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Doc 492 - Saving Grace - Marys Place Agrmt
Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701·1960 (541) 388·6570· Fax (541) 385-3202 -www.deschutes.org AGENDA REQUEST & STAFF REPORT For Board Business Meeting of August 31,2011 Please see directions for completing this document on the next page. DATE: August 18,2011 FROM: Debi Harr Children & Families Commission 330-4692 TITLE OF AGENDA ITEM: Consideration of Board Signature on Document # 2011-492, Contract for SUbgrant between Deschutes County Children & Families Commission and Saving Grace -Imagine Life Without Violence. PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: The 2011-2012 contract includes four funding streams supporting two projects: 1) Mary's Place Supervised Visitation and Safe Exchange Center; and 2) Saving Grace Comprehensive Shelter Services. $112,920 in Safe Havens funds and $88,086 in court filing fees partially fund Mary's Place. Mary's Place provides a safe, secure site for visitation and exchanges of children between custodial and non custodial parents with a history of domestic violence, sexual assault, child abuse or stalking. Mary's Place will provide a minimum of 1,700 supervised visits and safe exchanges to an average of 42 familes per month. Mary's Place also provides outreach to the Latino community. $2,407 in Deschutes County Children & Families Commission (CFC) flexible funds support a bi-lingual facilitator. A $15,000 BOCC Community Grant supports comprehensive domestic violence shelter services for 165 victims (women and children) including safety planning, shelter nights, basic needs, crisis counseling, mental health therapy and respite child care. Since September 2005, the County has applied for and received $1,124,771 from the Department of Justice, Office of Violence Against Women, Safe Havens: Supervised Visitation and Safe Exchange Program Grant. The current $349,891 three year Safe Havens grant provides a total of $23,243 for CFC to provide project and fiscal management and attend mandated trainings and a total of $326,648 for Saving Grace Imagine Life Without Violence to operate Mary's Place. Planning for Mary's Place began in 2003 and Mary's Place opened its doors in January 2006. The primary goal of this program is to keep victims of domestic and dating violence, sexual assault and stalking and their children safe and to hold batterers accountable. FISCAL IMPLICATIONS: The total contract amount is $218,413, and was included in the budget for fiscal year 2011-2012. RECOMMENDATION & ACTION REQUESTED: Approval and signature on document # 2011-492 ATTENDANCE: Debi Harr, Children & Families Commission DISTRIBUTION OF DOCUMENTS: Originals to Debi Harr, Deschutes County Children & Families Commission, 1130 NW Harriman, Suite A, Bend, OR 97701. DESCHUTES COUNTY DOCUMENT SUMMARY (NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board agenda, the Agenda Request Form is also required. If this form is not included with the document. the document will be returned to the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form electronically to the Board Secretary.) Please complete all sections above the Official Review line. Date: IJuly 18, 2011\ Department: \CFC Contractor/Supplier/Consultant Name: ISaving Grace -Imagine Life Without Violenc~ ~ Mary's Plac~ Contractor Contact: \Gail Bartle~ Contractor Phone #: K541) 504~ ~ Type of Document: Services Agreement Goods and/or Services: There are four funding streams supporting two projects: 1} Mary's Place; and 2} Comprehensive Shelter Services. A $112,920 Office on Violence Against Women, Safe Havens Grant and $88,086 ($79,485 for 2011-2012 plus $8,601 carry forward from 2010-2011) in court filing fees fund Mary's Place. Mary's Place will provide a minimum of 1,700 supervised visits and exchanges for families that have experienced domestic violence, child abuse, stalking or sexual assault. Mary's Place also provides outreach to the Latino community. $2,407 in CFC flexible funds support a bi-lingual facilitator. A $15,000 BOCC Community Grant supports comprehensive shelter services for 165 victims (women and children) including safety planning, shelter nights, basic needs, crisis counseling, mental health therapy and respite child care. Background & History: Mary's Place is a safe, secure site for visitation and exchanges of children between custodial and non-custodial parents. Pass through Federal Office on Violence Against Women, Safe Havens grantee since 2005. State of Oregon court filing fees supplement activities. CFC began monitoring the BOCC Community Grant in 2010. Agreement Starting Date: puly 1, 2011\ Ending Date: pune 30, 201 ~ Annual Value or Total Payment: 1$218,41~ cgJ Insurance Certi"ficate Receiied (C£eCk box) Insurance Expiration Date: 7/1/1 Check all that apply: o RFP, Solicitation or Bid Process o Informal quotes «$150K) cg] Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37) Funding Source: (Included in current budget? cg] Yes o No 8122/2011 If No, has budget amendment been submitted? DYes D No Is this a Grant Agreement providing revenue to the County? DYes [8J No Special conditions attached to this grant: Per grant document Deadlines for reporting to the grantor: Quarterly 15 days after the end of the quarter in October, January, April & July. If a new FTE will be hired with grant funds, confirm that Personnel has been notified that it is a grant-funded position so that this will be noted in the offer letter: DYes D No Contact information for the person responsible for grant compliance: Name: Hilla Saraceno Phone #: 317-3178 Departmental Contact and Title: Sarah Johnson Phone #: (541)322-7461 4r"' Department Director Approval:· ~11/~¥.Jo /1I~ature j5ate I Distribution of Document: Return both originals to Debi Harr at CFC, 1130 NW Harriman, Ste. A, Bend OR 97701. Official Review: County Signature Required (check one): 0 BOCC 0 Department Director (if <$25K) o Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. ______) Legal Review Date Document Number 2011-492 8/22/2011 REVIEWED LEGAL COUNSEL I/IiJeWED D~ For Recording Stamp Only Contract for Subgrant Under The Deschutes County Children" Families Commission (CFC) Contractor: Saving Grace -Imagine Life Without Violence Project: Mary's Place Contact: Gail Bartley Subcontractor(s): Insert if applicable THIS CONTRACT, made and entered into by and between Deschutes County, a political subdivision of the State of Oregon, hereinafter called "County," acting by and through the Children & Families Commission, hereinafter CFC called "Commission" or "CFe', and SAVING GRACE -IMAGINE LIFE WITHOUT VIOLENCE, an Oregon non-profit corporation, Federal Tax ID # 93-0797194 hereinafter referred to as "Contractor:" DEFINITIONS Application -The proposal provided by an applicant agency seeking funding. The application helps define the service to be purchased and the use of Commission resources. Community Plan -The County and State adopted 2001-2010 Community Plan. Director -The Director of the Office of the Deschutes County Children & Families Commission or the Director's designee . .G.r£D! -The application, award, and incorporated documents constituting an agreement between County and the Safe Havens Federal Grant, Oregon Commission on Children & Families Children Youth & Families grant, Deschutes County General Fund, and Circuit Court fees to carry out the Project, as defined in Exhibit A. Other grantjng organizations -Any entity providing resources (to the Commission) that provide funds for this contract. Commission -The Deschutes County Children & Families CommiSSion. Work plan -The attached document that details the performance measures which Contractor must satisfy in order to qualify for payment under this Contract. RECITALS WHEREAS, Contractor has submitted to Commission its application for a Subgrant award to undertake the Project, as set forth in Exhibits A and B: and WHEREAS, in reliance upon Contractor's application, and expressed willingness and /grants/2009-11/201G-11/Provider Contracts/Mary's Place -Doc. II 2011-492Page 1 of 32 Updated 8/22/2011 cCipability to undertake the Project pursuant to this Contract, County has selected Contractor to perform the services set forth in this Contract in accordance with the attached Work Plan and Budget; and WHEREAS, Contractor has agreed to complete the Work Plan and the Contract in accordance with the terms and conditions of all granting organizations managed by and through the Commission, now, therefore, in consideration of the mutual promises hereinafter stated, IT IS HEREBY AGREED by and between the parties above mentioned, as follows: 1. Effective Date: This Contract is effective at 12:01 a.m., July 1, 2011, or the date this Contract is fully executed, whichever is later. Contractor shall not be entitled to payment for any services that are or may have been rendered prior to the effective date of this Contract. 2. Duration. This Contract expires at 11:59 p.m. on, June 30, 2012 3. Contractor's Services. Contractor agrees to provide the services set forth in the Work Plan, marked Exhibit A, and in accordance with the Budget, marked Exhibit B, both of which are attached hereto and by this reference incorporated herein. Exhibit A may be modified during the term of this Contract only upon the written consent of Contractor and the Director, provided that a) the modifications are consistent with the Work Plan goals in Exhibit A, and, if approved, b) the value of services to be furnished equals or exceeds the value of services set forth in Exhibit A and Exhibit B, as determined by the CFC Director. 4. Consideration. The maximum consideration authorized under this Contract is $218,413. Said consideration is the complete compensation to Contractor for services performed. This Contract between the County and the Contractor is subject to the appropriation, continuation and sufficiency of local, state and federal funds. 5. Independent Contractor. Contractor is engaged hereby as an independent contractor, as that term is defined by ORS 670.600, and will be so deemed all purposes, including without limitation, the following: a. Contractor will be solely responsible for payment of any Federal or State taxes required as a result of this Contract. b. This Contract does not entitle Contractor to any wages or benefits generally paid or granted to County employees, including, without limitation, vacation, holiday and Sick leave, other leaves with pay, medical and dental coverage, life and disability insurance, and other forms of compensation. c. Contractor is an independent contractor for purposes of the Oregon Workers' Compensation law (ORS Chapter 656) and is solely liable for any Workers' Compensation coverage under this Contract. If Contractor performs this Contract without the assistance of any other person, upon County's request, Contractor shall execute a Joint Declaration with County's Workers' Compensation carrier absolving County of any and all liability for Workers' Compensation benefits under ORS 656.029(2). 6. Subcontractor Delegation. Contractor shall not assign or delegate the responsibility for providing services hereunder to any other individual or agency, unless outlined in this Contract or approved in writing by the CFC Director. a. Any delegation, subcontract, assignment, or transfer without the prior written consent of County shall constitute a material breach of this Contract. /grants/2009-11/201Q-11/Provider Contracts/Mary's Place -Doc." 2011-492Page 2 of 32 Updated 8/22/2011 b. Any such assignment or transfer, if approved, is subject to such conditions and provisions, as the County may deem necessary. c. No approval by the County of any assignment or transfer of interest shall be deemed to create any obligation of the County to increase rates of payment or the maximum Contract consideration. d. Prior written approval shall not be required for the purchase by the Contractor of articles, supplies and services which are incidental to the provision of services under this Contract and that are necessary for the performance of the work. e. Any subcontracts that the County may authorize shall contain all requirements of this Contract, and the Contractor shall be responsible for the performance of the subcontractor. 7. Duties and Responsibilities of County. a. Oversee the Contractor's completion of the Work Plan in accordance with the terms and conditions of the Grant, which is by this reference incorporated herein. b. Disburse Grant funds, as appropriate, upon timely receipt from Contractor of complete and accurate reports and documents required by this Contract or requested by County. Except as otherwise provided in this Contract, County will disburse to Contractor on a quarterly basis throughout the length of the contract within twenty-five (25) days after receipt of the required items referred to in 8 0) below. Payment may be delayed or denied, if required documentation is not received. Disbursement will include any unpaid amounts for satisfactory performance during the previous three months. Contractor shall make available quarterly reports based on a schedule determined by the Director at the beginning of the contract period. Reports may be submitted electronically using forms/templates approved by the Commission. The number of payments will be based upon the number of calendar quarters contained in the Contract. c. Maintain an inventory of all property purchased and provide reports in accordance with the requirements of the Commission. 