of this Agreement. In addition, under this Agreement,
Contractor may access and utilize certain of CDPH's Intellectual Property in existence prior to the
effective date of this Agreement. Except as otherwise set forth herein, Contractor shall not use any of
CDPH's Intellectual Property now existing or hereafter existing for any purposes without the prior
written permission of CDPH. Except as otherwise set forth herein, neither the Contractor nor
CDPH shall give any ownership interest in or rights to its Intellectual Property to the other
Party. If during the term of this Agreement, Contractor accesses any third-party Intellectual Property
that is licensed to CDPH, Contractor agrees to abide by all license and confidentiality restrictions
applicable to CDPH in the third-party's license agreement.
4) Contractor agrees to cooperate with CDPH in establishing or maintaining CDPH's exclusive rights in
the Intellectual Property, and in assuring CDPH's sole rights against third parties with respect to the
Intellectual Property. If the Contractor enters into any agreements or subcontracts with other parties
in order to perform this Agreement, Contractor shall require the terms of the Agreement(s) to include
all Intellectual Property provisions. Such terms must include, but are not limited to, the subcontractor
assigning and agreeing to assign to CDPH all rights, title and interest in Intellectual Property made,
conceived, derived from, or reduced to practice by the subcontractor, Contractor or CDPH and which
result directly or indirectly from this Agreement or any subcontract.
CDPH Exhibit D(F) 8/10) Page 10 of 26
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FULLY EXECUTED AGREEMENT NO. u�/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
5) Contractor further agrees to assist and cooperate with CDPH in all reasonable respects, and execute
all documents and, subject to reasonable availability, give testimony and take all further acts
reasonably necessary to acquire, transfer, maintain, and enforce CDPH's Intellectual Property rights
and interests.
b. Retained Rights / License Rights
1)
Except for Intellectual Property made, conceived, derived from, or reduced to practice by Contractor
or CDPH and which result directly or indirectly from this Agreement, Contractor shall retain title to all
of its Intellectual Property to the extent such Intellectual Property is in existence prior to the effective
date of this Agreement. Contractor hereby grants to CDPH, without additional compensation, a
permanent, non-exclusive, royalty free, paid-up, worldwide, irrevocable, perpetual, non-terminable
license to use, reproduce, manufacture, sell, offer to sell, import, export, modify, publicly and privately
display/perform, distribute, and dispose Contractor's Intellectual Property with the right to sublicense
through multiple layers, for any purpose whatsoever, to the extent it is incorporated in the Intellectual
Property resulting from this Agreement, unless Contractor assigns all rights, title and interest in the
Intellectual Property as set forth herein.
2) Nothing in this provision shall restrict, limit, or otherwise prevent Contractor from using any ideas,
concepts, know-how, methodology or techniques related to its performance under this Agreement,
provided that Contractor's use does not infringe the patent, copyright, trademark rights, license or
other Intellectual Property rights of CDPH or third party, or result in a breach or default of any
provisions of this Exhibit or result in a breach of any provisions of law relating to confidentiality.
c. Copyright
1) Contractor agrees that for purposes of copyright law, all works as defined in Paragraph a,
subparagraph 2)(a) of this provision] of authorship made by or on behalf of Contractor in connection
with Contractor's performance of this Agreement shall be deemed works made for hire". Contractor
further agrees that the work of each person utilized by Contractor in connection with the performance
of this Agreement will be a work made for hire," whether that person is an employee of Contractor or
that person has entered into an agreement with Contractor to perform the work. Contractor shall
enter into a written agreement with any such person that: i) all work performed for Contractor shall
be deemed a work made for hire" under the Copyright Act and ii) that person shall assign all right,
title, and interest to CDPH to any work product made, conceived, derived from, or reduced to practice
by Contractor or CDPH and which result directly or indirectly from this Agreement.
2) All materials, including, but not limited to, visual works or text, reproduced or distributed pursuant to
this Agreement that include Intellectual Property made, conceived, derived from, or reduced to
practice by Contractor or CDPH and which result directly or indirectly from this Agreement, shall
include CDPH's notice of copyright, which shall read in 3mm or larger typeface: Enter Current
Year e.g., 2007, etc.], Department of Public Health. This material may not be reproduced or
disseminated without prior written permission from the Department of Public Health." This notice
should be placed prominently on the materials and set apart from other matter on the page where it
appears. Audio productions shall contain a similar audio notice of copyright.
d. Patent Rights
With respect to inventions made by Contractor in the performance of this Agreement, which did not result
from research and development specifically included in the Agreement's scope of work, Contractor
hereby grants to CDPH a license as described under Section b of this provision for devices or material
incorporating, or made through the use of such inventions. If such inventions result from research and
development work specifically included within the Agreement's scope of work, then Contractor agrees to
assign to CDPH, without additional compensation, all its right, title and interest in and to such inventions
and to assist CDPH in securing United States and foreign patents with respect thereto.
e. Third-Party Intellectual Property
Except as provided herein, Contractor agrees that its performance of this Agreement shall not be
dependent upon or include any Intellectual Property of Contractor or third party without first: i) obtaining
CDPH Exhibit D(F) 8/10) Page 11 of 26
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FULLY EXECUTED AGREEMENT NO. u� /�California Department of Public Health Special Terms and Conditions
Exhibit D F)
CDPH's prior written approval; and ii) granting to or obtaining for CDPH, without additional
compensation, a license, as described in Section b of this provision, for any of Contractor's or third-
party's Intellectual Property in existence prior to the effective date of this Agreement. If such a license
upon the these terms is unattainable, and CDPH determines that the Intellectual Property should be
included in or is required for Contractor's performance of this Agreement, Contractor shall obtain a
license under terms acceptable to CDPH.
f. Warranties
1) Contractor represents and warrants that:
a) It is free to enter into and fully perform this Agreement.
b) It has secured and will secure all rights and licenses necessary for its performance of this
Agreement.
c) Neither Contractor's performance of this Agreement, nor the exercise by either Party of the rights
granted in this Agreement, nor any use, reproduction, manufacture, sale, offer to sell, import,
export, modification, public and private display/performance, distribution, and disposition of the
Intellectual Property made, conceived, derived from, or reduced to practice by Contractor or
CDPH and which result directly or indirectly from this Agreement will infringe upon or violate any
Intellectual Property right, non-disclosure obligation, or other proprietary right or interest of any
third-party or entity now existing under the laws of, or hereafter existing or issued by, any state,
the United States, or any foreign country. There is currently no actual or threatened claim by any
such third party based on an alleged violation of any such right by Contractor.
d) Neither Contractor's performance nor any part of its performance will violate the right of privacy
of, or constitute a libel or slander against any person or entity.
e) It has secured and will secure all rights and licenses necessary for Intellectual Property including,
but not limited to, consents, waivers or releases from all authors of music or performances used,
and talent radio, television and motion picture talent), owners of any interest in and to real
estate, sites, locations, property or props that may be used or shown.
f)
9.
g)
It has not granted and shall not grant to any person or entity any right that would or might
derogate, encumber, or interfere with any of the rights granted to CDPH in this Agreement.
It has appropriate systems and controls in place to ensure that state funds will not be used in the
performance of this Agreement for the acquisition, operation or maintenance of computer
software in violation of copyright laws.
h) It has no knowledge of any outstanding claims, licenses or other charges, liens, or encumbrances
of any kind or nature whatsoever that could affect in any way Contractor's performance of this
Agreement.
2) CDPH MAKES NO WARRANTY THAT THE INTELLECTUAL PROPERTY RESULTING FROM THIS
AGREEMENT DOES NOT INFRINGE UPON ANY PATENT, TRADEMARK, COPYRIGHT OR THE
LIKE, NOW EXISTING OR SUBSEQUENTLY ISSUED.
Intellectual Property Indemnity
1)
Contractor shall indemnify, defend and hold harmless CDPH and its licensees and assignees, and its
officers, directors, employees, agents, representatives, successors, and users of its products,
Indemnitees") from and against all claims, actions, damages, losses, liabilities or actions or
proceedings with respect to any thereof), whether or not rightful, arising from any and all actions or
claims by any third party or expenses related thereto including, but not limited to, all legal expenses,
court costs, and attorney's fees incurred in investigating, preparing, serving as a witness in, or
defending against, any such claim, action, or proceeding, commenced or threatened) to which any of
the Indemnitees may be subject, whether or not Contractor is a party to any pending or threatened
litigation, which arise out of or are related to i) the incorrectness or breach of any of the
CDPH Exhibit D(F) 8/10) Page 12 of 26
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FO99828-U03
MG99866-U03
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AI102677-U03
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DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� /�California Department of Public Health Special Terms and Conditions Exhibit D F)
3)
representations, warranties, covenants or agreements of Contractor pertaining to Intellectual
Property; or ii) any Intellectual Property infringement, or any other type of actual or alleged
infringement claim, arising out of CDPH's use, reproduction, manufacture, sale, offer to sell,
distribution, import, export, modification, public and private performance/display, license, and
disposition of the Intellectual Property made, conceived, derived from, or reduced to practice by
Contractor or CDPH and which result directly or indirectly from this Agreement. This indemnity
obligation shall apply irrespective of whether the infringement claim is based on a patent, trademark
or copyright registration that issued after the effective date of this Agreement. CDPH reserves the
right to participate in and/or control, at Contractor's expense, any such infringement action brought
against CDPH.
2) Should any Intellectual Property licensed by the Contractor to CDPH under this Agreement become
the subject of an Intellectual Property infringement claim, Contractor will exercise its authority
reasonably and in good faith to preserve CDPH's right to use the licensed Intellectual Property in
accordance with this Agreement at no expense to CDPH. CDPH shall have the right to monitor and
appear through its own counsel at Contractor's expense) in any such claim or action. In the defense
or settlement of the claim, Contractor may obtain the right for CDPH to continue using the licensed
Intellectual Property; or, replace or modify the licensed Intellectual Property so that the replaced or
modified Intellectual Property becomes non-infringing provided that such replacement or modification
is functionally equivalent to the original licensed Intellectual Property. If such remedies are not
reasonably available, CDPH shall be entitled to a refund of all monies paid under this Agreement,
without restriction or limitation of any other rights and remedies available at law or in equity.
Contractor agrees that damages alone would be inadequate to compensate CDPH for breach of any
term of this Intellectual Property Exhibit by Contractor. Contractor acknowledges CDPH would suffer
irreparable harm in the event of such breach and agrees CDPH shall be entitled to obtain equitable
relief, including without limitation an injunction, from a court of competent jurisdiction, without
restriction or limitation of any other rights and remedies available at law or in equity.
h. Federal Funding
In any agreement funded in whole or in part by the federal government, CDPH may acquire and maintain
the Intellectual Property rights, title, and ownership, which results directly or indirectly from the
Agreement; except as provided in 37 Code of Federal Regulations part 401.14; however, the federal
government shall have a non-exclusive, nontransferable, irrevocable, paid-up license throughout the
world to use, duplicate, or dispose of such Intellectual Property throughout the world in any manner for
governmental purposes and to have and permit others to do so.
i. Survival
The provisions set forth herein shall survive any termination or expiration of this Agreement or any project
schedule.
11. Air or Water Pollution Requirements
Any federally funded agreement and/or subcontract in excess of $100,000 must comply with the following
provisions unless said agreement is exempt under 40 CFR 15.5.
a. Government contractors agree to comply with all applicable standards, orders, or requirements issued
under section 306 of the Clean Air Act 42 U.S.C. 1857(h)], section 508 of the Clean Water Act 33 U.S.C.
1368), Executive Order 11738, and Environmental Protection Agency regulations 40 CFR part 15).
b. Institutions of higher education, hospitals, nonprofit organizations and commercial businesses agree to
comply with all applicable standards, orders, or requirements issued under the Clean Air Act 42 U.S.C.
7401 et seq.), as amended, and the Federal Water Pollution Control Act 33 U.S.C. 1251 et seq.), as
amended.
12. Prior Approval of Training Seminars, Workshops or Conferences
Contractor shall obtain prior CDPH approval of the location, costs, dates, agenda, instructors, instructional
CDPH Exhibit D(F) 8/10) Page 13 of 26
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FULLY EXECUTED AGREEMENT NO. u� /�California Department of Public Health Special Terms and Conditions Exhibit D F)
materials, and attendees at any reimbursable training seminar, workshop, or conference conducted pursuant
to this Agreement and of any reimbursable publicity or educational materials to be made available for
distribution. The Contractor shall acknowledge the support of the State whenever publicizing the work under
this Agreement in any media. This provision does not apply to necessary staff meetings or training sessions
held for the staff of the Contractor or Subcontractor to conduct routine business matters.
13. Confidentiality of Information
a. The Contractor and its employees, agents, or subcontractors shall protect from unauthorized disclosure
names and other identifying information concerning persons either receiving services pursuant to this
Agreement or persons whose names or identifying information become available or are disclosed to the
Contractor, its employees, agents, or subcontractors as a result of services performed under this
Agreement, except for statistical information not identifying any such person.
b. The Contractor and its employees, agents, or subcontractors shall not use such identifying information for
any purpose other than carrying out the Contractor's obligations under this Agreement.
c. The Contractor and its employees, agents, or subcontractors shall promptly transmit to the CDPH
Program Contract Manager 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 Agreement or
authorized by the client, any such identifying information to anyone other than CDPH without prior written
authorization from the CDPH Program Contract Manager, except if disclosure is required by State or
Federal law.
e. For purposes of this provision, 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.
f. As deemed applicable by CDPH, this provision may be supplemented by additional terms and conditions
covering personal health information PHI) or personal, sensitive, and/or confidential information PSCI).
Said terms and conditions will be outlined in one or more exhibits that will either be attached to this
Agreement or incorporated into this Agreement by reference.
14. Documents, Publications and Written Reports
Applicable to agreements over $5,000 under which publications, written reports and documents are
developed or produced. Government Code Section 7550.)
Any document, publication or written report excluding progress reports, financial reports and normal
contractual communications) 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 or
agreements 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.
15. Dispute Resolution Process
a. A Contractor grievance exists whenever there is a dispute arising from CDPH's action in the
administration of an agreement. If there is a dispute or grievance between the Contractor and CDPH, the
Contractor must seek resolution using the procedure outlined below.
1)
The Contractor should first informally discuss the problem with the CDPH Program Contract
Manager. If the problem cannot be resolved informally, the Contractor shall direct its grievance
together with any evidence, in writing, to the program Branch Chief. The grievance shall state the
issues in dispute, the legal authority or other basis for the Contractor's position and the remedy
sought. The Branch Chief shall render a decision within ten 10) working days after receipt of the
written grievance from the Contractor. The Branch Chief shall respond in writing to the Contractor
indicating the decision and reasons therefore. If the Contractor disagrees with the Branch Chiefs
decision, the Contractor may appeal to the second level.
CDPH Exhibit D(F) 8/10) Page 14 of 26
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FULLY EXECUTED AGREEMENT NO. u� /�California Department of Public Health Special Terms and Conditions Exhibit D F)
2) When appealing to the second level, the Contractor must prepare an appeal indicating the reasons
for disagreement with Branch Chief's decision. The Contractor shall include with the appeal a copy
of the Contractor's original statement of dispute along with any supporting evidence and a copy of the
Branch Chiefs decision. The appeal shall be addressed to the Deputy Director of the division in
which the branch is organized within ten 10) working days from receipt of the Branch Chiefs
decision. The Deputy Director of the division in which the branch is organized or his/her designee
shall meet with the Contractor to review the issues raised. A written decision signed by the Deputy
Director of the division in which the branch is organized or his/her designee shall be directed to the
Contractor within twenty 20) working days of receipt of the Contractor's second level appeal.
b. If the Contractor wishes to appeal the decision of the Deputy Director of the division in which the branch
is organized 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, Division 2, Chapter 2, Article 3 commencing with Section 1140) of the California
Code of Regulations).
c. Disputes arising out of an audit, examination of an agreement or other action 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 Agreement, shall be handled in
accordance with the procedures identified in Sections 51016 through 51047, Title 22, California Code of
Regulations.
d. Unless otherwise stipulated in writing by CDPH, all dispute, grievance and/or appeal correspondence
shall be directed to the CDPH Program Contract Manager.
e. There are organizational differences within CDPH's funding programs and the management levels
identified in this dispute resolution provision may not apply in every contractual situation. When a
grievance is received and organizational differences exist, the Contractor shall be notified in writing by the
CDPH Program Contract Manager of the level, name, and/or title of the appropriate management official
that is responsible for issuing a decision at a given level.
16. Financial and Compliance Audit Requirements
a. The definitions used in this provision are contained in Section 38040 of the Health and Safety Code,
which by this reference is made a part hereof.
b. Direct service contract means a contract or agreement for services contained in local assistance or
subvention programs or both see Health and Safety H&S] Code section 38020). Direct service
contracts shall not include contracts, agreements, grants, or subventions to other governmental agencies
or units of government nor contracts or agreements with regional centers or area agencies on aging
H&S Code section 38030).
c. The Contractor, as indicated below, agrees to obtain one of the following audits:
1) If the Contractor is a nonprofit organization as defined in H&S Code section 38040) and receives
$25,000 or more from any State agency under a direct service contract or agreement; the Contractor
agrees to obtain an annual single, organization wide, financial and compliance audit. Said audit shall
be conducted according to Generally Accepted Auditing Standards. This audit does not fulfill the audit
requirements of Paragraph c(3) below. The audit shall be completed by the 15th day of the fifth
month following the end of the Contractor's fiscal year, and/or
2) If the Contractor is a nonprofit organization as defined in H&S Code section 38040) and receives
less than $25,000 per year from any State agency under a direct service contract or agreement, the
Contractor agrees to obtain a biennial single, organization wide financial and compliance audit,
unless there is evidence of fraud or other violation of state law in connection with this Agreement.
This audit does not fulfill the audit requirements of Paragraph c(3) below. The audit shall be
completed by the 15th day of the fifth month following the end of the Contractor's fiscal year, and/or
3) If the Contractor is a State or Local Government entity or Nonprofit organization as defined by the
CDPH Exhibit D(F) 8/10) Page 15 of 26
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FULLY EXECUTED AGREEMENT NO. u� /�California Department of Public Health Special Terms and Conditions
Exhibit D F)
Federal Office of Management and Budget OMB] Circular A-133) and expends $500,000 or more in
Federal awards, the Contractor agrees to obtain an annual single, organization wide, financial and
compliance audit according to the requirements specified in OMB Circular A-133 entitled Audits of
States, Local Governments, and Non-Profit Organizations". An audit conducted pursuant to this
provision will fulfill the audit requirements outlined in Paragraphs c(1) and c(2) above. The audit shall
be completed by the end of the ninth month following the end of the audit period. The requirements
of this provision apply if:
a) The Contractor is a recipient expending Federal awards received directly from Federal awarding
agencies, or
b) The Contractor is a subrecipient expending Federal awards received from a pass-through entity
such as the State, County or community based organization.
4) If the Contractor submits to CDPH a report of an audit other than an OMB A-133 audit, the Contractor
must also submit a certification indicating the Contractor has not expended $500,000 or more in
federal funds for the year covered by the audit report.
d. Two copies of the audit report shall be delivered to the CDPH program funding this Agreement. The audit
report must identify the Contractor's legal name and the number assigned to this Agreement. The audit
report shall be due within 30 days after the completion of the audit. Upon receipt of said audit report, the
CDPH Program Contract Manager shall forward the audit report to CDPH's Audits and Investigations Unit
if the audit report was submitted under Section 16.c(3), unless the audit report is from a City, County, or
Special District within the State of California whereby the report will be retained by the funding program.
e. The cost of the audits described herein may be included in the funding for this Agreement up to the
proportionate amount this Agreement represents of the Contractor's total revenue. The CDPH program
funding this Agreement must provide advance written approval of the specific amount allowed for said
audit expenses.
f. The State or its authorized designee, including the Bureau of State Audits, is responsible for conducting
agreement performance audits which are not financial and compliance audits. Performance audits are
defined by Generally Accepted Government Auditing Standards.
9.
Nothing in this Agreement limits the State's responsibility or authority to enforce State law or regulations,
procedures, or reporting requirements arising thereto.
h. Nothing in this provision limits the authority of the State to make audits of this Agreement, provided
however, that if independent audits arranged for by the Contractor meet Generally Accepted
Governmental Auditing Standards, the State shall rely on those audits and any additional audit work and
shall build upon the work already done.
i. The State may, at its option, direct its own auditors to perform either of the audits described above. The
Contractor will be given advance written notification, if the State chooses to exercise its option to perform
said audits.
J�
The Contractor shall include a clause in any agreement the Contractor enters into with the audit firm
doing the single organization wide audit to provide access by the State or Federal Government to the
working papers of the independent auditor who prepares the single organization wide audit for the
Contractor.
k. Federal or state auditors shall have expanded scope auditing" authority to conduct specific program
audits during the same period in which a single organization wide 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.
The term expanded scope auditing" is applied and defined in the U.S. General Accounting Office GAO)
issued Standards for Audit of Government Organizations, Programs, Activities and Functions, better
known as the yellow book".
CDPH Exhibit D(F) 8/10) Page 16 of 26
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PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�!/�California Department of Public Health Special Terms and Conditions Exhibit D F)
17. Human Subjects Use Requirements
Applicable only to federally funded agreements/grants in which performance, directly or through a
subcontract/subaward, includes any tests or examination of materials derived from the human body.)
By signing this Agreement, Contractor agrees that if any performance under this Agreement or any
subcontract or subagreement includes any tests or examination of materials derived from the human body for
the purpose of providing information, diagnosis, prevention, treatment or assessment of disease, impairment,
or health of a human being, all locations at which such examinations are performed shall meet the
requirements of 42 U.S.C. Section 263a CLIA) and the regulations thereunder.
18. Novation Requirements
If the Contractor proposes any novation agreement, CDPH shall act upon the proposal within 60 days after
receipt of the written proposal. CDPH 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 of the proposal may be
made orally within the 60-day period and confirmed in writing within five days of said decision. Upon written
acceptance of the proposal, CDPH will initiate an amendment to this Agreement to formally implement the
approved proposal.
19. Debarment and Suspension Certification
Applicable to all agreements funded in part or whole with federal funds.)
a. By signing this Agreement, the Contractor/Grantee agrees to comply with applicable federal suspension
and debarment regulations including, but not limited to 7 CFR Part 3017, 45 CFR 76, 40 CFR 32 or 34
CFR 85.
b. By signing this Agreement, the Contractor certifies to the best of its knowledge and belief, that it and its
principals:
1)
3)
5)
Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded by any federal department or agency;
2) Have not within a three-year period preceding this application/proposal/agreement been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public Federal, State or local)
transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making
false statements, or receiving stolen property;
Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
Federal, State or local) with commission of any of the offenses enumerated in Paragraph b(2) herein;
and
4) Have not within a three-year period preceding this application/proposal/agreement had one or more
public transactions Federal, State or local) terminated for cause or default.
Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for
debarment under federal regulations i.e., 48 CFR part 9, subpart 9.4), debarred, suspended,
declared ineligible, or voluntarily excluded from participation in such transaction, unless authorized by
the State.
6) Will include a clause entitled, Debarment and Suspension Certification" that essentially sets forth the
provisions herein, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
c. If the Contractor is unable to certify to any of the statements in this certification, the Contractor shall
submit an explanation to the CDPH Program Contract Manager.
CDPH Exhibit D(F) 8/10) Page 17 of 26
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FULLY EXECUTED AGREEMENT NO. u�"/�California Department of Public Health Special Terms and Conditions Exhibit D F)
d. The terms and definitions herein have the meanings set out in the Definitions and Coverage sections of
the rules implementing Federal Executive Order 12549.
e. If the Contractor knowingly violates this certification, in addition to other remedies available to the Federal
Government, the CDPH may terminate this Agreement for cause or default.
20. Smoke-Free Workplace Certification
Applicable to federally funded agreements/grants and subcontracts/subawards, that provide health, day
care, early childhood development services, education or library services to children under 18 directly or
through local governments.)
a. Public Law 103-227, also known as the Pro-Children Act of 1994 Act), requires that smoking not be
permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, day care, early childhood development services,
education or library services to children under the age of 18, if the services are funded by federal
programs either directly or through state or local governments, by federal grant, contract, loan, or loan
guarantee. The law also applies to children's services that are provided in indoor facilities that are
constructed, operated, or maintained with such federal funds. The law does not apply to children's
services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment;
service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities
where WIC coupons are redeemed.
b. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of
up to $1,000 for each violation and/or the imposition of an administrative compliance order on the
responsible party.
c. By signing this Agreement, Contractor or Grantee certifies that it will comply with the requirements of the
Act and will not allow smoking within any portion of any indoor facility used for the provision of services
for children as defined by the Act. The prohibitions herein are effective December 26, 1994.
d. Contractor or Grantee further agrees that it will insert this certification into any subawards subcontracts
or subgrants) entered into that provide for children's services as described in the Act.
21. Covenant Against Contingent Fees
Applicable only to federally funded agreements.)
The Contractor warrants that no person or selling agency has been employed or retained to solicit/secure this
Agreement upon an agreement of understanding for a commission, percentage, brokerage, or contingent fee,
except bona fide employees or bona fide established commercial or selling agencies retained by the
Contractor for the purpose of securing business. For breach or violation of this warranty, CDPH shall have
the right to annul this Agreement without liability or in its discretion to deduct from the Agreement price or
consideration, or otherwise recover, the full amount of such commission, percentage, and brokerage or
contingent fee.
22. Payment Withholds
Applicable only if a final report is required by this Agreement. Not applicable to government entities.)
Unless waived or otherwise stipulated in this Agreement, CDPH may, at its discretion, withhold 10 percent
10%) of the face amount of the Agreement, 50 percent 50%) of the final invoice, or $3,000 whichever is
greater, until CDPH receives a final report that meets the terms, conditions and/or scope of work
requirements of this Agreement.
23. Performance Evaluation
Not applicable to grant agreements.)
CDPH Exhibit D(F) 8/10) Page 18 of 26
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FULLY EXECUTED AGREEMENT NO. u�#/�California Department of Public Health Special Terms and Conditions
Exhibit D F)
CDPH may, at its discretion, evaluate the performance of the Contractor at the conclusion of this Agreement.
If performance is evaluated, the evaluation shall not be a public record and shall remain on file with CDPH.
Negative performance evaluations may be considered by CDPH prior to making future contract awards.
CDPH Exhibit D(F) 8/10) Page 19 of 26
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PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�$/�California Department of Public Health Special Terms and Conditions Exhibit D F)
24. Officials Not to Benefit
No members of or delegate of Congress or the State Legislature shall be admitted to any share or part of this
Agreement, or to any benefit that may arise therefrom. This provision shall not be construed to extend to this
Agreement if made with a corporation for its general benefits.
25. Four-Digit Date Compliance
Applicable to agreements in which Information Technology IT) services are provided to CDPH or if IT
equipment is procured.)
Contractor warrants that it will provide only Four-Digit Date Compliant as defined below) Deliverables and/or
services to the State. Four Digit Date compliant" Deliverables and services can accurately process,
calculate, compare, and sequence date data, including without limitation date data arising out of or relating to
leap years and changes in centuries. This warranty and representation is subject to the warranty terms and
conditions of this Contract and does not limit the generality of warranty obligations set forth elsewhere herein.
26. Prohibited Use of State Funds for Software
Applicable to agreements in which computer software is used in performance of the work.)
Contractor certifies that it has appropriate systems and controls in place to ensure that state funds will not be
used in the performance of this Agreement for the acquisition, operation or maintenance of computer
software in violation of copyright laws.
27. Use of Small, Minority Owned and Women's Businesses
Applicable to that portion of an agreement that is federally funded and entered into with institutions of higher
education, hospitals, nonprofit organizations or commercial businesses.)
Positive efforts shall be made to use small businesses, minority-owned firms and women's business
enterprises, whenever possible i.e., procurement of goods and/or services). Contractors shall take all of the
following steps to further this goal.
1) Ensure that small businesses, minority-owned firms, and women's business enterprises are used to the
fullest extent practicable.
2) Make information on forthcoming purchasing and contracting opportunities available and arrange time
frames for purchases and contracts to encourage and facilitate participation by small businesses,
minority-owned firms, and women's business enterprises.
3) Consider in the contract process whether firms competing for larger contracts intend to subcontract with
small businesses, minority-owned firms, and women's business enterprises.
4) Encourage contracting with consortiums of small businesses, minority-owned firms and women's
business enterprises when a contract is too large for one of these firms to handle individually.
5) Use the services and assistance, as appropriate, of such organizations as the Federal Small Business
Administration and the U.S. Department of Commerce's Minority Business Development Agency in the
solicitation and utilization of small businesses, minority-owned firms and women's business enterprises.
28. Alien Ineligibility Certification
Applicable to sole proprietors entering federally funded agreements.)
By signing this Agreement, the Contractor certifies that he/she is not an alien that is ineligible for state and
local benefits, as defined in Subtitle B of the Personal Responsibility and Work Opportunity Act. 8 U.S.C.
1601, et seq.)
CDPH Exhibit D(F) 8/10) Page 20 of 26
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FULLY EXECUTED AGREEMENT NO. u�%/�California Department of Public Health Special Terms and Conditions
29. Union Organizing
Applicable only to grant agreements.)
Exhibit D F)
Grantee, by signing this Agreement, hereby acknowledges the applicability of Government Code Sections
16645 through 16649 to this Agreement. Furthermore, Grantee, by signing this Agreement, hereby certifies
that:
a. No state funds disbursed by this grant will be used to assist, promote or deter union organizing.
b. Grantee shall account for state funds disbursed for a specific expenditure by this grant, to show those
funds were allocated to that expenditure.
c. Grantee shall, where state funds are not designated as described in b herein, allocate, on a pro-rata
basis, all disbursements that support the grant program.
d. If Grantee makes expenditures to assist, promote or deter union organizing, Grantee will maintain records
sufficient to show that no state funds were used for those expenditures, and that Grantee shall provide
those records to the Attorney General upon request.
30. Contract Uniformity Fringe Benefit Allowability)
Applicable only to nonprofit organizations.)
Pursuant to the provisions of Article 7 commencing with Section 100525) of Chapter 3 of Part 1 of Division
101 of the Health and Safety Code, CDPH sets forth the following policies, procedures, and guidelines
regarding the reimbursement of fringe benefits.
a. As used herein 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.
b. As used herein, fringe benefits do not include:
1) 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, annual leave, vacation, sick leave, holidays, jury duty and/or military
leave/training.
2) Director's and executive committee member's fees.
3) Incentive awards and/or bonus incentive pay.
4) Allowances for off-site pay.
5) Location allowances.
6) Hardship pay.
7) Cost-of-living differentials
c. Specific allowable fringe benefits include:
1) Fringe benefits in the form of employer contributions for the employer's portion of payroll taxes i.e.,
FICA, SUI, SDI), employee health plans i.e., health, dental and vision), unemployment insurance,
worker's compensation insurance, and the employer's share of pension/retirement plans, provided
they are granted in accordance with established written organization policies and meet all legal and
Internal Revenue Service requirements.
d. To be an allowable fringe benefit, the cost must meet the following criteria:
1) Be necessary and reasonable for the performance of the Agreement.
2) Be determined in accordance with generally accepted accounting principles.
3) Be consistent with policies that apply uniformly to all activities of the Contractor.
e. Contractor agrees that all fringe benefits shall be at actual cost.
CDPH Exhibit D(F) 8/10) Page 21 of 26
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FULLY EXECUTED AGREEMENT NO. u�&/�California Department of Public Health Special Terms and Conditions Exhibit D F)
f. Earned/Accrued Compensation
1)
3)
Compensation for vacation, sick leave and holidays is limited to that amount earned/accrued within
the agreement term. Unused vacation, sick leave and holidays earned from periods prior to the
agreement term cannot be claimed as allowable costs. See Provision f 3)(a) for an example.
2) For multiple year agreements, vacation and sick leave compensation, which is earned/accrued but
not paid, due to employee(s) not taking time off may be carried over and claimed within the overall
term of the multiple years of the Agreement. Holidays cannot be carried over from one agreement
year to the next. See Provision f 3)(b) for an example.
For single year agreements, vacation, sick leave and holiday compensation that is earned/accrued
but not paid, due to employee(s) not taking time off within the term of the Agreement, cannot be
claimed as an allowable cost. See Provision f 3)(c) for an example.
a) Example No. 1:
If an employee, John Doe, earns/accrues three weeks of vacation and twelve days of sick leave
each year, then that is the maximum amount that may be claimed during a one year agreement.
If John Doe has five weeks of vacation and eighteen days of sick leave at the beginning of an
agreement, the Contractor during a one-year budget period may only claim up to three weeks of
vacation and twelve days of sick leave as actually used by the employee. Amounts
earned/accrued in periods prior to the beginning of the Agreement are not an allowable cost.
b) Example No. 2:
If during a three-year multiple year) agreement, John Doe does not use his three weeks of
vacation in year one, or his three weeks in year two, but he does actually use nine weeks in year
three; the Contractor would be allowed to claim all nine weeks paid for in year three. The total
compensation over the three-year period cannot exceed 156 weeks 3 x 52 weeks).
c) Example No. 3:
If during a single year agreement, John Doe works fifty weeks and used one week of vacation
and one week of sick leave and all fifty-two weeks have been billed to CDPH, the remaining
unused two weeks of vacation and seven days of sick leave may not be claimed as an allowable
cost.
31. Lobbying Restrictions and Disclosure Certification
Applicable to federally funded agreements in excess of $100,000 per Section 1352 of the 31, U.S.C.)
a. Certification and Disclosure Requirements
1)
3)
Each person or recipient) who requests or receives a contract or agreement, subcontract, grant, or
subgrant, which is subject to Section 1352 of the 31, U.S.C., 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 Lobbying") that the recipient has not made, and will not make, any payment
prohibited by Paragraph b of this provision.
2) Each recipient shall file a disclosure in the form set forth in Attachment 2, 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 provision if paid for with appropriated funds.
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 affect the accuracy of the information contained
in any disclosure form previously filed by such person under Paragraph a(2) herein. An event that
materially affects the accuracy of the information reported includes:
CDPH Exhibit D(F) 8/10) Page 22 of 26
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FULLY EXECUTED AGREEMENT NO. u�'/�California Department of Public Health Special Terms and Conditions Exhibit D F)
a) 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;
b) A change in the person(s) or individuals(s) influencing or attempting to influence a covered
federal action; or
c) 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 a(1) of
this provision a contract or agreement, subcontract, grant or subgrant exceeding $100,000 at any tier
under a contract or agreement, 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 a(1) of this provision. That person shall forward all disclosure forms
to CDPH Program Contract Manager.
b. Prohibition
Section 1352 of Title 31, U.S.C., provides in part that no appropriated funds may be expended by the
recipient of a federal contract or agreement, 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 or agreement, 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 or agreement, grant,
loan, or cooperative agreement.
CDPH Exhibit D(F) 8/10) Page 23 of 26
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FULLY EXECUTED AGREEMENT NO. u�(/�California Department of Public Health Special Terms and Conditions Exhibit D F)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
Attachment I
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, 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 shall require that the language of this certification be included in the award
documents for all subawards at all tiers including subcontractors, subgrants, and contracts under grants and
cooperative agreements) of $100,000 or more, and that all subrecipients 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.C., any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Name of Contractor Printed Name of Person Signing for Contractor
Contract / Grant Number Signature of Person Signing for Contractor
Date
Title
After execution by or on behalf of Contractor, please return to:
California Department of Public Health
CDPH reserves the right to notifiy the contractor in writing of an alternate submission address.
CDPH Exhibit D(F) 8/10) Page 24 of 26
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�)/�Calffornia Department of Public Health Special Terms and Conditions
Exhibit D F)
Attachment 2
CERTIFICATION REGARDING LOBBYING
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
See reverse for public burden disclosure)
Approved by OMB
0348-0046
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract a. bid/offer/application a. initial filing
b. grant b. initial award b. material change
c. cooperative agreement c. post-award For Material Change Only:
d. loan
e. loan guarantee Year quarter
f. loan insurance date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name
and Address of Prime:
Prime Subawardee
Tier if known:
Congressional District, If known: Congressional District, If known:
6. Federal Department/Agency 7. Federal Program Name/Description:
CDFA Number, if applicable:
8. Federal Action Number, if known: 9. Award Amount, if known:
10.a Name and Address of Lobbying Registrant b. Individuals Performing Services including address if different from
If individual, last name, first name, Ml): 10a.
Last name, First name, Ml):
11. Information requested through this form is authorized by title 31
Si
nature:
U.S.C. section 1352. This disclosure of lobbying activities is a g
material representation of fact upon which reliance was placed by
i
P
N
This
the tier above when this transaction was made or entered into ame:
r
nt
disclosure is required pursuant to 31 U.S.C. 1352. This information
Title:
will be available for public inspection. required disclosure shall be
subject to a not more than $100,000 for each such failure. Telephone No.: Date:
Federal Use Only Authorized for Local Reproduction
Standard Form-LLL Rev. 7-97)
CDPH Exhibit D(F) 8/10) Page 25 of 26
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�*/�California Department of Public Health Special Terms and Conditions Exhibit D F)
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
t
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a
material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying
entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the
implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year
and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the
reporting entity that designates if it is, or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is
the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient.
Include Congressional District, if known.
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For
example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action item 1). If known, enter the full Catalog of Federal Domestic Assistance CFDA)
number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 e.g., Request for Proposal RFP) number; Invitation for
Bid IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal
agency). Include prefixes, e.g., RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity
identified in item 4 to influence the covered Federal action.
b) Enter the full names of the individual(s) performing services, and include full address if different from 10 a). Enter Last Name, First Name, and Middle Initial
M 1).
11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid
OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection
of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project 0348-0046), Washington, DC 20503.
CDPH Exhibit D(F) 8/10) Page 26 of 26
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FULLY-U02
EXECUTED-U02
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11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�+/�County of Monterey
11-10592
Exhibit E
Additional Provisions
1. Additional Incorporated Exhibits
A. The following documents and any subsequent updates are not attached, but are incorporated herein
and made a part hereof by this reference. These documents may be updated periodically by CDPH, as
required by program directives. CDPH shall provide the Contractor with copies of said documents and
any periodic updates thereto under separate cover. CDPH will maintain on file, all documents
referenced herein and any subsequent updates.
1) Immunization Assessment of Child Care and Kindergarten Enrollees and Review of Child Care
Centers and Kindergarten Schools, developed by CDPH Immunization Branch, 2004.
2) Vaccine Adverse Events Reporting System, developed by the Centers for Disease Control and
Prevention.
2. Cancellation /Termination
A. This agreement may be cancelled by CDPH without cause upon 30 calendar days advance written
notice to the Contractor.
B. CDPH reserves the right to cancel or terminate this agreement immediately for cause. The
Contractor may submit a written request to terminate this agreement only if CDPH substantially fails
to perform its responsibilities as provided herein.
C. The term for cause" shall mean that the Contractor fails to meet the terms, conditions, and/or
responsibilities of this agreement.
D. Agreement termination or cancellation shall be effective as of the date indicated in CDPH's
notification to the Contractor. The notice shall stipulate any final performance, invoicing or payment
requirements.
E. Upon receipt of a notice of termination or cancellation, the Contractor shall take immediate steps to
stop performance and to cancel or reduce subsequent agreement costs.
F. In the event of early termination or cancellation, the Contractor shall be entitled to compensation for
services performed satisfactorily under this agreement and expenses incurred up to the date of
cancellation and any non-cancelable obligations incurred in support of this agreement.
3. Freeze Exemptions
A. Contractor agrees that any hiring freeze adopted during the term of this contract shall not be applied to
the positions funded, in whole or part, by this contract.
B. Contractor agrees not to implement any personnel policy, which may adversely affect performance or
the positions funded, in whole or part, by this contract.
Page 1 of 2
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
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1/24/2012-U04
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16616-U05
6-U06
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OF-U07
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ON-U07
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THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
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411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�,/�County of Monterey
11-10592
Exhibit E
Additional Provisions
C. Contractor agrees that any travel freeze or travel limitation policy adopted during the term of this
contract shall not restrict travel funded, in whole or part, by this contract.
D. Contractor agrees that any purchasing freeze or purchase limitation policy adopted during the term of
this contract shall not restrict or limit purchases funded, in whole or part, by this contract.
Page 2 of 2
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AGREEMENT-U02
NO.-U02
11-10592-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109074-U03
C5-U03
AGREEMENTS-U03
1/24/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�-/�State of California Health and Human Services Agency
California Department of Public Health
Exhibit F
Contractor's Release
Instructions to Contractor:
With final invoice(s) submit one 1) original and one 1) copy. The original must bear the original signature of a person
authorized to bind the Contractor. The additional copy may bear photocopied signatures.
Submission of Final Invoice
Pursuant to contract number 11-10592 entered into between the State of California Department of Public Health
CDPH) and the Contractor identified below), the Contractor does acknowledge that final payment has been requested via
invoice number(s) in the amount(s) of $ and dated
If necessary, enter See Attached" in the appropriate blocks and attach a list of invoice numbers, dollar amounts and invoice dates.
Release of all Obligations
By signing this form, and upon receipt of the amount specified in the invoice number(s) referenced above, the Contractor does
hereby release and discharge the State, its officers, agents and employees of and from any and all liabilities, obligations, claims, and
demands whatsoever arising from the above referenced contract.
Repayments Due to Audit Exceptions / Record Retention
By signing this form, Contractor acknowledges that expenses authorized for reimbursement does not guarantee final allowability of
said expenses. Contractor agrees that the amount of any sustained audit exceptions resulting from any subsequent audit made
after final payment will be refunded to the State.
All expense and accounting records related to the above referenced contract must be maintained for audit purposes for no less than
three years beyond the date of final payment, unless a longer term is stated in said contract.
Recycled Product Use Certification
By signing this form, Contractor certifies under penalty of perjury that a minimum of 0% unless otherwise specified in writing of post
consumer material, as defined in the Public Contract Code Section 12200, in products, materials, goods, or supplies offered or sold
to the State regardless of whether it meets the requirements of Public Contract Code Section 12209. Contractor specifies that
printer or duplication cartridges offered or sold to the State comply with the requirements of Section 12156(e).
Reminder to Return State Equipment/Property If Applicable)
Applies only if equipment was provided by CDPH or purchased with or reimbursed by contract funds)
Unless CDPH has approved the continued use and possession of State equipment as defined in the above referenced contract) for
use in connection with another CDPH agreement, Contractor agrees to promptly initiate arrangements to account for and return said
equipment to CDPH, at CDPH's expense, if said equipment has not passed its useful life expectancy as defined in the above
referenced contract.
Patents / Other Issues
By signing this form, Contractor further agrees, in connection with patent matters and with any claims that are not specifically
released as set forth above, that it will comply with all of the provisions contained in the above referenced contract, including, but not
limited to, those provisions relating to notification to the State and related to the defense or prosecution of litigation.
ONLY SIGN AND DATE THIS DOCUMENT WHEN ATTACHING TO THE FINAL INVOICE
Contractor's Legal Name as on contract): County of Monterey
Signature of Contractor or Official Designee: Date:
Printed Name/Title of Person Signing:
CDPH Distribution: Accounting Original) Program
COPH 2352 7/07)
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MG99866-U03
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6/1/2011-U011
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FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�./�I
r
t
California Department of Public Health
Travel Reimbursement Information
Mileage Reimbursement Increase Effective 7/1/11)
Exhibit G
1. The following rate policy is to be applied for reimbursing the travel expenses of persons under contract. The terms
contract" and/or subcontract" have the same meaning as grantee" and/or subgrantee" where applicable.
a. Reimbursement for travel and/or per diem shall be at the rates established for nonrepresented/excluded state
employees. Exceptions to Department of Personnel Administration DPA) lodging rates may be approved by the
California Department of Public Health CDPH) upon the receipt of a statement on/with an invoice indicating that such
rates are not available.
b. Short Term Travel is defined as a 24-hour period, and less than 31 consecutive days, and is at least 50 miles from the
main office, headquarters or primary residence. Starting time is whenever a contract or subcontract employee leaves
his or her home or headquarters. Headquarters" is defined as the place where the contracted personnel spends the
largest portion of their working time and returns to upon the completion of assignments. Headquarters may be
individually established for each traveler and approved verbally or in writing by the program funding the agreement.
Verbal approval shall be followed up in writing or email.
c. 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 exhibit to
determine the reimbursement allowance. All lodging reimbursement claims must be supported by a receipt*. If a
contractor does not or cannot present receipts, lodging expenses will not be reimbursed.
1) Lodging with receipts*):
Travel Location I Area Reimbursement Rate
Statewide excluding the counties identified below) $ 84.00 plus tax
Counties of Los Angeles and San Diego $110.00 plus tax
Counties of Alameda, San Francisco, San Mateo, and Santa Clara $140.00 plus tax
Reimbursement for actual lodging expenses that exceed the above amounts may be allowed with the advance
approval of the Deputy Director of the California Department of Public Health CDPH) or his or her designee.
Receipts are required.
*Receipts from Internet lodging reservation services such as Priceline.com which require prepayment for that
service, ARE NOT ACCEPTABLE LODGING RECEIPTS and are not reimbursable without a valid lodging receipt
from a lodging establishment.
2) Meal/Supplemental Expenses with or without receipts): With receipts, the contractor will be reimbursed actual
amounts spent up to the maximum for each full 24-hour period of travel.
Meal/Expense Reimbursement Rate
Breakfast $ 6.00
Lunch $ 10.00
Dinner $ 18.00
Incidental expenses $ 6.00
d. Out-of-state travel may only be reimbursed if such travel is necessitated by the scope or statement of work 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 for each 24-hour period computed at the rates listed in c. 2) above. For all out-of-state travel,
contractors/subcontractors must have prior CDPH written or verbal approval. Verbal approval shall be confirmed in
writing email or memo).
e. In computing allowances for continuous periods of travel of less than 24 hours, consult the chart appearing on Page 2
of this exhibit.
f. No meal or lodging expenses will be reimbursed for any period of travel that occurs within normal working hours, unless
expenses are incurred at least 50 miles from headquarters.
CDPH CMU 01 07/11) Page 1 of 2
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FEDERAL-U012
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DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�//�Travel Reimbursement Information Continued) Exhibit G
2. If any of the reimbursement rates stated herein is changed by DPA, no formal contract amendment will be required to
incorporate the new rates. However, CDPH shall inform the contractor, in writing, of the revised travel reimbursement rates
and the applicable effective date of any rate change.
At CDPH's discretion, changes or revisions made by CDPH to this exhibit, excluding travel reimbursement policies
established by DPA may be applied retroactively to any agreement to which a Travel Reimbursement Information exhibit is
attached, incorporated by reference, or applied by CDPH program policy. Changes to the travel reimbursement rates
stated herein may not be applied earlier than the date a rate change is approved by DPA.
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/her or a company car for transportation, the rate of reimbursement will be
55.5 cents maximum per mile. If a contractor uses his/her or a company car in lieu of airfare, 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.
5. The contractor is required to furnish details surrounding each period of travel. Travel expense reimbursement detail may
include, but not be limited to: purpose of travel, departure and return times, destination points, miles driven, mode of
transportation, etc. Reimbursement for travel expenses may be withheld pending receipt of adequate travel documentation.
6. Contractors are to consult with the program with which the contract is held to obtain specific invoicing procedures.
Per Diem Reimbursement Guide
Length of travel This condition exists... Allowable Meal(s)
period
Less than 24 hours Trip begins at or before 6 a.m. and ends at or after 9 a.m. Breakfast may be claimed.
Less than 24 hours Trip begins at or before 4 p.m. and ends at or after 7 p.m. Dinner may be claimed.
Contractar.-'may not claim: lunch or incidentals on one-day trips. When.�trips are less than.24 hours and there's no a
overnight stay.,, meals claimed are"taxable.
24 hours Trip begins at or before 6 a.m. Breakfast may be claimed.
24 hours Trip begins at or before 11 a.m. Lunch may be claimed.
24 hours Trip begins at or before 5 p.m. Dinner may be claimed.
More than 24 hours Trip ends at or after 8 a.m. Breakfast may be claimed.
More than 24 hours Trip ends at or after 2 p.m. Lunch may be claimed.
More than 24 hours Trip ends at or after 7 p.m.
Dinner may be claimed.
Contractor may not claim meals provided by the State, meals included in hotel expenses or conference fees,
meals included in transportation costs such as airline tickets, or meals that.are otherwise provided. Snacks and
continental breakfasts such as rolls, juice,.and coffee are not considered to:be meals.
CDPH CMU 01 07/11) Page 2 of 2
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AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�STATE OF CALIFORNIA
STANDARD AGREEMENT
STD 213 Rev 06/03)
This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCY'S NAME
California Department of Corrections and Rehabilitation
CONTRACTOR'S NAME
County of Monterey
2. The term of this Upon approval through June 30, 2013
Agreement is:
3. The maximum amount The total estimated amount of this Master Agreement shall not exceed Seventy Four
of this Agreement is: Thousand One Hundred Eight Two Dollars and Zero Cents $74,182.00). There is no monetary
obligation, either written or implied, created on this Master Agreement. Each Institution requesting
services under this Master Agreement shall encumber funds on a Purchase Order PO).The state
makes no commitment, either written or implied, as to the total amount to expend during the term of
this Master Agreement.
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a
part of the Agreement.
Exhibit A Scope of Work
Exhibit B Budget Detail and Payment Provisions
Exhibit B-1 Contractor Rate Request
Exhibit B-2 Rate Sheet
Exhibit B-3 Subcontractor Published Price Schedule
Exhibit C General Terms and Conditions*
Exhibit D Special Terms and Conditions
* Exhibit Cis incorporated by reference as a part of this agreement. It maybe viewed at wwnt/w.ols.das.ca.gov.!Standard+Lana!lace
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
AGREEMENT NUMBER
5600002347
REGISTRATION NUMBER
eP tt 4339
7 pages
2 pages
1 page
7 pages
1 page
GTC 610
12 pages
California Department of General
Services Use Only
CONTRACTOR'S NAME if other than an individual, state whethera corporation, partnership, etc.)
County of Monterey
BY Authorized Signatu
DATE SIGNED(Do not type)
I hereby certify that all condi-
tions for exemption have been
complied with and this contract
is exempt from the Department
of General Services sApApproval.
Exe
DG tter
By:
PRINTED NAME AND TITLE OF PERSON SIGNING
Ray Bullick, Director of Health
ADDRESS
1270 Natividad Rd.
Salinas, CA 93906
STATE OF CALIFORNIA
AGENCY ME
Calif r iekDepartment of Corrections and Rehabilitation
9-(,-11
BY A 1`h~p'zgc/Slgpayyre DATE
IfID(Do r1 1
PRINT FD NAME AND TITLE OF PERSON SIGNING
Bed h Victorioso, Manager, Institution Master Contracts Unit
Dat
Exempt per:
ADDRESS
10000 Goethe Road, Sacramento, CA 95827
BIB]
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EXECUTED AGREEMENT"�|E`R�MONTEREY COUNTY
RISK MANAGEMENT
168 W. ALISAL STREET 3RD FLOOR
SAUNAS, CA 93901-2680
831) 755-5458
FAX 831) 751-9597
www.co.monterey.ca.us
August 22, 2011
California Department of Corrections and Rehabilitation
Office of Business Services
Attention: Nathan Boone
1000 Goethe Road, Suite C-1
Sacramento, CA 95827
RE: Monterey County Health Department: Agreement #5600002347, Water Testing Services
By this letter I hereby certify that the County of Monterey is lawfully self-insured for purposes of General Liability
and Automobile Liability related to County sanctioned activities.
By order of the Board of Supervisors, the County of Monterey maintains a $1.5 million reserve fund to cover
occurrences within a self-insured retention level set by the Board. Above the self-insured retention, the County
maintains a primary excess layer through the Starr Indemnity & Liability Company with a master policy number
SISCPEL00007911, effective 7/1/2011-7/1/2012.
This policy and its limits are inclusive of EPL, Employment practice liability, E&O, Errors and Omissions Liability,
and property damage.
Through a Joint Powers Authority Agreement with other counties, the CSAC Excess Insurance Authority, the County
purchases a broad form property policy covering fire, vandalism, extended coverage, business interruption, etc. This
coverage is underwritten by Lloyd's of London and various insurers under master policy #EIAPPR-10-14.
The County is Self-insured for purposes of Workers' Compensation with statutory limits.
Respectfully,
Lydia Schumaker
Risk & Benefits Analyst
Risk Management
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EXECUTED AGREEMENT"�|E`R�CCC-307
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
Contractor/Bidder Firm Name Printed)
County of Monterey
Federal ID Number
94-6000524
Printed Name and Title of Person Signing
Ray Bullick, Director of Health
Date Executed
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. Gov. Code 12990 a-f) and CCR, Title 2,
Section 8103) Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
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 counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
BIB]
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AGREEMENT-U02
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2/13/2012-U04
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EXECUTED AGREEMENT"�|E`R�STATE JF CALIFORNIA
STANDARD AGREEMENT
STD 213 Rev 06/03)
AGREEMENT NUMBER
5600002347
REGISTRATION NUMBER
This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCY'S NAME
California Department of Corrections and Rehabilitation
CONTRACTOR'S NAME
County of Monterey
2. The term of this Upon approval through June 30, 2013
Agreement is:
3. The maximum amount The total estimated amount of this Master Agreement shall not exceed Seventy Four
of this Agreement is: Thousand One Hundred Eight Two Dollars and Zero Cents $74,182.00). There is no monetary
obligation, either written or implied, created on this Master Agreement. Each Institution requesting
services under this Master Agreement shall encumber funds on a Purchase Order PO).The state
makes no commitment, either written or implied, as, to-the lotalar otr 1o expend during the term of
this Master Agreement. Y9 r I / r, 1 tai T FAY
4. The parties agree to comply with the terms and conditions of the foliowing'exhibiits A~cNe f~e made a
part of the Agreement. JP'41N NJ rl IArr:
Exhibit A Scope of Work
Exhibit B Budget Detail and Payment Provisions
Exhibit B-1 Contractor Rate Request
Exhibit B-2 Rate Sheet
S`~~(p~OViSionS
bcontract et'IrSOe~ Pri'je *le
Exhibit B-3 Su
Exhibit C General Terms and Condit)
Exhibit D Special Terms and Cor
Austor-C roller
county of lonterey
7 pages
2 pages
1 page
7 pages
1 page
GTC 610
12 pages
* Exhibit C is incorporated by reference as a part of this agreement. It maybe viewed at wwvu.ols.dgs.ca.gov/Standard+Language
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
CONTRACTOR'S NAME if other than an individual, state whether a corporation, partnership, etc.)
County of Monterey
DATE SIGNED(Do not type)
PRINTED NAME AND TITLE OF PERSON SIGNING
Ray Bullick, Director of Health
ADDRESS
1270 Natividad Rd.
Salinas, CA 93906
STATE OF CALIFORNIA
AGENCY NAME
California Department of Corrections and Rehabilitation
BY Authorized Signature)
PRINTED NAME AND TITLE OF PERSON SIGNING
Bedeth Victorioso, Manager, Institution Master Contracts Unit
DATE SIGNED(Do not type)
California Department of General
Services Use Only
Exempt per:
ADDRESS
10000 Goethe Road, Sacramento, CA 95827
BIB]
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AGREEMENTS-U03
2/13/2012-U04
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EXECUTED AGREEMENT"�|E`R�County of Monterey Agreement Number5600002347
CDCR SCOPE OF WORK Exhibit A
pickup falls on a State holiday, pick-up services shall be provided the next regular
business day.
6. CALL BACK SERVICES
Should the Contractor fail to provide any of the specified services in the prescribed
manner; the State may call the Contractor to provide services within four hours, unless
otherwise specified, at no additional cost to the State.
7. ANALYTICAL EQUIPMENT AND SUPPLIES
The Contractor shall supply enough sterile sample collection bottles/containers,
including bacteriological examination containers no whirl packs will be accepted) that
are sterilized and contain the appropriate preservatives and dechlorinating agents,
refrigerants blue Ice), preservative reagents, shipping containers, labels and chain of
custody forms shall be provided by the Contractor at no additional cost to the
State/CDCR. Sampling containers, dechlorinating agents, preservatives, and holding
times shall be as set forth in either Recommendations for Sampling and Preservation of
Samples According to Measurement" in the USEPA Manual of Methods for Chemical
Analysis of Water and Wastes, or other procedures listed in USEPA approved manuals
i.e. SW 846) and Collection, Storage, Transportation and Pretreatment of Water and
Wastewater Samples, published by the Sanitation and Radiation Laboratory, California
Department of Health Services DHS). The above references to publications shall mean
the applicable provisions thereof as they exist at the time of collection and submission of
samples.
The Contractor shall supply enough sampling bottles/containers and packaging supplies
for the next regular draw of water samples by institution staff.
The Contractor shall also provide an insulated cooler Igloo or equivalent) and
refrigerants blue ice) for packaging of samples prior to pick-up by the Contractor, and
shall leave additional coolers and cooling agents with Institution staff for the next regular
sampling.
8. DOCUMENTATION AND CHAIN OF CUSTODY
The Contractor shall provide and use labels and chain of custody forms as standard
procedure. The labels and forms shall provide and identify space for entry of the
following information:
Labels
1) Institution name, City and County;
2) Sample identification number;
3) Time and date sample was taken; and
4) Preservative(s) used.
Chain of Custody Form
1) Institution name, City and County, agreement number;
2) Sampler name and telephone number;
3) Sample identification number;
4) Time and date sample was taken;
3
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EXECUTED AGREEMENT"�|E`R�County of Monterey
CDCR SCOPE OF WORK
Agreement Number5600002347
Exhibit A
5) Number and type of container;
6) Preservative(s) used;
7) Type of sample;
8) Analysis required;
9) Remark space for additional information;
10) Time and date sample relinquished and received;
11) Space for relinquishing and receiving person's signature; and
12) Space to Print Name of Signing Person
The Contractor shall institute procedural safeguards to ensure exclusive custody and
safekeeping of all samples, and designate individuals responsible for custody of such
samples.
The Contractor shall designate one 1) full-time employee as sample custodian and one
1) or more employee(s) as alternate sample custodian(s) to ensure that at least one 1)
such custodian shall be available to receive samples from the institution and/or
courier service at all times during the Contractor's normal business hours.
The Contractor shall maintain an area for storage of samples, which, in addition to
requirements imposed by other provisions of these specifications, shall be secured from
access by any person other than a designated custodian.
From the time of submittal to a custodian, samples shall, at all times, remain in the
actual or constructive custody of a designated custodian or analyst until released for
disposal pursuant to direction of the appropriate CDCR Institution Contract Liaison or
his/her designee.
Actual custody shall mean personal and constant control and surveillance
over the sample when it is being transported to or from the secured area
specified above and during the actual time that analytical services are being
performed on the sample.
Constructive custody shall mean those times when the sample is stored in
the secured area specified above.
The Contractor shall ensure that the custody tag identifies, by signature, the custodian
or analyst having custody of the sample and the location of the sample during the entire
period from the time the sample is submitted to the Contractor until the appropriate
CDCR Institution Contract Liaison releases it for disposal.
The Contractor shall ensure that all documentation specified in these requirements shall
not become separated from the sample until disposition of such documentation is
directed by the appropriate CDCR Institution Contract Liaison or his/her designee.
The Contractor shall be responsible for disposal of all samples when the analyses are
completed. No sample shall be disposed of until verbal release is obtained from the
appropriate CDCR Institution Contract Liaison or his/her designee.
9. LABORATORY PROCEDURES
4
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EXECUTED AGREEMENT"�|E`R�County of Monterey Agreement Number5600002347
CDCR SCOPE OF WORK Exhibit A
qualifications as those of the Contractor. Contractor shall ensure that chain of custody
requirements and requirements for time frames to perform analysis are maintained by
the subcontractor.
In addition, the Contractor shall provide written notification to the CDCR Institution
Contract Liaison of any and all sample analyses performed by a subcontractor, including
the name, address and certification number of the subcontractor.
13. CDCR CONTACT INFORMATION
Should questions or problems arise during the term of this Agreement, the Contractor
should contact the following offices:
Billing/Payment Issues:
Central Coast Regional Accounting Office
Phone Number: 805) 237-3030
FAX Number: 805) 237-3137
Scope of Service/Performance Issues:
CTF
Contract Liaison, Plant Operations
Phone Number: 831) 678-3951, Ext. 5975
FAX Number: 831) 678-5909
SVSP
Contract Liaison, Plant Operations
Phone Number: 831) 578-5500, Ext. 6646
FAX Number: 831) 678-5509
General Agreement Issues:
Office of Business Services
Phone Number: 916) 255-5624
FAX Number: 916) 255-6187
7
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EXECUTED AGREEMENT"�|E`R�County of Monterey Agreement Number 5600002347
California Department of Corrections And Rehabilitation CDCR) Exhibit B
Budget Details and Payment Provisions
1. Invoicing and Payment
a. For services satisfactorily rendered, and upon receipt and approval of
contractor's invoices, the State agrees to compensate the Contractor in
accordance with Exhibit B-1, Contractor Rate Request and the rates specified
herein on Exhibit B-2, Rate Sheet, which are attached hereto and made a part of
this Agreement.
b. Invoices shall include the Agreement Number, Purchase Order Number and
shall be submitted in triplicate not more frequently than monthly in arrears to:
California Department of Corrections and Rehabilitation CDCR)
Central Coast Regional Accounting Office
Salinas Valley State Prison or Correctional Training Facility
Attention: Accounts Payable
P.O. Box 7021
Paso Robles, CA 93447
2. Budget Contingency Clause
a. It is mutually agreed that if the California State Budget Act for the current fiscal
year and/or any subsequent fiscal years covered under this Agreement does not
appropriate sufficient funds for the program, this Agreement shall be of no
further force and effect. In this event, the State shall have no liability to pay any
funds whatsoever to Contractor, or to furnish any other considerations under this
Agreement, and Contractor shall not be obligated to perform any provisions of
this Agreement.
b. If funding for the purposes of this program is reduced or deleted for any fiscal
year by the California State Budget Act, the State shall have the option to either
cancel this Agreement with no liability occurring to the State, or offer an
Agreement amendment to Contractor to reflect the reduced amount.
3. Prompt Payment Clause
Payment will be made in accordance with, and within the time specified in, Government
Code Chapter 4.5, commencing with Section 927. Payment to small/micro businesses
shall be made in accordance with and within the time specified in Chapter 4.5,
Government Code 927 et seq.
4. Subcontractors
Nothing contained in this Agreement, or otherwise, shall create any contractual relation
between the State and any subcontractors, and no subcontract shall relieve the
Contractor of Contractor's responsibilities and obligations hereunder. The Contractor
agrees to be as fully responsible to the State for the acts and omissions of its
subcontractors and of persons either directly or indirectly employed by any of them as it
is for the acts and omissions of persons directly employed by the Contractor. The
Contractor's obligation to pay its subcontractors is an independent obligation from the
State's obligation to make payments to the Contractor. As a result, the State shall have
no obligation to pay or to enforce the payment of any moneys to any subcontractor.
Page 1 of 2
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EXECUTED AGREEMENT"�|E` R�County of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit B-1
Contractor Rate Request
WATER TESTING SEVICES
The contractor hereby agrees to provide all labor, materials, supplies, licenses, permits,
equipment and transportation necessary to perform all services required for the foregoing titled
work in accordance with the Scope of Work, all Terms and Conditions, and Disabled Veteran
Business Enterprise DVBE) requirements, if applicable, at the rates set forth by the contractor
in Exhibit B-2. Any and all services performed outside the scope of this Agreement shall be at
the sole risk and expense of the contractor.
Rates must be provided for all services listed in Exhibit B-2. Exhibit B-2 shall remain in force for
the stated term of this Agreement and shall include every item of expense, direct and indirect,
including any taxes incidental to the specified rates. Any quantities listed on Exhibit B-2 are
CDCR's estimates only. The State does not expressly or by implication agree that the actual
amount of work will correspond therewith and reserves the right to omit portions of the work as
may be deemed necessary or advisable by the State.
SMALL BUSINESS ENTERPRISE
Current law encourages state departments to first consider a Small Business Enterprise
Small)/Microbusiness Enterprise Micro) for contracting opportunities. The California
Department of Corrections and Rehabilitation CDCR) is committed to supporting Small/Micro
business participation in state contracting and seeks to use certified Small/Micro businesses
whenever possible.
For certification information, contact the Department of General Services, Office of Small
Business and Disabled Veteran Business Enterprise Certification OSDC) by telephone at
916) 375-4940 or access the OSDC Internet website at www.pd.clgs.ca.gov/smbus. The
CDCR asks that you encourage any subcontractor(s) and/or consultant(s) that are not currently
certified as a Small/Micro business, that you believe may meet the certification requirements, to
become certified through the DGS, OSDC. Please provide those subcontractor(s)/consultant(s)
with the OSDC contact and certification information provided above.
To ensure correct reporting of Small/Micro business and large business participation by CDCR,
the contractor shall complete the information section below.
PRIME CONTRACTOR NAME: County of Monterey
O I am a Small Business Enterprise. My DGS reference number is:
O I am a Microbusiness Enterprise. My DGS reference number is:
I am a large business.
NOTE: IF YOU ARE A CERTIFIED SMALLIMICRO BUSINESS ENTERPRISE AND FAIL TO
COMPLETE THIS SECTION, YOUR BUSINESS WILL BE CLASSIFIED AS A LARGE
BUSINESS.
Page 1 of 1
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`
R�County of Monterey Agreement Number 5600002347
California Department of Corrections And Rehabilitation CDCR) Exhibit B
Budget Details and Payment Provisions
5. City/County Rate Increase
It is understood that the city/county may regulate some or all of the contractor's rates for
services. In the event the city/county increases the rates that directly affect the services
provided in this Agreement, the contractor may, once during the term of the Agreement,
request from the State an increase in the rates stated in this Agreement. The contractor
must submit a written request to the State with a copy of the resolution from the
city/county listing the prior rates and new rates and effective date of the new rates.
Page 2 of 2
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`
R�County of Monterey
California Department of Corrections and Rehabilitation CDCR)
RATE SHEET
C TF WELL WATER/WASTE WA TER ANALYSIS
Agreement Number 5600002347
Exhibit B-2
ANALYSIS METHOD ROUTINE URGEN T
Est. #
of
Tests X Cost
per Test Total Est. #
of
Tests x Cost per
Test Total
Total Coliform MMO-Mug 72 X $22.50 $1,620.00 24 X $33.75 $810.00
Nitrate as N03) 300 24 X $24.30 $583.20 8 X $36.45 $291.60
Distribution system Total Coliform MMO-MUG 312 X $22.50 $7,020.00 80 X $33.75 $2700.00
INORGANIC CHEMICAL
excluding Asbestos)
6
X
$126.05
$756.30
Arsenic 200.8 6 X Included Included
Barium 200.8 6 X Included Included
Beryllium 200.8 6 X Included Included
Cadmium 200.8 6 X Included Included
Chromium 200.8 6 X Included Included
Copper 200.8 6 X Included Included
Nickel 200.8 6 X Included Included
Antimony 200.8 6 X Included Included
Thallium 200.8 6 X Included Included
Selenium 200.8 6 X Included Included
Nitrite as N) 4500N02-B 6 X Included Included
Cyanide 45000N 6 X Included Included
Fluoride 300 6 X Included Included
Lead 200.8 6 X Included Included
Mercury 200.8 6 X Included Included
Asbestos 1) 100.1 or 100.2 6 X $200.00 $1,200.00
TOTAL ROUTINE $11,179.50 TOTAL URGENT $3,801.60
1) Subcontracted test that is referred to outside laboratories; fees are subject to change without notice.
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`
R�County of Monterey
CDCR RATE SHEET
Agreement Number 5600002347
Exhibit B-2
ANALYSIS METHOD Est. # of Tests X Cost per Test Total
GENERAL PHYSICAL 6 X $31.29 $187.74
Color Std Method 18 Edition) 2120B 6 X Included Included
Odor 2150B 6 Included Included
Turbidity 2130B 6 X Included Included
GENERAL MINERAL 6 X $140.66 $843.96
Bicarbonate Alkalinity 2320B 6 X Included Included
Carbonate Alkalinity 2320B 6 X Included Included
Calcium 3111B 6 X Included Included
Chloride 300 6 X Included Included
Iron 3111B 6 X Included Included
Magnesium 3111B 6 X Included Included
Manganese 200.8 6 X Included Included
Foaming Agents MBAS) 5540C 6 X Included Included
pH 150.1 6 X Included Included
Sodium 3111B 6 X Included Included
Sulfate 300 6 X Included Included
Specific Conductance 2510B 6 X Included Included
Total Hardness 2340B 6 X Included Included
Total Dissolved Solids 2540C 6 X Included Included
Boron 200.8 6 X Included Included
Copper 200.8 6 X Included Included
Zinc 200.8 6 X Included Included
Potassium 3111B 6 X Included Included
DISTRIBUTION SYSTEM ANALYSIS
Lead 200.8 14 X $48.00 $672.00
Copper 200.8 14 X Included Included
Disinfection by-products
THM's & HAA5) 1t 121
3
X
$193.50
$580.50
TOTAL ROUTINE $2,284.20
1) Subcontracted test that is referred to outside laboratories; fees are subject to change without notice.
2) Panel Price; refer to Exhibit B-2, Page 7, for prices of analyses when ordered individually
2
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`
R�County of Monterey
Agreement Number 5600002347
CDCR RATE SHEET Exhibit B-2
ANALYSIS METHOD Est. # of Tests X Cost per Test Total
VOLATILE ORGANIC COMPOUNDS VOC 1) 6 $90.00 $540.00
1.1 Dichloroethane 502.2 6 X Included Included
1.1 Dichloro ro ene 502.2 6 X Included Included
1.1.1 Trichloroethan 502.2 6 X Included Included
1.1.1.2 Tetrachlorothan 502.2 6 X Included Included
1.12 Trichloroethane 502.2 6 X Included Included
1.1.2.2 Tetrachlorothane 502.2 6 X Included Included
1.2.3 Trichloro ro ane 502.2 6 X Included Included
1.2.3 Trichlorobenzene 502.2 6 X Included Included
1.1 Dichloroeth lene 502.2 6 X Included Included
1.2 Dichloroethane 502.2 6 X Included Included
1.3 Dichloro ro ene 502.2 6 X Included Included
2.2 Dichloro ro ane 502.2 6 X Included Included
Benzene 502.2 G X Included Included
Bromobenzene 502.2 6 X Included Included
Bromodichloromethane 502.2 6 X Included Included
Bromothane 502.2 6 X Included Included
Carbon Tetrachloride 502.2 6 X Included Included
Chlorodibromomethane 502.2 6 X Included Included
Chloroform 502.2 6 X Included Included
Chloroethane 502.2 6 X Included Included
Chloromethane 502.2 6 X Included Included
O-Chlorotoluene 502.2 6 X Included Included
P-Chlorotoluene 502.2 6 X Included Included
M-Dichlorobenzene 502.2 6 X Included Included
P-Dichlorobenzene 502.2 6 X Included Included
Ethylbenzene 502.2 6 X Included Included
Monochlorobenzene 502.2 6 X Included Included
Styrene 502.2 6 X Included Included
Tetrachloroethylene 502.2 6 X Included Included
Toluene 502.2 6 X Included Included
Trichloroethylene 502.2 6 X Included Included
Vinyl Chloride 502.2 6 X Included Included
X lenes 502.2 6 X Included Included
CIS-1, 2 Dichloroeth lene 502.2 6 X Included Included
Dichloromethane 502.2 6 X Included Included
O-Dichlorobenzene 502.2 6 X Included Included
1,2 Dichloro ro ane 502.2 6 X Included Included
Trans- 1,2-Dichloroeth lene 502.2 6 X Included Included
Methyl Tertiary Butyl Ether MTBE) 502.2 G X Included Included
TOTAL ROUTINE $540.00
1) Subcontracted test that is referred to outside laboratories; fees are subject to change without notice
3
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�County of Monterey
CDCR RATE SHEET
Agreement Number 5600002347
Exhibit B-2
ANALYSIS METHOD Est. # of Tests X Cost per Test Total
Radioactivity
Gross Alpha Radioactivity Nucleotides 1 24 X $58.50 $1,404.00
Synthetic Organic Chemical SOC 1 2 6 X $860.00 $5,160.00
Alachlor LASSO) 525 6 X Included Included
Atrazine 525 6 X Included Included
Bentazon 515.3 6 X Included Included
Benzo a) Pyrene 525.2 6 X Included Included
Carbofuran 531.1 6 X Included Included
Chloradane 505 6 X Included Included
2,4-D 515.3 6 X Included Included
Dala on 515.3 6 X Included Included
Dibromochloro rave DBCP) 504.1 6 X Included Included
DI 2-Eth Ihex I Adiapate 525.2 6 X Included Included
DI 2-Eth Ihex I Phthalate 525.2 6 X Included Included
Dinoseb 515.1 6 X Included Included
Di uat 549.1 6 X Included Included
Endothall 548.1 6 X Included Included
Endrin 505 6 X Included Included
Ethylene Dibromide 504.1 6 X Included Included
Heptachlor 505 6 X Included Included
Heptachlor Epixide 505 6 X Included Included
GI hosate 547 6 X Included Included
Hexachlorobenzene 505 6 X Included Included
Hex achloroc clo pentad 505 6 X Included Included
Lindane 505 6 X Included Included
Methox xhlor 505 6 X Included Included
Molinate 525 6 X Included Included
Oxam I V date 531.1 6 X Included Included
Pentachloro henol 515.1 6 X Included Included
Picloram 515.1 6 X Included Included
Pol chlorinate Bi hen is 505 6 X Included Included
Simazine 525 6 X Included Included
Thiobencarb 525 6 X Included Included
Toxa hene 505 6 X Included Included
2,4-5-TP 515.1 6 X Included Included
TOTAL ROUTINE $6,564.00
1) Subcontracted test that is referred to outside laboratories; fees are subject to change without notice
2) Panel Price; refer to Exhibit B-2, Page 7, for prices of analyses when ordered individually
4
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�County of Monterey
Agreement Number 5600002347
CDCR RATE SHEET Exhibit B-2
ANALYSIS METHOD ROUTINE
Est. # of Tests X Cost per Test Total
Biochemical Oxygen Demand BOD) 1)
405.1
24
X
$46.30
$1,123.20
Unregulated Chemical Monitoring Rule UCMR 2)
6
X
$960.00
$5580.00
Dimethoate 527 6 X Included Included
Terbufos sulfone 527 6 X Included Included
2,2,4,4-tetrabromodi hen l ether BDE-47) 527 6 X Included Included
2,2,4,4,5-entabromodi hen l ether BDE-99) 527 6 X Included Included
2,2,4,4,5,5-hexabromobi hen I HBB) 527 6 X Included Included
2,2,4,4,6-entabromodi hen l ether BDE-100) 527 6 X Included Included
1,3-dinitrobenzene 529 6 X Included Included
2,4,6-trinitrotoluene TNT) 529 6 X Included Included
Hexah dro-1,2,5-trinitro-1,3,5-triazine RDX) 529 6 X Included Included
Acetochlor 525.2 6 X Included Included
Alachlor 525.2 6 X Included Included
Metolachlor 525.2 6 X Included Included
Acetochlor ethane sulfonic acid ESA) 535 6 X Included Included
Acetochlor oxanilic acid OA) 535 6 X Included Included
Alachlor ethane sulfonic acid 535 6 X Included Included
Alachlor oxanilic acid 535 6 X Included Included
Metolachlor ethane sulfonic acid 535 6 X Included Included
Metolachlor oxanilic acid 535 6 X Included Included
N-nitroso-diethylamine NDEA) 521 6 X Included Included
N-nitroso-dimeth lamine NDMA) 521 6 X Included Included
N-nitroso-di-n-butylamine NDBA) 521 6 X Included Included
N-nitroso-di-n- ro lamine NDPA) 521 6 X Included Included
N-nitroso-meth leth lamine NMEA) 521 6 X Included Included
N-nitroso-pyrrolidine NPYR) 521 6 X Included Included
Radionucleotide
Radon 1) EPA 913.0 36 X $58.50 $2,106.00
Radium 226 & 228 EPA 903.1 36 X $311.00 $11,196.00
Uranuim 2) 200.8 36 X $63.00 $2,268.00
Radiolo Gross Alpha and Beta) 900.0/SM 36 X $94.50 $3,402.00
TOTAL ROUTINE $25,675.20
Total Well Water /Waste Water Routine $46,242.90
Urgent/Emergency $3,801.60
Grand Total CTF $50,044.50
1) Subcontracted test that is referred to outside laboratories; fees are subject to change without notice
2) Panel Price, refer to Exhibit B-2, Page 7, for prices of analyses when ordered individually
5
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�County of Monterey
Agreement Number 5600002347
CDCR RATE SHEET Exhibit B-2
SVSP WELL WATER/WASTE WATER ANALYSIS
ANALYSIS SITE Est. # of Tests X Cost per Test Total
Coliform Total & E. Coli) Distribution 144 X $22.50 $3,240.00
Nitrate Distribution 208 X $24.30 $5,054.40
Lead and Copper Distribution 40 X $48.00 $1920.00
TDS Distribution 208 X $19.80 $4,118.40
THM's & HAA5 Distribution 1 X 193.50 $193.50
Nitrate Well # 9 24 X $24.30 $583.20
TDS Well # 9 24 X $19.80 $475.20
Coliform Total & E. Coli) Well # 9 8 X $22.50 $180.00
GM Well # 9 1 X $140.66 $140.66
GP Well # 9 1 X $31.29 $31.29
IOC Well # 9 1 X $126.05 $126.05
Gross Alpha Well # 9 4 X $58.50 $234.00
Radium 228 Well # 9 4 X $186.00 $744.00
MTBE Well # 9 2 X $58.50 $58.50
Nitrate Well # 10 24 X $24.30 $583.20
TDS Well # 10 24 X $19.80 $475.20
Coliform Total & E. Coli) Well # 10 8 X $22.50 $180.00
GM Well # 10 2 X $140.66 $281.32
GP Well # 10 2 X $31.29 $62.58
IOC Well # 10 1 X $126.05 $126.05
VOC Well # 10 4 X $90.00 $360.00
SOC Standard T22 panel w/o Dioxin & Diuron) Well # 10 4 X $460.00 $1,840.00
Gross Alpha Well # 10 4 X $58.50 $234.00
Radium 228(1) Well # 10 4 X $186.00 $744.00
Chromium 6 Well # 10 2 X $86.40 $172.80
UCMR-State Well # 10 2 X $960.00 $1920.00
TOTAL ROUTINE $24,136.85
Grand Total SVSP
$24,136.85
1) Subcontracted test that is referred to outside laboratories: fees are subject to change without notice
6
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�County of Monterey Agreement Number 5600002347
CDCR RATE SHEf_T
INDIVIDUAL PRICE When Ordered Separately)
Disinfection By-Products Price
THM's $72.00
HAA5's $121.50
Radionucleotides
Raduim 226 $126.00
Radium 228 $186.00
Gross Alpha $58.50
Bross Beta $54.00
SOC's
EPA504 $63.00
EPA505 $94.50
EPA515 $94.50
EPA525 $135.00
EPA531 $103.50
EPA547 $103.50
EPA548 $108.00
EPA549 $121.50
UCMR State Panel
EPA527-Brominated Fire Retardants Insecticides & Metabolites
EPA529-Ex losives DNB, TNT & RDX)
EPA535-Herbicide Metabolites
EPA 525.2-Parent Herbicides Acentimides)
EPA 521-Nitrosamines
Exhibit B-2
7
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
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EXECUTED AGREEMENT"�|E`R�County of Monterey
California Department of Corrections and Rehabilitation
SUBCONTRACTOR'S PUBLISHED PRICE SCHEDULE
Agreement Number 5600002347
Exhibit B-3
TEST CPT FEE TEST CPT FEE TEST CPT FEE
BACTERJOLOGI c Parasites/Giardia & Crypto
florescent antibody) 87269/87272 $114.00 SEROLOGY:
B. pertussis Nucleic Acid
rlt iplification 87798 $85.00
MYCOLOGY: HIV Oral F.IA Screen $17.00
I lI'' Oral Western Blot 86689 $60.75
Other culture aerobic culture) 87070 $33.00 Fungus Smear 87206 $20.00
Rabies Testing FICA $98.00
Strep. Culture 87081 $26.00 Fungus culture with panel 87102/87107 $82.00
included identification) West Nile Vials includes 86788/86789 $45.00
Campylobacter Stool Culture 87046 $26.00 screening & confirmation
Fungus Identification-yeast per 87106 $85.00
Salmonella/Shigella Stool Culture 87045 $91.00 isolate) I IIV Serum includes screening
and confirmation) 86701/86702/ $45.00
F_,.coli 0157 Stool Culture 87046 $26.00 Fungus Identification mold per
isolate) 87107 $85.00 86689
Bacterial ID 87077 $82.00 Syphilis includes quantitative 86593/86781 $64.00
Fungus/Coccidiodes ID by probe 87797 $52.00 RPR a nd 1'PPA)
Gram Stain Smear
PARASITES: 87205 $20.00
MYCOBACTERIOLOGY:
VIROLOGY;
I13/AFB Smear 87206 $20.00 Influenza typing A&B) 87798 $85.00
Par sites/Intestinal Complete) 87177/87209 $104.00
113/AFB Primary Culture 87015/87116 $56.00 Influenza subtyping I-11, 113,1-15) 87798 $85.00
Parasites/Intestinal I'richrome
Stain) 87209 $59.00 includes ID & sensitivities)
FOOD PROCESSING:
TB/M. gordonac ID by probe 87550 $136.00
Parasi(es/Intestinal FE 87177 $111.00 Food Exaun Processing per $49.00
Concentrate) TB/M. avium ID by probe 87560 $136.00 s:unple)
Parasites/Blood Gicnisa) 87207 $98.00 rB/M. tuberculosis ID by probe 87555 $136.00 Selective Culture per agent) $17.00
Pinworm 87172 $15.00 113 / Quanuferon 1-18 samples) 86480 $70.00 Enriched Culture per agent) $33.00
Parasites/Crypto. & Cyclo. Acid
Fast) 87206 $114.00 113 / Quantiferon 19+ samples 86849 $41.00 OTI3)R FEES AND
SERVICES:
TB/AFT Sensitivity Panel 87188 $56.00
Parasites/Alicrosporidia 87206 $59.00 Phlebotomy $17.00
i Modified l richromc) M. iubcnw/asis Nucleic Acid
Amplification 87556 $85.00
BIB]
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EXECUTED AGREEMENT"�|E`R�GTC 610
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1. APPROVAL: This Agreement is of no force or effect until signed by both parties and
approved by the Department of General Services, if required. Contractor may not commence
performance until such approval has been obtained.
2. AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid
unless made in writing, signed by the parties and approved as required. No oral understanding or
Agreement not incorporated in the Agreement is binding on any of the parties.
3. ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in
part, without the consent of the State in the form of a formal written amendment.
4. AUDIT: Contractor agrees that the awarding department, the Department of General Services,
the Bureau of State Audits, or their designated representative shall have the right to review and
to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to maintain such records for possible audit for a minimum of three
3) years after final payment, unless a longer period of records retention is stipulated. Contractor
agrees to allow the auditor(s) access to such records during normal business hours and to allow
interviews of any employees who might reasonably have information related to such records.
Further, Contractor agrees to include a similar right of the State to audit records and interview
staff in any subcontract related to performance of this Agreement. Gov. Code 8546.7, Pub.
Contract Code 10115 et seq., CCR Title 2, Section 1896).
5. INDEMNIFICATION: Contractor agrees to indemnify, defend and save harmless the State, its
officers, agents and employees from any and all claims and losses accruing or resulting to any
and all contractors, subcontractors, suppliers, laborers, and any other person, firm or corporation
furnishing or supplying work services, materials, or supplies in connection with the performance
of this Agreement, and from any and all claims and losses accruing or resulting to any person,
firm or corporation who may be injured or damaged by Contractor in the performance of this
Agreement.
6. DISPUTES: Contractor shall continue with the responsibilities under this Agreement during
any dispute.
7. TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of
any payments should the Contractor fail to perform the requirements of this Agreement 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. All costs to the State shall be deducted
from any sum due the Contractor under this Agreement and the balance, if any, shall be paid to
the Contractor upon demand.
BIB]
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MG99866-U03
AS99892-U03
AS99894-U03
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DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
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HEALTH-U07
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EXECUTED AGREEMENT"�|E`R�8. INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor,
in the performance of this Agreement, shall act in an independent capacity and not as officers or
employees or agents of the State.
9. RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of
perjury, the minimum, if not exact, percentage of post consumer material as defined in the Public
Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the
State regardless of whether the product meets the requirements of Public Contract Code Section
12209. With respect to printer or duplication cartridges that comply with the requirements of
Section 12156(e), the certification required by this subdivision shall specify that the cartridges so
comply Pub. Contract Code 12205).
10. NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, 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 e.g., cancer), age over 40), marital status, and denial of family care leave. Contractor
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 Gov.
Code 12990 a-f) et seq.) and the applicable regulations promulgated thereunder California
Code of Regulations, Title 2, Section 7285 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 Agreement 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.
Contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the Agreement.
11. CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES
contained in the document CCC 307 are hereby incorporated by reference and made a part of this
Agreement by this reference as if attached hereto.
12. TIMELINESS: Time is of the essence in this Agreement.
13. COMPENSATION: 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, per diem, and taxes, unless otherwise expressly so provided.
14. GOVERNING LAW: This contract is governed by and shall be interpreted in accordance
with the laws of the State of California.
BIB]
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DO109622-U03
C5-U03
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6-U06
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EXECUTED AGREEMENT"�|E`R�15. ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if
these services or goods are obtained by means of a competitive bid, the Contractor shall comply
with the requirements of the Government Codes Sections set out below.
a. The Government Code Chapter on Antitrust claims contains the following definitions:
1) Public purchase" means a purchase by means of competitive bids of goods, services, or
materials by the State or any of its political subdivisions or public agencies on whose behalf the
Attorney General may bring an action pursuant to subdivision c) of Section 16750 of the
Business and Professions Code.
2) Public purchasing body" means the State or the subdivision or agency making a public
purchase. Government Code Section 4550.
b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is
accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of
action it may have under Section 4 of the Clayton Act 15 U.S.C. Sec. 15) or under the
Cartwright Act Chapter 2 commencing with Section 16700) of Part 2 of Division 7 of the
Business and Professions Code), arising from purchases of goods, materials, or services by the
bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to the bidder.
Government Code Section 4552.
c. If an awarding body or public purchasing body receives, either through judgment or
settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor
shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand,
recover from the public body any portion of the recovery, including treble damages, attributable
to overcharges that were paid by the assignor but were not paid by the public body as part of the
bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code
Section 4553.
d. Upon demand in writing by the assignor, the assignee shall, within one year from such
demand, reassign the cause of action assigned under this part if the assignor has been or may
have been injured by the violation of law for which the cause of action arose and a) the assignee
has not been injured thereby, or b) the assignee declines to file a court action for the cause of
action. See Government Code Section 4554.
16. CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of $100,000, the
contractor acknowledges in accordance with Public Contract Code 7110, that:
a. The contractor recognizes the importance of child and family support obligations and shall
fully comply with all applicable state and federal laws relating to child and family support
enforcement, including, but not limited to, disclosure of information and compliance with
earnings assignment orders, as provided in Chapter 8 commencing with section 5200) of Part 5
of Division 9 of the Family Code; and
b. The contractor, to the best of its knowledge is fully complying with the earnings assignment
orders of all employees and is providing the names of all new employees to the New Hire
Registry maintained by the California Employment Development Department.
BIB]
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2/13/2012-U04
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EXECUTED AGREEMENT"�|E`R�17. UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is
unenforceable or held to be unenforceable, then the parties agree that all other provisions of this
Agreement have force and effect and shall not be affected thereby.
18. PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of
$200,000, the Contractor shall give priority consideration in filling vacancies in positions funded
by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200
in accordance with Pub. Contract Code 10353.
19. SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING
REQUIREMENTS:
a. If for this Contract Contractor made a commitment to achieve small business participation,
then Contractor must within 60 days of receiving final payment under this Contract or within
such other time period as may be specified elsewhere in this Contract) report to the awarding
department the actual percentage of small business participation that was achieved. Govt. Code
14841.)
b. If for this Contract Contractor made a commitment to achieve disabled veteran business
enterprise DVBE) participation, then Contractor must within 60 days of receiving final payment
under this Contract or within such other time period as may be specified elsewhere in this
Contract) certify in a report to the awarding department: 1) the total amount the prime
Contractor received under the Contract; 2) the name and address of the DVBE(s) that
participated in the performance of the Contract; 3) the amount each DVBE received from the
prime Contractor; 4) that all payments under the Contract have been made to the DVBE; and 5)
the actual percentage of DVBE participation that was achieved. A person or entity that
knowingly provides false information shall be subject to a civil penalty for each violation. Mil.
& Vets. Code 999.5(d); Govt. Code 14841.)
20. LOSS LEADER:
If this contract involves the furnishing of equipment, materials, or supplies then the following
statement is incorporated: It is unlawful for any person engaged in business within this state to
sell or use any article or product as a loss leader" as defined in Section 17030 of the Business
and Professions Code. PCC 10344(e).)
S:\ADMI I\HOMEPAGE\GTC-610. doc
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2/13/2012-U04
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EXECUTED AGREEMENT"�|E`R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
1. Contract Disputes with Public Entities Supersedes provision number 6, Disputes, of
Exhibit C)
As a condition precedent to Contractor's right to institute and pursue litigation or other
legally available dispute resolution process, if any, Contractor agrees that all disputes and/or
claims of Contractor arising under or related to the Agreement shall be resolved pursuant to
the following processes. Contractor's failure to comply with said dispute resolution
procedures shall constitute a failure to exhaust administrative remedies.
Pending the final resolution of any such disputes and/or claims, Contractor agrees to
diligently proceed with the performance of the Agreement, including the delivering of goods
or providing of services. Contractor's failure to diligently proceed shall constitute a material
breach of the Agreement.
The Agreement shall be interpreted, administered, and enforced according to the laws of the
State of California. The parties agree that any suit brought hereunder shall have venue in
Sacramento, California, the parties hereby waiving any claim or defense that such venue is
not convenient or proper.
A county, city, district or other local public body, state board or state commission, another
state or federal agency, or joint-powers authority shall resolve a dispute with CDCR, if any,
through a meeting of representatives from the entities affected. If the dispute cannot be
resolved to the satisfaction of the parties, each entity may thereafter pursue its right to
institute litigation or other dispute resolution process, if any, available under the laws of the
State of California.
2. Confidentiality of Data
All financial, statistical, personal, technical and other data and information relating to State's
operation, which are designated confidential by the State and made available to carry out
this Agreement, or which become available to the Contractor in order to carry out this
Agreement, shall be protected by the Contractor from unauthorized use and disclosure.
If the methods and procedures employed by the Contractor for the protection of the
Contractor's data and information are deemed by the State to be adequate for the protection
of the State's confidential information, such methods and procedures may be used with the
written consent of the State. The Contractor shall not be required under the provisions of
this paragraph to keep confidential any data already rightfully in the Contractor's possession
that is independently developed by the Contractor outside the scope of the Agreement or is
rightfully obtained from third parties.
No reports, information, inventions, improvements, discoveries, or data obtained, repaired,
assembled, or developed by the Contractor pursuant to this Agreement shall be released,
published, or made available to any person except to the State) without prior written
approval from the State.
Contractor by acceptance of this Agreement is subject to all of the requirements of California
Government Code Section 11019.9 and California Civil Code Sections 1798, et seq.,
regarding the collection, maintenance, and disclosure of personal and confidential
information about individuals.
Page 1 of 12
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EXECUTED AGREEMENT"�|E`R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
3. Accounting Principles
The Contractor will adhere to generally accepted accounting principles as outlined by the
American Institute of Certified Public Accountants. Dual compensation is not allowed; a
contractor cannot receive simultaneous compensation from two or more funding sources for
the same services performed even though both funding sources could benefit.
4. Taxes
Unless required by law, the State of California is exempt from federal excise taxes.
5. Right to Terminate Supersedes provision number 7, Termination for Cause, of Exhibit C)
The parties hereto agree that either party may cancel this Agreement by giving the other
party written notice thirty 30) days in advance of the effective date of such cancellation. In
the event of such termination, the State agrees to pay Contractor for actual services
rendered up to and including the date of termination.
The State may terminate this Agreement and be relieved of any payments should the
Contractor fail to perform the requirements of this Agreement 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. All costs to the State shall be deducted from any
sum due the Contractor under this Agreement and the balance, if any, shall be paid to the
Contractor upon demand.
6. Contract Suspension
Notwithstanding any other provisions of this Agreement, pursuant to a Governor's Executive
Order or equivalent directive, such as a court order or an order from a federal or state
regulatory agency, mandating the suspension of state contracts, the State may issue a
Suspension of Work Notice. The Notice shall identify the specific Executive Order or
directive and the Agreement number(s) subject to suspension. Unless specifically stated
otherwise, all performance under the Agreement(s) must stop immediately upon receipt of
the Notice. During the period of contract suspension, Contractor is not entitled to any
payment for the suspended work. Once the order suspending state contracts has been
lifted, a formal letter from the Department will be issued to the Contractor to resume work.
7. Extension of Term
If it is determined to be in the best interest of the State, upon agreement, the State may
extend this contract, with no increase in service cost, for a period of one 1) year or less.
8. Contractor Employee Misconduct
During the performance of this Agreement, it shall be the responsibility of the Contractor
whenever there is an incident of use of force or allegation(s) of employee misconduct
associated with and directly impacting inmate and/or parolee rights, to immediately notify the
CDCR of the incident(s), to cause an investigation to be conducted, and to provide CDCR
with all relevant information pertaining to the incident(s). All relevant information includes,
but is not limited to: a) investigative reports; b) access to inmates/parolees and the
Page 2of12
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EXECUTED AGREEMENT"�|E`R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
associated staff; c) access to employee personnel records; d) that information reasonably
necessary to assure CDCR that inmates and/or parolees are not or have not been deprived
of any legal rights as required by law, regulation, policy and procedures; and e) written
evidence that the Contractor has taken such remedial action, in the event of unnecessary or
excessive force, or employee misconduct with inmates and/or parolees, as will assure
against a repetition of incident(s) or retaliation. To the extent that the information provided
by the Contractor fails to so assure CDCR, CDCR may require that any implicated
Contractor staff be denied access to and the supervision of CDCR inmates and/or parolees
at the facility and access to inmate and/or parolee records. Notwithstanding the foregoing,
and without waiving any obligation of the Contractor, CDCR retains the power to conduct an
independent investigation of any incident(s). Furthermore, it is the responsibility of the
Contractor to include the foregoing terms within any and all subcontracts, requiring that
subcontractor(s) agree to the jurisdiction of CDCR to conduct an investigation of their facility
and staff, including review of subcontractor employee personnel records, as a condition of
the Agreement.
9. Subcontracting
Services provided are to be performed primarily with the staff of the public entity or, in the
case of educational institutions, auxiliaries or foundations, by the faculty, staff or students
associated with the particular institution. Agreements are not to be used by state agencies
to circumvent the competitive bidding requirements of Public Contract Code Section 10340.
If more that twenty-five 25) percent of the total contract amount or $50,000.00, whichever is
less, is subcontracted, non-competitive bid approval must be obtained from the Secretary of
CDCR and the Department of General Services prior to the commencement of services,
unless the subcontract was competitively bid or the subcontractor(s) also qualifies as a state
agency, governmental agency, or joint power.
10. Subcontractor/Consultant Information
Contractor is required to identify all subcontractors and consultants who will perform labor or
render services in the performance of this Agreement. Additionally, the Contractor shall
notify the Department of Corrections and Rehabilitation, Office of Business Services, in
writing, within ten 10) working days, of any changes to the subcontractor and/or consultant
information.
11. Liability for Nonconforming Work
The Contractor will be fully responsible for ensuring that the completed work conforms to the
agreed upon terms. If nonconformity is discovered prior to the Contractor's deadline, the
Contractor will be given a reasonable opportunity to cure the nonconformity. If the
nonconformity is discovered after the deadline for the completion of the project, CDCR, in its
sole discretion, may use any reasonable means to cure the nonconformity. The Contractor
shall be responsible for reimbursing CDCR for any additional expenses incurred to cure
such defects.
12. Temporary Nonperformance
If, because of mechanical failure or for any other reason, the Contractor shall be temporarily
unable to perform the work as required, the State, during the period of the Contractor's
Page 3 of 12
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EXECUTED-U02
AGREEMENT-U02
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
inability to perform, reserves the right to accomplish the work by other means and shall be
reimbursed by the Contractor for any additional costs above the Agreement price.
13. Contract Violations
The Contractor acknowledges that any violation of Chapter 2, or any other chaptered
provision of the Public Contract Code PCC), is subject to the remedies and penalties
contained in PCC Sections 10420 through 10425.
14. Employment of Ex-Offenders
Contractor cannot and will not either directly, or on a subcontract basis, employ in
connection with this Agreement:
a. Ex-Offenders on active parole or probation, who have been on active parole or probation
during the last three years preceding their employment;
1. Contractor shall only employ ex-offenders who can provide written evidence of
having satisfactorily completed parole or probation, and who have remained off
parole or probation, and have had no arrests or convictions within the past three
years.
b. Ex-offenders convicted of drug trafficking in a prison/jail; escape or aiding/abetting
escape; battery on a Peace Officer or Public Official; arson offenses; or, any violations of
Penal Code Sections 4570-4574 unauthorized Communications with Prisons and
Prisoners Offenses).
c. Ex-Offenders are required to register as a sex offender pursuant to Penal Code Section
290.
d. Any ex-offender who has an offense history involving a violent felony" as defined in
subparagraph c) of Penal Code Section 667.5; or
e. Any ex-offender in a position which provides direct supervision of parolees.
An ex-offender whose assigned duties involve administrative or policy decision-making,
accounting, procurement, cashiering, auditing, or any other business-related administrative
function shall be fully bonded to cover any potential loss to the State or contractor.
Evidence of such bond shall be supplied to CDCR prior to employment of the ex-offender.
15. Conflict of Interest
The Contractor and their employees shall abide by the provisions of Government Code GC)
Sections 1090, 81000 et seq., 82000 et seq., 87100 et seq., and 87300 et seq., Public
Contract Code PCC) Sections 10335 et seq. and 10410 et seq., California Code of
Regulations CCR), Title 2, Section 18700 et seq. and Title 15, Section 3409, and the
Department Operations Manual DOM) Section 31100 et seq. regarding conflicts of interest.
a. Contractors and Their Employees
Consultant contractors shall file a Statement of Economic Interests, Fair Political
Practices Commission FPPC) Form 700 prior to commencing services under the
Page 4 of 12
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EXECUTED-U02
AGREEMENT-U02
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
Agreement, annually during the life of the Agreement, and within thirty 30) days after
the expiration of the Agreement. Other service contractors and/or certain of their
employees may be required to file a Form 700 if so requested by the CDCR or whenever
it appears that a conflict of interest may be at issue. Generally, service contractors
other than consultant contractors required to file as above) and their employees shall be
required to file an FPPC Form 700 if one of the following exists:
1) The Agreement service has been identified by the CDCR as one where there is a
greater likelihood that a conflict of interest may occur;
2) The Contractor and/or Contractor's employee(s), pursuant to the Agreement, makes
or influences a governmental decision; or
3) The Contractor and/or Contractor's employee(s) serves in a staff capacity with the
CDCR and in that capacity participates in making a governmental decision or
performs the same or substantially all the same duties for the CDCR that would
otherwise be performed by an individual holding a position specified in the CDCR's
Conflict of Interest Code.
b. Current State Employees
1) No officer or employee shall engage in any employment, activity or enterprise from
which the officer or employee receives compensation or has a financial interest and
which is sponsored or funded by any state agency, unless the employment, activity
or enterprise is required as a condition of regular state employment.
2) No officer or employee shall contract on his or her own behalf as an independent
contractor with any state agency to provide goods or services.
3) In addition to the above, CDCR officials and employees shall also avoid actions
resulting in or creating an appearance of:
a) Using an official position for private gain;
b) Giving preferential treatment to any particular person;
c) Losing independence or impartiality;
d) Making a decision outside of official channels; and
e) Affecting adversely the confidence of the public or local officials in the integrity of
the program.
4) Officers and employees of the Department must not solicit, accept or receive, directly
or indirectly, any fee, commission, gratuity or gift from any person or business
organization doing or seeking to do business with the State.
c. Former State Employees
1) For the two year 2-year) period from the date he or she left state employment, no
former state officer or employee may enter into an Agreement in which he or she
engaged in any of the negotiations, transactions, planning, arrangements or any part
of the decision-making process relevant to the Agreement while employed in any
capacity by any state agency.
2) For the twelve-month 12-month) period from the date he or she left state
employment, no former state officer or employee may enter into an Agreement with
any state agency if he or she was employed by that state agency in a policy-making
position in the same general subject area as the proposed Agreement within the 12-
month period prior to his or her leaving state service.
In addition to the above, the Contractor shall avoid any conflict of interest whatsoever with
respect to any financial dealings, employment services, or opportunities offered to inmates
or parolees. The Contractor shall not itself employ or offer to employ inmates or parolees
either directly or indirectly through an affiliated company, person or business unless
Page 5 of 12
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40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E` R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
specifically authorized in writing by CDCR. In addition, the Contractor shall not either
directly, or indirectly through an affiliated company, person or business) engage in financial
dealings with inmates or parolees, except to the extent that such financial dealings create no
actual or potential conflict of interest, are available on the same terms to the general public,
and have been approved in advance in writing by CDCR. For the purposes of this
paragraph, affiliated company, person or business" means any company, business,
corporation, nonprofit corporation, partnership, limited partnership, sole proprietorship, or
other person or business entity of any kind which has any ownership or control interest
whatsoever in the Contractor, or which is wholly or partially owned more than 5%
ownership) or controlled any percentage) by the Contractor or by the Contractor's owners,
officers, principals, directors and/or shareholders, either directly or indirectly. Affiliated
companies, persons or businesses" include, but are not limited to, subsidiary, parent, or
sister companies or corporations, and any company, corporation, nonprofit corporation,
partnership, limited partnership, sole proprietorship, or other person or business entity of
any kind that is wholly or partially owned or controlled, either directly or indirectly, by the
Contractor or by the Contractor's owners, officers, principals, directors and/or shareholders.
The Contractor shall have a continuing duty to disclose to the State, in writing, all interests
and activities that create an actual or potential conflict of interest in performance of the
Agreement.
The Contractor shall have a continuing duty to keep the State timely and fully apprised in
writing of any material changes in the Contractor's business structure and/or status. This
includes any changes in business form, such as a change from sole proprietorship or
partnership into a corporation or vice-versa; any changes in company ownership; any
dissolution of the business; any change of the name of the business; any filing in
bankruptcy; any revocation of corporate status by the Secretary of State; and any other
material changes in the Contractor's business status or structure that could affect the
performance of the Contractor's duties under the Agreement.
If the Contractor violates any provision of the above paragraphs, such action by the
Contractor shall render this Agreement void.
Members of boards and commissions are exempt from this section if they do not receive
payment other than payment for each meeting of the board or commission, payment for
preparatory time and payment for per diem.
16. Notification of Personnel Changes
Contractor must notify the State, in writing, of any changes of those personnel allowed
access to State premises for the purpose of providing services under this Agreement. In
addition, Contractor must recover and return any State-issued identification card provided to
Contractor's employee(s) upon their departure or termination.
17. Security Clearance/Fingerprinting
The State reserves the right to conduct fingerprinting and/or security clearance-through the
Department of Justice, Bureau of Criminal Identification and Information BCII)-prior to
award and at any time during the term of the Agreement, in order to permit Contractor
and/or Contractor employee) access to State premises. The State further reserves the right
to terminate the Agreement should a threat to security be determined.
Page 6 of 12
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EXECUTED-U02
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
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AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E` R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
18. Computer Software
Contractor certifies that it has appropriate systems and controls in place to ensure that state
funds will not be used in the performance of this Agreement for the acquisition, operation or
maintenance of computer software in violation of copyright laws.
19. Expendable Equipment
Expendable equipment is defined as expendable items which change with use and have a
unit acquisition cost of less than $5,000 per unit i.e. fax machines, computers, printers,
etc.). Title to any expendable equipment purchased or built with State funds as part of this
agreement will vest in the State. The Contractor must retain a listing of expendable
equipment purchases that are considered theft-sensitive" items, such as cameras,
calculators, two-way radios, computer equipment, etc., for audit purposes. Upon completion
or termination of the agreement, Contractors are required to leave all expendable equipment
for use by subsequent contractors or for the State to dispose of accordingly. The State may
authorize the continued use of such equipment for work to be performed under a different
agreement.
The cost of expendable equipment purchased should be comparable to the prevailing price
for similar items in the surrounding area.
20. Electronic Waste Recycling
The Contractor certifies that it complies with the requirements of the Electronic Waste
Recycling Act of 2003, Chapter 8.5, Part 3 of Division 30, commencing with Section 42460
of the Public Resources Code, relating to hazardous and solid waste. Contractor shall
maintain documentation and provide reasonable access to its records and documents that
evidence compliance.
21. Liability for Loss and Damages
Any damages by the Contractor to the State's facility including equipment, furniture,
materials or other State property, will be repaired or replaced by the Contractor to the
satisfaction of the State at no cost to the State. The State may, at its option, repair any such
damage and deduct the cost thereof from any sum due Contractor under this Agreement.
22. Disclosure
Neither the State nor any State employee will be liable to the Contractor or its staff for
injuries inflicted by inmates or parolees of the State. The State agrees to disclose to the
Contractor any statement(s) known made by any inmate or parolee which indicate violence
may result in any specific situation, and the same responsibility will be shared by the
Contractor in disclosing such statement(s) to the State.
23. Workers' Compensation
Contractor hereby represents and warrants that Contractor is currently and shall, for the
duration of this agreement, carry workers' compensation insurance, at Contractor's expense,
or that it is self-insured through a policy acceptable to CDCR, for all of its employees who
Page 7 of 12
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EXECUTED-U02
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FO96183-U03
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
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TO-U07
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ON-U07
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OF-U07
THE-U07
COUNTY-U07
OF-U07
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411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
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AMENDMENTS-U012
THERETO,-U012
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LOCAL,-U012
STATE,-U012
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PROGRAMS.-U012
EXECUTED AGREEMENT"�|E` R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
will be engaged in the performance of this agreement. Such coverage will be a condition of
CDCR's obligation to pay for services provided under this agreement.
Prior to approval of this agreement and before performing any work, Contractor shall furnish
to the State evidence of valid workers' compensation coverage. Contractor agrees that the
workers' compensation insurance shall be in effect at all times during the term of this
agreement. In the event said insurance coverage expires or is canceled at any time during
the term of this agreement, Contractor agrees to give at least thirty 30) days prior notice to
CDCR before said expiration date or immediate notice of cancellation. Evidence of
coverage shall not be for less than the remainder of the term of the agreement or for a
period of not less than one year. The State reserves the right to verify the Contractor's
evidence of coverage. In the event the Contractor fails to keep workers' compensation
insurance coverage in effect at all times, the State reserves the right to terminate this
agreement and seek any other remedies afforded by the laws of this State.
Contractor also agrees to indemnify, defend and save harmless the State, its officers,
agents and employees from any and all of Contractor's workers' compensation claims and
losses by Contractor's officers, agents and employees related to the performance of this
agreement.
24. Insurance Requirements
Insurance as required herein shall be a condition of the State's obligation to pay for services
provided under this Agreement. Prior to approval of this Agreement and before performing
any work, Contractor and any subcontractor shall furnish to the State evidence of valid
coverage. The following shall be considered evidence of coverage: A certificate of
insurance, a true and certified" copy of the policy, or any other proof of coverage issued by
Contractor's insurance carrier. Binders are not acceptable as evidence of coverage.
Providing evidence of coverage to the State conveys no rights or privileges to the State, nor
does it insure any State employee or insure any premises owned, leased, used by or
otherwise or under the control of the State. It does, however, serve to provide the State with
proof that the Contractor and any subcontractors are insured at the minimum levels required
by the State of California.
Contractor agrees that any liability insurance required in the performance of this Agreement
shall be in effect at all times during the term of this Agreement. In the event said insurance
coverage expires or is canceled during the term of this Agreement, Contractor's insurance
provider must agree to give at least thirty 30) days prior notice to the State before said
expiration date or notice of cancellation. Evidence of coverage required in the performance
of this Agreement shall not be for less than the remainder of the term of this Agreement or
for a period of not less than one year. The State and the Department of General Services
DGS) reserve the right to verify the Contractor's evidence of coverage; evidence of
coverage is subject to the approval of the DGS. In the event the Contractor fails to keep
insurance coverage as required herein in effect at all times, the State reserves the right to
terminate this Agreement and to seek any other remedies afforded by the laws of the State
of California.
Contractor hereby represents and warrants they and any subcontractors) are currently and
shall for the duration of this Agreement be insured. Contractor shall provide proof of self-
insurance against:
Page 8 of 12
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
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AGREEMENTS-U03
2/13/2012-U04
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16616-U05
6-U06
APPROVE-U07
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DIRECTOR-U07
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ON-U07
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OF-U07
THE-U07
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OF-U07
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
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DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E` R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
Commercial General Liability minimum of $1,000,000 per occurrence for bodily injury and
property damage liability combined
25. Tuberculosis TB) Testing
In the event that the services required under this Agreement will be performed within a
CDCR institution/parole office/community-based program, prior to the performance of
contracted duties, Contractors and their employees who are assigned to work with
inmates/parolees on a regular basis shall be required to be examined or tested or medically
evaluated for TB in an infectious or contagious stage, and at least once a year thereafter or
more often as directed by CDCR. Regular basis is defined as having contact with
inmates/parolees in confined quarters more than once a week.
Contractors and their employees shall be required to furnish to CDCR, at no cost to CDCR,
a form CDCR 7336, Employee Tuberculin Skin Test TST) and Evaluation," prior to
assuming their contracted duties and annually thereafter, showing that the Contractor and
their employees have been examined and found free of TB in an infectious stage. The form
CDCR 7336 will be provided by CDCR upon Contractor's request.
The following provisions apply to services provided on departmental and/or institution
grounds:
26. Blood borne Pathogens
Provider shall adhere to California Division of Occupational Safety and Health CAL-OSHA)
regulations and guidelines pertaining to blood borne pathogens.
27. Primary Laws, Rules, and Regulations Regarding Conduct and Association with State
Prison Inmates and Division of Juvenile Justice Wards
Individuals who are not employees of the California Department of Corrections and
Rehabilitation CDCR), but who are working in and around inmates who are incarcerated, or
wards who are housed within California's institutions/facilities or camps, are to be apprised
of the laws, rules and regulations governing conduct in associating with prison inmates or
wards. The following is a summation of pertinent information when non-departmental
employees come in contact with prison inmates or wards.
By signing this contract, the Contractor agrees that if the provisions of the contract require
the Contractor to enter an institution/facility or camp, the Contractor and any employee(s)
and/or subcontractor(s) shall be made aware of and shall abide by the following laws, rules
and regulations governing conduct in associating with prison inmates or wards:
a. Persons who are not employed by CDCR, but are engaged in work at any
institution/facility or camp must observe and abide by all laws, rules and regulations
governing the conduct of their behavior in associating with prison inmates or wards.
Failure to comply with these guidelines may lead to expulsion from CDCR
institutions/facilities or camps.
SOURCE: California Penal Code PC) Sections 5054 and 5058; California Code of
Regulations CCR), Title 15, Sections 3285 and 3415, and California Welfare and
Institutions Code WIC) Section 1712.
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AI102677-U03
DO109622-U03
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2/13/2012-U04
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6-U06
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DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E` R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
b. CDCR does not recognize hostages for bargaining purposes. CDCR has a NO
HOSTAGE" policy and all prison inmates, wards, visitors, and employees shall be made
aware of this.
SOURCE: PC Sections 5054 and 5058; CCR, Title 15, Section 3304 and 4603; WIC
Section 1712.
c. All persons entering onto institution/facility or camp grounds consent to search of their
person, property or vehicle at any time. Refusal by individuals to submit to a search of
their person, property, or vehicle may be cause for denial of access to the premises.
SOURCE: PC Sections 2601, 5054 and 5058; CCR, Title 15, Sections 3173, 3177,
3288, 4696, and 4697: WIC 1712.
d. Persons normally permitted to enter an institution/facility or camp may be barred, for
cause, by the CDCR Director, Warden, and/or Regional Parole Administrator.
SOURCE: PC Sections 5054 and 5058; CCR, Title 15, Section 3176 a) and 4696;
WIC Section 1712.
e. It is illegal for an individual who has been previously convicted of a felony offense to
enter into CDCR adult institutions/facilities or camps, or youth institutions/facilities or
camps in the nighttime, without the prior approval of the Warden or officer in charge. It
is also illegal for an individual to enter onto these premises for unauthorized purposes or
to refuse to leave said premises when requested to do so. Failure to comply with this
provision could lead to prosecution.
SOURCE: PC Sections 602, 4570.5 and 4571; CCR, Title 15, Sections 3173 and
3289; WIC Section 1001.7.
f. Encouraging and/or assisting prison inmates to escape, is a crime. It is illegal to bring
firearms, deadly weapons, explosives, tear gas, drugs or drug paraphernalia on CDCR
institutions/facilities or camp premises. It is illegal to give prison inmates or wards
firearms, explosives, alcoholic beverages, narcotics, or any drug or drug paraphernalia,
including cocaine or marijuana. It is illegal to give wards sex oriented objects or devices,
and written materials and pictures whose sale is prohibited to minors.
SOURCE: PC Sections 2772, 2790, 4533, 4535, 4550, 4573, 4573.5, 4573.6 and
4574; WIC Section 1152, CRR, Title 15, sections 4681 and 4710; WIC Section 1001.5.
g. It is illegal to give or take letters from inmates or wards without the authorization of the
Warden or officer in charge. It is also illegal to give or receive any type of gift and/or
gratuities from prison inmates or wards.
SOURCE: PC Sections 2540, 2541 and 4570; CCR, Title 15, Sections 3010, 3399,
3401, 3424, 3425 and 40045; WIC Section 1712.
h. In an emergency situation the visiting program and other program activities may be
suspended.
Page 10 of 12
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EXECUTED AGREEMENT"�|E`!R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
SOURCE: PC Section 2601; CCR, Title 15, Section 3383, 4002.5 and 4696.
i. For security reasons, visitors must not wear clothing that in any way resembles state
issued prison inmate or ward clothing blue denim shirts, blue denim pants).
SOURCE: CCR, Title 15, Section 3174 b) 1) and 4696.
J.
Interviews with SPECIFIC INMATES are not permitted. Conspiring with an inmate to
circumvent policy and/or regulations constitutes a rule violation that may result in
appropriate legal action. Interviews with individual wards are permitted with written
consent of each ward if he is 18 years of age or older, or with written consent of a
parent, legal guardian, or committing court, if 17 years of age or younger.
SOURCE: CCR, Title 15, Sections 3261.5, 3315 a) 3) X), and 3177 and
4700(a)(1).
28. Clothing Restrictions
While on institution grounds, Contractor and all its agents, employees, and/or
representatives shall be professionally and appropriately dressed in clothing distinct from
that worn by inmates at the institution. Specifically, blue denim pants and blue chambray
shirts, orange/red/yellow/white/chartreuse jumpsuits and/or yellow rainwear shall not be
worn onto institution grounds, as this is inmate attire. Contractor should contact the
institution regarding clothing restrictions prior to requiring access to the institution to assure
the Contractor and their employees are in compliance.
29. Tobacco-Free Environment
Pursuant to Penal Code Section 5030.1, the use of tobacco products by any person on the
grounds of any institution or facility under the jurisdiction of the Department of Corrections
and Rehabilitation is prohibited.
30. Prison Rape Elimination Policy
CDCR is committed to providing a safe, humane, secure environment, free from sexual
misconduct. This will be accomplished by maintaining a program to ensure
education/prevention, detection, response, investigation and tracking of sexual misconduct
and to address successful community re-entry of the victim. The CDCR shall maintain a
zero tolerance for sexual misconduct in its institutions, community correctional facilities,
conservation camps and for all offenders under its jurisdiction. All sexual misconduct is
strictly prohibited.
As a contractor with the CDCR, you and your staff are expected to ensure compliance with
this policy as described in Department Operations Manual, Chapter 5, Article 44.
31. Security Regulations
a. Unless otherwise directed by the entrance gate officer and/or Contract Manager, the
Contractor, Contractor's employees and subcontractors shall enter the institution through
the main entrance gate and park private and nonessential vehicles in the designated
visitor's parking lot. Contractor, Contractor's employees and subcontractors shall
Pagel 1 of 12
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EXECUTED AGREEMENT"�|E`"R�Count of Monterey Agreement Number 5600002347
California Department of Corrections and Rehabilitation CDCR) Exhibit D
Special Terms and Conditions for Public Entity Agreements
remove the keys from the ignition when outside the vehicle and all unattended vehicles
shall be locked and secured while on institution grounds.
b. Any State- and Contractor-owned equipment used by the Contractor for the provision of
contract services, shall be rendered temporarily inoperative by the Contractor when not
in use, by locking or other means unless specified otherwise.
c. In order to maintain institution safety and security, periodic fire prevention inspections
and site searches may become necessary and Contractor must furnish keys to
institutional authorities to access all locked areas on the worksite. The State shall in no
way be responsible for Contractor's loss due to fire.
d. Due to security procedures, the Contractor, Contractor's employees and subcontractors
may be delayed at the institution vehicle/pedestrian gates and sally ports. Any loss of
time checking in and out of the institution gates and sally ports shall be borne by the
Contractor.
e. Contractor, Contractor's employees and subcontractors shall observe all security rules
and regulations and comply with all instructions given by institutional authorities.
f. Electronic and communicative devices such as pagers, cell phones and
cameras/microcameras are not permitted on institution grounds.
g.
Contractor, Contractor's employees and subcontractors shall not cause undue
interference with the operations of the institution.
h. No picketing is allowed on State property.
32. Gate Clearance
Contractor and Contractor's employee(s) and/or subcontractor(s) must be cleared prior to
providing services. The Contractor will be required to complete a Request for Gate
Clearance for all persons entering the facility a minimum of ten 10) working days prior to
commencement of service. The Request for Gate Clearance must include the person's
name, social security number, valid state driver's license number or state identification card
number and date of birth. Information shall be submitted to the Contract Liaison or his/her
designee. CDCR uses the Request for Gate Clearance to run a California Law Enforcement
Telecommunications System CLETS) check. The check will include Department of Motor
Vehicles check, Wants and Warrants check, and Criminal History check.
Gate clearance may be denied for the following reasons: Individual's presence in the
institution presents a serious threat to security, individual has been charged with a serious
crime committed on institution property, inadequate information is available to establish
positive identity of prospective individual, and/or individual has deliberately falsified his/her
identity.
All persons entering the facilities must have a valid state driver's license or photo
identification card on their person.
Page 12 of 12
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EXECUTED AGREEMENT"�|E`#R�MONTEREY COUNTY BOARD OF SUPERVISORS
1EETING: June 14. 2011 Consent AGENDA NO.:
SUBJECT: Approve and authorize the Director of Health to execute on behalf of the County of
Monterey' standard a_rleenients. and any amendments thereto, for continued funding
from local. State. and Federal acencies for designated programs.
DEPARTIEtiT: Health
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health to execute on behalf of the County of Monterey
slandar a rreeme ntti. and any amen T s the reto. for c I,t diner +r l P. l l a l c al tat o ai~.,
n d nlen._ o nf i e ft ln S
i s
Federal a`-uencies for designated pro crams.
SLU:MMARYIDISCUSSION
The Health Department relies on a variety of local. State. and Federal rants to provide a portion of
the financial support required by the Department for the services it provides in the County. In
preparing the fiscal tear FY) 201 1 Requested County- Budget, the Department has co-0-pile,
Iist of Ioca". State and Federal programs currently providing funding for various proerams. These
same programs expect continued tundin`u beyond FY-201 1-2012. The State and Federal agencies
responsible for those grants require the Department to subiliII an application and final a`reement to
renew funding for the upcoininc fiscal year even though there is an established relationshiDD
etC~:een the Court y and the un ii1_" tl?e: c~' in the current fiscal year. In fiscal ear i l!= un-i U_l l
20l 1 the Board of Supervisors BOS ranted approval and aut e,.j the Director of tHealth to t iz_.
on behalf of the County in submitting the application and final agreement to renew grants with the
appropriate funding agency.
Continued support and approval by the BOS for this recommended action would allow the Director
of Health to continue to submit the approved resolution as authority to sizii. submit Lrant
r�ry
applications and i ant agreements to renew funding for those designated procIarns without having
to request BOS approval for each grant application. aareemenr. This still significantly reduce the
r
number of board reports submitted for approval annually and y',-III expedite the process.
The Department will continue to present amendments to the final grant agreement that require
ad~listmenis to the Final County Budget for changes In appropriations. revenues. andior positions.
to the BOS for approval.
OTHER AGENCY INVOLVEMENT:
Count: Counsel. Risk- N1anag`emcnt and the uditor-Controller agree with the process and will
continue to review each rranI agreement before the Department signs and submits the agreement
to the funding agency.
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EXECUTED AGREEMENT"�|E`$R�FINANCING:
The majority of appropriations and revenues related to Attachment a ha\e been included in the
Requested County Budget for FY 2011-2012. Adjustments in appropriations. revenue. and/or
position count will be submitted to the BOS for approval. There will be no new General Fund
Contribution.
Prepared by: Approved bv:
Susie McKee. Administrative Secretary
755 4520
Date: S t
Ly
Ray Bullick. Director of Health
Data:
cc: Charles J. 1cKee, County Counsel
Michael Miller. Auditor-Controller
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EXECUTED AGREEMENT"�|E`%R�40
Before the Board of Supervisors in and for the
County of Monterey, State of California
Approve and authorize the Director of Health to
execute on behalf of the County of Monterey
standard agreements, and any amendments
thereto, for continued funding from local, State,
and Federal agencies for designated programs....
Upon motion of Supervisor Salinas, seconded by Supervisor Armenta, and carried by those
members present, the Board hereby;
Approved and authorized the Director of Health to execute on behalf of the
County of Monterey standard agreements, and any amendments thereto, for
continued funding from local, State, and Federal agencies for designated
programs.
Agency
Grant/Contract Title
Calif Dept of Alcohol and Drug Beverage Container Recycling & Litter Cleanup Activities
Calif Dept of Alcohol and Drug Comprehensive Drug Court Implementation Grant
Calif Dept of Alcohol and Drug Department of Alcohol and Drug Programs ADP)
Calif Dep. of Alcohol and Drug Safe and Drug Free School and Communities
Calif Dept of Alcohol and Dmg Substance Abuse and Crime Prevention Act of 2000 Plan
Prop 36)
Calif Dept of Corrections Salinas Valley State Prison, Pathology Service
Calif Dept of Fish and Game Local. Assistance Grant For Area Oil Contingency Plan
Calif Dept of Health Care Services California Children's Services Administration
Calif Dept of Health Care Services Child Health and Disability Prevention Program
Calif Dept of Health Care Services Health Care Program for Children in Foster Care
Calif Dept of Health Care Services Medi-Cal Administration Activities MAA)
Calif Dept of Health Care Services Medi-Cal Participation Fee with Host County
Calif Dept of Health Care Services Monterey County Special Education Local Plan Area
SELPA)
Calif Dept of Health Care Services Targeted Case Management TCM)
Calif Dept of Mental Health County/City Performance Contract
Calif Dept of Mental Health Managed Care/Mental Health Plan
Calif Dept of Mental Health Mental Health Services Act MHSA) Agreement
Pa---,e I o[3
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EXECUTED AGREEMENT"�|E`&R�40
Calif Dept of Mental Health 1 Mental Health Services Act MHSA) Annual Update
Calif Dept of Mental Health Projects for Assistance in Transition from Homelessness
PATH)
Calif Dent of Mental Health State Hospital Bed Purchase and Usage
Calif Dept of Mental Health Substance Abuse and Mental Health Services
Administration SAr'~4HSA Block)
Calif Dept of Public Health AIDS CARE Early Intervention Services
Calif Dept of Public Health AIDS CARE, Ryan White Treatment Funds Title II
Calif Dept of Public Health AIDS Master Grant
Calif Dept of Public Health Beach Safety Program
Calif Dept of Public Health California Nutrition Network Local Incentive Award
Calif Dept of Public Health 1 Childhood Lead Poisoning Prevention Program
Calif Dept of Public Health Community Challenge GranuPostpone
j Calif Dept of Public Health Comprehensive Tobacco Control Plan
Calif Dept of Public Health Hospital Preparedness Program
CalifDept of Public Health Immunization Assistance Program
Calif Dept of Public Health Maternal Child Adolescent Health
Calif Dept of Public Health Minority AIDS Initiative
Calif Dept of Public Health Public Health Preparedness PlanrPan Flu
Calif Dept of Public Health it Regional Nutrition Networks for Healthy Active Living
Calif Dept of Public Health State Subvention OHO)
Calif Dept of Public Health STD Community Interventions Program
Calif Dept of Public Health vital Records, fees
Calif Dept of Public Health Women, Infants and Children WIC) Supplemental
Nutrition Program
Calif Dept of Public Health Beach Act Grant
Calif Dept of Public Health Tuberculosis Prevention and Control Activities
Calif Dept of Rehabilitation County Behavioral Health Cooperative Agreement
Calif Emergency Medical Services Maddy Fund
Authority v
Calif Office of Traffic Safety Pedestrian Safety Bike Safety
Calif Office of Traffic Safety Pedestrian Safety Safe Routes to School
Children's Services International j Children's and Families Commission Proposition 10)
Dept of Resources Recycling and Used Oil Recycling Block Grant
Recovery CalRecycle
First 5 Monterey County Secure Families/Familias Seguras Grant
Monterey County Office of Ed. Individuals with Disabilities Education Act IDEA)
Monterey County Office of Ed. Through and Beyond
Page 2 of I
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EXECUTED AGREEMENT"�|E`'R�o
State Water Resources Control Board i, Emergency, Abandoned. Recalcitrant EAR)
Substance Abuse and Mental Health Adult Drug Court Grant
Administration SAMHSA) and Bureau
of Justice Assistance BJA)
Substance Abuse and Mental Health
Administration SAMHSA) Center for
Substance Abuse Treatment CSAT)
Juvenile Drug Court Grant
y
PASSED AND ADOPTED on this 14t" day of June, 2011, by the following vote, to wit:
AYES: Supervisors Armenta. Calcagno, Salinas, Parker, and Potter
NOES: None
ABSENT: None
1, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of ilvlonterey, State of California, hereby certify
that the foregoing is a t<ue copy of an original order of said Board of Supervisors duly made and entered in the minutes
thereof of Minute Book 75 for the meeting on June 14, 2011.
Dated: Jude 1?. 2011 Gail T. Borkowski, Clerk of the Board of Supervisors
County of Monterey, State of California
Page 3 of 3
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EXECUTED AGREEMENT"�|E`(R�Attachment 23
County of Monterey
2011-12
Agreement No. EPO 11-27
2011-12 CDC Public Health Emergency Preparedness PHEP), State General Fund GF)
Pandemic Influenza, HHS Hospital Preparedness Program HPP) Funding
AGREEMENT
CDC CFDA # 93.069; HPP CFDA # 93.889; State GF Pan Flu Chapter 33
1. This Agreement is entered into between the California Department of Public Health, herein
after referred to as CDPH" and the County of Monterey, herein after referred to as LHD"
and/or Local HPP Entity".
2. The term of this Agreement is:-
August 10, 2011 through August 9, 2012 PHEP Centers for Disease Control and
Prevention CDC])
July 1, 2011 through June 30, 2012 Hospital Preparedness Program HPP])
July 1, 2011 through June 30, 2012 State GF Pandemic Influenza)
3. The maximum amount payable under this Agreement is $666,019, and is allocated as
follows:
$323,914, PHEP CDC Base Allocation. 8/10/11 8/9/12)
$0, Laboratory Allocation. 8/10/11 8/9/12)
$0, Laboratory Trainee Stipends. 8/10/11 8/9/12)
$0, Laboratory Training Assistance Grant. 8/10/11 8/9/12)
$0, Cities Readiness Initiative Funds. 8/10/11 8/9/12)
$267,443, HPP Allocation. 7/1/11 6/30/12)
$74,662, State GF Pandemic Influenza Allocation. 7/1/11 6/30/12)
4. The parties agree to comply with the terms and conditions of the following exhibits, which
are by this reference made a part of this Agreement.
Exhibit A Scope of Work 03 Pages
Exhibit B Budget Detail and Budget Provisions 04 Pages
Exhibit B, Attachment 1, Criteria for Payments 01 Page
Exhibit C Additional Provisions 03 Pages
Exhibit D(F) Special Terms and Conditions Federal) 25 Pages
Notwithstanding provisions 3, 4, 6, 12, 13, 17, 22, 23, 27,
and 30 which do not apply to this Agreement.
Exhibit E Non-Supplantation Certification Form 01 Page
Page 1 of 2
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SUSIE-U09
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FUNDING-U012
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EXECUTED AGREEMENT"�|E`)R�Attachment 23
County of Monterey
2011-12
Agreement No. EPO 11-27
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
CONRACTOR'S NAME
County of Monterey
BY Authorized Signature) DATE SIGNED Do not type signor must date)
t
PRINTED D TITLE OF PERSON SIGNING
Ray Bullick, Director of Health
ADDRESS
1270 Natividad Road, Salinas, CA 93906
STATE OF CALIFORNIA
AGENCY NAME
California Department of Public Health
BY Authorized Signature) DATE SIGNED
ADDRESS
1615 Capitol Avenue, MS 7002, P.O. Box 997377, Sacramento, CA 95899-7377
C J', 1 0. J r
A: R oVD AS TO NDEr.AN1;7
INSURANCE N G U A G E
By:
Date
T7
AG'ditor4 ontroller
County fl' Monterey
Page 2of2
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EXECUTED AGREEMENT"�|E`*R�County of Monterey
2011-12
Agreement No. EPO 11-27
EXHIBIT E
NON-SUPPLANTATION CERTIFICATION FORM
2011-12 CDC Public Health Emergency Preparedness PHEP), State General Fund
GF) Pandemic Influenza, HHS Hospital Preparedness Program HPP)
Fiscal Year 2011-2012
County/City and Name of Local Health Department and/or Local HPP Entity)
I hereby certify that the above-named local health department LHD) and/or Local HPP
Entity shall not use funds allocated by the California Department of Public Health
CDPH) to supplant funding for existing levels of service and that funds shall only be
used for the purposes specified in the Fiscal Year.(FY) 2011-2012 CDC Public Health
Emergency Preparedness PHEP), State General Fund GF) Pandemic Influenza, HHS
Hospital Preparedness Program HPP) Funding Agreement as approved by the CDPH.
I further certify that funds received shall be deposited in an interest-bearing Local Public
Health Preparedness Trust Fund as per the Health and Safety Code 101317 and
expended only for the purposes stated in the LHDs and/or Local HPP Entity's Grant
Application Work Plan and Budget, as approved by the CDPH.
Chairperson, Board of Supepvisors, Mayor of a City or designee:
Signature:
Az~
Printed Name: Jane Parker
Title: Chair, County of Monterey, Board of Supervisors
Phone: 831) 755-5842
Date:
Please return the original signed certification with your FY 2011-2012 CDC PHEP, State
GF Pandemic Influenza, HPP Funding Agreement Funding Agreement to:
California Department Public Health
Emergency Preparedness Office
Attn: Local Management Unit
MS 7002
P.O. Box 997377
Sacramento, CA 95899-7377
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EXECUTED AGREEMENT"�|E`+R�CCC-307
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
Contractor/Bidder Firm Name Printed)
By Authorized Sig iture
County of Monterey
1 Printed-Name and Title of Person Signing
Ray Bullick, Director of Health
Date Executed
Executed in the County Q
i Federal ID Number
94-6000524
Monterey
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. Gov. Code 12990 a-f) and CCR, Title 2,
Section 8103) Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
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 counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
BIB]
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CONTINUED-U012
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EXECUTED AGREEMENT"�|E`,R�California Department of Public Health Special Terms and Conditions Exhibit D F)
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
Attachment 1
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, 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 shall require that the language of this certification be included in the award
documents for all subawards at all tiers including subcontractors, subgrants, and contracts under grants and
cooperative agreements) of $100,000 or more, and that all subrecipients 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.C., any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
County of Monterey
Ray Bullick, Director of Health
Name of Contractor Printed Name of Person Signing for Contractor
EPO 11-27
Contract I Grant Number 5. re erson Signing for Contractor
q k-I--- \
Date
After execution by or on behalf of Contractor, please return to:
California Department of Public Health
Director of Health
Title
CDPH reserves the right to notifiy the contractor in writing of an alternate submission address.
CDPH Exhibit D(F) 9/09) Page 23 of 25
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EXECUTED AGREEMENT"�|E`-R�ACOR~�
CERTIFICATE OF LIABILITY INSURANCE DATE
1
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
MARSH RISK & INSURANCE SERVICES P
HONE
345 CALIFORNIA STREET, SUITE 1300 t A/C Not:
AIC. No.
CALIFORNIA LICENSE NO. 0437153 E-MAIL
ADRESS:
SAN FRANCISCO, CA 94104
INSURER(S) AFFORDING COVERAGE NAIC_#
C.O.MO-COM-LIAB-11-12 INSURER A Starr Indemnity & Liability Company 138318
INSURED
f M INSURER B
County o
onterey
158 West Alisal Street, 3rd Floor INSURER C
Salinas, CA 93901 INSURER D
INSURER E
INSURER F
COVERAGES
CERTIFICATE NUMBER:
SEA-002254783-01 REVISION NUMBER:3
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE ADDL
INSR SUER POLICY EFF POLICY EXP
POLICY NUMBER MM/DD/YYYY MMIDDIYYYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE S
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence $
CLAIMS-MADE E OCCUR MED EXP Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $
POLICY PRO- LOC $
AUT OMOBILE LIABILITY i COMBINED SINGLE LIMIT
Ea accident $
ANY AUTO BODILY INJURY Per person) S
ALL OWNED SCHEDULED
AUTOS
AUTOS
BODILY INJURY Per accident)
NON-OWNED
HIRED AUTOS AUTOS PROPERTY DAMAGE
Per accident S
$
A UMBRELLA LIAB X
OCCUR SISCPEL00007911 107/01/2011 07/01/2012
EACH OCCURRENCE 10,000,000
$
EXCESS LIAB CLAIMS-MADE AGGREGATE S 10,000,000
DIED X I RETENTION $ 1,500,000 S
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY WC STATU- 0TH-
T I N ANY PROPRIETOR/PARTNER/EXECUTIVE
N / A
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED?
Mandatory in NH) E.L. DISEASE EA EMPLOYEE $
If yes, describe under
DESCRIPTION CF OPERATIONS below
E.L. DISEASE POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES Attach ACORD 101, Additional Remarks Schedule, if more space is required)
xcess liability is a combined Public Entity form that includes automobile liability.
California Department of Public Health is included as additional insured where required by written contract.
CERTIFICATE HOLDER
Ca;ifornia Department of Public Health
1615 Capitol Ave., MS 7002
PC Box 997377
Sacramento, CA 95899-7237
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Keith W. Grand 4D liter C~
1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 2010/05) The ACORD name and logo are registered marks of ACORD
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EXECUTED AGREEMENT"�|E`.R�Starr Indemnity & Liability Company
Dallas, TX 1-866-519-2522
Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary
litigation expenses as Defense Costs ends when we have used up the applicable Limit of
Insurance in the payment of judgments, settlements or defense expenses, or the conditions set
forth in a. and b. above are no longer met.
SECTION II. WHO IS AN INSURED
The following persons or organizations are insureds under this insurance:
A. You;
B. Any individual who was previously or is presently elected or appointed as an official of the Named
Insured, including members of its governing body or any other agencies, districts, authorities,
committees, trustees, boards, commissions, or similar entity of the Named Insured, but only with
respect to their duties as an official of the Named Insured;
C. Your employees, past or present, while acting within the course and scope of their employment, or
your volunteer workers while performing duties on your behalf;
D. Any legally authorized purchase group(s) representing any Named Insured. The following are also
insureds with respect to such purchase group(s):
1. The agencies of a municipality participating as member agencies in the purchase group(s), and
any and all districts, authorities, committees, trustees, boards, commissions, or similar entity
subject to the direction or control of such agencies or for which the board members act as
governing body. A member agency includes any department or constituent agencies of the
member agency; and
2. Any person(s) who are past or present elected or appointed officers, employees, or volunteer
workers of the member agencies, whether or not compensated, while acting on behalf of the
member agencies and within the scope of their employment or volunteer capacities, including
acting on boards at the direction of the agencies.
E. Any person designated in paragraphs A. through D. above:
1. Using any auto not owned by you that is used in connection with your operations as a public
entity; or
2. Using with your permission any owned auto of yours or hired auto or any person legally
responsible for the use thereof,
except:
1. Any person using an auto while he or she is working in a business of selling or delivering autos;
or
2. The owner or lessee of any hired auto. This exception does not apply if the owner or lessee is an
insured designated in paragraphs A. through D. above.
PE 1001 12-10) Page 4 of 27
Copyright C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved.
Includes copyrighted material of ISO Properties, Inc., used with its permission.
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EXECUTED AGREEMENT"�|E`/R�County of Monterey
2011-12
Agreement No. EPO 11-27
EXHIBIT A
2011-12 CDC Public Health Emergency Preparedness PHEP), State General
Fund GF) Pandemic Influenza, HHS Hospital Preparedness Program HPP) Funding
Scope of Work
1. Service Overview
This Agreement is entered into between the California Department of Public Health,
hereinafter referred to as CDPH" and the County of Monterey, hereinafter referred to as
the LHD" and/or Local HPP Entity". LHD or Local HPP Entity agrees to provide to
CDPH the services described herein.
Activities must be in accordance with the Centers for Disease Control and Prevention
CDC) and Hospital Preparedness Program HPP) 2011-12 Program Guidance, State
General Fund GF) Pandemic Influenza, Public Health Emergency Preparedness PHEP)
Comprehensive Agreement Application 2011-12, Plan and Budget.
2. Service Location
The services shall be performed at applicable facilities in the County of Monterey.
3. Service Hours
The services shall be provided during normal LHD and/or Local HPP Entity working hours
and days, as well as other hours and days the LHD deems appropriate.
4. Project Representatives
A. The project representatives during the term of this agreement will be:
Department of Public Health
EPO Project Officer
Stacy Sher
Telephone: 916) 445-9192
Fax: 916) 650-6420
Email: stacy.sher@cdph.ca.gov
County of Monterey
Lin McCray, Public Health Preparedness
Coordinator
831) 755-4739
Fax: 831) 796-8589
Email: mccrayl@co.monterey.ca.us
B. Direct all inquiries to:
Department of Public Health
Emergency Preparedness Office
Attention: Local Management Unit
MS 7002
P.O. Box 997377
Sacramento, CA 95899-7377
Telephone: 916) 650-6416
Fax: 916) 650-6420
County of Monterey
Lin McCray, Public Health
Preparedness Coordinator
1270 Natividad Road
Salinas, CA 93906
831) 755-4739
Fax: 831) 796-8589
Email: mccrayl@co.monterey.ca.us
Page 1 of 3
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2/13/2012-U04
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6/1/2011-U011
ANY-U012
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STATE,-U012
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AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`0R�County of Monterey
2011-12
Agreement No. EPO 11-27
C. Either party may make changes to the information above by giving written notice to the
other party. Said changes shall not require an amendment to this agreement.
5. Services to be Performed
LHD and/or Local HPP Entity shall perform services as outlined in accordance with the
Public Health Emergency Preparedness, State GF Pandemic Influenza and HHS
Hospital Preparedness Cooperative Agreement Application, Work Plans, and Budgets.
6. Allowable Informal Scope of Work Changes
A. The LHD and/or Local HPP Entity or CDPH may propose informal changes or
revisions to the activities, tasks, deliverables and/or performance time frames
specified in the Scope of Work SOW), provided such changes do not alter the
overall goals and basic purpose of the agreement.
B. Informal SOW changes may include the substitution of specified activities or
tasks; the alteration or substitution of agreement deliverables and modifications
to anticipated completion/target dates.
C. Informal SOW changes processed hereunder shall not require a formal
agreement amendment, provided the LHD's and/or Local HPP Entity's annual
budget does not increase or decrease as a result of the informal SOW change.
D. Unless otherwise stipulated in this agreement, all informal SOW changes and
revisions are subject to prior written approval by the CDPH.
E. In implementing this provision, CDPH will provide a format for the LHD's and/or
Local HPP Entity's use to request informal SOW changes.
7. Reporting Requirements
A. Semi-annual written progress reports and expenditure reports must be
submitted according to the schedule shown below. The purpose of the
progress reports and expenditure reports are to document activities and
expenditure of funds.
Start of each grant through mid-year point April 2, 2012
Start of each grant through end of each grant November 1, 2012
B. Each progress report shall include, but not be limited to, data and information
required by statute and information needed to satisfy federal reporting and
CDPH monitoring requirements. The reports shall be submitted in accordance
with procedures and a format required by CDPH.
Page 2 of 3
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HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`1R�County of Monterey
2011-12
Agreement No. EPO 11-27
8. Expenditure and Program Requirements
A. In accordance with the LHD and/or Local HPP Entity signed Certification
Against Supplanting Exhibit E), funds shall not be used to supplant funding for
existing levels of services and will only be used for the purposes designated
herein.
B. In executing this Agreement, the LHD and/or Local HPP Entity assures that it
will comply with the LHD and/or Local HPP Entity Comprehensive Agreement
Application, Work Plans and Budget approved by CDPH.
C. Funds made available are limited to activities approved in the Work Plans and
Budgets. Any changes to the Work Plans or Budgets need prior approval from
CDPH before implementing. Any contracts or subcontracts needing approval
from Project Officer must be submitted prior to spending those funds.
Page 3 of 3
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40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`2R�County of Monterey
2011-12
Agreement No. EPO 11-27
Exhibit B
2011-12 CDC Public Health Emergency Preparedness PHEP), State General Fund GF)
Pandemic Influenza, HHS Hospital Preparedness Program HPP) Funding
Budget Detail and Payment Provisions
1. Payment Provisions
A. CDPH will make payments to the LHD and/or Local HPP Entity as authorized in
State statute and in accordance with the annual expenditure authority granted to
CDPH in the California Budget Act. Payments shall be made in accordance with
Exhibit B, Attachment 1. Payment beyond the first quarter shall be contingent
upon the approval of the LHD's and/or Local HPP Entity's funding Application,
Work Plan, and Budget and satisfactory progress in implementing the provisions of
the Work Plan, as determined by CDPH. Final payment is contingent upon
receiving acceptable progress and expenditure reports submitted in accordance
with timelines, formats and specifications to be provided by CDPH. Note: Both
HPP and the State GF Pandemic Influenza require submission of invoice forms to
be reimbursed.
B. Reconciliation with the payments shall be through a semi-annual expenditure
report and an annual reconciliation report. These reports shall be submitted in
accordance with timelines, formats and specifications to be provided by CDPH.
Expenditure reports and annual reconciliation report should be sent to:
California Department of Public Health
Emergency Preparedness Office
Attn: Local Management Unit
MS 7002
P.O. Box 997377
Sacramento, CA 95899-7377
C. The LHD and/or Local HPP Entity shall deposit advance federal fund payments
received from CDPH into separate Trust Funds hereafter called Federal Fund),
established solely for the purposes of implementing the activities described in the
LHD's and/or Local HPP Entity's approved Work Plan and Budget and Agreement
before transferring or expending the funds for any of the uses allowed. CDPH
requires that the LHD and/or Local HPP Entity set up separate Federal Funds for
PHEP CDC and HPP funds.
D. The LHD and/or Local HPP Entity agrees that any refunds, rebates, credits, or
other amounts including any interest thereon) accruing to or received by the LHD
and/or Local HPP Entity under this Agreement shall be deposited into the Federal
Fund established solely for the purposes of implementing the activities described
in the LHD's and/or Local HPP Entity's approved Work Plan and Budget and
Agreement before transferring or expending the funds for any of the uses allowed.
Page 1 of 4
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EXECUTED-U02
AGREEMENT-U02
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`3R�County of Monterey
2011-12
Agreement No. EPO 11-27
E. The interest earned on moneys in the Federal Fund shall accrue to the benefit of
the Federal Fund and shall be expended for the same purposes as other moneys
in the Federal Fund.
F. Any refunds, rebates, credits, or other amounts in the Federal Fund shall accrue to
the benefit of the Federal Fund and shall be expended for the same purposes as
other moneys in the Federal Fund.
G. Federal Fund reports will require the LHD and/or Local HPP Entity/City Auditor
Controller's or other authorized signature, certifying each report's accuracy and
availability of supporting documentation for the State's or the federal government's
review.
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act and/or other state statute of the current
year and/or any subsequent years covered under this Agreement does not
appropriate sufficient funds for the program, this Agreement shall be of no further
force and effect. In this event, CDPH shall have no liability to pay any funds
whatsoever to LHD and/or Local HPP Entity or to furnish any other considerations
under this Agreement and LHD and/or Local HPP Entity shall not be obligated to
perform any provisions of this Agreement except as to periods for which funding
has been provided.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes
of this program, CDPH shall have the option to either cancel this Agreement with
no liability occurring to CDPH, or offer an Agreement amendment to LHD and/or
Local HPP Entity to reflect the reduced amount.
3. Amounts Payable
A. The amount payable under this Agreement shall not exceed:
1. $323,914, CDC PHEP Base Allocation.
2. $0, Laboratory Allocation.
3. $0, Laboratory Trainee Stipends.
4. $0, Laboratory Training Assistance Grant.
5. $0, Cities Readiness Initiative Funds.
6. $267,443, HPP Allocation.
7. $74,662, State GF Pandemic Influenza Allocation.
4. Redirection of Funds
Any redirection of funds requires prior approval by CDPH.
Page 2 of 4
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EXECUTED-U02
AGREEMENT-U02
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`4R�County of Monterey
2011-12
Agreement No. EPO 11-27
5. Federal Cooperative Agreement Funds
A. It is mutually understood between the parties that this Agreement 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 Agreement were executed after that determination was
made.
B. The Agreement is valid and enforceable only if sufficient funds are made available
to CDPH by the United States Government for the fiscal years covered by the term
of this Agreement. In addition, this Agreement 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
Agreement in any manner.
C. It is mutually agreed that if Congress does not appropriate sufficient funds for the
program, this Agreement shall be amended to reflect any reduction in funds.
6. Accountability Requirements
A. CDPH may recoup funds that are not spent for allowable purposes as specified in
State statute and determined by CDPH. CDPH will notify the LHD and/or Local
HPP Entity prior to recouping such funds.
B. CDPH may withhold payments if the LHD and/or Local HPP Entity is not in
compliance with the terms and conditions of this Agreement or the approved local
funding Application, Work Plans and Budgets CDPH may withhold payments if the
LHD cannot demonstrate progress toward protecting the jurisdiction from the
threat of a bioterrorist attack, infectious disease outbreak or other public health
threat or emergency as described in its progress and expenditure reports. CDPH
may withhold or reduce payments if the LHD's and/or Local HPP Entity's
expenditure reports indicate that quarterly payments remain unspent. CDPH will
notify local health officials prior to withholding or reducing such payments.
C. The LHD and/or Local HPP Entity shall return unexpended funds unless carry over
of such funds is approved by CDPH and PHEP or the HPP grant period is
extended.
D. The LHD and/or Local HPP Entity shall maintain the supporting documentation
that substantiates all expenditure reports for a minimum of seven years.
E. Once every three years LHDs and/or Local HPP Entities are subject to an audit by
CDPH. The audit will consist of the review of financial records to ensure the
existence of proper documentation and the propriety of claims submitted to the
State for reimbursement. Such review will include substantive testing:
Page 3 of 4
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`5R�County of Monterey
2011-12
Agreement No. EPO 11-27
To determine that recorded and reported program funds awarded are
expended in accordance with terms of the grant Agreement with CDPH;
To determine that payments are for actual costs and reflect amounts billed to
the State;
To determine that payments are for services rendered;
To determine that grant funds did not supplant existing levels of State and
local funding for this program.
7. Unobligated Balances
At any time during the term of this Agreement, CDPH may request LHDs and/or Local
HPP Entity's to identify unobligated funds. The presentation of this information shall be in
a manner prescribed by CDPH to include identification of unobligated funds.
8. Terms of Agreement
A. CDC PHEP: This Agreement provides the local funding award for the CDC PHEP
federal cooperative Agreement Budget period August 10, 2011 through August 9,
2012. All services must be rendered by and purchases encumbered by August 9,
2012, unless grant is extended. Funds allocated under this Agreement must be
liquidated by October 1, 2012.
B. State GF Pandemic Influenza: This Agreement provides the local funding award
for the State GF Pandemic Influenza cooperative Agreement Budget period
July 1, 2011 through June 30, 2012. All services must be rendered by and
purchases encumbered by June 30, 2012. Funds allocated under this Agreement
must be liquidated by June 30, 2014. In order for CDPH to liquidate funds by June
30, 2014, a final invoice must be received by CDPH on or before May 1, 2014.
C. HPP: This Agreement provides the local funding award for the HPP federal
cooperative Agreement Budget period July 1, 2011 through June 30, 2012. All
services must be rendered by and purchases encumbered by June 30, 2012,
unless grant is extended. Funds allocated under this Agreement must be
liquidated by August 30, 2012.
Page 4 of 4
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
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THE-U07
COUNTY-U07
OF-U07
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411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`6R�County of Monterey
2011-12
Agreement No. EPO 11-27
Exhibit B, Attachment 1 Criteria for Payments
2011-12 CDC Public Health Emergency Preparedness PHEP), State General Fund GF) Pandemic Influenza,
HHS Hospital Preparedness Program HPP) Funding
2011-12 Agreement
CDC PHEP Base and Reference Lab Allocations Lab Trainee Stipends Lab Training Assistance Grants HPP
Cities Readiness Initiative CRI) $217,740 total to each Reference Lab) $30,000 each) $15,500 each)
CDPH must receive following signed Agreement CDPH must receive following signed Agreement CDPH must receive the following: LHD must: CDPH must receive following signed Agreement CDPH mu
documents: documents: documents document
Signed Agreement Page Signed Agreement Page Signed Agreement documents be an LRN Sentinel laboratory and Signed Agreement Page Signe
submitted signed Agreement documents
Non Supplantation Certification Form Non Supplantation Certification Form Lab trainee(s) must be included in Lab budget have applied for and received approval for Non Supplantation Certification Form Non
at least one lab trainee stipend
Certification Regarding Lobbying Certification Regarding Lobbying A copy of the LFS letter approving the trainee be a member of a training consortium with Certification Regarding Lobbying Certif
Criteria at least one other county
1st Submission of Work Plan Submission of Work Plan Name and proposed hire date of the trainee indicate what other county(ies) are part of Five Letters of Support Refer to the 11-12 Subn
the consortium and provide a letter from at Application Guidance)
Payment Submission of Budget Submission of Budget A training plan that provides 6 months of training least one other consortium partner agreeing Submission of Work Plan Subrr
with a completion date no later than Aug 9, 2012. to the arrangement. Submission of Budget
Only 12 traineeships available Submission of Health Care Facility HCF) Form
Award is dependent on number of trainees requested Award is dependent on availability of
Payment 25% of CDC PREP Base and/or CRI Allocation 25% of Lab Allocation not including lab trainees) AND availability of traineeships AND submission of all assistantship funds AND meeting all 25% of HPP H1 N1 Allocation I 25% of St
required documents requirements above
r
1st Payment Criteria must be met 1st Payment Criteria must be met 1 at Payment Criteria must be met 1st P
the Work plan and Budget must be approved the Work plan and Budget must be approved the HPP Work Plan and HPP Budget must be the C
approved apprr
Criteria All required application documents must be All required application documents must be N/A N/A An invoice with actual HPP expenditures above An in
submitted submitted the 25% advance amount must be submitted to expe
CDPH amor
All required application documents must be All re
2nd I
Payment CDPH will pay the Local HPP Entity for actual
expenditures above the 25% advance i.e. if a local
entity submits and invoice for 35%, CDPH will pay them CDPH wil
Payment 25% of CDC PREP Base and/or CRI Allocation 25% of Lab Allocation not including lab trainees) N/A N/A 10% because the local entity already received 25%). above th
All contracts or subcontracts above $5k must be
approved by CDPH prior to spending funds or seeking
reimbursement.
1st & 2nd Payment Criteria must be met 1st & 2nd Payment Criteria must be met 1st & 2nd Payment Criteria must be met 1st &
prior year-end progress report must be prior year-end progress report must be
prior year-end progress report must be submitted pnor
Criteria submitted submitted N/A N/A
An invoice with actual HPP expenditures must be subn
f(f An it
submitted to CDPH ex p2
3rd
Payment
CDPH will pay the Local HPP Entity for actual
expenditures above the 2nd payment). All contracts CDPH wil
Payment 25% of CDC PHEP Base and/or CRI Allocation 25% of Lab Allocation not including lab trainees) N/A N/A or subcontracts above $5k must be approved by above th
CDPH prior to spending funds or seeking
reimbursement.
1st, 2nd & 3rd Payment Criteria must be met 1st, 2nd & 3rd Payment Criteria must be met 1st, 2nd & 3rd Payment Criteria must be met 1st':
Criteria current mid-year progress report must be current mid-year progress report must be N/A N/A current mid-year progress report must be curd
subr
submitted submitted submitted
An invoice with actual HPP expenditures must be An it
Final submitted to CDPH ex e
Payment
CDPH will pay the Local HPP Entity for actual
expenditures above the 3rd payment). All contracts or'CDPH wi
Payment 25% of CDC PREP Base and/or CRI Allocation 25% of Lab Allocation or remaining balance
g N/A N/A subcontracts above $5k must be approved by CDPH above tt
prior to spending funds or seeking reimbursement.
Page 1 of 1
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AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
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MCKEES-U10
6/1/2011-U011
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AMENDMENTS-U012
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FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`7R�County of Monterey
2011-12
Agreement No. EPO 11-27
Exhibit C
2011-12 CDC Public Health Emergency Preparedness PHEP), State General Fund
GF) Pandemic Influenza, HHS Hospital Preparedness Program HPP) Funding
Additional Provisions
1. Additional Incorporated Exhibits
The following documents and any subsequent updates are not attached, but are
incorporated herein and made a part hereof by this reference. These documents
may be updated periodically by CDPH, as required by program directives. CDPH
shall provide the LHD and/or Local HPP Entity with copies of said documents
and any periodic updates thereto, under separate cover. CDPH will maintain on
file all documents referenced herein and any subsequent updates.
A. 2011-2012 Federal Guidance Documents:
2011-12 Centers for Disease Control and Prevention CDC) Public
Health Emergency Preparedness PHEP) Cooperative Agreement
Guidance.
2011-12 US Department of Health and Human Services Hospital
Preparedness Program HPP).
B. CDPH Guidance to LHDs and/or Local HPP Entities for CDC PHEP, State
General Fund GF) Pandemic Influenza, and/or HPP Program Funds.
C. LHD's and/or Local HPP Entity's Public Health Emergency Preparedness
Comprehensive Agreement Application, Work Plans, and Budgets and all
attachments refer to the CDPH Guidance to LHDs and/or Local HPP
Entities for all attachments).
2. Contract Amendments
Should either party, during the term of this agreement, desire a change or
amendment to the terms of this Agreement, such changes or amendments shall
be proposed in writing to the other party, who will respond in writing as to
whether the proposed changes/amendments are accepted or rejected. If
accepted and after negotiations are concluded, the agreed upon changes shall
be made through the State's official agreement amendment process. No
amendment will be considered binding on either party until it is formally approved
by the State.
3. Cancellation I Termination
A. This agreement may be cancelled or terminated without cause by either
party by giving thirty 30) calendar days advance written notice to the
other party. Such notification shall state the effective date of termination
or cancellation and include any final performance and/or
payment/invoicing instructions/requirements.
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PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`8R�County of Monterey
2011-12
Agreement No. EPO 11-27
B. Upon receipt of a notice of termination or cancellation from CDPH, LHD
and/or Local HPP Entity shall take immediate steps to stop performance
and to cancel or reduce subsequent contract costs.
C. LHD and/or Local HPP Entity shall be entitled to payment for all allowable
costs authorized under this agreement, including authorized non-
cancelable obligations incurred up to the date of termination or
cancellation, provided such expenses do not exceed the stated maximum
amounts payable.
D. Agreement termination or cancellation shall be effective as of the date
indicated in CDPH' notification to LHD and/or Local HPP Entity. The
notice shall stipulate any final performance, invoicing or payment
requirements.
E. In the event of early termination or cancellation, LHD and/or Local HPP
Entity shall be entitled to compensation for services performed
satisfactorily under this Agreement and expenses incurred up to the date
of cancellation and any non-cancelable obligations incurred in support of
this Agreement.
4. Dispute Resolution Process
A. This provision supplements provision 15 of Exhibit D(F).
B. CDPH may recoup from a LHD and/or Local HPP Entity any funds
allocated pursuant to this article that are unspent or that are not expended
for purposes specified in subdivision d).
C. CDPH may also recoup funds expended by the LHD and/or Local HPP
Entity in violation of subdivision d) of Section 101315 of the California
Health and Safety Code.
D. CDPH may withhold quarterly payments of funds to a LHD and/or Local
HPP Entity if the LHD and/or Local HPP Entity is not in compliance with
this article or the terms of that LHD's and/or Local HPP Entity's work plans
as approved by CDPH.
E. Before any funds are recouped or withheld from a LHD and/or Local HPP
Entity, CDPH shall discuss with local health officials or Local HPP Entities
the status of the unspent moneys or the disputed use of the funds, or both.
5. Financial and Compliance Audit Requirements
A. Paragraph d of provision 16 in Exhibit D(F) is amended to read as follows:
d. The audit report must identify the Contractor's legal name and the
number assigned to this Agreement. The audit report shall be due
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EXECUTED AGREEMENT"�|E`9R�County of Monterey
2011-12
Agreement No. EPO 11-27
within 30 days after the completion of the audit. The LHD/HPP Entity
shall keep a copy of the audit report on file and have it available for
review by CDPH or auditors upon request.
Page 3 of 3
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EXECUTED AGREEMENT"�|E`:R�California Department of Public Health
Exhibit D(F)
Special Terms and Conditions
For federally funded service contracts or agreements and grant agreements)
The use of headings or titles throughout this exhibit is for convenience only and shall not be used to interpret or to
govern the meaning of any specific term or condition.
The terms contract", Contractor" and Subcontractor" shall also mean, agreement", grant", grant agreement",
Grantee" and Subgrantee" respectively.
The terms California Department of Public Health" and CDPH" shall have the same meaning and refer to the
California State agency that is a party to this Agreement.
This exhibit contains provisions that require strict adherence to various contracting laws and policies. Some
provisions herein are conditional and only apply if specified conditions exist i.e., agreement total exceeds a certain
amount, agreement is federally funded, etc.). The provisions herein apply to this Agreement unless the provisions
are removed by reference on the face of this Agreement, the provisions are superseded by an alternate provision
appearing elsewhere in this Agreement, or the applicable conditions do not exist.
Index of Special Terms and Conditions
1. Federal Equal Employment Opportunity
Requirements 17. Human Subjects Use Requirements
18. Novation Requirements
2. Travel and Per Diem Reimbursement
19. Debarment and Suspension Certification
3. Procurement Rules
20. Smoke-Free Workplace Certification
4. Equipment Ownership / Inventory / Disposition
21. Covenant Against Contingent Fees
5. Subcontract Requirements
22. Payment Withholds
6. Income Restrictions
23. Performance Evaluation
7. Audit and Record Retention
24. Officials Not to Benefit
8. Site Inspection
25. Four-Digit Date Compliance
9. Federal Contract Funds
26. Prohibited Use of State Funds for Software
10. Intellectual Property Rights
27. Use of Small, Minority Owned and Women's
11. Air or Water Pollution Requirements Businesses
12. Prior Approval of Training Seminars, Workshops
or Conferences 28. Alien Ineligibility Certification
29. Union Organizing
13. Confidentiality of Information
30. Contract Uniformity Fringe Benefit Allowability)
14. Documents, Publications, and Written Reports
31. Lobbying Restrictions and Disclosure Certification
15. Dispute Resolution Process
16. Financial and Compliance Audit Requirements
CDPH Exhibit D(F) 9/09) Page 1 of 25
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EXECUTED AGREEMENT"�|E`;R�California Department of Public Health Special Terms and Conditions Exhibit D F)
1. Federal Equal Opportunity Requirements
Applicable to all federally funded agreements entered into by the California Department of Public Health
CDPH) formerly known as California Department of Health Services CDHS).)
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, disability, age or status as a disabled
veteran or veteran of the Vietnam era. 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, disability, age or status as a
disabled veteran or veteran of the Vietnam era. 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 CDPH, setting forth the provisions of the Equal Opportunity clause, Section 503 of the
Rehabilitation Act of 1973 and the affirmative action clause required by the Vietnam Era Veterans'
Readjustment Assistance Act of 1974 38 U.S.C. 4212). 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, disability, age or status as a disabled veteran or veteran of the Vietnam era and the
rights of applicants and employees.
b. The Contractor will, in all solicitations or advancements 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, disability, age or status as a
disabled veteran or veteran of the Vietnam era.
c. The Contractor will send to each labor union or representative of workers with which it 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 workers' representative of the Contractor's
commitments under the provisions herein 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 and furnish all information and reports required by
Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Era Veterans' Readjustment
Assistance Act of 1974 38 U.S.C. 4212) and of the Federal Executive Order No. 11246 as amended,
including by Executive Order 11375, Amending Executive Order 11246 Relating to Equal Employment
Opportunity,' and as supplemented by regulation at 41 CFR part 60, Office of the Federal Contract
Compliance Programs, Equal Employment Opportunity, Department of Labor," 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, including by Executive Order 11375, Amending Executive Order 11246 Relating to Equal
Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60, Office of the Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of Labor," 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 its books, records, and accounts by the State and its
designated representatives and the Secretary of Labor for purposes of investigation to ascertain
compliance with such rules, regulations, and orders.
f. In the event of the Contractor's noncompliance with the requirements of the provisions herein or with any
federal rules, regulations, or orders which are referenced herein, this Agreement may be cancelled,
terminated, or suspended in whole or in part and the Contractor may be declared ineligible for further
federal and 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, including by Executive Order 11375, Amending
Executive Order 11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation
at 41 CFR part 60, Office of the Federal Contract Compliance Programs, Equal Employment
CDPH Exhibit D(F) 9/09) Page 2 of 25
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EXECUTED AGREEMENT"�|E`<R�California Department of Public Health Special Terms and Conditions
g.