8. Duties and Responsibilities of Contractor. a. Carry out the Project as an independent contractor and not as an agent of County in accordance with the terms and conditions of the Grant and Scope of Work. b. Obtain prior CFC Director approval of all revisions to the Budget as detailed in Exhibit B that are in excess of ten percent (10%) of the amount of the contracted amount. c. Document and report cash or in-kind match in the amounts shown in Exhibit d. Prepare and furnish such plans, data, descriptive information and reports as may be requested by County, as needed to comply with County, State and or Federal requirements. Contractor agrees to, and does hereby grant the County and any other granting organizations the right to reproduce, use, and disclose all or any part of the reports, data, and technical information furnished under this Contract. e. Justify all costs by properly executed payroll records, time records, invoices, /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 3 of 32 Updated 8/22/2011 contracts, vouchers, orders, and any other accounting documents pertaining in whole or in part to this Contract, conforming to generally accepted accounting principles and in sufficient detail to permit County to verify how the financial assistance paid by County under this Contract was expended. f. Maintain confidentiality of all records pursuant to applicable Oregon Revised Statutes. Contractor shall not use, release or disclose any information concerning any employee, client, applicant or person doing business with the County for any purpose not directly connected with the administration of County's or the Contractor's responsibilities under this Contract except upon written consent of the County, and if applicable, the employee, client, applicant or person. The Contractor shall ensure that its agents, employees, officers and subcontractors with access to County and Contractor records understand and comply with this confidentiality provision. g. Submit to County, on a regular basis, the required reporting forms per the reporting schedule in Exhibit "A". h. Meet at least once during the Contract period Commission representative to discuss Work Plan Additional meetings may be required by the Commission. with a designated (Exhibit A) progress. i. When actual performance varies significantly from Exhibit A, the Contractor shall submit to the Commission a written explanation along with the quarterly report (or within the reporting time frame approved by the Director at the beginning of the contract term). Significant variance in performance means a 15% or greater variation reflecting poorer outcomes and/or outputs than as outlined in Exhibit A, Work Plan or the reporting time frame, and shall be deemed non-compliance with the work plan. In the event a Contractor does not submit a written explanation with the required reports when a significant variance in performance has occurred, the Commission staff liaison will endeavor to notify the Contractor and request a written explanation within 30 days of notification, provided however, that failure to provide such notice shall not excuse Contractor's non-compliance. j. The written explanation for non-compliance shall include at a minimum the following information: (1) an explanation as to why the Contractor is out of compliance; (2) clear description of what the Contractor is doing or proposes to do to correct the non-compliance; and (3) a proposed time line for bringing the program into compliance or an explanation for the reason the program will or may not be able to bring performance into compliance. k. The Contractor's written explanation shall be subject to review/approval by the Director and, depending on the severity of the non compliance, as determined by the Director, by the Commission's Program Committee and/or the Commission Board. I. Regardless of Contractor's explanation, Commission Board and the BOCC retain the right to take appropriate action in cases where reported outcomes and/or outputs vary Significantly from the agreed upon Work Plan, including reducing funding, withholding payment of funds and, in Commission's sole discretion, reallocation of grant funds for distribution to other contractors or programs. m. Assurances: The Contractor attests that the information provided to /gr3nts/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. It 2011-492Page 4 of 32 Updated 8/22/2011 Commission to determine Contractor eligibility for payment, including all required reports, is true and accurate to the best of the Contractor's knowledge. The Contractor's representative signing this Contract further attests that they have the authority to represent their organization in all phases of the contract, including the selection process. Contractor's representative signing this Contract understands that any false or substantially incorrect statements may disqualify the Contractor's proposal from further conSideration, and shall be cause for termination of any contract. n. Contractor shall expressly refer to the Commission's financial support by adhering to the CFC Co-Branding Goals, Guidelines and Expectations, as set forth in the attached Exhibit C. Any Contractor failing to identify itself as a CFC funded partner agency and/or to adhere to the CFC co-branding expectations outlined in Exhibit C may result in the termination of the Contract and/or cause the Board of Directors to sever any future funding partner relationship .. o. If a Contractor has any concerns, complaints or issues with the Commission the Contractor shall notify the CFC Director to voice such concerns, complaints or issues. The Contractor shall not voice concerns, complaints or issues it has with CFC in published materials or the media. Significant issues, complaints or concerns should be outlined in writing and directed to the CFC Chairperson. o. Family Violence Policy: No later than the end of the Contract term (or, if more than one year, the first anniversary of the contract), the Contractor shall prepare and adopt a formal workplace policy related to family violence. At a minimum, the policy will include a statement of how family violence victims will be supported and how the Contractor will provide necessary staff training in support of family violence victims. p. Child Abuse Reporting Policy: No later than the end of the contract term (or, if more than one year, the first anniversary of the contract), the contractor shall prepare and adopt a formal work place policy related to reporting of child abuse. At a minimum, the policy will include a statement of how child abuse will be recognized and reported and how the Contractor will provide necessary staff training to ensure that incidents of child abuse are recognized and reported. q. Perform services as an equal opportunity employer. Contractor shall not deny services or discriminate on the basiS of sex, race, color, age, creed, national origin, marital status, sexual orientation, disability or duration of reSidence, and there shall be no discrimination in selection, compensation, or other employment practices with respect to personnel coming under the auspices of Contractor. Contractor will otherwise comply with the provisions and requirements of Title VII of the Civil Rights Act of 1974, and all requirements issued by the Department of Justice. r. Age, Gender, and Culture Sensitivity: Contractor shall provide effective service without regard to the age, gender or cultural differences among clients. This includes Contractor having sufficient training and knowledge, as well as appropriate age, gender and cultural neutral program features. If local training programs to enhance service delivery in response to age, gender or cultural differences of clients are available during the contract term, Contractor shall partiCipate. s. Contractor shall not expend nor request County reimbursement of any grant funds for Activities and Services, including allowable costs, other than those set forth in Exhibit A, which are undertaken by, timely completed and properly /grants/2009-11/201()'11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 5 of 32 Updated 8/22/2011 documented by Contractor. 9. Additional State and Federal Requirements Applicable to Contract. If any funds to be paid to Contractor under this Contract are received by the County from any agency of the federal government, Contractor shall comply with all applicable federal, state and local laws, including but not limited to, OAR 423-010-0005 to 423-010-0040 and the following laws: a. Contractor shall comply with all federal, state and local laws, regulations, executive orders, codes and ordinances applicable to the Contract or to the conduct of activities under this Contract. Without limiting the generality of the foregoing, Contractor expressly agrees to comply with the following laws, regulations and executive orders to the extent they are applicable to the Contract: (a) all applicable requirements of state civil rights and rehabilitation statutes, rules and regulations; (b) all state laws requiring reporting of client abuse; (c) ORS 659A.100 to ORS 659A.409 and all regulations and administrative rules established, pursuant to those laws in the conduct of all programs, services and training associated with the Contract. These laws, regulations and executive orders are incorporated by reference herein to the extent that they are applicable to the Contract. Contractor shall comply with the provisions of ORS 2798.220, 2798.230 and 2798.235, which are incorporated by reference herein. Contractor shall comply with ORS 656.017 and provide the required Workers' Compensation coverage, unless exempt under ORS 656.126. b. Contractor shall obtain and continuously maintain all licenses, certificates, authorizations and other approvals required by applicable law to deliver services. c. When utilizing federal Title XX block grant funds, the additional federal requirements applicable to the Title XX block grant funds in 42 USC 1397 et seq., including but not limited to: maintaining and providing to County such documentation as the County shall require to comply with federal reporting requirements; 45 CFR Part 96; and the limitations on the use of Title XX grants in 42 USC 1397d. d. Contractor shall comply with all applicable federal and state laws and regulations pertaining to the provision of Medicaid Services under the Medicaid Act, Title XIX, 42 USC Section 1396, et. seq. including without limitation maintaining records necessary to fully disclose the services provided to individuals receiving Medicaid assistance, compliance with the disclosure requirements of 42 CFR 1002.3(a} and 42 CFR 455 Subpart (8); maintenance of written notices and procedures respecting advance directives in compliance with 42 USC Section 1396(a)(57) and (w), 42 CFR 431.107(b}(4), and 42 CFR 489 subpart 1; and certification when submitting any claim for the provision of Medicaid Services that the information submitted is true, accurate and complete. e. Contractor shall comply with all federal laws, regulations, and executive orders applicable to the Contract or to the conduct of activities covered by the Contract. Without limiting the generality of the foregOing, Contractor expressly agrees to comply with the following laws, regulations and executive orders: (a) Titles VI and VII of the Civil Rights Act of 1964, as amended, (b) Sections 503 and 504 of the Rehabilitation Act of 1973, as amended, (c) the Age Discrimination in Employment Act of 1967, as amended, and the Age Discrimination Act of 1975, as amended, (d) the Vietnam Era Veterans' Readjustment ASSistance Act of 1974, as amended, (e) the Federal Funding Accountability and Transparency Act (FFATA) of 2006, (P.L.. 109-282), /grants/2009-ll/201Q-11/Provider Contracts/Mary's Place -Doc. # 20ll-492Page 6 of 32 Updated 8/22/2011 provisions of which include but may not be limited to a requirement for Contractor to have a Data Universal Numbering System (DUNS) number and to maintain a current registration in the Central Contractor Registration (CCR) database, (f) all applicable rules, regulations and orders of the Secretary of Labor concerning equal opportunity in employment and discrimination against minority-owned, women-owned or emerging small businesses, and (g) all regulations and administrative rules established pursuant to the foregoing laws, (h) all other applicable requirements of federal Civil rights and rehabilitation statutes, rules and regulations, (i) all federal laws requiring reporting of client abuse, (j) the Americans with Disabilities Act of 1990 (codified at 42 USC 12131 et. seq.), as amended, in the construction, remodeling, maintenance and operation of any structures and facilities, and in the conduct of all programs, services and training associated with Contractor's programs and activities. These laws, regulations and executive orders are incorporated by reference herein to the extent that they are applicable to the Contract and required by law to be so incorporated. No federal funds may be used to conduct activities in violation of 42 USC 14402. f. When utilizing federal Title IV-B2 Family Preservation and Support Services funds, the additional federal reqUirements applicable to Title IV-B2 Family Preservation and Support Services funds in 42 USC 629 et seq., including but not limited to: maintaining and providing to County such documentation as the County shall require to comply with federal reporting reqUirements; 45 CFR Part 92; and the limitations on the use of Title IV-B2 funds in 42 USC 629d. g. When utilizing federal Child Care and Development block grant funds, the additional federal and state requirements applicable to Child Care and Development block grant funds in 42 USC 9858 et seq., and 45 CFR Part 98, including but not limited to: maintaining and providing to County such documentation as the County shall require to comply with federal reporting requirements; and the limitations on the use of such funds in 42 USC 9858d and 45 CFR 98.54 and OAR 423-010-0024(2). h. With respect to federal funds under this Contract, Contractor agrees to comply with the provisions of the OMB Circular A-87, Revised "Cost Principles for State, Local and Indian Tribal Governments." Federal funds received by Contractor under this Contract from the sources identified in paragraphs c, d, f and g of this Section 9 are subject to the audit requirements under the Single Audit Act Amendments of 1996 and OMB Circular A-133, Revised, "Audits of Institutions of Higher Education, and Other Non-Profit Organizations." i. All mandatory standards and policies that relate to resource conservation and recovery pursuant to the Resource Conservation and Recovery Act (codified at 42 USC 6901 et. seq.). Section 6002 of that Act (codified at 42 USC 6962) requires that preference be given in procurement programs to the purchase of specific products containing recycled materials identified in guidelines developed by the Environmental Protection Agency. Current guidelines are set forth in 40 CFR Parts 247-253. j. The following environmental laws: (1) all applicable standards, orders or reqUirements issued under the Clean Air Act (codified at 42 USC 7401 et. seq.) and the Federal Water Pollution Control Act, as amended (codified at 33 USC 1251 et. seq.), (2) Executive Order No. 11,738 of the President of the United States and (3) Environmental Protection Agency regulations set forth in 40 CFR Part 15. Contractor shall promptly report all violations of the federal laws to County. Contractor shall include and require the inclusion in all contracts with recipients receiving more than $100,000 in federal funds, language requiring /grants/2009-11/201o-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 7 of 32 Updated 8/22/2011 the recipient to comply with the federal laws and to report all violations thereof to County. OMB Circular A-l02, Revised. k. Contractor shall not permit any person or entity to receive Grant funds if the person or entity is listed on the non-procurement portion of the General Service Administration's "List of Parties Excluded from Federal Procurement or Non procurement Programs" in accordance with Executive Orders No. 12,549 and No. 12,689, "Debarment and Suspension". (See 45 CFR part 76). This list contains the names of parties debarred, suspended, or otherwise excluded by agencies, and contractors declared ineligible under statutory authority other than Executive Order No. 12549. Subcontractors with awards that exceed the simplified acquisition threshold shall provide the required certification regarding their exclusion status and that of their principals prior to award. I. Contractor certifies to County that, to the best of its knowledge and belief: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of Contractor, to 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 any employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative contract, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative contract. (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, or a Member of Congress in connection with this federal contract, grant, loan, or cooperative contract, Contractor shall complete and submit Standard From-LLL, entitled "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) 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 Contract imposed by 31 USC § 1352. 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. Contractor shall require this certification from all recipients of Grant funds by including it in and requiring that it be included in all contracts pursuant to which Grant funds are paid. m. The Americans with Disabilities Act of 1990, as amended (codified at 42 USC 12131 et. seq.), ORS 659A.l00 to 659AA09, and all regulations and administrative rules established pursuant to those laws, and in the conduct of all programs, services and training associated with the delivery of services funded with the Grant. n. Contractor shall comply with Executive Order 11246, entitled "Equal Employment Opportunity," as amended by Executive Order 11375, and as supplemented in Department of Labor regulations (41 CFR Part 60). OMB Circular A -102, Revised. o. Contractor shall comply with the Pro-Children Act of 1995 (codified at 20 USC § 6081 et. seq.). /grants/2009-1l/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 8 of 32 Updated 8/22/2011 p. Contractor shall comply with the federal Health Insurance Portability and Accountability Act of 1996 (\\HIPAA") and the federal regulations implementing HIPAA data and transactions and security and privacy requirements for protected health information and conduct activities in compliance with HIPAA. Individually Identifiable Health Information about specific individuals is confidential. Individually Identifiable Health Information related to specific individuals may be exchanged between County and DHS for purposes directly related to the provision of services to Clients which are funded in whole or in part under this Agreement. However, Contractor shall not use or disclose any Individually Identifiable Health Information about specific individuals in a manner that would violate DHS Privacy Rules, OAR 410-014-0000 et. seq. or DHS Notice of Privacy Practices, if done by DHS. A copy of the most recent DHS Notice of Privacy Practices is posed on the DHS web site at http://www.dhs.state.or.us/policy/admin/infosecuritylist.htm or may be obtained from DHS. q. By signature of this Contract, Contractor agrees to the terms and conditions of that certain grant contract by and between the County and the State of Oregon for this project, a copy of which is on file with the County, as if each and every term and condition were set out herein in full. r. That the funds made available to the Contractor under this Contract shall not be used to supplant other funds, but will be used to increase the amounts of such funds that would, in the absence of funds under this Contract, be made available for the Project. s. That matching funds (other private grants, in-kind services and volunteer hours) required to pay the portion of the cost of the Project shall be in addition to funds that would otherwise be available for the Program by Contractor and shall be provided as required in this Contract. t. Contractor agrees to comply with the financial and administrative rules applicable to the project. u. Contractor certifies that it will provide a drug-free workplace by publishing a statement notifying its employees that the unlawful manufacture, distribution, dispensation, possession or use of a controlled substance, except as may be present in lawfully prescribed or over-the-counter medications, is prohibited in Contractor's workplace or while providing services to DHS clients. Contractor's notice shall specify the actions that will be taken by Contractor against its employees for violation of such prohibitions. Contractor shall establish a drug free awareness program to inform its employees about: the dangers of drug abuse in the workplace, Contractor's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse Violations; provide each employee to be engaged in the performance of Work under this Contract a copy of this paragraph, that as a condition of employment to perform Work under this Contract, the employee will abide by the terms of this paragraph and notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five (S) days after such conviction; notify DHS within ten (10) days after receiving notice under the previous subparagraph from an employee or otherwise receiving actual notice of such conviction; impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program by any employee who is so convicted as required by Section 5154 of /grants/2009-11/201G-11/Provider Contracts/Mary's Place -Doc.1l2011·492Page 9 of 32 Updated 8/22/2011 the Drug-Free Workplace Act of 1988; and make a good-faith effort to continue a drug-free workplace through implementation of this paragraph. Neither Contractor, nor any of Contractor's employees, officers, agents or subcontractors may perform any work required under this Contract while under the influence of drugs. For purposes of this paragraph, "under the influence" means: observed abnormal behavior or impairments in mental or physical performance leading a reasonable person to believe the Contractor or Contractor's employee, officer, agent or subcontractor has used a controlled substance, prescription or non-prescription mediation that impairs the Contractor or Contractor's employee, officerl agent or subcontractor's performance of essential job function or creates a direct threat to the DHS clients or other. Violation of any provision of this paragraph may result in termination of the Contract. v. Contractor shall agree to, sign l date and comply with the Certifications regarding Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug-Free Workplace Requirements, marked Exhibit "0" attached hereto and by this reference incorporated herein. w. Contractor shall comply with federal rules and statutes pertaining to the Substance Abuse, Prevention, and Treatment Block Grant, including the reporting provisions of the Public Health Services Act (42 USC 300x through 300x-21) x. If and when federal or state grants have special conditions specific to the grantl the source will be marked Exhibit E, attached hereto and incorporated herein by this reference. 10. Under Expenditure of Funds. Funds determined by County to be under expended or unexpended, or unencumbered for authorized expenditures, shall be withheld by County from payment, refunded to the State, or reallocated by County as may be authorized or required. a. Unauthorized Expenditures: Any funds expended for unauthorized purposes shall be deducted from funds otherwise payable to Contractorl or otherwise subject to recovery by County and refunded to the Statel or reallocated by County as may be authorized or required. 11. Equipment. All equipment with a value of greater than $5,000 and purchased with Commission or County funds shall be marked as such, and will revert to County as its property when the program that purchased the equipment no longer exists or the equipment is no longer used for the purpose for which it was purchased. 12. Indemnity. a. To the fullest extent permitted by law Contractor shall indemnifyl save harmless and defend the State of Oregon, the Commission, its officers, agents and employees, and the County, its officers, agents and employees from and against any and all claims, lawsuits, or actions for damages, costs, losses and expenses, arising from Contractor torts, as the term tort is defined in ORS 30.260(8). b. To the extent permitted by Article XI, Section 10, of the Oregon Constitution and the Oregon Tort Claims Act, ORS 30.260 through 30.300, to the extent the Act is applicable,_County shall defend, save, hold harmless, and indemnify Contractor and its officers, employees and agents from and against all claims, suits, actions, losses, damages, liabilities, costs and expenses of any nature resulting from or arising out of, or relating to the activities of County or its /grants/2009-11/201().11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 10 of 32 Updated 8/22/2011 officers, employees, contractors, or agents under this Contract, except for liability ariSing solely out of the wrongful acts of employees or agents of the Contractor. 13. Contract Amendments. The parties may from time to time request amendments to this Contract. All such amendments, which are mutually agreed upon by and between the parties, shall be reduced to writing and by reference incorporated herein. 