Exhibit D F)
Opportunity, Department of Labor," or by rule, regulation, or order of the Secretary of Labor, or as
otherwise provided by law.
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, including by Executive Order 11375, Amending
Executive Order 11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation
at 41 CFR part 60, Office of the Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor," or Section 503 of the Rehabilitation Act of 1973 or 38 U.S.C. 4212)
of the Vietnam Era Veteran's Readjustment Assistance 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 or CDPH 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 by a subcontractor or
vendor as a result of such direction by CDPH, the Contractor may request in writing to CDPH, 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 Diem Reimbursement
Applicable if travel and/or per diem expenses are reimbursed with agreement funds.)
Reimbursement for travel and per diem expenses from CDPH under this Agreement shall, unless otherwise
specified in this Agreement, be at the rates currently in effect, as established by the California Department of
Personnel Administration DPA), for nonrepresented state employees as stipulated in CDPH's Travel
Reimbursement Information Exhibit. If the DPA rates change during the term of the Agreement, the new
rates shall apply upon their effective date and no amendment to this Agreement shall be necessary.
Exceptions to DPA rates may be approved by CDPH upon the submission of a statement by the Contractor
indicating that such rates are not available to the Contractor. No travel outside the State of California shall be
reimbursed without prior authorization from CDPH. Verbal authorization should be confirmed in writing.
Written authorization may be in a form including fax or email confirmation.
3. Procurement Rules
Applicable to all agreements in which equipment, property, commodities and/or supplies are furnished by
CDPH or expenses for said items are reimbursed with state or federal funds.)
a. Equipment definitions
Wherever the term equipment /property is used, the following definitions shall apply:
1) Major equipment/property: A tangible or intangible item having a base unit cost of $5,000 or more
with a life expectancy of one 1) year or more and is either furnished by CDPH or the cost is
reimbursed through this Agreement. Software and videos are examples of intangible items that meet
this definition.
2) Minor equipment/property: A tangible item having a base unit cost of less than $5,000 with a life
expectancy of one 1) year or more and is either furnished by CDPH or the cost is reimbursed
through this Agreement.
b. Government and public entities including state colleges/universities and auxiliary organizations),
whether acting as a contractor and/or subcontractor, may secure all commodities, supplies, equipment
and services related to such purchases that are required in performance of this Agreement. Said
procurements are subject to Paragraphs d through h of Provision 3. Paragraph c of Provision 3 shall also
apply, if equipment purchases are delegated to subcontractors that are nonprofit organizations or
commercial businesses.
c. Nonprofit organizations and commercial businesses, whether acting as a contractor and/or
subcontractor, may secure commodities, supplies, equipment and services related to such purchases for
performance under this Agreement.
1) Equipment purchases shall not exceed $50,000 annually.
CDPH Exhibit D(F) 9/09) Page 3 of 25
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EXECUTED AGREEMENT"�|E`=R�California Department of Public Health Special Terms and Conditions Exhibit D F)
To secure equipment above the annual maximum limit of $50,000, the Contractor shall make
arrangements through the appropriate CDPH Program Contract Manager, to have all remaining
equipment purchased through CDPH's Purchasing Unit. The cost of equipment purchased by or
through CDPH shall be deducted from the funds available in this Agreement. Contractor shall submit
to the CDPH Program Contract Manager a list of equipment specifications for those items that the
State must procure. The State may pay the vendor directly for such arranged equipment purchases
and title to the equipment will remain with CDPH. The equipment will be delivered to the Contractor's
address, as stated on the face of the Agreement, unless the Contractor notifies the CDPH Program
Contract Manager, in writing, of an alternate delivery address.
2) All equipment purchases are subject to Paragraphs d through h of Provision 3. Paragraph b of
Provision 3 shall also apply, if equipment purchases are delegated to subcontractors that are either a
government or public entity.
3)
Nonprofit organizations and commercial businesses, shall use a procurement system that meets the
following standards:
a) Maintain a code or standard of conduct that shall govern the performance of its officers,
employees, or agents engaged in awarding procurement contracts. No employee, officer, or
agent shall participate in the selection, award, or administration of a procurement, or bid contract
in which, to his or her knowledge, he or she has a financial interest.
b) Procurements shall be conducted in a manner that provides, to the maximum extent practical,
open, and free competition.
c) Procurements shall be conducted in a manner that provides for all of the following:
1] Avoid purchasing unnecessary or duplicate items.
2] Equipment solicitations shall be based upon a clear and accurate description of the technical
requirements of the goods to be procured.
3] Take positive steps to utilize small and veteran owned businesses.
d. Unless waived or otherwise stipulated in writing by CDPH, prior written authorization from the appropriate
CDPH Program Contract Manager will be required before the Contractor will be reimbursed for any
purchase of $5,000 or more for commodities, supplies, equipment, and services related to such
purchases. The Contractor must provide in its request for authorization all particulars necessary, as
specified by CDPH, for evaluating the necessity or desirability of incurring such costs. The term
purchase" excludes the purchase of services from a subcontractor and public utility services at rates
established for uniform applicability to the general public.
e. In special circumstances, determined by CDPH e.g., when CDPH has a need to monitor certain
purchases, etc.), CDPH may require prior written authorization and/or the submission of paid vendor
receipts for any purchase, regardless of dollar amount. CDPH reserves the right to either deny claims for
reimbursement or to request repayment for any Contractor and/or subcontractor purchase that CDPH
determines to be unnecessary in carrying out performance under this Agreement.
f. The Contractor and/or subcontractor must maintain a copy or narrative description of the procurement
system, guidelines, rules, or regulations that will be used to make purchases under this Agreement. The
State reserves the right to request a copy of these documents and to inspect the purchasing practices of
the Contractor and/or subcontractor at any time.
9.
For all purchases, the Contractor and/or subcontractor must maintain copies of all paid vendor invoices,
documents, bids and other information used in vendor selection, for inspection or audit. Justifications
supporting the absence of bidding i.e., sole source purchases) shall also be maintained on file by the
Contractor and/or subcontractor for inspection or audit.
h. CDPH may, with cause e.g., with reasonable suspicion of unnecessary purchases or use of
CDPH Exhibit D(F) 9/09) Page 4 of 25
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EXECUTED AGREEMENT"�|E`>R�California Department of Public Health Special Terms and Conditions
Exhibit D F)
inappropriate purchase practices, etc.), withhold, cancel, modify, or retract the delegated purchase
authority granted under Paragraphs b and/or c of Provision 3 by giving the Contractor no less than 30
calendar days written notice.
4. Equipment Ownership / Inventory / Disposition
Applicable to agreements in which equipment and/or property is furnished by CDPH and/or when said items
are purchased or reimbursed with state or federal funds.)
a. Wherever the terms equipment and/or property are used in Provision 4, the definitions in Provision 3,
Paragraph a, shall apply.
1)
Unless otherwise stipulated in this Agreement, all equipment and/or property that are
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this Agreement
shall be considered state equipment and the property of CDPH.
CDPH requires the reporting, tagging and annual inventorying of all equipment and/or property that is
furnished by CDPH or purchased/reimbursed with funds provided through this Agreement.
Upon receipt of equipment and/or property, the Contractor shall report the receipt to the CDPH
Program Contract Manager. To report the receipt of said items and to receive property tags,
Contractor shall use a form or format designated by CDPH's Asset Management Unit. If the
appropriate form i.e., Contractor Equipment Purchased with CDPH Funds) does not accompany this
Agreement, Contractor shall request a copy from the CDPH Program Contract Manager.
2) If the Contractor enters into an agreement with a term of more than twelve months, the Contractor
shall submit an annual inventory of state equipment and/or property to the CDPH Program Contract
Manager using a form or format designated by CDPH's Asset Management Unit. If an inventory
report form i.e., Inventory/Disposition of CDPH-Funded Equipment) does not accompany this
Agreement, Contractor shall request a copy from the CDPH Program Contract Manager. Contractor
shall:
a) Include in the inventory report, equipment and/or property in the Contractor's possession and/or
in the possession of a subcontractor including independent consultants).
b) Submit the inventory report to CDPH according to the instructions appearing on the inventory
form or issued by the CDPH Program Contract Manager.
c) Contact the CDPH Program Contract Manager to learn how to remove, trade-in, sell, transfer or
survey off, from the inventory report, expired equipment and/or property that is no longer wanted,
usable or has passed its life expectancy. Instructions will be supplied by CDPH's Asset
Management Unit.
b. Title to state equipment and/or property shall not be affected by its incorporation or attachment to any
property not owned by the State.
c. Unless otherwise stipulated, CDPH shall be under no obligation to pay the cost of restoration, or
rehabilitation of the Contractor's and/or Subcontractor's facility which may be affected by the removal of
any state equipment and/or property.
d. The Contractor and/or Subcontractor shall maintain and administer a sound business program for
ensuring the proper use, maintenance, repair, protection, insurance and preservation of state equipment
and/or property.
1) In administering this provision, CDPH may require the Contractor and/or Subcontractor to repair or
replace, to CDPH's satisfaction, any damaged, lost or stolen state equipment and/or property.
Contractor and/or Subcontractor shall immediately file a theft report with the appropriate police
agency or the California Highway Patrol and Contractor shall promptly submit one copy of the theft
report to the CDPH Program Contract Manager.
CDPH Exhibit D(F) 9/09) Page 5 of 25
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EXECUTED AGREEMENT"�|E`?R�California Department of Public Health Special Terms and Conditions Exhibit D F)
e. Unless otherwise stipulated by the program funding this Agreement, equipment and/or property
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this Agreement,
shall only be used for performance of this Agreement or another CDPH agreement.
f. Within sixty 60) calendar days prior to the termination or end of this Agreement, the Contractor shall
provide a final inventory report of equipment and/or property to the CDPH Program Contract Manager
and shall, at that time, query CDPH as to the requirements, including the manner and method, of
returning state equipment and/or property to CDPH. Final disposition of equipment and/or property shall
be at CDPH expense and according to CDPH instructions. Equipment and/or property disposition
instructions shall be issued by CDPH immediately after receipt of the final inventory report. At the
termination or conclusion of this Agreement, CDPH may at its discretion, authorize the continued use of
state equipment and/or property for performance of work under a different CDPH agreement.
9.
Motor Vehicles
Applicable only if motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH
under this Agreement.)
1) If motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, within thirty 30) calendar days prior to the termination or end of this
Agreement, the Contractor and/or Subcontractor shall return such vehicles to CDPH and shall deliver
all necessary documents of title or registration to enable the proper transfer of a marketable title to
CDPH.
2) If motor vehicles are purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, the State of California shall be the legal owner of said motor vehicles and
the Contractor shall be the registered owner. The Contractor and/or a subcontractor may only use
said vehicles for performance and under the terms of this Agreement.
3)
The Contractor and/or Subcontractor agree that all operators of motor vehicles,
purchased/reimbursed with agreement funds or furnished by CDPH under the terms of this
Agreement, shall hold a valid State of California driver's license. In the event that ten or more
passengers are to be transported in any one vehicle, the operator shall also hold a State of California
Class B driver's license.
4) If any motor vehicle is purchased/reimbursed with agreement funds or furnished by CDPH under the
terms of this Agreement, the Contractor and/or Subcontractor, as applicable, shall provide, maintain,
and certify that, at a minimum, the following type and amount of automobile liability insurance is in
effect during the term of this Agreement or any extension period during which any vehicle remains in
the Contractor's and/or Subcontractor's possession:
Automobile Liability Insurance
a) The Contractor, by signing this Agreement, hereby certifies that it possesses or will obtain
automobile liability insurance in the amount of $1,000,000 per occurrence for bodily injury and
property damage combined. Said insurance must be obtained and made effective upon the
delivery date of any motor vehicle, purchased/reimbursed with agreement funds or furnished by
CDPH under the terms of this Agreement, to the Contractor and/or Subcontractor.
b) The Contractor and/or Subcontractor shall, as soon as practical, furnish a copy of the certificate
of insurance to the CDPH Program Contract Manager. The certificate of insurance shall identify
the CDPH contract or agreement number for which the insurance applies.
c) The Contractor and/or Subcontractor agree that bodily injury and property damage liability
insurance, as required herein, shall remain in effect at all times during the term of this Agreement
or until such time as the motor vehicle is returned to CDPH.
d) The Contractor and/or Subcontractor agree to provide, at least thirty 30) days prior to the
expiration date of said insurance coverage, a copy of a new certificate of insurance evidencing
continued coverage, as indicated herein, for not less than the remainder of the term of this
CDPH Exhibit D(F) 9/09) Page 6 of 25
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EXECUTED AGREEMENT"�|E`@R�California Department of Public Health Special Terms and Conditions
f)
g)
Exhibit D F)
Agreement, the term of any extension or continuation thereof, or for a period of not less than one
1) year.
e) The Contractor and/or Subcontractor, if not a self-insured government and/or public entity, must
provide evidence, that any required certificates of insurance contain the following provisions:
The insurer will not cancel the insured's coverage without giving thirty 30) calendar days
prior written notice to the State California Department of Public Health CDPH)).
1]
2] The State of California, its officers, agents, employees, and servants are included as
additional insureds, but only with respect to work performed for the State under this
Agreement and any extension or continuation of this Agreement.
The insurance carrier shall notify CDPH, in writing, of the Contractor's failure to pay
premiums; its cancellation of such policies; or any other substantial change, including, but not
limited to, the status, coverage, or scope of the required insurance. Such notices shall
contain a reference to each agreement number for which the insurance was obtained.
3]
The Contractor and/or Subcontractor is hereby advised that copies of certificates of insurance
may be subject to review and approval by the Department of General Services DGS), Office of
Risk and Insurance Management. The Contractor shall be notified by CDPH, in writing, if this
provision is applicable to this Agreement. If DGS approval of the certificate of insurance is
required, the Contractor agrees that no work or services shall be performed prior to obtaining
said approval.
In the event the Contractor and/or Subcontractor fails to keep insurance coverage, as required
herein, in effect at all times during vehicle possession, CDPH may, in addition to any other
remedies it may have, terminate this Agreement upon the occurrence of such event.
5. Subcontract Requirements
Applicable to agreements under which services are to be performed by subcontractors including independent
consultants.)
a. Prior written authorization will be required before the Contractor enters into or is reimbursed for any
subcontract for services costing $5,000 or more. Except as indicated in Paragraph a(3) herein, when
securing subcontracts for services exceeding $5,000, the Contractor shall obtain at least three bids or
justify a sole source award.
1) The Contractor must provide in its request for authorization, all information necessary for evaluating
the necessity or desirability of incurring such cost.
2) The State may identify the information needed to fulfill this requirement.
3) Subcontracts performed by the following entities or for the service types listed below are exempt from
the bidding and sole source justification requirements:
a) A local governmental entity or the federal government,
b) A State college or university from any State,
c) A Joint Powers Authority,
d) An auxiliary organization of a California State University or a California community college,
e) A foundation organized to support the Board of Governors of the California Community Colleges,
f) An auxiliary organization of the Student Aid Commission established under Education Code
69522,
g) Entities of any type that will provide subvention aid or direct services to the public,
h) Entities and/or service types identified as exempt from advertising in State Contracting Manual
5.80. View this publication at the following Internet address:
http://www.ols.dgs.ca.gov/Contract+Manual/ChaiDters4throu hq 6 htm.
CDPH Exhibit D(F) 9/09) Page 7 of 25
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EXECUTED AGREEMENT"�|E`AR�California Department of Public Health Special Terms and Conditions Exhibit D F)
b. CDPH reserves the right to approve or disapprove the selection of subcontractors and with advance
written notice, require the substitution of subcontractors and require the Contractor to terminate
subcontracts entered into in support of this Agreement.
1) Upon receipt of a written notice from CDPH requiring the substitution and/or termination of a
subcontract, the Contractor shall take steps to ensure the completion of any work in progress and
select a replacement, if applicable, within 30 calendar days, unless a longer period is agreed to by
CDPH.
c. Actual subcontracts i.e., written agreement between the Contractor and a subcontractor) of $5,000 or
more are subject to the prior review and written approval of CDPH. CDPH may, at its discretion, elect to
waive this right. All such waivers shall be confirmed in writing by CDPH.
d. Contractor shall maintain a copy of each subcontract entered into in support of this Agreement and shall,
upon request by CDPH, make copies available for approval, inspection, or audit.
e. CDPH assumes no responsibility for the payment of subcontractors used in the performance of this
Agreement. Contractor accepts sole responsibility for the payment of subcontractors used in the
performance of this Agreement.
f. The Contractor is responsible for all performance requirements under this Agreement even though
performance may be carried out through a subcontract.
9.
The Contractor shall ensure that all subcontracts for services include provision(s) requiring compliance
with applicable terms and conditions specified in this Agreement.
h. The Contractor agrees to include the following clause, relevant to record retention, in all subcontracts for
services:
Subcontractor Name) agrees to maintain and preserve, until three years after termination of
Agreement Number) and final payment from CDPH to the Contractor, to permit CDPH or any
duly authorized representative, to have access to, examine or audit any pertinent books,
documents, papers and records related to this subcontract and to allow interviews of any
employees who might reasonably have information related to such records."
i. Unless otherwise stipulated in writing by CDPH, the Contractor shall be the subcontractor's sole point of
contact for all matters related to performance and payment under this Agreement.
j.
Contractor shall, as applicable, advise all subcontractors of their obligations pursuant to the following
numbered provisions of this Exhibit: 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 17, 19, 20, 24, and 31 or other
numbered provisions herein that deemed applicable.
6. Income Restrictions
Unless otherwise stipulated in this Agreement, the Contractor agrees that any refunds, rebates, credits, or
other amounts including any interest thereon) accruing to or received by the Contractor under this
Agreement shall be paid by the Contractor to CDPH, to the extent that they are properly allocable to costs for
which the Contractor has been reimbursed by CDPH under this Agreement.
7. Audit and Record Retention
Applicable to agreements in excess of $10,000.)
a. The Contractor and/or Subcontractor shall maintain books, records, documents, and other evidence,
accounting procedures and practices, sufficient to properly reflect all direct and indirect costs of whatever
nature claimed to have been incurred in the performance of this Agreement, including any matching costs
and expenses. The foregoing constitutes records" for the purpose of this provision.
b. The Contractor's and/or subcontractor's facility or office or such part thereof as may be engaged in the
performance of this Agreement and his/her records shall be subject at all reasonable times to inspection,
CDPH Exhibit D(F) 9/09) Page 8 of 25
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EXECUTED AGREEMENT"�|E`BR�California Department of Public Health Special Terms and Conditions
audit, and reproduction.
Exhibit D F)
c. Contractor agrees that CDPH, the Department of General Services, the Bureau of State Audits, or their
designated representatives including the Comptroller General of the United States shall have the right to
review and to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to allow the auditor(s) access to such records during normal business
hours and to allow interviews of any employees who might reasonably have information related to such
records. Further, the Contractor agrees to include a similar right of the State to audit records and
interview staff in any subcontract related to performance of this Agreement. GC 8546.7, CCR Title 2,
Section 1896).
d. The Contractor and/or Subcontractor shall preserve and make available his/her records 1) for a period of
three years from the date of final payment under this Agreement, and 2) for such longer period, if any, as
is required by applicable statute, by any other provision of this Agreement, or by subparagraphs 1) or 2)
below.
1)
If this Agreement 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 shall 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.
e. The Contractor and/or Subcontractor shall comply with the above requirements and be aware of the
penalties for violations of fraud and for obstruction of investigation as set forth in Public Contract Code
10115.10, if applicable.
f. The Contractor and/or Subcontractor may, at its discretion, following receipt of final payment under this
Agreement, reduce its accounts, books and records related to this Agreement to microfilm, computer
disk, CD ROM, or other data storage medium. Upon request by an authorized representative to inspect,
audit or obtain copies of said records, the Contractor and/or Subcontractor must supply or make available
applicable devices, hardware, and/or software necessary to view, copy and/or print said records.
Applicable devices may include, but are not limited to, microfilm readers and microfilm printers, etc.
9.
The Contractor shall, if applicable, comply with the Single Audit Act and the audit reporting requirements
set forth in OMB Circular A-133.
8. Site 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 of the
premises of the Contractor or Subcontractor, the Contractor shall provide and shall require Subcontractors to
provide all reasonable facilities and assistance for the safety and convenience of the authorized
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.
9. Federal Contract Funds
Applicable only to that portion of an agreement funded in part or whole with federal funds.)
a. It is mutually understood between the parties that this Agreement 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 Agreement were executed after that
determination was made.
b. This agreement is valid and enforceable only if sufficient funds are made available to the State by the
United States Government for the fiscal years covered by the term of this Agreement. In addition, this
CDPH Exhibit D(F) 9/09) Page 9 of 25
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EXECUTED AGREEMENT"�|E`CR�California Department of Public Health Special Terms and Conditions Exhibit D F)
Agreement 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 Agreement
in any manner.
c. It is mutually agreed that if the Congress does not appropriate sufficient funds for the program, this
Agreement shall be amended to reflect any reduction in funds.
d. CDPH has the option to invalidate or cancel the Agreement with 30-days advance written notice or to
amend the Agreement to reflect any reduction in funds.
10. Intellectual Property Rights
a. Ownership
1)
3)
Except where CDPH has agreed in a signed writing to accept a license, CDPH shall be and remain,
without additional compensation, the sole owner of any and all rights, title and interest in all
Intellectual Property, from the moment of creation, whether or not jointly conceived, that are made,
conceived, derived from, or reduced to practice by Contractor or CDPH and which result directly or
indirectly from this Agreement.
2) For the purposes of this Agreement, Intellectual Property means recognized protectable rights and
interest such as: patents, whether or not issued) copyrights, trademarks, service marks, applications
for any of the foregoing, inventions, trade secrets, trade dress, logos, insignia, color combinations,
slogans, moral rights, right of publicity, author's rights, contract and licensing rights, works, mask
works, industrial design rights, rights of priority, know how, design flows, methodologies, devices,
business processes, developments, innovations, good will and all other legal rights protecting
intangible proprietary information as may exist now and/or here after come into existence, and all
renewals and extensions, regardless of whether those rights arise under the laws of the United
States, or any other state, country or jurisdiction.
a) For the purposes of the definition of Intellectual Property, works" means all literary works,
writings and printed matter including the medium by which they are recorded or reproduced,
photographs, art work, pictorial and graphic representations and works of a similar nature, film,
motion pictures, digital images, animation cells, and other audiovisual works including positives
and negatives thereof, sound recordings, tapes, educational materials, interactive videos and any
other materials or products created, produced, conceptualized and fixed in a tangible medium of
expression. It includes preliminary and final products and any materials and information
developed for the purposes of producing those final products. Works does not include articles
submitted to peer review or reference journals or independent research projects.
In the performance of this Agreement, Contractor will exercise and utilize certain of its Intellectual
Property in existence prior to the effective date of this Agreement. In addition, under this Agreement,
Contractor may access and utilize certain of CDPH's Intellectual Property in existence prior to the
effective date of this Agreement. Except as otherwise set forth herein, Contractor shall not use any of
CDPH's Intellectual Property now existing or hereafter existing for any purposes without the prior
written permission of CDPH. Except as otherwise set forth herein, neither the Contractor nor
CDPH shall give any ownership interest in or rights to its Intellectual Property to the other
Party. If during the term of this Agreement, Contractor accesses any third-party Intellectual Property
that is licensed to CDPH, Contractor agrees to abide by all license and confidentiality restrictions
applicable to CDPH in the third-party's license agreement.
4) Contractor agrees to cooperate with CDPH in establishing or maintaining CDPH's exclusive rights in
the Intellectual Property, and in assuring CDPH's sole rights against third parties with respect to the
Intellectual Property. If the Contractor enters into any agreements or subcontracts with other parties
in order to perform this Agreement, Contractor shall require the terms of the Agreement(s) to include
all Intellectual Property provisions. Such terms must include, but are not limited to, the subcontractor
assigning and agreeing to assign to CDPH all rights, title and interest in Intellectual Property made,
conceived, derived from, or reduced to practice by the subcontractor, Contractor or CDPH and which
result directly or indirectly from this Agreement or any subcontract.
CDPH Exhibit D(F) 9/09) Page 10 of 25
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EXECUTED AGREEMENT"�|E`DR�California Department of Public Health Special Terms and Conditions
Exhibit D F)
5) Contractor further agrees to assist and cooperate with CDPH in all reasonable respects, and execute
all documents and, subject to reasonable availability, give testimony and take all further acts
reasonably necessary to acquire, transfer, maintain, and enforce CDPH's Intellectual Property rights
and interests.
b. Retained Rights / License Rights
1)
Except for Intellectual Property made, conceived, derived from, or reduced to practice by Contractor
or CDPH and which result directly or indirectly from this Agreement, Contractor shall retain title to all
of its Intellectual Property to the extent such Intellectual Property is in existence prior to the effective
date of this Agreement. Contractor hereby grants to CDPH, without additional compensation, a
permanent, non-exclusive, royalty free, paid-up, worldwide, irrevocable, perpetual, non-terminable
license to use, reproduce, manufacture, sell, offer to sell, import, export, modify, publicly and privately
display/perform, distribute, and dispose Contractor's Intellectual Property with the right to sublicense
through multiple layers, for any purpose whatsoever, to the extent it is incorporated in the Intellectual
Property resulting from this Agreement, unless Contractor assigns all rights, title and interest in the
Intellectual Property as set forth herein.
2) Nothing in this provision shall restrict, limit, or otherwise prevent Contractor from using any ideas,
concepts, know-how, methodology or techniques related to its performance under this Agreement,
provided that Contractor's use does not infringe the patent, copyright, trademark rights, license or
other Intellectual Property rights of CDPH or third party, or result in a breach or default of any
provisions of this Exhibit or result in a breach of any provisions of law relating to confidentiality.
c. Copyright
1)
Contractor agrees that for purposes of copyright law, all works as defined in Paragraph a,
subparagraph 2)(a) of this provision] of authorship made by or on behalf of Contractor in connection
with Contractor's performance of this Agreement shall be deemed works made for hire". Contractor
further agrees that the work of each person utilized by Contractor in connection with the performance
of this Agreement will be a work made for hire," whether that person is an employee of Contractor or
that person has entered into an agreement with Contractor to perform the work. Contractor shall
enter into a written agreement with any such person that: i) all work performed for Contractor shall
be deemed a work made for hire" under the Copyright Act and ii) that person shall assign all right,
title, and interest to CDPH to any work product made, conceived, derived from, or reduced to practice
by Contractor or CDPH and which result directly or indirectly from this Agreement.
2) All materials, including, but not limited to, visual works or text, reproduced or distributed pursuant to
this Agreement that include Intellectual Property made, conceived, derived from, or reduced to
practice by Contractor or CDPH and which result directly or indirectly from this Agreement, shall
include CDPH's notice of copyright, which shall read in 3mm or larger typeface: Enter Current
Year e.g., 2007, etc.], Department of Public Health. This material may not be reproduced or
disseminated without prior written permission from the Department of Public Health." This notice
should be placed prominently on the materials and set apart from other matter on the page where it
appears. Audio productions shall contain a similar audio notice of copyright.
d. Patent Rights
With respect to inventions made by Contractor in the performance of this Agreement, which did not result
from research and development specifically included in the Agreement's scope of work, Contractor
hereby grants to CDPH a license as described under Section b of this provision for devices or material
incorporating, or made through the use of such inventions. If such inventions result from research and
development work specifically included within the Agreement's scope of work, then Contractor agrees to
assign to CDPH, without additional compensation, all its right, title and interest in and to such inventions
and to assist CDPH in securing United States and foreign patents with respect thereto.
e. Third-Party Intellectual Property
Except as provided herein, Contractor agrees that its performance of this Agreement shall not be
dependent upon or include any Intellectual Property of Contractor or third party without first: i) obtaining
CDPH Exhibit D(F) 9/09) Page 11 of 25
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EXECUTED AGREEMENT"�|E`ER�California Department of Public Health Special Terms and Conditions Exhibit D F)
CDPH's prior written approval; and ii) granting to or obtaining for CDPH, without additional
compensation, a license, as described in Section b of this provision, for any of Contractor's or third-
party's Intellectual Property in existence prior to the effective date of this Agreement. If such a license
upon the these terms is unattainable, and CDPH determines that the Intellectual Property should be
included in or is required for Contractor's performance of this Agreement, Contractor shall obtain a
license under terms acceptable to CDPH.
f. Warranties
1) Contractor represents and warrants that:
a) It is free to enter into and fully perform this Agreement.
b) It has secured and will secure all rights and licenses necessary for its performance of this
Agreement.
c) Neither Contractor's performance of this Agreement, nor the exercise by either Party of the rights
granted in this Agreement, nor any use, reproduction, manufacture, sale, offer to sell, import,
export, modification, public and private display/performance, distribution, and disposition of the
Intellectual Property made, conceived, derived from, or reduced to practice by Contractor or
CDPH and which result directly or indirectly from this Agreement will infringe upon or violate any
Intellectual Property right, non-disclosure obligation, or other proprietary right or interest of any
third-party or entity now existing under the laws of, or hereafter existing or issued by, any state,
the United States, or any foreign country. There is currently no actual or threatened claim by any
such third party based on an alleged violation of any such right by Contractor.
d) Neither Contractor's performance nor any part of its performance will violate the right of privacy
of, or constitute a libel or slander against any person or entity.
e) It has secured and will secure all rights and licenses necessary for Intellectual Property including,
but not limited to, consents, waivers or releases from all authors of music or performances used,
and talent radio, television and motion picture talent), owners of any interest in and to real
estate, sites, locations, property or props that may be used or shown.
f)
g�
g)
It has not granted and shall not grant to any person or entity any right that would or might
derogate, encumber, or interfere with any of the rights granted to CDPH in this Agreement.
It has appropriate systems and controls in place to ensure that state funds will not be used in the
performance of this Agreement for the acquisition, operation or maintenance of computer
software in violation of copyright laws.
h) It has no knowledge of any outstanding claims, licenses or other charges, liens, or encumbrances
of any kind or nature whatsoever that could affect in any way Contractor's performance of this
Agreement.
2) CDPH MAKES NO WARRANTY THAT THE INTELLECTUAL PROPERTY RESULTING FROM THIS
AGREEMENT DOES NOT INFRINGE UPON ANY PATENT, TRADEMARK, COPYRIGHT OR THE
LIKE, NOW EXISTING OR SUBSEQUENTLY ISSUED.
Intellectual Property Indemnity
1) Contractor shall indemnify, defend and hold harmless CDPH and its licensees and assignees, and its
officers, directors, employees, agents, representatives, successors, and users of its products,
Indemnitees") from and against all claims, actions, damages, losses, liabilities or actions or
proceedings with respect to any thereof), whether or not rightful, arising from any and all actions or
claims by any third party or expenses related thereto including, but not limited to, all legal expenses,
court costs, and attorney's fees incurred in investigating, preparing, serving as a witness in, or
defending against, any such claim, action, or proceeding, commenced or threatened) to which any of
the Indemnitees may be subject, whether or not Contractor is a party to any pending or threatened
litigation, which arise out of or are related to i) the incorrectness or breach of any of the
CDPH Exhibit D(F) 9/09) Page 12 of 25
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MCKEES-U10
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AMENDMENTS-U012
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EXECUTED AGREEMENT"�|E`FR�California Department of Public Health Special Terms and Conditions Exhibit D F)
3)
representations, warranties, covenants or agreements of Contractor pertaining to Intellectual
Property; or ii) any Intellectual Property infringement, or any other type of actual or alleged
infringement claim, arising out of CDPH's use, reproduction, manufacture, sale, offer to sell,
distribution, import, export, modification, public and private performance/display, license, and
disposition of the Intellectual Property made, conceived, derived from, or reduced to practice by
Contractor or CDPH and which result directly or indirectly from this Agreement. This indemnity
obligation shall apply irrespective of whether the infringement claim is based on a patent, trademark
or copyright registration that issued after the effective date of this Agreement. CDPH reserves the
right to participate in and/or control, at Contractor's expense, any such infringement action brought
against CDPH.
2) Should any Intellectual Property licensed by the Contractor to CDPH under this Agreement become
the subject of an Intellectual Property infringement claim, Contractor will exercise its authority
reasonably and in good faith to preserve CDPH's right to use the licensed Intellectual Property in
accordance with this Agreement at no expense to CDPH. CDPH shall have the right to monitor and
appear through its own counsel at Contractor's expense) in any such claim or action. In the defense
or settlement of the claim, Contractor may obtain the right for CDPH to continue using the licensed
Intellectual Property; or, replace or modify the licensed Intellectual Property so that the replaced or
modified Intellectual Property becomes non-infringing provided that such replacement or modification
is functionally equivalent to the original licensed Intellectual Property. If such remedies are not
reasonably available, CDPH shall be entitled to a refund of all monies paid under this Agreement,
without restriction or limitation of any other rights and remedies available at law or in equity.
Contractor agrees that damages alone would be inadequate to compensate CDPH for breach of any
term of this Intellectual Property Exhibit by Contractor. Contractor acknowledges CDPH would suffer
irreparable harm in the event of such breach and agrees CDPH shall be entitled to obtain equitable
relief, including without limitation an injunction, from a court of competent jurisdiction, without
restriction or limitation of any other rights and remedies available at law or in equity.
h. Federal Funding
In any agreement funded in whole or in part by the federal government, CDPH may acquire and maintain
the Intellectual Property rights, title, and ownership, which results directly or indirectly from the
Agreement; except as provided in 37 Code of Federal Regulations part 401.14; however, the federal
government shall have a non-exclusive, nontransferable, irrevocable, paid-up license throughout the
world to use, duplicate, or dispose of such Intellectual Property throughout the world in any manner for
governmental purposes and to have and permit others to do so.
Survival
The provisions set forth herein shall survive any termination or expiration of this Agreement or any project
schedule.
11. Air or Water Pollution Requirements
Any federally funded agreement and/or subcontract in excess of $100,000 must comply with the following
provisions unless said agreement is exempt under 40 CFR 15.5.
a. Government contractors agree to comply with all applicable standards, orders, or requirements issued
under section 306 of the Clean Air Act 42 U.S.C. 1857(h)], section 508 of the Clean Water Act 33 U.S.C.
1368), Executive Order 11738, and Environmental Protection Agency regulations 40 CFR part 15).
b. Institutions of higher education, hospitals, nonprofit organizations and commercial businesses agree to
comply with all applicable standards, orders, or requirements issued under the Clean Air Act 42 U.S.C.
7401 et seq.), as amended, and the Federal Water Pollution Control Act 33 U.S.C. 1251 et seq.), as
amended.
12. Prior Approval of Training Seminars, Workshops or Conferences
Contractor shall obtain prior CDPH approval of the location, costs, dates, agenda, instructors, instructional
CDPH Exhibit D(F) 9/09) Page 13 of 25
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PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`GR�California Department of Public Health Special Terms and Conditions Exhibit D F)
materials, and attendees at any reimbursable training seminar, workshop, or conference conducted pursuant
to this Agreement and of any reimbursable publicity or educational materials to be made available for
distribution. The Contractor shall acknowledge the support of the State whenever publicizing the work under
this Agreement in any media. This provision does not apply to necessary staff meetings or training sessions
held for the staff of the Contractor or Subcontractor to conduct routine business matters.
13. Confidentiality of Information
a. The Contractor and its employees, agents, or subcontractors shall protect from unauthorized disclosure
names and other identifying information concerning persons either receiving services pursuant to this
Agreement or persons whose names or identifying information become available or are disclosed to the
Contractor, its employees, agents, or subcontractors as a result of services performed under this
Agreement, except for statistical information not identifying any such person.
b. The Contractor and its employees, agents, or subcontractors shall not use such identifying information for
any purpose other than carrying out the Contractor's obligations under this Agreement.
c. The Contractor and its employees, agents, or subcontractors shall promptly transmit to the CDPH
Program Contract Manager 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 Agreement or
authorized by the client, any such identifying information to anyone other than CDPH without prior written
authorization from the CDPH Program Contract Manager, except if disclosure is required by State or
Federal law.
e. For purposes of this provision, 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.
f. As deemed applicable by CDPH, this provision may be supplemented by additional terms and conditions
covering personal health information PHI) or personal, sensitive, and/or confidential information PSCI).
Said terms and conditions will be outlined in one or more exhibits that will either be attached to this
Agreement or incorporated into this Agreement by reference.
14. Documents, Publications and Written Reports
Applicable to agreements over $5,000 under which publications, written reports and documents are
developed or produced. Government Code Section 7550.)
Any document, publication or written report excluding progress reports, financial reports and normal
contractual communications) 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 or
agreements 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.
15. Dispute Resolution Process
a. A Contractor grievance exists whenever there is a dispute arising from CDPH's action in the
administration of an agreement. If there is a dispute or grievance between the Contractor and CDPH, the
Contractor must seek resolution using the procedure outlined below.
1) The Contractor should first informally discuss the problem with the CDPH Program Contract
Manager. If the problem cannot be resolved informally, the Contractor shall direct its grievance
together with any evidence, in writing, to the program Branch Chief. The grievance shall state the
issues in dispute, the legal authority or other basis for the Contractor's position and the remedy
sought. The Branch Chief shall render a decision within ten 10) working days after receipt of the
written grievance from the Contractor. The Branch Chief shall respond in writing to the Contractor
indicating the decision and reasons therefore. If the Contractor disagrees with the Branch Chief's
decision, the Contractor may appeal to the second level.
CDPH Exhibit D(F) 9/09) Page 14 of 25
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AGENCIES-U012
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EXECUTED AGREEMENT"�|E`HR�California Department of Public Health Special Terms and Conditions Exhibit D F)
2) When appealing to the second level, the Contractor must prepare an appeal indicating the reasons
for disagreement with Branch Chief's decision. The Contractor shall include with the appeal a copy
of the Contractor's original statement of dispute along with any supporting evidence and a copy of the
Branch Chiefs decision. The appeal shall be addressed to the Deputy Director of the division in
which the branch is organized within ten 10) working days from receipt of the Branch Chief's
decision. The Deputy Director of the division in which the branch is organized or his/her designee
shall meet with the Contractor to review the issues raised. A written decision signed by the Deputy
Director of the division in which the branch is organized or his/her designee shall be directed to the
Contractor within twenty 20) working days of receipt of the Contractor's second level appeal.
b. If the Contractor wishes to appeal the decision of the Deputy Director of the division in which the branch
is organized 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.)
c. Disputes arising out of an audit, examination of an agreement or other action 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 Agreement, shall be handled in
accordance with the procedures identified in Sections 51016 through 51047, Title 22, California Code of
Regulations.
d. Unless otherwise stipulated in writing by CDPH, all dispute, grievance and/or appeal correspondence
shall be directed to the CDPH Program Contract Manager.
e. There are organizational differences within CDPH's funding programs and the management levels
identified in this dispute resolution provision may not apply in every contractual situation. When a
grievance is received and organizational differences exist, the Contractor shall be notified in writing by the
CDPH Program Contract Manager of the level, name, and/or title of the appropriate management official
that is responsible for issuing a decision at a given level.
16. Financial and Compliance Audit Requirements
a. The definitions used in this provision are contained in Section 38040 of the Health and Safety Code,
which by this reference is made a part hereof.
b. Direct service contract means a contract or agreement for services contained in local assistance or
subvention programs or both see Health and Safety H&S] Code section 38020). Direct service
contracts shall not include contracts, agreements, grants, or subventions to other governmental agencies
or units of government nor contracts or agreements with regional centers or area agencies on aging
H&S Code section 38030).
c. The Contractor, as indicated below, agrees to obtain one of the following audits:
1)
If the Contractor is a nonprofit organization as defined in H&S Code section 38040) and receives
$25,000 or more from any State agency under a direct service contract or agreement; the Contractor
agrees to obtain an annual single, organization wide, financial and compliance audit. Said audit shall
be conducted according to Generally Accepted Auditing Standards. This audit does not fulfill the audit
requirements of Paragraph c(3) below. The audit shall be completed by the 15th day of the fifth
month following the end of the Contractor's fiscal year, and/or
2) If the Contractor is a nonprofit organization as defined in H&S Code section 38040) and receives
less than $25,000 per year from any State agency under a direct service contract or agreement, the
Contractor agrees to obtain a biennial single, organization wide financial and compliance audit,
unless there is evidence of fraud or other violation of state law in connection with this Agreement.
This audit does not fulfill the audit requirements of Paragraph c(3) below. The audit shall be
completed by the 15th day of the fifth month following the end of the Contractor's fiscal year, and/or
3) If the Contractor is a State or Local Government entity or Nonprofit organization as defined by the
Federal Office of Management and Budget OMB] Circular A-133) and expends $500,000 or more in
CDPH Exhibit D(F) 9/09) Page 15 of 25
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EXECUTED AGREEMENT"�|E`IR�California Department of Public Health Special Terms and Conditions Exhibit D F)
Federal awards, the Contractor agrees to obtain an annual single, organization wide, financial and
compliance audit according to the requirements specified in OMB Circular A-133 entitled Audits of
States, Local Governments, and Non-Profit Organizations". An audit conducted pursuant to this
provision will fulfill the audit requirements outlined in Paragraphs c(l) and c(2) above. The audit shall
be completed by the end of the ninth month following the end of the audit period. The requirements
of this provision apply if:
a) The Contractor is a recipient expending Federal awards received directly from Federal awarding
agencies, or
b) The Contractor is a subrecipient expending Federal awards received from a pass-through entity
such as the State, County or community based organization.
4) If the Contractor submits to CDPH a report of an audit other than an OMB A-133 audit, the Contractor
must also submit a certification indicating the Contractor has not expended $500,000 or more in
federal funds for the year covered by the audit report.
d. Two copies of the audit report shall be delivered to the CDPH program funding this Agreement. The audit
report must identify the Contractor's legal name and the number assigned to this Agreement. The audit
report shall be due within 30 days after the completion of the audit. Upon receipt of said audit report, the
CDPH Program Contract Manager shall forward the audit report to CDPH's Audits and Investigations Unit
if the audit report was submitted under Section 16.c(3), unless the audit report is from a City, County, or
Special District within the State of California whereby the report will be retained by the funding program.
e. The cost of the audits described herein may be included in the funding for this Agreement up to the
proportionate amount this Agreement represents of the Contractor's total revenue. The CDPH program
funding this Agreement must provide advance written approval of the specific amount allowed for said
audit expenses.
f. The State or its authorized designee, including the Bureau of State Audits, is responsible for conducting
agreement performance audits which are not financial and compliance audits. Performance audits are
defined by Generally Accepted Government Auditing Standards.
9.
Nothing in this Agreement limits the State's responsibility or authority to enforce State law or regulations,
procedures, or reporting requirements arising thereto.
h. Nothing in this provision limits the authority of the State to make audits of this Agreement, provided
however, that if independent audits arranged for by the Contractor meet Generally Accepted
Governmental Auditing Standards, the State shall rely on those audits and any additional audit work and
shall build upon the work already done.
i. The State may, at its option, direct its own auditors to perform either of the audits described above. The
Contractor will be given advance written notification, if the State chooses to exercise its option to perform
said audits.
The Contractor shall include a clause in any agreement the Contractor enters into with the audit firm
doing the single organization wide audit to provide access by the State or Federal Government to the
working papers of the independent auditor who prepares the single organization wide audit for the
Contractor.
k. Federal or state auditors shall have expanded scope auditing" authority to conduct specific program
audits during the same period in which a single organization wide 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.
The term expanded scope auditing" is applied and defined in the U.S. General Accounting Office GAO)
issued Standards for Audit of Government Organizations, Programs, Activities and Functions, better
known as the yellow book".
CDPH Exhibit D(F) 9/09) Page 16 of 25
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EXECUTED AGREEMENT"�|E`JR�California Department of Public Health Special Terms and Conditions
17. Human Subjects Use Requirements
Exhibit D F)
Applicable only to federally funded agreements/grants in which performance, directly or through a
subcontract/subaward, includes any tests or examination of materials derived from the human body.)
By signing this Agreement, Contractor agrees that if any performance under this Agreement or any
subcontract or subagreement includes any tests or examination of materials derived from the human body for
the purpose of providing information, diagnosis, prevention, treatment or assessment of disease, impairment,
or health of a human being, all locations at which such examinations are performed shall meet the
requirements of 42 U.S.C. Section 263a CLIA) and the regulations thereunder.
18. Novation Requirements
If the Contractor proposes any novation agreement, CDPH shall act upon the proposal within 60 days after
receipt of the written proposal. CDPH 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 of the proposal may be
made orally within the 60-day period and confirmed in writing within five days of said decision. Upon written
acceptance of the proposal, CDPH will initiate an amendment to this Agreement to formally implement the
approved proposal.
19. Debarment and Suspension Certification
Applicable to all agreements funded in part or whole with federal funds.)
a. By signing this Agreement, the Contractor/Grantee agrees to comply with applicable federal suspension
and debarment regulations including, but not limited to 7 CFR Part 3017, 45 CFR 76, 40 CFR 32 or 34
CFR 85.
b. By signing this Agreement, the Contractor certifies to the best of its knowledge and belief, that it and its
principals:
1)
3)
5)
Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded by any federal department or agency;
2) Have not within a three-year period preceding this application/proposal/agreement been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public Federal, State or local)
transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making
false statements, or receiving stolen property;
Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
Federal, State or local) with commission of any of the offenses enumerated in Paragraph b(2) herein;
and
4) Have not within a three-year period preceding this application/proposal/agreement had one or more
public transactions Federal, State or local) terminated for cause or default.
Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for
debarment under federal regulations i.e., 48 CFR part 9, subpart 9.4), debarred, suspended,
declared ineligible, or voluntarily excluded from participation in such transaction, unless authorized by
the State.
6) Will include a clause entitled, Debarment and Suspension Certification" that essentially sets forth the
provisions herein, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
c. If the Contractor is unable to certify to any of the statements in this certification, the Contractor shall
submit an explanation to the CDPH Program Contract Manager.
CDPH Exhibit D(F) 9/09) Page 17 of 25
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EXECUTED AGREEMENT"�|E`KR�California Department of Public Health Special Terms and Conditions Exhibit D F)
d. The terms and definitions herein have the meanings set out in the Definitions and Coverage sections of
the rules implementing Federal Executive Order 12549.
e. If the Contractor knowingly violates this certification, in addition to other remedies available to the Federal
Government, the CDPH may terminate this Agreement for cause or default.
20. Smoke-Free Workplace Certification
Applicable to federally funded agreements/grants and subcontracts/subawards, that provide health, day
care, early childhood development services, education or library services to children under 18 directly or
through local governments.)
a. Public Law 103-227, also known as the Pro-Children Act of 1994 Act), requires that smoking not be
permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, day care, early childhood development services,
education or library services to children under the age of 18, if the services are funded by federal
programs either directly or through state or local governments, by federal grant, contract, loan, or loan
guarantee. The law also applies to children's services that are provided in indoor facilities that are
constructed, operated, or maintained with such federal funds. The law does not apply to children's
services provided in private residences; portions of facilities used for inpatient drug or alcohol treatment;
service providers whose sole source of applicable federal funds is Medicare or Medicaid; or facilities
where WIC coupons are redeemed.
b. Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of
up to $1,000 for each violation and/or the imposition of an administrative compliance order on the
responsible party.
c. By signing this Agreement, Contractor or Grantee certifies that it will comply with the requirements of the
Act and will not allow smoking within any portion of any indoor facility used for the provision of services
for children as defined by the Act. The prohibitions herein are effective December 26, 1994.
d. Contractor or Grantee further agrees that it will insert this certification into any subawards subcontracts
or subgrants) entered into that provide for children's services as described in the Act.
21. Covenant Against Contingent Fees
Applicable only to federally funded agreements.)
The Contractor warrants that no person or selling agency has been employed or retained to solicit/secure this
Agreement upon an agreement of understanding for a commission, percentage, brokerage, or contingent fee,
except bona fide employees or bona fide established commercial or selling agencies retained by the
Contractor for the purpose of securing business. For breach or violation of this warranty, CDPH shall have
the right to annul this Agreement without liability or in its discretion to deduct from the Agreement price or
consideration, or otherwise recover, the full amount of such commission, percentage, and brokerage or
contingent fee.
22. Payment Withholds
Applicable only if a final report is required by this Agreement. Not applicable to government entities.)
Unless waived or otherwise stipulated in this Agreement, CDPH may, at its discretion, withhold 10 percent
10%) of the face amount of the Agreement, 50 percent 50%) of the final invoice, or $3,000 whichever is
greater, until CDPH receives a final report that meets the terms, conditions and/or scope of work
requirements of this Agreement.
23. Performance Evaluation
Not applicable to grant agreements.)
CDPH may, at its discretion, evaluate the performance of the Contractor at the conclusion of this Agreement.
CDPH Exhibit D(F) 9/09) Page 18 of 25
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EXECUTED AGREEMENT"�|E`LR�California Department of Public Health Special Terms and Conditions
Exhibit D F)
If performance is evaluated, the evaluation shall not be a public record and shall remain on file with CDPH.
Negative performance evaluations may be considered by CDPH prior to making future contract awards.
24. Officials Not to Benefit
No members of or delegate of Congress or the State Legislature shall be admitted to any share or part of this
Agreement, or to any benefit that may arise therefrom. This provision shall not be construed to extend to this
Agreement if made with a corporation for its general benefits.
25. Four-Digit Date Compliance
Applicable to agreements in which Information Technology IT) services are provided to CDPH or if IT
equipment is procured.)
Contractor warrants that it will provide only Four-Digit Date Compliant as defined below) Deliverables and/or
services to the State. Four Digit Date compliant" Deliverables and services can accurately process,
calculate, compare, and sequence date data, including without limitation date data arising out of or relating to
leap years and changes in centuries. This warranty and representation is subject to the warranty terms and
conditions of this Contract and does not limit the generality of warranty obligations set forth elsewhere herein.
26. Prohibited Use of State Funds for Software
Applicable to agreements in which computer software is used in performance of the work.)
Contractor certifies that it has appropriate systems and controls in place to ensure that state funds will not be
used in the performance of this Agreement for the acquisition, operation or maintenance of computer
software in violation of copyright laws.
27. Use of Small, Minority Owned and Women's Businesses
Applicable to that portion of an agreement that is federally funded and entered into with institutions of higher
education, hospitals, nonprofit organizations or commercial businesses.)
Positive efforts shall be made to use small businesses, minority-owned firms and women's business
enterprises, whenever possible i.e., procurement of goods and/or services). Contractors shall take all of the
following steps to further this goal.
1)
Ensure that small businesses, minority-owned firms, and women's business enterprises are used to the
fullest extent practicable.
2) Make information on forthcoming purchasing and contracting opportunities available and arrange time
frames for purchases and contracts to encourage and facilitate participation by small businesses,
minority-owned firms, and women's business enterprises.
3)
Consider in the contract process whether firms competing for larger contracts intend to subcontract with
small businesses, minority-owned firms, and women's business enterprises.
4) Encourage contracting with consortiums of small businesses, minority-owned firms and women's
business enterprises when a contract is too large for one of these firms to handle individually.
5) Use the services and assistance, as appropriate, of such organizations as the Federal Small Business
Administration and the U.S. Department of Commerce's Minority Business Development Agency in the
solicitation and utilization of small businesses, minority-owned firms and women's business enterprises.
28. Alien Ineligibility Certification
Applicable to sole proprietors entering federally funded agreements.)
CDPH Exhibit D(F) 9/09) Page 19 of 25
BIB]
40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`MR�California Department of Public Health Special Terms and Conditions Exhibit D F)
By signing this Agreement, the Contractor certifies that he/she is not an alien that is ineligible for state and
local benefits, as defined in Subtitle B of the Personal Responsibility and Work Opportunity Act. 8 U.S.C.
1601, et seq.)
29. Union Organizing
Applicable only to grant agreements.)
Grantee, by signing this Agreement, hereby acknowledges the applicability of Government Code Sections
16645 through 16649 to this Agreement. Furthermore, Grantee, by signing this Agreement, hereby certifies
that:
a. No state funds disbursed by this grant will be used to assist, promote or deter union organizing.
b. Grantee shall account for state funds disbursed for a specific expenditure by this grant, to show those
funds were allocated to that expenditure.
c. Grantee shall, where state funds are not designated as described in b herein, allocate, on a pro-rata
basis, all disbursements that support the grant program.
d. If Grantee makes expenditures to assist, promote or deter union organizing, Grantee will maintain records
sufficient to show that no state funds were used for those expenditures, and that Grantee shall provide
those records to the Attorney General upon request.
30. Contract Uniformity Fringe Benefit Allowability)
Applicable only to nonprofit organizations.)
Pursuant to the provisions of Article 7 commencing with Section 100525) of Chapter 3 of Part 1 of Division
101 of the Health and Safety Code, CDPH sets forth the following policies, procedures, and guidelines
regarding the reimbursement of fringe benefits.
a. As used herein 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.
b. As used herein, fringe benefits do not include:
1)
2)
3)
4)
5)
6)
7)
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, annual leave, vacation, sick leave, holidays, jury duty and/or military
leave/training.
Director's and executive committee member's fees.
Incentive awards and/or bonus incentive pay.
Allowances for off-site pay.
Location allowances.
Hardship pay.
Cost-of-living differentials
c. Specific allowable fringe benefits include:
1) Fringe benefits in the form of employer contributions for the employer's portion of payroll taxes i.e.,
FICA, SUI, SDI), employee health plans i.e., health, dental and vision), unemployment insurance,
worker's compensation insurance, and the employer's share of pension/retirement plans, provided
they are granted in accordance with established written organization policies and meet all legal and
Internal Revenue Service requirements.
d. To be an allowable fringe benefit, the cost must meet the following criteria:
1) Be necessary and reasonable for the performance of the Agreement.
2) Be determined in accordance with generally accepted accounting principles.
CDPH Exhibit D(F) 9/09) Page 20 of 25
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40952-U01
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
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ON-U07
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OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`NR�California Department of Public Health Special Terms and Conditions
3) Be consistent with policies that apply uniformly to all activities of the Contractor.
e. Contractor agrees that all fringe benefits shall be at actual cost.
f. Earned/Accrued Compensation
3)
Exhibit D F)
1) Compensation for vacation, sick leave and holidays is limited to that amount earned/accrued within
the agreement term. Unused vacation, sick leave and holidays earned from periods prior to the
agreement term cannot be claimed as allowable costs. See Provision f 3)(a) for an example.
2) For multiple year agreements, vacation and sick leave compensation, which is earned/accrued but
not paid, due to employee(s) not taking time off may be carried over and claimed within the overall
term of the multiple years of the Agreement. Holidays cannot be carried over from one agreement
year to the next. See Provision f 3)(b) for an example.
For single year agreements, vacation, sick leave and holiday compensation that is earned/accrued
but not paid, due to employee(s) not taking time off within the term of the Agreement, cannot be
claimed as an allowable cost. See Provision f 3)(c) for an example.
a) Example No. 1:
If an employee, John Doe, earns/accrues three weeks of vacation and twelve days of sick leave
each year, then that is the maximum amount that may be claimed during a one year agreement.
If John Doe has five weeks of vacation and eighteen days of sick leave at the beginning of an
agreement, the Contractor during a one-year budget period may only claim up to three weeks of
vacation and twelve days of sick leave as actually used by the employee. Amounts
earned/accrued in periods prior to the beginning of the Agreement are not an allowable cost.
b) Example No. 2:
If during a three-year multiple year) agreement, John Doe does not use his three weeks of
vacation in year one, or his three weeks in year two, but he does actually use nine weeks in year
three; the Contractor would be allowed to claim all nine weeks paid for in year three. The total
compensation over the three-year period cannot exceed 156 weeks 3 x 52 weeks).
c) Example No. 3:
If during a single year agreement, John Doe works fifty weeks and used one week of vacation
and one week of sick leave and all fifty-two weeks have been billed to CDPH, the remaining
unused two weeks of vacation and seven days of sick leave may not be claimed as an allowable
cost.
31. Lobbying Restrictions and Disclosure Certification
Applicable to federally funded agreements in excess of $100,000 per Section 1352 of the 31, U.S.C.)
a. Certification and Disclosure Requirements
1) Each person or recipient) who requests or receives a contract or agreement, subcontract, grant, or
subgrant, which is subject to Section 1352 of the 31, U.S.C., 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 Lobbying") that the recipient has not made, and will not make, any payment
prohibited by Paragraph b of this provision.
2) Each recipient shall file a disclosure in the form set forth in Attachment 2, 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 provision if paid for with appropriated funds.
CDPH Exhibit D(F) 9/09) Page 21 of 25
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
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16616-U05
6-U06
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THE-U07
DIRECTOR-U07
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MCKEE-U09
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`OR�California Department of Public Health Special Terms and Conditions Exhibit D F)
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 affect the accuracy of the information contained
in any disclosure form previously filed by such person under Paragraph a(2) herein. An event that
materially affects the accuracy of the information reported includes:
a) 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;
b) A change in the person(s) or individuals(s) influencing or attempting to influence a covered
federal action; or
c) 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 a(1) of
this provision a contract or agreement, subcontract, grant or subgrant exceeding $100,000 at any tier
under a contract or agreement, 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 a(1) of this provision. That person shall forward all disclosure forms
to CDPH Program Contract Manager.
b. Prohibition
Section 1352 of Title 31, U.S.C., provides in part that no appropriated funds may be expended by the
recipient of a federal contract or agreement, 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 or agreement, 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 or agreement, grant,
loan, or cooperative agreement.
CDPH Exhibit D(F) 9/09) Page 22 of 25
BIB]
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EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
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STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
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THERETO,-U012
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LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`PR�California Department of Public Health Special Terms and Conditions
Exhibit D F)
Attachment 2
CERTIFICATION REGARDING LOBBYING
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
See reverse for public burden disclosure)
Approved by 0MB
woe-oo46
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract a. bid/offer/application a. initial filing
b. grant b. initial award b. material change
c. cooperative agreement c. post-award
For Material Change Only:
d. loan
e. loan guarantee Year quarter
f. loan insurance date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name
and Address of Prime:
Prime Subawardee
Tier if known:
Congressional District, If known: Congressional District, If known:
6. Federal Department/Agency 7. Federal Program Name/Description:
CDFA Number, if applicable:
8. Federal Action Number, if known: 9. Award Amount, if known:
10.a Name and Address of Lobbying Registrant b. Individuals Performing Services including address if different from
If individual, last name, first name, MI): 10a.
Last name, First name, MI):
11. Information requested through this form is authorized by title 31
U.S.C. section 1352. This disclosure of lobbying activities is a Signature:
material representation of fact upon which reliance was placed by
the tier above when this transaction was made or entered into. This Print Name:
disclosure is required pursuant to 31 U.S.C. 1352. This information
will be available for public inspection. required disclosure shall be Title:
subject to a not more than $100,000 for each such failure. Telephone No.: Date:
Federal Use Only Authorized for Local Reproduction
Standard Form-LLL Rev. 7-97)
CDPH Exhibit D(F) 9/09) Page 24 of 25
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AS99892-U03
AS99894-U03
AI102677-U03
DO109622-U03
C5-U03
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2/13/2012-U04
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PROGRAMS.-U012
EXECUTED AGREEMENT"�|E`QR�California Department of Public Health Special Terms and Conditions Exhibit D F)
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a
material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying
entity 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 a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the
implementing guidance published by the Office of Management and Budget for additional information.
Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action
3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year
and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the
reporting entity that designates if it is, or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is
the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient.
Include Congressional District, if known.
Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For
example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action item 1). If known, enter the full Catalog of Federal Domestic Assistance CFDA)
number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 e.g., Request for Proposal RFP) number; Invitation for
Bid IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal
agency). Include prefixes, e.g., RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan
commitment for the prime entity identified in item 4 or 5.
10. a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity
identified in item 4 to influence the covered Federal action.
b) Enter the full names of the individual(s) performing services, and include full address if different from 10 a). Enter Last Name, First Name, and Middle Initial
MI).
11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid
OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection
of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project 0348-0046), Washington, DC 20503.
CDPH Exhibit D(F) 9/09) Page 25 of 25
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EXECUTED AGREEMENT"�|E`RR�MONTEREY COUNTY BOARD OF SUPERVISORS
MEETING: June 14,'M 1 Consent AGE", DA NO.:
SUBJECT: Approve and authorize the Director of Health to execute on behalf of the County of
Monterev standard agrees?ents. and any amendments thereto. for continued fundln'_'
from local. State. and Federal agencies for designated programs.
DEPARTMIENT: Health
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Approve and authorize the Director of Health to execute on behalf of the County of \lonterev
standard agreements, and any amendments thereto. for continued funding= from, local. State and
Federal agencies for designated programs.
S UtIMARY`IDISCUSSION:
The Health Department relies on a variety of local. State. and Federal grants to provide a portion of
the financial support required by the Department for the services it provides in the County. In
preparing the fiscal year FY) 2(11-2012 Requested County Budget. the Department has compiled
IISt of local. State and Federal programs currently providing funding for various programs. The
game programs expect continued funding beyond FY 201 1-2012. The State and Federal agencies
responsible for these grants require the Department to submit an application and final agreement to
renew funding for the upcomin`` fiscal year even though there is an established relationship
bet~~een the County and the funding agency in the current fiscal year. In fiscal, years 2003 thro l ii
01 1 the Board of Supervisors BOS1 granted approval and authorized the Director of Health to act
on behalf of the County in submitting the application and final agreement to renew grants with the
appropriate funding agency.
Continued support and approval by the BOS for this recommended action would allow the Director
of Health to continue to submit the approved resolution as authority to sign. submit grant
applications and grant agreements to renew funding for those designated programs without having,
to request BOS approval for each grant application'agreewent. This will significantly reduce the
number of board reports submitted for approval annually and will expedite the process.
The Department will continue to present amendments to the final rant a reenlent that require
adjustments to the. Final County Budget for changes in appropriations. revenues. and or positions.
to the BOS for approval.
OTHER AGENCY INVOLVEMENT:
County Counsel. Rini` ManagemenI and the Auditor-Controller agree with the pros ss and ktl
continue to review each grant agreement before the Department signs and submits the agreement
to the funding agency.
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MOCO HD EXECUTED AGREEMENT|Eo�o�r rr: OF ire rl;n174c.
STANDARD AGREEMENT
F:EG TP cir'tJ tll_ t_
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I
PI
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y
1. This Ap eement Is enterer Into between the State Agency Dina- the arl'ractec named b tl
XEAfEft rJ~r.E
Cali;orrli r De{-iarLment DI Public Health
Moriteroy County Health D par1rnent
2. The term of this 1G~iitl tt~11 Llrough O /33 2012
Agreement 15'.
ery.EEk.9E+rrNe ER
11-10234
9.
I~1?_ Nik[:H C:]r'hrrif r:llz!el
The rneximum amount $ 700,000
of ti Apreemetilt is: Seven Hari-died Thousand Dollars
The pari_ies agree to Comply wib, the terms and conditions of the fr llaveir g- exhibiis, whidi are by This reference made a
part of this ADreeme n':_
xhibit A- Scope of'Alork 51 pe 5
Exhibit 6 B dgrt Detail and Pey-mtinl Previsions 4 pages
Exhibit B, Attachment: I Eudret 5 Prg4s
Exhibit C Gene; al Terms and Conditions GTC 610
Exhibit 0(F) Special Terms and Canditi x_ Attached hereto as part of the agreement} 2 peges
Notwithstanding Provision 6 which does not apply to this agreement]
Exhibit E Additional Provisiq n
Exhibit F Contractor's Release
Exhibit G Travel Reimbursement Informp-tion
Exhfhii H information Privacy and Security Re.quirerierts
3 P,7- C- E- Is
1 pa es
2 paces
1IJ pages
I' 5hcrwri ahCve SA,itn en7 A51 e.5k r), are hereby Ir1E:17r?or�.1e1 b` refer e az;d rnarie part of t1--j s areerent a it a 7 d he:etr
Th asnd u n r nts c a n be v I,ved ar iii o ci'a.dcs a. L"'V aMdaiyTLaIIqu'� E.
IN WITNESS 1AMEREOF thin Agreennetit hat b"n ececuted btythe psrtteg herele.
CONTRACTOR
r 3L c r w i_ sfa.h_r:'xa~ Jn Al t~ 1, crerres3 c ccr.', z, n r r. cr
Monterer County Health Deparin font
KY Ziqareur
*1Ter fck] Tyi rFF ru t JIr4
Ray B.rlli k, Director of Healih
ADDRESS
1270 Nati fdsd Rd.
S'Jinsz, CA 939QR
A.G'edC'' NAME
alt r;l;'r t-partjnent of Eubkc Health
cfi ro=c c i r r;
N-AM-S rrnTiLErt FERc N=1C.:Jir?
in ers, Chef, Contacts and Purchasing Services Secf r-n
acc:�~eC
I Cap-itool Avenue, Suite 7r 1:5178, MS 18,02, T C Box 997377
Sacrament,), CA t 99,-7377
C-t3Jifoorni Depdrrr'1aent of
i 7namI Smrvark.; arse Qirly
BIB]
40956-U01
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APPROVE-U07
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MOCO HD EXECUTED AGREEMENT|Eo�o�l:aglrf lm n Dep3rtme-nf cif t4eialth t~` Taaill ord Conditions Ex1I Lit U F,i
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF PLpBLfC HEALTH
CERTIFICATION REGARDING LOBBYING
Att_?chlnent I
The Lrndi.rsigr,Od ceritfm,s, to the best of hs or hEr knawwtedq and te-itef, 1i::~. t.
j) No Feder-al appropiiatxt funds ha c been paid or will Rio paid, by of on behalf of the undersigned, To
any per-,on for rnf aencinq or attempting to infxuerce ar4 offcor or empfoyeo of an agency, a fvt arnber of Cfirigre
4n off
cer or empay of Ccngre55, or an employee of a iemoer of Congress in connection w411 he makiii0,
awarcirr0 or eniernq isito or this Federal conirsct, Federal grant, or cuoperatc' e agreement, and tote e:'tenssan,
conlinualiori, renewal amendment, or moctificat n Lef this Federal oantraci grant, or cor-1pmerat ie egreornent.
2) If any funds other than Fed.eral appropriated funds have been paid err vrll be paid to any person for
influer,cinti or attempting' to Infliuerce an afti nr or employee of any agency i the Unitod Uicte Qriernment a
Member of Congress, an. officer or eiilpioyeo of Carig>oa or an eml yee Of a s.Morriber cf Congress in
connecta'n with th s Fedvarat contract, grant, or coop'?rati` e scree aint, the Laden*oi red shalt c mplete and submit
Standard F m LLL, D SCioFure of Lobby n0 /sci v iti in 3cr rdarce with its instrur-6cm:5.
t?;f Pie undersigned Shalt require that the language of this certifk?ation br irtcluded in trio a aru
r ccurnents for all 5:iba% and at all tiers including suocortrv.tQr5, sut-grants. n: contracts tir cle grants and
t operative aQi eerieri's~ of $10I,Q00 or more, and that all subrecipients shall certify and d scf e accordingly.
rilrt certification is a material represenlc hin of fac. upon whrrfl mlianr`,e was p! cod whon this tranti.a:lnon n'its
made or erltojic4J into Submission of this eerlifr-atbon r a prerequisite For making or L11 Cring into ihis trans ar for
imposed' by Section 3352_ Title 31, U_u.C., any persrsrr wno fails to file the- squared i=crtification shall be ei.lbject
a c-101 po,rialt`yr of not kts than a10,DIX and not mare than 310o,00D f r each such failure-
County of Monterey Ray Bullick
Nare Cr
rrr v- ri r^i a Pei-,cr. siariw. It i mirtn�r
C[xtrci e bun~tr'r a arere 3t r}e: 5,.1 v' g7i rr. tr-f i_ ea b= r
10/11/11
Director of Health
After a-Xr_tition b/ or on bahaIf of Contracto please return t
California Derartme of Public Health
CDPti ruscr=ti5 the riushht to notihry the ve niractor in thin of an a1?s2ir1Jlr'_. subn issiUi1 oddre s
CDP i rxi-a,+r1 U 17l c5i)) Pa 23 cf 25
BIB]
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MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
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LOCAL,-U012
STATE,-U012
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AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�CCC-307
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
Contractor/Bidder Firm Name Printed) i Federal ID Number
County of Monterey 94-60005241
By Authorized Si
r' ame and Title of Person Signing
Ray Bullick, Director of Health
Date Executed Executed in the County of
Monterey
10/11/11 t
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. Gov. Code 12990 a-f) and CCR, Title 2,
Section 8103) Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
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 counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
BIB]
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MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
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411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o� A-,r[IF<AIII) RA
STANDARD AGREEMENT
2113=~ ii11
L Check here if additional pages are added:
pages)
This Agreement is enterer f into between tho State Agency an
A E EFO rover f
California O iaiirLLri nt of Public Health
Cklk 11w, I tl:.x:14A VI
Monterey County Health bepartmernt
the Go Itracte( namoc belu'.,c
I
2. The term of viir, 10.31 /2011 through 0R13Qi2'G 12
Agreement is:
3. The maximum am,ouni $ 7010,000
of tl'riS A eernant is: Surer Hurxiied Thousand Dollars
L. aaEEMEFlT'Ji,?.!FF
1'i=10234
rS!rr j Ir t_n_:i2^ciwj
4. The parlios egree to eompty with the terms and cor titiorrs of the foIIa'lrirg exhibits, whir;h are by this reference made a
part of I.15is r mOonla i
Exhibit A Scope of Work 51 p
Exhibit B Budget Detail and Payment Provisions 4 pages
Exhibit B, Attachment l Sudcet 5 p:-
Exhibit C General Terms and Tditions GTC 61 1
Exhibit D(F) Special Terns and Ccrtdi4ia ns Attached hereto as part of this agreement) 25 pages,
Notwithstanding Provision 6 which does not app`s to this et eernent]
Exhibit E Additional Pro its ns 3 paces
Exhibit F Contractor's Release 1 pages
ExhibrtC T errj#t r.t information 2 pars
E fibk #)-,4r4 F~ oVqg ajrit egiirerne is 10 p ges
APPROVED AS TO INDEMNITY/
liNSURANO LANGUAGE Reviewe'4 to f 4 4 rovisIons
uditorie'ontroller
1 i-tri5 mown above with an M a T" v~ v
r'",,r_. r`
1~k. ore hereby Incur4-~ r-1e fi>`ere~ d r
lt ea~t~rrit a-~- if aid he- e C_I.
There &P--u' nt can be L',ieived at hi 4o && dos wr,':,rands drama jau s'?e.
tP4 WITNESS 4'1HEREOFr this AOreoment has been txecUt rt by the parties hereto_
CONTRACTOR
frltaf~;fCh F_�Cr.~irynr.tiy~y~t~1�e s'.s;G fitec,ac~R_.r_r:,~ tnerr,cr::
KY A. NVOW V
P?L?JT'cD A? l
FE
F.=~SpJ t llt
Ray Bullick. Director of Health
1270 Natividad Rd.
SalirFs, CA 9QFt
STATE OF CALIFORNIA
AG[ IC kM
Californiaa Department of Pubkc Health
FA1 1Er1 NAM= AfDTT,LE OF FEA: OPi ItsWX
Sandra linters, Chief, Contracts and Purchasing Services & ctiurI
C.alttorrrfit apart teejfl rat
Din t services 41517 only
xr rlltil. pe
15.01 Capitol o enue, Suite 71,5178, IS 1802, PO Box 997377
Sacramento, CA 58 99-7377
BIB]
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
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OF-U07
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MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
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LOCAL,-U012
STATE,-U012
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MOCO HD EXECUTED AGREEMENT|Eo�o�Monterey County Health Department
11-10234
Exhibit A
Scope of Work
1. Service Overview
Contactor agrees to ro,tide to the California Department of Public F1eatlh the services
described herein:
4_ The mission of the Network fora H�;althy Calffornia Nutt work) is to create innovative
partnerships that v o with tow- n rrie Californians to increase fruit and vegetable
consumption, physical activity and food security with the goal of preventing obesity and
other diet-related chronic dikedses per Health and Safety code 104650-10485-5. To support
this goal, this contract will implement a coordinated regional program that provide-s
integrated nutrition education interventions and physical activity promotion acti Mies to the
targeted population as described in Exhibit A, Scope of Work
S. The Contractor shall provide the specific sen ices, deliverables, and objectives specified in
the approved SCAN' and any subsequent formal amendments approved in writing as required
pursuant to this aggreement_
C. The Contractor shall cooperate with CDPII or its designee by participating in meetings
and;/or site visits as CDPH may deem necessary to monitor ntr ctor c rnpiiance with the
agra eme t_
2. Project Representative
A, The project represeniatN1es during the term of this agreement will be:
Cailforn[a Department of Public Health
COPH Contract Manager Monica Regalado
Telephone: 916) 449-5931
Ear 16) 44'9-5414
E-mail: monica,r ala is=~ cd. h. by
Monterey County Health Department
Project Director: Nliaomi Hreplich
Telephone: 831) 796-28T2
Fax: 331)424-0985
E-mail: hrepichnc~ co.montere y.ca_us
B. Direct all inquiries to,
California Department of Public Health
Monterey County Health Department Regional
Nett' ork)
Network for a Haa ttiy Caiffonmr
Attention: Shardool Doon ursee
1616 Capitol Avenue, Suite 74.516, MS
7204
P_0. Sax %_7377. N-1S 72(}4
Sacs nerto, CA %_899-737-7
Telephones: 9-16} 449-54-33
Fax: 916) 449-~t14
E-mail. uhar�fool.doongi_rsee'ycdph,ca.goy
Niaornl Hrepich
632 E, Atisal St.
Salinas, CA 913905
Telephone: 831) 796-2872
Fax: 831) 424-0985
E-mail: hre ichnsA o.nl--onteray. ca~u
C. Either party may make changes to the information above by giving written notice to the other
part; Said changes shall not require an amendment to this agreement.
Page 1 of 5 t
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
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APPROVE-U07
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OF-U07
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TO-U07
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ON-U07
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COUNTY-U07
OF-U07
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411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
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STATE,-U012
FEDERAL-U012
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DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Monterey County Hc-417 ith Depar wren t
11-10234
Exhibit A
Scope of Work
3. Contractor Requirements
The Contactor shall comply with the guidelines for the development of all education materials
as outlined in the Network Local Projects Program Guidelines Manual. These Guidelines have
been incorporated into this agreement and made a part hereof by reference in Exhibit E,
Additional Provisions, paragraph 1. Without limitation, the Contractor shall comply with the
following requirenents,.
A, Submit any news release related to this agreement to the State for review prior to its
release.
2, The Contractor agrees to cooperate with the State in data collection related to evaluation of
program effectiveness as requested in the manner, format, and timeline prescribed by the
State. Data shalt include� at a minimum, demographic descriptions of the population served,
audience reach, and items to measure program effectiveness_ The data shall to submitted
in the required form prescribed by the State.
C. The Contractor agrees to cooperate th the State in the resew and, when appropriate, e
field testing of statewide e alualion instruments and ne-11dy developed educational materials:
D. The Contractor shall ensure that the USDA SNAP-Ed Its clearly identir od as a sponsor or
support organization on afl materials and products funded by the agreement electronic,
print, audiovisual, rrmedia, rest:.). The Contractor a grees to abide by the I-Oulde-l.ines set for
usage of the Network logos on any product, generated by the Contractor.
E. The Contractor agrees to per ate vith the State by participating in statewide meetings
and site visits, as deemed necessary by the State,
4. See the follovong pages for a detailed description of the servies to be performed.
Page 2 of 51
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
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16616-U05
6-U06
APPROVE-U07
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TO-U07
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ON-U07
BEHALF-U07
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THE-U07
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OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Pluri, ii A, E'i lLI:,IFlf iii FXHIFI�li A +it1161"'1: nno Hopp! iJ1MY1
Scope of Work V, 11-';02
GOAL 1 mplcri'ria11! a i Irrlt'n1,1'u;n iwu pu` h' health nutrition spt rrlac:J1 rn ftrr,111i t I'ta 211167 11"el ry t LUi1a:,f1r.,, w r_rd.:e i"'1Jtt and ++'rcjet;rnle rxrn::.uiilp,irl-' I'r1 llvs Mil yt;:I:rr-iv'
tanl6ng lt,r. IJppI.;R1?,:I II NuI i115G'1,j1uu+1-:1;3:111 f''I'r=ti 1an-1-Ecucatian i;St'1A.P-E`'r) eNil}le pI: piJI,Iliev.1
AstivitylMetltrids
Tlrttirr;rrrrs�
Katy flr:liwc:rlblor
45"w Gilue I Pt~lnnirl C a1 i
G m li ri sa,gran7
t[np trate9i� IBIt i r511141?tiie *I 1~, J11 1'16 f t5glca of t rll Lwitinll, Yrilur,ldaduil irral lt, lc1 li rli ablfr daiic nE,, and,
drallli IkJS ta u r uri Jettti' rk giant I and I mryr lr y�.
nrrlu~hi~aalis_Il,. n u11ttCflnill,.1 Pruga~aitloprJr~'llr~n;~; and
f+~', R. i grr f n.,~ f l a~ t s l,fuN, to r.l l rr'IC-ilr~ u Savo r w y
1 liira~rrilatt
f riti SL ttvt rkfLlRl t 1.1 11 Jru uvl, rind P' f asfn~re 1n col ghnr iw n nsa x.11 r;liit tilt rl t fr1 + fat is Ohm tal Iri~rlrk; M Lch(llntatN X1111 tw1 Alia',' Key
a
1} t+pt,ln,it II;r*+I:rllr ral ig dvl urrlontE
E reu'.ur11Loi 15,
r:i11
C', RC, Lal C,
Rot C, Pf-'C, PAS,
r,riC,(f;
r111nir: Urrh'redira.ilas is lan;
lyderna� Cc:?trnur1ications Plan:
Nlad: a,'PR mart and c. tnc'aig-i and
pr4:1 i1'arn urrti P.ltly't.t G J LlG"*. Viiiy
it"111p!C7r illll r"ItJ?:'rcltfjll"i r'%1' I~1ntr
each per ca rlnaigr, and prtcNrprani
awaked)
iS.I1111i1 I iiJ J I lJ l 1;hr F-^lFirt;
Irill'rna i nunu:.rahnn-. Hart
+ rualaarilr and 1it r. mil 4,LnI'1"Ia'niILallorrr Plans for' program Lcordl:".arinni1111Gr:r'lr:nr'.?nd f l tf
canlrwnicatn ns
W.'I plan emu campaign and pia ram csper.;ln^.1 rular's
J11 I Ph, lop
2
3Y r J.'IsfrliJr_>t
2'
PD, La, C, ReL C
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campagrr arc I.p-agrarn a:rd
physical uctl rrly inttlfll al' m
u:lp,IaltllI.i F:J:�an a i)11r+ I� ru'l
r:ampn lgn r1u,c r:'7rll:a:ri ali'ardedt:'
bf di" 2 Planrt>tng Cvaaltlatt n Ptr luatllail, i 8 I n11:Iw a1 2012.il'l~s +- I> ff rl taxGrl~ t'~1 1 iJrv'pLir! Up jr tti5rc1 aUr it't7,5 1u' M'k111 aGc~I1 Ff rl and cav Llal rc4 Tonal
ntal-u, urti MAY, including an4?ax fr l.rr trxne~r5, Onto cnmri 51Iir u111 rl'ne<1u eyla r u t a lt'I0s,
1) r; 1'Ir::d~�I, IJu' 1t7 5'5rc+'orrnatrfre research of e' fluactie,n flrutd?,1�,'II:Ff 4 fa'l:l. Iairlrpaq1fic and p orlra!rls
Actvlw, f� nIii lr!cIIJY'a: par`.Us'pa1:i1111 in wV tirkgro'.,ps, ant 5~rc{II",,d Itt c'11( i.rld1::11R i I.10'1Y1:w 11I lr`riillw+
lnextar rip':1 c, at^rlrt 4'lil I- u L:cl C111'ell rr'1"tlu~lxrF(s L"-illrl?~.Il won D.r^"'! JI71",r r,'li ers 3f�ltl r.i II,I{?,'t 1YW
income adm.tI a:-rhi cIden 11.'rilualuou ur i!lr ur'J t-11u1:q,_rlls w 11 be prr:;,vr d1:d Aa1i51niea migh? he
iinplorrlan:ed b obtaining 117.:!:51 1rf m rll flnl 111,'.lil:t:: vit olue l,iurt'u or printed Jrveys, Ccnduelin,a
111r1_ir it o t ajr e, C IL' r:�1 new Irue:erals, r ilmlpl[ r-l,rerltrnrl hr:r;tl r r' a tror tJl'+'47f tr'+lr_ f surrJrry'S
rcrlrlllu:I t:J v el.:,:111'.1 %.:ur'aurncr Ming r:.1 new r''ale,ial� Cr
2012
iUf',n"II I.:1r1gd h;:j dtr!lU 1;1r.>'I
insrriIlllt?ris Ilrllnll"1r'ti' rrt
par1iclpaI an 1,SX 1 Reper. Form)
Jk'1'kl 1 1'I 7::::.: f \.~~�, Fi,,' F...:1 r.^, 1',c r,"c"f 1 r: L~i,.1 e;, i i li^rir 5 I. ccf Il, rr1'__b_r., 1, r_ i~rl~4r.;~- L I:.f::.fr L2` ll i7 rn. 1',734:1 I I!t r:. 1::. 1:.
r,,.sls'If, i{t'l l; r.....t. IC,~.:r l�'rtlr i- I- r' u.,,~:r I'-:,III i r,1~,
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�PIr nrl nrg A t-,raiu;arh;n I xi Ilt;y+ %,
7Cr.',z,r! nt V ork
rr'actlt'illyt ethii &
e?~ It11111t,"fl'IUr' I'Li Celvv;flrncrrlt C1 t~ir~ I z11t rr I I r,l ITo r�i]I,il:lil iIr1S" *1 LI111t11'9!a S atom EARS; and
D1i'er rFTtrlr11 FJ~r1Y litr?.71r?''!'I n r~1Lluir ed Actdv!{''c a m. y nciIu'i?, h{9.~1 I' rh'I IErlii;r,!!J In rCt1'I,ixw ptrr Lw~~L'r
C,IIat testing at new dais ttJlll I_liC y!;1i:rrl f qut` avutinn in tole,:cmferenct=s and i:" w on tall'
Ir*,; dbbak an tha rE?parting prams;
7 I"rlr'Irx!'rlr--il 8 t'TTI-annu,l 1.:.il"lirl~t r- t, il:.G toat.`oonri jrt. uNey. A,:tiv'il:es may inCIIiit'?;�tOrtlr.fi):'I;IIJr"
hi. uvQ'y' du:;ign. c' seminatlon, at surr.++.lik t"r1Nurrk lu LC:LJIC pa'! CipaliCtn iieg ergiq,r"1lq nt inr
rl,??ht rdf I'r1rldci p1",Ijur Is and p.tirtni r 1 as pllrarrrl,3 o IitLI-e grid cl u r-r+?nt reg. ilts show 1 be
affi>,r IIu r;, a of iijWro meetings vaVIngii t:.rn1 ii nr rt rll~'tI1 ox"Il$'sil!4Lmi
FI Dc gn and in?�lemt nr t U11 c,1tl4 9�I u71 I I1lr J It IN 1r IhM amp= a reg;,on i 3.^r'I'.'9Ihn'. 1t:'
itI",I Irnudia!:Ctc�" kr.,intg Me atr ibk C.'ia 1 IrI9 91i:9'f N)LIlCd SIG"diass I miniantrr
a) Skill b.3sr d 1, mlllrl:;
b) Pi cmi5"ng Prad�.+".1?�, I'SrSch3 I1t,.e`;!' 941!:yr9iitojr.:tlic,,n ReKwmr 1t'rwm 5t attr�: r:nll?tint"pI'ItVrr
rtculings,
I ink, AVItP %4,iA4'ti.trr( lr:u.rP,lidt,r:!{I~"FS Of SC!?Ilt?,~ttr� dig w,~r,!r?!Itt!7 rt,}'7f.t;l1 &-ilVllrb' 06cmt,t
P"r1?4�r:'nl)?rn rcx3 rctrtirillcs to incrIeaE. 3'e'ia,enr' s of t frt i 5 f 9"IIII! in tllt;, rC lan.