14. Early Termination. This Contract may be terminated as follows: a. Mutual Consent. County and Contractor, by mutual written agreement, may terminate this Contract at any time. b. Party's Convenience. County or Contractor may terminate this Contract for any reason upon 30 calendar days written notice to the other party. c. For Cause. County may also terminate this Contract effective upon delivery of written notice to the Contractor, or at such later date as may be established by the County, under any of the following conditions: (1) If funding from state or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services as required in this Contract. This Contract may be modified to accommodate the change in available funds. (2) If state laws, regulations or guidelines are modified, changed or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this Contract or are no longer eligible for the funding proposed for payments authorized by this Contract. (3) In the event suffiCient funds are not appropriated for the payment of consideration required to be paid under this Contract, and if County has no funds legally available for consideration from other sources. (4) If any license or certificate required by law or regulation to be held by the Contractor to provide the services required by this Contract is for any reason denied, revoked, suspended, not renewed or changed in such a way that the Contractor no longer meets requirements for such license or certificate. (5) If County disbursements of financial aSsistance under this Contract for a particular Activity or Service is reduced for any reason, County is not required to utilize other County funds to replace the funds no longer disbursed under this Contract as a result of the disbursement reduction. Furthermore, County may, from and after the date of a disbursement reduction described in the preceding sentence, reduce or eliminate the quantity of Activities or Services within a particular Funding Area commensurate with the size of the disbursement reduction for that Funding Area. (6) Notwithstanding the foregOing, County shall make payments to reimburse Contractor for services provided prior to the effective date of termination where such services are authorized pursuant to this Contract and are not disputed by County. d. Contractor Default or Breach. The County, by written notice to the Contractor, may immediately terminate the whole or any part of this Contract /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 11 of 32 Updated 8/22/2011 under any of the following conditions: (1) Contractor fails to perform, observe or discharge any of its covenants, agreements or obligations set forth herein, including but not limited to, Contractor's failure to comply with the Plan; (2) Any representation, warranty or statement made by Contractor herein or in any documents or reports relied upon by County to measure Contractor's performance hereunder, including without limitation, the conduct of Activities and or delivery of Services, the expenditure of financial assistance or the performance by Contractor, is untrue in any material respect when made; (3) Contractor (i) applies for or consents to the appOintment of, or taking of possession by, a receiver, custodian, trustee, or liquidator of itself or all of its property, (ii) admits in writing its inability, or is generally unable, to pay its debts as they become due, (iii) makes a general assignment for the benefit of its creditors, (iv) is adjudicated a bankrupt or insolvent, (v) commences a voluntary case under the Federal Bankruptcy Code (as now or hereafter in effect), (vi) files a petition seeking to take advantage of any other law relating to bankruptcy, insolvency, reorganization, winding up, or composition or adjustment of debts, (vii) fails to controvert in a timely and appropriate manner, or acquiesces in writing to, any petition filed against it in an involuntary case under the Bankruptcy Code, or (viii) takes any action for the purpose of effecting any of the foregoing; or (4) A proceeding or case is commenced, without the application or consent of Contractor, in any court of competent jurisdiction, seeking (i) the liquidation, dissolution or winding-up, or the composition or readjustment of debts, of Contractor, (ii) the appOintment of a trustee, receiver, custodian, liquidator, or the like of Contractor or of all or any substantial part of its assets, or (iii) similar relief in respect to Contractor under any law relating to bankruptcy, insolvency, reorganization, winding-up, or composition or adjustment of debts, and such proceeding or case continues undismissed, or an order, judgment, or decree approving or ordering any of the foregoing is entered and continues unstayed and in effect for a period of sixty consecutive days, or an order for relief against Contractor is entered in an involuntary case under the Federal Bankruptcy Code (as now or hereafter in effect). e. County Default or Breach. Contractor may terminate this Contract in the event of a breach of this Contract by the County. Prior to such termination, the Contractor shall give to the County written notice of the breach and intent to terminate. If the County has not entirely cured the breach within 10 calendar days of the date of the notice, then the Contractor may terminate this Contract at any time thereafter by giving notice of termination. 15. Payment on Early Termination. Upon termination pursuant to paragraph 14, payment shall be made as follows: a. If terminated under subparagraphs 14 a through 14 c of this Contract, the County shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. County shall not, however, pay Contractor for any obligations or liabilities incurred by Contractor after Contractor receives written notice of termination. b. If this Contract is terminated under subparagraph 14 d of this Contract, County /grants!2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 12 of 32 Updated 8/22/2011 obligations shall be limited to payment for services provided in accordance with this Contract prior to the date of termination, less any damages suffered by the County. c. If terminated under subparagraph 14 e of this Contract by the Contractor due to a breach by the County, then the County shall pay the Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. 1~. Remedies. In the event of breach of this Contract the parties shall have the following remedies: a. Termination under subparagraphs 14 a through 14 c of this Contract shall be without prejudice to any obligations or liabilities of either party already reasonably incurred prior to such termination. Contractor may not incur obligations or liabilities after Contractor receives written notice of termination. Additionally, neither party shall be liable for any indirect, incidental, consequential or special damages under this Contract or for any damages of any sort arising solely from the termination of this Contract in accordance with its terms. b. If terminated under subparagraph 14 d. of this Contract by the County due to a breach by the Contractor, County may pursue any remedies available at law or in eqUity. Such remedies may include, but are not limited to, termination of this Contract, return of all or a portion of this Contract amount, payment of interest earned on this Contract amount, and declaration of ineligibility for the receipt of future contract awards. Additionally, County may complete the work either itself, by contract with another Contractor, or by a combination thereof. If the cost of completing the work exceeds the remaining unpaid balance of the total compensation provided under this Contract, then the Contractor shall pay to the County the amount of the reasonable excess. c. In addition to the remedies in paragraphs 14 through 17 of this Contract for a breach by the Contractor, the County also shall be entitled to any other equitable and legal remedies that are provided by law. d. If amounts previously paid to Contractor exceed the amount due to Contractor under this Contract, Contractor shall repay any excess to County upon demand. e. If the County breaches this Contract, Contractor's remedy shall be limited to termination of this Contract and receipt of Contract payments to which Contractor is entitled to the date of County's breach. f. Neither County nor Contractor shall be held responsible for delay or default caused by fire, civil unrest, labor unrest, riot, acts of God, or war where such cause was beyond reasonable control of County or Contractor, respectively. Contractor shall, however, make all reasonable efforts to remove or eliminate such a cause of delay or default and shall, upon the cessation of the cause, diligently pursue performance of its obligations under this Contract. For any delay in performance as a result of the events described in this subparagraph, Contractor shall be entitled to additional reasonable time for performance that shall be set forth in an amendment to this Contract. g. The passage of this Contract expiration date shall not extinguish or prejudice the County's or Contractor's right to enforce this Contract with respect to any default or defect in performance that has not been cured. Specifically, but without limiting the generality of the preceding sentence, termination of this Contract shall not affect County's right to recover from Contractor, in accordance with the /grants/2009-1l/2010-1l/Provider Contracts/Mary's Place -Doc. # 2011-492Page 13 of 32 Updated 8/2U2011 terms of this Contract, any financial assistance disbursed to Contractor that is identified as an Underexpenditure or Misexpenditure, as those terms are defined in the State. 17. Contractor's Tender upon Termination. Upon receiving a notice of termination of this Contract, Contractor shall immediately cease all activities under this Contract unless County expressly directs otherwise in such notice of termination. Upon termination of this Contract, Contractor shall deliver to County all documents, information, works-in-progress and other property that are or would be deliverable had this Contract been completed. Upon County's request, Contractor shall surrender to anyone County designates, all documents, research, objects or other tangible things needed to complete the work. 18. No Third Party Beneficiaries. County and Contractor are the only parties to this Contract and are the only parties entitled to enforce its terms. Nothing in this Contract gives or provides any benefit or right, whether directly, indirectly, or otherwise, to third persons unless such third persons are individually identified by name in this Contract and expressly described as intended beneficiaries of this Contract. 19. Successors in Interest. The provisions of this Contract shall be binding upon and inure to the benefit of the parties and their successors and approved assigns, if any. 20. Work Standard. Contractor shall be solely responsible for and shall have control over the means, methods, techniques, sequences and procedures of performing the work, subject to the requirements of this Contract and any amendments thereto and shall be solely responsible for the errors and omissions of its employees, subcontractors and agents. For goods and services to be provided under this Contract, Contractor agrees to: a. perform the work in a good, workmanlike, and timely manner using the schedule, materials, plans and speCifications approved by County; b. comply with all applicable legal requirements; c. comply with all programs, directives, and instructions of County relating to safety, storage of equipment or materials; d. take all precautions necessary to protect the safety of all persons at or near County or Contractor's facilities, including employees of Contractor, County and any other contractors or subcontractors and to protect the work and all other property against damage. 21. Drugs and Alcohol. Contractor shall enforce a zero tolerance as to dealing, possession, or use of drugs or alcohol by Contractor or its employees, subcontractors and agents while performing work under this Contract, and upon request by County. demonstrate that a zero-tolerance drug testing policy is in place. 22. Expense Reimbursement. If the conSideration under this Contract provides for the reimbursement of Contractor for expenses, County shall only reimburse Contractor for expenses reasonably and necessarily incurred in the performance of this Contract. Expenses reimbursed shall be at the actual cost incurred, including any taxes paid, and shall not include any mark-up unless the mark-up on expenses is specifically agreed to in this Contract. The cost of any subcontracted work approved in this Contract shall not be marked up. Contractor shall not bill County for any time expended to complete the documents necessary for reimbursement of expenses or for payment under this Contract. /grants/2009-11/201Q-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 14 of 32 Updated 8/22/2011 23. Criminal Background Investigations. a. Contractor understands that Contractor is subject to periodic criminal background investigations by County and, if such investigations disclose criminal activity not disclosed by Contractor, such non-disclosure shall constitute a material breach of this Contract and County may terminate this Contract effective upon delivery of written notice to the Contractor, or at such later date as may be established by the County. b. Contractor shall take reasonable precautions to assure that Contractor's and its subcontractors' employees and agents do not present a substantial risk of harm to children who receive services from contractor or its subcontractors. Such precautions should, if practical, include inquiries through the Sheriff's office or the Oregon State Police about criminal convictions for child abuse, any sexual offense, child neglect or any other offense against persons which Is indicative of harm to children. No one who has demonstrated behavior that may have a detrimental effect on a child shall have access to children. 24. Reports. Contractor shall provide County with periodiC reports at the frequency and with the information prescribed by County. Further, at anytime, County has the right to demand adequate assurances that the services provided by Contractor shall be in accordance with the Contract. Such assurances provided by Contractor shall be supported by documentation from third parties. 25. Access to Records -Audit. Contractor shall maintain fiscal records and all other records pertinent to this Contract. a. All fiscal records shall be maintained pursuant to generally accepted accounting standards, and other records shall be maintained to the extent necessary to clearly reflect actions taken. All records shall be retained and kept accessible for at least three years following the final payment made under this Contract or all pending matters are closed, which ever is later. If an audit, litigation or other action involving this Contract is started before the end of the three year period, the records shall be retained until all issues arising out of the action are resolved or until the end of the three year period, whichever is later. Contractor shall furnish County with its annual audits or reviews that relate in any manner to the funds received under this Contract. b. County, State of Oregon and the Federal Government and their authorized representatives shall have the right to direct access to all of Contractor's books, documents, papers and records related to this Contract for the purpose of conducting audits and examinations and making copies, excerpts and transcripts. These records also include licensed software and any records in electronic form, computer hard drives, tape backups and other such storage devices. County shall reimburse Contractor for Contractor's cost of preparing copies. At Contractor's expense, the County, the Secretary of State's Office of the State of Oregon, the Federal Government, and their duly authorized representatives, shall have license to enter upon Contractor's premises to access and inspect the books, documents, papers, computer software, electronic files and any other records of Contractor which are directly pertinent to this Contract for the purpose of making audits, examinations, excerpts, copies and transcriptions. c. Contractor shall document the expenditure of all funds received under this Contract. Contractor shall maintain all expenditure records in accordance with generally accepted accounting principles and in suffiCient detail to permit County, State of Oregon and the Federal Government to verify how the finanCial assistance paid under this Contract was expended. /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 15 of 32 Updated 8/22/2011 26. Ownership of Work. All work of Contractor that results from this Contract (the "Work Product") is the exclusive property of County. County and Contractor intend that such Work Product be deemed "work made for hire" of which County shall be deemed author. If, for any reason, the Work Product is not deemed "work made for hire," Contractor hereby irrevocably assigns to County all of its right, title, and interest in and to any and all of the Work Product, whether arising from copyright, patent, trademark, trade secret, or any other state or federal intellectual property law or doctrine. Contractor shall execute such further documents and instruments as County may reasonably request in order to fully vest such rights in County. Contractor forever waives any and all rights relating to Work Product, including without limitation, any and all rights arising under 17 USC § 106A or any other rights of identification of authorship or rights of approval, restriction or limitation on use or subsequent modifications. County shall have no rights in any pre-existing work product of Contractor provided to County by Contractor in the performance of this Contract except to copy, use and re-use any such work product for County use only. If this Contract is terminated prior to completion, and the County is not in default, County, in addition to any other rights provided by this Contract, may require the Contractor to transfer and deliver all partially completed work products, reports or documentation that the Contractor has specifically developed or specifically acquired for the performance of this Contract. 27. Materials. At all times, Contractor shall make reasonable efforts to use recycled materials in the performance work required under this Contract. 28. Constraints. Pursuant to the requirements of ORS 279B.220 though 279B.235, as applicable, and Article XI, Section 10, of the Oregon Constitution, the following terms and conditions are made a part of this Contract: a. Contractor shall: (1) Make payments promptly, as due, to all persons supplying to Contractor labor or material for the performance of the work provided for in this Contract; (2) Pay all contributions or amounts due the Industrial Accident Fund from such Contractor or subcontractor incurred in the performance of this Contract; (3) Not permit any lien or claim to be filed or prosecuted against County on account of any labor or material furnished; and (4) Pay to the Department of Revenue all sums withheld from employees pursuant to ORS 316.167. b. If Contractor fails, neglects or refuses to make prompt payment of any claim for labor or services furnished to Contractor or a subcontractor by any person in connection with this Contract as such claim becomes due, the appropriate County representative may pay such claim to the person furnishing the labor or services and charge the amount of the payment against funds due or to become due Contractor by reason of this Contract. c. No person shall be employed for more than ten (10) hours in anyone day, or forty (40) hours in anyone week, except in cases of necessity, emergency, or where the public policy absolutely requires it, and in slJch cases, the person so employed for the excessive hours shall receive at least time and one-half pay as follows: (1) For all overtime in excess of eight hours in anyone day or 40 hours in any one week, when the work week is five consecutive days, Monday through Igrants!2009·11/2010-1l/Provider Contracts/Mary's Place -Doc. 1# 2011·492Page 16 of 32 Updated 8/22/2011 Friday; or (2) For all overtime in excess of 10 hours in anyone day or 40 hours in any one week when the work week is four consecutive days, Monday through Friday, and (3) For all work performed on Saturday and the following legal holidays: • New Year's Day on January 1. • Memorial Day on the last Monday in May. • Independence Day on July 4. • Labor Day on the first Monday in September • Thanksgiving Day on the fourth Thursday in November. • Christmas Day on December 25 • Each Su nday. (4) An employer must give notice in writing to employees who perform work under this Contract in writing, either at the time of hire or before commencement of work on the Contract, or by posting a notice in a location frequented by employees, of the number of hours per day and days per week that employees may be required to work. Persons employed under this contract shall receive at least time and a half pay for work performed on the legal holidays specified in any applicable collective bargaining agreement or in ORS 279B.020(1}(b}(B} to (G) and for all time worked in excess of 10 hours in anyone day or in excess of 40 hours in anyone week. d. In the case of contracts for personal services as described in ORS 279A.055, the employee shall be paid at least time and a half for all overtime worked in excess of 40 hours in anyone week, except for individuals under personal services contracts who are excluded under ORS 653.010 to 653.261 or under 29 U.S.C 201 to 209 from receiving overtime. e. Contractor shall promptly, as due, make payment to any person, co-partnership, association or corporation furnishing medical, surgical or hospital care or other needed care and attention, inCident to sickness or injury to the employees of Contractor, of all sums which Contractor agrees to pay for such services, and all monies and sums which Contractor collected or deducted from the wages of Contractor's employees pursuant to any law, contract or agreement for the purpose of providing or paying for such services. f. This Contract is expressly subject to the debt limitation of Oregon counties set forth in Article XI, Section 10, of the Oregon Constitution, and is contingent upon funds being appropriated therefore. Payment under this Contract is also subject to the County's receipt of funds from the State of Oregon, appropriated for services provided under the direction of the Commission. Any provisions herein, which would conflict with law, are deemed inoperative to that extent. 29. Contractor Not an Agent of County. It is agreed by and between the parties that Contractor is not carrying out a function on behalf of County, and County does not have the right of direction or control of the manner in which Contractor delivers services under this Contract or exercise any control over the activities of Contractor. 30. Partnership. County is not, by virtue of this Contract, a partner or joint venturer with Contractor in connection with activities carried on under this Contract, and shall have no obligation with respect to Contractor's debts or any other liabilities of each and every nature. /grants/2009-1l/201O-1l/PrOYider Contracts/Mary's Place -Doc. #l2011-492Page 11 of32 Updated 8/22/2011 31. Insurance. In conjunction with all services performed under this Contract: a. Contractor shall maintain Commercial General Liability insurance with minimum limits of liability which are not less than the tort claim limits set forth in ORS 30.260, as may be adjusted from time to time and shall furnish an endorsement which names Deschutes County, the Children and Families Commission, and their officers, agents, employees and volunteers as an additional insured. b. Contractor shall maintain automobile liability insurance, if applicable, of not less than the limits set forth below. Insurance shall provide coverage for any motor vehicle driven during the course of providing services under this Contract. (1) $500,000, combined single limit, or (2) Split limits of $250,000 per person, $500,000 per occurrence, $100,000 property damage. c. All insurance poliCies shall be written on an occurrence basis and be in effect for the term of this Contract. Authorization from Deschutes County is required for any policy written on a Claims Made basis. d. Proof of Workers Compensation from the Contractor is required prior to the commencement of the Contract. e. Prior to executing this Contract, the Contractor shall provide County the Certificates of Insurance, and upon County's request, certified copies of Insurance poliCies and declarations. f. Contractor shall immediately notify County if any insurance coverage required by this Contract will be canceled, not renewed, or modified in any way. g. Thirty-day cancellation notice is required on all policies. 32. Non-Appropriation. In the event sufficient funds shall not be appropriated for the payment of consideration required to be paid under the Contract, and if County has no funds legally available for such consideration from other sources, then County may terminate the Contract in accordance with Section 14c of this Contract. 33. Attorney Fees. In the event an action, suit or proceeding, including appeal there from, is brought for breach of any of the terms of this Contract, or for any controversy arising out of this Contract, each party shall be responsible for its own attorney's fees, expenses, costs and disbursements for said action, suit, proceeding or appeal. 34. Waiver. County's delay in exercising, or failure to exercise any right, power, or privilege under this Contract shall not operate as a waiver thereof, nor shall any single or partial exercise or any right, power, or privilege under this Contract preclude any other or further exercise thereof or the exercise of any other such right, power, or privilege. The remedies provided herein are cumulative and not excluSive of any remedies provided by law. 35. Governing Law. This Contract shall be governed by and construed in accordance with the laws of the State of Oregon without regard to prinCiples of conflicts of law. Any claim, action, suit or proceeding (collectively, "Claim") between County and Contractor that arises from or relates to this Contract shall be brought and conducted solely and exclusively within the Circuit Court of Deschutes County for the State of Oregon; provided, however, if a Claim shall be brought in federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon. CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY /grants/2009-11/2010-1l/Provider Contracts/Mary's Place -Doc. # 2011-492Page 18 of 32 Updated 8/22/2011 CONSENTS TO THE IN PERSONAM JURISDICTION OF SAID COURTS. The parties agree that the UN Convention on Intemational Sales of Goods shall not apply. 36. The provisions of the Deschutes County Code, specifically 2.37.150 are hereby incorporated. Such provisions are available on the internet at the following address: http://web.deschutes.org/dccode/Title2/htmllchapter2.37.htm. 37. Severability. If any term or provision of this Contract is declared by a court of competent jurisdiction to be illegal or in conflict with any law, the validity of the remaining terms and provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if this Contract did not contain the particular term or provision held invalid. 38. Merger Clause. This Contract and the attached exhibits constitute the entire Contract between the parties. All understandings and agreements between the parties and representations by either party conceming this Contract are contained in this Contract. No waiver, consent, modification or change in the terms of this Contract shall bind either party unless in writing signed by both parties. Any written waiver, consent, modification or change shall be effective only in the specific instance and for the specific purpose given. 39. Counterparts. This Contract may be executed in several counterparts, all of which when taken together shall constitute one contract binding on all parties, notwithstanding that all parties are not signatories to the same counterpart. Each copy of this Contract so executed shall constitute an original. 