I Cu'riJ4. 5ur'e'wk' of
sllrr.'~~I a+.� Iv�-,;,I~i;a N> U�Ic. I;' td I!:J G.rCL"I. CCr171`IIIJ alc.: d
a1'ru1;
LrJ p;G'lt p i 7"vited C,r.......:r chi 1-:cr.rrrlaE 7:n-:uyrl +t Y 1t't,~., s 9 i.,~ rk
F.it!!
haa: d.^rt i; IWI:i i''r A knxrr Rsa, ar kr. to
t q, c:�r CHI, C a 11^u r r iez"!tt lt^a:r:tt
i
I
o1a er 1.2011
SC 1enrbiir 30,
2J12
1 11)t+U 1, 2011-1
p 1t= 7'oe' 30,
201)
3,-A 9:rbcr 1, 20''1-
r1)111rrj% 31
YOU
I0ctobe. 1, 2U 1
Er p ember 3-3.
2C 2
4)ctobar 1, t011-
up( ii bur as
4.)dobrrr 1 7111.
Semen-bnr:10,
2,912
5s::11 t+a.t 1. 2W12
tR r:n,porYm1aIa
start
pa,
1.11'
PD, 9:;,I.,, Rc
Pit C.", RC
ti/ 111.GI'c-y Ginp�'1�y I lac,illh t;OI)i:,
rr1.11:4
Kaye Defiv rab les
s,tht'nIL: urnrn y, a� mlirtic- pafion
SON I on i 0mr
Suhrlit. E.al)iinnry' rt' aii r I13th r',
I 3!ol."4r Reporl Form) and cb-ic-al
crrialy.aia of iosult:=
Sulon rt rain nL1 Et'aiuatiin Plan:
a1-,t; of t vl'tuutiurl rr�5u,'`t'5 and
Wc.t ar,aI tin of rt:s 1
5tanda:rdiaec Pool Evnion6no;
scrIrrlar',rc�1'evaljation rrru11a arid
f slit:il ts181'{' r�;f I rr ui;s
hula- i t. Tr.: iriir:.p Ev iIuMbon Plat:
rli a r, y u1 9_ UIU,lt nl Iusulis and
i'R;li r1t 1r' 7ltt r)? ii" Ill:;;;,
1%. Ca PAS
Iihrrtl' 3 irithrrrJ^.Cc- J Post
trylli311t ri; SI Ir1iI IlOry Ilr A r!luwlicxn
r'st:rtt9 and cri ical 3r'aly!,t; rir
rese.'1t"a
S>,tbrnlt: Summa, a narr.ir:lpa tt d
ln~lc1ut'r,n;:Eas(~~l0a Gr1nrt r-0r1)
n
3unmir aumnlary it)iI 1:1It,Cial
analysis rtf results
51
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�i`'8:.:rdiu11l Q. I=valuallc."', EXHIBIT A.
c;r::�^''ri 471' V r ft h
A tivity Methods
7'l Us n"1 Me I'er plat s proe'I,.tii i CI7i'. J,,�rl;t;;1r vil Ai7'L4l; e LJlctv.1,irlcs 111:16 I ccmpleta IEtquiied
campailQn and pr.^Jpir,imsuccess sinner. nrAl N1.Jlrrlloll LLduc;ti1iccn1rici riti,'L7 r;me studim., iricliidinq
p rims and case sl d1, Uxi_?I::Al'.'e u�tJrnmaries, ar, rt renr:t'i 1 lle`+C;r'L\'
locyl I ii r'1 ij: i lin f Jtl lbxce 1hai has beenl:>d':, ncec a-trl etrlh;"rnred dur;ilq I rip
cLlntr~ir:1 pn nrt,"~ I;s`vakip':?;1(111+,ii;iI LOS U ls'r' 8'"iy new,, ini:i:Jti'.es as the np5'r.Irrunily ariLes.
i? I 0I lo.rhi.!t~ln 1-li:7Yrc'1 ril%.'1,', C�:JtaIpCJic"2 succes 1cN ACIJr.er nn 1 i iilit, 1 Yid 1'; d
r;, +_ IL r7efu,! Pr &c', aril success rnry facu.re sal r, w,.rti,r9taoir11 Ir;fJ!`-11, r, li irn inc u'.:,Irp. or lo-;0.1
or;;lik'y pzirtnerchips.
iII Orir Irtiligr;ltic��, To'r'n` success tnrlj r.C.ll.et: con h ou vtiviI,! In;r?Cirtt'Inln
and 11r' Itr`. +;r^ ic".Ii~f lie: u1 II7rs rl;:rllc}I7
c!,1 1 JI1B Lu 1ullo C Y"rl s~',n+aNw li~1r sr.r ti r:*'I IC;L, i.r"ea!7 I irru1 IIJ r'.+I,;r rl 1"; I F
i4rr117ciit~ y I]CIL. 1. 1."�'l l�:iU rl.
li i S I p ihic,, i an on J+ +p b en,:e�e S'77 ril'c,: pine lL I'.I?;y IJ:;y t7.' fl l ffl r+, a!f ill Illclf 11,'BI:'rlf Ill't E,.u,d
11 url I t to irl Iplcc ur errplc''A'ee at parnctp31111g Li h n:r rr + Jl,rriii 7A giir,'ft
Itl1(tlc!"'ir.'cl 71:1x!-,it iU i7L;1411i1E' +Jr!j tuJ.?I'r,{l[-'A"'c'cit3?,_1lalu,:.lion lid r: s,l ii[t In 111,,eo I1arr]iali:rc
r1 g11.,.":rld hrii: a!�;,',ttti't1C:" rriuv iiii;Iiju.'S:LIIJ,zt:.'cr Lhf_' +:Et111jpa,;L- an,
LYi i1'll] L vlq)r7n"J.'? 0 1 V Y 231 wid plantlirv, lct' an Man Arila"!d: tl foil jij7�ii AiJdy scheduled 1!:'
r Y 2013 I'Gtf.tlLlal r' I,`ir::1 r"r1 i"t'r Ifiurti�I 4f+711 Vlirnc:,7L i:;l' Si,clp 7 of tt,'!r4. +_'L''Ic?'7lfa�ei will he Lcr idlorc
Tirn4Ira irre
r p LIgC! 1,
2019-.
I 2712
f iy 1.rirl;a' 4 1
F;e? rlc:�llt:�r.r u
2012
L', r L.I:itl:ll I ti rti;.,
2M.11
By re+ptcirllbr_':'
30, 2011?
By SAPMnsw
IT 20'1
By npternt!c!
X", 1701 2
t r r 2 0 1
I,.,ir. rlr!t r:
r17 I
f~allr 201
aclis;n: ler yil.
20'12
during s'l ay phar riinq n11d i3i1dre9secr nn I'lo' rlIrr,
rl1 Miens Me ICllr, tt I. 1,1 a,a G t� lG' USDA argti' 3+ die' r rnr1 inter'r.rllie, 1 1'1' tlitirIi ll:,il tell crileri'n,
nrtatlincB Cti 111c z Its lua ntJnd.+r La r,ualJ`p'ir[g CenUS taus uvill;l Arrr ricarl rmnlufliy iJ r'ry
AC.S,i 1 t r i bcrivlll fr;?y iiicIih'Ir! I:uJ". Rrlu Ilux lilllilt!a OLGcirltirlr the nurnb.'r of pc'iirl'Us+ pa,1ners, C cher 1-
lter enl n si:e inc lcv. incril- r" ti I t;IJ1111,!Iv 111 Igl,vtr_'u!SI', q iElI111ri1 r1 ciil MM I:_:,_l:, Ihal. Liywr o i'!,b_, riooi 30
Yndilalt.i'w n OE.rr 2312 ii well as 300II.;:II7a. r,.J;31111r11p~ 1 LIL:Li,, N WON II" ci. r1E'n Li! cu!I'11U uIQiiIIG iii Acre 2M2
rt,Q t,;ai E,.' Ii.;i i;,r; Ir' orrnarrc'n' i rites Ill tii i110 ye';ii1 34111l i'Iii I Z'r(Erjt ft.
repan
Laawarl I'1:+ I ul-r 1_rc f J fir itr1.J L.a 1t' rr c11:: r: i,1i i 1; t:r.U 1 R=r r t rlrri it 4 t::. dIE.'M
i
l'illi, r. I'- I'.:?r,'I r.9.-:., I 1'. ri i f l:�II I_!_t lu!,y i.l iii'It I c'1:? 1_ 1]�' r:
Respailisible.
St l.rr
Ct:
Rot C
PAS
Lea L 0
W ni utc;rr y I, ounly week Up
M 1 1(:i d
Key DerIv'eraibles
Ul:'ri l uciripl 1od L-7,1:.:a;uc"irr,
Sub it c: la?leted rase sludie=;
nd success stories
a1,ibci 1 L n r.+ll:lPrI tJ.:i. 1L+i)II?:
anr] i u1cr.:.s Ciorie
Sub i l C'11;t. Ict[d G~1Crl lU';�Ir,:i
rMl iY^I'1n ed case Muth'?
and success slories
ub u l Cc"i +lctcd I'.~7g.ai sluvil,�,
tll;'s Juiiidlit^.1Ii.I! 1', Jlic: cctiiip iIi it
ub'nir C~~Jrrl ply of partil_ir aLian
PD. La 1. G,PPC
43iJ\V Rcpur", Folnl'e
i=Ct, Lat,L i['P"_ Llc=li'eLil iao. E.unun arr r a ral','si~ t1.
RcI C ii Rirl s.?; 11.7{O r7ari u jot!
1 rl^, i r, Ir.' tai 1, 1:.- r+l r., 0`�r 1t�' i s P,l Air^
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�
o�I' illr>rnrl C:IJr: ri t i r,tuortq 1_,'r,.i-U3l r1, rulr rytt~re I c'.Jn h' tlt:h C~r:'rt't.
r4'i iIi r:I rU'nrvt r 1 11 1 l.,''234
Activityff+lethods
TIfmalmniu-
f2~~spr~rtsrGle~
Key Do.]
t r3
10LtYjectltrt~ a�glc n,sl ct7< trdina1 OO t 7r11iii1llj Tr'iuinlrg10 Frorrr Oct ihti^+r 1, 011 through sr3 k mbar�30, 2C!1 ertreas itw rarrior,: l ras trn annulration lrrd physical,
livi rf6e'. l~+ttl.,14-funded fiq r?nv5 t.r,ri rltnwr-, sevRi tlle4 nib
i
a f 1bb1cr Irj',r- ncamo population by Asti 1ir+ k"lthx rap lo thr lc* i"tfr,htr r~ri'r Emir ing hp~: trtui~itabs nnd off rirlt tt, o to
gthrt�e n=!ion-spcnsured 1rslnlnrg anri r otlr a Sharing, eilerut'
i�
rP P. rynal lr7ultnrl t1i tw; rnd tlc;tc f' inrilize nos of a:r h1 P'rratirk- fun,lec rciects in the
r. i'lIO1,.n(I I i q Irl.t C,r'ti, ltr r:lliv�o f,-lrtrlr::''s.
7,), Pr;?rllr'itti, r dhllc l;:.f j iiJ r1rovic"Et i;1Cis"i"=aa for Y othv l6:t'air. i n 9 s withlr'1 Iie e'ts"'?o n Eng77tr. N iWtvca,-
ItJ,-,,,11.r r;rct:t,id 13, 1r1, nro`'i scrr'irg tt-a eIiC,ible Icia-incon-me iiudionre. f rp,'rt~i! he�-tdy7ttr� rOr
Sant vilti,il d'Tontof t!lrc_ r4ir 6''G;"1V train igs durintg": the cx!ntroc-,. perinc, 1,-jt'4r tt.c rtr':,
cludo:
a I>]r:nintg' CE termlrtce L':"'%r4"frrol drr,t? C,;:'trl:. as r~)Itr J(7 f ll_lilwlr'"i vrld iir. lr rirron".5, a5 nooc ra
Ibl remcafit c: 1e^lolats'lyers ar.d slsrt-z1 otif r:I�r:p a1tve ill r"i ttvr ri;
ltr;r,lrr. pr lects, regional I-:rllahrorairve''' p-.irtrlers, ar'd other: sar:Itlcr ihd't lit;IlJlr.', la,le+ Ir 1rltr, I It( t'I.
jaudlc'`ilr;, Proido pr_rsr',7allzed ci!I:*eacl' c-, alp r"d r'?:1?rW Rand d i 7n1rnir:lt~1 it
I li'r1ie it t,'. It. Irli rtf,tllm I f:rl I.-;air' ml?; 1"r illi lr;i5 6t1at4ld Iflr`i"�t icI r'tfl?d Cr qtr tal nr?L!rl 5 frarii
I above t tu.,i,7P1ti�r!t:il vl~, rl, t~`.r tl f', +;I L.�I1 t,,il:ir lllri.lr:i C%l: tl'f sr.Joafors rid coprcinalo
le7;ai511 c f-,
Co-cter 1 AV 1-
SeptemLl�r 30,
2012
t lc: nt,At I r t t,
0c cber 1, 2C' 1-
Sac4omber 30,
2012
i,,c:rut.:r 1,
111rt
By No'.emoer 15,
201'i-
Sett-amber +0,
2012
Submit: r rr rrlar>yi c=
PD. t�C response anc
recornmeridalions
s Fcirrn
Submit: 3trrrmary o-*
PD. pa`th' pa io I 1'VS h"'t~yt` R or'l
r-o, CC
Forrrr
Bright. r:nlelrl' o:�
rY ir`~ ttii l1) l L`.';F="."ar h'nP! rI
r'i,I RYI;
Submit: r ai^Ilrlc t:'. tu.nit or
Plan and o,rnmpon* rts,
comp,eter7 t^'ect'criG Aciivity
1Traclt;ing Form i:A,- accndas.
r,atar ils. sLrnmary and grit cal
nnalys.:S. of evaluzljon results
a�;l~r+^u r' 1r,.! C!a.!::;,t t�:C t.'l;ll'V`W. LC"7'C9I~aS.,.i G Mr'cJia ta.r.r~ia,.~ti~r r",:�r i, i l ty;: vtl~; y.,~ ti.~� t. r'. rllat[ ht., t:rraiRra,a^ ai i~ 3 a, L. t.ai:r~in.;a-r trlt I M-n::: si;!3r` i'I' is I-r~�.,r�i
f'1g4� a i talr.r rr` A. aei r`a, t._ I-:;alt et t a r f: rcl Ji- Ic ul r:.^.rr r,.r,ht I oltl r Is:r
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�
o�c,,?iorarl CQwrt. Train' n EX-1 3l1 A rAt: tore) County Hea{<1Ii De p,
Scacri of Afork
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Califarnia Dietetic Asscciaiitr, G.alf-lomia Fr nhonl N'.alrilxiii t,~slfx:�:,"alirv*, tl'4nr;, t;;,o 11y 1fl'saxnt?, of
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ill 1.I.Jiatilti Ei r idr� I w ild.
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purirlci'r. prc+,'i' e ev ft�5e, technical assifaan. fc'uiti t'.rii~rgienlo`nt P:U oi:t frrv^�;tL'�rl'.Kl1ic'rlt~,
IIlr1)rrrrs'3:IJUn on rc rrvs such as Iy~LaiLi`urkmateri.3.s lid':e'Cornnlu'r I0i'Wi51~"r. IIirCJ Lif.:rtal',}"`"y~t'lrlkll
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1 elr ai Lr 11'ri!1~. rn_, n~.:in'.IC'Y h3sl~._s
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ris:~ir1artc`a, u?_ that fu_* hr; ac'iglble Icw-incc-e pc1owl-a1i' i l r r1 li:r; r' Illl'1'IS 171',II'' S'AUhu'I;' ftlr:"r' To
siIpr;l.)rI. thi:s'f.?lu.
al Di velcc. and impl rr,{n: a rapid canirrun iatioria Sy91C:Iri:11u'I Will irrIorni rttcl~lt'I:rr 4-ri.lr+41r'tf Lllill<ir t": irr:d
par;ners of criY:cal and regional inftarmnlienn n"ti rr(:po')rIwiitie's i:u':rocll i:-% laic-t isa;. iy lio r.
1"re k1rteerr: should include variOLtr Cr",P'! llll,l�lllr'tt^$ rr1~ 1'tu Includirt.'1: rsn-ails Ir`.ronic anld'iiob-
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40956-U01
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LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
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2/13/2012-U04
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THE-U07
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AGREEMENTS,-U07
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
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AMENDMENTS-U012
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CONTINUED-U012
FUNDING-U012
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STATE,-U012
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o�Regicr'al & Tra.ning Xhtrli";I ii Monterey M my Health Cle:'i
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
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AUTHORIZE-U07
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THE-U07
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OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
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i fklrl r l atlllr.srli r: llilt5n t).~i~ A'w~itrrk:titi,'�1.YIY2ti. Itr~ i5 s7nd ra`cI c: i a pa t m Bz~_efft. rtsto prx~.r Iiderw atrrti ar, rJ"utiat *".
ph.~ st,Jt I. tM f f:.rnrrlC:t.,;n try Ylir~+rt~l~. h;wrv!.
tllr_ c n and
inccc"rr.a corimimera,iricludlr.~ r updatlnQ will it11 Ala n rtnc a msa
t~rrir nltllr ar-~-1irr~ ipIant r,~ and I:a1t7Wreniergency'fa?d uAteLs at mv?a_ Mg
provide nufri:i~n eidi a:ati0i-r in C.wIFresi.~ c!fii~_t'-~_
times.
1; Esia li.h ar Ir t~ tc:lrkin, rt I+i4n7rI in; rn1 111 lie.1 fl"DAf nded pn:,gram:a 11 al resh tiN;C,
Nla:ian_ ac! B-eakrasI, Lunch, r ar.k, Jnunr: r1,,.7r l+ 7 UC f'SNEP. tild arid Acul: Care'=icod
Program 3p�iny! E, etc 13no ling'; with rt eta ill 7'I tl to 111 IR1rrIiil eIAC'�.-is to C!rc�v!dc nL.tril:trri C!cLtca:l!"'n
and nj!'s ca ac:IviN, prix:^1Lrttori is the e!Iglole lL I"II.I. e all iC, II
i ry!"I alp-3t 1711 JI tu iri!; 1,ltht'IF*115rr)JC.r,I, 11 t`'sh canners. ant;-h4+nger ard food aec 1rity
r7 t'1"4"C:f::3tt?~: o al C:; ll rCr.l'i III Y:=.-r' r11Ydj L?arltrit.5. jrir:f +150.'.5, and others nerving the elig?hip. li:ywa'-incorne
pc,')IJI:a;ior, ul y a1;n 111x r xlr:l,tiiit r til,IttG_ 1 i el! v:rt can P an try tiler or strengthen 1hi quality of nulrlion
F!Z!. 1l n of Cal r�5�'r r;i'Ir;t?5 Intl h~ r ri"I?:`.I r1 I:r'if' cisir t?Ulion E�Ites. T-ie plan E-!ICIi!j Int''ICtr
I'fit?f1C311t 3t71r t14:"Il: tr nl J.11t It IIIC:�t,'.rrrl CIS.?clIra I{ jffJfe Ily the t'/oo of eo,icaricr 0ferec 1Eelt-g.I"�Id�rd
Ino`t'icIJal 41.x, S t7d> I tt:'. I a1ic Vin r11U'rr" i_f t`{ c ic:i:ien ever.l' f�`ir P_aon L.a is L a m11ntrliu- of Gsix
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�f'l_egio~l+l C:rlC:vii1 f; iIiir?, I_,rI EI[.IT A,
A IIVi1y'irrt1fliort:y
Tirrtulr;i!nn
Ro tnrarlr.ihI['
Sthfl
rvlt sere C�at:ncy' ear, 1:,. r:,l
Kay Deliverables
abjectly G Reogllon it Cry rrlim tiorl; & Training PhysIear r,:liv i Training and Technical A: list rbce furl ettito'* Birtr-ers: From Oc�Ctik:: r 1. 20111 1111 aa,,j 3+ 3piumboi
f 1rti r+1'dti'cr tIii u� lit + and uantj at h Y I i'.'jk' ir'tc� 1r it d tifif~ nl ltriticiri 1u tXii by I nin rrin7r!tirl r, It itlr lfrt ON +ti+. + Ya@in skit-b sadd traj iings:
a s7 r P q 1 q,
ciandiiciin 8'set ionaf support rriirii 1rq jrna~ry, 60 pre--cntatior,;s.; t.c!uctinc one I'P'rfnk-,11 rif.t-'it's iri'te4lralloil Ri?: r� iic' 0I1ir' case; aryd providing I 9nicel assi!.tan':� to 100
L,6i t rik of the l'dcrt'it'rirh-f. ndrd prt'Jjelr1~iiI Litt- rcjic i:
1:1 Plan Ini, iti;, i,~ll 1,i 1, nli uva'ua:e iri e cn.r_ r,w;;;Li trir'ninrq!s cc nt-fJncec projeci--:i
aiidk.'` t~:]rTl ri r t,'r vr' jl It'r c iib e iv\'-In' orn tar' iI on t7,4'stlr a pi I'}'S1 3 IwI:j riesources.
p!, t,ljr_ hest- r apprr._cnr_s I': oilt�,,Iic Ii cir integrate riigr-q-jaltiy
ph}'sjcnl W'!j;yr Ir1r exIM nJ iutlib Jr educa:jon progaim n su N P H I u:rsc:1 tr_aini irt~� an an icipated tc'
last t vo ro;!ur i to ri riirtii iii of 15 r4iriirapana. Ira lrril'r rll.r:rl I l,: all:i t'I_r. U.ro ir5r!_trca
ci, r.,h as Oar,,.:' V v x--,, ip";r as welt as hiuIit ghiing Me 1, mu e a i.pl N fri i.lflil tr'i't'':iii;:3t
fir.'�t't'r"~'rr Tr:�oiii')l. t::!r Qn for r r 9r'i i!Ilij, 116 11a1 rr_i 5 t.?urr:.e as thc;y he Cime,
iaiIaaIe Tritnir::a Tln'; No odr is other fr+aclur, ap.:n:r.:?;'J I'1r t te!'n-Jri l:`Flti`alt,_a ac.t!a'^a:r re5c.Jrca5
easel on r tilts ottt",ed N eriI
r CIC1 i;" III t'iiin,r!, s nd iresentador a p Ci is i!r1 t:'1'r f a(:.t sitr i' C:"rnlcal s glance to Not nr};-
jfurdea p O Ir iI1l iiiid,r r p,a nera hat sets'e the NOW Ir:: Iiicc-' o target aidien:ra. taw,ing epic
i houla Le t 11 ir thr 1;1r IL'al'? F1Cir' from r+'~Aeiir 1 r,lt rr l+:ti rrl' L in' trip pr:ij c1a as well as partners
i-ind s niuOi tr a F F' pt"v'a.ical ac�:i'.itvr rearii r~e 11-< x:1111 eu 41r*nre teaser, pub1iv t^eai1l'.
a;~prc^!er.tles
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r;.:blic ieo;1h aripoaches:ci Ili Ilr:wo Ma I r'r, tr l1r_iLon at ph'y' I_a a::�fl4'i:jr W o e:4'.siir+g
a n d ov ts rgetrry the etigi,M Kate IJi.'_ e CuWulaik:ri The I
t:!aics and pr'srr'ii tu l soul ado'uss iderlliiarl lr'.ajning and iiNY Iiiolfr:" Ld' ner_'cti. i�LIr;~+.6=1:;;1{ fLndeeed
prc':ecta and r+itij!~,ii:al pai'tr criu dimuldi Qum prortl.rer'dy Iii I,I" i Ir i;o. The cr'aeri is c:n:icip ted too 1as! 7t11:,,
rrllnir1iL.n' of I-ii- r aunt; rare; trim}' no a'3 Sired in crr',pr' ic' wh'i't to C'q llr''_'d Promising Practice_
Ex:'-tance t a I'iii'4 II n;.!r d r. Itinr rni'nni, ni"f I,t itril urn' rmeei in r'r rlrr'= r iw
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I 11,el r_ C il
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�I I a 7 al t':iirr, i t'r.,t nirl!t
/kci ivitx''IUl cth[t't:is
T iii t aam',e
id Sh~Car1~ rttlr!
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al1f, 1r Ire 11w1 f?nr} 111j1rl'.'ior Ccucatlcr'I 6621,'7 MOM t-J['::i c on he 3tPst p'hi�r� al ft:hvit}' fesoarch
are un.1:'[m r rj`t: r 11 1:;'hrr 11
are al IC. Sr.JUiGt7 raGt7i 1 En'-.".1Cfi1n r�.y Pt I ilf;tx aJsl'7 of rH'A'ti�.ti"PC1 pr i'f I i(,:I 171 +'.`.1 4111-I'U
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Winton L`IJi i:.1u;?!j'.C tl` Ilfrlnt c d~ls 1t rlarlf st,r:s 7!( r.;'I[ h'luln~
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p and U r r rl I ti F t, I Iu[t'` t1 I i'1ri
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�l'~ e fal r.i f' ri I f tl~lI C: I I;II--1I1!]
A.ciiwdlWMi Ihads
X IIEl!T,
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derrlr ic,. ratter on iriter.'ertlcrls, y M lpl l'<; otllr w we mCiion. Tr til nIt c e II:11.: d rrll:llldl' IFtl,iff?t_ll I tfi, i; t11111r,%: fir'
l?:IC;t1 VI:111�c, p'ope', trr., a d Sa e Q n, Il1lycli::;;tl I0wI:'j remora lc'^rC1a".1c- nn m:.Jiq,., n':1 cit111,r
I+:i,Ir',, 4I r ttrlll hroLlgt- ccllabor3tfr ru y fill II"11( alr3 rfG~l'U'i l'3 it managers.
Tirml;lri ii
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Phi, I:,FJi�ILIILY I'I I'. rr P AF AM irl, W r'hi l.:I-., C: rlrrr,J7lyy. I CA h r l r- r
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Ccmm Collabcr & Er;tage Win:
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wUIff Ivey Deliverables
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O1.itaciiw'cy 0 Community Cola bursU L1n & Eligriy:,grit,:rll ftglan~jl Collaborative: Fr i October 1, 201:11 thrraugn Sehlrl mh�=r::au, 2042, m.1 ii11;l.e1.`51n(11cYr;,ilitK)l+, a i5rt:.'ElU f, VC,
Rr�, sfs3na1 Cr horative 1c+pron;ote. res^curre Fhanirltry,::tinoolj rtutlition,rood securi y, and physical ac1ivit y psnf'essioi:il_k Sammg thn rl ila�c lr,~ua':irlr rrri u uI ulitr! r�rtllr tlcri
i, IPilth ick.xs and r.:.rxir f;niltitJrl of s rvices, grid ica='litlN- arks al,i alt. ru I L":~flxmll 114th-iticrn and physical ar;iir"'ity: issues af7eczinQ he eligtblr-: it_id�'-income Pali. kii[k iii,
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BIB]
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LI21329-U03
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
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2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
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BEHALF-U07
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STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
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DESIGNATED-U012
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o� CO.! abc E'it1 mvril IX 1 1IT ry r,a1as^1ere;,r' CM 14 hen 0 Opp,
Scare cv fork: 1� 022-s
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Key Deliverables
I i r I jt r'i{ri(ion education Initiatives: From Octrber 1'� 21011 1t-rL~tJar11i t5ri':1ember' 1], 2:012, throucgh,the Collaborative,
lt e
fie Rt.'ng nail Ntyr'i i
ngeon the eligible Imv-tnc. n)6 prN u! tlcin in r w"
Ir'ir 1hr'cwuclh life cxt l?iirx1 of at least one. NulndiL i tdwAlkirl 111itijilivra�
1 Bui ding upon the drat. iic In M Jnr.: p j xsu ur d L x. fUg er"for=_., Reciicr.-al Cal alaoraa r, iiir~- Iti,r:;N'sdil
lr COn ftalionviilh eljiblr'. IL.',+r-1r'r.^l.lllt? 11',''l11e-~~l~I"I!;"cl;lwlla',~�.?n 4.!mLrS, irnplenmer;1 a-. lea q-,:irw r:'?1t'r:�jIc
NIJ rle.IDn Ecucatlun Inltiabi 4E1J a-, del r}f c, a!1i1 LIosu'ibod in he tru,,,io:'7W Ne;w:71,t: I:i:tl:llh.hf t 7; aht'1us'I
The l riit'at do rnu'E�i be supported lilt 71I'll Il,1 ii.al.lur. F iln Lo assist: Ir, pramotf ng 3 Wafll emtin1 3rd
rc-_shzHti"an. Regional Nuth-,ler: Ec.`ijc-l:il::-i In 1 vilve" s may builrJ Luaar a.nd c- enhance lAar +ca"F' a3i1�Ipgiq n
ir'd z'rcr'am raWc; y cJDmrrtlt:rie a;.11wiri 1i1tt1 I`411:t14t".ltd;- funded prolectE ar:d efforts, i3ndw carl-lt'eicn
ilr"Lj iug"elmaGt:.ri;iE�=_ 35,'ie a:7 CIf.rtipiorl 11nivI's, U:.U rt'iC+''al, Er�d hLlnjrrLy'2t,',:J. 1%le'.W inrli I.:vesRini''
t;{ r:Lfi:sLl+{;"ai uppcrurii1ieEanME.
1 J�Jtl:r!1;ati.: jll Inr viic" i nod Sr'j[r1 the NEl(s5. Ther^i nl:k' htar: tiii me riot II 5d to: cieziting a,11
I1k.31'.e C rirY1rY1:.!rrll til.,ri PI i and 1i17ICl1'1C. deter-mli'.g FL' ii,ii.li:, c mL ri; c c I t,l:l1 J dill.a. pliinn.n
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Corm n Motor & ngagenierrl r:?'.I fl`7IT A.
t~,rtivityriMt~ Jio s
T nlcerr:eme
Keys Dc+liv'erabW
Objective- 11 C. 4011191rkliy C(119bOrta9k rii B Engagement Mini-Grants: Fran WOW t AOI1 tlij I~';t1:ar_y t ititJr r 0, 2012, Niu Rv icjal P'!c;�d;vcvk w'ill adrt $niitera mini
gran s pro; rar11 I slr S~,I:t a I;If,~rltar111ir~ fnr aj.1. raF rislte ci'rnmunity agencir-_,.1r'rf I:, srf-i l e'e s c"fi itle." ill st.l r t~,ar1 of t t w CoIlatib w_ 1r� k e~ e s Ndc~ir,il_ n
1 I. esat c n Edrilcatulra
nt.iaii es tint 4w c 0anal,Jrlmel" Fn1fr /yew i l tlt L.i`Lirrii.a.
IL`s I?rpillnt-. l"ti r isc.,awc coring it� L. fre.iird tii Y-Pr';lll; Iirn!Ir;.4'ii 71r.
pp.i tI.S11:, irr s~titall,I hat pow du 1r_ c than; cr eqn! 10 a DC D ft."' z!J' lu II; Or" I riil;l'lrtp r;r;;.i ilf';)n Ord LIiWsical ls'iit_y' pronlo.ic., iip:i&r: r Ilkt~lr;: Irvj' t'lr:nr is Ir1r.rlr'~:
voithi trip. rr.c:u11 MII^ lrcir I mod WPM Pyrirtwc:i:1; pdorltles_ Regic.i I r3.,aL:lr' it"~'r 1�,trrI ii I'�,4tdl_dllf;r=
nl:i3:1'eps, a 1 wnr:Illllr.'�.' f; iVti't:r halt 1::tjrns arrf ad!-ere C Ls;:A gIJIav i os, t itii W t71E'�"It
appIic IcnfI_ r:ao'ea, aril 7pt:c,'Ydi.r,:ar1 Fulcaspa. imiri-gr'in:.applic3rir::nrn-lire.
1 aflr;f r nur:...lh~,tt I'r.~i i tti:ar'I r:r_.CL tlt'q Lei-?. cic'i I G;�'i;3kc~I i;Y4~r nu'~tlillr E Siii; r.[I'"i.i~i iI Elcaf
F-':7u Ui I'i i i1! I1I~ 1d;it}C,Iu:}� ti co iflict cf In:or0 d I.i r� iiienlb. rr of ti, rr cr, cip I'i inq rr'rr''la':J.; + Iy
n at t Tan 3tp I lie re.rtA V It rrWl,eij
71; I'rr ti::'I! it 911l Crdna... sr'f and LlAget'ui-diri nai'!'Ii LE! q into rrrfr'LA~.i K Ioi111 r.1fW_ al 1f';.71Ci'll�h
111x'� mi';t3^W r ii rc:.111 Wr'oslcc to en sore 3n..._Rt'aL'ilil pror Ii fY^,tillslt q tlll i1r 111:.;wdrr�A.
f Is trllrnr-ic., ihl:3::1 r 1. s r f.,,irr r fri:,m rnir bran:,atlla'.iret'ir 3
Regnnc? Ca abuatr- or t g inc cc l w6 ri3 x' hI'_1I I"Icrn ciftur ccmPIL?dCn Of' heir prc.j ci=
5 Ono mod 1�,:,1 I1r1.:':)i1 mint L,d,�... t4'.C prt.)Azc d imp,. Casirsr's and u.Iie AW lL,it.il'; d ow E:r n11 U'r.!;+.,i:x
xlev II':iwv 1 ri'll1 L1rr ie: us,
J nuR y 1-
Apr 30
201
is L;nkrlrr 1 AD I
Sef`le i-be' t.:;i
231
0bn'r 1 201'
fir; Fpp~nti~lb~r
Stxff
PJ,
PD I C
PD
2 71'2
I
Sut t lit g sn: ppiica:ic nl
G n Fie a ie!aa 1esn i
sig t lic ce�-I fi:eIions. rlr q ne=i
cu f
i.t lnrr r 1
fur'dinr. n- t1:,
1l 1 1:!4
Si. brni-.
ATF to L Luectnle re; i-e 1 # i,"
a i!.:^ C G'T:Cf I t. i of ii.�. r i� I: vr...,
Ct1t:I':1 I s n"1141 7rr
rr,?' v7 +,'_,... L;�~_ i_-t,:ad r_la,^_.r: vrrr r-~'r
10 r z^'r- r., E: h I:, rx:;l G I r ar c.,
A
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Comm l r.':1br v t 1 Ifa,zr,,L'n: EX!-E f A
A"I.C1lwetyW4rthods
Tiaanifralno
Raapot,nsible
Staff
lrtiit jr y C;ul�nt'; I bath DeO
11 10234
Key L7a3FIx'i rt llilr:w
O'?i7M131ua1 12 Comr11111nit' C'otfabi+raticn & Ei gaaroIo'rant t usines.s Ganneudaivs: From October 1, 2011,11 lllr� u!Dll F~tr L4"�1111 r' 30, 2012, anh. nce cearan`ections bebraelen
chl9 and ror niunir!, y:iuth cirg nii atiur t, r iilrti ip;fi"lg'in the Cf.ii,*; rr'.q f rwr J^'.i I'r1Lf! f.,~artl 1"! i' urnd itan cir'nrritanity by recruiting a m nimurn of 11 parfn rs fmriii ihr:
i 4r i.ae community to provide in-land ria4p':'r'1:10 purlicipatinpp schools 3rd konli`nl.irut"y': i{ou4i ors tiri4waA uns-
1) WWI connect ons ne rl tL pw g ac'o IO, c.nr1l111Lanita r it'.I r;' 61 Ie'li illltr ar rf are
I Y._ it o sses i x I Iudiny gr'L�I shine Yr 1 11ro iluc If idl. r1ra' JL E te. 1 I It 1( m j I Ir ltirl r ii PL1rs.:snc
li.i'uhr rs rwC'ri Aairh i#'� h ei I I^!; irrl +11lrlr li for pr'dl. f J Ig IL r'. +;t(G I YI t lll' r1L:s T um
g+g
I_i:'Inc�:-ses t:' erck'Ice rJinx11er. rr.I ir,ru- ser'iicesi cndui::t ril'i"s, 1 Irl,r r1+j I� I,r?:,'. adepi a 9 9 il11!.11111!,; 1.,."'l,l r'.It t 1.If I-G!llc
h 1 it o 1c. Inform Wool sne cem Jilisy you!h o aniza icn T& he oM"Io on its ilt<:t L rl'J Cict'b'_'r 1. 2 iI i X, 1 r
is f=rsure fo111:ua I�1rr'lJ l'f nc^ity *hr''cald be g1 er to criY" 1'.llill~ olfia 1 i f-'nIxx- ti,-optemonr'u0, f'f't"
F'i:$iYllr a,:liL'+�.)i�: and llrvic' Partner comm Jnrq!rll it i lstyl:.tniza lone Mh lc+nal h. IJ.Fth tt e nd, f il'r, fri 2'112 On file: tr,ar`k ca
ecruniilc t' Js 11r"�:c1: Iri zorTir- ini:ies l't'It'i a 3rae nu*iil1er'r)I'r;ti lrticlpc';ti'liil schools ari'ic' cw.Jlr, L3te ilCi+:ll'14VIk~t^ aer-ei'I: d?la'I? 1
fq._ It.::r!Iioru 1:.e,ll;iyallr�ltrt lx~'tlt' cit'tir Rfa4~;,1~� Wool? l;y FI yolk Conner- lh husinemes
I-aniIved in Ine r' o l;.,i i, I rL ain if +:pt.:�`ble. 1'1ei:Ill Ill: t' iii111 l'aitr-k t.+JSinoEs prrtne.`E. with tn9no. y:-)U
irete5andi,ir:3rirlirr'liltl"� li.i:r"cJt~'ILln:lem~nC.
Objective 13 Comm.tir'trtyl ChiMzyboratftin & Eng!ageeaaant-PNuyrl,i a tl Activity Partnerships: From r_ 1ober 112011 I:tirc Jytl I r;ll ai='Im,- 0, 2012, dovolop and r ain ain
r ya r 2 a r I'll rr l'.I'Y r";Y1t"?' u-- I ms
ptly-+il l 14.t,.I~1tr i uiYtll~1O ips kh public and prtti7lt�,l IIrU rAi.h,n ine region, e.:ippar, I:rLL J g~,Jl to +,Y i1~.~11. Fallri I YCti,il} intaghatiora end pw.ehml'Stion for N
Y YI'Ii F. IIy1ill.ll aKa.i'riL�y' I saurr~'e onlir daze bases.,
i
rr inn-titi'k r;.:;-(i id Liv li w-1'. lrcr. t�:: of reyierial Iii IC SI 4 1l It rLls'rLl ICes by c,: rafit,titirliq uubrmr:a iC+ I., to I a sK2
1) Develop and in:3:Asiln 4111,: i;)=F_tv41'ypar;nerE,hip5iwith p.ih*:;;=) pr vain onat'es in he rroicr.(at.,
Icra; par}:: and ctrcrr-al af) I; ItS c I u-'I-r;':' itphy mal sctiiiI fq;lr i,�iii:arFort tcE.lms, t"e h ind
fines=_ gyres, and l.nivai lr I l i t i rn'vo!1ir;: Jopw 1'rer1-G-,1 to DrO'vale i r L lr oJu_s31+c'n rr!smirces a.na
expcr.ISe to the region la iil.:'lihi'k h?. I-'tt;`.,lr._;ll:'rl cf ptt'y'Sic. 111+I r l,!'^' 4 lll irlu r41i.'it,cn l.dllcoac'i
serving the eligible
Or'c ier 1 I.:' 1.
Sepl.ember Jr
2JI2
PA9
ubrnit Wing f porn':'rs me
riirrirrll;7ry Cll
WO R ti I'l] r o rd O'w':' r ti port
owl,,
2:I Ad1arcY nd k?'J'.':1?'"k l, tiry`',Iii r1Y i3f;l;a'it n'nr'.ll C�.rGi111:Ag +'J Cio'Ii'ii Iflr' N. n[':Il or rlp i i--ta"-eSS and
Nc"I5. f rof^' 4.arla. 1ii.r,?k lr, I Ca J.rna.:.ci' e i.jnl iJion, on if Ir';ir.ral Ie.e_. Exsrnpieduties
inrlu:? p't7mc 1i 1e Ft.: ll'utl^a' it t-: ey, ill, 5'r.u w iVl I r'.I f ra:'-'IrIL.I_r maic'ials rIa'ie v,
d rriei inr and event all P.c'.rJ;11"C":Y r.;Jrcinatrnn
Ira 1 r 1 III'-I
2012
711w111'gt. atlf' dr'r id dL.i'CGIG'_'
151:IlwI 1<,I, +lir. I lYtrl;
I'I"':-
jLr.q, it I'li. L.rl r), l RI rc t0 s I r' t f1. r.r. Il; I'- 1., L:_,.
i. 7Phlt. P A. nrii I" He rl-i... Ir. no t i' 1 lli WW-
we
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�irw,f L Ltil s, e"ga +. Inr.,.r^i H1 B T A
dkct ltyJMrtlhi is
I,' I'ir;li:ir_.t': it rkvG Califcrlllil +c`.$I I: L,l.!rnr*=;Irll:l+?5 trairtin lrlsq".sill is ttnl;a c
r'+'17hVl3te'k's+1th r� icr nl niiy %Il nc.1 v l'p' nirl.r.3rs 1c. siintIIII
frlr'l'_,poc-c-s catians. E1C_ th 1t;!,II". 1?Ltrcion.I e lc the Ir Irllc target nucler k. 1.}�:j5;hrly;l
ihv!q r,__,l l ii's'It!~ crltne iIIj 1Y.1 sitci, r-P,errri::t:r, on lY*r 1-ut''+ Move fed& i i'w'eLs'.1!= ag
N,al omi' dlilc Federation, kiLc! nn u u4;) I'1o Go-.1_ nc.'`s l�i:'.jnrr:Il or /'h't t,,7u1 f=:ir: ss anc Spcls,
i.Ca'r t! Ir't5 1.1clll+?Il!~+3 44e~51'.e I'Y't. d;r' If-0 +IJllr 1,r",;i t,r du I7u.rt cf t'iE+ r'tngjt''i c
jI,FJi� ds b1ty of hc:
i- ire tijljr YI divides nc Il'Ie lli! +.'i;)r~y' Lr_Yillt:+ly
1
Timefra.met
C(`.CDrr 1,21311-.
zl pttomt!esr U
012
77)1
rde.spalait0 311,
5t-0 ff
P. A Ct:
1 0:_3'1
Key L1a?Il'.'ro-r.Ad(ui,
C jhrrii'. List of poricipal atg Goff
n t1 L:I'r: Rr pon1 Form)
7,_�hmiC u,7--orb +f
suk rono tc' orihr're
l +t,at:liiscs nclu' Inc C:;3,
till bur t.jorrit!c=J am oori c;
Iirinury+
1, l3";' r:",r, art rn;n1'r
On file f)' r;;+r:crtic
si,bmissicns
Sbjecily 14 Community Collaboration & Fnqacjomatrt-Ctri'drJ'rer?'a,; t a r11eP4I, f r- raafatargir Fh'ato's' ilck9=1rw j, 1: I Will r t tt,'or 1, 21111 1 1 IrciylY al,t nr r l 3t:;', 2012,,
cc,ndkrcl one FI r qra1.0tr,. rc.~ y i Irri_,.' as p t: tJYis'd rJI I 3 wr r r,7t1 re!%.
c r, of thl rcir~, I~-!��n~;,+r rl.~,tn;~'y k~ni~r,_;_mer�,1. 1 d ncltf.,.,, ir. Irr),y,udr~~ o1lgii;'Ic Iryaa-lncr'll. 21-1!:a 11 i;~ dnlr_'rul's.E
t f?fren r;, rl.tikwil,f_:ri': i], t':ld 3t 1tt1~'F5 11t iI tl:l1'iftaarl cirri t1':'SIC~i 3' I':I"I rr Ifted rR, V` i rrY I ni 7 em 7t�:r: Ilr'"c r, r r, r�
p 5 t t t u v lnl, L fzdc t tr 71 1! d.4 at_ fc
hreafihv jr,rje
F'�iota'. ic:E r' t rl a.lt I 1rc':I!? cj ry 1, 1- +1',il tli Glllirirr rr r,3t,L? or) iuiiA:311._r.' tr+!11 il`
iil;i,lr':a4~S i-~L rt'/;nr 17.1,a,r'''~.�~3lfrlt' i.:7Yl 1711{ nq n.l`1r, r"!ay)f1,11 t!' e:
the
i Will jr+~ rid identjfyjr, d jl;:wr: i'I
I I'lllr; n t ariIClFlcl'f Y,Inii':J!Jlrli; r hli"r, cir'd'rdeo c,:niponer j, irny':Jir:jj irnin'nq to idtdtt leorjer.s IV,, i11f'.
1I I Its, 4 EltiDr cf ti f? t�17YIr e'1 nerr:r pt t id2'~1 fi':S ILirJrr7ur'nr T r'l, gi t:1 K.1` L r.ditlrlq t7171'91tn.11Y17f
17,'!''lrr,.f r. ttf h I`^ritoj tlr:n broil:':!:, r ICrli] tr3i;II'lf:',11 CI{::Ii LIC'd3f io Lln 1 3 prominent
7!Yl!lt!,!r: y o_oton to, c tolay r�t0!rf rlr?nC^''ia`.in+,' edi t.r f.i;)c7) Irnc In 3'I+_ cc aI etl 1 f-or 1'-
i_ic.:ubcr 1 201
k1')t"he i dl C r'rri; Ac, n.!r Y tn I I 11',l_ t 1 I,~t::r;eY
r". f r'',tcijona I'r'k=. ci
r Ell Yd'=+rl`.;irf up iii iir, lilt c.-oc'[irs1 it-'c,owint i roii h 1':i
xeitlr, Fr n inin'. rr'r f f,tt~'k'ni;",li i!it tFf,�ti +! rc,;'r+rl.rt;7`'i, ro�? r!itll r::lrnrrn.lnl'y r?._nIJ k Sii'uir:fI cir
21-
a i G r Fir;al:Il'}' fuG'a %d riii} IY:a! IZi`y hrr:'Llg htta ligi rt h%I1I1 tdn'r:r r r l_1'rtt yr 31]
IIIum11� ut 13ft 1::!'i uice prt I�lf:nrn rr?;.t n"Ylicf c t:-IC: re tic-,,;)I Fait"rl",ir: t f rt 7Lnr Inida:i':e?.
r1r'i'L� It i+ YI t' t it l
orI age fle'tl t is ar r': i,-i lk tall1 el.tii i'I4 I I:. tf!:;atrts tL11''.t!?if�. u:1
R:�'l r 4 +71 Y'_ 4L.!r1.: it j I� i t 11111i_~ illy f.r r,".: no f1.r11t:pnatn
p
a rinr, c ii`nl"r7;(tn, lir: o::ip ic'7'Jf
ii' GfCr. a� tlil::il,i'all l!
E;'ectror cr::'iftt ri'
dri dr' c F'-...:os 3ndr
narra:i',e3. Sn1;c'I
i1t1C1 ducu^!im-inc the LIrOrcl
p! It.'. r': b, r rct' r' v: ccoi' cf
re,L-Ir q lli: r:' I Ircr_7e and
dl r illrlrn'.ty cf res=_`its
1.Jsna n!u, tl trrrl; c:oFllf.s.
4�J t.'1_i 4. F._J i l il... t r+l L:!: I I_[::i vJ" 7: i.~.1f:'.4-:'Iti1,I t'~
r i t',~i7l:r 1'� kr.~!y r'-s.', c., Z i lj,,...4r jrr; yr. t'1 i,l;y t:. 1i'a:.o-;
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�t;4~nv1; r.-.i;lt.:cyr i rty:7;7erlu-nl
A,ctivityt'rtteR;hods
irni fraInc.
Responsible
Staff
Key Detiverab1<_ s
ohiecfl'rle 15 Corrirta411111y QrAl,,taboraliun & Engagement Latino Health Po aretiess Mont By SeWen,t'er2U, 2012, engage et_'�aibse law-irlcemeLetino residents,
r;~rt wunte: rlw~l,ll<7 v, 1lu 1111' r On(: 6"'11ua`lun t}r lOadd. s to dur~tifj and, pr'tamole scTlutions to in,,rea e the awailabilily of heal.hy foad~�' and cppccitrnitiei for p�'i{si~ I auts'u'it'g in
ali'�mule ire!+,-ili~~ m l.:~Cinca cr,t'1�Irtlliclltsry. Via'` r t:in lue1ir.y. ii L Dino 1�loal�-h jArarere=_.s onth 1'LHAMi1 consl_imer dT cwotmerYtf`nr im as'iart of the La-Arlo Camp n' art LFIAA i`s a
ut'nth-long t11r:tG�i+tdi effort rlurlrtl S:I-t,,tc n et 111o r4lou aili:gns,kvit'7ldat anal liepanic Herita Wont. All b,feAtect r-funded projecit are encouraged to participate w'hcrre
app'. il hle. I Ir:I li nin:rkettnrl + ttCI1tt5- and f d, tlllr ito,1 aVll'1a o place in IccSw-inc orite c mml'tl.lni ie acrot s the X1a1e to lLrdnq fun and educatlryn l a.^ttv1ies a ericour age
r_+ryrlsurnerP. in ri;ake fte;ilihy 1r:tltij: H'4ii4i::t r'iiorrly. to t c1:: rrpIurrier1 t'.- L.FIAirrl, and where a'v'ailable., re' ions will partner with Biriation-ni 1 eaiF ti^.'e h events to react-, ever
more eliglible Ic?ir,incrmie Uaiinotr ilr c, rlibninn,~
tv'il' her t f'It, 1�'i~llrll_li.li�:,trI 1 Isur Curtin 1iee and C'.lr5:snlt?If i.rtlta Iii tC� Il 1?tl 11{ raie ies and to
u�i.'r.IL.;S...: ta. n'ury 1t1,.'r�r f,lcll lest t_ djr,I hc.a.It71@ tr^ rriijrfies f'.-eli!i,:le lw-in':orrte Latino farnOes.
j2,, E.ducA-e corrlml tits' residents sid eaders or the idCl'tlil'IL?il AM IIW9 Y i..itlo r1 tll j-1;I 111.1 tir.'.Jurt for
ornc inq and Imp-ernen int; the rate'~'Fs.
pi
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�o�Vedic, Rnd Piblic uliricns I;,k:l II�:d" 1,
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icc!pt3 iii J'i'(irIt 1 1022
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exposure. 41ablish credIaility, and hL id Ma MO r alr ri&� IilL Ioi nuirtion ectucaiion, physical
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
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MOCO HD EXECUTED AGREEMENT|Eo�o�a1" 3 zinc Puhl c F,ela1ic'ns. X IIm l 1',. tiw9�:1n~ef~! GIJr`:Y 7'.:3':k' fTl::
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Key Deliverables
e:1 s' i1 yrTel+tttlctclr WT
O1jt> ti'utx 11 ft'k dia & Public RoI 1tionS Liaison: From 0,&Ohr'x 1, 2011 11".m ugl3 Sep-lerrtber 2.0, 2012, the r~ik?nr,'' r',fFJ'us'erk will seine as Morita, liaison
with te): Nl[stW4"uriLl and PJ[:t441tttk,-Furlde41 par1n rs in tha regir,rl Y7ft~r1''f tlnci r:i,r,7ml lrir:atir;rn nnrf cln;lnt 6r 1 n for r,/0iorn 1 nmedia & cl public Telstiona'nvent
and Ctpporturlilies.
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tI11)r1 L'ti_ Ili'ait'1 AMC G_tur c1 the rsn"Imli-:iI ar.d to prorri tlnp nt' iIthir tln;iit71:. i ve
II'ilfuj IfMc4fl!J t.'UrrlrnI'tlt'r inu'rrlbira Examc'lc! may ncltj' r-.' Moms E-acF, Teachers,
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�mo i i i{nc:' Puklfl E,'<, I.pIL;IT A
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aEply m cr e 11 in about r,. gr n31 n i,i r_. ua._~I media a":1lk~l.IF_
C h lmornns fir Clunge web sc: i niml 1u11 0" I!lirw iirr,o dur ng the i_ontrac' year. Ssirh
inform Ann migr-:t he in the ic'.^n of rl C F r M' alli"fit., resciarses 1ci cc!nsumer inquiries, r G:her
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tiflhi' ilti;ailt"j Um r i:tra:i year). Spokespeople shoulo har:e 1 IriO crl t`r ise in rrticnl,
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�E'r.HII IV on c1 Cc'u-.l',~ I-�raiD'-r:-,
LINK Ord FOAL R daticns Scope of wmkW-102M
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rld:ct Clr 4i.'+cnl cr b half tf1 ie F;Gciin nl'.JM attend re ev fttiri-{.^.ersc r Intl gs.:7r +acillarlle.,
Each F:erdo_m should plan or nininiu of 41e,pea;,Ie to participate in f 1 fcdlrl'r~i g
cr,l.ut:v a sche+~ulera r,31r InCz as r&e.',~-11':c the t e~gt+'n' 011'.6 hr'i t; 1110,11 r;"irling r,C.rrirlr, I'
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�1AC--lia ai-l ICU+:; it a:. l 1t15., EX 12,1r A
c:(;r�on ref War'A
CRY
cfiul! rr~1~t
Y flctds Tinir.:frmrnl:
Staff My DiAivvmWe
O1)j6c:tivi20 Media & Public i elatfuns P'4Th1 c F"Cre8ta114>t1 r: F irirrl...Ir,tlr^r 2011 ih t:tiyh Snpicrnbei 30, 2012, the R ItY}.I?r7rl. divwc:rk vAt provlaf: arg11in
II ershfp and cc* +rdinat`on of reqiar~~widd iii 1hli rrl t1ms fbi' ever�7ts End other pro9�,arn-fii lsi d actin. ities to hose maxim a' su port and. puhL.r e o!,ti to ssue
1act;i'nq rltltrnfion du iit)rl,yphr' ical I:I tivity r orriraiic'n, anc fi.cld ssecur.1'' anionq eligible lr w-ir1};;r, m INrti Jr r71 +w~a itill!,l n i a71ourriuin IJf 500 000 i:1} 1 000,01+111
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rl' a5ea 1E?di3 aWori ptri i ffu I=1C IfY 1, r 11 Irlr tl 1 rr tc"i and aIe'id r nI i3,:e.' on a r-.rtl
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n grr,'rrt., r 2 r)1 P D, G 1 l r Itc- Ir l Mel + i 1 tl il.tt~lX U lJc':f L+art+ Cr^a in the region illt as tpfrltirlal~'-`, Il{'lll 91.?:"Illlr A
f,.incfF.d t, i1 I,i n ite ita[gcii'i WE au.r_ach should ircuderwrll eml rror.ik:r_1 nledW, Iltili. r On RT: rr f.:.+ v'craaG
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t. es. This may Ch ih'1 t. Ift l1J1 rrlr.dio.c':nd-,'C.il:� hg a spc+kespersiin tiler is mur 3cdkr
dewJ opir,.q edia partni-lr--t, p Li lt flue Gttllc',� a_1'v:'rk_f'. nde'd proiectE, win the reci,hn in
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�r' t1 a G1lu.1 Poblic Fcla:lc'c h 311I3IT
A h r.r'lwCy County Weak I:.
t a i t r d Vklni k 01 1-1 c2a1
AetiullylMaihuds
lio
4Ybl Fr-in Fr'it:err:J`k'r;fagtu Fvst;ttiray;t
dI, i~llrSl'.IrF?~7'Pl'i:ivt:rP'j1.'Ga1;11p.r nnI'oivWrLJprYour 1.i!I"!rl'IIrii_hra:vn,teI,.lune,',
e) t?prl 111."1. rri'c'lcliit evenrr 4 Ir: t:lMDI`c'.tire padnt't r stich as bul n!al I=rnil'en I. tic:Tt"ink Your
ZHnk i PK:i11I events ar_'aW:lit n,:. tilt ough_ut t'-le ge ir;, 10.1t4Llr:.:11 Canned FnQ:J f0cn1li
ahn. arri}, National Scho I Rre ih"ciu At ck fat3n.h); h'J 11ional Nutrition r1' c'lr'1 fM;: il;i fbIiC
He mm tir'me,I:: til'e',;; Ja:ic,::.rt I r." er:,' rillarr:et \ Jt ek trt,idcl:.ti; HI rags r ekmo1,e Month
Niitinna l Cnhnc iiui t Ale k II Crt,t?3";,, r',vu"-rrlors Council or F':I'^If�.ss and
pnrr;, Gi'!^.rr-ril!'r's Challenge: r lams Tas%rce on Youth and WuNulac,= sicRIucs5 FI'
Fir,". tt irr'u 1,1 cc'ng,rrlrr eq~ i:w,wvrment forll`i1 c lIrlnrl L:LiLIrio Heald rMrJrit
Il7e or Bi i t%or;ii I l,`,<2 It+1 rJ1ur:t I Septpm%,-per acid C c-tuber~i
TJmuframe Resp nsikaii:
Staff
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rr,etli,= I,:Ir; iii rutg, nri.7 Pirt u. sccC,tiny ut.`ii_ S'm':ii:u f-, Ir c' L'ny and h'M' ny rr;I1,t?'�2tnar 13,
pportru? iris to kcal f': 1 em r'::l1
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artiv taus rdarra:i v e
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo� o�t1:.tia nr':1 F'u;1Qii: I13[ti:Anr; Xri1?I"1� i P. ru,r:I:y l a0n Dept.
n 1.-P'J
MOr. n, Awk 1:'1'-102
Activetv,iMothods
Tim0riam e
1) i ar.Il,r~~:~l. w;uY. a X1.1.11it Ir.,l-~ti~.- cir: vpporr`Y^ I s11N 4�
ip d~ alJllc m ma anc. u. c.,rl~. t. Im~_: Thlr.=;c-
I
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2012
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kil;tlto R4044tia~ns to Children Flom k Ictod: r 1. 2011 through eper1
r
+
1
1',
7~1 i'1F rr. if1
r'si, r-~Y,4
1 + Ill]tt"31G' lQ'r'~'-lnCr f17~': t'.�'t!Il~l~'~1(i'~r~G'-c^aged 44;";!'IIIt1d'+'.Il'd't11.FY I~,Y"Ilii;1,1'G~1'7:'i Y~tal4+tyJ'd ik' cQl'r~`M7~,lffj~~'d r i'.essa e in crin1Y` llaritty t'LF;hngs_
I" *:Ia;J i;_I awa mess of lie C Yu''. k'Pr. F'i ur rr1}:' 17"YI:1i.11Y~ r1 nnc i y rie Ilia:'. ctigible
1SY",Ifir.:1" i t' 21w?nie' l r'r atps 11 Ircl, an efi110IJn i- 10 11-;,.F+.;y f-''ill1 r:l r:ila r+~`Il. Li"r
widiic1ing i var>rry r Y' 4y r"�,. r p 1"c%wd niarF e.1ir q X r:i public n_laric Is ir:i I'." M.-- Auvinlq on""
p, ijllr; rr;Ial.onS 3r:1:'u'',14 n'l:7'r IGluje promo:iono CC)I(i its, e' tine c'f hli'*,nn.:11,5 Ir' M doll &V
rrrrTll-;'iib + ernes tag Qtl'.c_�IIIL"-1, niolS, CCr1'�''+ur"".115,' Iil,Allr".ir i'teards). 11~~rl~l:ah':Ct?+: 11 in co1'mir'nunae'
I,tt_r:,ls E.111c p'acemio l C1r4r`w n__ Iiiough kn raTe.t c! mown, C:or.IrcnnIe arI'.ctng and
F11.:0lk_ r laic=is i'ltirs Y p al. not ons ccrldl ul d in yr.fr:,nl:s artd c1111lrli.1ni r',111I
rn a ni~rlYir ten pr. rftlr.
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or.FTt+ llrl I'J.
earl 2
Responsible
stafr Key Detlverablras
3ubalit: Prc re.:3 F F,-rar
J lrali've, co*rpl-=1ed
t'Q 1 r.~': c le.ctr>u~-1ic ATF
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r'L V,w 4 p t:.-Y:1I i 1,11.1, 11' Lr rHi Pl:v 771 1. R1a!yl4 a~Idi'i;lir" r:l I 1 r I�. Ilya i Li 11s'
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�!o�Retail
EXHIBIT A Meirs!eer. f Cc ur,i^y' I- eaiii'n
5 z;apo of Work 1 1-1 123 4
Ar,.livityi 1otMecat@s
11rrri�41rrrncl
Icy' Clasliverables
G;'!a' CI~~e'2~ F ei fl 11a'rel1.trrlrl'( 1a1 l tlamtier l 201') l Gazti.5 rtlit and'Lre i ble-relpte.d aw,'ir rra ask, rs lti,l g and tle"siwsd o;'i.oflg eligible loeti-inWirrie~
g i w r
i
m fie iarlri trim xx ith a ni-ifrrmtxla G tiil(fI1if su ororkari;6 t rciret�r lryrc arlrirL,r'andi endeiat si'car,P., tai i
iarrr. ril re + r laltt rll trlra l fir
+t d p li i r"c5~~&P
Q
minimum of iwo, Elio}-limo tlh cy de Ensure that u rninirt%uri1 c 25's'ur`e tang t� hi~M 71 L;`.ftof r. t L;ati'no shdpper;1.
1: tr wl.c r0o c, w i�,h the Fm/ate' nrrs.:-,mro i r,{rt:.: aPi'�'.Tr7 lr hl i''s' rIr".1 cl'_ lct.' a list of fly t rllur~;:n[1 Llpt'rrr r_: i 7r eery' a lor^r3u, ur-iii cr indepmnder,i!i.r.rnr, r 1-sat r-iter to EIigiblE
irrco'" far. 11Crrrr- 1t~;it parti~~icia e. n i",N it he rr, r fi nl y, sr. L,ti,Callabar. fe'ii'li': c;ir^eI r',dc,t!. r r* staff, r"~a r~,t)''1 I,_anded pr^.jr:+_fs. Lric s: Vuridor Naver'-bt^ Ili Rini C
Iinigrin ir1Il'1ti4^r; Ic c'ricrfixs qi. Iir nq tares is a-gel for particip.:i:,n Frir-am tl" Iviscrr}' group of
r:.tari'gi 11cjri pi rarn LI.As, nil w Ii!,'t r~r lirridt:d projects, 5`:xhrcc riprlliC;i'ili 1i:;' i c'r"1 fy priori i ed
rutailtI.
2) Lsta1:dish^ for-al parner::hips with the rr�ariagr^r'EkNvner!i Of the elar;tecr' r:1ua!ifyiri grocer}' stare
ouatioriz Mr1:iin-arr, the rrlr.nP,rs ill'r:; llirougti t o rer^,ainder of the contract Ctolla.bcrate as appraprirate
with carnpaign r nd prelgr a r'i gall', Loc:�Lil hicerrf v'e A ieert danr' rltii r` r'ic lrta'cir~. riurded prc~iPctri'i, a rid
WIC Vp.rrlcsr Any partnership triii nrr enravd ha dorc- the end of the r nn1r' r^t Kati=~ril'1 be
replaced iy 11r,i,rnt r Lur ho'iscal fear War Inc p,i'l-ivrsn p'.'as ter.^�iriated
it c lc+c:l, it ra and ain^air hp al. rrs.wii�.rio erch,pndv a g o;-t n ai? 11 e E,r ne ih o re a.il It<cation
I,clccordinq t,.7 tie gr_ nIP.lI ec:<'rtitlln."9:1 Irt ttre, Rrlfrliirrn~llr";'f'.7i'11 r'{r^.i'~I!lQ~'atft�'tLliicOg r %!.r'sa,l. Mwr...er,:;h ardrrirllij
materials n1U:R,: I:r@ ri tp1csyi d for at loam two, t::''.ee mmnli'r cleu,
AI t'ilit each sic re r r��:.c� tucry month and mame rt q Ac co Ie to contorts Lite piacac en and rr1?kee i or:
the ieria
LfiLi*od r Ci. r'C;r a Crrrao� o s-rrr.,rin� r.U_ ran t ar:rniralr W:+ i tiy` r y+ xr_tiHil'~ iL Li: l t::
5',,', i rr:ry C awr 1r r� r I- In w s c: u! L.:,�r.1ir.:.trcr 11. Ctnr L"rri:5' I I_s9L>i L�siidr
By
Jsrsicir! 31 2C12
1f rough
1ptenl cr r,
2C) 12
C,t.,r.iif r 1 2011-
Ecr iosiil_ur 17,.
20 12
Crct it er 1 C' 1-
Septe=,r~l rrer a.
GupwiSible
staff
Rei; 4
RetC CHI
cal C
Subm t: Priariiized list of
idendfred pre arch.'. ric.alifrr'ir:g
retail prsrlr-ri. r 11'r EL part 01
7i�J~d1 r"rrr~r irr,' c-perating plan
suDmit b;: i11i(.:iertti'�cl AL r. 1rC 1iC
f:4krtrsc' li ti:aticrs,
ATF P 0
on Pilo: Signed partnership
ugrccrnerit or partnership
gum'rarr found in the e''rCrr;
tirltr`�
Ferrrrrlit' Cilp LLsd elect rnnic:
frII` is v1'sLires
of days. iiemsc'irpki, d otc.'.
A i of w,ss1s nr' I culls;
1:71itCii h rt rciidi-iatw L. it C: c nn r~ny=pan ir: I,;.I A
L lUI r_r A r.z'nt I-' l'7
+ii,?r,1
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�"o�1 O T A. Irl:c e' e:ur^i'y' I r-ci?I 1 L C',;L
tx,ir_. 0, /I.i,-trk 1 1 cl2 Ia
Ac ivityJM*thod
1drrl 1=rzl ilia
I ly Delat"erabQ-,,
01feeetht 2,3 Refaffl PFomotlrectki. rum ctnb r 1, 2011 bough ptFm +M~':1.~, 2012: maintain sstrlr.- fa;a r,t1 hs v n-' rife t ll tti,pq"At1 Ct r I Jul t
l l
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6bd dtemmstrrqilCen...,
iltar# K U it r eligil~ile I a tt ari ri-lr 4 t'"r 1 t-Fear-alcl rhili1r n, Pm R &'u''cw 91w Sol as e Iis u L tir ttie 1 17 ri+1 i 1 Iw 1"il!7i" t'~ N:If r.lad' r # I~,~'rti / t-.lal'Ci Ens um ti-laa;,for
r:, W11 t I L W l t tJ Il I It: I lltu II I e, 4�I 1 Iut CI IUilUIt
11 ftieril. Iy qualifying retail le..:Xlr is wItirh to car-ril.lc 1'c,fl.d ernl,.,~nistraiion', as nu W 400 irr Me AtF�W
Ensii'"t? Ina: I'2.'7 mm! Sfie? I 3t r. it aIIl.;t'Air 1_1 n1C+":.'t3; r~IS'It"`:~
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7F, 11,
camp- n tir'd prl`_*"lrcirrl staff and ithnr flJlr;', ifl{-f'IncEd C: riferr1^i to of lr r 1 Ir.c il
f l�"' t,:lf
in'Ert e ii oIr wifv:c:. E, acipr trim"ii Imdlratp iith miler Mtn! A;r+'i(-pjnc ed p oll.:w.1.; Ih;.ii I_or-Juc facd
1r r)-ic.'i fr7tion�'a a: pal Ii I. it opc_ of ttchc
October 1 ri'I 1
e ru.r tl
I
13 1. omit: Iart ltar I;r.Irri cIi,.ri<r;i
suites 10 be rich c:;
An lti?r;I ct'ld mndt_, ed as part
of Prog,am cner tine Lir,,
r:r; plcl d cIrr c1:�aric Tf= 1 at 5i'' J
Ir: cattor of Cicrno Iiet, the
1 2Gxirc'ina:e r'reli rain I ii",I,.;, 1c) ct slits p 1 tt.o c'N.IIlfa. idc'i and ii t_:Lc7Niti_1 f.1"::"nT ionc n--' fcjne~
Ir,�ie�mars:ra11"r"rl r.Llll. itst:.
t;+ rt vide it inir-q 1o ra likti HIc. tth Lti.,,ie on Um t;uc, sstd h1fda leer i l.urt of ir-s;tcre fnari
don'Unstra:i Fb ld"+' il) 1hte 11 I cct S efy?f)tv"1'Fi. ui f f`(I'SIiv r.;i K. N1an e I-.I;r r71Lin'1 P e WM t r Ma ra 1o
orSLn i ap�:ircq(.o1.1�,Yt L.tffir- g f e;s.:i1 E., it i air G; load demnnsl"3r1t i arl":: is frcni:or 111alltt, i+1
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Si:' 1Pron-Oti= IIpfxrnintg fact'.' cerli;il' r1 +iiC+ to Increase pa rrfi.lf 9ttclr and prcr ie to W valuc 1o
c,il_ir i(7:;I� lui i:ci ir'i.
4 x_ Inds f tJlr ill," ce ettit.lc Tod dI_-c'n:,tr,iaort r,t;L urdinq 1'C" dire:'t::iti proviCic�d in the 7; if 1
r A7 r~!t lt itl tl
Ler~,~lyd. 1'laie+_;. C:atar:h:r I7 clot:rl L:.It awe slcrr WT 1,:1.1Yi I. I I" I.t3i r e',' t rrit i An s l F.7y ti.'~":~r_.J l,elahrr Ith i'r4P1 r1:1y Ia'01 1-41 C rr-4' i r;;;!r�. ri:Ite 1�,i+r: f:r.iw"' P+I'r 1,-81ii'
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bucmit: Timm rlrl r;lcrsda nnr.
F:LrinlllfQ I, t f7VdIUat,,'on
i:;.jr1lcl3orial rieter'iS31a
St. bml
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t r;ilur~sl rr lar #! of pec't'":i-
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�#o�E1^.H, H r I
Scope fit.!1"dn,k
Ad h.'ity/MotPiods
6) 11 wu 1Llt1!rr: dr'r'. i tl'le E ihlrilJ'r3R. Qldv;:,! F'ay' +~,rlt'1Sj.C?ire;) %Iafi 1.g1=r, p;.ii l rind dcu'adue.-t lode tuuii. In
CrtS p3rtli,ip 1ir~a Iri tF't;., I'�*L�tuljji-'f,arl,-n) thgt'."dill lr. t::�Ih rninl'~~I1n1 of Sn elfr, Ic Ic,"r,+-iiY- to I-
S"L?ar-n1 dr' arti,'."'G73:Ir, in tlli. rdilia'r.Ifi.i PiLverl i 1 I 1 r+ n
a 11 Ifr t.;lcf., tul tcalr~; nr,1'y' I
SIconductLiJ by I.`h2 J^?1,:ilr 1 1'I~I.~tilttl or i1 drr?II 1 i-'a'rt?r I'1 +r' ui,.rr1,UiJlalri niaff
f'o In W,a: u'd�.'iri+. %w!: i'�i�'K:4'iai 5WI yr,Y1 t.", I'.3: toted r8, prn,+ Jc'_''' In J1Xli 1 ri fc':i r.,uf It`,;
1anizalic 1511 I:u�-i.;l"I:alr^. Ih"I C'tf r.3 r:.'". 31'Id ai?y: ir_a I`w...1 A:i1-.: nf'Wt t�!ft ye I7uyilarr Said n�+::r,ia'O Q Wall ledii::
nc,rrs,je,ur 3 1-fu1 a i,i? 1r.-ggir! Fa:-,l i pf:crt�'I a vent. A vl 1.'!,, iljl 3 c.i vitie 1;.: J ftrinrlir! J 3r+3l i fi:+Uir
v.'ilhir thr~ r�q*c,! I +Z: ar t'1 V rrgir+.vil M.i t~iri S ri1C1'e pI Inninc: hr in Dezei r" er: urhih-- Irai h'r Ihr: Rr1ta+1
Rv, un'i?, sh:c.W 90 Jde pJIIir: ii Iinn in to G'Ihr:" va J rnpIi rIrtnlar,ri 1))n the L51� i:;,rifioig,+
levv:6'::in i. 7rr;lli,i?,. 1-841, P i:.i.::i 3i.n_Lv(Ir IIII+igi:ilirin 3rngF;;T1, rlrGr rr?!"rriur':++;1.
P.',-i�.' I:".*I1-,nr'1e'i4p1, x,+":31 a'rl"Ii::J I. r r. n1.her f41911.4vfk'-I~.lri+ i u a+ rid., andk;f''artllP nr-.i, anrigr I
f n'imm idr:'{;�m[,ria,e;
+J tr. Vn:~ nar is a of G!;,rcnl_. am tlf::,'ri.d,c;re: in L-,1'i-InU31'fe con;"; liur'riller: aia::v:!3 Il.Ow
Nam i i Lm ina nrlr 11ic,p, E.ANi".ra uu::nnr jrt5"J rre L:: n:ikr. ai ll' i 1 1I I r l ii +'i+r ril f
3) Cuc�riin$tr cc"OH evurrl.
S 11.r't?'r C:our.1'w" Hi,a1,h I)ept.
11-10234
Rf sponsible
surf uy 7elirreiralml s
Tirnutr-wna
Criotier 2,911-
iWr;+lrllll f 30,
20'2
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icutlur1 a7 d resc_,cas fc I r eyr"nt� Irl fcu'r are?r.3, c 8ner'n1t"1u 4urnr-un.Y p3h fI Ir.""), ider':Iil"rlruj ynd May 2:11
5tti.:i.,ting a medi.3 Nut er".he everr:lt, Ifdeiul"y,,,j and ucr1actinq I ral I.IS.' On rrkkFers t::1
suC+pcI tale rvP."�I,rid cbtdining fwi: ar':i'/eiieLtl:.lc ants Dhysisal ac r.'r qi prrll'.it charati4rs a he
a'.'.'drn rl to rticialJpriits di. ring the ev nz
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rrrnd11r,r=.3 Fry ran fit Ii.' INii Far:4ran7
nnr. C.i'rt4.'"'il klll'S r''L1lM1'$r j'itl, f,
r,lrr,:.iiiQi1 +cei t`IQ Nrr
r,if. I_ rr,~le& C�kclrunir- rt.TF l#
f ic+!<rs, of children da.)
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p rnershl s i!im e rot I f Dint in,
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4',v_ C 1r11!`,' h r�-.v;,+rl I'la' r I~rt I I C tl Ji h,lY, liY' H1''�q 1-ii;illfl l_-^4:;rE
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�$o�Waif t s',I WIT
l:'~a le�.rrw+i t, I I Cl;! w
A ctivitjtt i th!aa:I
mj(
Timefraine
Rcspflrls.ilale
ply DelilrcraIr,k.,.
L7) it I'Ie. F tw, lc1i; Is 11,x. ULir1c I+':a 3 Wool t r�.t, it us! conicr,iir:, al. 1ed t iii. iiz a, J v='ci&i i
ChYi71t & IQi1100nq! 2:i il4' Jpr.anlll"9 d'rrl_ni r'1: ra r~:fallf' lric
May 2r 1 i e.
Ci,, ih Irr 1 r, xr, 1 iyt,= rrrr, n:i
il'?:,:i! ij, ll:1e::; 1111!"t:f:r i:
ta r ft,tc.ll.IrSr,.a On t le K wit I':t":,II_ r1:'I:d
i I',: r rh l,;c: f Iii Ig,. t} Ti.if'.'r top r~,ri L- r
H' 1 L4f5 and i il^ rti
17i I at C.' r Ir f k Iu and 1 Ir I III,'
L 711 U' 1 t lilll,;: r ilr Ligi'm tie flit Inl of yeber1ber by R i lir,e'tij'L)IIJ11o ins r.,r events conn:l.it lei? h!
1 L';f�r II ll d,a<:Ifl and v"4: 1[
r rv!r t'?, 1t ri, I al ili i_I:t ri SlC: t.�. 2
Ott 01v 24 Retail CoMlorem Scaclal Rasponsibrlit~y+ Parlna~rships: By ape her a11, 2014 Powk agroemc'nrs %v,'In ir 1ea- 5 I;i cn 0,! lnc:t tiy pEJrirtirs g ra.er
shippers, ol er's II.I.fitvt1cirs, s hoIt~_.s1c II:+1''' ma t. r1'.M_�tC� Ink.) and n. at ir.~l~, eet 12 r~.tall 4 i.J n- n!a C'1 fi.r.Tv, T� coupons,
ra ail air" a tIG. S!'elJtn.Ii:tirT!pll",.,I!",,,i!vClir.latiiJr'I
rEl'1( 1r1;r,'lk it ikt ns tha roust met and j'.!? WOit n...l li 3�fu'r~,.~ i1 t O r. t:rk p p-j_, rl1iT 1.l�". r: X511,11 t11r::Tr r ILI,`.k!,L 1 r_ ntiCla n iRt1 n tr,~1.,>
a sup~-1ar. iVtC Y~'Y,~IIJt3', of J~tlrli c'.rfti,:r
produce itcrris an, fc-od dt r1T a 7 1'`111,1�1c gat. G,'t'inllJf a1 t7. 1_.11 cil_inlzdii' ns' f."L3.L'i ieati th cllnis s II.!~i1.' l gaxTl,. a`i
I rr r t nli} IT., I,,T r1n I} fc.itltll lans
wok.itr_s'i Each dc,narinn. rru-~." i1e,rr_h at lead 2011 pa`rt,cipan(C.
rh, al i r� c 1 1- iLerll111 1111 I Y', it r Cf,. n!
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Ol:Jji ctiv'e 26 Retail Trartrii g &Technical Assis.ttmco to staff& Partnars. 1- e,I�iterrtt r J#;D: 201': prr.;r'!ride-trainin g nlatericll_, ar�d Lochn,'t:_Tl assistar:e1=n Raglrun: l
r4etl crkstaff nn d c C 1A L'1` fundei M-r(ve-i r is a c~ J� d t
II 1 t a nd retail p,,~rrnrrr., 1") 11:1.1 T cr~r1 1�nt, I^ g gunli,r, rn, 1,1.1 tlr i, it 1l?r:Slcpria{_ a. iviiies, Ir rldi-117 lii'-f;li nrJ rl~,
f c r nld r Mtt ii'I are 1",:111=., 3;nil chow to solicit do'-i t!o isi t YFtC,1Ra to atio.-n...
1 TL t n It iii iI'Lty C ri ti, p I 1111 IU:Iif nil r't:l,ail I1,rIG':; an r' +r,! ia=,t 11'_ 11"J)lv.:;lul3 1" 1.:.'
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v.rn;yP+�In h;'i. w_ twl I% t.: I I:i 1 l1� str;.Ii, i`rl t F.....,. r
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�%o�4'r-1a 1 ll_i':.I ifM
AcliVilyfril,ela1od5
2) r'! i're aciplica ble. wannerI epl t s rilatlunr' rif Clu, Ilt 1'�Ifl i hail lcca.ilcrns Q h i'F pon 1 i'rnp iigr" and
rircgiarn A.dv.'sorj CorrP.i 1 ee it the Regional fall Ocit'`K?tivj to identify pr Alt- i t uritw, and irliilaLvei
lh ak lrt create rit7 tf 4"1nCl ili Lnu.r~rrYiP cFpr criuniClelsy NE"Ci'. 1 do 1n re rr=1ail 4't1
r r r k+. ut1 agenda
apeh uCnt~l.l.r
ler-:s in ad. nce of the n-icciirlrls c ccrif rrfl Iwu'� Lopir:�s we relevant m, the ivwilnr's isle rests. AF,
r e; essi3rp', r> ei ur:I rcitu I;crartnu rs tip flll":I;I.i rti and W+ahligh','i Fit Ike.!) uo ia;I Ccillabo ad'vt: nin-etlnq
w; Cd
i' r +'.r:"1c~^,.:1 w11d We rl r r i r rrol'dl.^f~ 4'SIIIi f), ir,ir.~rle
u_:1? f 71'lh''y In r., j id of ro AWW+'r Pi�rrsit'rli
Aw1'Vw and i_tiiC3ri';r Prtltrr_ ilbri M) inde'pendent re:,3Or ill1rin:7t C'W'iir+flrioi on prop r truth ar'.<i
f-1:�-I hlc, storac'le ar d display rt +I, oI to +1elp 4mpr. i' ui till r1 rl ih l;. and qu intitp of I i;rl s ono u,xlsirr r s
l aI Eiblrt:c Icc,al eliaihltl lrre. it,?x)nir' rc_niderls thr?;111u,"h 111'4all~itl'~n fund in CITE 1',, 1,:1P,' r a-rPr;N v
ir' rfu'rt qtr' Iti I rural, zq f3ewu
o) A^ np.+rr plia"e, edunMe F ill; on 1ni: boruaiii'._ of ruccrpWul M h eloi it ni^. bQneftt! rr lw'ist(:r I;Ef3Ti
otlrt'ir'4'IC ccupors and i rmn tr.;tl.?i.:rrj with their IuC7:1 i:: III Ir 1,L1ff L,ti r VVI yir I":t.
A) Ptr`tner with faor:s t:E!C'u iii 11!1Ki1"tl~ci:IC+,r~3 sur:h rus t{]i'l?d bar*-, CaiiFre:yh of fi'. e o 111_I'W'IC clinics win
he r, uaf of incrr?riUnq 1rii i and veTMjctable--rei.:tr',rl kncv.'iedrae rwl:lllr;, and L1urc.r'n23sln:q hab,its
among eligible low-in illu families
r rx Banks: n
Rer the Rrrr'lrl Fraf. ri;Iel1 rr.Yln rl'.t'idI. tuchiical 3qsr.,,r i nce artt! rrrilc'ials tra
cot3rdlil. tot at I cc,inty flocc l:Wynkr. who vow in turn prc�r.r11IP n.r.uis.tiiniu and mfr Ei'i919 ril pr::ui"1'11):11` 1ho
Cfirisr rtuhun cf fruits and 1.rrtrt t_'.1111~ a� multiple tt:1ti;1 p i;sitflr 5, Ir Sh2r R g.ir:,an
bj C:.IFr�r
l-1e` flt f+�'.'fuir PPC:irrn' un rt~yri:in,,td fr',Yrla`,ri�r'a GuIul.�?, cWhorl;i; wItr':, CaIFre5h Men iii d tllt o loud
a i
a:urikp' organizations to 1r uuide heir pr_'mc~tlc+ma: rii. Jti�ri~;11i~ lo f Reg ian~~l V a!r-,,G!, wn: staff ic, r_, I st Ibuie
1w'hil conducting uci demo raircrnr rtc re Lou, z:and clher 1 rctall Ir?,s:.at zin5.
r;I'tMC non-,:
Or thh? r?i lerr! rG'~7Felrrl IPE'Ijir~'Dl`ll It�i lrr is f1`_r'.`., Gicir'IV. dr'cr- f'u'I illi('S ul
fv r4!rl~i J-'rt':~"r.; 1'' I II Ir.��~>`:
I
TIltiherrarrii�
iwtak>Cr 1, 2011-
Septe 1717C'r 30,
2012
C'viober 1 2C1+J I�
re pternb+er i;�),
2
20 2
Oc cnrur 1, 7;;t1'
Sepirrnbrr t~,
71112
0 ctnit':4r 1, f 0111-
r`.~1;~�r^ ter," 3
2 n 1
icptcniiz cir
C 12
Umber I 101 1
Sep rni rr ir
to 1:J
eL4cbor 1. 2011-
Septern er rJ
1 201 *,j
LogenJ.ILl 1',rsra;r-Pr`�.rrei!,'lultt:.ycruart,rrt: r.1ar:,ai'.cimrylL�f',;S Wc,-:;;1+:.'rr:'_ ter.
v' v,-,�
P�s�,_
i Fr' A. rwtr C%!", t^,:;u- r::'. n'p;;tli +:rul Jir~2t:;, I"II f:r:n'r~ r_ Fl' r f
Fla:i3pu rlsibk
Sts ft
Re l C Ai t,arl
F ID, Rei C
Rri; C
Ret r.,
rul.nl,wo f Courtly Fea1117 i i i
p
11-10234
Koy clliYerabled
Sulrrrtirl CurnsrletcdeItictr'aruc;
ivrr
Submit: Crrmpl+&tet) c1c.-ct'rinic
TF
Subrn 1' C;:ttrrtcrlr_,rrv:-1 tlcrtrcrnic.
ATF
a i:hn71C 4_,.irnp'utea e!ectrciii:
JAIT
+tit)Iiiil: Ccrrpleied P.I~'-;~`Ifcl't
ATF
Ric, C
irf.1
1 s;ol,,iir...:.";a t.n',:I~-ral:al ldl
Subriic tArlupiltclcelectroiic
/TF
Submit: C0mpl'1. I tic lronva
ATF
La: r1i: r: urA19 H: ir, r, t w t':_ tl1r
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�&o�EXHI E1 T A Decit,
scope c 1-1o2:'.4
Ac i' ityMethods I rl7I,ztr� rrla
Staff
Key Dr�~irvva~ra l)lea
Objective 26 Wc-rk.ite P ecrtritrriond and Impl-mentarlor: Not Applicable iW.`~ no$ pin of tiviS+:ot�1racL orttr rr� inten ionglfy omitted.
Oblertl e 27 Wel rk. itb Partnerships, Nol r\ppilcaL,,k NA) ncf P. par of thi,, rA- lilr'a+ t: content ants=rrtir rally until-e'.J
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�'o�it, ndF EX.-itA1 r".
tg1C"Il,rirp'a 4_:~L:"!r: I 4U_II'i0 ep'.
1 I;:.'^1
i Respoaslihrf?
y
I,. Stal`f Key G+cl vera:J�c'.5
Objective 2B Sc:hcaDlk CI alssrr, o n-l ased Cludida'�u Ed.ucnthn rtivites: Ftl ri.: 1, 2011 tllYu' qjh WW WO, 311, 2-01Z Ilriprcti'ra fruit and ve? i.-,hle id
Iibt cal acllvlatr` relale'J ai4~"i7r r aa~', Vula."airdge, attrrludds. AiUs ar*id l.tlmWWa Imnrig oltiuiblo tl +ra-inr�ome D- to 1--yNor-ald rrhildren thrnlcgh eYCYlratinrlrr,l,," I
dLd it lessons and ether lri +^1, In 1".I ltIr)l1:+ as pan c4 th l.l`IS"id; eri's rl I; t't t}f:~1 Y l_ S,il~f7,riY1,'o r vII nU: 11,210 101 tllr' ri ytorl': eligible low-income Y'r- to 1 r ear- oIcf
r IIII"~rr 17 l`il.h";1'.t"L'l"I to 164 1a:5"_roc.-T-t a sed octi'di i a from the iJf_!+:lf C' l C+ Rr'sc;elf o'Kil 3
I11 ti r"P'I' iprlfl 1IL WON u I_, Ir.=1 pl ll'' MOM tlcr.lri, F'cl'.'i+1F.
Isapp+or to ari: folll.:a I,;pn'ith n:urnh i:;nd I II i i iadu tl-acherl a ei rlhle icx:-Ir.::Jrrle li,:ad:,
IrlncI.nli"11j f'aitrG: i r tllr' ll r rtr +1,'i l'~ri lr~,inr1 11r i-plmn'fe'ftn iori 1',,fIf+ i n f Y_'~1 f:r`:a::+!!Y�;~r�
P ti 1411+ F"C t r 1-"P I:::, t Fo 1, 1h'i a Yh T: I it i:~ i"+ 1:'I"l vli ZI I AIL: iGrll+.i I' i?w_+ I+J wuridiurt.
all or Sao, i Rya rt, v Li+i`.r~ P,!r il;,l I.II: b III I t lic c'icol yiii r
7`Inlefr~ir'rll
r:�n_ bah"m 31
r,F:r
Llomn C:c,^-pI I:-:c
ele-ct:or`ic A"r i k'
it ieHche v_� 1P f i3c"iviP' s
c,,onduczt?rt i' cf i:-]P. tS,
1.Y l:alt!M1A,'i LiL+. I:.~,'r'.!fII
teach-ors anc other sahov
staff regarr in q Me r
r?ri1( i3\? I 1r I t it a, ci
in
Mil',
un ribu I i+_.� IL L~r_ Iuti r
iurnls ar:.1 p.:7i:ici::'at:7r'
reports
21 Motu II: t,? eic ti acurc i:-. I qi Yt d 1 A= t1. 1 i i +t,l.'g
MAMMA, Ls n4 ti,- n!+i}' Irtit It+' i t1~U~Y41.'JY_ Lit!:1t, aF,._9 q" id-
/"tctlvlt
i k'6ntrtfrr
ds
C_.iober 1 P01
WIN snow f rrt h+ ii:
WPQ PP ON
x.11 t. 1- I, 1(it:'i H'
progiess ri9FJr, lir_lraI e.
rlr-:,
C+-w�tl- r. rD r, i.Y: artllnx�~,r: P.9 r.: rt y I~ ii.r rr~r.al"s� r 1'il t Lal n'.� r.- 9I
h.s.r, +" 0 Y I-.le t, It'~il
ewnJ I~rt:p.-.+I[sa i:
PP O: r 1`.:�.:;C[�]rrirint,0 cgaJ, P't,.niM1 Amount r,aliT:. II t::a, 1^dr li+r=Cn 9
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�(o�3CI1OJIs EXHIBIT 1 V.tilr:,itrC??,i r1 Dr`
fiucpe OVAlorl 11-132311
4.s;tN jr.%1ethc,cds
Timef rare
Respons 1 Li le
staff Key Jr.:liw'o;ratiles
O1hj�ctIwr fib. lurid srvhr bl Eased Pr w'njrotlons: From t ir'hei` 1, 2m 1. throur'ah s ipi�mh'er ail r)12', rr*. a1&0 of he rr i ln`s fir lkt i It + 1CIe 9- its 11�
ear� tid d- iu ort ilh Three I1~a1 I Cr+i'v'rtairrtlcrl�aclu~ ter fri M 1yy ir~61;2fctiviiy prt'imQ1''ion incl adr g' tt Ie si t n' protY11 1i 1r5 r l l r tia~iti s nr d Ji 1: C# X11 111ia
cei~atria.
r!Iat^r P(tw'I C~.ii".rr1G'J6''rl an' unl opPrati rig pk 1. IdC?nlif'i scb. o s 10
r' oi': a added support to CCsr�dut,I p,o' o liens w'ith p'it itf,; grvon to cf1ic,ai Pc',Rr P'r1rrror
Feleel W I h Cl':;),,a szv)ff to iL'ltlfy elevarfl; rll,l rl110ri'- alr'":t I::hly icaI e':ti'I',y' r is l j10171C.1ion'S e.g
r atir'nol *d.it+ hurl MCIn'h, h'ralk to 11 c,t r'd11)!IJ.r, T'ut' Turn=76f"Wr.n; Tr'y i-r rwrtilhfnrg Nevr
tC,;r4 f7~--}i'"�tart~ rt'taf,(Ar;'ra r;'1rI,,tlth, inciudnr rar.:p pr�cmotli:ri with ai1iv:1''Rs ar#% rl Coii.Ju'lod
n I ha ref?t''tiws t,jrlpur. L=chccil.s b'.' Pr widir'r;1 It rr'rtrrr.L` rnalerals� fdr"M-"IIor_'; tp
CClMS1.i15-g an S f~i i F, lr,ri IactleG, Lird L',c ii ctinq snhc,Q's'r,"4tti i:rpp ir'rl.:le parent" r`t
Ci elilrier C11-
auFil.E;mber 30
2012
submit: C rmpkkied
C.'L'::roni ATF t. +'lf_',;=lS
tt Of prr}r)lo',K_IIi,, elc:
fl iratllvt description M
pr,molftiraI effor-,; arid
Or ataa. ic�~all,i-dei Ioi::l-; e i
t-iy,Lomi ed rrl.3I0r ri1
Objective 0 chCrr r ParentEducatncin: Fror'iOctubirn' a.` 20111hrmAgIn Sep1u nthor 310, 2012, partnerwIUheeItcgrtklu low! income tertlen1ar'f suliorsl siies
irticipl;t;lrt l irtilhe Chll b"rrn i,r'owor"f'-',tG'y! C'amop: igr Pen impp'rot' 1t'iA it i,nd 1.ttgoiable and physicc11cdF.'iwy-rblated uas r e;:u, Ilcl-.,I0ugu, altitudpa i'nt sl fit*, to
support their chiidrep';;1 frill and ds r?i llle ar urilg!tluri a+lid physical activilly hehy4vilxG i1wlorl' tiareriN, of elit'1iI,1e: Iowa-iric;cinitr c lenient.=rr+-` je ctilidre ri thr tr h y
iliwribut to of paint materials to reach a mlraimurn, or, 120 pr=.cent an V4Cr'cige, or six. timers., virf 2) fir t irrr'1terectimn with Ir; ren1, ill ar hero" x�'tes�to re,ach,~a m1r41rrluml
of 30
r n1,6
11 P'ar;:nar ywitli r IIr. Jla to crov�de wvritier' lufrilr'Ir r ir aririr materL la l() cnra rta that c,Jpio-f
JuJI,l',il c.I promotion and ry,,lr~hf r ri'io+:,sa'-ir3'r i.'-.1 t�iP,r!iC r.:'rl'!,I. ra'^ily nekvsIe11. r!
1 rll' ir''' ii P ivnr IPli:1}'P C;_-401 L<i,igrl CJciri'r"(I. brrF'.'ll, r ty',, iir"Id rrt`i' ucLicaii3r ral rirl I GC Cc on the in Ith Li i ieII'tS Gr f, ui::. t1e'y{ tnt Ie,s, l' IIjL"rliyslc rl c! iv
1 c' ki iG.r itl v.,LI I Jsr 3r i4`J,'Trir'
t~'r.frw,lr+ et rr to Ircil.ice in;ouiicilicm a Li,sut keel r0mrrurl ns and +_':uiits, rncludlnq comlalw,n,1`p'
Lr n'S az which IN--r Lithe! r)MILs'l-A, earl" Lri lyr1,:ipfrig=anly will rftr'lill,.lct tiitur'vurI'L7f'ri.
2: Prove:dr. r r r r p~ i C�EJ,'iir, ri,,., r irfy rrrm 4tre-i ur-d basic rurnion e.ft cxIon I,Ci. g
ir.3rnr,, u'I" mod denlri i r.-: t~ nos, F)IIy;:e IC<:lI ifCivi'y, deml rire'r t 1 o r1i ir r p r F. ri
l l 1 It Cf J s r?;i Ch,
iy's uc:i s tl.c 1. +,.�hr. aI r tytAz, coon hCu er, F!,irur':I. e c; u;i citlon meerir, i I_':t r.r
parer-ana f, r'1"Plly C,dit'�'it d EVell- cci'Idu.:l!'.Il t rt'oI altr_S.''Vhen rin-o-siol I'I'r'I C: 1'
finc ei'' IIFro,,h rrtrir at.Il r rje I.I r, r ry I i:_t no the to pm'-'-,:lre C: IIFrF:o,;li park p,=1 fl"
r
18lieuLdcala:e vinI all,e r'a I"
h:J 1 d r'rv.',.`?rk 5v1'f, o'er 11r a,+ib ii
Octeater 1, 21`11 1
iepru mb.r 7'0.
2012
C'ct drat r ri' I
F.'er1'enlt i. r +U
2 as2
LIUrfl t. Compiett ci
I,,vlertrtr tic 4 J F- 4, Cl
r7f I'li3d dit'.iirlu[Lid rr of
PPC PP A Iti1r;rt:e redi_:!lcx.i etc
FPC Pr' A
On file r'nr, y�Iliy'~~i' w"4,Ic~or~'d cr
t ri lnml s.i meleri.:Is
*al I'O"rli:.' 1 4 o'
I alts<n.ir~" # cr f,yremF,
r'u ahed F: rc',
Lr tma 1�''P Pfr qe,_I ll t aE C(: y.r.t'dc:I p,: hl,.ian_.I+:i:., +t:. r tllalr-;;r�yl,, e Cv IJ, t:t:r; W A,.".,
a
I i I:,,,:Ni rI;J't C,ii rrllr�=' r, hr, A r~::,+r 1"'lot p o- 3+.,~' r I I'rLa'G l'',:: I r_; G�n�Itr-rt.C'r r zealrri i
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�)o�zf:t{,^I:al._, I I IF:I1 r J Yo S
IC of"L1ork 11.10234
ra l 11'KI"flhd: aF~~3':F Tirrli?Irwlrr e
ResponI' 1c? I
staff Key DNivemWes
Objective 31 Sch' ols ChIrd Nutr'I110nt lrllvoI 1oodscr'vkko: I`r Irn 0;::kiiL.ul 1, 011 llir'� u~Yr c t rnvt'r +(}, 2012, f1 s,~tirxnrtxk cY'lilr~ ulralicr>~r~C.ht~ell 9r.:'J1j,!zj1i is
staff frrirn 10, eligible tow-ir rome RFhirh'ais lr ih Mown e' that prn;C+�cth v' pI I11� rittttl lti of ti tu"; ri:,,nrr nt,"ll r'r'Iar i i S ftal_'used OI' MY* it*, I1C[rlwe% Cmd;thysica1
dL-twit! t:tu ti2;r pdihicr trrizh ch.ilc: nutnireru'sc'hcal fa'icseric:e tart lo roach tr inirrn.trtn of 480 n1 the region's t jink1 lrvr il'=r gym? I t 11 I e IS C1 11!J11fen With
AU N i:nri r. tat lle-mn si q in the c t terhh3 fl r it le asst 1:10 school days.
1: r'A't', v" n hit I rllr,'1Ior rcIi:rl it It r4':c._ t.II at quul't'dI! i LiCI 111''liii st."luoi*3 k1.# Gliorl.
1111 IV IIer.Ltl' u: nl c, i1, i"Jing 1,,~,wyn a Fleydment If Fe jcat,r, irainirgst re,~ar'tirlp I h r 1 r11' u~tmli r c pi te'
pL,' It:'rw ir r Ll,rlle iaI Iii lar._ he.' al, n13F' 1'a t~rh,=ru.r. i ihha'', rlrrlrl:r 17t_r A P ehO nip-' A i- T c'
1 a ltil atiui lir".'.i
LD 1' i_Itnl_a,
falit qr I aF;l; 1;,1,11; r r. nEi11111171ifq'i,
I'I i c* I'h I h I,I rl #I t tr: r,1 r, r,l u 1 t I'rlr I ll J t I i1I tIl t iri!1 r_?ll ur Iar ti' Ghoc'S to dl'- Ila'r
Ilrli rc mvi L:c IFi:_lr
i d1J rLI' ef,dbir II iuti ar. In 111. car ir-'a u at leaC1 6C I i uoi nap, t.li.h ncorl rating
7
r, t
or 1 7I ak t nic f f kes r
I r n, I, a I t t
I, ifi rE'li' In'7l'll rr;i~ 1111`1 rf!li il'. it jr r r n',Iht oa, rilu tt fill III %i,sno messages Win
H
11
nlf fl` J 11 # I itl LI P 1111: rS,_rllill Ilil II_Y r1 Iti i III::.' I i"1
u I~I.I.iylr 1 r~ lC'r SI^ar'-n kfn_ at'rji,_n~t,
i
121! wauhed, Cc
and l wuhed, Cc.
u,l i j t it it s to zr1 oze gjards Itlgh p MAg Hit an1 e P ank Jtying trirh maH C' grq
i
yy
ard rr[e I r11 rr.jit e emii art.i f"JtF.ic.,_t al.,ivi,y huII Yin
Jp'rc;tirrr a.~~c.hirrilsr School Power Partner'a~Fnlrn I;tf;Lr-FJr* 1
r::11 t 117n,uc'h s?pIrmh
er''11,
1121, r
j s r,1 t!u1, wrtnr:r=.hlf,- uirI a rnit'in-iw'uo`S nr#.=lir',rir,: 3
L
elemeriarr cr:nrical te.n Jut nc' it uF a r: ltr.al.4 Ior1;rJ iun tr
r,,l,, int~ ltII. i i l Ir tel 41rL*Cl itir_ a In lI +_:
I 1 a i F C1rr'Y' Iyty: i
1rl',~
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40956-U01
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LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
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AUTHORIZE-U07
THE-U07
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AGREEMENTS,-U07
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MCKEE-U09
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MCKEES-U10
6/1/2011-U011
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AMENDMENTS-U012
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MOCO HD EXECUTED AGREEMENT|Eo�*o�CClnlrrlo,lIt"' F'! ltll r~!I`r a 11w3~:C u; i:XI 110,1T f4tk7f tcf?'r' oiir:'~ l~r? i;11'I i 4.;:1
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1, 2011
thr^air4h plemEal r30.' 2012 inlprove,fruil and
t i nd tty % lr i ti'0 r Exi, Ikrnrerie,; krtov Jg+ nittt~tr~ ll.N, aI7d l f'4.vi6r;a arr1biig e'1i"l
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ir_rit lru. rtd rc+lloro-up with conir.'uii"y yuoth +urganizadon ai,ntf lt r ligit:'io G',v-Irfconu_ CY^s
including iUr- jtLv,'li fl.irid� J 1_ YO's1 r' gard.inq inirile lief t i tun of thaw Cinfflr'71f,'7i,f'rr 4r1'!!J 11f L JY~:3i l 41~r, lfr
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40956-U01
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
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Irtt+rarcfio ww�i h 3rr?9ryts it C'YO 8ilcs toite-aah,mtnimlfnl of 24 y t1`_ms
11 Da-trier with CYC's to piurv-Q lr_e'w'rii:en rulrinon eCMU4 iolt aalor als 10 p:-irenlti trial. uppurt cvo-
W-me grrOrnothc,n^a anc IyaIHJ'.eit;'rk` rn05SO-gr.M3 Via ff~ Jr eS( a?'1 he O�''orh family rto"dwslellers and rner i i
sr'icl+ C.,h fr.>'J'ea'E: r',:w,y~ar I'M
y! C c7'r?,+sxr) pa rent ro,l'turas, and cal'!Yer e it.E, +'t rlu.l p'inI: aECSrr
fry us~ad on the h lth k~s'rYt~lfls nl' i'rwt vcr~ ts:hl' and hy'"Stcal acti r lyr
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October 2011-
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
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PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�,o�Cc u 1i r',:t i t I:": 1l all ai!;Irnl L F,p IIEc f ai futt_tl1 r. r, r I c=,r'I., i, 1.I1 I a
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dM l"II:."`:i' uQI- f' scat a f, ph'y': on Eras�t1' de.rlr'"rl.,_:]:icn 1 4: rrrn C VOI cox-A_:. u_�h
as open hc!IiRe-i ll, J1.11r 1 ar rlf i a f.arn ly-C.+rlnf leI IIf:C.S 41r' 1.1 C'".r_ I at 17"0.-1, Irr? 0"k r'It;-1'1
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r11 r N t IL�h a111
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it:: r=1 Il'Iti,'i.�I 5 r��:II an LIL i.1L:'te: 3nC the t.,,Y'.rl:i,'-.1 I1!' 11all_a:Jfaia'w'i7 iii:uzicrn!�,
c?a0'r" Ftr',,.t1 i uc,r_; III�t,uii o.
Ic. cb r 2011-
2012
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�-o�iiriItvuJr it', E'rii;ls 3 XI I12.I s A Mo; r~rr Ccouirty Healt., Dept.
coon of tr:rorlc #11 1U'.".
Acti vityr',tr+JiJawhods.
Tiimefra.lie
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Objective Irm plll 111 Conirnuriityr Event Particip~aitient Fmni roofer, 1 011 tilrou Ii Ss tk 3�w1>ESc~a'30, 20112, imp+roYe fr iit,and vegeiablean C
hyt iu l la i'yrt f' t ro Ir,ire� aplini n s k i nd 1 17 Ir r c o ti JiolL t e r r a ic.ome� d lts aitnen ++ ai te'"re ri ijt9I L n uc~t'~rtrit err at krt,
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it 1",' awl I.fl~.�+ t' mf.irm,+; at
CGnnirii'"Iltir' J r]S?t.' m.~`4133- as CI LIIt1 dc}n`Ity cu't rally'-apnropr4 fairs fr':;tiwitl'$, ankh othor
CU 1Ur;_li gat Ii lr+g-,; to ioach fine tar q i acil~nr t I3"ISi rrir'njl that multiplti t trc-ar_?ptlic areas within
the region are seated 7,h cn; are ih,r L reato*t a,rriciork i, largo ewcrlts 16-rat serve high rn'ijaiow.s
of the target n,,adience ho+lak1 be tits'ccus. Ccorcirlate a4iivd;les',Oth rr.tgi+ttnal porlners fait ril'a'y
Irr,.,ltioe, bUt Ore r�ICA urn kid to, Cll,'!r1','?r!ri'.5 rr17':+:�Y~rlr'!a 1 t�Vark II'u PrLjru'!:r'd l,lr
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as apprapr>t3te
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W eplen1ber 30. 2C 12
Lat C
Submit:. Annual operating
plans. cnnlraletel1
eIr c:tr`nnie A.T'F t a` sites,
2) Oifet semi-annual i:air:ing so Cr mi-nu+ ii"}' I file filth Luadors f CH'Ls'I to conduct interventions at
feesti'rials and oih�r event using Lila Coffe. 1:PG.;iir' tJ;;: y yjri~ r' IJrriS'"i'+n X1]1 k3iiCrn anna F`ItiYsk,:iil
+dr l.irYrlel"n' C-t1'7il`t1~~!NJfIS rJ! aUrr'rFrrluni( p.lar!rT m. nt i1 and Inc comp lntorn ir'alr)lllq v dc.,u Criswe
l tut CHLs are ireirec to provicre I asic iri(irrmitiorl, Ups. irtd rcoferals relaled to rutrivion,
physical acti':itir, end C ll`fe hl.
r.~,l Using 1trA rat?.nl11JGtflt *llf_c irt;ll't"411,1 9r11.W 6i 71!an Fli1!]'I I1 tt'.Sh."f311'IC i L,rl II f1 1 JOQfl'.5",
r_;itrtlfhl'~ rlrrl,p' Evorit:5 manual as a r uide', plan, t Onrr'li''l^tle, and Wt'I�tl,"'t 1L iICrna activities at
fairs, fec.ii�trals and''rther c tJIt1,Ir 1I m:;ititrlr'lr'l l a L�1,ssu,u apprwpriate CHI, siaff nc, i'-rr:it ling the
arcper r^?.iml>er Cl sti-iff, ivderliityririg sl.vftwi'h apnrrapriste cultural ri-nt 1 inllr.:+['iril, r~y.'oo1 i c tu~r' thhu
cltld; er LI Lo Lie 5{' led and, as rer_errsnr5t, pp{ If,arl;ait food handling wilificdir, ir, S cure
dar.atee produce sampler andr,.lr co ll.,, l v fill'ordination 1Mwith the Regional rt.!, i'It Pro.7naJdl as
Iif.'n1"�� ril",I?, Prorriotu'lhia u`SrCrlt to the tar'gei ticierire in rad4"ance of pur"liomd rr, I'=rr_rughl the
rm.-Au, cu-r,"' In i'}' partner, r'IL +r, l ia1lh fs'y't.`'1t urgar1lzr3ra. Conduct falCI t p at_'.l"lriii: s as
r~eedea.
October 20" 1 I.,at l-.il r1
Sr-,pterlbe, 211121
P-u:k:ru0:1'e I
Saprtember 30
ocation of sites
ualifira(ion d at1 etc,)
I,lkanllt, f aI'llrlt a:lr-w110=1
On File: Sign-in sheet
electronic; i%TF f# of
S�ut'r,it: Comp,+ece-d
t
ira
qt C. 1.~.~ e toms A a i>,
M r-
+partnershdp ngreerneni
with IOsaa'ral crryani els
CI I U- I etc.,), signed
L_ MntlTD rrcl_,.: L.) r t'cln 1ice, r, r"' 6.4:1 r_ c!~�i'Ial; I ii: Ld Iv 1 tr at... t.r: t Lali�rc,:_ jctJirZL,r:r,
wIl.' t:' r l'rr.~� r, r'o.t.t�
frI A uy.� I:1, a s Ft:![ 2 r:,tlztr:rir iarir,t::d rtr,.u t. do IrI' Lr:yir+
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�.o�I,.;.C711 n 1r f_'.r:, W,. I;1B"sT A rt'ir:'df:f*"p Dc cc 1- c+f'u'dc rk 1'-1 23�11
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t I.^.e5s, n1 IX1ll Wks us ap'E r rp'i:7 e.
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iok I1q f".i,' Map TN Is am ua fired to pEI s'tdc, +is+,.
tt1I EXIc t_'L`!31 x r4':Ia:r. r. rrl I f It:q"1 I,_lX_Ic l ilrtl':I`.y Ir3irllr:] ill J l.-,;11 II.'`�+!1
l.`i FIru r l[;':'ll 1'.EJ Uf l n L. t 1 I nt rr3" J'F1e l r il::arltr'lc7 luti':itd?_ t f'c:.i iurnier:i rIY~'rEW?�;,
11`:er;ie p;"up Id.t a'. +3-'I, q icri.ui'ir':tit I:u. pilau 111 o I F.,1,: vi r.+1ri i j +ttt'r wi:1,
p f-'! w e A frd r i r l i[ i l r r I nt t_,, for l e31-die rr'.;i 1
pp'^InNa... Won 1ar".1Ii I L. L'rTi.:9th'l, Secure h.ris Wr.'r food u nu ws.lp,i.ullus for 41ni
ei71f.'1`t dtir�Il`.+ I' IQ-DiO 1"1L e e'rl. Iii Iir. M MO FILLj_''IGir I ddkiai-rcf ci j'!rlil I: l1: 1 I'll r1U II
11R P;ioiia comrlilr:'It, parlrlr!*', and lit culc'r_afi v I'1 Iarrn rSAey ni;3fr.{1l If! it r_Ir'; ull+duc":
fah our urn.yr:lv.'ll'I,�; ls I+ LtC.i!i I_tlilize oJierNeiv1ufle: il]II_�dlClhC:IFie:yt' ptirUn'Ir;:ion
ifl~ i;l a I I: of Th Mein t", Prcdii i p Ir'
ICp, I i u' It; t.�.Ir y In, F E1_l;i ct't nC: Si +r +1"+. i;:
rf1-r.�'l:.c, i.! 1:';t p n 5o 1 or al oLI l: Jl'. r_ rll'.1 S wIIh rl+=R and in ITtI. f. t'L1rr
at_'prcpnai! tcr:II.t 1,? II Itlr i xt'ilh IFr h r.~tri ara'i l.'.r t
a.n�j'r*p:. h:: I; rlti rM,i 1.~,:!r,, ntil!y' cc: 14-Jae r rs�,-"'^'ii7.,i~ N!e' e.'r,l� err' 4;;ii~ i'S 1-':r!r:'L:., t. S:
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Key Deliverable
tibbill il'I'IU._iI lu Ur_'';=r ing
r comp amd
a ec'r+D,nl,' TF IN t'f s 1
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�/o�tir~u trt~r y Couri^;r I aalkh Dept_
FXt'ill:ill A,
CDrrlrnurdr fVeri i
f 1'-1U23d
of 1AVOrk
Actty ityr)Miothods
Fibsptn.sibte
Tirnaframe
arktii`P
Key Deliverables
Oh),dc,flv'o 32x. GcIrnmrgunilty Events Weal h +M Iy' 1 I1b~t~trtt Pr orc otft n in F sd~uak~: 1 y!' S p1enii r, 2012 wiltrt ra d'aliveery 01niitriti n dimr kl in:
ttt} CuIN>st'~t I utlih~tri igs t rid n1111,11 no 01 3 I'C:8tl^ar l w'1I I~#tural a YeriC or rti. ti3r~5 togard ng 111;s, Importance f nvdrea ii q A6
JCt 1t rt
I� stl,~ ls
i f rs f P p. r A, A
nurrlt~#ir tit Wen crti dhut Af r h a111Y b ii7 1 jJ s. actlal. U o hicrtstra rrJn.h end tp I G Apr I[tfitr, o,. Lti1u1 rtirsal I~tt~ukd Irt luxi>/ Y f,~ t~ t~-f P Nrl tir 1~+1 i
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cr~ll~rr7urniiy a onoieF. ha> Ii lpQnt
4nr}rc'l rtr the tii ftl ctrl n es w�1 tl,+ o r ertl it ss ekor r 5:I li l examples r urll" r^ratttat irr rx,,aemen r d r,.nrlna~r.,ti~z 1 1~i c:1er
ne Ittf
1 ip&, ur, ceWeoapnq parnF,,rsll pig, t%gitli t byal r~r'giililTa~r*, t=rio ate them a tll I e impporlan or
i IcreaF.r d wa5iI hitlt4" t.f 1IIJ Its di d ti'tm'tlchiiiiir:5 epporwriltIF for V. Fdca" wlh%dM'y, 1r'^~ I dlFr +~�h
f'tt-nbc r 1 CA S.tbm it: De rnntpcr-1 in
tf1jj11 UUn at IL.S IYeliu arI1] GL'fT.Iasur'.~r,( LuIIrlra1u a t1II Pr Irl 41 c na4'niiu~.ui, Ti=nip u. ti.~,r,~~.:~.~'~;:�.f tjI i'�1 2131 report 11e4I1G7tIAI.
ktij.,'t''v"�I'ri I tr.,,lr~.�;
IIL:YC~ti7rltf frfllf n FIa~~ Crt1J1 ti~dwi'r'17r /~ gjl'r1~`(1L''dr~'" r`rc:urrirJrdr.~~:' n? Crjenri?rfnIrtr f v iW; mci LI�.l
acid stuecesi strriees 101 Lupporl those eVorrts.
Itemt',Nr f:'' t
OI c rtik+re 3. 9'00il iiu ntt Ev ii1s Floe and FalrnStyrE' ItiII~L riiaiuocrt:t Gctri5l clIons 8 r e kl calla dr'rhg t Ci93srrlufiit+!
t'i~a'~C~t w7
b t curin reerrt?n1n frkm1 a nnIr I11 Un't^Cti( Loral IIdo i I I~.~ p:1~r don itlnns and pu wt t e i I~r,s fr l t h llrllt~
6 lbnt g g itdrF,eks and farrrtryt^!t� rrt.lrl~013 to' 5r1,-Ad
sad� rgani;P ii~in-~, direrrhe alth r;tJt~+r c rc'ifr_'S ticoI crrt7t~nur'iri L- Jrh rani vii; boils, r1d t1hcr partcirar using him ivc.'x erll,w^ kpi na'Jrildl Ii t t u' rtcl6e~t
aw".tiviti 4 tr gtr the e II Ipakt It5'awf=tricr_Imra prpul tirnri.
E 1 S C Lire agreements from f ei. arid lalmotti, rnalku.15 rrt rxi,ieate op IC t Jnd.ies to
4NH, L''r;, K; p, rlne"y, facuitat e c or,l'IL:-t Jr r c',wean rarI''.eila and prif-x.ri a1i1 coii"r�`r15 do-liW'G:-.y of
produce iLri i on grid ap e'=1a.r1Ce5 &V'.;inp t s,neaaker�c.
October 1, 2011-
eEltem e rl, 2 i 12
I a C',
Sat]ITti,. Ccrrraleted
eledrer;e.ATF tit r,r'
ire F miet 11;5, o f
t OoNOtirx, a".e,
On file- P rtnersh p
ogrecmcnl'i
Legend VIP r7 t 1iri3 rnr PC,: ai r, ualai, 6cr, VC: \itxri:I Ix-ii-Ili i r: AS NI'�. ir;i Af,Il4ii!; Sp c-WIE�1, CC: cd Ib:t:,lavr. C-:r1.r:ur.iIr�� I I:; arr,a a.'.r''. 181,0f Ltl A. tuL'r":I
F;, r~ 1114', I_ I Ji1 m'. iI, PP A. 1 u 4,^h 1: h-r,',r I t c!sr r IU Ir.V' I Leac n
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�0o�E XF- B IT A
ilfN 11.11 Utl[2L
Faith
1. 1 LI'234
ActMtyiMethods
YIatt fra5atttc.,
i"x, l1O si bk
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Key{ 1']rrl I vr lily s
nd Re"t;rul�#rnc4 t. No4 App1i able I`VA) ni r 5 Fv3r1 of #l G:[rritraCt; Ociritent itiiensioriall~! c iftect
tb tinr 1 1diti t r&atcrships rid c Lath r3tives: Not Ap lIclab#n NIA) not p nit off lli conlfac., r~L4 rhl inlbrdinrlRlt/ omi4ted, 41
ian irtlrnt on':~ll~y~~ Ymitted,
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�1o�Wn"'l�_Illl:r G,:ll.L!4'_'rrq_nl_ iers ti:nc Oren f-it-::ai:h Si f MY Ws E,X,I`ll3t1 A. WromV C:+I,ntj Halt Dap:
Scrrc ofMiorI: lit, i rl
Ac tivityr olethod Timelrl.me
6 i.`�'9 j w n w'.I b W
S;t~fi
Objective 4. Commmnaty+ Eased 0rr4,,ntrz.rt10n & Dirtjrl. Health rvi`r Prl +1r~ duc bona L ssorp:s; From October a, 20.11 Eh i)Ugh epke Hirer f O 2012,
Inipn.'ti^e VA and JgiC~ Wall 6Iiid I. a_ ls' iCCDi r,1i+J. i~reI! a;e~ nr:r.ls' I�."J~. +li4ri sot, y, ltl J by y I� Idarrillyrng, rf
I f-;s 1~,i't4,_1rl'I L,~.Itri,lt"'fw rirta IiC11t}IL'. ICI., 11~n7lb a~iuilt_clL:dlng,;
Llu7A.'llll' ir1d providhIg LSt1 1 C^�`'!, tr� cc+rnmulniri b. r.ed CirY. t+tI.`�' 11cjr' t CM) and dirr?'Cthc':iI" i seirJii=.Y rovidol`5 C1.H.r-.,r's"1 ID co id C,'t r' iiirifirir'I educhlivirl tF.A5cn9 fror71 t'�t?
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11 I}_ ON, r(LIL L, aid ULCL'e Wlnorsl p: i;i. t1W' I-u.('Lt. trrd DH SW to Wdr_rne? We
i f,.Zo:: tc educ._:F AQiL Ft KW Ir rnrlr, 11 IL_ ll,r!I,t fn l r>adcb e:7 arld pnrr,k.a ri,.�,i'Lf1"y' ana
tr;IN and ril yklq U lt'i1L L'Ilyh%5IC!' ASM-tncome du t.: can 1~K. 10 L;,II WC I w:.l,l'ti'_ Il�hr lfI'?l- LUM
p1. W cl...lx9yW`r'lM er�t'I"Llr'Y"erial Cihyngt=:n in t'_Ii'r� cafiirtt.ll'L'li*
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n` rlfe['If.',t1 Ord tdl;.+;+ ut. Jt_ll r d.:.,z or I I usage of K-.,- ti'ILtr II-s f:l af,.!Ir_ 1!.;'T1'4t'.:ort1';< f~,r.LLr Llc� I~,
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701:
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40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
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PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�2o�Au r'ir1i t`atlcn
x"tt dlvitWMt thuds
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40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�3o�Ao ii:�I; rJr:!ln E:H B q A I.9oriter,' t cent'; Healtri Dep,
On um of y'w'n.rr: P11-1023
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�4o�f.drrliniStra;l9on
Arti'rri tyllVlothud
r:IUBI_ A
t1lt rYl V ur
u'1 Quarterly ri dices due one month fol umn!7 Me We e of tt7e quicker January 31. April 30, July 3
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September 310,
2012
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co,er1,2011-
Se;atatriber 30
1"r. et Q
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SOW Re" M l i m)
Oct file: Agendas. c+1. 1arlah a%
applicable, see below
Submi.: List of psr.iclparrng ssicfl
and dams i:s�oN epr,n Ferm
On Ma Ary,on�Jas
D, L.=a1 4, r_at au iirii' i:.lc t l l 71 a ipr kllr1q Aafi
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BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�5o�dxnrilsiratidn i~)crlII;i11 \
C 0 P e CAt 1,� 0I P.
ActIvI1 1M(,tFa o.-;
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Itilttin of I.Itiiii wi kaainirita. JS onit r es also rr, Jrvlwr+ ar-y+ f+"Ir Pr tjc-;:1 Dir!^~z-icris, Collaborative Cnorr.lirnatnr
arwd M 11,-1 vrir'~clfna.ti i'ar. TrEiinirlg~J n'e~'rn^ rer'Id,li'ue it rf15,oLlu ed to include Lv in Secr,anic itsi
I~t~'JC�UY'`t:nei f}'.' 1 uric Feuruary 202) and ct".e in Or,ncin Linty r r Los An+;�de'S Country 1!+d'fo'tir 21:3:11.
Gates enr.1 lur a j( Th w t prrrAd,ed for plannog p+.!? l ti 3!}~1 wtri~' u~7.jr"~ iccrianpr-.
di Piei cot Stat'ocw de C�411 otii:"1iwrt f toy fa;~E~'r![?r!r7:'f'tllJklSr 7'! p E 1C,fl,l"II:r +!a4.'i'Ir,:r1
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2x12
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i d;EJI`orial r-rL!fVFkryrt: Project Dire- c i or r-t!ITIt3'!o1' Ia't?renonta': ve
1) RaThin Your Drink Activities: f=I xrtt,:: iris c. iri monthly ReTh nl:''your hint
r"I! Eir t to rogrc�nal fw'utrih.tn Ed!.;sCnl ru7 Initi'tSwun and up to one fz- ce-:c-f;te rnrie ir;i i75~til"I4r'121f
r,i I It c * might i c'ude: padilpia.lic'n ua 101 Irl1 tJowdopmcnl processes, pIaI-1F51ir+a] mw;lrsritlla,
Y1 I r'Ir__ Y
r~r I I 41,11�4. a-an.'' best c r
a i i
pr'� pal
1Lit 1 A fe is cr.+Cclilr, and r't' 3 1J:7 II ri il:f u I
4witr'r" r Ip__.__.
2: E iti.un3 that eppropralp gbiif Pam r7:I I:! in regicm-specula i-z nnical yrx Ft111'11;11 ttrr('!L`ri4+tiitjra
P nirrlum'.
a) Canal-aign and pruur;grri le�.:.nriic a w T� t'lra calls pertaining to the Kprrtlic, let?nlr ail1.1. 15lanrLi
tic ado of the region
f'4cyrember2e'l I
& May 202
Monihty
October 1, 2011-
Srptember 30,
2C
Cc.:reber 1 2011-
Soptember 30,
20012
Ra poni ihire
Staff
PC!. CQ Lai C,
PC r^,J:it C Pfi,S
PD F
u+, tit:
w+lonitll
October 1, 2011- I'D Pill,:,
Sup':wnbe- 30, Re-, L, PAS
r 9e~rtt r+-y I r,;l1.i. I Icafth Dapt
J11 1 10234
Key C7e:Ff rabI
Submit: Liar of part)Ctp 1i^'n1 Mari
and dates Sr.}bnr Repo i 1 Yirr'+i)
On rile: +9ateriars
+ubinit: ia:t of part; palir�n staff
4nrr dolor SC~',"d R'I?port Fan'rr
On ftle r' tar;d cs, hlzntorial
SutbrliL List of pariicipa:fng rtafx
aria dal,* t?+IJ Report Forni
On tree AX end;it; f,iatoriata
aI:irri!1 Lis', of participating s-a-rr,
c1:atl'%, iroy cunintuticris SCtw
Isafrtr, I cir mr
On file: AOen h, a1'rtczri lls
I�I;rrni1: List or pairticipahng staff
nr!e'1 dcitr,: I(S D'q^i epc* t Farn-1)
I.ri;)nift. List of participabrig staff
Mid c4Gita5 3O'fy Reperi For'n;I
2T l 2_ 1')1 t rile dlr.+ad t
Ii i Ar7,ozi:: f ogr E,s Rpt'.'.:arr ft'.le?:r"li l~iti� uii 4r., r,~iti'f"eii N e" L'V(Vi r:1,,f' w III t7.wwr.,i ai:tt fit Ur,I;i uriiu
lr r:an'n+' nco'i�:+re iet r-"r,,grri5i ri I rue dback.
Mari!.; arp'
2012
Subr-il:' List of pa pa':irp s�ia
and aaatooo 4;30',N' Reorar' Fomi:
I c11t, I!' r a,7t is rv-,,.--o� 9 +rt:l y f; r cdt� + L"! r st I~~rri r-, i�i'nal_I C ra t.7 r u r I i i'I
Wt:b', r: 1^"7 t s.~�';"'I,,."'., f 2:. 7::i i r: h...,:,1 r:. r7 iIr +.ra i. nr:
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�6o�Ad,ii Irs1I torI XI�YIH.II A
cr�pe ci V41W
JActiaitvF,1 ithe.rJ4r,
Tin71?drame
el One hapirg t-I�r`rllth as Partners in Education 1.11J, I Ca.Iilnrr.,ii Lv?ico rsuty+;-:rrkirg rneeli'- f March L. JJy
cJ1-u- il t;yr t'u) 1v'ui-' r4 nf(.ercd in most regsionsJ 2012.
31 Er c�"sio in at y;,terlne-l prr irr3ri' and fly gal al:Jtt IJ,t-1 cipr:J`,ra in rc+riul!'oe Site VMS at n i ilm1FrrT crie
jt:ti,"t fiscal and progra disi1, any one e2t`il Ilt r i 11,1 4lrl and program. N-.tilaIr... r, I. r:,,l�
A may ho
C=CIittJLrt:i?'il' 1r tiyT~~ltlty! a:r!ri er riiuu: i 1}~i' rl�"i iits'!i:li i"r,It,tMC.t'er 05ir may Aso be reVecte'd to nom one,
Y11 by to rill t4'JclrI p'rcg�rrni:.riill71r~i1u,t+ ticepiu y am.
1) Ens to ft-.:at aopropri. ie s1ai ra! Lir/e afnIhflrl l train
17tIq,ti rrcli r"tGJr'4Lrnr. 3.-rrpo r VVnr�:. Y.1 rrtirltmni rn
Ig tear S"L;pportE I_-sr ph d Jt en anr' Ile
N l t dert 0111
r1:1r`I'r,~ 311
2 i1
ta�t GPR aria Fir-_`,6A Certifcalir:'rn: rr+.'. n-ilnirtr{JI)i 1e ir't;dri,'I,' J'i I'1ri',rir' Pt jalr_a:,`.~?r~rt:f per 1311 t.= Fp' laf?lJr.r ri,
It,t:l I t cu, rar1, rt+f sa:tic.n. 2011
b) Food l'1andti^Ig Itif,t 1!r tt y l4`.II rl- ir W~ air.?'r tl t mac 5 the ccJnt5r t"E1LI gAIllk I'll l:'t')tl e?~11,:l f;l,th+rtl'J
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e3rtt Iii? fi?.7ui:'L'+mr?r�fs of the C.'.tLl'tl'yr Ir) J.ti'ilir;H A'. rillnt:''^-iJIT1
Mei agci snd 3pproori3te cemrnLirlttp I)r ulrlr Ieaak' rrl:,sa bc~ c� rtiii d.
c) t3r~!l7rt+-;.r ra!`;I'rl:-rr, 7r~ IrcirItnf tt`1'arlIC ll"tc't a`1 ate Sta`g, incr`uding CnniociiCn and Prc rnrn
Managers, Physical rat:t u'it t 1 ir'ihSt, Pro;uctJi'ector, Ooll;orcr iti4e l t c dirater. and NxYi i i
CIs'pi t tJil nil, tii` r JI t.Jlp t 11
s_1 5 r^_ rdi~istor re-cc'+a.~ k_rI rI and t1
r^^ 1r clt i1nC~' on La~'. Y of tf7r=r'd".'i.l r.~l Ir:rY:r!N l 3111y")iilf'irl
mg anl5, Int-1'a11.'n3 and 1.ItI11 f I11)Illr cJf�;�.14'111F!.a. err Shd111Ig an s'JCII r'u1 ai'C'44111+"I JCt+?4:'1l til 11G".If:k.IttLYl,t'l11
t r'x. r I w aN f t
Id1,:n"tillarlr r"1rJ[ iii 1itrl.r7t I: riC1 11Lt<ll~) address FIJI r1w) 117," 11611
any. r~u7,11,~r r11 d.tr,l" r~ alt"�. ii.r`
bciIi acing it e r:a;ir,r� 1 i'Il r l r.: trl" lion opparlu nit ie twrt:n Varialj of t;t,lrPn, r!Si, k
d; Clio Ii- n rar ol:crnai pre-aponoved rneel 1': lr:1i.;tr 1'. tllr c Cal choice f=ir Prcre_C l ector, earl^~ tactobe'
girl"I M:. r-: nag er PTtrr. a.-...l r r IKI:.,~
Act tr C? + y
rr'IIII.atifrar� ail t_r_�riinc-~,1~~rr r~ f,tlc~~ia a p t_n,-,c- r
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4r ilm" 1y tiJnr?i',v' t?1a;i.1t1 T): ii,
I.' i 1I:i;?
Responsible I
S'taf`f 1 kcey 12e.llarrs7 IbJe
1 Idl�OR Wt of tt;all lial",In 7 tali
RFC, PAS arid t731 a 1` a"' I.I.f Jr" r iirrlt
On tile Asgerrdan, Materials
Fl)
P1
PA
r
SCI
All SInifi
All larl
ISular Il: Iratog c. Cyrtccmi s o
Initu visit t'Jarmt,u-a)
Oil 111j:
i,rrlp'04rarnort" Pl i P P; Li r-ur
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S Llbrnil�. List al pa,tr oa-in,1 51sf
and dnitco jO),1V Won rorrnl
ii IaIn j'.,;r:irdr.
ti:iihft71' y' Of t:L,r'![rY I
ce:hif Galion
ubrn-l l:;l�J!,~ rrf cr_rri'ICc~'ICr.'7 icr
invNind Off
ta~wiblrnit. I-ct an I ain in da c and
alitundco:a 30%11.1 I?wport Pc m)
ern 1it:u Traairi ii1 ma:a-ala
elltai)I_ t. 1= it L�u tr t i:J1i
and da'ien I: u J. l,e.-1 t't, ti
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�7o�A, IiiIl7l?1Ei a41on
ActivityAtle tltods
Timefrarwe
Rosponsiblo
Staff
Key Deliverables
Ohjteefnws 4TAdl-a irilstratl trb M+iaia t+ l;~y'r pk;r1 I iti~:r r t iii:'rd'arn O abor 12611 through apt rrb~r 30.20012,'ca tply trriih g iid nc r/1~Ce Ca'r; F rr I ra
and prc ducriiryn, es'tablir h and lrnp l'ne I tiryq pl+ i:iri 1 nL in an J p( O r iurras fot,lrrareh u.ming'sicl"agle;and dr rng of hv. enlacontract, carrrpa gn on pr rt~rn,
material,:
i I 4, 17tCll`r' W IClt rlur t it rr. r o I ttrari to ateli wis Croatia,, and p-od--mlion as pr, *.Jra,
1 i rta Lit l l f 1 1 b,mit t.orr.pleleu materials
r
i
r
1
I
taalrl
r
tlr,.~ 1
t r yr~ti fr r;,.__Potit r Er Il
Arld1:31
dl
t!r: Ii.~en ing c3jrtamc nt. yarnl?r Cr
r.3 CtIi Is r,
rrl yitr
30
e
ti'
II t
ltF rur,lc'rrfolm sam
le fi4ral
r
r
p
it tnr M; +t~r7 r~a nr 4r i r r;
t. r 1Yrir c p od+~on and dis_e~mr^.gtion of male 1 tl~d tl aelcrpt.c rr I
21?
r'n?CId9:t
a,!1?i]J rfl,'~d rrrlr~ he1C~'; s:',KIfP,
2) 4"J�i-ehoJ eisicre and track fl".a~"Lntcir"y' IcYI'a;Cari ii r%dr I Iii ri pr" 1 pro,,yan1'�n-ati ritits %qua.ntity Sri. Dctober 1, 2011
matenale; is de,w endens upcr-, each region's tnlrr rt n aCliarnr^r. Ile and con tact miring t rrppr-fjpn l ep'm'ti dr 30
use a` onlir ordering syslem. Oac iions ww~;ll be ridjur~Oed i ne irk l:l. M 2012
G r:.l-II?.Il t~<an;e e i:nurr{ 1 aILh 1.?r=w:d
cr:rlar" s:i'f r rih trl? 1".12J=1
PD,RC.,tatC
Rol. C, PPC
tiut:oI Cch,";plt?1ed IAAR
On f le, rolater=als request tracking
Lt,mLr(i D. tiLt Gwtc~:_si i4 i:rra,:t.r1 i:w*0r,21r:r r.'( rdiiryiti L.',. rvt-+alr+, I lr::, ICI ii,_Yi t irA i;~~ a I I,; i;irl aiI i L. Artir tole; L A Lill it PI' C Frxrrr
ri r.~s~;rrJrtyl,~r rrrr f!.:'rrAew f i:;:arL Ii{ G. tt i I C.:arrtii~ralr;~; i lt. L r,mrrdt1rij IIr^Xr rr I rr;.iirr
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�8o�Monterey County Health Department
11-10234
Ext blt B
Budget Detail and Payment Provisions
1. Invoicing and Payment
A. For nevi: es satisfactorily rendered. and upon receipt and approval rjr the invoices, the State
agrees to compensate the Contractor for actual expenditures incurred in accordance v ittr
the budget(s) attached hereto-
S. Invoices shalt include the Ag eement Number and shad be submitted not nice frequently
than quarterly in arrears to:
Luton ica Regalado
Cal ornia Department of Public Health
Networ* for C-1 He lthjf caufomia
1616 Capitol kvenue. Suite 74_516
PAS 72G4
P.a. Box 9.971377
cratmento. CA 958-9-9-7377
The State, at its discretion. may designate an alternate invoice Submission address. A
change in the invoice address shall be accomplished via a written notice, to the Contractor
by the State and spoil not require an amendment to the Amendment.
C. Invoice shall.
1. Be prepared on contractor's letterhead and be signed by an authorized official,
employee or agent certitt,inq that the expenditures claimed represent aytu7l e pense:-
for the service performed under this agreement. Y
2. Bear the Contractor's name as shnix- an the Agreement.
3. Show a unique invoice number assigned by the Contactor.
Show an invoice date reflecting when the invoice wivas prepared.
5. Be mailed no later than five days after the invoice date.
6 Show the Contractor's vendor number assigned by CDPH-
7. Show the Agreement number assigned by CCPI.
k. Shoot the Contractor's reriittan addres
9. Identify the billing andior performance period covered by the invoice.
10. Itemize costs for the- billing period in the same or greater level of detail as indicated in
this Agreement. Subject to the terms of this Agreement, reimbursement may only be
sought for those costs and?nr cost categories expressly icientif ed as allowable in thi
Agreement and approved by CDPH.
0. Quarterly Invoices shall be submitted for payment within sixthy 1g) days fotlcw,Ong e end of
each calendar wader in which the war; was performed and costs incurred in the
performance of the agreement, unless the agreement has reached the expiration or
termination date see paragraph 4, Timely Subrnission of Final Inivoice or a later or alternate
deadline- is agreed to in writing by the Pragran Contract fv anager tskl)-
E. The Contractor may submit supplemental to voices to the CM if it has determined that there
arc expens=es incurred dux-ing the term OF the contract that have not been previously billed.
The Contractor must subrmmtit a written jtrsttf`rca- o' to accompany the supplemental iri oic 1sj
e1of4
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�9o�Monterey County Health Departrnent
1 1-10234
and shall submit the documents to the CM for approval. The supplemental invoice(s) cannot
exceed 20% of the total contract amount for the fiscal y=ear in avhi the supplemental
invoice(s) i.s submitted. Supplemental invoices for the first, second, and third quarter are
due no later than S4 days after the end of each quarter. A supplemental invoice for the
fourth quarter is due no later than 120 days after the end of the fourth, quarter. If yo are
seeking an exception to these requirements, you must send a written request to the CNI and
provide justification that explains the circumstances surrounding your Inability to meet these
requirements. Exceptions may only be granted after Netv1ork management has revie,'ved
the request and has made a determination.
F. The State may, at its discretion, choose not to honor any delinquent Invoice if the Contractor
fails to obtain prior written State approval of an alternat�. invoice submission deadline.
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year end; or any subsequent years
covered under this Agreement does not appropriate suffint funds for the program, this
Agreement shall be of no further force and affect- In this event. the State shall have no
liability to pay any funds whatsoever to Contractor or to furnish arty other considerations
under this Agreement and Contractor shall not be obligated to perform any provisions of this
reernent.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this
program, the State shall have the option to either cancel this Agreement wi}.h no liability
occurring to the State, or offer an agreement amendment to Contractor to reflect the
reduced amount.
3. Prompt Payment Clause
Paw rent will be made in accordance with, and Aithin the time specified in, Government Cade
Chapter 4.5, commencing vii Section 927.
4. Timely Submission of Final Invoice
A. A final undisputed invoice shall be submitted for payment no more than sixty 60) calendar
days following the expiration or termination date of this agreement, unless a later or
alternate deadline is agreed to in writing by the program ChM Said invoice should be dearl
marked Final Invoice", indicating that all payment obligations of the State under this
agreement have ceased and that no further payments are due or outstanding.
B. The State may, at its discretion, choose not to honor any delinquent final invoice if the
Contractor fails to obtain prior written State approval of an alternate final invoice submission
deadline.
C. The Contractor is hereby advised of its obligation to submit to the State, with the fine
invoice, a completed copy of the Contractor's Release Exhibit F)".
Page of 4
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�:o�Monterey County Health Department
11-1 034
5. Expanse Aiiowahitity 1 Fiscat Documentation
Invoices, received from i the Contractor and accepted for payment by the state, shall not be
deemed evidence of allowable agreement costs,
B, Contractor shall maintain for review and audit and supply to COPH upon revue-st, adequate
documentation of all e. nses claimed pursuant to this agreement to permit a deterr-r ination
of expense altowability.
C. If file allowabillity of an expense cannot be determined by the State because invoice detail,
fiscal records, or backup documentation is nonexistent or inadequate according to generally
accepted accounting principles or practices, all questionable costs may be disallowed and
payment may be q+,1thheld by the State. Upon receipt of adequate duoumentation supporting
a disallowed or quesi onabie expense, reirnburaernent may resume for the amount
substantiated and deemed alioix ble.
D_ Travel is a reimbursabl s e pense, receipts must be maintained to support the claimed
expenditures- For more information on altoviable travel and per them expenses and
required documentation, see Exhibit G entitled, Travel Reimbursement Information".
6. Recovery of Overpayments
A. Contractor agrees that claims based upon the terms of this agreement or an audit finding
andor an auditing finding that is appealed and upheld. Will be recovered by the State by one
of the follow ng options:
Contractor's remittance to the State of the fu it amount of the audit exception wttiin 30
days folI' lnq the State's re-quest For repayri;ent;
2) A repayment schedule which is agreeable to both the State and the Contractor,
R. The State reserves the right to select whi p option as indic led above in paragraph A will be
employed and the Contractor will be notified by the State in writing of the claim procedure to
be utilized.
C. Interest on the unpaid balance of the audit finding or debt will accrue at a. rate equal to the
monthly average or the rate received on investments in the Pooled Money investment Fund
commencing on the date that an audit or examination finding i_ mailed to the Contractcf,
beginning 30 days after Contractor's receipt of the State's demand for r�,pavment_
D. If the Contractor has filed a valid appeal regarding the report of audit findings, recovery Of
the ove-rpa rnent M11! be deferred until a final administrative decision on the appeal has
been reached, If the Contractor loses the final administrative appoai. Contractor shall repay,
to the State. the aver-claimed or disallowed exporisers, plus ac eo interest- Interest
accrues from the Contractor's first receipt of State's notice requesting reimbursement of
questioned audit costs or disallowed expenses,
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�;o�Monterey County Health Dep.-arl.ment
11-10234
7. Revenue
A.
This provision supersedes and replaces provision 6 entitted_ Income Restrictions`
appearing in Special Terms and Conditions Exhi it D(F).
B, If the Contractor realizes a profit from the sale of nutrition education materials video's,
literature, etc, paid writh agreement dollars), it must report the amount to the State as
Contractor income on the SF- &k f rm The Contractor shall make the SF-269 form
available to the State on request. The Contractor shall place any income, fees, or
reimbursements accruing to or received by the Contractor for services rendered under this
agreement into a separate identifiable account. Revenues generated by the Contractor as a
result of this State agreement must be utilised to meet identified, agreed upon, program
related needs of the Contractor, or must be returned to the State. Any revenues accruing to
the Contractor, based on seniices supported in whole or in part by the State pursuant to this
agreement, shall be used to defray costs incurred by this project to measurably expand the
program or improve the quality of services detailed in this agreerrent, and must be approved
in wMing by the $Late. Adequate documentation of the use of these funds shall be
maintained,
S. Restriction of Funds
The Contractor shall use funds pursuant to the Agreement oril-y and shall not, in whole or in part,
freeze, restrict, or prevent the use of funds for the use pursuant to this Agreement; Contractor
hall not divert or use funds for other purposes.
Advance Payment
No advance payment is allowed under this agreement-
Page 4 of 4
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�<o�Exhibit B Attachment F
BUDGET
10111111 9130112
Monterey CQutity Health Dept.
11-102:14
T'EIlz ONN1.L S,4T. tfil1G;S
1. l"Lwsldilaa>r'l'ltlr v,r117lrai nh rl 3�'T'odnl. FTt' 4, 1'ratal
akk a lcciinu.l) Dollars
il"1~.' B' a n~.�s.a h,
ail i. v 1 Sn 41 wvs ti`_.'~a"r+{,i.
i,11-t Pro t.trr
G~111~. li~~,LWGLLC~4_~JKYTrr11Cl<Ilt'rC. IC-~~1'~ull�~'17C9'~Il&L~
rseatir Prt'<v' 07nr�d Cf?PS]ti,9ad C1"r1l:i,Iii Rnhy` #."r>H.1~61tay~clT 5
P(-.) s 70,43,92 I.11(X)0 6921
I~If.�, rl! L'id. T ils I 1a 1.1"4ri I 1 1,1.,] ty 1'1.1 1wiu riIrrla'lsl i
7.i +
I~,T,I;wiai'I
y w
1'id1L~.~,P] i lal`d~ll_il7bli II}1~1 l 77rc 1111 7 II''u f,C:1tl rlis ll~a,tu~r F"rt CC l]
T1.]7, I Ilirixr i Iaiit G CL)PS 1),1�a-or 1PJa A.z4_.L3i11-: y4�
CL)PS1:11 37 r r t. fi v
p
l'i4Jc. LlJ9lt_,err:
lical1:liI.Lxdrr
PrDn7ratLron raI 1Y.Irr 17,277 CI.~}-1U4O y 1102
1`i lc: Re-s.2 il oilreliiittl3 75`,aT I4_1_l&I'S 171, NfrtJLU 07clrrlrnaii-r-25"e, f L11'S TIl 1
db~ 5
1 1Ii 4.III
t'~'b.Ir
CT1 I'Ttt.i;ii11 E Luarloiont P~:Iari7aiii,i 1]t i1Lh LI dr",
1"i.i]e: T'cw~vr I'1' C'-Dwrdta;i r 1L�1�tl!S 1I
7~,'F 17
1 I00{I
5 57,64?
S.
r.,,,�
1it1r. 416111j t,4IIIr.ffl altw i( 13.I'? II,
i 12 I:
111176
Y c7,42I
1"iC1r: C:;, III i f.,.,riiw1 T'za:fraffirf;,l fl innkanliIV 111v.ulIJi rider 7,27 I] I r;+? I s 3 7
SUBTOTAL Lti~q.t fY Ln4 s 376
78 7
Sri 16 Jil';L'S#;lIkIP'T tures
w' s#)rli.a[iu14 L CI]t.*.:-whilioncducatLou c'JLUua:t i i n d buds?iet, supcr. i.c. s 111111 uirn rx ucr.;,tinn.t ri1`iid- r.eI1'iiilirt II pe
a u rr)c r�_latc il mrcrfr1 p, n., i1,::Lrrlir1:s 1)r1 rmu, 1bl ll`1 11114 pijr ip;11e:5 r1 L]LC L n,i(L I1 craLlkihr}rtIi-%,c. Coo ryl i na clantr c i reI)aFLI
6 t rY kpi i i 41a"*!wti,
1 l r1.,f`c 9110 f.11 X C f�3 111v rIWIrlI iccn rr1114 itIIon rognaia. inti.Judanr prr,;rrc1, udminisTratj1111, PIs"5i 01 tlia( 1 iaf3rErirI, I1eP I Irs49�IS)lIrIIi�141 i�4-
l:hG 1LIIII.L1t n z=dkiCdli.nn LaIup nt- t acid TL1516CdaB, and uthcr nwTi-tikmi arid. 1)h3,9kL,2l ii L1r pii-i1L1u111f
iii piij
r�i17TL4
y
Pticje I of 5
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�=o�E ii1bit B Attachment I
BUDGET
1011111 9130112
M'oilteray County Health Dept-
11-10234
I{
Assestsdllr I'1t]t4t,;1[_rl1!rdinti1~4I Ilhltlmtlillilrl+':dlrrarnliel l lrnRr~sal 9nronllsr:~llrl. i1c~'arl,^~in.lcnt. UL7aicrthr.diTt-clarx�all:r'
CoE rdinaloT, implements c:�'rpii[gn and pro-ram DMriIima t,iJ4lcii tiu 1 drillrllrnn, km 1Mei Tali' *' iiiw Ctt' proiccts and partncu5 scrvmt t'h
54lp1llanb.:11C:'rt Nltlrullell) Av:ifil'.;'incc 11rro'rzni-F.ducatio]) SNAP-Ed) eligible 1Gar 1 a1Lld1Cn11t, I:Uytstlldw-. mid iz-s i#`71s %1 1, 1acrin i]1,
cif r i ble hilcr"r",tuhun sites ili)Il i141i I.IS'r74:1` for i mil liti ri frlml t, i'i"lp,I'lii't 1 41 11^illl:l, arlt'L assi.l i4i h ra^i aired cantIact tluctlenl�nl dime
11n4 reputing'.
l lEtrler hl'':jLl"Ciiillit t!i^IfIC i"'S l:li'I'liliL:+ti 4It11, I;Ylil.llaii t ail Iii inLic 1)rkiL,1 tin'I cai1,pr11gr- st:Zt1�a.nd nurrll]"]n wIJILICuI10n III IL41h.lCk 11!+1.iL
r
ti illt"1 I1I I1k)liiil'Ial a c1]\ritics: 44m iv 1h 3c-fouls,
mid 1nl!ci v tIiix ugh on otgtriL`-ll hl nla'J
a'tll:lc'Ul:l~::anti I VV- 116 ut heil l l.IL fiiit:sa 1 1111 a
L7izalia iii p511.mminL and p urns 1tig gu(K1 1L'"iyllll i1I.riloil;h cti. wirit13tifoii
cllilullCrr., fain) lacirkti' 1~: 112%iE3lit'I i, and cnnlnllil'Itt'6' o1-.
f ui.i rilD:N'1 I,1 i iltlil]l1'1:1 Ile lidlti~ 91.11'4 d"~ht' iit:lll.1157: illlil develop culruralh' atid It1npuisirl all y 7nntpci ent nulT7tLDr1 C1i17K-LII411'ii I111d
e'LL77Catinn ITJAterual. to pr,.-,rn It t`XL l1.11g and.-or It:' IJ,,volop r1 W^ 11(t4Sil;II ilk llvli't l'71iiei1111'1OJ1 i1 zan ra11cni k5frilhliTil7Ctr1 r dLicillifi:l),
t.1a.^;4parld I"Il1r ftirlp,.,aft"miumitvclu4t.".3Chprtlgran'iCo Cr3".a rnpais 17t11r1ii':i1:ij^i: b1 11n1"�nt.'i luirl4li:a:^- I;4)iilm7tl4t`p' 3warcuess.iiiid
iiil
i
h]1.iii iJ~'e i LIuj4 iii ni t~ ri it d fiCil l'l9i'r 71;:1.1w'4: Ill i14a11!' i.
a'~1l114"lti' 1.`i4*~:a 41 llt' 11Y31i.`." 1 c iii aro I1urrititlt Cd jintion octivl1ks oft L'o1l",1171:4];, li' +l l1.uI L: i N'I'Ir S11ClhLS: and
9pCCl31t M.'ent.S TVIVlti t.U U1,11rllia:m k'-dkIfillKm t191![llieti. r.t7flrllTl'1i41 I'lull Airily C l.lc f7LIi1 I]L1L! 7L'zl.l iLCC4'r'L'L'p' 1It1t Si11)CNn
Vllalli'I 311h?nh* 1 L1'4,~oi-k-Lruitdul h'lrnijcctc and p.l:rrller:i saving tbe'Si~^t11J t4 du thte ili il� nt"�,
corns-1n d.trainii 1at"fi,a'.'.ref�i!;k hiJtni'Iod pr~%tc:LS^ a13d 11t11u1m sl_:it'itik 1.1.17-S AP. F d r:li aiNc IltW1)la.tion. nn in[ezration ofphyaical
tl 1iM')Lv into 1141411 ion 0.(1414i1I olR IFIt4". I' la'GI'IClI"Ih1w_ Cr rdinarc- cit tiff a ploy ra'i acLtvtly d ernriri tr.lfio phut ila nnrl^Itinri and
physical aC4]'4'ity rl:4 iircef~ t i dllslribilti. tIi nldirp3alii I di.lil4 illtiil At�irii V01 I'll I
lc]llti:lCS 0311 1110 Pt;[;IOI,'ilara~'a''tlI'il Clirti5ii CCIA.it ls. iii";li1aIiut: 1'I'a.illlt[i, ld llirl.ir1ai1'lliip' u i iioC135:nxdia Taliln, tieI'~~u11; Us 1I41.u pri lk r
r
l
iiie i:la7 tV:Ill[ai. C 14 111h S~CF7t!_ and +' r� it>tial I'wlrl is rclrliia,~lrrs nt-1 mL~3Eu
a'i l ll" r. ll)]Llt_l Pllltnt7:d, 7 n.1] p Ti iY')a.iltl^
r ills,: t1 It, ti s
l i' t
a" t.flL_S in. strppoit of Rr.IuV:O 1il l min tincl 7_ YiiCa iciri actii it'Elv rar' JLiriL lic S N,,ill-E J L ligiblr pupir Littuut
Wt'1�t{i:s.1vi111ili4. Ptnjca". Coor'dinalor in SNAP- d compalkinl11cs to k:UtrJ7L::I 11111 ritlalrl vtliit`;itiiisi g11[L:i'L"(`liririrti arA1 p rttcipate in local.
C1'CT71'S' m pSL'in7lltL he il.kll'L L'a7Cil:1~' and p.I] yr. rah 7C'l l'r l l'"( for S,+N A hl,Fih cl iSihIC:i.
T011 1)all;ars
i
L tIEN I+I1 w"
F1MC+
nt.lud_., 11 rill p
cliu~a~�nt. atirl.rs cclltllrn~~rtticSrl, ttli_ nsllnn.�:a-, ern ltrr~t~ ir�,�,1I:ar7La>. 11A lslcfli~al,rl+.'rltni;ti~lsinrr ha~ni:.tiLy at ipproxanulltly
I.4, i(`'cl.!t'p a;?I I. i 1, j':1�r~ti7iliil'I^';'.
13'9'O'�F 4L�: S 18_k,742.
Per5tl11u101 Salarla!s and Fri rl'gt Renc-1115. 4:1tlifti niil Lll'l):9r6n.eM ail 1 Nrl lll94: 114-:,lih C T}1�TTh::l all reirtth,trs rho criRCT ctdll' for
se rviia!ti' 1t`YfiiriHW'4h iii4 itlvolce J dhlir-iiLg the ii)'1'CIICL2 pit I irnd! a.ti Iiiiitiucd in 1~xbi9iit It. 111)") 1111i1 1';a9kll'iii 17, t $ I I 1J1* tlik a i c,ii trait. v.
P'Jt:1ts 2 of 5
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�>o�E hlb t 8 Attachment I
BUDGET
101'1111 91301112
Monterey County Health Dept.
11.10234,
ORATE t.Tl 1G L I.PE NS
F
u
t 11L?4.,14~r,,I P,ywtat- nna cxpinsl.s for rnrnlin5 Gl nr+rsililers tLnd cc+rre'spondmCc in strppor~L at`fUtnit.on tdUCILLOn ucttYrli.es ira drc rrtbed in;
npe 01 Work, rnclltdii Fcdi�
x, ictc, s3'r; 540 x 12 num)
i' rnerul 11 ice S.uppiic pe.1L, prn,:ils, pulrtr, li Idcru, primer earrrr,i2cs, cm- U90 1 ry ytic
piicnlia3t
4Y
o wr~dr1:l;rl~,r1 Tr'+c ki,7r'a1 ar~,}'; 1itilt'~r'~i~;l, rrirr.+l, fKf_' rrsrr7tlk~rrr~rn_~ rcvic.L ut crPr rFi.L.1+'~ 1 xxiir,~ 1JC 1_ x 1~ a~a~,a s: ti: 1 l T L:: r;LC7" lt~lrc1
13L71 ter I"] S 141111__...,
1 1111"hlt +''1' EXP.ENlwEa-
i
SLJ.II'1'O'.L'AL,
Ceimp�ttr. Two 360-C,iU Umovc,'1_Erink Center M 3i and l3tmdled. Scrracc S 4,200
21U0
Disposal., MAC P.p. t,Spares. l'N Spt) 1t 14) plus applicable aic tax ti',r I'rnrrartl. Brant L',isttia) n t 1. 1,1 CIO
Disposal, MAC l.:pi, pines. 1'N Sptj It 4) plus applicable Wale taw' Fier Propunni sMscalut r,Pc'r r:t~rac, I 1,1~,iCr
C"ompttters will meet 1', r tvork nimmi rrr, requtremer11s; ape ti1icni c n will be submiticd Crib approval prior to pure' ha
4rr1Y� u PER DU M^*:
f~rtirZL fip~a(;~ far Co r 1~;Iidrtr,�,ilyatt eri'plol.v! itoiti'IrIe
1 ReP-l0rnal A! al tt1,NNh S 1;1- c~ tr,tN~~ruttr
1�1
t-Ora woa~ CoI11 hi 1
7
iN lwvork, Sriiiw
1L Ctd1nb
raLiv M t in in Stri.rtuhwW 2 nlrlrl)
1
%
t
#~Nchvurk Wit! trnnr~ 1rainingwP,1.Ldu Spokes r nt Crlrirungvi 6 s1 JTT
L-`ago 3 of 5
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�?o�Exhibit 8 Attachment N
BUDGET
1011 f I I 913011.2
SiIiSC ON'I:"Jot. i tll;:
1~ Ala~ai etn2 dn3infistrnflan-T1i1D
Monterey County Health Dept.
11-10124
hnliuG I)rrll*lrs
gttw~~xrstruet4~r i~t a=siai a ifli ttlanr'~fn4 the trtllgivipc c_gr 31TM1 trEy[~a~1 t,OEa~etr~,r
Inm htaml+~rcx'a2aaunt5r l.l:ca]tla i5cp aimucnt will rllr,~ini:;iy r r a. prd?
rxttrta grunt ilalltt1ituuq: tlaa~ C.crtt:ral
Cr:ia t R t iron in. 1t.ica:t irtini2ranir wt ii r raattlar i lfru'~:1'~~ laid rlri will ht,, A~tr tr,lx~~,l to r,14iaEir in a,ot r,tir, nI ily or' r Bali{;r1i4-atc gig m
I:arttnir-1 rrI.ICutiun. toil USDA approval la the lnyfr"d bJmw.'l; i iviem rai:"the mini-grant gprac,m is to support ftl+pcr'turiffic!a tir
apJirr.iprrare cr~rtntnanii~ rcrlclcs and lrartlat tlaala3 t0 c?tCa",t11c i�~~itii' ill rlTklallrt nflllr, l~'ratlyil'i~lrn rcirolt: tu~rr
Ltn f+Yx t nrtr~ri Ii i iltRtt e- unii'iar w_uu finer L rtpL�~ tnrn nt I"urun)s.
J. aiYt~ Cr�u
ni[Tat lliv C c,un;~:lirim 1 mti:.f�. Head S.t3rt I1rt~,rrgr: rtI
t
2. Nativ idad Medicl Foundation
3, KnYhleen Ncilm
4. JJ.iiz 1Jn-IYw.kir 11:0srpitalJ'uit
mcl~-taarart
TT l_T~ M 1L-CJiUrlf A letrtni Ir tiwC~ea: lei":1, adnutu rr~rtr. e 1 re r.
J C'w;rLkrnnl~l Lizaimtr L ely vrt:ier, L:w:eScutiwe t)ii�ru.l,r
I. 1'Itrnrlitt,+'enf r
0.'f`E'lllf, f'()S 1 4
l i fll,};�5 Orf rU r is l,nLlrG7kC~.1 al]l~'+'rti:
11:o1 imnal J"I iruin i t t Mee lrr x
2- i 51.:11:3 bn crl trauttnus. 1 rraanhi-sing
practic=e esc6hanne, I PA R.scnin: Sbnwca 9 PA a tiini trnaai:irr
t 4il13ltcarai i' c 1rr`.;:.ef i Ikg; and 3 rkli'1 rst~,t+, t]faatatitri na, eri lad
X71 Ftt andt cXltcttse.; rn %Ittptcln_lu 3 regional rrabtainp as indie3tod in l:ic aria of Wr rk 1(itarltfdn
apptlapriatCe 1',rlperlism"gv%:akers aml ucafenals fr'r list]nbflliurt to pirrtitipirrtls),
1. 11313, kt.: events e,4! $17'Xt ouch S5,IK',
u tllics and oarcrtals k rcwrLl1t" 3 v mis au 5255:1 ench 5750
pup lies 311d Patattiri.ls COT f"1 A1211111 ra.li~re. w 7si rw and sulact?ntinillrc rMtcctime, i I ra'r^etnau=. 6o~ 11
I ti~~tib.t_
Ph ical ALtivi9ie5. Mini rrainiues o: t! nar ctrni+ i l r:;ti;' ca_h)
S 2 t 110
S 2,704
5 2,111 f)
2?U
2 500
1(I,5Ix:
TJI1'T�O'VA1.: 11, 16,500
1, 625,
5,w50
5,100
7 5,11,
4110
Page 4 cot 5
BIB]
40956-U01
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
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2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
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411-HEALTH-U08
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6/1/2011-U011
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MOCO HD EXECUTED AGREEMENT|Eo�@o�Exhibit B AUachrant I
BUDGET
11111111 913 0112
Monterey County Health Dept.
1100234
i1J' a1 1 1'lutmutmn s 1.~ alu:ititi~u +Jhjrctl~re llrtria�uriI tlnrdill7tittli c~ W in r'hit Jve 4, 5, a Itltvl'~, t"'In'nrrnroi1 C ci1]abor7di1ail. &
T I. a clx, mtt: IJaj Iiv, S arltt 9
l`,iutdtlrrn dataya WRl 1'711rri21i; rc uIr'd for the J ally r v l;lL"~41a a1 Itrarlirnm su rvrr e~ aarrl f id dtnit
a) f4u966ui1 t4911r'Ximvl nlatcriak!t and PA rdix,.ia,Il+t11 trlilllira n a imirn c,-CU hir iti to inr-luding brt:ithii1
and uthcr prtnt:'il rtwl"'thu1 of dlptslliurion ill Conn lllii O t t1$7 rink` c bu7 4nft' tagimi prcwi)7'tkm75i1J
everItii and ataiI unthits, 111 ev ndt., i 31Jri I)artia.ipantw X 33.10 tt),?fI'I+ till taxes, SetI 611pi(rt:
hlsaA j lcci.ll nuv'tpapLr if
ritsTttl!;L IICa)f11mtl)I" 1's:`I_`Itwt1Ck Is{11r17~'ti.,~ SIlYl131_L*n PI'UTI7i1lloL17; 4'1RIGl 4, 1111711o1"clt,'i`h rlltdil6vk. I iii:!