40 . Amendments. This Contract may not be waived, altered, modified, supplemented, or amended in any manner except by written instrument signed by both parties. 41. Notice. Except as otherwise expressly provided in this Contract, any communications between the parties hereto or notices to be given hereunder shall be given in writing, to Contractor or County at the address or number set forth below or to such other addresses or numbers as either party may hereafter indicate in writing. Delivery may be by personal delivery, facsimile, or mailing the same, postage prepaid. a. Any communication or notice by personal delivery shall be deemed delivered when actually given to the designated person or representative. b. Any communication or notice sent by facsimile shall be deemed delivered when the transmitting machine generates receipt of the transmission. To be effective against County, such facsimile transmission shall be confirmed by telephone notice to County's Director of Administrative Services. c. Any communication or notice mailed shall be deemed delivered five (5) days after mailing. Any notice under this Contract shall be mailed by first class postage or delivered as follows: To Contractor: To County: Trish Meyer Saving Grace Violence -Imagine Life Without Hillary Saraceno, Director The Children & Families Commission 1130 NW Harriman, Suite A 1425 NW Kingston Avenue Bend OR 97701 Bend, OR 97701 42. Survival. All rights and obligations shall cease upon termination or expiration of this Contract, except for the rights and obligations set forth in Sections 15 and 16. /grants/2009-1l/2010-1l/Provider Contracts/Mary's Place -Doc. # 2011-492Page 19 of 32 Updated 8/22/2011 Dated this ___ of _____, 2011 BOARD OF COUNTY COMMISSIONERS Tammy Baney, CHAIR Anthony DeBone, VICE CHAIR ATTEST: Recording Secretary Alan Unger, COMMISSIONER CONTRACTOR: iL DATED thiSk~'-'day of August, 2011 By: Trish Meyer Saving Grace -Imagine Violence Life Without , } /grants/2009-11/201G-ll/Provider Contracts/Mary's Place -Doc. II 20 1 1-492Page 20 of 32 Updated 8/22/2011 EXHIBIT A -Part One I_ Contractor shall meet all performance outcomes as outlined in the attached Work Plan (see Exhibit A attachment). II. Contractor shall adhere to the following performance standards: 1. Community Plan: All programs funded by the Children & Families Commission support and advance priorities in the current Deschutes County Community Plan. Identified priorities will address the specific required outcomes for each area. 2. Target Population: CFC funds are allocated for the purpose of serving children ages 0-17 and their families. 3. Emphasis on Prevention: The majority of CFC resources will be expended on prevention efforts within the community. Although not strictly defined, the intent of the CFC Board is to fund programs with evidence of protective factors (based on the target population) and to address risk factors as far "up-stream" as possible. 4. Evidence-based, Best Practices and Outcome Oriented: Proposals must result in positive change in their outcomes over time. Activities and interim outcomes must directly tie to the designated priority outcomes. Projects/programs must meet the standards for "best practices" as provided in OAR 423-001-006 (3). Best Practices are defined as "research-based or evidence-based" programs, practices and principles that have been shown to reliably produce measurable and sustainable improvements in productivity, efficiency, and/or effectiveness. Applicants are free to use best practices recognized by other reputable sources. Reputable sources include journals or web sites of professional organizations, universities, and state or federal government agencies. 5. Sustainabillty: Sustainability is critical to the health and viability of local programs helping children and families. All children's programs will be strengthened by taking strategic actions that increase visibility and community awareness, diversify and increase revenue, increase efficiency and contain costs. CFC will continue to take deliberate actions that promote sustainability. These actions include but are not limited to: a. Sustajnability -Grantees/contractors will be encouraged to strengthen sustainability through (1) public awareness activities, (2) collaboration, (3) cost saving measures, and/or (4) actions to generate added revenue and / or program volunteers. b. Grant Match -The Grantees/contractors must demonstrate that, by the end of the contract period, at least 25% or $20,000, (whichever is less) of project funds will be in the form of cash. The match must come from sources other than the Commission. The source of match must be included in the budget document. Cash match is defined as funds derived by fund raising activities, grants or any source other than state general fund or Federal Medicaid resources. c. Suggestions for CFC -Children's programs are encouraged to contact the Commission (see web site: deschutes.org/CFC) with suggestions on how we might (1) increase resources for local programs or (2) help agencies reduce costs and increase levels of quality service. /grants/2009-11/2010-11/Provlder Contracts/Mary's Place -Doc. # 2011-492Page 21 of 32 Updated 8/22/2011 6. Organizational Capacity: Grantees/contractors must have organizational competencies (e.g. an involved governing board and internal controls) and a demonstrated capacity to deliver a quality of service that incorporates best practice standards. 7. Community Responsibility, Collaboration, and Leverage: The community must be involved in any project supported by the Commission. Funding should help generate additional resources (e.g. cash, volunteers, and facilities) from the community. Grantees/contractors must document community involvement as well as their plans to leverage resources. 8. Accessibility of Services: Accommodations must be made to assure that eligible recipients will be able to benefit from available services, regardless of their school, residence or place of employment. Transportation and any physical access barriers will be addressed so that services and activities are truly accessible. 9. Age, Gender, and Cultural Considerations: Contractors are expected to be culturally competent in the delivery of services and assure that they have the capacity to meet the needs of the targeted population. Contractors shall adhere to the requirements as provided in SB555, and prepare and implement a Cultural Competency Plan if required by the Commission. 10. Reporting Requirements: Contractors will be required to submit the Children & Families Commission standardized Reporting Form, Monitoring/Client StatistiCS, and a Request for Funding on a regular schedule determined at the beginning of the contract period (reporting requirement time lines may vary from the quarterly time line, if approved by the Director at the beginning of the contract period). Reports 15thare due to the Commission by the of the month following the end of the reporting period in which expenses were incurred throughout the life of the contract. Contractors are allowed to submit one late report during the contract period. Subsequent late reporting may result in forfeiture of 10% of their allocated funds for that quarter. If a Contractor is more than 30 days late in submitting required reports, the issue will be brought to the Commission Board and Governing Board for discussion and possible action before any funding is released. A representative from the Contractor's agency will be required to attend. If a Contractor misses the required reporting deadline twice in one contract year, the Contractor must come before the Commission Board and Governing Board and explain why the deadlines were missed. The Commission Board retains the right to discuss and take appropriate action in such matters prior to the release of any funds. Any funds withheld from the Contractor due to late reports will be allocated to Commission's grant fund balance for future distribution. Any grant restrictions or limitations will be taken into account in the future allocation of such dollars. All funds allocated to the grant fund balance will be placed on the Commission's consent agenda for their approval prior to transfer. 11. Community Justice: A portion of the funding through the Commission is related to Juvenile Crime Prevention (JCP) and community justice. JCP work and community justice incorporate crime prevention as well as early intervention. Contractors funded with JCP funds must endorse and support balanced and restorative justice principles. These principles include accountability, community protection, service to crime victims, restoration and competency development. 12. Length of Contract: Contracts will generally be one year in length (generally July 1 -June 30) unless otherwise specified. Updated ",nTn"/grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 22 of 32 13. Contractor's Reporting Requirements: Contractor is required to submit the following: [8J Quarterly Work Plan Report [8J Quarterly CFC Demographics report [8J Quarterly Funds Request o Ongoing reporting into Comet data system. Submit to CFC quarterly. o Program Data submitted to CFC staff semi-annually o Monthly MDS Report (due by the 10th of the month) [8J Office on Violence Against Women, Safe Havens: Supervised Visitation Grant Program Semi-Annual Progress Report. Quarterly reporting due dates: October 17, 2011 January 17, 2012 April 16, 2012 July 16, 2012 r /grants/2009-1l/2010-1l/Provider Contracts/Mary's Place -Doc. # 2011-492Page 23 of 32 Updated 8/22/2011 EXHIBIT C Deschutes County Children" Families Commission (CFC) Co-Branding Goals, Guidelines and Expectations The purpose of this document is to clarify and highlight the co-branding goals, guidelines and expectations of our partner agencies funded by the Children & Families Commission (CFe). The charge of the local CFC is prevention and early intervention in three primary focus areas: Early childhood care and education, reducing high risk behaviors among youth, and protecting children and families from harm. The Commission achieves its charge by engaging the community to identify strengths, gaps and needs in the community and to find solutions for addressing those needs in order to ensure children, youth and families are protected, healthy and successful. This is done through collaboration, partnerships, and investing in needed services and long-term solutions. Funded partners shall include the CFC logo in printed and electronic versions of program reports, brochures, flyers, newsletters, media coverage, and announcements and on the agency web site. Upon execution of the contract, CFC staff will send via e-mail an electronic copy of the CFC logo in a reproduceable format. Funded partners will actively promote the agency's affiliation with CFC by identifying itself as a CFC funded partner agency with a simple statement such as "This program funded in part by the Deschutes County Children & Families Commission". Funded partners will also recognize the support of the CFC at their events and this can be done in the spoken or written program. We understand there are significant costs associated with reprinting brochures and publications. With this in mind, CFC funded programs are not asked to reprint materials right away. Rather, it is expected that as new publications and materials are produced or when it is time to re-order supplies, funded programs shall include modifications in published materials to comply with this policy. As an alternative to reprinting, funded partners may add stickers identifying CFC on current brochures. In the future, the CFC may furnish the stickers. The CFC has set very specific guidelines for community partner use of the CFC logo. Here are a few points to remember when using the CFC community partner logo: 1. The CFC logo and/or agency affiliation line -"Working together to find solutions" should be shown and included with the CFC logo whenever possible in all publicity, news releases, and brochures. 2. You may not alter or crop the logo in any way and when resizing, be certain the logo retains its shape. 3. The recommended minimum width is .75 inches wide. 4. The logo must always be printed in the same color as your publication, i.e., if you are printing a one-color newsletter, use the same color as the newsletter. If you are printing in full color you must use the full color logo. 5. For web applications always use the full-color version and a link to the CFC website at www.deschutes.org/CFC. If you have any questions or concerns about how the logo can be used or the placement of the logo, please contact the CFC office or your agency's assigned CFC staff liaison. /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. 1# 2011-492Page 24 of 32 Updated 8/22/2011 Exhibit 0 Compliance with provisions, requirements of funding source and Federal and State law$, statutes, rules, regulations, executive orders and pOlicies. Contractor certifies under penalty of perjury that the following statements are true to the best of Contractor's knowledge: 1. If Contractor is currently performing work for the County, State of Oregon or federal government, Contractor by signature to this Contract declares certifies that; Contractor's Work to be performed under this (ontract create no potential or actual conflict of interest as defined by ORS 244 and no rules or regu lations of Contractor's employee agency (County State or Federal) would prohibit Contractor's Work under this Contract. Contractor is not an "officer," "employee," or "agent" of the County, as those terms are used in ORS 30.265. 2. No federally appropriated funds have been paid or shall be paid, by or on behalf of Contractor, to 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 the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. a. If any funds other than federally appropriated funds have been paid or shall be paid to 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 this federal contract, grant, loan, or cooperative agreement, Contractor agrees to complete and submit Standard Forrn-LLL "Disclosure Form to Report Lobbying," in accordance with its instructions. Standard Form-LLL and instructions are located in 45 CFR Part 93 Appendix B. If instructions require filing the form with the applicable federal entity, Contractor shall then as a material condition of this Contract also file a copy of the Standard Form-LLL with the Department. This filing shall occur at the same time as the filing in accordance with the instructions. b. Contractor understands this certification is a material representation of fact upon which the County and the Department has relied in entering into this Contract. Contractor further understands that submission of this certification is a prerequisite, imposed by 31 USC 1352 for entering into this Contract. 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. c. Contractor shall include the language of this certification in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly. d. Contractor is solely responsible for aliliabiJity arising from a failure by Contractor to comply with the terms of this certification. Additionally, Contractor promises to indemnify County for any damages suffered by County as a result of Contractor's failure to comply with the terms of this certification. 3. Contractor understands that, if this Contract involves federally appropriated funds, this certification is a material representation of facts upon which reliance was placed when this Contract was made or entered into, submission of this certification is a prerequisite for make or entering into this Contract imposed by Section 1352, Title 311, U.S. Code and that 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 $100,000 for each failure. Contractor Signature /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 25 of 32 Updated 8/22/2011 EXHIBITE DepaatmeDt ofJustice Office 011 YIOleDee ApiDSt Women AWARB CONTINUATION SHEET 'AGE Ceopentive AgreeIneat AWARD DATE OfI2lI2lIIO SPECLfL CONDITIONS 1. 'The ncipicat ....to comply willi abc 6aDdal_1iIrainiIIIatM .........set fordI in die cum:ot ecIitioD orlile OfficcOil VtOIcacC ApiaIt WCIIlCD (OVW),......GniarJ Mr I l'III"f!I c:Jaidt. 2. TIle RICipiaIt ~that faibn to submit IIllCceptabIc Equal Employmeat ()ppaduaity Pia (ifrecipient is rcquiI:at to IUbmit OlIO pullU8Dt to 28 c.F.R. Section 42.302).·lhItia IpJIl1MId by Ibc Office Cor Civil Jti&hta. is • vioIaaiOll ofks Cenificd ArsuraIIce$ _ may result in suspcosion or iamiDadioo or ftmdiog, uatiI sucb time u IIIe recipieat is ill oomp6ance. 3. TIle n:c:ipimtagrees tocompty with IIIe cqrnizational audit ~ofOMB cu.:w.r A-133, Audit ofSlates. Local GoYemmeats," Noo-PJrit o,paizatlorw, IIld fbdber uadentrDd& ad....tbat ftDIs may be withbeId. or odIerRllalcd~maybeialpolOd,itGUtr'lndi.audit __(if..,)hmOMBC'acuJarA-133"'(_ uy .....otD01 pIIIl"')IR_A~"pnIIIIpdy ....m.d. fadhcrdclcribed ill lbeaunDl edi&ioIl of'1IIeOYW a..drI GrInIJ ~0uicIr:. 4. Recipicat uDlbl'.luk tad....-tIIat it CIII80t UIO fIllY fiIdcraI tUucII. ehber cIinIcdy or~.ia .uppon oflhe OIIIIcaiw:Dl.RpcaI. mOdi~or....oflilY law. n:pJatien orpOlicy. at 1lIIY Ie¥d ofJOVIIIIII1CIIl without Ibc expraa priorWiiaeo appi'oYII ofOVW. in order. avoid 'rioIIdioD ()f 18l1SC § 1913. 1be ncipiCIDt may. ~.usc: fecknd fimcJs to ~wiIb and ~iDfonnIIioiI Co Fedcla1. -'1oc:Il.1rilia1111d territorial public officialsand·· ~. • to -.,p1Dd ~~to ......orelidtilllle'dOmeStic v.iote8ce. daaias v.ioIcnce. seXualassaCI1IIkiag (as1bole ierms,. defiaed in 42.tJSC 13925(.}) whee suCh cOllrbOndion ad provirion of ioformrtioa is coaaiateat willi Ibe activities otherwiIC audIorized UDder ..patpqram. 5. 'The recipieGt must pmmptIy.mcrto tile DOl 010 811)' credible tMdence!blt. priacipal, employee. agent. c:oatrIClOI", subpatcc.lIJboaolnlCtor. or GIber pcnoa ....ciIber J) subaIiUIIcl .......forJIIIDI fiIIIds under the FaIle Claims Ad; or 2) commillled. erimiaII or Civil ¥io1atioa 01'....peMiaiDJ to hid. coafIict of'iatcnst, bn'bery. patuity. or similar mialoaduct iDwIviDI JIIIlt fiDds. This CQIldition abo I!pPIies to 811)'~PoIentiaI had, waste, abuse, or miscoaduct sboukI be rcpoItecf so abc OIG by mriI: Office orlile IatIpecf«GeaeraI U.s. DcpertmcQt or Justice JDVaIipdoas Division 9$0 PeI8yMaia AYeDUe. N.W. Room 4706 W'1bia&ton. IX 2OS3O HDIIiJ:Gia~v hodiae: (COIIIICt iahldltiGo in Euslisb ad SpaaiIb): (100) 169-4499 or bodine fiIlt: (202) 6 J6-9881 Additical iDformaIiOll is available fiom abc DOJ 010 wdIsite It www.usd!g.p/1Jii. /grants/2009-1l/201()'11/Provider Contracts/Mary's Place -Doc. "2011-492Page 26 of 32 Updated 8/18/2011 EXHIBITE DcpartmCIII ofJustice Office on Violcoc:c ApiDSt Women AWARD CONTINUAnON SHEET Cooperative Agreemeut AWAAD DATE O9I23IlOIO SPECIAL CONDmONS 7. The n:cipienIl8fee5to IXItIIply with any additiooal rcquitemeats that may be imposed during the grut performance period ifthe qcocy deIcrmincs that die mcipieat ill hip.risk JrIDICC. cr. 28 c.P.R. pans 66, 70. 8. The pllllee IlJl=lto comply with all relevmt ItIIUlOry _ reguIafOIy ~wbidI may iDc:1udr:, among other relevant autborities. die Violcoc:c ApiDst Womcu Act of 1994, P.L. 103-32l, the VlOlcoc:c Apinst Women Act of 2000, P L 106-386, the Onmibua Crime Control_ Safe StreeIs Act of 1968, 42 U.S.C 3711 et seq .. the Vio\eace ApiDst Women and Deputment or Justice Rautborization Act of2005, P.L. 1()9.162. and OVW's implemeatina replatioIIIIat 28 Cf'R Pan 90. 9. Approval ofthis IWIId does DOt indiCllc approval ofll1Y c:oosulllllt ratcin excess of$6S0 per day. A dc:Iailed justification must be submitted to and approved by the Office OIl Violence Against Women prior to obligation or cxpendiIun: ofsuch fuDds. 10. The DireetorofOVW. upoa I fiDdiD&thaI then:hu beea lRlbstMtial flaiJlftby the ......tocomply with applicable IawI, n=pIItioos."or die tamI aod c:ouditioaI ofdle ...or c:oopealliYC apomc:at. will 1ermiDate or JUSpCIId UDliI the DinIctor» satisfied dud there is DO Iooger IUCb flillae.1II or pill ofthe ....or coopendiw: ~in ICCClfdaoce with the provisioI1s of 211 CPR Part 18. .. appticable mutIIiI muIIDdis. 1 I. The polICe agrees to submil semianmml proaras n:pons dial dac:ribe project acdYi1ia during the n:ponina period. Prop:sa n::portI must be submitll:d wi1hh130 dayI after die cad or die n:portina pcriclda. wbidlare JIQIIIIr)' I.JUIIC 30 _ July J • December 31 for Ibt duratioo ofthe ,WIld. Futlim aWII'ds may be witbbeI4 ifproarcsa n:poI1S II'C clelinquenL GnDtces an: requin:d to submit this informaIion 0DIiDt.1broagb the Gnmts M.ImqemCIIt Sysan (OMS), 011 the sernHmual pn.'Itp'eIS report for the rell!MlDt OVW pnt JX'OII'IIDS. 12. Under the Go'lenllllClll PctfonnIDc:e aod R.aubs Act COPRA) aDd VA WA lOOO, sram-are required 1.0 collect and maintain data that measuR! the effectiYCDCll$ oftheir pant.fimdcd. KIivities.. Ac:conIiDJiy, the araatcc qrees to submit 1CItIi-IIIDIIII electronic pn.'Itp'eIS tepOIU OIl pR)II'IID IIdivities UId propaD effec:dvc:aess 1I1IIIIIIIIft$. WOI'IIlationthat gnutees must collect underGPRA and VAWA lOOO inc:IudeI, but is DOt limited to: I) IIUI1lber ofpersons served; 2) mamber ofpcrIOIIS IICddDg IICnices who c:ould DOt be acned; 3} 1IUIIIber ofsupervised Yisitatioo _ exchange CCllters supported by 11K: prosram; 4) IItImbcr ofsupervised visits betwcea pmDlS aDd c:hiIdral; _ S) IlIIUIbcr ofsupervised exchanges between parents and cbildren. 13. A 6naI 'I'CpOI1, whicb provides a summary ofprogress toward achieving the goals and objectives ofthe award, si,gniflClUlt results, BDd lOY products developed uDder the award, is due 90 days after the end ofthe award. The Final Progra& Report should be submitted 1.0 !he Office 011 Violcoc:c Apinst WOIIIID thmuab the Gnm1s Management System with the Report Type indicated lIS "Final". 14. TIle pIII= qrees to comply with the applicable requirem.cnls of28 C.F.R. Part 38. the Department ofJustice reauJation governina "Equal TI'W.II:IImt for Faith BISCd Orpuizalions" (the "Equal Treatment R.eplation-). The Equal Treatmalt RquIation provides in part that Department ofJustice grant awmIs ofdirect fiIIIcliIIa may DOl be used 1.0 I\md any iDIIereDtJy reliaious activities. such as worship, n:Jigious instnJctiou. or proseJyti2aQon. Ilccipienls ofdirect graDII may still engage in iDberendy religious activities. but such activities must be scpII'IIIC in time« place &om the Depanmeot ofJustice ftmdcd program. BDd pamc:ipaOOa in such activities by individuals I'IIIICeiving services &om the grantee or a sub-pnlee must be voluDIary. The Equal Treatment Regulation also maIa::s clear that orpuizalions participating in programs directly fimdcd. by the IJcIpartment of1ustice are DOt permitll:d to discriminate in the provision ofservices 00 the basis ofI beneficiaJy'. religioo. /grants/2009-11/201()"11/Provider Contracts/Mary's Place -Ooc.1I 2011-492Page 27 of 32 Updated 8/18/2011 EXHIBITE Depamncut ofJUSIice Offic:e on Violc:uce Apinst Women AWARD CONTINUATION SHEET PAGE Cooperative AgreelDellt AWARDDAtE O9I2lIlOIO SPECIAL CONDmONS 19. W'dhia '" days after Ihc cad of18)' coofCNDCC, mcetiD&. mrat.1eIIIiDar, symposium, ttaiDiallldivity. or similar event ftmdcd VIldcr lbiIawanr. UId Ihc IOtal COlt ofwIdcIa c.u:eedI $20.,000 in award fUnds, Ihc recipieat must provide Ihc propam manapr wid! Ihc folJowins information IDd icemizecl COllI: I) name ofeveot; 2) event dates; 3) IocadoII of C'lCDt; 4) number offecknl aueodees; S) aurober of1IOrI--feden.l1UImCIces; 6) COi5lI ofevent 1If*C. iDdudiDa rooms for break-out sessions; 7) costa ofaudio visual acnices; 8) OIberequipmentCOSll (e.... computer fees, lcIepbone fees); 9) COltS ofpriotiJIa UId dislribution; 10) COltS ofmeall pn:widecl duriIIa die mmI; II)COltS offtlfi .........pn:Mded durio& Ihc ne:at; 12) COltS ofCII'CIIt pIaaaer; 13) COIStI ofCWIIl &cilitaton; UId 14) III)" other din:ct COltS 8IOCi1led with the CYalt. The recipient mustallo itemize aDd report 18)' oflbe foIlowiDa attaIdec (mcludiD& participeDlS. prescnten, speakers) COSIIIbIt are pIic1 or n=imbuacd with cooperadvc ~fimds: I) IIICIIla md incideatal expenses (M.tIE portion ofper diem); 2) lod&iD&; 3) 1l.......1atioo to/tiorn evemloc:ation (e.... common carrier. privately owned vehicle (POV»; aDd 4) IOCI1 tnaponaticla (e. ... nmJal car, POV) ateveat Jocadon. Note IbIt ifany item is pIic1 for wid! ~-.or my 0Iber IIOI'I-a'Wa1'd ftmdiDg. dial that poI1:ion of Ibe expcmse does bOt need to be reported. 20. PursulDt to Eurcutive Order 13513, "Federal Leadership on RecfociDs Text MCSSIIiDI WhiIc Driving.· 74 Fed. Res 51225 (Oetober 1,2009), die Department CIICOUI'I.pI .ecipieaIs aad subroc:ipiCDIS to Idopt aDd enforce policies bInDing employees tiorn tt::Itt messagina while driviD& 18)' vebic:le duriq die COWIe ofpcri:InniDs work: fimded by this gram, aod 10 establish workplace safely policies and coodPct educalion., aWll'CDCl$, UId 0Iber orutn:ach to decrease auhes caused by diSlraCtcd drivers.. /grants/2009-11/2010-11/Provlder Contracts/Mary's Place -Doc. # 2011-492Page 29 of 32 Updated 8/18/2011 EXHIBITE J)cpanmc:IIl ofJuscice Office on Violeoee ApiDst Women AWARD CONTINUATION SHEET PAGE Coopentlve Agreement AWAfU) DATE O9Il3IlOIO SPECLfL CONDf110NS IS. The ~aarees dill it will JUbmit..-rtY fiDmcialllllllS n:porIIlO OVW oo-line (at ....J/analS.Ojp.utdoj.JOV) ..die Sf 42.5 Federal. FiDadaI RcpoIt form (avli11b1e for viewio& lit www.~ombI~..:.lbrmsIff._nport.pclf).lIIIt ....,lO.,.....dleeadofclCbcalcadar qumter. Tbc fiDaJ report ahaI. be IUbuIiUed IIIIt laterdla 90.,.~tile tad oftile award period. 16. Pursumt lO 28 CfR 166-34. the 0f'6c:e OD Violeace ApiIIst Womea nIIICIrVeII a myalty-ftcc. ftIIIIeX.duaivc, and im:wcable license lO lepcoduce. publish« odJerwise ute,and lO IIItIIoriD 0Ihm lO use.. in whole or in part (iDcludiDJ ill the cn:edoo ofderiwtivc 'I1IIJI'b). for F..' 00veramaIt P'IJIPC*$: (a) any wort dIat is subjoc:IlO copyrigbt and wu developed UI.1der thilaWll'd, tubIwanf. COPUad or lAIbc:oaCIacl puIlIIIIIIt lO Ibis award; and (b)any wort dill is subject lO copyright for wbich 0W'IICrIbip was pun:haaecl by a recipic:at. subrccipiaIt or a CODlnII:tor wid! support UDder Ibis awan:l. III Iddilion,tIIe recipic:nt (or ~c:omractor «1Ubec.1I1....) lDIIIIt obtIiD aclnacewritlelllpllRWal fiom tile Oftice GIl V"aoIeoee ApiDst Womea pmpIIIllllllllfll'.....lO tIrii &\nId, 1D4 ....comply wiIb all CCIIIJIIitiaaI spcci1ied by tile pmpIIIl anaaaaer in coaaectiao wiIb &bat tppnMl berocc:l) ........fimrk lOpurdIa&c Ott_ship of. 01' a licaDse lO use.. a copyriJIded weD; or 2) iDcoIpoI_ any copyripIed wart. or portioo IhIIrioI; _.DeW wort.: developed uader Ibis awri It is the teSpOIIII"biUty ofthe n:cipicnt (aDd ofeedllUlncipient. CCIIb1ICtor« IIUbcoatnIctor • appIbbIc) to ensure dIat Ibis c:oaditiao is iDcJudcd in 1lIIY subawIad. CoaInc:t or nbcoaIrIc:t under Ibllaward. 