S5,11'f l cab. 1,11 bh]'Ih�1"tt.Si'fJ1'w.ll?S %vf i?t' S,llrf,l.,ie"Pi ll'i,a~! C t711Tia7'i'fl t�' rVt:C!(ii i P.', r,M'r ha I
S2. l 7. per tlnI $636
10 Fnnd fbr ti c:d dvlllflx rfrll IL a dirks, as i.ndscatrd in Il)r &:ti Oj c nMark; t`uI Retirii sI.uri k u�xI dcrrut LuIistca
1oc,Il 4i;x IM RSnns aid.l'1owl 1-l'by 1 Ii51til."r., 1414 achieve ii qutrl al i?.I:iI;lt 1 foad 6:n1o6 nul Ii.) G'ScitAi
S 5O'penuml tlat1u,1ivc of f irid nrd salppli sM 911 food dcm-m x att p:riicipilill; a S?.t"rtiy- 59,UUO
t a7ill t Ca'ilin'lr+sr~irr i:nkln a ralslarl J.ltfgt+t.;a cotta rt 31ar r,m+�e 1t`m?alarl +. S, l~Lrti1 C:ftjc,ts; t 3 iiu.l 2:5, S' hwIs Oht.tctsy:l- hti, 29 and 0,
C4rruunif'4 Ylil.lrli iignni7atiou g Icc!1w+. 3134 3�1 311 35, Cmim-L'lltlt'r voir; Oh j t tiwrti 37,
t l t1 I t:csn niuiu r dLibc1 Ills?I] Fl+c;~�~;cinrrt Obj:c~ti eve, IU, I~, 1�dL ti PR I it jceIi
apprcm 1,1 I'Tci.71 EirectC.wvs, 6'
20
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au117ta::1. e:<jECI.f_� sl.lch i 1 ru n`iV cun.n.,C'I, Cfh I7I I i711tl llv ink~n'1.^_lLL lii.liiiifi.w, CC I1irTa1r1 i n11th LII ic. f}t'C.S in I'ni iI I Inn, roil TCn"lltri.`C.
I 51r lt'I'1.]
CUP MmM riktulhu,rse dhe t aun!r.1vlorr for expensts imtetrrrell alral irrva-ulccd dhteln lr t1rti.lm'nrl, unite ree1II.'Ab
TOTAL.
4915Itu_ P
r70k00I)
Page 6 of 5
BIB]
40956-U01
MOCO-U02
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MOCO HD EXECUTED AGREEMENT|Eo�Ao�CCC-307
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
Contractor/Bidder Firm Name Printed) Federal ID Number
By Authorized Signature)
Printed Name and Title of Person Signing
Date Executed Executed in the County of
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. Gov. Code 12990 a-f) and CCR, Title 2,
Section 8103) Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following, actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
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 counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Bo�GTC 610
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1. APPROVAL: This Agreement is of no force or effect until signed by both parties and
approved by the Department of General Services, if required. Contractor may not commence
performance until such approval has been obtained.
2. AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid
unless made in writing, signed by the parties and approved as required. No oral understanding or
Agreement not incorporated in the Agreement is binding on any of the parties.
3. ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in
part, without the consent of the State in the form of a formal written amendment.
4. AUDIT: Contractor agrees that the awarding department, the Department of General Services,
the Bureau of State Audits, or their designated representative shall have the right to review and
to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to maintain such records for possible audit for a minimum of three
3) years after final payment, unless a longer period of records retention is stipulated. Contractor
agrees to allow the auditor(s) access to such records during normal business hours and to allow
interviews of any employees who might reasonably have information related to such records.
Further, Contractor agrees to include a similar right of the State to audit records and interview
staff in any subcontract related to performance of this Agreement. Gov. Code 8546.7, Pub.
Contract Code 10115 et seq., CCR Title 2, Section 1896).
5. INDEMNIFICATION: Contractor agrees to indemnify, defend and save harmless the State, its
officers, agents and employees from any and all claims and losses accruing or resulting to any
and all contractors, subcontractors, suppliers, laborers, and any other person, firm or corporation
furnishing or supplying work services, materials, or supplies in connection with the performance
of this Agreement, and from any and all claims and losses accruing or resulting to any person,
firm or corporation who may be injured or damaged by Contractor in the performance of this
Agreement.
6. DISPUTES: Contractor shall continue with the responsibilities under this Agreement during
any dispute.
7. TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of
any payments should the Contractor fail to perform the requirements of this Agreement 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. All costs to the State shall be deducted
from any sum due the Contractor under this Agreement and the balance, if any, shall be paid to
the Contractor upon demand.
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Co�8. INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor,
in the performance of this Agreement, shall act in an independent capacity and not as officers or
employees or agents of the State.
9. RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of
perjury, the minimum, if not exact, percentage of post consumer material as defined in the Public
Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the
State regardless of whether the product meets the requirements of Public Contract Code Section
12209. With respect to printer or duplication cartridges that comply with the requirements of
Section 12156(e), the certification required by this subdivision shall specify that the cartridges so
comply Pub. Contract Code 12205).
10. NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, 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 e.g., cancer), age over 40), marital status, and denial of family care leave. Contractor
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 Gov.
Code 12990 a-f) et seq.) and the applicable regulations promulgated thereunder California
Code of Regulations, Title 2, Section 7285 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 Agreement 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.
Contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the Agreement.
11. CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES
contained in the document CCC 307 are hereby incorporated by reference and made a part of this
Agreement by this reference as if attached hereto.
12. TIMELINESS: Time is of the essence in this Agreement.
13. COMPENSATION: 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, per diem, and taxes, unless otherwise expressly so provided.
14. GOVERNING LAW: This contract is governed by and shall be interpreted in accordance
with the laws of the State of California.
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Do�15. ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if
these services or goods are obtained by means of a competitive bid, the Contractor shall comply
with the requirements of the Government Codes Sections set out below.
a. The Government Code Chapter on Antitrust claims contains the following definitions:
1) Public purchase" means a purchase by means of competitive bids of goods, services, or
materials by the State or any of its political subdivisions or public agencies on whose behalf the
Attorney General may bring an action pursuant to subdivision c) of Section 16750 of the
Business and Professions Code.
2) Public purchasing body" means the State or the subdivision or agency making a public
purchase. Government Code Section 4550.
b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is
accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of
action it may have under Section 4 of the Clayton Act 15 U.S.C. Sec. 15) or under the
Cartwright Act Chapter 2 commencing with Section 16700) of Part 2 of Division 7 of the
Business and Professions Code), arising from purchases of goods, materials, or services by the
bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to the bidder.
Government Code Section 4552.
c. If an awarding body or public purchasing body receives, either through judgment or
settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor
shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand,
recover from the public body any portion of the recovery, including treble damages, attributable
to overcharges that were paid by the assignor but were not paid by the public body as part of the
bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code
Section 4553.
d. Upon demand in writing by the assignor, the assignee shall, within one year from such
demand, reassign the cause of action assigned under this part if the assignor has been or may
have been injured by the violation of law for which the cause of action arose and a) the assignee
has not been injured thereby, or b) the assignee declines to file a court action for the cause of
action. See Government Code Section 4554.
16. CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of $100,000, the
contractor acknowledges in accordance with Public Contract Code 7110, that:
a. The contractor recognizes the importance of child and family support obligations and shall
fully comply with all applicable state and federal laws relating to child and family support
enforcement, including, but not limited to, disclosure of information and compliance with
earnings assignment orders, as provided in Chapter 8 commencing with section 5200) of Part 5
of Division 9 of the Family Code; and
b. The contractor, to the best of its knowledge is fully complying with the earnings assignment
orders of all employees and is providing the names of all new employees to the New Hire
Registry maintained by the California Employment Development Department.
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Eo�17. UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is
unenforceable or held to be unenforceable, then the parties agree that all other provisions of this
Agreement have force and effect and shall not be affected thereby.
18. PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of
$200,000, the Contractor shall give priority consideration in filling vacancies in positions funded
by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200
in accordance with Pub. Contract Code 10353.
19. SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING
REQUIREMENTS
a. If for this Contract Contractor made a commitment to achieve small business participation,
then Contractor must within 60 days of receiving final payment under this Contract or within
such other time period as may be specified elsewhere in this Contract) report to the awarding
department the actual percentage of small business participation that was achieved. Govt. Code
14841.)
b. If for this Contract Contractor made a commitment to achieve disabled veteran business
enterprise DVBE) participation, then Contractor must within 60 days of receiving final payment
under this Contract or within such other time period as may be specified elsewhere in this
Contract) certify in a report to the awarding department: 1) the total amount the prime
Contractor received under the Contract; 2) the name and address of the DVBE(s) that
participated in the performance of the Contract; 3) the amount each DVBE received from the
prime Contractor; 4) that all payments under the Contract have been made to the DVBE; and 5)
the actual percentage of DVBE participation that was achieved. A person or entity that
knowingly provides false information shall be subject to a civil penalty for each violation. Mil.
& Vets. Code 999.5(d); Govt. Code 14841.)
20. LOSS LEADER:
If this contract involves the furnishing of equipment, materials, or supplies then the following
statement is incorporated: It is unlawful for any person engaged in business within this state to
sell or use any article or product as a loss leader" as defined in Section 17030 of the Business
and Professions Code. PCC 10344(e).)
S:\ADMIN\HOMEPAGE\GTC-610. doc
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MOCO HD EXECUTED AGREEMENT|Eo�Fo�4:-.fhV111Ir7 i,Yy 5:~i~ui i1 1 P1.t sa HkN lii Exhibit D F}
Speci,i1 Terins and Con litioits
F c
fe f}' f~ dde 5L rvJ t ontr ti or rat r s"'f'#ents s cf rani reem 17[�
The- use of fl d rr[l s o trt th'roughoui this exhibit is f'.'}r ccnven erlce only tni x1,011 not be
qo' errt the meaning f any spe=cific term or condif n
u�- Ii to i b",s'p el or to
Thp terms ccniraci'`1 Contractckr" and ub-antrac.1rr" hall also mean, agreemen't' grartr' 9 Mint ail,e-am6nt',
3fantee" and ubeiraritEe respectively
The terms Califorriia Deporin-ient of Public: Health` and CDPH" sh.ati have the same meaning and refer to the
tCEnlifornia Sta e agency that is a party to this Agreement
Shia exhibit contains provisions that require strict adherence to various contracting laws and policies. Somo
pr wisions herein are conditional and only apply if specified conditions exist i.e agreerrter~t total exceeds a certain
arnouni, agreement is ferle illy funded, ec-). The provisl;ins her-n ap* h this A0ro r ent unless the pro'siori
are rerno~ied by reference on the face of This Agreement, the provisions are s,up ersed=d b an alternate arc=;-ision
appearing et- w f i re in this Agreement, or tare- applicable c1ri.iditions do nal exist.
index of Speclat Terms and C-osi itiort
1 Fede al Equal Employment Opportunity 17. Human Subjecias Use Requlrtment
Requirements
13. Rovajion Requirements
2 Tra'v l and Per Pielri Rairob r emeni
1 9 Debarrn Brit arrtd S is ensi:LL Certirc ation
3 Procurement Rites
20. Smoke-Free Workplace Certification
4 t Disposition.
Eqwpmerit Ownership I Inventory
21 Covenant Against Coraingent Fee
5 Subci itract Requirements
22. Payment Withhold 4
E Income RL-1.1:71 inns
2u. Perf m. an.ro Evaluation
T idit and Record Rr=tEnkion
2f1. OFf eels Not to Ee.n fit
8. Site lrrspection
25 Four-Digit Date Compliance
9 Federal Coniracct Fu, Ids
26. Prohibited Use of State Funds for Softrare
10 Intellectual Property Ri hts
2T Use of Small, Minorit'r Ovm&d and Women's
11 Air or Water Pollution P~quirrenieni s Businesses
12. P'ricr Approvat of Training Seminars, 114oiksh 26. Alien I ehgthd t9 Ceitit at7ei1
orontererlce
2. Union Organizing
1 3- Confidentiality of Information
36; Contract U n fermit' Fringe Benefit F Il w biliti)
14 arty ritten Reports
Documents Pubkcaticros
31. Lobbying Restriction and Discos ere Cer=,ificaf-in
1 5 Dispute Resolution Process
16 Financial and Compliance Audit Requirements
CDPH Ej_�iitd DIr) #92tft~
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Go�Cadiforr-ta Jopalrnen t of public I teal,i in s Special I er7r`i aiid C t kitiuns Exhibit D F)
1, Federal Equal Opportunity Requirc-m-onts
i. pptirrable to all k-Jerally hinded agreements entetccrJ into by the California Department of Public itl-alth
CDPH foorrnerly known as California Department of I1eatth S rlices
a The Contractor wilt not discriminate agains any employee or applicant for Fmployrnent because of r
col r, religion, sex, nation-ial origin, physical or n' ral hanthcap, dis ahiliiy, age or status as a disabled
a'etoran or veteran of the VIElinarn era The Contractola wilt take affirmative action to ensure that qualified
appr nts are ern phyed, and tti-a employees we treated during errtpt ytrr enit, without regard to thntr race,
color, r= ii pion, sex, na ional origin, physical or mental handicap, disability, age or status as a disabed
v:reran or veteran of the Vietnam era. Such action shall include, but not be limited to the folloMwr
errkpla'ment, upgrading, demotion or b'arisfer, recruitment or recruitment adv+ertising; layoff or terminat-on,
rates of pay or ether Corms of cc i7pensaton: and career ievebapment opportunities and ceiection for
training, including apprent trip. The Contractor agroes to post in conspi ous places, available tu
employees and appfidant for employmrent, notices to be provided by the Federal Goiernriiont or CD PH,
setting forth the provisions of the Equal Opportunity clause. Section 503 of the Rehabilitation Act of 1973
and the affirmative acti-cn clause required by the Vietnam Era Veterans' Readjustment Assistance Act of
1974 U 33.C. 42-121. Such n+ tines shall state the Contractor's obligation under the tow to, take
affirmative action to employ and advance in employment qualified applicants without discrimination based
cin hem race, color. religion, sex, national origin physical or mental handicap, d sabilily, age or status as a
disab' d veteran or veteran of thu Vir@iraarti era and the rights of applicants and employee
b The Contractor girl, in an solicitation r advancement for employees placed by or on tohalf of tie
Contractor, state. trial all q',ia i`1ed applicants viitl receive consideration for employment without re=gard to
rare, color, rettg~arl, sex., national igin physical or mental handicap, disability, age or status as a Jisabbied
veteran or veteran of Vie Vietnam era.
C.
The Contractor will send to each. labor union or representative of workers with which it has a llec+re
tbrga irlg agreement or other contract or unrderstandin a notice, to he pravtded by the Federal
Government or the State, a+dvi fig the labor union or worktirs' representative of the Contractor's
commitments under the provisions herei}n and shall pos=t copies of the notice in corer. picuous places
available to employees and dpplrcants for employment
d. The Cor;tractoYr will comply with all provisions of and furnish all information and reports required toy Section
503 of the Rehabilitation Act of 197 3. as amended, the Vietnam Era'.Oeterans' Re-adjustment Assistance
Act of 1974 3B U.S 421Z) and of the Federal Executive Order No. 11248 as am-ended, including by
Execulf-ve Order 11375j, Amending Execubte Order 11246 Relating to Equal Employment Opportunity,'
d=irt as supplemented by regulation at 4f GFR Far 60, Offce of the Federal Contract Compliance
Pr rams, Equal Employe. ent Opportunity, Department of Labor,' and of the rules., re utations, and
re event orders of the Secretary of tabor,
e Tarr Contfador will furnish all information and report`. required by Federal Executive Order W. 112,=O as
amen Gd, Including by Exec ttve Order 11376, Amendinig Executive Order 11246 Relating to Equal
Employment Opportunity,' and as supplemented by r-egulatiorn at 41 CFR part 60, Office of the Federal
Contract Compliance Programs, Equal Employment Ooporiunity, Department of Labor,' and tti+
Pehabilit n t of 1973, a rcl by the rules, regulations, and orders of the Secretary oaf labor, or pursuant
t Crew, acid will permit access to its books, r cords. and accounts by the State and it desianat e.1
representatives and the Secretary of Labor for purposes of inves5gation to a centairr Gompriance yit i such
rules, rev utahor and orders.
In the event of the Con race s noi'ttornp4ianC i Willi the requirements of the provisions herein or with any
federal rules, regulations, or orders %,h Ch are refeiencad herein, this Agreement may by cancc*Ilryi
lemn irlated, or suspended in whole or in part and the Contractor m:ay~ be declared ineligible for further
federal and state contracts in acrxirrJance wi h procedures authorized in Federal Executue Order No
11246 as amende l and such other sanctions eel y troimposed and remedies invoked as provided in
Federal Executive eider No. s 1246 as amended, in luding by r ecutve Order 11',175. Amending
e ut t Order 1246 Relating to Equal Employment Opportunit'y',' and as sLlpplornen ed by regulation r
41 CFR part Bt), Office of the Federal Contract Croiriptiarice Programs, Equal Eniployrricnl Opportunity
DCpartment of Labor,' or by rule, regula ion, or order of the SOcrCtarf of Later, or as ocher rise provided
by law.
cDPlt F:ar rl C.'!F, l5+i3'9 plc 7 e.1 II.
BIB]
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DO109645-U03
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2/13/2012-U04
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16616-U05
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APPROVE-U07
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411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Ho�alrf aria Lupaitrrieril r:-I Publy.: Health Special I or7ii.v i'rr� Cianditioiis L.':rii ut U u-:
g-
he Contractor will nicluju tho provisions of Paragraphs a through g in every subconta+ct or purcini3s=_
order unless exempted by ruts-r, rogulation.s, nr orders Of the Secretary of Labor issued pursuant to
Federal Exe vtNe Ordar No. 11246 as am ended. irnictudirig by Executive Order 113175, urea=riding
Exectittue Order 11246 Rela+ang to Equal Empr'oyment Opportunity,' and as supplemented by regulation at
41 CFR part. 60, Office of the Federal Contract Cornpli3nce Programs, Equal Employment Opportunity,
Department of Labors' or Sed Fl f of the. RahabiMia n Act. of 1973 or 38 US C 4212) of the Vietnam
ra V'eterara's Reacjustrrreri: Assistance Act, so that such prov sions wig be bindirrp upior each
subcon'rictur or veridor. The Con ractor wilt Lake such actionvmlh respect to any subcantracl or purchase
order as the- CDirecto-r of the:. Offrc.e of Federal Curttract Compliance Prbgr'ams or CDPi-t may direct as a
means of enklrcing such pn fi ions including sanctions for ro icomplian pta'v Jed, ti r-'r r, that in the
event the Contractor b ornes i!nvol; of n_ or is threatened with IFt ation by a subcontractor or +=endo as a
result Of Such direction by CDPFI, the Contractor may request in wTi�iripi to OPi-l, who, in turn, iris;
request the Unto plates to enter into such litigatiti i tc pfoteci the interests of the State and of the United
States.
2. Travel and Per Diem Reimbursement
Applicab if brass andior pCi I iQiri cA*penses are reimbursed WIN ar~raerr si5t funds.
Reimbursement i;c trawl and per them expenses from DPH uixier this r risen shall, erne ss Otherwise
specifier in this Ag=eerr ens. be at the rates currant, in effect, as est4 lished t the California f epanmer~t of
Per`eonriei Administration iDPA), for misrepresented state employees as stip laud in CDPI-l's Travel
Relrmbufsi rent Infarniation E.xh=hrt IF the DFA rates charge dr,rring the term of the Agreement, the new ra4es
shall apply upon IhAlz effective date and rise amendment to this reemerail shall be necessary Exceptions to
DPA rates rr,ay to app r ied by CDPH u r the subulission of a statement by the Contractor indiccattng that
such ratios are not Cvailable to than Contractor. N a travel cuts de the State of CalifrjrnLi s1-ial1 be r irrtrrrs i
art out prior atllf'O4ization from CUPH. Vefbal authorzzat ii should be confirmed in vvfiti'lg. 114ritten
authC rizatiori ma!~ be in a form including fax or email confirmation
3. Procurement Rules
Applicable to all agreements in which equipment, proverty, c riirrr itiea andror supplies are furnished by
COPI-i or expenses for said hems are reimbursed with state or federal finds
Equipment definitions
h rover the term ectiripi- iant i'Property is used the following definitions shall apply:
t1 Major tqu'rpmerrttprdiperty: A tangible or nisrig MI i em having a bare unit c=ast of 900 or more
t it*i a lets expectance Of one d1t year or mw e and is either furriklhed by CDPH or the cost is
reirtibiwsed through I! ais Agraemar:t. Software grid videos are examples of iritan�glbte item that meet
this definition.
12) Minor eguipmi ntl'ptopi rty: A. tare ibie item 1ia'ilnrj a base orbit cost of Itrss than $5.llne with a life
expectancy of one, 1) year or i and is- either fern shed by COPH cir tine east is roirnbur ed through
this Agrment
Government and public entiti including state collogrs unrvemsit} s and auxiiary organ tions)-
w Whether acting as a contractor an ar subcontractor, may secure all coriirmr'd1ie supplicls:, equipmecn,
and seivices related to such purchases that are required in performance of this Agreement. Said
procurements are subject to Paragraphs d through h of Provision 3. Paragraph c of Provision 3 shale also
apply, if equipment purtiasea are deleaeted to subcontractors that are nrrnr,rcfit organizations or
conic iorciaf bus ne e
Nonprofit orpiiriizations and commercial businesses, whether acting as a contractor and or
subcontractor, may secure cornrriadi tes, supplies, eauiprr ant arid services related to such purchases for
performance under this Agreement
1) L quiprr ent purchases strafl net exceed S 0,OiDD annualh
To secure equipment abt re the annual maximum limit Of SS;OO,lXi'3, the Contractor shall rrmak.c
array geernents through the appmpriiate CDPHl P cgq'rirn Corr l^r Manager, to ha'r oil r raining
t H r.fiib 7r i i i Fl;_! 3 err 2i;
BIB]
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
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2/13/2012-U04
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16616-U05
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APPROVE-U07
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MOCO HD EXECUTED AGREEMENT|Eo�Io�California Dep rime t o! P�ihlif- I lealth Spacial Terrri5 and Cond-itson:
Exhibit 0 IF)
eiuiprrient purctiased3 through CDPH's Purchasing Unii The cost el equipment purchased by or
through COPH shall be deducted f'rariii the funds available in this Agreerrietit Contractor Shall submit
t i the CDPI I Program Contract NI-a sagcor a ilai of Equipments cificatione for those items that the
State must prcizure. Tha State may pay than veridO directly for eut:h arranger! equipment purchases
and tFtle to the eouipm-~iit v All remain with CDPH- The equipment wit! be delivered to the Contractor's
arldras5, as stated on the tare of the Agreement, unless the Contractor notifies the CLa PH Program
Contra t Manac ec, in %vritiirg. of an alternate delivery address.
2) All equ.prr er purchases are sulj ct to Paragraphs d through h of Provls:,an y. Paragraph b of
Provision 3 Stall aI apply, if equipment purchases are e1 afed to subcontractors th=at are ether a
go vemrrFent or public. entitty.
3) ttor pro Ii organizations and commercial businesses. shall use a procurement sy~~.=.t�rxii that meets he
fallm%w rig standards:
ta't
1.1 intain a code or standard of conduct hai shah govern the performance of its officer--,
ompIbyei s, or agents ongaged in awarding procurement contracts. No emp3oyee, officer, or
agent shall participate in the selection, award; of administration of a procurement, or bid contract
in il.l rich, to his or her knorMedgo. he or she r ins a financial interest.
Procurements shall be conducted in a mariner that provides, to the riia;vmum extent practical,
open, and free campetttior;.
K, Procurements shall be conducted in a manner that provides for all of tt T- fol owing.
1] A aid purcha= irq Onr5 essar'y or dupbcaie it�rns:
21 Equipment solicitat r+s shall be based upon a cigar and curate descaption. or, the technical
requtrrrients of the goods to be procured.
31 Take positive steps t-o 1t1,~ y t e rmal,
and veteran f3Avn[ business-es,
d-. Uln ss waived or otherva e stipulated in writing by CDPH. pro written autl'orlration from the appropriato
CO PP Progrsarr. Contract Manager will be required fore the Contractor Will be reimbursed for any
purche of $,O or more for commodities, siupp,, equipment, and services relaied to such
Purchases. The Contractor must provide in i1s t� rest f~or authorization all particulars necessary, as
specified by CDPH, for evaluating the necessity' or desirability of incurring such costs. The teem
purchase" excludes the purchase of services from a subccntrar for and public utility services at rates
es atAsthed for uniform appli;^ bili y to the general public.
a. to special circumstances, dote mined by MPH e.g., when CI PIt has a need to morito r_.ertair,
purchases, etc.). CDPH may require prior written authors Lion aridlor the submission of paid vendc-i
receipts for any purchase, regar4tess of dollar arriount. CI?Pti reserves the right to either deny claims for
rairnsbt enient or to request rep. yrrent for any Contractor andlor subcontractor purchase that COPH
determines to be urlnecessra y in carrying cut perfc. maretr under this Ag_feG rrient.
f The Contractor and"or subcontrac-tor mast maintain a copy or narrative description of l_he procurement
system, guidelines, rules, or regulations era' will be used to make purchases under this Agreement. The
Stale reseplt_ts the right to request a copy of These documents anti to inspect the purc-teasing pry='tir'e; of
Lhe Contractor a'ii: rr subcorttrctcc at any 1 o it
g For all purchases the Contractni- and/or ub-r era or must. maintain copies of ell paid vendor invoices,
do uments, bids and other irl orniation used in vorvdcr setectinn, for inspection or audit. Jus1fCations
Supporting the absence of bidding I e., sole source purchases) shall also be maintained on file by the
Contractor and-'or subcontractor for inspection or aud.-I
CD PH may, vo-th Cause e.g., with reasonable suspicion of uriiio est aiy purchases or use of ina prc riata
purchase practi.ce.s, etc withhold, cancel, mi~ lif~, or retract the del gated purchase s,ithort'r granted
under Paragraphs b and/or c of Provision 3 by giving the Contractor no leas than 30 calendar days wrtten
noticri
rOnrI shell G,� hr-',si sago:. i cf 25
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�Jo�r 3l forr-fia Department of Public. IIea"tr i SpcCial Terms a id Conditnnn Exhibi" U fry
4. Equipritetit Ov,1nars11lp I Uivcntcry I Disposition,
Appi=:eb to ap.repment!5 in which equipment and/or pro-giorty it furnished by CLIP! i anWrnr when said i'sem_
arse purchased i r rtimtrurs-ed with site or federal fund'
a. 1.n her-u.'er the tens equipnir'i t andlar pr-ope-rt"y are used in ProvLsinn 4, the definitions in Pro'osifon 3.
Fla-rag raph a, shall apply-
Unless other ae stipulated in this Agreement, all equrprliernt and%or properly that are
p;,�rct a Ed e;mbursed with agrcerrrsnt funds or furnished by CDPH under the. terms of this Aureern nt'
shall to cx)nsidr red tal~-u equipment and the properly of CDPH
l) CDPI-i requires the reporting, tagging ar~d annual inventor] ng of all equipment and/or proper y tai is
furnished by GDPI-1 r purchasod;ra?irribursed with funds provided through this agreement.
Upn receipt of equipment and/or property, the Conlraclc'r snail report the receipt to the C;DP}H
Program Contract Manager. To repot the recoipt of said heel is and to receive properly tags,
Conlra(--Lor shall use a Form or format designated b CDPH's As-set Manaoornent unit. If the
appropriate forth i.e-. Contractor Equipment Purchased wi h CDPH Funds) does not a?cornpairiy this
Agreement, Crontractor shall request a copy from the MPH Program Contract Managed.
21 If the Contractor enters into an agreameni with a term of more than t'r+ l've months, the, Contractor
shalt submit an annual indentory of state equipment and/or property to the CI tPH Program Goniracct
onager using a form or format desiFgriated by CDPH's set Management Unit, if an inventory
report form i.e., Inventory,'DispositiOni of 01JPl4-Funded Equipma,7t) does not accompany this
AgreerneriL Contractor shall request a copy fiiarrs the COPH Program Contract Manager, C-Qnitric(or
shall'
tnclude in the inventory report, equipment andllof pscipefy in the Contrar for p s-sass ion an or in
the possession of a subcontractor ine-ludiri independent consultants),
bi Siiomit t e nventeury report to COPH r-_i<ording to the instructions appeehnq on the inventor form
or issued by the CCPH Program Contract Manager.
Fc;) Contact the GDPH Progjr2rri Contract Manager 10 t arrt how to rervtove, trade-in. sell, t ansfer or
survey off, from the inventory report, Ek;?p rod equipment an-Tar property that is no longer panted,
usable or has passed its rife r kpe to ic'3- ln�_ cctioris will be Supplied by CDPH's Asset
Management Unit.
b. Title to state equipment anificir ptrspertc shall not be affected by its iincorp atfon or attachment to any
croperti not owned by the Stale.
Unless ott`epMso stipulated, COPE! shall be under no oblige tin to pay the oust of restoration, or
rehatilitation of this: Contraclof's ar:d cr Subcontractor's fa--wility which may b affected by the removal of
any state equipment anther property.
The Contractor and/or Subcontre to shall maintain and admin ter a sound business prbg art for
er:siring th= proper arse, maintenar ce, repair, protec:tion. inc=ur nc and ores' rvo n of state e uip,rr t
and/or propertt
1) In admiritst tiring this prCvision, COPH may require the Contractor art/or Subcontractor to repair or
replace, to CDPH"s satisfaction, any damagoti, last Or stolen state equipment and/or property
Centract4r en ir uh ontr tar shall imniedi, ter file a theft refit with the appropriate polite age�ic.7
or the Calituinia l-firifw y Parot and Contractor shell promptly submit one copy of the ihe_t report 10
me CDPH Pr ira' n t' of trwt Manager
Unless ettrerwise si3pulated by the program funding this Agreement, equipment andrr~t proporly
p~u haSedlr rent ur� d with ajreerneni funds or Furnished by CFDPH under t e t-amis of thks green ena_
sM 311 only, be used for performance oaf tlii�u Agrocrr cot or another CDPH agreurnerit.
CD PH EYhrba Di,FI t gy'p' f'i#j? u125
BIB]
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AI102677-U03
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BOYDA-U04
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411-HEALTH-U08
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MCKEES-U10
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STATE,-U012
FEDERAL-U012
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DESIGNATED-U012
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MOCO HD EXECUTED AGREEMENT|Eo�Ko�C t slornia Departrnent ccf Public Hoalth Speoia! Terms and Gendiftoons Exhib l D F)
Mnin sixty 15 0"1 calendar OaV'S prior to the termination ea! end of this, Agreement trip COnirac-tor Trait
provide a vial nventory report of equipment andIorproperty to the CDPH Prcgr.am Gontracl Manager and
shall, at that tirri�i, gLery. CDPH as to the requirements, including th� manner and metba%d, of retuning
state equipment and/or proper;, to CDPH Final dispo5;idon of equiprnerTt andUor property sh i] be. at
CDPH expense and urdi to CDPH inetructons q uiprri nt ar or property d sposition it tru brit,.,
all be issiJed by GUPH it rr'radiately after receipt of the final ir+ientory report. At the termination or
c-anrlusi n at this Agreement CDPH rrtay at its dtscretia i, authorize the continued use of slate Equipment
andirit properly for performance of work under a different CDPH agreement
g Motor Vehirfes
1
f3}
Applicable only if motor vehinles are puchasedkeirnburse-d with agreemu'ni funds or furnished b;' Ct)PH
under this Agreement)
It motor ve-hicles are pu chas dkoffitursed with agreement funds or furnished by CL1PH under Oh
terms of this Agreement, within thirty Ce) catanrta days prior to the termination or end of this
Agreement, the Contra for ardror Subcotitr'acbtr shall return rich vehicles to CDPH and shalt deliver
all ncctzsary documents of fide or registration to enable the proper transfer of a marketaL}tc trLe to
DDpt.
l?i l=' motor vehicles a o pilrchased eirribursed with agreement funds or furnished b- COPH under the
terms of this r greement, the State of Calif rnia shaft be the legal owner of said motor 1ehir- a and the
Contract shall be the registered u%vner_ The Contractor and/or a subcontractor may only use said
ve ices for performance and under the terms of this Aareemenl
T Contractor and/or Subcontract+lr agree that all operator; of motor vehia:les.
our haser'reirr burs d with agreement funds or furnished by CDPH under the terms of this
Agreement shall hold a vat State of California driver's l nse. In the event t tat ten or more
passengers are to be transported its any one vehicle, the operator shall a so�told a State of calirornia
Class S driver's dense.
41 If any nialor vehicle is purchased rerrinbursed kvth agreement funds or furnished by CL1PH order the
turr-Es of this Agreement, the Comt met:r aridier Subcan-actcir, a~i applicable, shall prode, main'-.sin,
certify that, at a rniriicnumn, the following type and arriount of automobile liability insurance is in
effect during the term of this Agreement or any Extension period during which any Vehicle remains in
the Contractors anci'or Subcontractor's, possession:
Automobile Liability Insurance
I a} TI Con'ractof, by signing his Agreement, hereby certifies that it possesses ill c: ire
automobile liability insurance in e amount of 1,OC0.DDO per occurrence for bodily injury aria
property damage combined. Said insurance must be obta recd and made ri ective. up ici the
delivery date of any rri for vehicle- pup liased/reimbi.jr ed with agreement funds or furnished by
CDPH or=der the terms of this Agreement- to the Cwt.-actor and or Subexamractor.
rni i ha Contrautur and/oi Suorxentractor shall, as seen as practical, furnish a copy of the Certifcs1e of
insurance to the CDPH Program Cr l acct Manager. the certificate of insuranc shalt idsontiN the
CDPH contract or agreement number forviiiich the insurance appli s.
c) The Consracto wdfor Subcontractor agree that bodily injury and property damage liability
insurance; as required herein, shall terrain in effect at all times during the terra of this Aureer ionI
or until such time as the motor vesicle is returned to COP H
ldl The Contract f and or 5euut ritrac.tor aor�e to provide, at least thirty i,3 CJ) days prior to the
exxprcahon date of said insurance coverage. a copy of a now certificate of insurance evident i'ig
continued coverage, as indicated herein, fw not less than the remainder of the term of this
Agreerrieni, the terns of any extension or continuation thereof, or fora perioe of not less than nrip
1,) Par_
C:r]P`ti FXh=Ft; t11;FI g!O i Dann r.: 15
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AI102677-U03
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2/13/2012-U04
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PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Lo�ytt it lit ity IV t It II! t_l t-uum.' Iiuait ii ineriai I erms ant) i_r?i'.J'-iiiutin
I-,Xr"IID11, I! 11 i
+ei Th= Contractor CII1d,hhr SuL'{:unr3cfor, if not a self-irtsur&J governr.i_'rit r3ridrt}I public entity, must
Provide evidence. that rev requircrf ctrl>f air s Of insurance c itltain till fi if dd111 J p�ro'ih;ion='
a~l
21
P1
ThR insurer 1.171 not cancel tile nsured's cwt'" i ge iviihoult gi-ving t,Lilrtt}' 3C) caIc 1= 1r E u5's prior
wr-ntlan notice tin the State Cali`c.rrn:! 1a~"sttrn~.nt cf Public Health Ci PHi)
The St k u California its officers, agents, t'IIIployLes and servamis are incll_sded a
additional Insur d t"iJ only 14'litt respect to work rfotr! fof the St IH under ths_:
A.greervient and any extension or continuation of th=s Agreenip_rit_
ThE insurasice Carrier shall notify CGEH, in writing, of the Contractor's failure to pay
p omiums; it cancellation of sucri Pi cis; of any other substantial change, inclix irig. but nol
11,-sited to, the status., coverage, or scope al 11e required inFkjrarncr'. Such notices sf3ull
conta i a reference to each agreemertt r url ibor tiff v inch the insurance W=5 Qht wined.
The Contractor c1ndDr St.jl;,rrontractor is hereby advised that Oop}E of t_- th teataa t Inslir.sro e
rriay be subject to review and approval by the Department of General Services iteiGS): Office of
Risk and lrr_.uraiiee ftlanafyement. The Coontra_ti)= shall b notified by C Ptl, in wntirin,, if th:;s
provision is applic-ut o to this Agreement If DGS approval of the t=e:rtficate of hisurarice is
requ the Contractor fees that no'rmrk a' sere ce shall be performed prior to obtaining solid
apprc-'a'ai
g) tit the event the ntractor and/ur s ubcontr'actor fails to keep insurance covefage as require-d
raef-evi, in Effect at all hems duriho vets cle possession, OPH may, in addi ion to any othOr
re-rnedlos it m y have, terrlninatee this Agreement upon the occurrence of such event
5. Subcontract Requirements
r plicabtta to agreements under vmich servirrs are to be perft i by subcontractors inck d'ng in eper;den
7ri suttarits. is
Pilo vaitten utllor�zat t will bru required L'. fore tha Contractor enters Into or s reimbursed ftif any
subcontract f4- services costing $t,ODO or snare. Except a5 indicated in Paragraph a(3) her- n, when
scouring subcentra,_ts for senAces costing S5,G00 or more, the Contractor shall obtain at least three t Js.
c fuse fy a sole 4o r^ Tmnrt7.
s l TM)M Contractor ust provide in its reque l Fur euihoorizatirrt, all in'orma'kin necessary for 1a UO[`rig
the nt 0SS;Ly or desirability of incurring such cost
i The State may idientif= the information needed to fulfill this requirement.
3 Sfroceritracts performed by the following enti ies or for the service types listed below are exempt hum
the bir1rfisg and sole source Jug- ifirahon requirements,
tat, n Ioc z l weir'rneniit enbty or the federsI goverrir�--ient.
i;b) A State college or university from any State.
1;, 5 A Joint Poi� e-r Authaority,
i,d}n atfrar sira, 3rtizt f t
1 5 v It:4:?' of a Cali army Stale Wiiv r,itj or a Cikirn n Community college e) A fraundntion organized to support Ihte Board of Gaverimrs of the California Community Colleges,
f) An auxiliary organization of tt~u Student Aid Cornni�ssicrt established under Education Cade Fi
f 522,
g) ErttitickG of any type that will provit s s_ubveiitiori ad or direct ervices to tiho public.
h) Entities and/or service types kient-ffed eis exempt from advertising in State cntrat tiit-g fvta=it al
5 80 View this pubhcatlon at the Following Internet address:
http,'"!?www,ols,d�l r t.gav+'Cpr,tra~t= 1 nilhapter4thropJgh6 Itrr,
CDPI't reserves Vie right to ppr. to or d sapprove tho S l tioft of J 7" j7ri1iac ui` arid with advance
written not'e. requite the- subst*ttliior of subcontractor and requre' the Contractor to tcrir?inaal'?
ia n cntrac f entered i ito in support of this r greement.
CORI x-iicat t)fi1 t'�'u"-`1 P,!l 1 1 2.t
BIB]
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
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2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
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411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Mo� p,a,u,_",es,,,.i,, Ii,ifiiI_.]Lirl,;tzii It_11;is?11i{1 iiaiaUt-,
L-}:tlim1 t'1
11 1J ictl receipt of a vi:li1er notice from COPH requiring trio s-ubstittitior. and,or Liu. rnir;ctcri o'
subconi'ract, the t"1cJtltr etcr shall take st3=''F la en 1re. the c nip!Lturri of 3'1't work in Progress uiid
cleft a ropiw: merit, if aped ible, wi hir5 JJU calendar days a longer peer-od is agreed to by
Cr1PH.
c Actual i:uhvnntracii e witw-n acreement beevleoerl the Contractor aril: a SI1b n rH t rf G^f 1f
more are subject to ale prior review and wait-en approval of f:C1PFt. Mp'tt nisi'. at 4` dis.reti,_i1, u' cl t,:,
waive thks right. All such waaiv:er_ thiall to confirmed ir? writing by CDPH.
d. Crntracto;r shall miintain a copy of ea_-h suhcor tra entered into in suppart of third AtgrcfJriran aril half.:
upon request by cli'PH. make copies wail able for approval inspection. or ai.uCli
e CDPH assumes no responsibild-y for the payment cf SL t n ractors. used in 1he perforinarre of this
igreerr:e~t Cv~'raci=a aI r_p'�s sole rssVitisit; Ity t,ar the payment of subcontractor_ used in the
perforrrlanr_R of this A eRiTien',
q
The Contractor is responsible for all p rfgrma'IGe. requirements under this 4grecment even though
perfy;mance may be carried but tf-j ugh a sutccnirart.
The Cc tractor steal ensure that all mibcorzacts fz~r services include 1re'vis.oritst reetuirng ci]mpliarce
with applicable to rr`3s and irk iar5 pal ifs in tlrisAgreement.
The Contractor grow to include the fcifl wir.:_j clause. relent to record rotor`=tiori, in all sutcorit acts for
service
Narii� i agrees to maintain and preserve, unite thn e years after termination of
gr-commie Ntrmbet) and final payrnent from COPH to o Llie Contractor, to permit DFH orany duly
authorized repres�intatstie, to have a less to, a>mrnine or audit any per inert Looks, docut: ents,
papers and records related to this subcontract and to all v interviews of any employees who
might rrzsiscnahr�,f have information related to such records."
Unless otherisu stipulate=d in tiling by CDPH, the Corth'actor shall the st tcontrac-tor'S le puirt of
nnt{ ct for all matters related to peth mince and payn~etn' under this Agree rent.
Contractor 11 shall, z as adviso all su contractors of 1liuir obligations pursuant to the fcllemwig
iumbered provisions of this Exh:hit 1. 2, 3, 4, 5, Put 7 a, t j. 1, 12. 13, 14, 17, 19, 20, 24, and 31 or either
nur'ribered t ro'vic n_s herein that d e-med appli able.
6, fricame Restr ttieric
Unless c'therwi stipulated in Ctti k? reertl rit, the Cc r ct r agree,-;S that any re'lir` s, rebates, crecits. or
ostler am ount3 including any interest the ni accruing to or received by to Contractor under this A r&errunt
hall be paid by the Contractor to CRPH, to went That they are property allocable to costs for whch the
Ccr tractar has been reimbursed by CDPH under this Agreeme it.
7. Audit and Record Retention
Apprlicsable to a greernents in excess of $10 Ot)
The Curltractcit arc;`? r 5ubcoritracto shall rracllret%l n tknrf{ r i m jo urrwi1'.s; +R'ndd Otrier ir: Ce
procedures and practScas, sufficient to property reflect all direct and iriC.iract costs of whateVar
nature dammed to have been incurred in the p=m orm once s:l Lrii A r ement inrflu~ii7g cry mgt{t ir. rods,
and expenses. The foregoing annebtuto`s records" for the Dur io o of this orcvishn
b. The Coiner-actor's and or subc:e:ntr lctor facility o offer or such pair,' thereof as nay be engaged in Thu
p: rforrna nce of this /Vie sm nt a i 1 tiisiher rt-�'_`.ori s sNill tic, b'ect at it re sort b e. tinlar to in o
auditand repsodty tion.
CoruLrador agrees, that CDPI i. th= Cepanniorit of C3e:neral Services, the Bu reau of ate- ud t,., or bier
de tgnsTe1 repcesuritafr includ na he Comptroller General cif the Unlite~' Status shall have the rigll' to
c lEzhhih r1(F;, 19129: r agar a ci i`:
BIB]
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MOCO HD EXECUTED AGREEMENT|Eo�No�California fovp: rtmene of P'trthtic emith peci_al Terms and Cc,
eerie end to any rect rd5 ar I supp[ rtirs iccrsrnentation perpainirsg to the p,r term nce of tiii.,
Agreement, Contractor aurees to allow Elio audltO((S) accOss to such r.-cords during normal bu5.ine$!
hro irs arid to al w irate-Tvioi if any r~mp yoe who might rea nabfiy have information n_tati= i to such
record. Ftr-Jkrr, time Contractor agrees to int:lude a similar rihjht of the State to audit records and
interview- staff in any subcontract related to performance of this A reement. t;4 C 13546.7, COR Title 2,
Section 16 6)
The Contra_ or ared,or Suboontrai;tor uh38 presort and make lab Ie hr her reeor ts 1 for a perad of
three years f=cam the data ci final payment under lrtis 4wreernont, and 2) for such for sr period, if any, as
is required by applicable sta;uta, by any other provision of this Agreement. or trs s tr( paraura~o s 1'j or 2
tie,lox-
1) If this Agreement is completely or partiatlyr terminated, the r ards renting to the work. terminated shall
be preserved and made a valable fur a period of three years, from the date of any resat=ing foal
settlement
i, 2} If any i a n, c cirri, nego al i in, ear at, or other action invaNwig the records has been sta rte d bEfar_,
the expiration of the three-year peri_pd, the records shall be retained until co pletion a tt: action and
resolution Of alt rssuos which arise from it, or until trio and of the regular three-year period, which er
6 tat�q_.
o. The. Contractor and/or Subcontractor shall comply vi O the above requirements and be aware of the
penalties for violations of fraud and for obstruction of investigation as set forth in Public Contract Code
10115.10, if appp b�s.
The Contractor arias r S bcont> corm at its disccL-tcn, following receipt of final pay?m grit under this
Agreement, reduce its acc ruts, books and records related to this Agralarri art to microfilm, cornputor disk,
C ROM, or o tier data c rag rrieduari. UPGn request u
an auth sized representative to inspect, audit
or obtain copies of sal r ords, no f. c-;<itrector and/or Subcontractor must supply or crake raiat e
appli bte do-vie hardwaJe, andror software necessary to view, copy andior print said records.
Applrcdte devices may include, but are riot limited to, microfilm readers and microfilm printers, etc.
The ntractor shall, if appble, cnmptyr with the Single Audit Act and the audit r>e porting requi�ernents
set fortr, in OMB Cirr&i'er A-133.
8, S[te Inspection
The State, through any authorized re- preseritativses, has the right at all reasonable times to inspect or otherwis=e
evaluate the work performed or being performed borounder including subcontract supported activities and the
premises in which it is be4rricj performed, It any ins +cb n or evaluation is made of the premises Of the
Contractor or ubcooritraotor', tbp Contractor shaft provfrlo and shall rr uire Subcontractors to provide all
r nable Facilities and assistance for the safety and oinvanicnc of the authorized repr entahses in the
perforrrrance of t ei duties. AD Irisp>3ctions and evaluations shall be performed in such a mariner as will not
unduly delay the work.
13. Federal Contract Funds
Applicable e, rily 3o that portion of an agreement Funded in part or whole with federal fuiirrds.l
a. It it mutually under>;tor d between the parlios that this Agreernent may have been wTitl:e-n before
ascertaining t e ava tabiGty� of congras-sional appropriation of funds, for the mutual benefrt of both parties.
in ogler to void program and iiscot de rys which would occur if the Agreement were executed after that
determirraticri was mare.
b. This agrer_�rfr[ rtt IS vaial and errlorcuable only if szripiciertt funds are made available to the State by the
Urrr-itod States Government fog the fiscal years t3';ered by the term of this Agreement in addificn, the
Agreement s subject to any additional restrictions, lirnitat!o i or c=onditions enacted by the Congress or
any statute enacted by the Congress which may affect the provisions, torrns or funding of this Arrccemterit
in any martnoc.
COPH Exfitri' DIH I;r. rC:i R-Itx 9 of 25
BIB]
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FO96184-U03
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
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16616-U05
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411-HEALTH-U08
MCKEE-U09
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
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MOCO HD EXECUTED AGREEMENT|Eo�Oo�Car?fornia CeDartment of Public; Health Special Terms and Conditions Exhibit D iF::
tl is mut' a 1 agreed lrtat ii the Congress does not appropriate sufficient funds fir the program- this
Agr'ee?me t hall be arr<sairded to reflect any reduction in funds
d CDPH has the option to invalidate or meal hr Agreement with 31-days advance written net!ce or to
amend the Agree�nent to retied any reduction in funds
i0. Intellectual Proporty Rights
a. Ownership
2)
i 1) Except Wtiere CDP'H has agroed w a ti ed wriling to accept a license, CDPH shall be, and rertain.
YAthout additional c n,pensat in, thu sole owner of any and all rights, title and interest in all Intellectual
Property, from the moment iDf cr tire, voneth,2f of rkpt ntiy conceived, that are made, conceived,
derived from, of reduced is practice by Contractor jr CUP11 and which result dir tly or irddirectij from
this Agreement
For th purpc5es of this f=erment, irrt ectuat Property rrfeans recognized protectabie rights and
intetast such as: patents, whether or not issued) copyrirlhts, traderrta_rks, servsce marks, o pliCat<4aa
for any of the fore otng. inventiorls, trade secrets. trade dress, logos, insignia, color cot bir.aLuns.
Burls, moral rights- right et public tyT, autn-rorntjis, c tract and l cpnsing Fight,-;, works, mask
let rk3, industrial design rights, right-5 of priority, know ho,%%,, design flows, methodologies, devices,
business processes, dev> rprnents, innovations, fiord will and all other legal right. protecting
r itart ihfe proprietary information as may exist navy and/or here after conic into existence, and all
renewals and externsions, regardless of wahcet et those rights arise under the laws of the United States,
or any other state, country or}urisdiction_
a) For the purposes of the definition o irrteltectual Property, v rks' means all literary works, writings
and printed matter inclurmg the medium by which they are recorded or reproduced, photographs,
art work. pictorial and graphic representations and r-Ys of a Similar nature, ifni, motion pictures;
die ital images, anirraian cells, and other audiovisual works including positives and negatives
thereat sound recordirios, tapes, ed+uc4ational materials, interactive iidsas and any +cthef rnat-riots
or products created, produced, concept alized and heed in a tangible medium of exprevsion. It
inctuous prebmir-ai and final products and any materia% and information de elop l for the
purposes of pr during these final products. Works does not it elude articles submitted to peer
review or reference journals or independent research projects
3i In 11h performance of this Agreement. Contractor will exercise and utihhzc certain of its lntr}iiectuat
Property in existence prior to the effective o t3 of this Agreement. M addition, under this A: e-uiner'zt,
Cvrlttactcc may access, and utilize certain of CPPN's Intellectual Property in exister, e prior to tfie
efffect date of this Agreement. Except as oihere-ire set forth herein, Contractor shalt not use any of
COPH's intellectual Property nod. existing or hereafter existing for and purposes witrout the prior
written, permission of CDFf-I, Except otherwise set forth herein, neither the Contractor nor
CDPH shall give any ownership interest. In or rightly to Its intelfeetuai Property to the other
Party- If during the term of this Agreement, Contractor access any third-party Intellectual Property
that is trcensed to C1DPH, Contractor agrees to abide by all license and confidentiality TesMaicins
applicable to CDPH in the gird-porgy`s li:,ense agreement
cat} Contractor agrees to cooperate with CDPI-t in establishing or maintaining CDPH's excIusWe rights in
the Intellectual Property. and In assuring CUP-(`s sole r its against third partes with respect to the
Intellectual Property If the Contractor enters Into any areen-ents or subcontracts with other parties
in order to perform this Agreement, C- nhr3ctot shelf requite the terms of the Agreement(s) to include
all lclteilectuad Property prosrisions $ ch terms roust include, but aru not limited to, the Subcontracts.
assigning arid agreeing to assign to CDPFI all rights, title and interest in Intellectuat Proper' made,
come ed, der.ed from, or reduced ti practice by the subcontractor. Contractor or CDPH and lhich
result directly or indirectly from this Agreement or any stnc ar ir~1!1t.
5) Contractor further agrees to assist and cooperate with CDPri in all reasoniab4e respects, and execute
of c u�narttr and, subj=_cl to reasonable S ailabitit;,�, give trk_:tirn ny and take all further acts
reasonably ne-.essary to aeguirL=, lrensfer, mainlain, and enforce CDPH's Intellectual Property rr!ghts
and interests.
c li Ezh ii OrFi J!5-1030: rage 15 of 2_a
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
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THE-U07
COUNTY-U07
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MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Po�Gatfl7."n:a DepLiF1 nr ft of Public Hea-T-, Special Teals and Cond~itior Exh!L'kt U t;F- i
b. Retained R:igltts I License Rights
011 Except fcr tntetlectua Property made, conceiVEd. derived frrrri. or reduced to pr. Ct e b\ Contra for
or CDPH and which result lire= sty or indirectly from Isis Agreement, ntraut,'r shall retain ti'IL> tip all
of ti intfei teal Property to the exient such irtlolluctuat ProF~:!rty is in xrstenrte prior to the. r floc Iva}
Nate of this A.gre-emer!t. ConhaCGar l1=iri t,y grants to CDP'H. without adrditionaa c:omrensatioon, a
permariEnt, rvor1-t=a!iIusive, royalty lrer-, pad-up, worldwid}+, lrrev'ocable. perpetual, nor-term�naNe
n ens_, to vso, reproduce, manufacture. sell, offer to sell. irirport, expos, mcdi�y, pubh ly' and privataty
display]pefform, distribute, and dispose CoritraGtor's Inteltectuit Property with the right to sublicense
through mu'ztiple layers, for any purpose whasc ver, to the extent it is in orporated In the intfallecual
Property re ullting from this Agreement, unle s Contractor assigns all rights, tilt�c and Interest In the
Inteilectr at Properly as set forth herein-
2a f r thine in this proYis n Shall restrict, limit, or otherwise preerd Contractor from uising any ideas,
concepts, t;nuvr-how, methodology or techniques related to its performance under this Agreement,
provided that Contractor's use does not infringe the patent, copyright, trademark rights, license or
otthcr Inlellectuat Property rights of CDPH or third party- or resirit in e breach or default of any
provisions of this ExhiM or result in a breach of any pro isions of law relating to r nfidentialit,-.
G. Gopyritght
1) Contra!cior agrees that for purposes of copyright law, all works as defined in Paragraptl a,
subparagraph 2)taj of this provision] of authorship made by or on betialf of Contractor in connectV0,n
with Coritraatx's performance of this Agreement shall be deemed %vork.s shade for hire". Contractor
further agrees that the v, art of each person utili=ed by Contractor in cennection with the p rfor i7ar e
of this A%reerrierit twit be a work, made for Mire," wh her that pets-en is an employee of Contractor or
diai p r cn has entered into an agreement with Contractor to perform the work. Contractor shall
enter into a written agreernant with any such person that. 1) all work performed for Conti actor shall be
deerlied a work made for hire` under the Copyright Art and that person shall a: sign a11 right, title,
and interest to CDPH to any work product made, conol`ved, derived from, or reduced to practice by
Contractor or CDPH and witch result directly or in iirect=yr from this Ag.MernErnt.
i7) All r iater%als, including, but rat limited to, vi real works or text, reproduced or drstributod p uisualnt to
this Agreem=ent that include intellectual Property made, c ricei'rod, dorvved front, or reduced to
practice by Contractor or DP+-I and wwhih result directly it irrdirecl_y from this Agrees ent, hail
irtciude CDPt-i's notice of copyright, which shall read to 3rnm or larger typeface: Eater Current
Year 2077:, eft], Department of Public Heath. This materiat may not be reproduced or
disseminated without prior Britten permissIon from the Drpartmerit of Public. Health.' This notice,
should be placed prominently on the materials and set apart from other matter on the page where it
appears, Audio prods ptionos shall contain a similar audio notice at ccpyr yrot.
i1. Patent Fights
With respec to in snt ns made by Contractor in the performance of this Agreen're it, which did not result
from e a h andevatopment spe i'iz illy i ncurded in the Agrerementi s s+ e of + mrk. Contractor hereby
grants to CDPH a lie'ii e as described under Sect fn ti of this provision for de� es or material
incarporatimg, or made through the use of such inventions. if such inventions result fors- research arid
development wor specifically hiduded Et tnin the Agreernen s scope of work, then Contrarbr agrees t
assign to CDPH, without additional compensation, all its right, title and interest in and to such inventions
and to assist CDPH in securing United State's and foreign patents with respect thereto.
Third-Party Intellectual Property
Except as prov-cted 110f0in, Contractor agrees that its performance rf this Agreement shah. rot be
dependent upon or include any Intellectual Property of Contractor or third party without first. i) eb1airi no
CDPH's prior rtteri approval-, and iii1 g ar;tiro to or obtaining for GDP}[, without arjditift~at corrij en atiar'i
a f sense 7<--, described in erection b of this provisia- ri. for any of Contractor's or third-party's lnt llect=ual
Property in existonc�u prior to the uifectiva date of this Agreement If such a license upon the these terms
uaiattainabte, and CDP'rH determine-s that the tr,tetlectual Property should be included hi of is requir_Cd for
copit F:ehi>!ir Dif 5ligi Fagg 11 Of 2tt
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Qo�Cniffarnia Depnrtrr;en of Public Heat, Spe-cial Terms and Dondifions Exhibit U F)
Contractor's parfo,rinarace at this Agreement, C.ontrac of shall o7talr, a theorise under terms acceotablu to
CfI PH
f. Warranties
ti
31
Contractor represents acrd %varrariL. that.
d{ It Is free to enter into and fully perform this. Agreement.
lb} It has Gaeurt?d and will secure all rights and licenses necessary for its performance of ttrus
Agreement
Neither i'r,trt ctor's p rtcrrnarn of this nar the exercise- b; ttrer Party of the ri h s
grarifed in this Agreement, nor any use, reproduction, manufacture, sale, offer to sell, import,
export, rnrcdincaficn, public and private displayipertorn'tance, distribution, and drs i;ior of the
Intellectual Property mhc#+ oo iceived, dert ed from, of reduced to practice by Contractor or
CDPH and which result directf'y or indirecfty from this Agreement will infringe upon or vioiat=_ any
Inteilectuat Properly right non r sefo ire o li ati on, or other proprietary right or interest of any
third-party or entity now existing under the is vs of or hereafter existing or issued by, any stale.
the U rifted States, or any fore n country. There is currently no actual jr threatened claim by wis
strcn third party based L-n an alleged violation of any such right by Contractor.
I d) Neither Oon; ractor's pe rforrrearice nc! arv part of its performance itl violate trio right, of pri v 3cw u".
or constitute a libel or slarvder against any person or entity.
e} It has secured and will siaciine all rants and l cenee necessary for I nielkotual Propemy, iincluding,
but not lirznited to, cori ents, era s or reitrases fi all authors of rr,ufiie or perfo�rn, races used,
and talent radio, tension and w bon picture Want) owners of any interest in and to real estate,
sites, locations, prope* props that may be u-Scmd or shown,
f) it has Not granted and shall not grant to any per m or entity any right that would or might
derogate. encumber, Or mtorfere with any of the r~gF-t- Wanted to COF-H in this Agrer=rnrn'
l.g; It ias apprmFdate //terns ar'frl controls in place to ensure that state funds will not be uS'ed in the
pei orrriance of this Agreement fci the ecquis tstn, operation or maintenance of cornp,,ter
software in violation of copyright iaivs.
rr) It has ri>c nowlodge of any outstanding claims, h ruses or otter charges, lions, or encumbrances
of any kind or nature whatsoever that could affect in any gay Contractor's perforrnan e of this
Agreement.
2) C OPH MAKES NO WARRANTY THAT THE INTELLECTUAL PRD Pl=RTY RESULTING FROM THIS
AGR1-EMENT DOES NOT INPRlNGE UPON ANY PATENT, TRADEPAC;.RK COPYRIGHT OR THE
L1K.E, NOWT^: EXISTING OR ilk:E+S1-OU N T'L`S 1SSUE0.
Intellectual Property Indemnity
1) Contractor shall indemnify, defend and hold harmless CDPH and its I ensiee and assignees,
and- its
officers, directors, employees, agents, representatives, successors, and users of Rs prodii j;s.
t'I J rrirtitees` from and against all claims, actions, damages, losses Eiabttitir_s or actions or
proceeding-5 with respect to any t(-ereof), wtiether of not rightful, arising from any and all actions n r
claims by any third party or expenses related thereto including, but not limited to, all legal efperises.
court crests, and attorney's fees incurred i�~ ir~restigatir~g preparing, serv rig as a grin 55 in c'
defending against. any such claim action or p4roceedir g. commenced or threaten di to'ritii-ch any cif
the Indernnitees may be subject- whetter or not ntractor r a party to any peridini or threat!--sieri
lbaal on Y.h)ch arise ot�t of are related to 1) the incorrectness or breach of any of ttu
representations. warranties; covenants or agreeemeents of Contractor pertaining to Intellectual Property.,
or ii) any Intellectual Pinup rt infringement, or any other type of actual or alleged infri ircr'nent clai7,
arising out of CIDPH's use, reproduction, manufacf<ire, scale- offer to sell, distribution, import, export
modification, public and prey,OM perfcrrtira e&displ license, and dispiosit on of the Intellectual
MPH C hi it D;F;F rfr,rt i g~- 12 or 2 s
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Ro�California De iar!rnnr it al Puljl t-taahs~ Special Terris and Ccndition-,
Exhibil I) F,
Pm;perty made, conceevod, r rlvod from. or reduced to practice by Contractor or COPY' and which
result dir57cctiy or indirectay from this Agree7-rrent. This indemnify crdiigation 5hal apply ifrespecbve of
whether she infrilgar ent claim is based on a sent_ tr irirrtark, or cc~p ri hI registration that E uteri
n`tor the efiectrve date cif th Agreement CDPH reserves the right to participate in andlnr control, at
Contractors. e pense. any such. infringement Fir-bon brought against CDPH.
2) Should any Intellectual Property licensed AY th Contractor to 0017H under this regiment t~ crm
the subject of an Intellect ai Property i frlg orient cipim. Contractar will exercise its aulllorrl-i
reasenaf ty and in crood faiti'r to preserve CD PH 5 fight to use the licensed Intef ect jai ay in
ac=dence with tha Agreement at no expense to MPH- CDPH 81-tall have the right to monitor and
appear through its cyivn counsel at Coniradur's expense in any such claim or anion. In the defense
or sretttament of the clair�, LGnSrac-tor may obtain the right for CDPI-I to canLnue usi l the licensed
Intellectual Property; or, replace or niodify Die lip. cased in eltectual Property so that the replaced or
modified Intelti ciu&l Property becomes non-infrtligging provided that such replacement or modification
functionally equivalent to the original licensed intellectual Property If such remedies are not
realGnatly available, GDPIi shalt be entitled to a refund or all monies paid under this Agreement,
witroout restr.tion or limitation of any other rights and remeriie available at law or in equity
3) Gontra`t_ir agrees tt-a9 da limes a lon- would be inadequate tot irr p-ansate
CDPH or bread n any
term of ti is Intoll&clual Property Exhibit by Coniractcr, Contr for a knowludoe_. CUPH wcrriri offer
irreparable harrii in the o-,,ent ul such breach and agrees GDPI-f shall the ciritibier3 to obtain equitable
relief, including without limitation an injunction, from a court of corrrpetent turrsdiction, without
restriction or limitation of airy other righis and remedies available at law or in equity.
h. Federal Fundirig
In any agreerneft lorded in whole or in paft by the federal gover nt, CDPH may acquire and maintain
the tntellectuia! Property rights, title, at vi ownership, which foul directly or indirectly from the A' reemerrk
except as provided in 37 Code of Federal Regulations part 4D1 14; lever, the federal godorrrriient shall
have a rton-Ex lu 1Ive, nontransferable, irrevocable, paid-up license throughout the vier d to use, duplicate,
or dispose of such Intellectual Property t iroughout the vmMi rn any manner for gcr'emmeiital purposes
and La hw e and permit others to do so.
i. Survival
The, provvisiers set forth herclh shalt sur ivi-, any terrninaticn or expiration of this Agreement or any project
schedule,
11. Air or Water Poll onion Requirements
r'ant' federally furdr d agreem-ill ri ancifaz 3u1,)ccant,a t in excess of $100,001) must C-Ompiy with the foli-trruiri
provisions unless said agr!err=-nt s exerr'�pt under-10 CFR 15,5
aa. Government contractors agree t tcrriply with all appIicabe standa:d5, orders, or requirements issued
under section 306 of the Clean A4 Act 42 U.S.C, 1857(h)j- section 5&8 of the Clean Water Act 33 U S. C.
1363). Executive Order i173g, and Fnvircinrneiiiarl Protection Agency regulations 40 CPR part 15)
b. fnstitulions of higher education, hospitals, nonprofit organizations and commercial businesses agree to
compry with all apphcabte standards, orders, or requirements issued under the Clean Air Act r42 U.S.':
7401 et t5tq.1, as amended, and the Fed~~l Water Pollution Central Act 33 U.S C. 1251 et q.) as
ameri iJai.
12. Prior Approval r1 Trainirlg Seminars, Workshops or Conferences
Contractor shall obtain prior CDPH approval of the Location, casts, dates, agerda in._Lru-:Arjrs instructional
rra-tenals, and attendees at ar reirnbul abli tfairllr g s?�1Trnfil, workshop, or co condur-Aeu pu,rsuan
to this Agreement and of any reimbursable pubticitt or educational materials to be made available for
distribut it The Contractam shall a kr l ge the support of the State whenever publicaing the woe< under
this Agreement in any media. This pro ision rf-es riot app'y to necessary staff rneetiriys or training S^'' 5n-ns
held for the staff of the Contractor or Subcontractor to corafuct routine lxIsirre= matters.
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�So�Cal omia Departmu�it of Pubo Health wpfj._faI i oxms and Co idifions Exhibit D F)
13_ Confidentiality of Information
a. The Contractor and its employes, agents, or submntraci!ors shall protOct from unauthorized disclosure
ream et. and other identifying information corteerr~ing persons either roc' ivin.~j services. pursuant to this
Agreement or parsers whose nary o or identifying infcarrrrai an become available or are disclosed 1c0 the
Contractor, ifs employees, agents, or subcontractors as a resuh of services performed under this
Agreement, except or statistical informations not identifying any such person
a The Contract.3r and its employees, agents, or subcontractor, shall not use such identifying infurriiaticn for
any purpose other than carrying cut the Contractor's o ig t ns under this Agreement.
c. The Contractor and its employees, acrcnts, ec subcontractors shall promptly tr3nsin:t to the CDPti
Program Contract Manager all requests for disclosure of such ideftlafying information not emanating from
the client or p snort.
The Contra tor shall not diltse, except as otherwise specifically permitted by this Agreement or
ad!hofized by the client, any such identifying information to anyone other than CDPH w tiiout prior writlern
arithorizatiori arcwn t ha CC?PH PTc rani Contract Manager, except If disclosure required by SL:i`E or
Federal taw
e. For puap Os ri"f this proovisi+cm, dontiry shai� iridiude, but not be limited to name-, identifying number,
syirn ol, Of either Identifying psaiticula; as-signed to the l dxviduai, such as finger or voice print or g
photograph
f. As deemed applicable by MPH, this provision may be supplemented by additsonal tetni'-s and concid ns
cove*ing personal health information PHI) or personal, sensitive, an6'or confidential: information PSCI)
Said terms and conditions will be oirttir`.ed in one of more exhibits that will either be attached to this
Agreement or in porated into this Agreement by reference-
14. Documents, Publications and Written Report
r,ppf- able to agreements over $5,0011 under tfich public Lions, written reports and documents are
developed or produced GovernmerttCode Section 55x=0.)
Any document.- publ cation or written report e ctuding progress reperti;, t'rnanciar reports and norrnai
contractual communi tons) prepared as a requirement of this Agr rTient shall contain, in a separate section
preceding the main body of ih r ocurri nt, the number an c, 1sr amounts of all contracts or agreements and
subcontracts relating to the preparation of such document or report, if the total cost for work by n employees
of the 3taty exceeds $5,000.
15. Dispute Resolution Process
A C-c tractnr grievance exists wfienever there is a dispute arising from COPH's actari in t hi:
administration o f are agreement If there is a dispute or Brie ryce b�tm3on the Contractor and CDPH, the
Contractor must seek resolution using the procedure outlined be oN.
1 t The Contractor should first informally discuss the problem With the COPH Program Contract Manager.
It the problem cane be resolved interrnally, the Contractor shalt direct its td rfevance iociether with any
eurthnen, in writir-e to the program Bran &i Chief. The grievance shall state the issues in dispute, the
legal authority or other basis far the Contractor's position and the remedy sought. The Branch Chief
shall render a decision within tan $0) Working drys after receipt of the written gnevortcu room the
Contrarctor. The Branch Chief shall resperid in writing to the Contractor ndica1ing the decision and
reaaYans therefore. If the Contrac�or disagrees with the Branch Chief's si cistton, the Contractor may
appeal to the second level.
When appealing to the second leie'ef, the Contractor must prepare an appeal inrdiroting the reasons for
disagreement with Branch Cruet`s decision The Contractor shall inci+ide with the appeal u Copy of the
Contrabior's. original statement of dkspute aking with any supporting rvidence and a copy of the
branch Chie s decision. The appeal shall be addressed to the Deputy Director at the div.ei;ion in which
Conti E.rhit-it O(F; r` ir7 t aaa 14 or 5
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�To�CaIifnrnis Department of Public Health Special Terms and Gonditiouns Exhibit. L F)
the branr i5 Organi7e1 within tar, 10) working day's from receipt of the Branch Criiers deci iuri. The
Deputy Cti e st r of the ra'E''iston in which the brar'cft is organized or his;her designee shall meet with the
COritract to rd-iiow the issues raised, A r ten decision signed
Ex the Deputy Director al the divisio ri
in which t e branch is organized or hither designee shell be directed to the Contractor within too nit;.'
2G', working dav':s of rccelpt of tic�_' Cunlractor's second level appeat.
h. Ii the Confrect~=or wishes to appeal the decisirrn of tehje Deputy L`rirectiir of the dr,'isior, in w hici the bran h is
rgani'ed or his/her designsee, the Contra'cticx shall follow the procedures set forth in Div siun 75,1
commencing with Section 3.8050 of the Health and Safety Code and the regulations adopted thereunder
i'T LJe 1, Subchapte 2 55, comrmer sing with Section 151. California Code of Reguleti:,ns p
c Disou;es arisiria c it of an audit. examin lion of an agreerrterlt or other action not cued bry subdivision
a) of Section 2004, of h:aptOr 2.1, Title 22, of the California lCode of Regutaiions, and fur which no
procedures for appeal are provided in statute, re uktha l or the Agreement shall; be handled in
accordance with the procedures identifiiod in Sections; 51016 through 51 NIT Title 22, Catifomia Code of
f? e u> t1$
d. Lniess otherwise stiputated.in writing by GDPH, all dispute, 1rie.VRilce andtrr appeal core-e5pondence shah
be directed to the CQPH Program Contract Manager
e. There are oryariiz atioaaf ditferances within CDPH';; funding programs and the matte[ eirlent wets
tentified in this dispute ra lotion prows siori may not app in every contractual situation. When a
grie.'ance is received. and organizational d fferertces exist, the Contractor shell notit'ied in w:siting by the
CDPH Prc gran, Contact Manager of the level, cant[, anti, or title of the appropriate management official
that is re5poris bfe fir uir a decision at a given l vol.
16, Financial and Compliance Audit Requirements
a. The definitions used in this pro4 si are contained in Soc�ion 3 304Q of the Health and Safety Code. which
by this reference is made a part hereof.
b. erect service contract means a ntract cc agreement for services cx nta:ried rn local a5si tarrce or
subvention pingrarr s or both see Health and Safet`y+ I-f&S] Cite section 32"L120). Direct service contracts
shall not include contracts, agreer tents, grants- or sub:'ert?ons to other gov+eernrriental agencies or units of
ouvernrjmi nt nor contracts or aegreemerits with regional centers or area agencies on aging H 3S Code
section 33030).
The ContractDr, as indicated below, agrees to obtain Brie-of the llollo,w-ing audits'
1)
3)
3)
If the Contractor is a roonorofrt organization as defined in H&S Corse section 3. Q10) and receives
$25,000 or rn�rre from any State agency under a dihect service contract or ec reemertt; the Contract of
agrees to obtain an annual single, manizaban wvide, financial and c' npliance audit. Said audit shall
be conducted a ding to Gan�fall p#td,~udi
tig r~ land ids. Tail audit does not fulfill the audit
requiren-ients of Rai raph c(3) below. The audit Stlall to completed by the 15th day of th fifth
ri ifk'i follC?unnq the end of the Ci ntractor's tit al year, ancfIor
If the onir ntor g,-V,ri rot'it_c1r a ization s defined in, H& S Code section 3:8046} arid' roc,eives less
than V5.000 per year from any Stag agency urger n direct 5&r~iiqe r. ntr ct� f i reenient, the
Contractor agrees to obtain a biennial sar'Ftie, organization wide financial and comptiiance L-1idit unless
there is e*d dunce of fraud or other violation of state law in nneclrrl with this Agreement This audit
does net ftiiltflf the audit rerfuiiements of Paragraph c(3)1 beki The audit shall' be completed by the
15th day of the fifth month iollcitAnng thee end of the C-ontraetrars fiscal year, andlor
If the CE.nitractor is a Stale or Local Government rniity._c, r t'toriproft organization as defined by thn
Federal Office of Mar aerrjent and Budget. OMB] Circular A-13i) soil expert t, S500.000 or mare in
i=gJQr$t awards, the Contractor agrees to obtain aGn annual sinctlr, organ t s'i wide, financial and
compliance audit according to the requirements specified in ON18 Circular A,133 entifted Audits of
States, Lc-jai Coverrimarils, and Nori-Profit Organizations". An audit conducted p4ursuant to this
provision w ll fulfill thu audit requ i ements outlined in Paragraphs l'�(1 t and ct2) obov`e, l he audit shall
be completed bye the end of the. ninth crr,anth following the end of the udil period The requirernienta cit
CDPH &xi,ih rj(r) fL L 25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Uo�ifur?'ia Clepartme 1t of ist lii: Health Spci l Terms and sryr ditii ns Exhibit D IF)
This provi in apply if
a;+ The Ccntracier is a recipient experrdling Federal awards received d irecf y Rotor Federal awarding
agencies, or
d;i The Contractor is a suGrecipiena e<pendrrrd Federal awards reieivad irom a p,-5s-through enlitj
such as the Slate, County or community based ocfariiz3tion.
4) If the otn-ract, submit=_. to CRPH a report of an audit other than an 0M B A.-113 audit, the Contractor
must also subrmt a certification indicating the Contract has not epferlded $5D0 OUu or more in
re-derail funds for the yoar covered by the audit report.
d. Two copies of the audit report shall be de.Wored to the CDPH program funding this Agreement. The auJ t
report must identify the Contractor's legal name and the number assigned to this Agreement. Tn+F audit
repo; t shall t due within 341 clays after the completion of the audit Upon roc ipt of said audit report, the
CDPI-i PrNram Contract Marta jer shall forward the audit report to CDPH's Audits and invlestklaticirss Unit
if the edit report was submitted under Section 16c{3_~, unless the audit repot irs from a City, County, or
Special District within the State of California whereby the report will be retained by the funding program
c. The cyst of the audits. d sccit ed Fermin may be included in the fund ng for this A9reomerft up IQ Lne
propnF innate aniouni this Agreement represents of 1 he Conlract is total revenue. 1he Ct7?'H progran
Lund=rig this Agreement must provide acNan e Written approval of the specific amount allayed for said.
audit expenses.
f
The State or its authorized designee, including the Bureau of Stato Audits, is responsible for conducting
agreement performance audits which are not financial and eomptianca edit; P_c ormance audit=} are
defin by i eneralry Ac peed vetnrnent Auditing Standards.
g. Nothireg in this A r er ririt limits the i te's rea o. aikrility or authorityy to enforce State law r r eel tuns,
Proi:eduree, or rop-Ming r uiremenhs arising thereto.
ii. Nothing in this proviskwi limits the out onto roi 1h State to alake audits of t 0-s Agreement provided
however, that if independent audits arr-.anr ed for by the Contractor meet Generally Accepted
Go emmental Auditing Standar the State shafi rety on those audits and any additioonnal audit wcork and
shall build upon the wok already done.
The State may, at its option, dire-rt its- own auditors to perform either of the audits described ahrve Thee
C-ccitcactor Y All be given advance written notification, if the State chooses to exec cite its eeption to perform
said audits.
The Contractor shalt include a clause in any agreement the Conti ctor enters into wiith the audit firm doing
the single organiz-atcn w de and l to provide access by the State or Fe oral Government to the wOrk.in
papers of the independent, auditor r ho pepar the singii~ or artization vide audtt for the Contractor,
Federal or state auditors shall have expanded scope auditing" authonty to eandu t specific program
aurlds during the same perrad in which a serge organization wide audit is irvg performed, but the audit
report has not been issued. The federal o stairs auditors shaft review ar d have access to the current audit
irk being conducted and + ill not apply any testing or review, procedur which have not been satisfied by
previous aLFJit work that has been completes.
The terrn+'expanded scope audits is applied and defined in the VS General Acc untie' i Office GAO i
issues Standards for Aadit of Govvt11r7ir;rti + r ra; i_alir'tt rProgrwrrs. AclirIe and Fi rrrtiors, better
knoviri as the yelrow, book
17. Hun-an Subjects Use Roqutirornents
/ppta.able only to federally furtdea agre-eincnteigrants in wwwhicti purl orri-anc-c directly or through
subcontractrsubaward, includes any tests or examination of materials derived from the human body.)
OPH Extiitd uir, r: Lr'J r';,,j r k t.i r:lj
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Vo�California Departinurit of Public Health SpEc-tal Terms and Ccndiliu-na< L-.dijbrt D F)
By signing this Agreement, Contracor agreets, that it any perfcrmarnce under this Agreement or any
su 7contract jr 5Lit agree anent includes any tests of emdrnineilion of materials dercjed from the hu.rizin Lady for
the purpose of providing information. diag-rnosis, prevention. treatniortt or asSs,srnent of disease, impairment.
or t altt"i of human being, 911 Io{rations at which such examinations are performed shell meet the
equirome+nta of 42 U.S.C. Section 261a C MA) and the requ a ions thereunder.
1it. Novatioin Requirements
If the Contractor proposes any novation agreement, CDPH shati at upon irto prop isal within 60 oa a after
rec,eipt of the written proposal COPH may review and consider the proposal, consult and negotiate utth the
Contractor, and accept or rejec-t alt of part of the proposal Acceptance or rejection of the proposal may t:--
matte crafty within the 60-day f rirYd and confirmed in writing within five days of saki decision. Upon written
acceptance of the prof, osaf, CDPII will initiate an amendment to this Agreement to forrnat r implement the
approved prope.
19. aebarment.and Suspension Certification
Appticabte to all agreernrorrts fur dod, in pail or wvha with fetttiraf funds.)
a By signing t7iis Agreement, the Contra tor!Grantaeri agrees to colnpf~ witii applicable federal suspension
and debarment regulations inoriding, but not limited to CFR Part 3{01 r, 45 CPR 7 40 CR; 3' or 34
GFR 85:
h. By signing this Agreement, the Contractor certifies to the best of its knowledge and biaiief, that it and Is
principals.:
t1 i Are not pre ntly debarred, suvpended, proposed for debarment, declared ineltgibie, or v'etufntary
excluded by any fer1 rai departrrr nt or agency;
2) Have not within a trues yeir pGtiou precedinrri iii} ap:11%aburt/pr p r r agreement been corwicled of
or had a ciy,ii judgment rendered against thorn for cornrrtissi~'i of fraud or a criminal offense in
c-nnection with obtaining, attempting to obtain, or perf, i ii: a public Ftrjeral, State or tc
transaction or contract under e public transa o n; violation of Federal or State arititrus statutes or
commission of embezzlement. theft, forgery, bribery. falsification or destruction of records, making
false statdment or receiving stolen property;
Are not presently indicted for r otherwise criminally or civilly charged by a c vernmenial entity
Feder-,-; State or local) With commission of any of tie of enses enumerated in Paragraph b(2) herein,
and
1,47 Have not within a three-year period preceding this applicatior,,'proposai;agre'err nt had one or more
public transactic s Federal. State or local) terrrninated for cause or default.
halt not knowingly enter into any tower tier covered transaction with a person who is proposed for
debarment rudder federal regulations i.e 4E CFRR par; i<, subpart 9.4), debarred, suspended, dteclvrod
inel.i!g ble, or voluntarily excluded from participation in such transaction. unless authorized by the State.
h't Will, Include a clause entitled, t ibarrrLent and Suspension Certification" that essentially sets forth the
provisions Heroin, in all Jovxtr tier covered transactions and in all` relic-Ataiioos for Traver tier covered
trartsartioris.
It the Contractor is unable to certiay to any of the statements in this certification, the Contractor shall
suemit an explanation to t e to C7 FH Program Contiact Mana� Er.
d The terms and definitions herein have the meanir,'gs set cm in the Definitions and Co',cciage Smcbons tit
the rules implementing Federal Executive Order 12549
e tf th e Contractor knce%.ingty violates this certification, in addition to other remedies available to 1h,;- Federal
Go,,ernment, the CDPH may terminate, this Agreement fm cause or default
SOH Exhibit UT) 9,t? l P&Ie 1? f 25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Wo�C alri'ui.,ia Department of t uhli Hralt~~ Crresral t mom a*id condition= F.xhihit D F)
20. S rnoke-Free Work place Certifre itfon
Applicable to federally find-ad aoroemE tst/rants and subcontracts?subamards, that provide hoalth, days care,
earl' dnifdtrcod deve-topn ent writ s, education or library services to children tinder 1$ directly or is it ough
local g-werrirnen s
a Public Late 103-2274 also known as the Pro-Chikdren 4cl of 1994 n~t� requires That smocking not be
permitted in any pU tion of any indoor facility raw-ned or leased or contrad-ted for by an entity and used
rou irety or regularly for tho p vi. io cif health, day care, earty cbiiIdho d development serums a, education
or tibrarky service to ctihd en under the age of 18, if the se~ricas are funded by federal prograr is either
directly or through state or local govem merits, by fedfal grant, contract, loan, or foan guarantee. The ie law
also awlies to children's services that are provided in indoor facilities that are constructed, operated, or
maint led whh such federal funds- The law does not apply to children's services provlrjo-l in private
residences; pi rticons of facilities used for inpatient drug or alcohol treatment service providers whose sole
source of appl able federal funds is Medicare or Medha i; or fac4ities viliere WIC coupons are
redeemed.
b Fa#lu-e to compl=y with the provisions at the law may result to the imposition of a civil rr rrietary penalty of
up l o$1,000 for each victafiorn and/or the i=riposition of an adrrani tratiVro npliance order on the
res-possible party,
By signing this Agreerrerrt, Contractor or Grantee certifies that it will comply with the requirements of the
Act and Will not allow sri-oldur g withwi any portion of any indoor facility used for the prcvision of services for
ritdren as defined try the A_ct, The prohib ns herein are effect pe r:lber 2S, 189
Contractor or Grantee further agr e that if will insert his certif cat n into any subawards subcontracts or
subgrants) entered into that provide for tali-eon's s�ntir s as described in the Ac
21. Covenant Against Contingent Fees
Applicable on to detaliv urtied agresrr}ents_}
The C +ntractor warrants that no parson or selling agency has Gees employed or retained to sotic V enure ibis
Agreement upon an agreement of urn erstanding for a commission. etc ntaFgo, bro'refage, or coo tirrgent fee,
exempt bona ide employees or bcaJ fido established commercial or selling agencies retained by the
Contractor for the purpose of securing bus ries--s. For breach or violation of this warrants. C.OPH shall havf the
right to annul this Agreement wahout Imbliity or in its d cretion to deduct from the Agreement price or
conisider-ation: or oiherwis rec rrer, the full are:-aunt of such commissran, percentage, and ti.rokc:rage or
contincerii fee.
22. Payment Withholds
Applicable only if a final report is re uired by this Agri.=,merit, Not, applicable to cdo rarnm moat entities.
Unless waived on otrienivise stipulated in this Agreerr nt_ CL1Pki mart', at t3 di-scfation, withhold 10 percent
i;1u of the face amount of the Acr rmdent: 50 percent t% of the finial in-voice, or 53,00 vohiche er is
greater- until COPH receives a final report that rr a8ts the terms, conditions aaidtc'rscore of vmrk requirements
of this Agfeement.
23- Performance Evaluation
Not applicable to grant agreements.)
COPH may, at its discretion, evaluate the performance of the Contractor at tie cone ur on of this Agrb erneilt
If p~~rfcrrnanca a:al ra;ecd, trip evaluatics) stall not be a public record and shall remain c.i rife vita CDPH
Negative q_ rformance evaluations may be c nsidered by CDPH prior to making future contract awards
COPE{ Er OA 0;F! E'. Dg)r Fags 1 S o'. 25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Xo�f a iforrtiL. Department of Public i-{ta l i piacr,.il Term,5 and Conditions E hiblt U Ft'
24. Officials Not to Botlefit
No members f rjr delegate of Congress or the 33t3 B Legislature shall be admitted to, oily share or part of tni=_
r�a; r: emerit, Or Ic any ben Fit that may arisa Lir rutror r. This p envision shall nit be construed to oxtpnd to This
Ar rof inert if rrl r a with a corporation for its guneral Lens tits.
25, t=our-Digit Late Compliance
Applicable to argrc r nis in wh h Information Technology IT) sorVices fro provided to COPHH or if IT
equipment is fprxurod.)
Cont:aitrr rrarat t'i At it will p4twide e oily Four-Digit Date Compliant as defined below) Oeriue;ahies and/Or
services to the Slat Four Digit Date Compliant.' Deliverables arils ices can accurately p,ocess, calcuLate,
eompaia, and sgrrence date data, including without limlraLari date data arising out of or ralatirig to leap years
2:10 changes i i ce?nturie5. This warranty and ropresontation is sub)ect, to the warranty terns aril conditions of
this Contract and does nit tmit the generality c f warrarily obligations set forib elsewhere herein.
Prohibited Use of State Funds for Software
Appl bfe to aq-eern nts in wh h mputor sohvai,, is used in performance of the. work-)
C ntractor r:>art:t es that it has appropriate systems afia contras in pkace to ensure that state firnrds will not be
used in the performance of tilts Agreement for the ac utsltioni, operation or maintenance of rt'iputt~r scfivare
in aricial oli of copyright iawa.-
27. Use of Small, Minority Owned and Women's Businesses
Applicable to Mat portion of an agreernerit that is federally fueled and entered into with instttu irons of higher
edticat'ort, hospitals ni nprel'st organ at~aris or cornmvercial businesses-)
Post+ie errors sniali be macro to Lr2e small businesses, minority-owed arms and warneri's business
enterprises, whe` ever possible i i.e fire ur'ernent of gods anchor ser e Contkactrrs shati take all of the
fofowing steps to further this goal
1) Ensure that. areal: t u messes, minority-cwnod irms, an i aar'rlei` i ti isi oss enterprt
fullest extent practicable.
s are. used to the.
f2t Make infor i'abon on forthcoming purchasing and contract-ig opportunities available and arr nga time
frames for purchases and orgn,racfe to encourage and fa-104 Late par cipat n by small businesses, mrnvorit t-
owned firms. and yr rneri s business enterprises.
ir1 r in tilO con trait process wheth.sr firsts c rrhp irk fi r larger contracta intend to sii rfjntract with
small businesses, rr�inorit'y-own-e firma, andviagner0s t jsinrass enterprises
r-r t7ura a contracting wlti consortiums of srhiall businesses, minority-Own d firms and wornenrs businp1 ss
enterprises when a contract is too large for oneof t ese firms to handle 4i th.iduelly
uj Use the services and assist-am ceee, appropriate, of such organizations as the Federal Small Business
Adr=rirristration and the U.S Department of Cornn ce's Wri&i 0,+ Busiris:, De'ieloprmont oency in the
s~olir:ttaton and utilization of small businesses, minortt1 med firms and vivornen's business Crterprtses.
Z. Allyn Ineljfbility Certification
Apptrcablo to so proprietors entenng fssterarl}t funded agreements.)
By signing this reerrnO+nt tie Contractor certif tii.all hwst c is ridl an alien that rs ineligible for state and
k ai bape its. as defirred in Subtitle B ref ttru Personal Responsibility and Or-k Opportunity nct ii I tom.
16501. el seq.)
cDr i E7, bi10 r 1, ewa91 at~ ig r 2s
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Yo�California Dt!parrrr_unt nf Fublic Hekalth Speri yl Terne acrd Conditions Exhibit D' Ff
29- Union Organizing
Applicable only to +ararst agreement)
Grantee, by signing this Agreement, her~oby a~~krlo'wtadges the appbeabllitf of G-o- ernment Code coon
16645 thruu-gh 166"4G to this Agreement- FurthCrrrnore, Grantee- by signing this AAre ment, hereby cerctios
that,
a No state fujicis drsbursed by tt"ls grant will be used to assist, promote ur d-eter union organizing.
b. Grant shall account for 51ate. fends drrliur_ed fo a sped expenditure by ties gm-it, to show those
funds were allocated to ti t expenditure.
Grantde shall, where state fu;-ids are not designated as de: rtF in b herein, altocate, on a pro-rata basis.
all di`~rsements that support the grant program.
If G arilloe makes a p#:riditurea to assist, promote or doter union organizing. Grantor will maintain records
sufficient to show that rla state funds were used for thoose e pen titures, and that Grantee shah prc~vvirde
throw records to the Attorney General upon r q ast.
30. Contract Uniformity Fringe Benefit Attowability)
sApplica only tat nonprofit Organizatcns
Pursuant the proviso is f Article 7 c inmencing with e tio4i 100525) of Chf ipter 3 of Part 1 r if Division
101 of the Health and Safety Code. CDPH sets f� th irf tollov it policies. procedures, and guidelines
regarding the reimbursement of fringe benefits.
a As u*_> d herein fringe benefits shall mean an employment benefit given: by area's ennplrye to an employee
in addition to one's regular or riornaal wages cr salary,
b.
As used herein franoe benefits do not include.
41) Crrnpensation for per onal services paid currently or accrued by the Contractor fur services of
ernploy s rendered during the, term of th s Agreement which is identified as regular or ngrm.al
salaries and wages, annual leave, vacat m, si leaia, holidays, jury duty asidlor rrrilitara
as'eJ training
2) C~ecter's and execut ie caln rr e_e rn&mbar's. fees.
Incentives awards artd!cr bonus incentive pay.
4) Aikr.4 nces or off-site pay.
5) Location allwwances.
6) Hardship pay_
7) Est of-li iing di`ffe nt is
c Spe1--ifc allowable fringe benefits lud-e:
d 1) Fringe benefits in the form of employer contributions for the employer's portion of payroll taxes i. e
FICA- SUL SDf), employee health plans r.e., health, dental and vision), unemployment insurance,
wrark_e"s cocnpe.ication t-iscuran and the employer's share of pensiorv'retirement ptans, prev ed
trey are rgrant>sd in ac rdanre with established written organizaIian policies and rarer all le=gal and
Irlerraf Revenue Serve requirements.
d. To be an allojrrablo fringe benefit, the cost must r eet the fal-lawir*g criteria-
I) 13e necessary and reasonable for the performance of the Agreement.
2) Be determined in ae ordance Stith generally accepted accounting principles.
3) Be consistent with policies that apply uniformly to all act%t dties f the Contractor
e. c-oni�a for agree that all fringe benefits shall be at actual cost
CC)Pi`l Ext ill Dig! ISM 9', P.gr- 1'i l If-
BIB]
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MG99866-U03
AS99892-U03
AS99894-U03
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DO109645-U03
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2/13/2012-U04
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
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CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�Zo�V ilrfor i Departrr�nt if Public Health Special Terrti=, and cond=lihr3s xhihit 1) r)
f EarnedfAccrued Cornpenc-aWn
3)
Compensation for vacation, sick leave and hclidays is limiteJ to that amount earnoc1accruLld Within
the agreer ent term. Unused vacation, sick e and holidays earned from pericd prier to to
agreement term cannot be claimed as allovc-ible casts. See Prov-sion f 3)(a)) goer are exarnpk:.
lei For multiple year agreemerits, vacation and ick leave crrmipenaat n, which is earnLdtaccru d but not
paid, due to erriployaef s) reel tak.ir lime off may be tarried over and claimed within the overall terni of
the muihplr:F oars C.f the Agreerriitit. H5lirday:s cannot be carried over from one agreement year to the
next. See Provision f 3)(b) foi an example.
For single year agreement vacation, sick leave and holiday compensation that is eamed1accrued but
not paid, due to employee(s) not taking time off within the term of the Agreement, cannot be claimed
as an allrnvab e c c: t See Provision f 3)(c) for an example.
Example No, 1:
If an erripl::yee, John, Dc 7-- earrislact rues three weeks of vacation arE-l. twelve days of lick. leave
each gear. then that is the rnaximurn amount that may he claimed daring a o-ne year agreement
s
It John 7 e has firs wfa t�~ of
vacation and eights n days of sitk le-a�e at the beginning of an
agreerrto t. tti Contractor during a one-year oiudget period i fay only claim up to three weeks of
vacation and delve days of sick, leave as actually used by The rii lcy=a_ Amounts
earrieWaccrued in periods prior to the beginning of the Agreement are riot an allcewabl cost.
b) Example No= 2
If during a three-year mu ple year) agreement. Jc rn Doe does not Use his thr&e weeks of
w,acaton in year one, or his three weeks in year t o, but he des actually use nine vreeks in year
t err: the Contractor would be allowed to claim all nine weeks paid for in year three The total
compernsation. over the three-yea3r period canon-ot exceed 1513 w e-e':s i 3 x 52 weeks)
cy Example No. 3:
If daring a singre year agreemenr John Doe v c-rks fifty weeks and rased one week of va.ato i and
one week of sic.'eave and all fifty-rkvo weeks have t en billed to C DPH, the remaining unused
tiio weeks of vacation and seven days of sick tome may not be claimed as an allowable cost.
31, LoWying Restrictions and DiscIG-surve Certification
plicahle to r deraily funded aigre relents in e cess, of $100000 per Se~--tion 1352 of tree 31, u.S.C. i
a. Certification and D do sure Requirerif-'rrts
ti E Bch person or recipients who requests or receives a of rtract or agreement, sus cunt, mot, grant, c r
sua rant= which is s itj ect to w ct ri 1352 of the 31, U. E-3 C., and which exceeds $100,000 at any tier.
shall file a certification in the form set forth in Attachment 1, c foisting of one page, entitled
certifcati rr Regarding Loblaying') that the recipient has not made, and will not make any payment
prohibited by Paragraph b of this provision.
t? Each recipicat shall file, a disclosure in the form set forth in Attaciriment en iiled Standard Fonvr-
LLL i cl; sure+ f tout=yir,ct Activities if such recipient has made Or has agreed to make any
paymen using nonappropriated funs to include profits from any covered federal action) in
connection with a contract, or grant or any ex'=.ension or amendniarit of that contract, or grant, which
vioutd Lx' prohibited a irjer Paiaq apii b of this prrsli-_;OOri if paid for with appropriated ffundds.
i Each recipient shall file a disclosure form at tree end of each calendar auarler in which there= occurs
any e eni that requires disclosure or that materially a`tsct the accuracy t, the inturrrvaban Contained in
any disclosure form pioviCouSly filed by such person uri+der Paragraph r2 h rein An e4'ont that
rilatr-ri_i y uffirctu the accuracy of tl' information reported includes'
Mr*; the it D fl l- fy-j 21 ct 25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
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THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�[o�Califurnia L partrrjlnr of Publi Health Special Terms and Con fitsrrnl Exhitrt 01Fl
is ct!nul3uve vicreasE of $25,0Og or more in the arnount paid or e.rpecte to be paid for
inlluen in or attempting t^ riffueno- e cc1er?d federal action:
b) A cl�iarign, in the pers> s.; or ir'ir if:iduals(s) influencing or attempting to influence a covered federal
action. r+r
c) A diange in the offeerts). empiayee s), er rriember(s) contacted for the purpose of influencing of
attempting to influence a covered federal an n.
4) Each person 4w recipient) who requests or receives frond a person referred to in Paragg:alrh af,1l of
This provision a contract or arireernerit, subcontract grant or subgran exceeding $1 10-000 a any tier
u-vder a contract or agreement, or grant shall file a certification, and a disclosure form. if required to
the next tier above.
5) All ri scrasure forms but not certifications) shall be forwarded from tier to tier until re-ceived by the
person referred to in Paragraph a(l) of this provision. That parson shall forward art disc sure forms
to GDPH Program Contract Manar ar.
b. Prohibition
yeclion 1352 of Tttfr, 11, L1,S.C, provides in pearl that no appropriated funds may be expanded by the
recipient of a federal contract or agreement, grant, loan, or ow4arative agreement to pay any porv.~n for
influ ping or attempting to influence an officer or errtployee of any agency, a Member of Congross, are
offr or employes of Congress, or an employee of a f.1em f of Congress in connection with any of he
r lam awarding of any federal crewel or agreement, the making of any
f tci; my c tired federal actions
federal. grant, Ilie reaping of any feral loan, entering into of any cooperative agreement, and the
extri, c ntiouatiori, renewal, ar�iendrrierlit, or modificatiQn of any federal contract or agreement, grant,
loan, or cop-- ratve agreemii tt-
COPH Eztsabli DfFi 9D i r'yg= 22 r' 25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�\o�ria Dep7rlmenl PiIt,Ii~-: FIe. Ith S; a~ Terms_ ir- d Cor,ditioris L; li.b t L3 Fl
STATE OP cALIFORttlA
Cf.LiFG NJA DEPARTGMFNT OF PUBUC HEALTH
CERTIFfCATiON REGARDING LOBBYING
Aitlichirrnt t
T sr t12d ci'iiiIos, to ih best f or her and befii~I', inat-
1) No Federal Qppr p-timrod furois tev-c bOf pfd Or will ti-2 paid, h of on t::jh:: lr of Me ur di-r-sxj;,cd, m+
any per3cn fir il�encin3 or lien-iptin' k inf uercre an uffx-Far or arripkc~vCC Of an ar.~cr r:y, a itt-?ri'it_r of Congress
n officer or Empbyr~a of Congre.s5, or an em ployree of a termer o Congress in connection w l i Lhe making,
a aiiriq or artel ng into of this Federal contract, Federal grant, or coop-,R.ative agireerrent, and itiC extanszcm,
continuslior, relic ral amendment, n' m;,Qificaatii n rf this Fedmml aritrect grant, or roo, rattre ogre cmEnt.
12;, if any funds rather than Fe f tal appropriated funds have lb&-e paid or will be paid to any person for
tnfiuerr In- or ortempting to infuof.ce a t o l c r or cm 51G 3 E of 2h ag ncy of the Linn f a at_s'cu nrnent a
Member of Gongre- an officer or emp4cy'ee C'er-- re s, of nn errp4ci i e of a Member all Congress in
cxtnnect: in vvi h tftts Federal contaac rant or coo orativ i clo reoment tlio uridersir rio'.t Shalt cxmrnp e and
b
tt nd Form LLL, cIosure of Lobbying Aotiv itie in occordorzvre with its insi r actions.
+) Th-e vndersstgnad shall require that the tangutiag: of t his certifa:atti4on be ircl'.ided- in trio awarci
d-ccumen's for all s 1bawards at 50 tiers irvoluding subcortcs tore. sub!grPn e, and can r f r der r nl and
Giar_+parat e 3 r am fl s3 f ff + r more; an d tFat 11 sut,ra~zipianta 5h.911 certify aril iiscfg, r corditi1-:;4V
Irhiz vertrfiicatiori is a rilatj3rial reore~Ent2ti` rf fart upon which rLsllanca was plan 3d when this transaction wss
rr ade or enteierxd into- Sutimis<slor of this cer'if abcn Its a prerogUisite for rn5kirig or CrttOririg info lhts transaction
imposs d by See en 1 52. TWO 31r, U...C.i sn parson Who fads i_i filr the requaroc ccrtificatlon shall he subject to
civil ii3ralry of net to than 510,01M and not rriore than 11JG,COD for ea ti such failure-
7nir~ tci C +r+^uwr
tJ~7 fr a_ x! cc ri:rc V P r r,
Lcr rz i +<3 1um r
S i a r n a h r ct 1 n 5 r kri ia kr rha
T-riti
After executirn b yr on b hat= of Contractor, please r ti m ta:
tralefornta D p_ rtrneni of i ubtic f-leal h
CIONt l ra icrVOS the riUm fl to nohtry tfie oriiraclor in wi=tui o an OIt Iri iti_ subrr?Is=ion adidrez~r
COPir frf rfi LN I` it`ai; P'i 23 ct 5
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�]o�Ca-'AL)rn a 1Uo-dnlllem f Pohl-,` Health Special i errmi4 and C onhbS i
ep_.:t Type:
Attachment 2
CERTIFICATION REGARDING LOBBYING
I c; ilplt_ t IhI, tnrm t�:.L di ctc`3P 1Cl~A tlllg +_'~r b a r.W! krnni t(.) 01 U 3 C, 13512
SFr: rave.mu for pubic burden d';sclasurrsj
Ty e:. of Fadural, Icn: tailts of Federal Amon.
f a arr a bWoftq riapp licailrn
t. yiSrI b IiT1 31 a'Aird
1 co EeW s ems, ni rg. post-xxar+
d Ivor
U Isar. ararlle_
lcr 1[Srw-ance
N re ari A: d-rrr of R;7pcrtng Eit-cy:
Pr enr El t Z-Aw-dee
Tier it kntr. n.
CcMre 6. rgl t�11:i ri_i ii knr.rx*t:
0 Fcdfaf DerarlTnenlAgency
Federal AU-on r 1 1 be it kri n
t u a Mimi and Address of L-~bL~jxig R iranr
6VkTdA4c:-kIa1. 7:;r rarrt8, li`f`t rsrrte. tl 1.
Inrc4r atii It r--7x-!t-W- rrn-tsI tI i!-Tr a,t r:r aJ r+y we 31
U C W%fl 1 112 cG Ii- Lr~ f[tt-rnq=tatna f. k i"tread
L-3�e arizt)2-1 Cr Lpcr, Sn:~ rEI K- x G:1_r_t3 the 1&'
4( rtc3 fir i`t, nar ss tt r *, r 3a ynfa'aa it is Tli6
ywk---m IS rcra:9, v r# lo 3' U C 7 t.2. T F rnatt,n
wr t' awfaL�`r-- f'r mink trs er:. te, rtad t3s tra s-oi t~,
ru a taart.rnre3thanSi IIU W)t)ft.t? V-#--U0, la 1XI!,
i
Authorize for Leal HeprotujctF_rn
S,andord Fcirr_-LLL 4lRo w
i DFi-I Fxhiait D,, 7 M U5) Pilgo 4 of 25
Exhibit D i,F)
Lfi=lcE av l i?6
a. II':i[ist fle'ti]
If k prKti; Er:rt1 n
any drre-, of Prig;
b. m ioral caenge
For Maw=gal Change OrPi:
Yfer curter
ztata of Iaat report
I Suba 3r3ee, Erler Naar.
Cari:.rems o l Lri`"I if knt nr:
E'C:2f I f"fGf3rit #~rreY}~arr /Gan:
A Number- if a pbcsb
9. AwaidAcniunL Iiitrn~~n.
$
Indfe ua Pertan-ling Ser rl? a?s fiI It_+tII &tdrss if dif r,7rgt r y-,
ri i
i La.:! name, Fir_St n r., t+V
SignLure:
lit Narra3
ele�t ane N
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�^o�CalifL'Inia Depcrlr Ierl? of P b i Health Special Terxis arid Conditions
Extiflit Cy IF)
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIE
Ttiz- ni�el:7s, rr, 4~ ire hal to mn:doled ap inn rerci ra on t.; rti Irr:* rte. arcce r,r prime FedernI mcin._rr at the r tlf3ltr a� receipt t'l +: +,vred t 3r, 3I arirr. cc
n ti tai er, to a rae-r iu�: Iit rig put~unr. Lt We 1, 1 I.Z, G c,_i,:?, 1 2 I N! Itinq et c Vern is m:wrNj fur ear Fat nit, t r r?rs k, I 6.4 pZTrrre.-r, k+ uv skrrrrs
t"r3t}' Icr nll Jri~,_t $fr++n-L I'r,' Iu i-t1U!rrrt eri r. ilr-rir cr t-?{ee ci 171!5 +, iri/, a Pr1emt:'S Un Jtg.`3, tr! &711-,."l v etPl_k: rr!J h1._. j;%f
a~ar!;5-r. r_r,Irrua.;ti:t'r tsAt: r!'N:i Ff:it w,l fQri).r Crrm:r?iei it rlt�.rii�.' 11'+=1rril.!(41.11 r+,lrrNtNtt~~if,dn,f,i ai t. R#Gt 45r_s~gla`i,:!'tli j jltlir,
v.>r I j IIIN r A l l CI I.i l r r c lia I a/.7! r1i fr;kJij j?r
lit!nIttyNhl'}:w~ O cni rntl Fedrtrrt aclir s_rw r hiet:t:.!!vj in 811d,0; has 7irro te,1nl Eire Zr 7ucztrrrmc sl w;r.vcrce Fr, l:il r
tit3riftpfarstile:r t.'cr:.crtiiFairr arr9_r
ider!fii} ttiQ apprr-piii n cl:.crirr attt)n 0 IFe: rc>E_vl i 1-it, is a I;rlsh.-rrp tepurt, mul1w.-I 710 moi[r'y;i char,gn fro Infcnr atinn rymvrjstr rcc rIn.i c ti the 4~c-ar and
cunrW ii tt-e cha<tyn o:usnw r! the d,r ca the l3 l R rc ruby uhmr cr r t tr is rep- iTc fn ty'*x I pps cn.ered Fr~ ni
Enter Irn her name, da gets, crt, a.c1S are nip cad Cr irrc rcpprani crnrf. inctce uan?re;cs d Llicrrcl, t 7n C:lr_-:h TAt. app~upricle tt:sfvti:Iic-n c/ in
r rtr'j + tt. Ytr+t r'o4grialAf. i 4. cr wst;�!;. ic be a a tits ut +uhrN3`d rs?p+r I;terall, u + N e rr tt!a i:i. r; a rIm a j the rlr.l c.1.'.'N,<+ardeu rr th!-. error:
Ihn isl et. SuGasarcn t_,ct.jd_ Guc rc net Ir+tci lc suhrrrrv':3s suhg rir ii ceniract arrand: I;rcer grarls
h rt, er r nn Mini; ten relay in item 4 *.tcc7� to ar2ti,' Minn rip ss the tall nnlrc, address, chi, ate arc i::oce cf t r_ p*inie f e+ erl recc4enL In:t ce
Cx. est tv l Diy7@ct i' ki n.
ErLr the, nm i cr the ferielcJ s +rry maker ti 7 ar lean o?Traiment. inclu!!e at team cce c arii:n[rrri l r 4� aFa
t`fri inY.'� Cl Trc rn rtatian, tlnrxid jar. Cc:x;i t;r:art
F;ei.=, 0Fire ex�r'
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rLrrxxs tc;-cntc st er~7.'=.3~reer-erg, Paar, area lean rrrtmnni5
Er-mrlr rrrni apprc +r FF6itaf cz:rrit)=ng numtr4r;+s'aJt. in tnrthe Fadnral a cn ctk_d ut eri t a.g., RcaLcsi tr-Frcpss3tRUFF; nr3-ter Inv n_n tc� Ei:i
IFFi, n r *K, iriril srr?~r,: merl number the cants.- pr=a L a= ran z1; rr r^tw. d<e 9p 1~'&li c'Urt f{ y` rr' ri'Gi nun!ler tl4ii)! v t1+�= Fw r r +
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Ft;f a fta=c ed Fo ra! aF-tzr. wn mn irp,;ra tF'c, cr.y; Ar v 1 Cr Vail r-_airirrr ire: r. hj tom: Fnnerz. g~Trcy. inter Fedora arri+rt r' 1rr aa:nvkor, cr-rtirrrt
kr the r erbt} icentrfer in ter-; d is
77 Tai Erlrr ihp I'Lli r n� mess, cir., Bich and vrs cede of Lie tcbccrrh, r--2,-mar>_ under itrc Lct*?f q Dr:,: iuie Ay! rj iW Nngnga+j rr r�- cn.iir
d+aritAnd in!ram4 U?Irrr.ww tt'6 C.;ow'R,i Fe hr3t CK!icri
I1 Fr am tha. it it r F z rd rte rRy +�t to f i F E root; E.r i.;ict. n i�.;;air flit a f,Iras attftrse tram 10 rat Er ar La;i i a-rh: Fsr:I F-Jartr_ any PJ.r}i I-nal
INti.
11 The cei- i iii elirl3t stall nvj-i a'd lain the Izrr-. Gnnl herher rare: tr3e, and tee4 ere rLirE
Ac;ordt tc Ilte Far;errrviP: I- Juadiarr, Act, an cii-elided, nu cersui art retiuied to rnNpiur?r] 1u ti z*lkeC1Cjr1 or rifr rmali rfl i.ci i a it iiipla i, a valil
C7t.1d yard Fi�:irrber. hr^ v'alid G'r.1EI ccnts+3t: rrrmEer tar Ir-iis irctrrimalicn sate tF7ra is Otdd hi<j. Cr34.1-Cie--_ Pl lie; repcrtlns tjrrjert rcr ttis;
er,jtn�< ri tit it Qrmadcar is tln ic3y M av 3e M rrir[4rir,:, r,irr r npcrrao, iraiL ding time fee rcvievn-n inslrrefctis, aeztr=dell; exlsli:-ri t'inL-*_ icurunt,
gilt irrl 5c+3 trL3fita.r rra Ctit ncese id e r + +iflj Bco re av r~7 t`rtg cflt9rtt n y1 inicrrnatitrrl. 5tnd rr:rictris re larifir tfie Euz#en
e ma".e or cn tiU'rr V i lt Cr 11`ia~ iclldi k. ut intnrma cii, rnc*idrhi 3Lejge5licr.; ter feaijeir'r7 tnt, bUrl6rr. a rn miter' of P. in mrrrl cnr
h ud t. PaFcrurark. Ri- LIc+ m Prot cI, O r+�1A-0C"+48), r.`Jastirr lcri, GC 2'[1503.
fitIE:hitarfii t,ytic; f=ir} * cr'25
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�_o�k1onterey County Health Depar'irnerit
11-10234
Exhibit E
Additional Provisions
1. Additional Incorporated Documents
A. The folloring documents and any subsequent updates are not attached, but are
incorporated herein and made a part hereof by this reference. These documents my be
updated per�odicali~y by CDPH, as required by program directives. COPH shall proMe the
Contractor with copies of said documents and any periodic updates thereto, under separate
er, CDPH will maintain on file; all documents referenced herein and any subsequent
updates-
1. Regional Nety o & for a Healthy California Guidelines Manual and any revisions
thereto. Revision October 1.:011)
htt itwv+w.cdrxh.ca.gov/programsicpnsfPageslRNGuidelinasManuat.espx
2_ Nafwork for a Healthy ifz i Program Letters and any revisions thereto-
htt F1hvww.cdph.ca.gov1nr-p rarnsfc rnsfPa-p! f rc w~prtiLett rsa$r c
a. United States Department of Agriculture State Suppfemental Nutrition Assistance
Program Education SNAP-Ed) Plan Guidance. Revision Date FY 2012)
http:ltwww.nal.us�fa.govtfsn1Guidance PY2012SNAP-Ed a�dance.pdf
2. Cancetiation I Termination
A. This agreement may be cancelled by CDDPH without use upon 30 calendar days advance
written notice to the Contractor_
8. CDPH reserves the right to cancel or terminate this agreement immediately rr cause. The
Contractor may submit a written request to terminate this agreement only if MPH
substantially fails to p erform its responsibilities as provided herein-
C. The term for pause:* shall mean that the Contractor fails to meet the terms, conditions,
and/or r=esponsibilities of this agreement. Causes for torminalion include; but are not limited
to the following occurrences:
1) If the Contractor knowingly furnishes any statement, representation, warranty. or
rtification in connection with the agreemment, & ih representation is materially raise.
deceptive, incorrect, or incomelvte.
2) if the Contractor fails to perf_ rn any material requirement of this agreement or defaults
in performance of this agreement.
3) If the Contractor riles for bankruptcy, or if CDPH determines that the Contractor
becomes financially incapable of completing this agreement.
D. Agreement termination or cancellation shall be effective as of the date indicated in CDPH`s
n-otzcati-on, to the, Contractor. The notice shalt stipulate any final performance, invoicing or
payment requirements.
E. In the event of early termination or cancellation, the Contractor shall be entitled t-;i
compensation for services perform d satisfactorily under this agreement and experises
incurred up to the date of cancellation and any non-cancelable obligations incurred in
support of this agreement.
Page 1 of, 3
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�`o�Montoore,y County Hes-Ith Department
11-102.34
Exhibit E
Additional Provisions
In the event of terrninetion, and at the request of CDPH: the Contractor shall furnish copies
of all proposals, specifications, designs, procedures, layouts, copy, and other materials
related to the services or deliverables provided under this agreement, whether finished or in
progress on the teninatiori date.
G. The Contractor will not be entitled to reimbursement for any expenses incurred for services
and deliverables pursuant to this agreament after the affective.date of lerrnination,
H. Upon receipt of notification of termination of this agreement, and except as otherMse
specified by CDPH, the Contractor shall:
1) Plano no further order or subcontracts for materials, services, or facilities.
2) Settle all outstanding lia>a lit�es and all claims arising out of such termination of orders
and subcontracts.
3) Upon the effective date of termination of the agreement Contractor shall transfer, assign
and make available to CDDPH all property and materials belonging to CDPH, all rights
and claims to any and all reservations, contracts, and arrangements with owners of
media/PR materials, or others, and shall make available to COPI-t alt w�r;tten information
regarding CDFH's rnedim'PR materials, and no extra compensation is to be paid to
Con tractor for its. servi s,
4) Take such action as may be necessary. or as CDPH may specify, to protect and
preserve any property related to this agreement which is in the possession of the
Contractor and in which CDPH has or may acquire an interest-
V CDPH may, at its disr;`etlon, require the Contractor to cease performance of certain
r.mponents of the Scope of Work as designated by CDPH and complete performance o
other components prior to the termination date of the agreement.
3. Avoidance of Conflicts of Interest by Contractor
A, CDPH intends to avoid any real or apparent conflict of interest on the part of the Contractor,
subcontractors, or employees, officers and directors of the Contractor or subcontractors.
Thus, CIJPH reserves the right to determine, at its sole discretion, whether any infom tion,
assertion, or claim received from any source indicates the existence of a real or apparent
r1+t t of i serest ne, if a con`tict is found to exist to require the Contractor to submit
additional information or a plan for resolving the conflict, subject to prior CDPH review and
approval.
B. Conflicts of interest include, but are not limited to:
1) An instance where the Contractor or any of its subcontractors, or any employee, offcer,
or director of the Contractor or any subcontractor ha an interest., fnarrciaI or otheraise.,
whereby the use or d�sdos rre of information obtained hi'=e performing scribes Under
the agreement 1ioutd allow for private or personal benefit or fclr any purpose that is
contrary to the goals and objectives of the agreement.
2) An instance where the Contractors or any subcontractors employees. officers, or
directors use their positions for purposes that are, or give the appearance of being,
Page 2of3
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�ao�t lontenayr County Health Departri nt
11-1C 4
Exhibit E
Additional Provisions
motivated by a desire for private gain for themselves or others, such as those with whom
they have farnil yr. business or other tie=s.
C. if CDPH is or becomes a care of a known or suspected conflict of interest, the Contractor will
be gWWWen an opportunity to submit additional info mation or to resolve the conrrlict. A
Contractor with a suspected conflict of interest under this egreer7 nt will have five 5)
wing days for the date of notificaUo n of the conflict by CL)PH to provide complete
inforrnatir regarding the suspected conflict. If a conflict of interest is determined to exist by
COPH and cannot be resolved to the satisfaction of CDPH, the conflict will be grounds for
terminating the agreement. CDPH may, at its discretion upon receipt of a written request
from the Contractor, authanze an extension of the tin eli ie indicated herein.
Page 3 rrf3
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�bo�ales W H-11. j
Contractor's Release
Instructions to Contractor-,
Exhibit F
With final inaroice{ep submit one 11} original and one j1} copy. The rlnginn-, niust b X the, on nji Sirlnak re. of a person
authorized to bind the Comtmctor. The add tionnl rxipv may hetar hnt~n.nti~Rd re,
Submission of Final Invoice
Pursuant to contract number 11 1 t'I entered info L kwun the California Depa-rL�rent o Put iy_ Health CCDPH)
and the Contractor 3entified bell-e- Into Contractor W c* a Xn(ywlodgee that final payment has been requee?ed Via Invoice
number(s) iri the imaunt(s} of $ and dated
It rteee Barr, cntor Sot Attachod in the appropriate biccks and at':ach a list of in floc number:, dollar imowirt and. iriMr_Iac 4 alte.i.
Rolearm of all Obligations
ay' sign hmg lh torm, aril arr+on rei_I t t of Bile amount PC-, ed in the Invoice nn ber(e) referenced a eve, the D,ntraoto r does
hereby rele sa and disc-h. rge the ur_,te, I L,trlcr_ S, ttrlt-rl V id rail I, r.l 3 of and f tim any and alt liabilities, L'ipa ion Fl irr,=, and
demands teat-wever arising from the ebic e refereen ed rtes,-1tamr_A_
Repayments Due to Audit Exceptions I Record Retention
By signing hie form, Contractor a:_t nc'iledges that expanses Gut:-jorized for reimbursement does not gu;ararteo firi,11 ltr,^.ti llilii! t
said expenses, Contracbr ag,-eds that the arritlunt of any eusteinad audit e e epl one reeuidng from an.� subee quent audit mode
alter r I pa riser t gift u., row"wor" to the slats,
All expenso and aCceuntinq rx. sod_s rotated to the ate'' e.�e referenced contract must be maintained for audit pur-Fo es for no ieaa t n
three +,'wata be M Ir` *. dat�i eat tin-al payment, unluse a Icn-a or term is staled in said contract:.
R&cyctad Product L sL Certification
4 a' ignmr this fora, Contractor c:ur ifre~ undr p nifty of p ry jur j that a r-_i-. imum of 0% unfst-s othu iAso specified in writing of goat
consumer material, as defined In thu Put k Guntrac. r_d', Srle ion 122 0, in products. ma lcrial:~ r r d s, or supi Iies offered or old
to the t le rec,rateF of wheahr r i ri le the negtivirLLmLr L of Public Cron 13e1 God o S,=Lon 1220 Intructc=r sp1xilic. tenet
Feint=_ror duplication cartddsea offered or einid Ci the Store cCorrlpjrV'ih this requlrr'meints of Section 1? I5U{
Reminder to Return Stag EguipmerWPr'operty if Applicable)
ter its only If squi;rcrr rrt'x s r,r[m je tr COPH or pwcraeeu wttn or ralmb rz+3o by Ccnitra�.t fur!
Unless CUPI-i has rrldp o'td the= r_:ontinExud use and pct c ion of Stage uquiprnccnl as dean d in thl ab+_-5're rofe>renr.;ura cis ract) for
use In er nnectior MU) another CLIPH a re+`rtlent, C Imesctr is+.jrGxm- to promptly lnitlale arraingeiri nti to acc krnt Ir and return
equipment on CDPH, at CDPH's t ease, If said equipment has rat passed i_s� ful fifa ax}' ct. ncy as defines; in the at�.r,,a
referried contract
Patents 1 Other Issues
By signing this form, CcnL acior further agrees, in connection with pasta-, matters and th any la me that are not specific-ally
roIet d as set lortf'a above, t: at i''ili comply with all of the pru'Vision contain eed in the ass v rore-renced corirract:, irrck iinff, but lot
limit-d to, bNo e fire.'k l.in_. rddatine t:, n atlt tlT;n to he ntF~ anti re', tt j to the de-fem. or pr1 secuilcu-i a f lit>s,,tirln.
ONLY SIGN AND DATE THISDOCUMEt4TWH�N ATTACHING IT TO THE FINALtNVOICE
Ce h-acter`s Legal Name i m I r_ I`. r: Monterey County Health Department
tiig at,ura of Cotraclor or Official Designee: Data:
Printed Nafi e(Titlo of PFursori Siginri-g: R v Eutl ck Director of Health
Distributi�4v A r~�uc�tln Q1gii 0 PI ar==tt
152 7,57-
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�co�lifarni.! Ckip rtini"ni ar Pubic i-calif- Exhibit G
Travel Reimbursement Information
ileage Reimbursement Increase Effective Z/1/1 1
The fedlvs intj rate policy is to be applied for reirribursinr the Lawol a_xperisas of persons under contract The terms
contract-` andd o; sub ontracr have the sarrmo meaning as grantee" and/ar suhgran ee- where applicable.
a. Reimbursement for travel anc or per l~ezm sbali be at the rates established for narurepre ented!exciuded state
errip=loye s. Exc wris. to Departrrient of Patsonnft A,dr linistration OPA) lodging rates maybe approved by the
CaJi!ornia tepatfinerut of PA-41c HaaJUr COPH) ixpcn the receipt of a statement oruw th an invoice Indicating that su.jclI
rates are not available.
b. Start Term Travel is defined as a 24-hour period, and less than 31 consecuti',te days-, and is� at least SD mils from trio
main office, headquarters or primary residence, Starting time is henever a contract or subcontract emolovee Ii es
his or her hornE' or headquarters. Headquarars' is defined as the place where the contracted porsonnet spailds the
largest portion of their wok;. ng ii me and returns to upon the completion of assignments. Headquarters may be
individually established for each tray=ale and approved tterbally or in v.,citing by the p-rograrn fundln~ L no aCreerriarit.
Verbal approval shall e foltowe tip to writing or f--.ma
c. Contractors on travel statue for more than one 24-heus period and less than 33.1 conse uti; e days may claim a
fractional part of a period of more than 2$ hoirrs, Consult the chart appearing on Page 2 of this exhibit to
determine the heir tai r* art llcwari,�, Al icy-gun l reimbursement claims must be supported by a recta' if a
contraccr does not or ce-nn ut present receipts, lodging expenses w l not be reimbursed.
1) Lodging with receipts'):
r v l_L tLOI f.Ar
I aiate>r lci excludirti the unties ideri'i d below)
Counties of L> Ang es and San Diego
Refrnbursement Rate
fi 94,00 plus tax
1 TOi.D plus tax
Counties of Alameda, ai Frar-cisco, San Nlaieo, and Santa Clary S14D.0plus tax
Reimbursement for actual lodging expenses that
e3rceFd the above afTfwniW may be lowed with the advance
approval, of the Deputy D ire for of the California Department of PLibl r Health CDPH) or his or her designee.
Receipts are rartuired.
Receipts front Internet lodging reservation service-3 such as Priceline.com which require prepa`itrnent for that
sorviee3, APl= NOT ACCEPT A1LE LOE 6ING RECEIPTS and ere not reimbursable without a Valid ladoing receipt
frrxll a lodging establishment.
2) Meea!ISupptomiental Expenses grit,, or without recaipls), W&h receipts, the contractor tail's be reimbursed actual
arriounts spent up to the rnaxir murrr for ate, r full 24-hour pa od of tra el.
Meat I Expense Raimbur; anient Rate
are-3; fat $ 5.00
Lunch 7O.OO
Dinric $ Ia.OLJ
Incidental experi:see $ 6.00
d. Out-of-statatravel may on t be reinibursad if such travel is niroess Latad by the scope or staternen t of wurk ar.rd has
been approved in advance by the pro rare with vttt,ch the C;entrar:t it hold. Fix out-of--state travel. contr:n_turs may be
reimbursed actual lodging expenses, supporte by a receipt, and may be reimbursed for meals and supplernerita l
expenses for each 24-hour period computed at the rates listed in r:. 2, above. For all out-of-stain travel,
ittractors sub'cantractor must have prior CDPH written= or verbal c pproval. Verbal approval shall fie corairrned in
writing email or memo}.
In comp i ing allowances for continuous periods of travel of less than 24 hours, consult the chat appearing on Pace 2
of this exhibit.
f_ No riieal or lodging expenses will be reimhersed for any period ur travel that seders within normal n acing hours, uiir ss
expense we incurred at least 50 mires from headquarters.
H Ct41U 01 1071111 Page 1 of 2
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40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�do�Travel Reimbursement Information Continued} a:hi hi` t
2, If any of the reimbursement rarer stated mere:n is charted v DPA, r* tcirrr=al Wont-ad amerenm�n:ili he required o
ircolrF� rte to the now razes. Huvt1 e.=or, CDPH shall lrrfo(rn thy? S:CnUiL rtcr, in ritinq, of h r-~ tined travel el imt,urs- rrd.-eri: ru Vr;-~
and the applicable effective date of any raw chai7Lu.
At CDPH's dlsr otion, cI1angts or roe�SiOd,3 rr a-Ua by COPH to this exhibit, exc4udirfn travel rein burseni rir ili_"i 3
established by OPA may be applied mtroactivel to a y agreeniertt to whir.- a Travel
I eimblirvem@ It fd feirnat an exhibit is
att. ched, incorporated by reference, or appliEd by DPH pro rim colic#. Changes to the travel reirnburserrl tit rags
stated herein may not be applied eariiar than the date a rote change is approved by, DPA_
a. For transoorta[ion e: nenses, the contractor must retain err for parking; taxi. airline, bus, or all tickets; car enial; or
any ether traveh receipt pertaining to each trip for attachment to an invc ce as substantiation for relrmburserna it_
Reimbursement may be re uested for c, mrnerci rl carrie=r fares; private car mileage, parking feoees: bri,tine teed taxi, bus, or
streeiJar fares; and Eu-to entet fees when substantiated by a receipt.
Note on use of autos: If a contractor uses hismer or a company carrfor transportation, the ram, of rr rlmbur=arriwnt will be
55.5 cents riazirfmurn per mile. If a coritractn uses hisrhher a company tar In lieu of" airfare, the air coach fare will b-a
he naxin um paid by the State. The c arf ract r mu t pro i 1 a s ost imp~ri n upon rev best by� thF tale. i aseli to ar.d
routine aulometr e repair expanses are net reimbursable.
5. he cardtractc is required to furnish details surr ending earth period of tra','el. Travel expert se reimbLrsenient dretail nea r
inctuda, but r-iet be limited to: purpose of travel, departure and return times, destination points, mites driven, mode of
transpr taLion, etc. Reimbursement fc� travel expenses may be tvitnheld pr: nddin~ receip of adequate travel docurnentazion.
C ritraciers are to cens.u;it Lh the program v} th which the contract is held to obtain specific invoiciri procedures.
Per Diem Reirrbbursement Guide
Less than 24 hours
Trip begins at or before i am
and cobs at or after g am. Breakfaast mazy be aime~d
than 24 hours
Less a
T- rip at or before 4 f3_ri~_ t
and nd,:i at or c'tft~3r 7 p.m. Dldii"'ior may be d:7i?Tlod.
+ 3
24 hours Trip be3tlins at or before 6 a n. Breakfast may be cairn ed.
24 hours Trip boons at or before 1"1 a.rri. L urnch rr'ir be clairlod.
24 hours Trip begins at or before 5 p.m_ Dinner may be claimed.
More than 4 hoi<rrs Trip e-rtds at or after 3 eis Sreakfas may be cis.im J,
More than 24 hours Trip ends at or after 2 p.ni: Lunch may be claimed.
More than 24 hours Trip ands at r-.r after 7 fr,rn; inner era; be r lainier'.
C. OF c4.aJai r c 11 e Pay. o 2 oft
BIB]
40956-U01
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AI102677-U03
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2/13/2012-U04
BOYDA-U04
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APPROVE-U07
AUTHORIZE-U07
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DIRECTOR-U07
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COUNTY-U07
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AGREEMENTS,-U07
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MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
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MOCO HD EXECUTED AGREEMENT|Eo�eo�Monterey County Health Department
t 1-10234
Page 1 of 0
Exhibit H
Information Privacy and Security Requirements
For Nonr-HIPAA,'HITECH Act Contracts)
This Information Privacy and Security Requirements Exhibit For Non-F-IIPAAMITECH Act Contracts)
hereinafter referred to as this Exhibif) sets forth the information privacy and security requirements
Contractor is obligated to follow with respect to all personat and confidential information as defined herein)
disclosed to Contractor, or collected created, stored, transmitted or used by Contractor for or on behalf ref
the California Department of Public Health hereinafter CDPH;), p rsuent to Contractor's agreement with
CDPhi. Such personal and confidential Information is referred to herein collectrrely as CDFH PCI) CDPH
and Cor>+trector desire to protect the privacy and provide for the security of CDPH PCI pursuant to this Pri~.acy
Exhibit and in Compliance with state and federal laws applicable to the CDPH PCI.
1. Order of Precedence: With respect to information privacy and security requirements for all CDPH PCi,
the terms and conditions of this Fx ihit shall tale pre denr_.o ove-r any conflicting terms or conditions set
forth in any other pdri of the agreement between Contractor and COP; f, including Exhibit A Scope of
Work), all other exhibits and any other attachments, and shall prevail over any such conflicting terms or
ariditiOns,
II. Affect on lower tier transactions: The terms of this Exhibit shall apply to all contracts, subcontracts, and
suba r:ards, regardless of whether they are for the acquisition of services, goods, or commodities, When
e pFica le the Contractor shall Incorporate the rielevant provisions of this Exhibit into each subcontract or
subaward to its agents. subc-sontra tors, OT independent consultants-
III- Definitions: For purposes of the agreement bet;va n Contractor and CDPH, including this Exhibit, the
follavAng definitions shall apply;
A. Breach: 6rea $ means:
1. the acquisition, access, use, or disclosure of CDr H PCI, in any medium paper, electronic,
oral), in violation of any state or federal law or in a manner not permitted under the agreement
lween Contractor and CDPH, including this Exhibit, that compromises the privacy, security
or integrity of the information- For purposes of this definition, compro-misses the privacyy,
security or integrity of the information" means poses a significant risk of financial, reputational,
or other harm to an inidt iduai or individuals; or
2. the same as the definition of brea of the security of the system" set forth in California Civil
Code section 179829(d).
S. Confide Wal information- Ca nf`�den al information" means information that.
1_ does not meet the definition of public records" c-r t forth in California Government Codf-!
sr,ctkin 2(e). or is exempt from disclosure under any of the prodisk ns of Section 625 0, Pt
seq. of he California Government code for any other applicable state or federal la:+ s; or
2 is contained in documents, files, folders, books or records that are dearly labeled, marked or
designated with the word confidential` by CDPI-l: or
3. is personal information" as defined in this Exhibit-
C. Disclosure: Disclosure" means the release, transfer, provision of, access to, or divulging in any
other manner of information,
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�fo�Monterey County Health Department
11-102,34
Page 2 of 10
Exhibit H
Informati=on Privacy and Security Requirements
For Non-HIP IITECH Act Contracts
D. Personal Information: Personal information" means information, in any mediu
electronic, oral) that:
paper,
1, by itself directly identifies or uniquely describes an irrdivi dual or
2. creates a substantial risk that it could be used In combination with other information to
indirectly identity or uniquely describe an individual, or link an indivi
1 4 uai to the other
information; or
3. meets the definition of personal information' set forth in California Civil Code section
179-3-3(a) or
4. is one of the data elements set forth in California Civil Code section 1798 29(e)i 1 i. 2,i or J); or
5. meets the definition of medical information- set forth in either California Civil Code section
179&.29::fi(t) or California Civil Code section 56.05(g); or
6. meets the definition of health insurance information' set forth in California Civil Code section
1 2 J8.29(fX(3
E. ecurfty lln dent Security Incident' means:
1. an attempted timach; or
2, the attempted or siuccessful modification or de struction of CDPH PCi, in l olation of any
state or federal lax or in a manner not permitted under the agreement betw=een C ontra for
and CDPH. including this Exhibit; or
3_ the attempted or successful Modification or destruction of, or interference vith,
Coontracoc s system operations in an inforn-ion technology system, that
n gativet
impacts the confidentiality, a.tailabilit f or integrity of CDFH PCI, or hinders or makes
impossible Contractor's receipt, olt-ectton creation, storage, trar~srni. sion or use of FCi
byr Contractor for or on behalf of CDPH, pursuant to Contractor's agreement with COPH,
including this Exhibit.
F. Use: Use" means the sharing, employment, application, utilization, examination, or analysis of
information.
IV. Disclosure Restrictions: The Contractor and its errrplayees, a=gents, or subcontractors shall protect from
unauthorized disclosure any CDPH PCI, The Contractor shall not disclose, except as othervise
specifically permitted by the agreement between Contractor and CDPH including this Exhibit) any
CDPH PCI to anyone other than CDFI-f without prior written authorization from the CDPH Program
Contract Manager, except if disclosure is required by State or Federal law.
V. Use Restrictions: The Contractor and its employees, agents, or subcontractors shall not use any COPH
PCi for any purpose other than carrying out the Contractor's obligations under its agreement with CDPH.
VI. Safecuards: The Contractor shall implement adrrinistrative, physical, and technical safeguards that
reasonably and appropriately protect the privacy, confdenti~afity, security, integrity, and availahility rf
CDPH PCI, including electronic or c:-ompu'erized Ci PH PCI, The Contractor all develop and Maintain a
written information privacy and security program that Includes administrative, technical and physical
safeguards appropriate to the size and complexity of the Contractor's operations and the nature and
scope of its activi ies in performing its agreement with CDPH, including this Exhibit, and which
incorporates the requirements of Section VII, Security, below. Contractor shall provide CDPI-t with
Contractor's current and updated polities.
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�go�Monterey County Health Ocpartrnent
i 1--102.311
Page 3 a 10
Exhibit H
Information PrW cy and Security Requirements
For Non-HIPAA'HITECH Act Contracts)
VII. Security_ The Contractor shall take any and all steps necessary to ensure the continuous security of all
computerized data systems co t9 grog COPH PCI, These steps shall include, at a mi 3lmurm
A. complying with all of the data system security precautions listed in the Contractor Data Security
Starldar t forth in Attachment I to this Exhibit;
1 providing a level and scope of security that is at least comparable to the level and scope of
security established by the Office of Management and Budget in OME Circular No. A-130.
Appendix III- Security of Federal Automated Information Systems, which sets forth guidelines for
automated information systems in Federal agencies-, and
In case of a conflict between any of the security standards contained in any of these enumerated
sourc of security standards, the most stringent shall apply. The most stringent means that
safeguard which provides the highest level of protection to CDPI-t PCI from breaches and security
incidents.
VIII. Securi Officer The Contractor shall designate a Security Officer to oversee its compliance with this
Exhibit and for communicating with CDPH on matters concerning this Exhibit.
I_ Traini The Contractor shall provide training on its obligations under this Exhibit, at its own expense, to
all of Its erriployees who assist in the performance of Contractor's obligations under Contractor t;
agreement with CDPH, including this Exhibit, or otherwise use or disclose CDPH PC 1.
A- The Contractor shall require each employee who receives training to sign a c-er=coticn, indicating
the employee's name and the date on which the training was completed,
B. The Contractor shall retain each employee's written certifications for CDPH inspection for a period
of three years following contract termination.
X. rr~ fa e ir pfi e: Contractor shall discipline suss employees and other Contractor workforce
members who intentionally violate any pro osionss of this Exhibit, including by termination of employment,
X1. Breach and Se urip, Incident Responsibilities:
A. Notification to COPH of Breach or Security Incident: The Contractor shall notify CDPH
immediately by telephone call plus email or fax upon the discovery of a breach as defined in
this Exhibit), or within twenty-four 24) hours by email or fax of the discovery of any security
incident as defined in this Exhibit), htotifcation shall be pro-.ided to the CDPH Program Contract
Manager, the COPH Privacy Officer and the GDPH Chief Information Security Officer, using the
contact information listed in ction XI(E), below If the breach or security incident occurs after
business hours or on a avekend or holiday and involves CDPI PCI in electronic or computerized
form, notification to CDPH shall be provided by calling the CDPH lIT Service Desk at the
telephone numbers listed in Section XI(E), belcm For purposes of this Section, breaches and
security incidents shall be treated as discovered by Contractor as of the first day on which such
breach or security incident is isItowtwii to the Contra or, or, by exercising reasonable diligence
would have been know to the Contractor. A Contractor shall be deemed to have knowledge of a
breach or security incident if such breach or security incident is known, or by exercising
reasonable diligence would hav been known, to any person, other than the person committing
the breach or security Incident, who is an employee or agent of the Contractor.
COPH ins 110)
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�ho�tfontere~,~ County Health Department
11-10234
Paoc4of 10
Exhibit H
information Privacy and Security Requirer-ments
For N n-k-flP HF{E H Act Contrasts)
Contractor shall take:
1. prompt corrective action to mitigate any risks or damages involved with the breach or
security incident and to protect the operating environment; and
2. any action pertaining to a breach required by applicable federal and state laws, including,
specifically, California Civil Code sect on 1 7g5.2
B. fnvestigatlori of Breach: The Contractor shall immediately investigate such breach or security
incident, and within venty-two 72) hours of the discovery, shall inform the t DPH Prey rant
Contract Manager, the CDPH Privacy Officer, and the COPH Chief lnforrnation Security' Officer f-
1. what data elements were involved and the extent of the data involved in the breach,
inciudir spec fically, the number of ad-Pvduals hose personal information was
breached, and
2. a description of the. unauthorized persons known or reasonably believed to have
improperly used the CDPht PCI and/or a des caption of the unautho ed persons k n- or
reasonably believed to have Improperly acoessed or acquired the CO PH PCI, or to whom it
is known or reasonably believe have had the CDPH PCI improperly dii osed to them; and
3. a description of where the CDPH PU is believed to have been improperly used or
disclosed; and
4. a description of the pro-bable mouses of the breach or security incident, and
whether Civil Code sections 17g1_2g or any other federal or state laws requiring ind-i-vidue-11
noc-ations of breaches have been triggered.
C_ Written Report: T t:e Contractor shall provide a written report of the investigati to the CDPH
Program Contract Manager, the CDPH Privacy Officer, and the CDPH Chief Information Security
Officer within five 5) go ing days of the discovery of the breach or security incident, The report
shall include, but not be limited to, the information specified above, as well as a full, detailed
corrective action plant including information on measures that were taken to halt and or contain
the bf-e-ach or srrity incident, and measures to be taken to prevent the recurrence of such
breach or security Incident.
D_ Notification to individuals: If notification to individuals %--;hose information was breaded is required
under state or federal laww,r, and regardless of whether Contractor is considered only a custodian
and/or non-owner of the CDPH PCI, Contractor shall, at its sole expense, and at the sole election
of CDPH, either:
1. make notification to the individuals affected by the breach including substitute notification,
pursuant to the content and timeliness provisions of such applicable state or federal breach
notice lays, The COPH Privacy Officer shall approve the time, manner and content of an'y
such notifications, prier to the transmission of Butt notifications to the individuals; or
2. cooperate with and assist CDPH in its notirtuation including substitute notification} to the
individuals affected by the breach.
E_ CDPH Contact lrifar�nati To direct communications to the above referenced CDPI staff, the
Contractor shall initiate contact as indicated herein. GDP reserves the right to make changes to
the contact information low by giving written notico to the Contractor Said changes shall not
require an amendment to this Exhibit or the agreement to which it is incorporated-
CDPH r'sl f2`1
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�io�Monterey County Health Department
11-1 23
Pao5of10
CDPH Program
Contract
Manager
See the Scope of
Work exhibit for
Program Ocintract
Manager
Exhibit H
Information Privacy and Security Requirements
For Ion-HIPM.+.JHITECH Art Contracts)
Privacy Officer
Privacy Office, o Office of Legal
Services
California Department of Public
Health
P.O. Sox 997377, MS 059E
Sacramento, CA 95899-7377
Email: orivracy F}^dnh.co.oo~
Telephone, 877) 421-9E34
CDPH Chief Information
Security Officer and COPH IT
Service Desk)
Chief Information Security Officer
Information Security Office
California Department of Public
Health
P.O. Box 097413, tots 6302
Sacramento, CA 95899-7413
Email: pi isc~Y~i cipr.c r_o v
Telephone: IT Service Desk
916) 440--7000 or
800) 579-0374
XII. Documentation Disclosures for Requests for Accounting: Contractor shall document and make
available to CDPH or at the direction of CDPH) to an Individual such disci ures of CDPH PCI. and
information related to such disclosures, necessary to respond to a proper request by the subject
Individual for an mounting of disrdosures of personal information as required by applicable state or
federal law
Xlli.
RYquest f r_CDP I Phi to Third Parties: The Contractor and its employees, agents, or subcontractors
shall promptly transmit to the CDPH Program Contract Manager all requests for disclosure of any CDPI-I
PCI emanating from third parties to the agreement between Contractor and CIJFH and not emanating
from an Individual for an accounting of disclosures of personal information pursuant to applicable state or
federal lavw).
XIV, Audits, Inspection and Enforcement: From time to time, CDPH may inspect the facilities, systems, books
and records of Contractor to monitor compliance with this Exhibit. Contractor shall promptly remedy any
violation of any provision of this Exhibit and shall certify the same to the CDPH Program Contract
Manager in writing- The fact that CDPH inspects, or fails to inspect, or has the right to inspect,
Contractors facilities, systems and procedure-s does not reliove Contractor of its responsibility to comply
with tiis Exhibit, nor does CDPH's:
A. Failure to detect or
B. Dete+ on, but failure to notify Contractor or require Contractor's rern iatirin of any unsatisfactory
practices constitute acceptance of such practice or a waiver of CDPII's enforcement rights under
the agreement and this Exhibit.
XV. Indemnification: Contractor shall indemnify, hold harmless and defend CDPH from and against any and
all c'aims, losses. liabilities, damages, costs and other expenses including attorneys fees) that resull
from or arise directly or indirectly out of or in connection with any negligent act or omission or willful
misconduct of Contractor, its officers, employees, agents or subcontractors relative to the CDPI-I PCI,
including without iirnitrtion, any violation e of Contracto s responsibilities under the agrcoment between it
and CDPH, iriduding this Exhibit, wit respect to the CDPH PCI.
MR IPSt 2x101
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�jo�r 1onterory County Health Deipy: rtment
10-2,34
Page 6 0! 10
Exhibit H
Information Privacy and Security Requirerne-nt
For Non- HIPA JHITECH Act Contract
XVI. i"erri ination:
A. Termination Upon BLgach: A breach by Contrracte r of any provision of the Exhibit, as determined
by CDPHI shall constitute a material breach of the agreement between Contractor and COPH and
grounds for Immediate termination of the agreement by CUPH_ At its sale discretion, CDPH may
give Contractor 30 days to cure the breach.
B_ judicial or tritirii: tratiye Proceedings, Contractor will notify CDPH if it is named as a defendant
in a ciirrt nal proceeding related to a violation of this Exhibit. CDPH may terminate the agreement
bet,+Neen Contractor and CDPH if Contractor is found guilty Of a crirtninel violation related to a
violation of this Exhibit- CDPH may terminate the agreement if a fndinsg or stipulation that the
Contractor has violated any security or privarcl law-vs is made In any administrative or civil
proceeding in which the Contractor is a party or has been joined.
X II. Return or Destruction of COPH PCI on Expiration or Termination: On expiration or terniin.et on of the
agreement between Contractor and COPH for any reason. Contractor shall return oir destroy the CDPH
PCI: If return r destruction is not feasible, Contractor shall explain to C PH why, In writing, to the CDPH
Program Contract Manager, the CRPH Privacy Officer and the CE)PH Chief Information Security Officer-
using the contact Information lister in Section XI(c) above,
A. Retention Reouired by Law: If Required by state or federal law, Contractor may retain,
after expiration or termination, COPH PCI for the firr s peci�fiied as necessary to comply
with the law
B Cbliruaon-s Continue Until Return or Destruction: Gcintractor`s obligations under this
Exhibit shall continue until Contractor destroys the CDPH PCI or returns the COPH PCI to
CDPH; provided wev'er, that on expiration or termination of the agreement bet" een
Contractor and CDP H, Contractor shall not furtf:er use or disclose the CDPH PCI except
as Required by state or federal law.
C. t ot`Ifrcatien of Etaction to Destroy CDPH PCI: Contractor elects to destroy the CDPH PCl_
Contractor shall certify in writing, to the CCPH Program Contract Manager, the CDPH
Privacy Officer and the CDPH Chief Information Security Officer. using the Contact
information listed in Section XI(c), above. that the COPH PCI has been destroyed.
XVIII. Amendment: The pars acknowledge that Federal and State laws relating to information security and
privacy are rapidly evolving and that amen d.rnent of this Exhibit may be required to provide for procedures
to ensure compliance with such laws. The parties specifically agree to take such action as is necessary
to Implement new standards and requirements imposed by regulations and other applicable law rely tin,
to the security or privacy of CDPH PCt_ Upon COPE' request, Contractor agrees to promptly enter into
negotiations with CDPH concerning an amendment to this Exhibit embodying written assurances
consistent with new standards and requirements imposed by regulations and other applicable lavss.
CDPH may terminate this agreement upon thirty 30) days written notice in the event.-
A. Contractor does not promptfyt enter into negotiations to amend this Exhibit when requested by
CDPH pursuant to this Section or
B. Contractor does not enter into an amendment providing assurances regarding the safeguarding of
CDPH PCI that CDPH in its sole discretion deems sufficient to satisfy the standards and
requirements of applicable laws and regulations relating to the security or privacy of C PH PCI.
Corti 1F.SR 1; 1 D,
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
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AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�ko�Monterey County Health Department
11-10234
Page 7 of 10
Exhibit H
Information Privacy and Security Requirements
For Non-HIPH!TECH Act Contracts)
XI X Assistance in Litigation or Administrative Proceedings: Contractor shall make itself and any
subcontractors, employees or agents assisting Contractor in the performance of its obligations under the
agreement bet wen Contractor and CDPHF available to CDPH at no cost to COPH to testify as witnesses,
or otherwise, in the event of litigation or administrative proceedings being commenced against CDPH; its
director, officer,, or employe es based upon claimed violation Of laws relating to security and privacy,
which involves inactions or actions by the ntractor, except where Contractor or its su ntsactor.
employee or agent is a named adverse party.
XX, Disdalner: CDPH makes no warranty or representation that compliance by Contractor with this Exhibit
will be adequate or sat sfactoriy for Contractor's own purposes or that any inrorrnation in Contractor's
possession or control: or transmitted or received b Contractor. is or will be secure from unauthorized use
or disclosure. Contractor is solely responsible for all decisions made by Contractor regarding the
safeguarding of CDPH PCI.
I, No ThinPam t r~t~ ctaiies: Nothing express or implied in the terms and conditions of this Exhibit is
intended to confer, nor shall anything herein confer, upan any per-son other than CDPH or Contractor and
their respective successrrs or assignees: any rights; remedies; obligations or liabilities whatsoever,
II: Interpretation- The terms and conditions in this Exhibit shall be interpreted as broadly as necessary to
implement and comply with regutations and applicable State laws. The parties agree that any ambiguity
in the terms and conditions of this Exhibit shall be resolved in favor of a meaning that complies and is
consistent with Federal and State regulations.
XXill. Sur'iva The respective rights and obligations of Contractor under Sections VI, Vii and Xl of this Exhibit
shall survive the termination or expiration of the agreement between Contractor and COPH,
C O P IP R f 1I))
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�lo�Monterey County Health Department
1.1-1034
P;-i. e 8 Of 1t
Exhibit H
Information Privacy and Secui-14, Requirements
For Non=HIPAA'HiTECH Act Contracts)
Attachment I
Contractor Data Security Standards
I. General Security Controls
a. Corrffdentialfty Statement. All persons that will be working with CDPH PCI must sign a
con t` enti.ality statement. The statement must include at a minimum, General Use, Security and
Privacy safeguards, Unacceptable Use, and Enforcement Policies. The statement must be signed
by the workforce member prior to access to CDPH PCI. The statement must be renewed
annually- The Contractor shall retain each person's written confidentiality statement for CDPH
inspection for a period of three years following contract termination.
b. Background check. Before a member of the Contractor's vxorkforce may access COPH PCI,
Contractor must conduct a thorough backgrourrd aleck f that worker and evaluate the results to
assure that there is no indication that the worker may present a risk for theft of nrdential data,
The Contractor shall retain each workforce e mber's badkground check documentation for a
period of three 3) years,fotlowlrig contract termination.
c. Wcrkstat on/'Laptop encryption. All 1tv. rlcstations and laptops that process andIor store CDPIHI
PCI must be encrypted using a FIPS 140L-2 certified algorithm, SUZ' as Advanced Encrypt on
11 Standard AES}, with a 1 8bit key or higher. The encr`yp oon lu on must be full disk. unteCs
approved by the COPH Information Security Office.
d. Server Security. Servers containing uner4crypted CDPH. PCI must have sufficient administrative,
phisi 1, and technical controls in place to protect that data, based upon a risk
assessr reritrsy tern security revievit.
e, Minimum Necessary. Only the minimum necessary amount of COPH PCI required to perform
necessary business functions may be copied, do.A.ntoaded, r exported.
r. Removable nedfa device-5. All electronic flees that contain CDPH PCI data must be encrypted
when stored on any rerlo;rable media or portable device i,e, USB thumb dries. fiopples,
CDIDVD, Blackberry. backup tapes etc.;,, Must be encrypted using a FIPS 140-2 certified
algorithm, such as Advanced Encryption Standard AES}, with a I2Sbit key or higher
g. Antivirus software. All workstations; laptops and other systems that proe ss and,'or store CDPH
PCI must install and actively use comprehensive anti-virus soft' are solution with automatic
updates scheduled at least daily.
h. Patch Management. All workstations, taptops and other systems that process ardor store
CDPH PCI must have security patches applied, with system reboot if necessary. There must be a
documented patch manager nt process which determines insta lwon tirneframe based on risk
assessment and vendor reco mmendatiit ns. At a maximum., all apptic2bte patches must be
installed within 30 days oG vendor release_
User IN and Password Controls. All users must be issued a unique user name for accessing
CDPH PCI. Usernbme must be promptly dis bled, deleted, or the password changed upon the
transfer or termination of an employee with knowledge of the password. Passwords are not to be
shared. %4ust be at least eight character--,. Must to a non-dictionary wr,rrd. Mu: t not be stored in
0 DP+-i. IF R 42'iC
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�mo�Monterey County Health Department
11-10234
Page 9 of 10
Exhibit H
Information Privacy and Security Requirements
For Nc HIP I4iITECH Act Contracts)
readable fom at on the computer. Must be changed every 60 days. Must be changed if rnvc-aled
or compromised- Must be composed of characters from at least three of the icllowinq four groups
from the standard keyboard:
Upper case letters A.-Z)
Lower case letters a-z)
Arabic numerals 0-9)
Non-alphanumeric characters punctuation symbols)
Data Sanitizaton. All CLPR PCI must be sanitized using HI ST Special Publication 800-H
standard methods for data sanitization when the COPH PSCI is no longer needed_
2. System Security Controls
A. System Timeout. The stem must pro ide an automatic timeout, requiring re-authentication of
the user session after no more than 20 minutes of inectMty`.
B. Waxr?frr-g Banners. All sy'steiis containing CDPH PCI must display a warning banner stating that
data Is confldential, syrstems are logged, and system use is for business purposes only. User
must be directed to log off the system if they do not agree with these ruirements.
C. System Logging. The system must maintain an automated audit trail such can identify the user
or system process which initiates a request for CDPH PCI, or which alters CDPl-i PCI. The audit
trail must be date and time stamped, must log both successful and failed asses, must read he only, and must be restricted to authori users. If CDPH PC[ is stored in a data a e, dalabase
logging tunclionalit mu=st. be enabled. Audit trail data must be archived for at least yem's after
occurrence.
D, Access Controls. The system must use role based access controls for all user as. thentications,
enforcing the principle of least privilege.
E_ Transmission encryption. All data transmissions of CDPH PCI outside the se;.rre internal
network must ended using a FIRS 1401-2 certified algorithm, such as Advanced Encryption
Standard AES), will, a 1 Sblt key or higher. En ptidni can be end to end at the nets ork level, or
the data files containing CCPH PCI can be encrypted. This requirement pertains to any type of
COPH PCI in motion such as webdite access, file transfer, and E-Mail.
F. Intrusion Detection. All systems involved in ateessing, holding, transporting, and rate cling
CDPH PCI that are acre; sible via the Internet most be protected by a comprehensive ingruSian
detection and prevention solution.
3. Audit Controls
A. System Security Review. All s,, aterrrs pressing and/or storing GDPH PCI must have at least
an annual system ri. k asses mentsecurity review which provides assurance that ado>inis�rative,
physical, and technical controls are functioning effectively and providing adequate levels of
protection. Reviews shall include vulnerability scanning tools,
corgi iPSR.12,1[_}
BIB]
40956-U01
MOCO-U02
HD-U02
EXECUTED-U02
AGREEMENT-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�no�Monterey County Health Department
ii-1tj2
Pave 10 of 10
Exhibit H
Information Privacy and Security Requiremen
For Non-HlPAAJHlTEC;H Act Contracts)
B. Log Reviews. All systems processing and,/or storing CDPH PCI must have a routine procedure in
place to review system Is for unauthorized access.
C. Change Control. All systenis processing an Vor storing CDPI-f PCI must have a documented
change control procedure that ensures separation of duties and protects the c fidentialit~f,
integrity and availability of data.
4. Business Continuity I Disaster Recovery Controls
a. Disaster- Recovery- Contractor must establish a documented plan to enable ntinuatiion of
critical business processes and protection of the security of electronic CDPH PCI in the overt of
an emergency Emergency means any circumstance or situation that causes normal csoniputur
operations to become unavailable for use in performing the work required under this agreement
foT more than 24 hours.
b, Data Backup Plan. Contractor must have established documented procedures to backup CQPH
PCl to maintain retrie,rable exact copies of C1PH PCI, The plan must indude a regular schedule
for making backups, storing backups o1fz1te, an inventory of backup media, and the amount of
time to restore CDPH PCI should it be lost- At a minimum, the schedule must be a weekly full
backup and monthly offstte storage of CDPH data.
5. Paper Document Controls
A. Supervision of Data. CDPH PC[ in paper form trail not be left unattended at any tirile, u nlesss it
is locked in a file cabinet, file room, desk or office. Unattended means that information is not
being ob,serseed by an employee authorised to access the inforrrnatiori, CDPH PCI in paper form
shall not be left unattended at any time in vehicles or planes and shall not be checked in baggage
on commercial airplanes,
B. Escorting Visitors. Visitors to areas where CDPH PCI is contained shall be escorted and CDPH
Phi) stall be kept out of sight while visitors are in the area.
C. Confidential Destructors. CQPH PCI must be disposed of through confidential rr-iris, using
KIST Special Publication 800-8 standard methods for data sanitiyatiori when the CDPH PSCI is
no longer needed.
C. Removal of Data. CD PH PCI must not be removed from the premises of the Contractor except
with express written permission of CDPH.
E. Faxing. Faxes containing CDPH PCI shall not be left unattended and fax: machines shall be in
secure areas- Faxes shall contain a confidentiality statement notifying persons receiving faxes in
error to destroythem. Fax numbers shall be verified with the intended recipient before sending
F. Mailing. CDPH PCI si;afl only be mailed using secure methods. Large volume mailings of CDPH
PHI shall be b a secure, bonded courier 4 h signature required on receipt. Disks and other
transportable media sent through the mail must be encrypted with a CDPH approved solution,
such as a solution using a vendor product specified on the CSSt.
CDPH 1PSR t;1O}
BIB]
40956-U01
MOCO-U02
HD-U02
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
MOCO HD EXECUTED AGREEMENT|Eo�oo� NOTEXTPAGE
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LI21329-U03
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FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109645-U03
C5-U03
AGREEMENTS-U03
2/13/2012-U04
BOYDA-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
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ON-U07
BEHALF-U07
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THE-U07
COUNTY-U07
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MONTEREY-U07
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AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�STATE OF CALIFORNIA
STANDARD AGREEMENT AMENDMENT
STD 213A_CDPH 9/09)
Check here if additional pages are added: 1 Page(s)
Agreement Number
10-95274
Registration Number:
1 This Agreement is entered into between the State Agency and Contractor named below:
State Agency's Name
California Department of Public Health
Contractor's Name
County of Monterey
2. The term of this
Agreement is:
July 1, 2010 through June 30, 2013
Amendment Number
A01
Also known as CDPH or the State
Also referred to as Contractor)
3. The maximum amount of this $ 1,003,527
Agreement after this amendment is: One Million, Three Thousand, Five Hundred Twenty Seven Dollars.
4. The parties mutually agree to this amendment as follows. All actions noted below are by this reference made a part
of the Agreement and incorporated herein:
1. Amendment effective date: July 1, 2011
II. Purpose of amendment: This amendment decreases the funding level for years 2 and 3 of the contract term
due to the revised state allocation formula.
Ill. Certain changes made in this amendment are shown as: Text additions are displayed in bold and underline.
Text deletions are displayed as strike through text i.e., Strike).
Continued on next page)
All other terms and conditions shall remain the same.
IN WITNESS WHEREOF, this A reement has been executed by the parties hereto.
CONTRACTOR
Contractor's Name If other than an individual, state whether a corporation, partnership, etc.)
County of Monterey
Printed Nave and Title of Person Signing
Ray Bullick, Director of Health
Address
C/O Emily Sciolto, HIV/AIDS Programs Coordinator, County of Monterey
1270 Natividad Road, Salinas, CA 93906
STATE OF CALIFORNIA
fling
S.aadr-a==atdPs!Chief, Contracts and Purchasing Services Section
CALIFORNIA
Department of General Services
Use Only
Exempt per:
Budget Act of 2011, Chapter 33
Address
1501 Capitol Avenue, Suite 71.5178, MS 1802, P.O. Box 997377,
Sacramento, CA 95899-7377
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�STATE OF CALIFORNIA
STANDARD AGREEMENT AMENDMENT
STD 213A_CDPH 9/09)
Check here if additional pages are added: 1 Page(s)
Agreement Number
10-95274
Registration Number:
1 This Agreement is entered into between the State Agency and Contractor named below:
State Agency's Name
California Department of Public Health
Contractor's Name
County of Monterey
2. The term of this
Agreement is:
July 1, 2010 through June 30, 2013
Amendment Number
A01
Also known as CDPH or the State
Also referred to as Contractor)
3. The maximum amount of this $ 1,003,527
Agreement after this amendment is: One Million, Three Thousand, Five Hundred Twenty Seven Dollars.
4. The parties mutually agree to this amendment as follows. All actions noted below are by this reference made a part
of the Agreement and incorporated herein:
1. Amendment effective date: July 1, 2011
Il. Purpose of amendment: This amendment decreases the funding level for years 2 and 3 of the contract term
due to the revised state allocation formula.
III. Certain changes made in this amendment are shown as: Text additions are displayed in
Text deletions are displayed as strike through text i.e., Strike). Reviewed 24 q f sc
Ck,klkv- k.
All other terms and conditions shall remain the same.
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
Contractor's Name If otherthan an individual, state whethera corporation, partnership, etc.)
County of Monterey
By(Authorized Signature)
FS
Printed Name and Title of Person Signing
Date Signed Do not type)
Address
C/O Emily Sciolto, HIV/AIDS Programs Coordinator, County of Monterey
1270 Natividad Road, Salinas, CA 93906
STATE OF CALIFORNIA
Agency Name
California Department of Public Health
By Authorized Signature)
Z
Date Signed Do not type)
Printed Name and Title of Person Signing
Sandra Winters, Chief, Contracts and Purchasing Services Section
Continued on next page)
CALIFORNIA
Department of General Services
Use Only
Exempt per:
Budget Act of 2011, Chapter 33
Address
1501 Capitol Avenue, Suite 71.5178, MS 1802, P.O. Box 997377,
Sacramento, CA 95899-7377
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
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LI21329-U03
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FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
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411-HEALTH-U08
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MCKEES-U10
6/1/2011-U011
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AMENDMENTS-U012
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
IV, Paragraph 3 maximum amount payable) on the face of the original STD 213 is decreased by $50,406 and is
amended to read: $1,053,933 One Million, Fifty Three Thousand, NiRe HURdFed ThiFty ThFee DellaFs.) $1,003,527
One Million, Three Thousand, Five Hundred Twenty Seven Dollars.)
Provision 4 Amounts Payable) of Exhibit B Budget Detail and Payment Provisions is amended to read as
follows:
4. Amounts Payable
A. The amounts payable under this agreement shall not exceed:
1) $351,311 for the budget period of 07/01/10 through 06/30/11.
2) $351,311 326,108 for the budget period of 07/01/11 through 06/30/12.
3) $1 326
108 for the b
ri
f 07/01/12 th
d
et
d
h 06/30/13
u
g
pe
o
o
roug
B. Reimbursement shall be made for allowable expenses up to the amount annually encumbered commensurate
with the state fiscal year in which services are performed and/or goods are received.
VI. All other terms and conditions shall remain the same.
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MG99866-U03
AS99892-U03
AS99894-U03
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DO109962-U03
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2/24/2012-U04
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AMENDMENTS-U012
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DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274, A01
Memorandum of Understanding MOU)
Amendment I
HIV Care Program
In that certain agreement made and entered into July 1, 2010 between the California
Department of Public Health/Office of AIDS and the County of Monterey.
1. Provision 2 MAXIMUM AMOUNT PAYABLE) is amendment to read as follows:
The maximum amount payable by the STATE to the CONTRACTOR under this MOU
shall not exceed the following:
A. $296,803 for the budget period of July 1, 2010 to June 30, 2011.
B. $296,803 275,198 for the budget period of July 1, 2011 to June 30, 2012.
C. $296,803 275,198 for the budget period of July 1, 2012 to June 30, 2013.
D. $898,409 847,199 for the entire MOU term.
2. Provision 3 MOU EXHIBITS) is amended to add Exhibit A-4, entitled Scope of
Work" Year 2 consisting of 21 pages; Exhibit A-5, entitled Scope of Work" Year 3
consisting of 21 pages. All further references to Exhibits A, A-1, and A-2, in the body of
this agreement or any attachments thereto shall be deemed to read Exhibit A-3, entitled
Scope of Work" Year 1; Exhibit A-4, entitled Scope of Work" Year 2; and Exhibit A-5,
entitled Scope of Work" Year 3.
Provision 3 MOU EXHIBITS) is further amended to add Exhibit B-2 Al, entitled
Budget" Year 2 consisting of one page to be replaced in its entirety; Exhibit B-3
Al, entitled Budget" Year 3 consisting of one page to be replaced in its entirety.
All further references to Exhibits B, entitled Budget" Years 1, 2, and 3 in the body of this
agreement or any attachments thereto shall be deemed to read Exhibit B-1, entitled
Budget" Year 1; Exhibit B-2 Al, entitled Budget" Year 2; and Exhibit B-3 Al, entitled
Budget" Year 3.
3. The effective date of this amendment shall be July 1, 2011.
4. All other terms and conditions shall remain the same.
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FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit B-2, Al
BUDGET
Year 2
July 1, 2011 through June 30, 2012
HCP
Budget MAI
Budget Total
MOU Budget
A. PERSONNEL $20,061 $0 $20,061
B. OPERATING EXPENSES $1,850 $0 $1,850
C. CAPITAL EXPENDITURES $0 $0 $0
D. OTHER COSTS $224,278 $26,000 $250,278
E. INDIRECT COSTS $3,009 $0 $3,009
TOTALS $249,198 $26,000 $275,198
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit B-3, Al
BUDGET
Year 3
July 1, 2012 through June 30, 2013
HCP
Budget MAI
Budget Total
MOU Budget
A. PERSONNEL $20,061 $0 $20,061
B. OPERATING EXPENSES $1,850 $0 $1,850
C. CAPITAL EXPENDITURES $0 $0 $0
D. OTHER COSTS $224,278 $26,000 $250,278
E. INDIRECT COSTS $3,009 $0 $3,009
TOTALS $249,198 $26,000 $275,198
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PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274, A01
Memorandum of Understanding MOU)
Amendment 1
HIV/AIDS Surveillance Program
In that certain agreement made and entered into July 1, 2010 between the California
Department of Public Health/Office of AIDS and the County of Monterey.
1. Provision 2 MAXIMUM AMOUNT PAYABLE) is amendment to read as follows:
The maximum amount payable by the STATE to the CONTRACTOR under this MOU
shall not exceed the following:
A. $54,508 for the budget period of July 1, 2010 to June 30, 2011.
B. $54,508 50,910 for the budget period of July 1, 2011 to June 30, 2012.
C. $54,588 50,910 for the budget period of July 1, 2012 to June 30, 2013.
D. $483524156,328 for the entire MOU term.
2. Provision 3 MOU EXHIBITS) is amended to add Exhibit A-2, entitled Scope of
Work" Year 2 consisting of 6 pages; Exhibit A-3, entitled Scope of Work" Year 3
consisting of 6 pages. All further references to Exhibit A, entitled Scope of Work" in
the body of this agreement or any attachments thereto shall be deemed to read Exhibit
A-1, entitled Scope of Work" Year 1; Exhibit A-2, entitled Scope of Work" Year 2; and
Exhibit A-3, entitled Scope of Work" Year 3.
Provision 3 MOU EXHIBITS) is further amended to add Exhibit B-2 Al, entitled
Budget" Year 2 consisting of one page; Exhibit B-3 Al, entitled Budget" Year 3
consisting of one page. All further references to Exhibits B, entitled Budget" Years 1,
2, and 3 in the body of this agreement or any attachments thereto shall be deemed to
read Exhibit B-1, entitled Budget" Year 1; Exhibit B-2 Al, entitled Budget" Year 2; and
Exhibit B-3 Al, entitled Budget" Year 3.
3. The effective date of this amendment shall be July 1, 2011.
4. All other terms and conditions shall remain the same.
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FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit B-2, Al
Budget
Year 2
July 1, 2011 to June 30, 2012
Original
Budget This
Amendment Amended
Total
A. PERSONNEL $47,455 $3,883) $43,572
B. OPERATING EXPENSES $1,000 $198) $802
C. CAPITAL EXPENDITURES $0 $0 $0
D. OTHER COSTS $0 $0 $0
E. INDIRECT COSTS $6,053 $483 $6,536
TOTAL BUDGET $54,508 $3,598) $50,910
Page 1 of 1
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DESIGNATED-U012
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FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit B-3, Al
Budget
Year 3
July 1, 2012 to June 30, 2013
Original
Budget This
Amendment Amended
Total
A. PERSONNEL $47,455 $3,883) $43,572
B. OPERATING EXPENSES $1,000 $198) $802
C. CAPITAL EXPENDITURES $0 $0 $0
D. OTHER COSTS $0 $0 $0
E. INDIRECT COSTS $6,053 $483 $6,536
TOTAL BUDGET $54,508 $3,598) $50,910
Page 1 of I
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FULLY EXECUTED AGREEMENT NO. u�
3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
1. Introduction
1. Mission Statement
The goals of the California Department of Public Health, Office of AIDS CDPH/OA) are:
1) to minimize new HIV infections and 2) to maximum the number of people with HIV
infection who access appropriate care, treatment, support, and prevention services. The
services required by the HIV Care Program HCP) and Minority AIDS Initiative MAI)
Scopes of Work SOWS) in this Memorandum of Understanding are consistent with, and
are designed to support, these goals.
2. Service Overview
CDPH/OA utilizes federal Health Resources Services Administration HRSA) funds to
provide support for HIV/AIDS services in local areas. Federal HRSA funds include Part
B and Minority AIDS Initiative funding. HIV care services are funded using a Single
Allocation Model to consolidate HRSA program funds into a single contract in each local
health jurisdiction or service area.
Through this single contract, the Contractor agrees to administer A) HCP and, if
applicable, B) MAI Outreach and Treatment Education Services.
A. The Contractor agrees to administer HCP and to ensure the provision of the HIV
care services as described in this SOW. The Contractor may provide direct client
services exclusively or subcontract all or part of the client services. The
Contractor ensures that, if all or parts of the client services are subcontracted to
other client service providers, all services provided by the subcontracted agency
will be in accordance with HCP
B. If funded, the Contractor agrees to administer the MAI outreach and treatment
education services focused on providing access to, and engagement in, medical
care for HIV-positive persons of color, including access to AIDS Drug Assistance
Program ADAP), Medi-Cal, or other appropriate program
II. HIV Care Program
1. HCP Services
The HIV care services to be provided under HCP are HRSA-defined service categories.
For a listing of HRSA service category definitions, and the specific services included in
each category, please refer to the HRSA website at www.hab.hrsa.gov. Additional
information can be found in the HCP and Budget Guidelines.
CDPH/OA will not require local utilization of HRSA's 75 percent Core services) / 25
percent Support services)" requirement for prioritization of services.
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FULLY EXECUTED AGREEMENT NO. u�
3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
HCP is a two-tiered approach to service prioritization and delivery and utilizes the
HRSA-defined service categories, both the Core and Support service categories.
HCP prioritizes service provisions as follows:
Tier One: Outpatient/Ambulatory Medical Care, as defined by HRSA. Services
include, but are not limited to, primary medical care, laboratory testing, medical
history taking, health screening, and prescribing and managing medications.
Contractors must ensure that Tier One medical services are provided for all
population groups in their geographic region via all HIV/AIDS or other funding
sources before allocating HCP funds to Tier Two services.
Tier Two: HRSA-defined Core and Support service categories that 1) assist with
access to Tier One care, 2) support maintenance in Tier One care, and 3) reduce
the risk of treatment failure and/or HIV transmission. HCP funds may be allocated
for any Tier Two service only after Contractors have ensured Tier One services are
adequately provided in their geographic region via all HIV/AIDS or other funding
sources.
The following HRSA service categories are included in Tier Two of HCP:
A.
i Mental Health Services A Legal Services
Medical Case Management Svcs Treatment Adherence Counseling
includes Treatment Adherence) Health Insurance Premium and
i Case Management Non-Medical) Cost Sharing Assistance
Oral Health Care Home- and Community-Based
AIDS Pharmaceutical Assistance Health Services
A Substance Abuse Services Linguistic Services
Outpatient and Residential A Medical Transportation Services
A Health Education/Risk Reduction Psychosocial Support Services
A Home Health Care i Medical Nutrition Therapy
A Hospice Services i Early Intervention Services
Outreach Services i Referral for Health
i Emergency Financial Assistance Care/Supportive Services
i Food Bank/Home-Delivered Rehabilitation Services
Meals i Respite Care
i Housing Services Child Care Services
The Contractor shall:
1 Provide comprehensive, ongoing medical services to individuals with
HIV/AIDS. Services must be based on the HRSA service category,
Outpatient/Ambulatory Medical Care or, if these services are not funded
by HCP under Tier One, the Contractor must demonstrate and document
the availability of primary medical care for HIV-infected persons within
each population group in the service area.
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3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
2. Provide Tier Two HRSA Core and Support services as necessary, and as
funds permit, to ensure access to Tier One care, maintenance in Tier One
care, and reduce the risk of treatment failure or HIV transmission.
3. Develop and implement a system of service delivery that offers
comprehensive, ongoing health and support services to individuals with
HIV/AIDS, that actively seeks individuals who know their HIV status but
are not accessing services, that reaches out to people who are HIV
positive but unaware of their HIV status, and that is coordinated and
integrated with other service delivery systems as appropriate.
4. Advisory and/or focus groups will meet at least annually to provide input
to the Contractor on issues such as needs assessment, service delivery
plans, and comprehensive planning. The Contractor shall maintain
minutes and/or documentation of the advisory or focus group meetings.
The advisory and/or focus group, should be made up of representatives
from state, federal, and local programs that provide health services and
education and prevention services; non-profit and for-profit community-
based agencies; staff from other key points of entry into medical care,
who either provide services to individuals with HIV/AIDS, or who may
have contact with HIV positive individuals who are not in care or not
aware of their HIV status; individuals with HIV, and their advocates, etc.
The advisory group provides information to the Contractor regarding
health services delivery and the needs of individuals with HIV/AIDS living
within the community.
5. Ensure the protection of the client's privacy and confidentiality at all times.
In addition, federal law requires that individuals have a right of access, to
inspect, and obtain a copy of their protected health information PHI) in a
designated record set, for as long as the health information is maintained
by a CDPH health plan, CDPH providers, or business associates. There
are limited exceptions to an individual's right of access PHI 45 C.F. R. s
164.524).
6. Ensure that any subcontracted agencies have the organizational and
administrative capabilities to support the program services and activities.
The Contractor is responsible for quality assurance and utilization review
activities for subcontracted HIV care services.
7. Ensure that any subcontracted agencies have appropriate facilities and
resources, including an adequate physical plant and appropriate supplies
and equipment available for the provision of services and practical
support functions.
8. Develop and maintain working relationships, and coordinate an integrated
system of service delivery, with entities who provide key points of entry
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FULLY EXECUTED AGREEMENT NO. u�
3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
into medical care, including but not limited to emergency rooms,
substance abuse treatment programs, detoxification centers, adult and
juvenile detention facilities, California Department of Corrections and
Rehabilitation, Transitional Case Management Program TCMP) for
incarcerated populations, sexually transmitted disease STD) clinics, HIV
counseling and testing sites, mental health programs, homeless shelters,
health care points of entry specified by the State, federally qualified health
centers, migrant health centers, community health centers, health
services for the homeless, family planning grantees, comprehensive
hemophilia diagnostic and treatment centers, and non-profit and for profit
private entities that provide comprehensive primary care services to
populations at risk for HIV. The coordinated, integrated system of care
must be informed by HIV epidemiological data and other data sources
and should include leveraged resources. The Contractor shall keep
documentation of these working relationships.
9. Ensure that case management services that link available community
support services to appropriate specialized medical services shall be
provided for individuals residing in rural areas as appropriate.
10. Ensure HIV care services will be provided in a setting that is accessible to
low-income individuals with HIV disease. Facilities must also be
accessible for hearing-, vision-, and mobility-impaired persons in
accordance with the federal Americans with Disabilities Act ADA).
11. Provide targeted prevention coordinated with all state and federal
programs to low-income individuals with HIV disease and to inform such
individuals of the services available under Ryan White Part B.
12. To the maximum extent practical, ensure that HIV-related health care and
support services delivered pursuant to a program established with
assistance provided under Ryan White Part B will be provided without
regard to the ability of the individual to pay for such services and without
regard to the current or past health condition of the individual with HIV
disease.
13. Ensure that services provided to women, infants, children, and youth are
tracked and reported see Data Collection, subheading F).
14. Ensure that services provided under this contract are in accordance with
the program policy guidance issued by Division of Service Systems
DSS), HIV/AIDS Bureau HAB) see www.hab.hrsa.gov), CDPH/OA's
HCP and Budget Guidelines.
15. Ensure that the Ryan White HIV/AIDS Program funds do not comprise
more than sixty percent 60%) of any subcontracted agency's total
budget. Ryan White HIV/AIDS Program funds are intended to provide
Page 4 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
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NO.-U02
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LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
additional funding to those areas negatively affected by HIV disease and
cannot be used to supplant local HIV-related budgets.
16. Ensure that clients are eligible for Ryan White services in accordance
with the program policy guidance issued by DSS, HAB see
www.hab.hrsa.gov). Screening and reassessment of client eligibility must
be completed and documented every 6 months to determine continued
eligibility for Ryan White services.
Ensure that eligibility policies do not deem a Veteran living with HIV
ineligible for Ryan White services due to eligibility for Department of
Veterans Affairs VA) health care benefits. Ensure policies and
procedures classifying veterans receiving VA health benefits as
uninsured, thus exempting these Veterans from the Payer of Last
Resort" requirement per Veterans Policy 07-07, Policy 04-01, and
Parham Letter 08/04 see www.hab.hrsa.gov).
17. Ensure that no more than ten percent 10%) of the allocation is used for
non-direct service functions such as:
a. Routine contract administration and monitoring activities, including the
preparation of applications for these funds, the receipt and disbursal
of program funds, the development and establishment of
reimbursement and accounting systems, the preparation of routine
programmatic and financial reports, and compliance with contract
conditions and audit requirements;
b. All activities associated with the Contractor's subcontract award
procedures, including the development of request for proposals,
contract proposal review activities, negotiation and awarding of
subcontracts, grievance process, monitoring of subcontracts through
telephone consultation or onsite visits, reporting on subcontracts and
funding reallocation activities.
18. In addition, ensure that no more than ten percent 10%) of the allocation
is used for all subcontracted agencies' non-direct service administrative)
functions without prior written consent from OA.
19. Conduct assessment of HIV/AIDS service needs for the geographic
service area at least once every three years. Review the assessment
annually and, if needed, update it. Ensure that no more than five percent
5%) of the allocation is utilized to plan, conduct, and evaluate the needs
assessment process. Needs assessment activities may not be billed to
CDPH/OA more than once during a three year contract period.
20. Ensure that client service providers who provide Medi-Cal reimbursable
services are certified as providers for purposes of Medi-Cal billing see
Page 5 of 21
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40963-U01
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EXECUTED-U02
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LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
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DIRECTOR-U07
OF-U07
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411-HEALTH-U08
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
www.medi-cal.ca.gov) and have the ability to bill other third-party payers
for covered services.
21. Ensure that funds are payer of last resort by ensuring that client service
providers bill all other third-party payers, including Medi-Cal, before
invoicing HCP.
22. Funded service providers should integrate, and work collaboratively, with
other such services and coordinate with other available programs
including Medicaid), to ensure continuity of care and prevention of
services of individuals with HIV is enhanced.
23. Ensure documentation of written referral relationships with entities
considered key points of access to healthcare systems for the purpose of
facilitating early intervention services for individuals diagnosed as being
HIV positive.
a. Work with consortia, service providers, and individuals with HIV/AIDS
to identify key points of entry.
b. Monitor the use of referral and linkage agreements by funded service
providers.
24. Ensure funds are not used on prohibited activities see
www.hrsa.hab.gov) and CDPH/OA's HCP and Budget Guidelines.
25. Prohibit employees from soliciting or receiving payment in kind or cash for
the purchase, lease, ordering, or recommending the purchase, lease, or
ordering, of any goods, facility services, or items.
a. Documentation is required by the Compliance Plan or employee
conduct standards that prohibit employees from receiving payments in
kind or cash from suppliers and contractors of goods or services.
26. Ensure that funds are not utilized to make payments for any item or
service to the extent that payment has been made, or can reasonably be
expected to be made, with respect to that item or service:
a. Under any State compensation program, under an insurance policy,
or under any Federal or State health benefits program; or
b. By an entity that provides health services on a prepaid basis.
27. Ensure that funds are not used to:
a. Make cash payment to intended recipients of services;
Page 6of21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
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AGREEMENTS,-U07
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MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
g.
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
b. Develop, promote, or advertise about HIV services that target the
general public.
c. Generate broad scope awareness activities about HIV services that
target the general public.
d. Pay costs associated with the creation, capitalization, or
administration of a liability risk pool other than those costs paid on
behalf of individuals as part of premium contributions to existing
liability risk pools), or to pay any amount expended by a State under
Title XIX of the Social Security Act.
e. Pay for any item or service that can reasonably be expected to be
paid under any State Compensation program, insurance policy, or any
Federal or State Health Benefits Program except for programs
related to Indian Health Service);
f. Pay for any item or service that can paid by an entity that provides
health services on a prepaid basis;
For the development of materials, designed to promote or encourage,
directly or indirectly, intravenous drug use or sexual activity;
h. Purchase or improve other than minor remodeling) any building or
other facility; or
i. Pay for automobile parts, repairs, or maintenance, pet care or
supplies, funeral expenses, etc. see www.hab.hrsa.gov).
28. Ensure that all approved subcontracted agency invoices are paid within
45 days of receipt.
29. Ensure that no funds are carried over into subsequent contract years.
30. Ensure compliance with the federal HRSA Ryan White Program,
CDPH/OA's HCP and Budget Guidelines, CDPH/OA Policy Letters,
Management Memoranda, AIDS Regional Information and Evaluation
System ARIES) Policy Notices, and other program guidelines issued by
CDPH/OA.
31. Administer Ryan White Part B funds appropriately, maintain records and
invoices using standard accounting practices, coordinate federal and
state data reporting, and arrange for fiscal audits.
32. Annually evaluate the cost-effectiveness of the mechanisms used to
deliver comprehensive care.
Page 7 of 21
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FULLY-U02
EXECUTED-U02
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NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
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OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
33. When issuing statements, press releases, requests for proposals, bid
solicitations, and other documents describing projects or programs
funded in whole or in part with Federal money, the Contractor shall clearly
state the percentage of the total costs of the program or project which will
be financed with Federal money, the dollar amount of Federal funds for
the project or program, and percentage and a dollar amount of the total
costs of the project or program that will be financed by nongovernmental
sources.
34. Ensure that Management Memoranda responses are accurate, complete
and received on or before the required response date.
35. Ensure compliance with the following requirements regarding imposition
of charges for services, for those providers who charge for services:
a. In the case of individuals with an income less than or equal to one
hundred percent 100%) of federal poverty guidelines FPG) see
www.aspe.hhs.govlpoverty), the provider will not impose charges
on any such individual for the provision of services under the
contract;
b. In the case of individuals with an income greater than one
hundred percent 100%) of the FPG, the provider:
i. Will impose charges on each such individual for the
provision of such services and
ii. Will impose charges according to a schedule of charges
that is made available to the public;
c. In the case of individuals with an income between the FPG in
Columns A and B see table below), the provider will not, for any
calendar year, impose charges exceeding the percentage in
Column C of the client's annual gross income:
Column A: Client's Column B: Client's Column C: Charges are not
income is greater than income does not exceed to exceed
100% of FPG 200% of FPG 5% of the client's annual
gross income
200% of FPG 300% of FPG 7% of the client's annual
gross income
300% of FPG 10% of the client's annual
gross income
36. Cooperate with any Federal investigation regarding the Ryan White
program funds.
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LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
37. Participate in any state-mandated meetings, trainings, WebEx
conferences, Webinars, teleconferences, and/or other conferences to be
determined.
38. Take steps to ensure that people with limited English proficiency can
meaningfully access health and social services. For detailed information
on the specific responsibilities of Contractors regarding linguistic
competence, see the Office of Civil Rights OCR) website at:
http://www. hhs.gov/ocr/civiIrights/resources/specialtopics/lep/poIicyguidan
cedocument.html
39. Ensure compliance contract Anti-Kickback Statute conditions 42 USC
1320a 7b(b). Processes and standards must be in place to avoid fraud,
waste, and abuse mismanagement) of Ryan White funds.
40. Ensure Ryan White Part B funding is only used to supplement and not
supplant existing federal, state, or local funding for HIV testing, Health
Insurance Premiums and cost sharing.
B. Monitoring Activities
The Contractor shall:
1 Conduct site visits and document/monitor the activities of subcontracted
agencies to ensure contractual compliance not less than once every year.
For all deficiencies cited in the contractor's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the
plan.
2. Provide any necessary assistance to the State in carrying out State
monitoring activities and inspection rights for both contractors and
subcontracted agencies, as provided in this agreement.
3. Make available to authorized State and/or federal representatives all
records, materials, data information, and appropriate staff required for
monitoring or inspection activities.
4. For all deficiencies cited in the State's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the
plan. Provide the corrective plan to the State within 30 days of receipt of
the monitoring report.
C. Partner Services PS)
The Contractor shall ensure that client service providers:
Page 9 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
1. Inform clients of the availability of PS. Client service providers may either
offer PS directly through their agency or by referral to their designated
local health programs.
2. Maintain documentation when PS is offered and the outcome i.e., the
number of partners to be notified by the client and/or by the health
jurisdiction). Client service providers using ARIES should document these
encounters on the Basic Medical screen. Client service providers not
using ARIES should document these encounters in the client medical
records.
D. Reporting Requirements
HCP Contractors are required to submit quarterly financial and narrative reports
to OA. Financial Reports are to be submitted with the monthly / quarterly
invoices. The HCP Quarterly Narrative Reports are due to OA according to the
following schedule:
Reporting Period Due dates
July 1 September 30 November 15
October 1 December 31 February 15
January 1 March 31 May 15
April 1 June 30 August 15
The quarterly HCP Financial Report tracks expenditures for the
Contractor and any subcontracted agency for the quarter reported. The
quarterly Financial Reports shall include the administrative costs of the
Contractor and each subcontracted agency, amount of funds obligated to
each subcontracted agency, total expended quarterly by each
subcontracted agency, percentage expended for the quarter, and total
number of unduplicated clients for the quarter reported.
2. The quarterly HCP Narrative Report is an opportunity for the Contractor to
describe their HCP programs, services provided, progress and
accomplishments, and to identify any technical assistance needs. The
quarterly Narrative Reports shall include, for the quarter reported only,
descriptions of the programs, services funded with HCP funds, any
general accomplishments within the programs, issues or concerns with
the programs and services funded in your county, and any technical
assistance and/or training needs of the contractor and/or subcontracted
agency.
Contractors may access the HCP Financial and Narrative Report
formats at:
x
http://www.cdph.ca.gov/programs/aids/Pages/OAContractFY1 1 12.asp
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LI21329-U03
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FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
E. Data Collection
The Contractor shall ensure that client service providers:
1. Collect the HCP minimum data set. The HCP minimum dataset includes
data elements required by a) HRSA to complete the Ryan White
Program Data Report RDR), the Ryan White Program Service Report
RSR), selected HAB Quality Management QM) indicators, and the
Women, Infants, Children, and Youth Report, and b) CDPH/OA for its
development of estimates and reports i.e., estimate of unmet need for
HIV medical care, statewide epidemiologic profile, Statewide Coordinated
Statement of Need) and to conduct program activities.
2. Directly enter data into ARIES within two weeks from a client's date of
service. Client service providers may import data into ARIES from other
data collection systems only if they obtain prior written approval from
CDPH/OA; said providers may not use CDPH/OA funds to develop or
maintain their import systems.
3. Electronically submit the aggregate-level RDR through HAB's Electronic
Handbook EHB). The RDR reporting period is January 1 through
December 31 of the previous calendar. Submission deadlines will be
announced in ARIES Policy Notices.
4. Electronically submit a Provider Report for the RSR through HAB's EHB.
Unless exempted by HRSA, client service providers who provide RSR-
eligible services must also upload a Client Report, which contains client-
level data, as an XML data file to HAB's EHB. The RSR is due twice a
year: a) The first report includes data from the first six months of the
current calendar year, and b) The second report includes all the data
from the entire previous calendar year. Submission deadlines will be
announced in ARIES Policy Notices.
5. Comply with the policies and procedures outlined in ARIES Policy Notices
issued by the CDPH/OA see www.projectaries.org).
F. Client Service Provider/Subcontracted Agency Reporting Requirements
Comply with the State's timeline to submit to the State a list identifying the names
and budget overview of all service provision and subcontracted agencies and
total funds available to each Client Service Provider. OA's HIV Care Section will
provide the required forms to complete the budget overview and all service
provision information. These forms are located on the OA website. Please click
on the link to access the current forms at
http://www.cdph.ca.gov/programs/aids/Pages/OAContractFY1112.aspx
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FO96184-U03
FO99828-U03
MG99866-U03
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AS99894-U03
AI102677-U03
DO109962-U03
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2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
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COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
G. Quality Management Program
The Contractor shall:
Ensure that all client service providers have a QM program in place. The
QM program should fit within the framework of the client service
providers' other programmatic quality assurance and quality improvement
activities. Client service providers may use an existing QM program e.g.,
Joint Commission on Accreditation of Healthcare Organizations,
Medicaid) or develop their own program. Service providers may add
additional program specific or other HAB indicators to their QM plan. The
HAB QM Technical Assistance Manual can be accessed at
ftp://ftp.hrsa.gov/hab/QM2003.pdf. HAB's performance measures Web
page also contains a wealth of information, including more detailed
descriptions of its performance measures and frequently asked questions
http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html).
2. Incorporate selected indicators from Groups 1 and 2 of HAB's HIV/AIDS
Core Clinical Performance Measures for Adults and Adolescents also
known as HAB QM indicators) into QM programs as CDPH/OA
implements selected HAB QM indicators as part of its QM and monitoring
program. Specific indicators will be identified and released by OA
Management Memorandum. Contractors and subcontracted agencies
can monitor their progress in meeting HAB QM indicators for Groups 1
and 2 by using the Compliance Reports in ARIES as appropriate.
3. Please refer to management memorandum 11-01 at
http://www.cdph.ca.gov/programs/aids/Pages/tOAHCPMAIsp.aspx for
more information.
H. Data Encryption
The Contractor shall adhere to the Information Privacy and Security
Requirements Exhibit J). In addition to the procedures set forth in the
Information Privacy and Security Requirements exhibit, Contractors must ensure
that all mobile devices are equipped with encryption software, even if the
Contractor or their subcontracted agencies do not store confidential information
on the mobile devices.
III. Minority AIDS Initiative MAI)
1. MAI Services
Page 12 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
Minority AIDS Initiative MAI) services must be targeted to HIV infected persons of color
and must be planned and delivered in coordination with local HIV prevention outreach
services to avoid duplication of effort. The goal of MAI is to increase access to, and
engagement in, HIV/AIDS medical care for HIV-positive persons of color. This is
achieved by providing outreach and treatment education services to HIV-infected
persons of color who have never been in care, or who have been lost to care. For
additional MAI information, please refer to the MAI Budget Guidance
In accordance with HRSA guidance, OA has defined two MAI service categories, 1)
outreach and 2) treatment education. Outreach and treatment education are the only
allowable service categories for MAI funding. These service categories are designed to
meet the needs of persons of color in order to ensure that minority clients can access,
engage in, and remain in care; receive help in adhering to treatment; and be provided
with education and support that will enable them to become active participants in their
own health care and improve their overall quality of life. MAI outreach and treatment
education services are defined as follows:
Outreach Those activities typically performed by an outreach worker that results in:
1) Identifying HIV-infected persons of color who know their status but have never been
in care or who have been lost to HIV medical care; 2) Removing barriers that have
prevented access to HIV medical care, and 3) Establishing engagement in HIV medical
care. Outreach services should be conducted at times and in places where there is a
high probability that people of color with HIV infection will be reached.
MAI outreach services do not include routine HIV counseling and testing or HIV
prevention education. These services may be provided on a case-by-case basis for a
specific MAI client only when the service is necessary to remove a barrier to care for that
client.
Treatment Education The provision of health education, treatment adherence and risk
reduction information to HIV-infected persons of color who know their HIV status but are
not accessing medical care or to HIV-infected persons of color who are lost to care.
Information includes educating clients living with HIV about how to communicate with
medical providers, the importance of treatment adherence, how to manage medication
side effects, how to understand their laboratory results, how to improve their health
status, how to reduce HIV transmission, and identify medical and psychosocial support
services and counseling that are available locally.
For designated county local health jurisdictions receiving additional HRSA funding
specifically for MAI outreach and treatment education services to communities of color,
the following services and standards must be adhered to:
1 The Contractor may provide direct client MAI services exclusively OR may
subcontract all or part of the MAI outreach services. The Contractor must ensure
that if all or part of the MAI client services are subcontracted to other service
providers, all services provided by the subcontractor will be in accordance with
the MAI funding and reporting requirements.
Page 13 of 21
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
2. The Contractor may employ MAI outreach staff or support other activities to
identify HIV-infected persons of color who are out-of-care or lost-to-care and
gradually engage them in appropriate HIV care and treatment services. Target
populations are those out-of-care, HIV-infected persons of color who have been
unable or unwilling to access services for HIV, despite an awareness of their
positive serostatus. As a member of the HIV care program team, the outreach
staff person will take actions to reduce or eliminate any cultural or other barriers
that prevent access to and/or continued engagement in HIV care services. The
Contractor must meet specific parameters to support the needs of this project.
The parameters include the Contractor's ability to do the following:
a. It is strongly recommended that MAI outreach staff be culturally and
linguistically competent street-level" workers who reflect the communities
they serve. Highly recommended is experience in two or three of the
following areas: street-based outreach, HIV counseling and testing,
health education or HIV case management.
b. MAI outreach staff are to take actions to reduce or eliminate any cultural
or other barriers that prevent access to and/or continued engagement in
care and treatment services. This individual links and supports the client
in accessing suitable HIV care and treatment services.
c. In lieu of outreach positions, MAI funds can also support
outreach/treatment education activities or interventions for HIV-infected
persons of color, as determined at the local level and approved by OA.
d. Commit to submitting data in an accurate and timely fashion, including
committing to full participation in any evaluation or research component.
e. Be able to commit the MAI outreach worker to participate in ongoing staff
trainings including but not limited to, attendance at various state-
mandated meetings, trainings, Webex/teleconferences or conferences as
required.
A. The Contractor shall:
Provide services that identify and engage HIV-infected persons of color
who know their HIV status but are not accessing medical care, to reach
out to people of color who are HIV-infected but unaware of their HIV
status, and/or to locate and reestablish access for HIV-infected persons
of color who have been lost to care.
2. Work with existing community resources and entities that serve as key
points of entry into medical care, including but not limited to emergency
rooms, substance abuse treatment programs, TCMP for those individuals
released from state correctional institutions, detoxification centers, adult
Page 14 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
and juvenile detention facilities, STD clinics, HIV counseling and testing
sites, mental health programs, homeless shelters, Federal Qualified
Health Centers, etc. to coordinate and integrate HIV care service delivery.
3. Ensure that MAI outreach and treatment education services are planned
and delivered in coordination with local HIV prevention outreach
programs and other HIV services providers to avoid duplication of effort.
4. Ensure that services are responsive to the needs of the clients in the
service area, are sensitive to linguistic, ethnic, and cultural differences of
the population(s) being served, and that services are linguistically and
culturally appropriate. Services may not be denied due to immigration
status, place of residence within California, current or prior health
condition, or inability to pay.
5. Ensure that PS is offered on a routine basis to all HIV-positive clients.
Clients should be made aware that receiving assistance in the referral of
partners is voluntary and will be offered periodically.
6. Ensure that MAI planning efforts are coordinated with all other local
funding streams for HIV/AIDS to ensure that Ryan White HIV/AIDS
program funds are the payer of last resort, maximize education and
outreach efforts to link individuals to ADAP and other appropriate
program, and reduce any duplication.
7. Ensure that client eligibility and service provision under this contract are
in accordance with the CDPH/OA's MAI Budget Guidance. Screening
and reassessment of client eligibility must be completed and documented
every 6 months to determine continued eligibility for Ryan White services.
Ensure that eligibility policies do not deem a Veteran living with HIV
ineligible for Ryan White services due to eligibility for Department of
Veterans Affairs VA) health care benefits. Ensure policies and
procedures classifying veterans receiving VA health benefits as
uninsured, thus exempting these Veterans from the Payer of Last
Resort" requirement per Veterans Policy 07-07, Policy 04-01, and
Parham Letter 08/04 see www.hab.hrsa.gov).
8. Ensure that MAI clients have access to, and are enrolled in, ADAP, Medi-
Cal, or other appropriate program(s) providing HIV medications.
9. Ensure HIV care services will be provided in a setting that is accessible to
low-income individuals with HIV disease. Facilities must also be
accessible for hearing-, vision-, and mobility-impaired persons in
accordance with the federal ADA.
Page 15 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
10. Ensure the protection of the client's privacy and confidentiality at all times.
In addition, federal law requires that individuals have a right of access, to
inspect, and obtain a copy of their PHI in a designated record set, for as
long as the health information is maintained by a CDPH health plan,
CDPH providers, or business associates. There are limited exceptions to
an individual's right of access PHI 45 C.F.R. s 164.524).
11. Ensure that any subcontractors have the organizational and
administrative capabilities to support the program services and activities.
The Contractor is responsible for quality assurance and utilization review
activities for subcontracted MAI services.
12. Ensure that any subcontractors have appropriate facilities and resources,
including an adequate physical plant and appropriate supplies and
equipment available for the provision of services and practical support
functions.
13. Ensure that all service providers have a QM program in place. The QM
activities should fit within the framework of the Contractor's or
subcontractor's other programmatic quality assurance and quality
improvement activities. Contractors and subcontractors may use an
existing QM program or develop their own program. Service providers
may add additional program specific or other HAB indicators to their QM
plan. The HAB QM Technical Assistance Manual can be accessed at
ftp://ftp.hrsa.qov/hab/QM2003.pdf. HAB's performance measures Web
page also contains a wealth of information, including more detailed
descriptions of its performance measures and frequently asked questions
http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html). It is
strongly recommended that HAB Group 1, 2, and 3 indicators be
incorporated into QM programs because CDPH/OA is planning to track
selected HAB QM indicators as part of its QM program.
14. Ensure that no more than ten percent 10%) of the allocation is used for
non-direct service functions such as:
a. Routine contract administration and monitoring activities, including
the preparation of applications for these funds, the receipt and
disbursal of program funds, the development and establishment of
reimbursement and accounting systems, the preparation of routine
programmatic and financial reports, and compliance with contract
conditions and audit requirements;
b. All activities associated with the Contractor's subcontract award
procedures, including the development of request for proposals,
contract proposal review activities, negotiation and awarding of
subcontracts, grievance process, monitoring of subcontracts
Page 16 of 21
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
through telephone consultation or onsite visits, reporting on
subcontracts and funding reallocation activities.
15. In addition, ensure that no more than ten percent 10%) of the allocation
is used for all subcontractors' non-direct service administrative)
functions.
16. Ensure that service providers who provide Medi-Cal reimbursable
services are certified as providers for purposes of Medi-Cal billing see
www.medi-cal.ca.gov) and have the ability to bill other third-party payers
for covered services.
17. Ensure that funds are payer of last resort by ensuring that service
providers bill all other third party payers, including Medi-Cal, before
invoicing MAI.
18. Ensure that funds are not utilized to make payments for any item or
service to the extent that payment has been made, or can reasonably be
expected to be made, with respect to that item or service:
a. Under any State compensation program, under an insurance
policy, or under any Federal or State health benefits program; or
b. By an entity that provides health services on a prepaid basis.
19. Funded service providers should integrate, and work collaboratively, with
other such services and coordinate with other available programs
including Medicaid), to ensure continuity of care and prevention of
services of individuals with HIV is enhanced.
20. Ensure funds are not used on prohibited activities see
www.hab.hrsa.gov) and CDPH/OA's HCP and Budget Guidelines.
21. Prohibit employees from soliciting or receiving payment in kind or cash for
the purchase, lease, ordering, or recommending the purchase, lease, or
ordering, of any goods, facility services, or items.
a. Documentation is required by the Compliance Plan or employee
conduct standards that prohibit employees from receiving
payments in kind or cash from suppliers and contractors of goods
or services.
22. Ensure that funds are not used to:
a. Purchase or improve any building or other facility, with the
exception of minor repairs or remodeling approved in writing by
the State;
Page 17 of 21
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�3�County of Monterey
10-95274 A01
g.
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
b. Pay for automobile parts, repairs, or maintenance, pet care or
supplies, funeral expenses, etc. see www.hab.hrsa.gov); or
c. Make cash payment to intended recipients of services.
d. Develop, promote, or advertise about HIV services that target the
general public.
e. Generate broad scope awareness activities about HIV services that
target the general public.
f. Pay costs associated with the creation, capitalization, or
administration of a liability risk pool other than those costs paid
on behalf of individuals as part of premium contributions to
existing liability risk pools), or to pay any amount expended by a
State under Title XIX of the Social Security Act.
Pay for any item or service that can reasonably be expected to be
paid under any State Compensation program, insurance policy, or
any Federal or State Health Benefits Program except for
programs related to Indian Health Service);
h. Pay for any item or service that can paid by an entity that provides
health services on a prepaid basis;
For the development of materials, designed to promote or
encourage, directly or indirectly, intravenous drug use or sexual
activity;
23. Ensure that all approved subcontractor invoices are paid by the
Contractor within 45 days of receipt.
24. Ensure that funds are not carried over into subsequent contract years.
25. Ensure compliance with the federal HRSA Ryan White Program,
CDPH/OA's MAI Budget Guidance, CDPH/OA Policy Letters,
Management Memoranda, AIDS Regional Information and Evaluation
System ARIES) Policy Notices, and other program guidelines issued by
CDPH/OA.
26. Ensure compliance with the following requirements regarding imposition
of charges for services, for those providers who charge for services:
a. In the case of individuals with an income less than or equal to one
hundred percent 100%) of FPG see www.aspe.hhs.gov/poverty),
Page 18 of 21
BIB]
40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
the provider will not impose charges on any such individual for the
provision of services under the contract;
b. In the case of individuals with an income greater than one
hundred percent 100%) of the FPG, the provider:
i. Will impose charges on each such individual for the
provision of such services and
ii. Will impose charges according to a schedule of charges
that is made available to the public;
c. In the case of individuals with an income between the FPG in
Columns A and B see table below), the provider will not, for any
calendar year, impose charges exceeding the percentage in
Column C of the client's annual gross income:
Column A: Client's Column B: Client's Column C: Charges are
income is greater income does not not
than exceed to exceed
100% of FPG 200% of FPG 5% of the client's annual
gross income
200% of FPG 300% of FPG 7% of the client's annual
gross income
300% of FPG 10% of the client's
annual
gross income
27. Cooperate with any Federal investigation regarding the Ryan White
program funds.
28. Participate in any state-mandated meetings, trainings, WebEx
conferences, teleconferences, and/or other conferences to be
determined.
29. Administer MAI funds appropriately, maintain records and invoices using
standard accounting practices, coordinate federal and state data
reporting, and arrange for fiscal audits.
30. When issuing statements, press releases, requests for proposals, bid
solicitations, and other documents describing projects or programs
funded in whole or in part with Federal money, the Contractor shall clearly
state the percentage of the total costs of the program or project which will
Page 19 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
be financed with Federal money, the dollar amount of Federal funds for
the project or program, and percentage and a dollar amount of the total
costs of the project or program that will be financed by nongovernmental
sources.
31. Take steps to ensure that people with limited English proficiency can
meaningfully access health and social services. For detailed information
on the specific responsibilities of Contractors regarding linguistic
competence, see the OCR website at:
http://www hhs gov/ocr/civiIrights/resources/specialtopics/lep/poIicyguidan
cedocument.html.
32. Ensure compliance contract Anti-Kickback Statute conditions 42 USC
1320a 7b(b). Processes and standards must be in place to avoid fraud,
waste, and abuse mismanagement) of Ryan White funds.
33. Ensure Ryan White Part B MAI funding is only used to supplement and
not supplant existing federal, state, or local funding for HIV testing, Health
Insurance Premiums and cost sharing.
B. Monitoring Activities
The Contractor shall:
1. Conduct site visits and document/monitor the activities of subcontracted
agencies to ensure contractual compliance not less than once every year.
For all deficiencies cited in the contractor's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the plan.
2. Provide any necessary assistance to the State in carrying out State
monitoring activities and inspection rights for both contractors and
subcontracted agencies, as provided in this agreement.
3. Make available to authorized State and/or federal representatives all records,
materials, data information, and appropriate staff required for monitoring or
inspection activities.
4. For all deficiencies cited in the State's monitoring report, develop a corrective
plan, submit it to the State for approval, and implement the plan. Provide the
corrective plan to the State within 30 days of receipt of the monitoring report.
C. Reporting Requirements
Each MAI contractor is required to submit an MAI Quarterly Narrative Status
Report. The MAI Quarterly Narrative Status reports are due to OA according to
the following schedule:
Page 20 of 21
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40963-U01
FULLY-U02
EXECUTED-U02
AGREEMENT-U02
NO.-U02
10-95274-U02
LI21329-U03
FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit A-4
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 2
REPORTING PERIODS DUE DATES
July 1 September 30, 2011 November 15
October 1 December 31, 2011 February 15
January 1 March 31, 2012 May 15
April 1 June 30, 2012 August 15
1. The quarterly MAI Narrative Status Report is an opportunity for the
Contractor to provide program accomplishments, successful outreach
and/or treatment education strategies, challenges and lessons learned,
problems or issues, and requests for training and technical assistance, in
addition to reporting numbers of clients served and the types of services
provided.
Contractors may access the Narrative Report format at:
http://www.cdph.ca.qov/programs/aids. Each MAI contractor, on an annual or as
needed basis, must comply with the State's timeline to submit to the State a list
identifying the names and budget overview of all service providers and
subcontracted agencies and total funds for service provision that are available to
each. OA MAI will provide the required forms to complete the budget overview
and all service provision information. These forms are located on the OA
website.
D. Data Collection
1. Until MAI reporting is incorporated into the State's ARIES data reporting
system, Contractors receiving MAI funds for outreach and treatment
education services must track and report activities manually. Both forms,
r',1A/ Demographic Reporting Form and MA1 Client Contact Reporting
Form, are to be submitted to OA on a monthly basis either via fax or
email. These forms may be accessed via OA's website.
2. Ensure compliance with all CDPH/OA Policy Letters, Management
Memoranda, ARIES Policy Notices, and other policies and procedures
issued by CDPH/OA.
E. Data Encryption
The Contractor shall adhere to the Information Privacy and Security
Requirements Exhibit J). In addition to the procedures set forth in the
Information Privacy and Security exhibit, Contractors must ensure that all mobile
devices are equipped with encryption software, even if the Contractor or their
subcontracted agencies do not store confidential information on the mobile
devices.
Page 21 of 21
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MG99866-U03
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AI102677-U03
DO109962-U03
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2/24/2012-U04
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16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
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STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
1. Introduction
1. Mission Statement
The goals of the California Department of Public Health, Office of AIDS CDPH/OA) are:
1) to minimize new HIV infections and 2) to maximum the number of people with HIV
infection who access appropriate care, treatment, support, and prevention services. The
services required by the HIV Care Program HCP) and Minority AIDS Initiative MAI)
Scopes of Work SOWs) in this Memorandum of Understanding are consistent with, and
are designed to support, these goals.
2. Service Overview
CDPH/OA utilizes federal Health Resources Services Administration HRSA) funds to
provide support for HIV/AIDS services in local areas. Federal HRSA funds include Part
B and Minority AIDS Initiative funding. HIV care services are funded using a Single
Allocation Model to consolidate HRSA program funds into a single contract in each local
health jurisdiction or service area.
Through this single contract, the Contractor agrees to administer A) HCP and, if
applicable, B) MAI Outreach and Treatment Education Services.
A. The Contractor agrees to administer HCP and to ensure the provision of the HIV
care services as described in this SOW. The Contractor may provide direct client
services exclusively or subcontract all or part of the client services. The
Contractor ensures that, if all or parts of the client services are subcontracted to
other client service providers, all services provided by the subcontracted agency
will be in accordance with HCP
B. If funded, the Contractor agrees to administer the MAI outreach and treatment
education services focused on providing access to, and engagement in, medical
care for HIV-positive persons of color, including access to AIDS Drug Assistance
Program ADAP), Medi-Cal, or other appropriate program
II. HIV Care Program
1. HCP Services
The HIV care services to be provided under HCP are HRSA-defined service categories.
For a listing of HRSA service category definitions, and the specific services included in
each category, please refer to the HRSA website at www.hab.hrsa.gov. Additional
information can be found in the HCP and Budget Guidelines.
CDPH/OA will not require local utilization of HRSA's 75 percent Core services) / 25
percent Support services)" requirement for prioritization of services.
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ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u� 3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
HCP is a two-tiered approach to service prioritization and delivery and utilizes the
HRSA-defined service categories, both the Core and Support service categories.
HCP prioritizes service provisions as follows:
Tier One: Outpatient/Ambulatory Medical Care, as defined by HRSA. Services
include, but are not limited to, primary medical care, laboratory testing, medical
history taking, health screening, and prescribing and managing medications.
Contractors must ensure that Tier One medical services are provided for all
population groups in their geographic region via all HIV/AIDS or other funding
sources before allocating HCP funds to Tier Two services.
Tier Two: HRSA-defined Core and Support service categories that 1) assist with
access to Tier One care, 2) support maintenance in Tier One care, and 3) reduce
the risk of treatment failure and/or HIV transmission. HCP funds may be allocated
for any Tier Two service only after Contractors have ensured Tier One services are
adequately provided in their geographic region via all HIV/AIDS or other funding
sources.
The following HRSA service categories are included in Tier Two of HCP:
fr Mental Health Services
Medical Case Management Svcs
includes Treatment Adherence)
Case Management Non-Medical)
fr Oral Health Care
fr AIDS Pharmaceutical Assistance
Substance Abuse Services
Outpatient and Residential
i Health Education/Risk Reduction
Home Health Care
Hospice Services
Outreach Services
i Emergency Financial Assistance
i Food Bank/Home-Delivered
Meals
Housing Services
A Legal Services
i Treatment Adherence Counseling
Health Insurance Premium and
Cost Sharing Assistance
Home- and Community-Based
Health Services
Linguistic Services
A Medical Transportation Services
i Psychosocial Support Services
i Medical Nutrition Therapy
Early Intervention Services
i Referral for Health
Care/Supportive Services
Rehabilitation Services
Respite Care
A Child Care Services
A. The Contractor shall:
1. Provide comprehensive, ongoing medical services to individuals with
HIV/AIDS. Services must be based on the HRSA service category,
Outpatient/Ambulatory Medical Care or, if these services are not funded
by HCP under Tier One, the Contractor must demonstrate and document
the availability of primary medical care for HIV-infected persons within
each population group in the service area.
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FO99828-U03
MG99866-U03
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AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
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16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�!3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
2. Provide Tier Two HRSA Core and Support services as necessary, and as
funds permit, to ensure access to Tier One care, maintenance in Tier One
care, and reduce the risk of treatment failure or HIV transmission.
3. Develop and implement a system of service delivery that offers
comprehensive, ongoing health and support services to individuals with
HIV/AIDS, that actively seeks individuals who know their HIV status but
are not accessing services, that reaches out to people who are HIV
positive but unaware of their HIV status, and that is coordinated and
integrated with other service delivery systems as appropriate.
4. Advisory and/or focus groups will meet at least annually to provide input
to the Contractor on issues such as needs assessment, service delivery
plans, and comprehensive planning. The Contractor shall maintain
minutes and/or documentation of the advisory or focus group meetings.
The advisory and/or focus group, should be made up of representatives
from state, federal, and local programs that provide health services and
education and prevention services; non-profit and for-profit community-
based agencies; staff from other key points of entry into medical care,
who either provide services to individuals with HIV/AIDS, or who may
have contact with HIV positive individuals who are not in care or not
aware of their HIV status; individuals with HIV, and their advocates, etc.
The advisory group provides information to the Contractor regarding
health services delivery and the needs of individuals with HIV/AIDS living
within the community.
5. Ensure the protection of the client's privacy and confidentiality at all times.
In addition, federal law requires that individuals have a right of access, to
inspect, and obtain a copy of their protected health information PHI) in a
designated record set, for as long as the health information is maintained
by a CDPH health plan, CDPH providers, or business associates. There
are limited exceptions to an individual's right of access PHI 45 C.F. R. s
164.524).
6. Ensure that any subcontracted agencies have the organizational and
administrative capabilities to support the program services and activities.
The Contractor is responsible for quality assurance and utilization review
activities for subcontracted HIV care services.
7. Ensure that any subcontracted agencies have appropriate facilities and
resources, including an adequate physical plant and appropriate supplies
and equipment available for the provision of services and practical
support functions.
8. Develop and maintain working relationships, and coordinate an integrated
system of service delivery, with entities who provide key points of entry
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�"3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
into medical care, including but not limited to emergency rooms,
substance abuse treatment programs, detoxification centers, adult and
juvenile detention facilities, California Department of Corrections and
Rehabilitation, Transitional Case Management Program TCMP) for
incarcerated populations, sexually transmitted disease STD) clinics, HIV
counseling and testing sites, mental health programs, homeless shelters,
health care points of entry specified by the State, federally qualified health
centers, migrant health centers, community health centers, health
services for the homeless, family planning grantees, comprehensive
hemophilia diagnostic and treatment centers, and non-profit and for profit
private entities that provide comprehensive primary care services to
populations at risk for HIV. The coordinated, integrated system of care
must be informed by HIV epidemiological data and other data sources
and should include leveraged resources. The Contractor shall keep
documentation of these working relationships.
9. Ensure that case management services that link available community
support services to appropriate specialized medical services shall be
provided for individuals residing in rural areas as appropriate.
10. Ensure HIV care services will be provided in a setting that is accessible to
low-income individuals with HIV disease. Facilities must also be
accessible for hearing-, vision-, and mobility-impaired persons in
accordance with the federal Americans with Disabilities Act ADA).
11. Provide targeted prevention coordinated with all state and federal
programs to low-income individuals with HIV disease and to inform such
individuals of the services available under Ryan White Part B.
12. To the maximum extent practical, ensure that HIV-related health care and
support services delivered pursuant to a program established with
assistance provided under Ryan White Part B will be provided without
regard to the ability of the individual to pay for such services and without
regard to the current or past health condition of the individual with HIV
disease.
13. Ensure that services provided to women, infants, children, and youth are
tracked and reported see Data Collection, subheading F).
14. Ensure that services provided under this contract are in accordance with
the program policy guidance issued by Division of Service Systems
DSS), HIV/AIDS Bureau HAB) see www.hab.hrsa.gov), CDPH/OA's
HCP and Budget Guidelines.
15. Ensure that the Ryan White HIV/AIDS Program funds do not comprise
more than sixty percent 60%) of any subcontracted agency's total
budget. Ryan White HIV/AIDS Program funds are intended to provide
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6-U06
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THE-U07
DIRECTOR-U07
OF-U07
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ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�#3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
additional funding to those areas negatively affected by HIV disease and
cannot be used to supplant local HIV-related budgets.
16. Ensure that clients are eligible for Ryan White services in accordance
with the program policy guidance issued by DSS, HAB see
www.hab.hrsa.gov). Screening and reassessment of client eligibility must
be completed and documented every 6 months to determine continued
eligibility for Ryan White services.
Ensure that eligibility policies do not deem a Veteran living with HIV
ineligible for Ryan White services due to eligibility for Department of
Veterans Affairs VA) health care benefits. Ensure policies and
procedures classifying veterans receiving VA health benefits as
uninsured, thus exempting these Veterans from the Payer of Last
Resort" requirement per Veterans Policy 07-07, Policy 04-01, and
Parham Letter 08/04 see www.hab.hrsa.gov).
17. Ensure that no more than ten percent 10%) of the allocation is used for
non-direct service functions such as:
a. Routine contract administration and monitoring activities, including the
preparation of applications for these funds, the receipt and disbursal
of program funds, the development and establishment of
reimbursement and accounting systems, the preparation of routine
programmatic and financial reports, and compliance with contract
conditions and audit requirements;
b. All activities associated with the Contractor's subcontract award
procedures, including the development of request for proposals,
contract proposal review activities, negotiation and awarding of
subcontracts, grievance process, monitoring of subcontracts through
telephone consultation or onsite visits, reporting on subcontracts and
funding reallocation activities.
18. In addition, ensure that no more than ten percent 10%) of the allocation
is used for all subcontracted agencies' non-direct service administrative)
functions without prior written consent from OA.
19. Conduct assessment of HIV/AIDS service needs for the geographic
service area at least once every three years. Review the assessment
annually and, if needed, update it. Ensure that no more than five percent
5%) of the allocation is utilized to plan, conduct, and evaluate the needs
assessment process. Needs assessment activities may not be billed to
CDPH/OA more than once during a three year contract period.
20. Ensure that client service providers who provide Medi-Cal reimbursable
services are certified as providers for purposes of Medi-Cal billing see
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OF-U07
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ON-U07
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COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
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FUNDING-U012
LOCAL,-U012
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FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�$3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
www.medi-cal.ca.gov) and have the ability to bill other third-party payers
for covered services.
21. Ensure that funds are paver of last resort by ensuring that client service
providers bill all other third-party payers, including Medi-Cal, before
invoicing HCP.
22. Funded service providers should integrate, and work collaboratively, with
other such services and coordinate with other available programs
including Medicaid), to ensure continuity of care and prevention of
services of individuals with HIV is enhanced.
23. Ensure documentation of written referral relationships with entities
considered key points of access to healthcare systems for the purpose of
facilitating early intervention services for individuals diagnosed as being
HIV positive.
a. Work with consortia, service providers, and individuals with HIV/AIDS
to identify key points of entry.
b. Monitor the use of referral and linkage agreements by funded service
providers.
24. Ensure funds are not used on prohibited activities see
www.hrsa.hab.gov) and CDPH/OA's HCP and Budget Guidelines.
25. Prohibit employees from soliciting or receiving payment in kind or cash for
the purchase, lease, ordering, or recommending the purchase, lease, or
ordering, of any goods, facility services, or items.
a. Documentation is required by the Compliance Plan or employee
conduct standards that prohibit employees from receiving payments in
kind or cash from suppliers and contractors of goods or services.
26. Ensure that funds are not utilized to make payments for any item or
service to the extent that payment has been made, or can reasonably be
expected to be made, with respect to that item or service:
a. Under any State compensation program, under an insurance policy,
or under any Federal or State health benefits program; or
b. By an entity that provides health services on a prepaid basis.
27. Ensure that funds are not used to:
a. Make cash payment to intended recipients of services;
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THE-U07
DIRECTOR-U07
OF-U07
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AGREEMENTS,-U07
411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�%3�County of Monterey
10-95274 A01
9.
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
b. Develop, promote, or advertise about HIV services that target the
general public.
c. Generate broad scope awareness activities about HIV services that
target the general public.
d. Pay costs associated with the creation, capitalization, or
administration of a liability risk pool other than those costs paid on
behalf of individuals as part of premium contributions to existing
liability risk pools), or to pay any amount expended by a State under
Title XIX of the Social Security Act.
e. Pay for any item or service that can reasonably be expected to be
paid under any State Compensation program, insurance policy, or any
Federal or State Health Benefits Program except for programs
related to Indian Health Service);
f. Pay for any item or service that can paid by an entity that provides
health services on a prepaid basis;
For the development of materials, designed to promote or encourage,
directly or indirectly, intravenous drug use or sexual activity;
h. Purchase or improve other than minor remodeling) any building or
other facility; or
i. Pay for automobile parts, repairs, or maintenance, pet care or
supplies, funeral expenses, etc. see www.hab.hrsa.gov).
28. Ensure that all approved subcontracted agency invoices are paid within
45 days of receipt.
29. Ensure that no funds are carried over into subsequent contract years.
30. Ensure compliance with the federal HRSA Ryan White Program,
CDPH/OA's HCP and Budget Guidelines, CDPH/OA Policy Letters,
Management Memoranda, AIDS Regional Information and Evaluation
System ARIES) Policy Notices, and other program guidelines issued by
CDPH/OA.
31. Administer Ryan White Part B funds appropriately, maintain records and
invoices using standard accounting practices, coordinate federal and
state data reporting, and arrange for fiscal audits.
32. Annually evaluate the cost-effectiveness of the mechanisms used to
deliver comprehensive care.
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AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
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SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�&3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
33. When issuing statements, press releases, requests for proposals, bid
solicitations, and other documents describing projects or programs
funded in whole or in part with Federal money, the Contractor shall clearly
state the percentage of the total costs of the program or project which will
be financed with Federal money, the dollar amount of Federal funds for
the project or program, and percentage and a dollar amount of the total
costs of the project or program that will be financed by nongovernmental
sources.
34. Ensure that Management Memoranda responses are accurate, complete
and received on or before the required response date.
35. Ensure compliance with the following requirements regarding imposition
of charges for services, for those providers who charge for services:
a. In the case of individuals with an income less than or equal to one
hundred percent 100%) of federal poverty guidelines FPG) see
www.aspe.hhs.gov/poverty), the provider will not impose charges
on any such individual for the provision of services under the
contract;
b. In the case of individuals with an income greater than one
hundred percent 100%) of the FPG, the provider:
Will impose charges on each such individual for the
provision of such services and
ii. Will impose charges according to a schedule of charges
that is made available to the public;
c. In the case of individuals with an income between the FPG in
Columns A and B see table below), the provider will not, for any
calendar year, impose charges exceeding the percentage in
Column C of the client's annual gross income:
Column A: Client's Column B: Client's Column C: Charges are not
income is greater than income does not exceed to exceed
100% of FPG 200% of FPG 5% of the client's annual
gross income
200% of FPG 300% of FPG 7% of the client's annual
gross income
300% of FPG 10% of the client's annual
gross income
36. Cooperate with any Federal investigation regarding the Ryan White
program funds.
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FO99828-U03
MG99866-U03
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AS99894-U03
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2/24/2012-U04
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�'3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
37. Participate in any state-mandated meetings, trainings, WebEx
conferences, Webinars, teleconferences, and/or other conferences to be
determined.
38. Take steps to ensure that people with limited English proficiency can
meaningfully access health and social services. For detailed information
on the specific responsibilities of Contractors regarding linguistic
competence, see the Office of Civil Rights OCR) website at:
http://www. hhs.gov/ocr/civiIrights/resources/specialtopics/lep/policyguidan
cedocument.html
39. Ensure compliance contract Anti-Kickback Statute conditions 42 USC
1320a 7b(b). Processes and standards must be in place to avoid fraud,
waste, and abuse mismanagement) of Ryan White funds.
40. Ensure Ryan White Part B funding is only used to supplement and not
supplant existing federal, state, or local funding for HIV testing, Health
Insurance Premiums and cost sharing.
B. Monitoring Activities
The Contractor shall:
Conduct site visits and document/monitor the activities of subcontracted
agencies to ensure contractual compliance not less than once every year.
For all deficiencies cited in the contractor's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the
plan.
2. Provide any necessary assistance to the State in carrying out State
monitoring activities and inspection rights for both contractors and
subcontracted agencies, as provided in this agreement.
3. Make available to authorized State and/or federal representatives all
records, materials, data information, and appropriate staff required for
monitoring or inspection activities.
4. For all deficiencies cited in the State's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the
plan. Provide the corrective plan to the State within 30 days of receipt of
the monitoring report.
C. Partner Services PS)
The Contractor shall ensure that client service providers:
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FO99828-U03
MG99866-U03
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AI102677-U03
DO109962-U03
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16616-U05
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OF-U07
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ANY-U012
AMENDMENTS-U012
THERETO,-U012
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FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�(3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
1. Inform clients of the availability of PS. Client service providers may either
offer PS directly through their agency or by referral to their designated
local health programs.
2. Maintain documentation when PS is offered and the outcome i.e., the
number of partners to be notified by the client and/or by the health
jurisdiction). Client service providers using ARIES should document these
encounters on the Basic Medical screen. Client service providers not
using ARIES should document these encounters in the client medical
records.
D. Reporting Requirements
HCP Contractors are required to submit quarterly financial and narrative reports
to OA. Financial Reports are to be submitted with the monthly / quarterly
invoices. The HCP Quarterly Narrative Reports are due to OA according to the
following schedule:
Reporting Period Due dates
July 1 September 30 November 15
October 1 December 31 February 15
January 1 March 31 May 15
April 1 June 30 August 15
1. The quarterly HCP Financial Report tracks expenditures for the
Contractor and any subcontracted agency for the quarter reported. The
quarterly Financial Reports shall include the administrative costs of the
Contractor and each subcontracted agency, amount of funds obligated to
each subcontracted agency, total expended quarterly by each
subcontracted agency, percentage expended for the quarter, and total
number of unduplicated clients for the quarter reported.
2. The quarterly HCP Narrative Report is an opportunity for the Contractor to
describe their HCP programs, services provided, progress and
accomplishments, and to identify any technical assistance needs. The
quarterly Narrative Reports shall include, for the quarter reported only,
descriptions of the programs, services funded with HCP funds, any
general accomplishments within the programs, issues or concerns with
the programs and services funded in your county, and any technical
assistance and/or training needs of the contractor and/or subcontracted
agency.
Contractors may access the HCP Financial and Narrative Report
formats at:
http://www.cdph.ca.gov/programs/aids/Pages/OAContractFY1112.aspx
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FO99828-U03
MG99866-U03
AS99892-U03
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MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�)3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
E. Data Collection
The Contractor shall ensure that client service providers:
Collect the HCP minimum data set. The HCP minimum dataset includes
data elements required by a) HRSA to complete the Ryan White
Program Data Report RDR), the Ryan White Program Service Report
RSR), selected HAB Quality Management QM) indicators, and the
Women, Infants, Children, and Youth Report, and b) CDPH/OA for its
development of estimates and reports i.e., estimate of unmet need for
HIV medical care, statewide epidemiologic profile, Statewide Coordinated
Statement of Need) and to conduct program activities.
2. Directly enter data into ARIES within two weeks from a client's date of
service. Client service providers may import data into ARIES from other
data collection systems only if they obtain prior written approval from
CDPH/OA; said providers may not use CDPH/OA funds to develop or
maintain their import systems.
3. Electronically submit the aggregate-level RDR through HAB's Electronic
Handbook EHB). The RDR reporting period is January 1 through
December 31 of the previous calendar. Submission deadlines will be
announced in ARIES Policy Notices.
Electronically submit a Provider Report for the RSR through HAB's EHB.
Unless exempted by HRSA, client service providers who provide RSR-
eligible services must also upload a Client Report, which contains client-
level data, as an XML data file to HAB's EHB. The RSR is due twice a
year: a) The first report includes data from the first six months of the
current calendar year, and b) The second report includes all the data
from the entire previous calendar year. Submission deadlines will be
announced in ARIES Policy Notices.
5. Comply with the policies and procedures outlined in ARIES Policy Notices
issued by the CDPH/OA see www.proiectaries.orq).
F. Client Service Provider/Subcontracted Agency Reporting Requirements
Comply with the State's timeline to submit to the State a list identifying the names
and budget overview of all service provision and subcontracted agencies and
total funds available to each Client Service Provider. OA's HIV Care Section will
provide the required forms to complete the budget overview and all service
provision information. These forms are located on the OA website. Please click
on the link to access the current forms at
http://www.cdph.caqov/programs/aids/Pages/OAContractFY1 112.aspx
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AI102677-U03
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OF-U07
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ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�*3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
G. Quality Management Program
The Contractor shall:
Ensure that all client service providers have a QM program in place. The
QM program should fit within the framework of the client service
providers' other programmatic quality assurance and quality improvement
activities. Client service providers may use an existing QM program e.g.,
Joint Commission on Accreditation of Healthcare Organizations,
Medicaid) or develop their own program. Service providers may add
additional program specific or other HAB indicators to their QM plan. The
HAB QM Technical Assistance Manual can be accessed at
ftp://ftp.hrsa.govihab/QM2003.pdf. HAB's performance measures Web
page also contains a wealth of information, including more detailed
descriptions of its performance measures and frequently asked questions
http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html).
2. Incorporate selected indicators from Groups 1 and 2 of HAB's HIV/AIDS
Core Clinical Performance Measures for Adults and Adolescents also
known as HAB QM indicators) into QM programs as CDPH/OA
implements selected HAB QM indicators as part of its QM and monitoring
program. Specific indicators will be identified and released by OA
Management Memorandum. Contractors and subcontracted agencies
can monitor their progress in meeting HAB QM indicators for Groups 1
and 2 by using the Compliance Reports in ARIES as appropriate.
3. Please refer to management memorandum 11-01 at
http://www. odph.ca. qov/programs/aids/Pages/tOAHCPMAIsp. aspx for
more information.
H. Data Encryption
The Contractor shall adhere to the Information Privacy and Security
Requirements Exhibit J). In addition to the procedures set forth in the
Information Privacy and Security Requirements exhibit, Contractors must ensure
that all mobile devices are equipped with encryption software, even if the
Contractor or their subcontracted agencies do not store confidential information
on the mobile devices.
III. Minority AIDS Initiative MAI)
1. MAI Services
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PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�+3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
Minority AIDS Initiative MAI) services must be targeted to HIV infected persons of color
and must be planned and delivered in coordination with local HIV prevention outreach
services to avoid duplication of effort. The goal of MAI is to increase access to, and
engagement in, HIV/AIDS medical care for HIV-positive persons of color. This is
achieved by providing outreach and treatment education services to HIV-infected
persons of color who have never been in care, or who have been lost to care. For
additional MAI information, please refer to the MAI Budget Guidance
In accordance with HRSA guidance, OA has defined two MAI service categories, 1)
outreach and 2) treatment education. Outreach and treatment education are the only
allowable service categories for MAI funding. These service categories are designed to
meet the needs of persons of color in order to ensure that minority clients can access,
engage in, and remain in care; receive help in adhering to treatment; and be provided
with education and support that will enable them to become active participants in their
own health care and improve their overall quality of life. MAI outreach and treatment
education services are defined as follows:
Outreach Those activities typically performed by an outreach worker that results in:
1) Identifying HIV-infected persons of color who know their status but have never been
in care or who have been lost to HIV medical care; 2) Removing barriers that have
prevented access to HIV medical care, and 3) Establishing engagement in HIV medical
care. Outreach services should be conducted at times and in places where there is a
high probability that people of color with HIV infection will be reached.
MAI outreach services do not include routine HIV counseling and testing or HIV
prevention education. These services may be provided on a case-by-case basis for a
specific MAI client only when the service is necessary to remove a barrier to care for that
client.
Treatment Education The provision of health education, treatment adherence and risk
reduction information to HIV-infected persons of color who know their HIV status but are
not accessing medical care or to HIV-infected persons of color who are lost to care.
Information includes educating clients living with HIV about how to communicate with
medical providers, the importance of treatment adherence, how to manage medication
side effects, how to understand their laboratory results, how to improve their health
status, how to reduce HIV transmission, and identify medical and psychosocial support
services and counseling that are available locally.
For designated county local health jurisdictions receiving additional HRSA funding
specifically for MAI outreach and treatment education services to communities of color,
the following services and standards must be adhered to:
The Contractor may provide direct client MAI services exclusively OR may
subcontract all or part of the MAI outreach services. The Contractor must ensure
that if all or part of the MAI client services are subcontracted to other service
providers, all services provided by the subcontractor will be in accordance with
the MAI funding and reporting requirements.
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MCKEES-U10
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DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�,3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
2. The Contractor may employ MAI outreach staff or support other activities to
identify HIV-infected persons of color who are out-of-care or lost-to-care and
gradually engage them in appropriate HIV care and treatment services. Target
populations are those out-of-care, HIV-infected persons of color who have been
unable or unwilling to access services for HIV, despite an awareness of their
positive serostatus. As a member of the HIV care program team, the outreach
staff person will take actions to reduce or eliminate any cultural or other barriers
that prevent access to and/or continued engagement in HIV care services. The
Contractor must meet specific parameters to support the needs of this project.
The parameters include the Contractor's ability to do the following:
a. It is strongly recommended that MAI outreach staff be culturally and
linguistically competent street-level" workers who reflect the communities
they serve. Highly recommended is experience in two or three of the
following areas: street-based outreach, HIV counseling and testing,
health education or HIV case management.
b. MAI outreach staff are to take actions to reduce or eliminate any cultural
or other barriers that prevent access to and/or continued engagement in
care and treatment services. This individual links and supports the client
in accessing suitable HIV care and treatment services.
c. In lieu of outreach positions, MAI funds can also support
outreach/treatment education activities or interventions for HIV-infected
persons of color, as determined at the local level and approved by OA.
d. Commit to submitting data in an accurate and timely fashion, including
committing to full participation in any evaluation or research component.
e. Be able to commit the MAI outreach worker to participate in ongoing staff
trainings including but not limited to, attendance at various state-
mandated meetings, trainings, Webex/teleconferences or conferences as
required.
A. The Contractor shall:
1 Provide services that identify and engage HIV-infected persons of color
who know their HIV status but are not accessing medical care, to reach
out to people of color who are HIV-infected but unaware of their HIV
status, and/or to locate and reestablish access for HIV-infected persons
of color who have been lost to care.
2. Work with existing community resources and entities that serve as key
points of entry into medical care, including but not limited to emergency
rooms, substance abuse treatment programs, TCMP for those individuals
released from state correctional institutions, detoxification centers, adult
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AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
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FUNDING-U012
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STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�-3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
and juvenile detention facilities, STD clinics, HIV counseling and testing
sites, mental health programs, homeless shelters, Federal Qualified
Health Centers, etc. to coordinate and integrate HIV care service delivery.
3. Ensure that MAI outreach and treatment education services are planned
and delivered in coordination with local HIV prevention outreach
programs and other HIV services providers to avoid duplication of effort.
4. Ensure that services are responsive to the needs of the clients in the
service area, are sensitive to linguistic, ethnic, and cultural differences of
the population(s) being served, and that services are linguistically and
culturally appropriate. Services may not be denied due to immigration
status, place of residence within California, current or prior health
condition, or inability to pay.
5. Ensure that PS is offered on a routine basis to all HIV-positive clients.
Clients should be made aware that receiving assistance in the referral of
partners is voluntary and will be offered periodically.
6. Ensure that MAI planning efforts are coordinated with all other local
funding streams for HIV/AIDS to ensure that Ryan White HIV/AIDS
program funds are the payer of last resort, maximize education and
outreach efforts to link individuals to ADAP and other appropriate
program, and reduce any duplication.
7. Ensure that client eligibility and service provision under this contract are
in accordance with the CDPH/OA's MAI Budget Guidance. Screening
and reassessment of client eligibility must be completed and documented
every 6 months to determine continued eligibility for Ryan White services.
Ensure that eligibility policies do not deem a Veteran living with HIV
ineligible for Ryan White services due to eligibility for Department of
Veterans Affairs VA) health care benefits. Ensure policies and
procedures classifying veterans receiving VA health benefits as
uninsured, thus exempting these Veterans from the Payer of Last
Resort" requirement per Veterans Policy 07-07, Policy 04-01, and
Parham Letter 08/04 see www.hab.hrsa.gov).
8. Ensure that MAI clients have access to, and are enrolled in, ADAP, Medi-
Cal, or other appropriate program(s) providing HIV medications.
9. Ensure HIV care services will be provided in a setting that is accessible to
low-income individuals with HIV disease. Facilities must also be
accessible for hearing-, vision-, and mobility-impaired persons in
accordance with the federal ADA.
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FO96183-U03
FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�.3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
10. Ensure the protection of the client's privacy and confidentiality at all times.
In addition, federal law requires that individuals have a right of access, to
inspect, and obtain a copy of their PHI in a designated record set, for as
long as the health information is maintained by a CDPH health plan,
CDPH providers, or business associates. There are limited exceptions to
an individual's right of access PHI 45 C.F.R. s 164.524).
11. Ensure that any subcontractors have the organizational and
administrative capabilities to support the program services and activities.
The Contractor is responsible for quality assurance and utilization review
activities for subcontracted MAI services.
12. Ensure that any subcontractors have appropriate facilities and resources,
including an adequate physical plant and appropriate supplies and
equipment available for the provision of services and practical support
functions.
13. Ensure that all service providers have a QM program in place. The QM
activities should fit within the framework of the Contractor's or
subcontractor's other programmatic quality assurance and quality
improvement activities. Contractors and subcontractors may use an
existing QM program or develop their own program. Service providers
may add additional program specific or other HAB indicators to their QM
plan. The HAB QM Technical Assistance Manual can be accessed at
ftp://ftp.hrsa.gov/hab/QM2003.pdf. HAB's performance measures Web
page also contains a wealth of information, including more detailed
descriptions of its performance measures and frequently asked questions
http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html). It is
strongly recommended that HAB Group 1, 2, and 3 indicators be
incorporated into QM programs because CDPH/OA is planning to track
selected HAB QM indicators as part of its QM program.
14. Ensure that no more than ten percent 10%) of the allocation is used for
non-direct service functions such as:
a. Routine contract administration and monitoring activities, including
the preparation of applications for these funds, the receipt and
disbursal of program funds, the development and establishment of
reimbursement and accounting systems, the preparation of routine
programmatic and financial reports, and compliance with contract
conditions and audit requirements;
b. All activities associated with the Contractor's subcontract award
procedures, including the development of request for proposals,
contract proposal review activities, negotiation and awarding of
subcontracts, grievance process, monitoring of subcontracts
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�/3�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
through telephone consultation or onsite visits, reporting on
subcontracts and funding reallocation activities.
15. In addition, ensure that no more than ten percent 10%) of the allocation
is used for all subcontractors' non-direct service administrative)
functions.
16. Ensure that service providers who provide Medi-Cal reimbursable
services are certified as providers for purposes of Medi-Cal billing see
www.medi-cal.ca.gov) and have the ability to bill other third-party payers
for covered services.
17. Ensure that funds are payer of last resort by ensuring that service
providers bill all other third party payers, including Medi-Cal, before
invoicing MAI.
18. Ensure that funds are not utilized to make payments for any item or
service to the extent that payment has been made, or can reasonably be
expected to be made, with respect to that item or service:
a. Under any State compensation program, under an insurance
policy, or under any Federal or State health benefits program; or
b. By an entity that provides health services on a prepaid basis.
19. Funded service providers should integrate, and work collaboratively, with
other such services and coordinate with other available programs
including Medicaid), to ensure continuity of care and prevention of
services of individuals with HIV is enhanced.
20. Ensure funds are not used on prohibited activities see
www.hab.hrsa.gov) and CDPH/OA's HCP and Budget Guidelines.
21. Prohibit employees from soliciting or receiving payment in kind or cash for
the purchase, lease, ordering, or recommending the purchase, lease, or
ordering, of any goods, facility services, or items.
a. Documentation is required by the Compliance Plan or employee
conduct standards that prohibit employees from receiving
payments in kind or cash from suppliers and contractors of goods
or services.
22. Ensure that funds are not used to:
a. Purchase or improve any building or other facility, with the
exception of minor repairs or remodeling approved in writing by
the State;
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MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�03�County of Monterey
10-95274 A01
g.
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
b. Pay for automobile parts, repairs, or maintenance, pet care or
supplies, funeral expenses, etc. see www.hab.hrsa.gov); or
c. Make cash payment to intended recipients of services.
d. Develop, promote, or advertise about HIV services that target the
general public.
e. Generate broad scope awareness activities about HIV services that
target the general public.
f. Pay costs associated with the creation, capitalization, or
administration of a liability risk pool other than those costs paid
on behalf of individuals as part of premium contributions to
existing liability risk pools), or to pay any amount expended by a
State under Title XIX of the Social Security Act.
Pay for any item or service that can reasonably be expected to be
paid under any State Compensation program, insurance policy, or
any Federal or State Health Benefits Program except for
programs related to Indian Health Service);
h. Pay for any item or service that can paid by an entity that provides
health services on a prepaid basis;
i. For the development of materials, designed to promote or
encourage, directly or indirectly, intravenous drug use or sexual
activity;
23. Ensure that all approved subcontractor invoices are paid by the
Contractor within 45 days of receipt.
24. Ensure that funds are not carried over into subsequent contract years.
25. Ensure compliance with the federal HRSA Ryan White Program,
CDPH/OA's MAI Budget Guidance, CDPH/OA Policy Letters,
Management Memoranda, AIDS Regional Information and Evaluation
System ARIES) Policy Notices, and other program guidelines issued by
CDPH/OA.
26. Ensure compliance with the following requirements regarding imposition
of charges for services, for those providers who charge for services:
a. In the case of individuals with an income less than or equal to one
hundred percent 100%) of FPG see www.aspe.hhs.gov/poverty),
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FO96184-U03
FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
MARCELLAC-U04
16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
THE-U07
DIRECTOR-U07
OF-U07
HEALTH-U07
TO-U07
EXECUTE-U07
ON-U07
BEHALF-U07
OF-U07
THE-U07
COUNTY-U07
OF-U07
MONTEREY-U07
STANDARD-U07
AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�13�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
the provider will not impose charges on any such individual for the
provision of services under the contract;
b. In the case of individuals with an income greater than one
hundred percent 100%) of the FPG, the provider:
i. Will impose charges on each such individual for the
provision of such services and
ii. Will impose charges according to a schedule of charges
that is made available to the public;
c. In the case of individuals with an income between the FPG in
Columns A and B see table below), the provider will not, for any
calendar year, impose charges exceeding the percentage in
Column C of the client's annual gross income:
Column A: Client's Column B: Client's Column C: Charges are
income is greater income does not not
than exceed to exceed
100% of FPG 200% of FPG 5% of the client's annual
gross income
200% of FPG 300% of FPG 7% of the client's annual
gross income
300% of FPG 10% of the client's
annual
gross income
27. Cooperate with any Federal investigation regarding the Ryan White
program funds.
28. Participate in any state-mandated meetings, trainings, WebEx
conferences, teleconferences, and/or other conferences to be
determined.
29. Administer MAI funds appropriately, maintain records and invoices using
standard accounting practices, coordinate federal and state data
reporting, and arrange for fiscal audits.
30. When issuing statements, press releases, requests for proposals, bid
solicitations, and other documents describing projects or programs
funded in whole or in part with Federal money, the Contractor shall clearly
state the percentage of the total costs of the program or project which will
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FO99828-U03
MG99866-U03
AS99892-U03
AS99894-U03
AI102677-U03
DO109962-U03
C5-U03
AGREEMENTS-U03
2/24/2012-U04
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16616-U05
6-U06
APPROVE-U07
AUTHORIZE-U07
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COUNTY-U07
OF-U07
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AGREEMENTS,-U07
411-HEALTH-U08
MCKEE-U09
SUSIE-U09
MCKEES-U10
6/1/2011-U011
ANY-U012
AMENDMENTS-U012
THERETO,-U012
CONTINUED-U012
FUNDING-U012
LOCAL,-U012
STATE,-U012
FEDERAL-U012
AGENCIES-U012
DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�23�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
be financed with Federal money, the dollar amount of Federal funds for
the project or program, and percentage and a dollar amount of the total
costs of the project or program that will be financed by nongovernmental
sources.
31. Take steps to ensure that people with limited English proficiency can
meaningfully access health and social services. For detailed information
on the specific responsibilities of Contractors regarding linguistic
competence, see the OCR website at:
httr)://www hhs gov/ocr/civilrights/resources/specialtopics/lep/policyguidan
cedocument.html.
32. Ensure compliance contract Anti-Kickback Statute conditions 42 USC
1320a 7b(b). Processes and standards must be in place to avoid fraud,
waste, and abuse mismanagement) of Ryan White funds.
33. Ensure Ryan White Part B MAI funding is only used to supplement and
not supplant existing federal, state, or local funding for HIV testing, Health
Insurance Premiums and cost sharing.
B. Monitoring Activities
The Contractor shall:
1. Conduct site visits and document/monitor the activities of subcontracted
agencies to ensure contractual compliance not less than once every year.
For all deficiencies cited in the contractor's monitoring report, develop a
corrective plan, submit it to the State for approval, and implement the plan.
2. Provide any necessary assistance to the State in carrying out State
monitoring activities and inspection rights for both contractors and
subcontracted agencies, as provided in this agreement.
3. Make available to authorized State and/or federal representatives all records,
materials, data information, and appropriate staff required for monitoring or
inspection activities.
4. For all deficiencies cited in the State's monitoring report, develop a corrective
plan, submit it to the State for approval, and implement the plan. Provide the
corrective plan to the State within 30 days of receipt of the monitoring report.
C. Reporting Requirements
Each MAI contractor is required to submit an MAI Quarterly Narrative Status
Report. The MAI Quarterly Narrative Status reports are due to OA according to
the following schedule:
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DESIGNATED-U012
PROGRAMS.-U012
FULLY EXECUTED AGREEMENT NO. u�33�County of Monterey
10-95274 A01
Exhibit A-5
HIV Care Program and Minority AIDS Initiative
Scope of Work, Year 3
REPORTING PERIODS DUE DATES
July 1 September 30, 2011 November-1 5
October 1 December 31, 2011 February 15
January 1 March 31, 2012 May 15
April 1 June 30, 2012 August 15
The quarterly MAI Narrative Status Report is an opportunity for the
Contractor to provide program accomplishments, successful outreach
and/or treatment education strategies, challenges and lessons learned,
problems or issues, and requests for training and technical assistance, in
addition to reporting numbers of clients served and the types of services
provided.
Contractors may access the Narrative Report format at:
http://www.cdph.ca.gov/programs/aids. Each MAI contractor, on an annual or as
needed basis, must comply with the State's timeline to submit to the State a list
identifying the names and budget overview of all service providers and
subcontracted agencies and total funds for service provision that are available to
each. OA MAI will provide the required forms to complete the budget overview
and all service provision information. These forms are located on the OA
website.
D. Data Collection
1. Until MAI reporting is incorporated into the State's ARIES data reporting
system, Contractors receiving MAI funds for outreach and treatment
education services must track and report activities manually. Both forms,
MA! Demographic Reponinc/ Forte and Mr'A! Client Contact Reporting
Form, are to be submitted to OA on a monthly basis either via fax or
email. These forms may be accessed via OA's website.
2. Ensure compliance with all CDPH/OA Policy Letters, Management
Memoranda, ARIES Policy Notices, and other policies and procedures
issued by CDPH/OA.
E. Data Encryption
The Contractor shall adhere to the Information Privacy and Security
Requirements Exhibit J). In addition to the procedures set forth in the
Information Privacy and Security exhibit, Contractors must ensure that all mobile
devices are equipped with encryption software, even if the Contractor or their
subcontracted agencies do not store confidential information on the mobile
devices.
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