17. Tbc p1IIlIee aareeslbat JI'IIII funds will DOl support acdvities Ibat may eompRlaIiIe victimaf'ety....u: pre-triaI IhmioD JllOIIUIS DOl ~by OVW or tile pllcadcrlt ofa....in IUd!JIIOIQIDI; mediIrion.CQUpIca COUIISdiag,IImiIy COUIIIC1iIIg atany oIbcrDllUiaer ofjaiat ~COUDIICliDI; JI1I.IICIaIDIy COIIBIIOIiD8 for victims. penetiziDl victims wbo refUse lO talifY. at pmIDCIliD& procccIma dIIIl woald n'JqIIire YicIims to aeek JcpJ BIDCCioos apiIISt dicit Ibuaca (e.J.. seek a proIcicdcMl an:Ier, file formal compIIiDt); or tile pllccmleatofpc:rpdl'ldlWS in anp.rJIIIIIIiII&CIDI pqrams. 18. All materials aDd pubUcatioDs (wriUc:n. visual. at 8OIIIICl) raaJtma Iiom awanl JlClivitiel sbaII caaIaia tile followillg statemeaII: -nis project was IUppOdI!cl by (kant No. . awantod by tile Oftice GIl VtOIence ApiDst Womco, U.s. Depattmeot ofJustic:o. Tbc opinious. fiIIdiIqp. COlIC""'" and I'OCOIlIII1I:nd Clq)lCIiSCd in Ibis pubIicatioaIpmpe.xbi.bition are tbosc orllle 8IIIbor(s) and do DOIlICCCSSIInly reflect tile views oflbc Departmeot oflustice, 0ffIee on VIOlence Against Womea. /grants/2009-11/20lO-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 28 of 32 Updated 8/18/2011 EXHIBITE. DepIrtment ofJustice Office on VIOknce ApiDst WOl'IIeII AWARD CONTINUATION SHEET PAOE Cooperative Agreemeat AWAItDDAnl ota3I2OlO SPECIAL CONDl11ONS 21. 'TERMS OF COOPERATIVE AGREEMENT The Office OD Vioialce ApiDSt WOlDCII (OVW) ... elccIed to ....iDto a Cooperative ApeemeDt widlllcIcIwtes Couaty IIId its JIRIjoc:t parUIerI to ia:raso IlVIiIIbIe aupa ...viIitIdoa IIId afc cxcIIq.e tcrVices for victims of domcstk violc:ace, c:hiJd 1busc.1CXUIl .........dItiq vioIeace, 1Dd...w..TlDs deciIion reftects • S1nXIJ mUIWIl illfelat in illCRllini tile IIfety IIId wdI-beina of viClimlIlld their dlI'ldna daria, supcrvisod viaitatiODa _ safe cxcbanJeS. The.WIld n:cipit:nt ac:laIowledps that OVW will play I ptbstMdaJ role in IhIpins IUd moaitoring tile project. STATEMENT OF FEDERAL INVOLVEMENT The 0fIicc on VIOIeace ApDt WOlDCII (OVW) wiD: I. PnMdc die services of. FedcnI Propm SpeciIlilt ..a siqIe poial ofeODIICC fiw die administratiao oflhis c:oopcntiw: IpIIiImeIlt. 2. Moaitor]ll'Ollml dcve10pmcat IIId impIcmcntadoo,. _ ftalfiIlaa OYCnigbl fuactioft l'CJIIII'IIiDI tile pcoject. 3. Review IUd eppmve CODteat IIId format oftile materials pmcb:ed ill COIIjuDc:tion with Ibis project. 4. Provide input, nMfin:ct tile project .1ICCded, and actively mooitor tile pmjeI:t by methods includin& but not limiled to oaaoiDl c:odtw:t wid! tile n:cipierlt. S, AppIove sites IUd dates ofall project reIaIcd IiClMtics. /grants/200!Hl/201Q..ll/Provlder Contracts/Mary's Place -Doc. # 2011-492Page 30 of 32 Updated 8/18/2011 I EXHIBITE Dcparuneot ofJustice Office on VioIcuc:e ApiJlst Women AWARD CONTINUATION SHEET PAO£ Cooperative Agreement AWARDDATE O9I2lI2OIO SPECIAL CONDmONS 22. TERMS OF COOPERATIVE AGREEMENT STATEMENT OF RECIPIENT RESPONSIBILITIES DesdIuteI County will 'IYOIt collabara1ively in acb.,ef!he pIIaaiag IDd ~pIIases oftile project with c:oIJabontivc .......Saw. ~1mI&iDe Lifo WlIIaout Y"1OIeDce. R.ecipienta wiU: I. Work closely with OVW iIIlhe development and implementatioa oflllis project. 2. EnsIIR\ Ibat a muJti.disciptinary team participates is project cIcvdopmcat IDd implementwtion. The multi-. diJciplia8y team sbould iacludc .epeseatlldltll &am Ihe ",-apIICY.bltllll«IocaICIIID'I.oIIICl tbcdomeltic ~astIIUItapncy. RepvescIICIItMs wiD ~III IheCoasultiac committee; IIteDd meednp IDd iDsdIuIIes,as deaiplted by OVWjMdtubIIIDIiaIly ~ill lhepllamla,g_ ~ofviailadoa IDd ex"...... ~aoudiDed by !be ..-prosnm. 3.ldeatiJY a ~of!he .....lIFGCY to ICM.~coonIiDaIor. 1bb .qIl'CIICIIIItive wi1I Sllbst1mtially participaIe in IlII11PC=Ct5 ofIhe pat JIRljcct; c:oontiDIIC dcw:Iopmc:allDd impIt:IrIcmIdic activities; IDd IdtcDd meeti:op and iDsdtules, as deslpalcd by OVW. 4. Work coopendively IDdcoDaboralivelywitb OVW tedmical assi.stance provider(.) for !be Supetviscd VL'litation OmIt Program, tbroughout Ihe term ofIbis lIJ1'CCIDCIIl. S. AltaId !be New Gnmtce 0ricIIIaIi0n. The orleacadon will provide JIlIIIl and ,fiaIIICial maoagcmmt ioformation. COfttCIIt II'IiDiIIg, IDd III opportIJIIity for exc:IIIuIJe and coalition bulldiDa amooa aWIId n:cipients. 6.1'1rticip11c in all OVW timdcd toclmica1assistallce oppanuoilies rdated 10 Ihe Supc:rvised VISitation OmIt Program, iacludiIlg, but 'DOt Iimitcd co, IJ1IIIIeC mectiap, OIHitc tedInic:aI eailCaDcc, IDd site visits. 7. A1toc:atcproject timds. udeslpatcd by OVW, forallowlblecosm I'operticipale is OVW-spoasored redmical assilDloce. Funds desiJIIIIk:d for OVW~tecImicaI assisIaace may 'DOt be used for any OIlIer purposo wilhout prior Ippn)VaI ofOVW. TechaicaI assistaoce iocIudes, but is not Iimitcd co, pe«4O-peC:r eoasul1ations, foeus 8f01IPS, mmtoring lite visits, confen:oces IDd workshops condw:ted by OVW-clesipaled tcdmicaIl1SIistanc:c providets or OVW-desigoatcd coasulllllts and COIItI'III:Un. 8. Pn:widc OVW with Ibe agenda for lIlY IminiDg seminars, wurbbops, orCOllferences DOt aponsored by OVW dill project I1aft' proposes 1'0 8UcDd usia& pant fimdI. The J1IIIIIIIIe nut receive prior approval limn OVW before usiIIg OVW pat ftmds 10 attend uy IraiaiD& worbboprs, or COIIfereIIcea 'DOt IpOII.tCIl'IId by OVW. To request approval, JrIIIIeeS mllSllUbmit a Gnat AdjIISlmeat Notice (GAJIQ request 1IIrouJh!he 0I'ImtI MaDaacmeat System 10 OVW with a copy ofb ev..... broc:IJuR, curriculum aacIIor apoda, a de:sc:ripdGa oflhe bosIa or 1rIinm, _III CIIItimIIed bm&bIown or COllIS. The GAN n:quat sboaId be submitted 10 OVW at lClUl20 da)'s 'bofon: n:P1ration for!be CVCIII is due. kpprovallO IIIIeDd non-OVW sponsond progIIIDS will be liveu 011 a c:asc-by-case basis. 9. EnsIIR\ that pal ftmds will be used to support supervised visitation aod safe visitation cxc'-&e ofcbiIdmt by IDd belweeII pareNs in situations involvina domestic violence,. child abuse. sexual assault. or ItaIkiDg. The JnIIIICC may 'DOt usc pant fUnds to support individual couaseling. family COUDSdiDg. parent educatioa, support groups or 1betapcutic supervision. The gnmtce may not require victims 1'0 attend or uttlize parent education or ocher prosnm services. /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 31 of 32 Updated 8/18/2011 EXHIBITE· ~tofJusucc Office 011 V'JOIencc Apinst Women A W AU CONTINUATION SHEET PAGE Cooperative Agreement A W AltO DATI! 0!lI23I201O SPECIAL CONDmONS 23. TERMS OF COOPERATIVE AGREEMENT STATEMENT OF RECIPIENT RESPONSIBILITlES (CODtinued) 10. I?osIR dat pant fiJDds WJllDOt be used rDprovide oftiite orovc:mi&bt viIiaItioa IIIMcca. Offsite visila1iOll iDdudcs, but is DOt limiUd to, any moaiton:d visit between 1 child and IIIDIK'UIIodiaI pImIl that OCCIIIS outside !be premiIa oflbc: Yisitatioa center. 0venrigIIt visitatioa iDduda, but is DOt limited lO, any monitored visit between 1 child and IIIOIKUStodiaI pmallbal occurs outside ofdie aonnaI operaIiDs boUJs or die: visitation CCIIlCr. II. 0c:veI0p fOl1llll aftiIiations wilb oqaniDlions that wiD be: able: rD provide tervlca aDd consultalion rD !be p!'OII1UIIS in Ibc:ir won wiIb c:IJilcbIlaDd )'IImIIs. AcI:ordiDJIy. panIees must ea.blisb 1 c:onsaltma commilteC Ibal iDchIdIi:II CIqIedS in Ibc: f'oIJowma fields: cfIiId abase and IqIect.,IDI:8III healIb, bdcrer'1 iIIlcrvc:nUoo, law c:aforcemcat, child pnICeCtion ac:rricea, and IIdvocacy tOr victims ofcIomade ~dating violcDcc:, sIaIkia& and ICiIWIIISIIIIIlt. 12. 0c:veI0p and impIemaat adecpte aeevrily lDII!UUteI, iaclw:IiDa but DOIlimltecI." IdequaIe flIciIitics, procedtaa, and JIOIIClIIIId capable orprevtIItiDs vioIeocc. for die opc:ndoa oraupervised ~pnIpImS or safe visllIdon cxd1IDac. Any .........' daIp or nMsioa to CCII'" &eililies (JIICIudiII,IocIdoD) and/or policies and pn:lIOCOIs must be: lUbmiaed to OVW for review and approval 13.l?osIRthai iffc:c:s an: cbaqJcd for use ofprogramsorsc:rviccs, any fc:c:s c:barged must be: based on the inc:ome ofthc iDdividuals using lbe programs or services, UDlcss odIerwise provided by court order. 14. Ensure dat lbe grut project is developed and implcmcDted iIIl_dIIIt is COIISistaIt wilb tile Guiding PriDcipIe:s oflbc: Supervised Vilitldioa PIogrun. The Ouidio, PriDeipIcs embody Ibc: SIIdIItOr)' ~and objecdves ordle Supervised V'1Iitadoa I'rofInIm. They II'C iatcDded to &vide pncIice for OVW ,...toes. 1bt ItIIIdIRIs and practieeI included wiIbin !be GaidiDg PrincipIa II'C CODIidcred to be: aooct pnc:tice when addmaiag Ibc: DCcds of victims ad lbeit c:bildrm. Ccnlas funded UDder die Supervised V'1Si1aIioD Program CID ad arc ~to 10 beyond die prKtiees outline wiIbin Ibc: GuidinJ Principles. 15. Atp;e I1IOl to eapae in activities which c:omproJniIe victim saiIty. inc:ludiDg 1M not IimiIlCld to: I) KcquirinJ adult victims to pri:ipdc in modiatioo or family COIIIIIICliog; b) pnMdiDs viIitatioa or ~serviees wbic:b do DOl IICODUIlI tOrdle afetyofadull vic:Ums; c:} roquirlDa 1 court order ill ordcrto IICCCU visiIa1iOII andIorexc:lJlD&e 1Ctvices; aod d) pvviding c:ustody CY8IwIIioDs or court reports based on subjcdive illformation and opinions ofcentcr staff and volunteers. 16. Demonstrate lhat each visitadoolexc:bange ceoterimlolvcd in 1 mulli-:jurisdictioaal ~modS tbc: s1aIUu.y and minimum nquircmencs oftbe Supervised Visitation GnnI Propm. III ~ach c:CIIIer must opcntc: IS IICIpIIIfe faciJily for 1 minimum of20 hours per week. /grants/2009-11/2010-11/Provider Contracts/Mary's Place -Doc. # 2011-492Page 32 of 32 Updated 8/18/2011 BUDGET EXHIBIT B Progra m Name: Comprehensive Shelter Services Payme nt Schedule: Bi-annual Contrad Period: 7/1/2011 to 6/30/2012 REVENUE -Source Amount % ! Amount Granted from CFC in this proposal: $15,000 BOCC Communi!y Grant $ 15,000.00 6% User Fees/Program Fees 0% Other: County General Funds (do not indude this proposed grant) $ -0% Other: Federal Funds $ 98,739.00 41% Other: State Funds $ 22,974.00 10% Other: United Way $ 22,500.00 9%1 In Kind (food, clothing, diapers, etc.) $ 22,500.00 9% Private Grants $ 10,812.00 I Donations -General Fundraising $ 46,409.00 19% Interest 0%. 0% Vounteer Hours 126.45131 hours @ 21.36/hr) $ 2,701.00 1% Total Revenue $ 241,635.00 100% I S:\CCFamilies\Grants\2011-2012\Original Provider Workbooks\Mary's Place 11-12.xlsx BUDGET -Expenses EXHIBIT liB" Cont. Program Name: Comprehensive Shelter Services Contract Period: 7/1/2011 to 6/30/2012 Proposed Expendi tures from CCF funding requested in this proposal Proposed Expenditures from other sources Total Program Cost Administration Cost- Indirect Charges for Program Administration Admin % cannol exceed 8% $ 19,331.00 $ - $ 19,331.00 Direct Service Personnel List # of people and FTE for each person AdvlTherapist .29661336 FTE Bi-lingual Adv..01163405 FTE ED .01082154 $ 13,624.00 $ 500.00 $ 876.00 $ 32,308.00 $ 42,477.00 $ 59,708.00 $ - $ - $ 45,932.00 $ 42,977.00 $ 60,584.00 $ - Subcontractors/Consultants $ 5,829.00 $ 5,829.00 i Materials & Services $ 55,471.00 , $ 55,471.00 I Office Supplies/Expenses 2,611.00 $ 2,611.00 I Capital Equipment Other TRAVEL & TRAINING 6,199.00 $ 6,199.00 Volunteer Resources $ 2,701.00 $ 2,701.00 TOTAL: $ 15,000.00 $ 226,635.00 $ 241,635.00 S:\CCFamilies\Granls\2011-2012\Original Provider Workbooks\Mary's Place 11-12.xlsx I Commission on Children & Families EXHIBIT "A" ProgramlProJect Work PlanIQuarterly Report Provider: Contact(s): ProJect/Activity: Contract Period: Saving Grace -Imagine Life Without Violence Janet Huerta Mary's Place 7/112011 to 6/3012012 support services to 165 (women and children) 100% of BOCC funds are reported at I12.;n.1IUll however services be reported to 6.30.2012 Focus area: Family Functioning Outcome (HLO): Reduce Domestic Violence that their treatment at Mary'sl!!#as=S:les=sed~+-__-l!-__ "" ..".j""'.... t t respectful of their cullure #Successful Targel20 == -== shelter victims surveyed will gain knowledge to stay safe Target: 44 by "nnnvmn"", victim surveys BUDGET EXHIBIT B The budget must contain at least 25% or $20,000 (whichever is less) of project funds in the form of cash. The match must come from sources other than the Commission. Cash match is defined as funds derived by fund raising activities, grants or any source other than state general fund or Federal Medicaid resources. Prognm Name: Mary's Place Payment Schedule: Quarterly Contnct Period: 7/1/2011 to 6/30/2012 , REVENUE· Source Amount % Amount Requested from CFC in this proposal: $203,413 Safe Havens 112,920.00 34% FY 2010·2011 Filing Fees Carry Forward 8,601.00 3% Filing Fees 79,485.00 24% CYF Flex -Bi-lingual 2,407.00 1% User Fees/Program Fees $ 7,500.00 2% Other: County General Funds (do not include this proposed grant) $ - Other: Federal Funds Other: Public Funds State Tax Return Checkoff Other: Private Grants $ 15,000.00 5% In Kind $ 15,388.00 5% Donations -General Fundraising $ 86,839.32 26% Interest Volunteer Hours 100 @ 21.36/hr) $ 2,136.00 1% Total Revenue $ 330,276.32 100% BUDGET -Expenses EXHIBIT "B" Cont. Prognm Name: Mary's Place Contract Period: 7/1/2011 to 6/3012012 Proposed Expenditures From CFC Funding Requested in This Proposal Proposed Expenditures From Other Sources Total Administration Cost- Indirect Charges for Program Administration Admin % cannot exceed 8% $ 26,251.23 $ 26,251.23 Direct Service Personnel List # of people and FTE for each person see below Safe Havens Filing Fees CCFGrant $ 108,569.00 $ 88,086.00 $ 2,407.00 $ 1,153.56 $ 5,854.90 $ $ $ 109,722.56 93,940.90 i 2,407.00 i TOTAL PERSONNEL $ 199,062.00 $ 7,008.46 $ 206,070.46 i Subcontractors/Consultants $ 8,185.00 $ 8,185.00 Materials & Services $ 72,153.63 $ 72,153.63 Office Supplies/Expenses $ 1,500.00 $ 7,215.00 $ 8,715.00 Capital Equipment Other TRAVEL & TRAINING $ 2,851.00 $ 3,914.00 $ 6,765.00 I Volunteer Resources $ 2,136.00 $ 2,136.00 TOTAL: $ 203,413.00 $ 126,863.32 $ 330,276.32 ACORQ.. CERTIFICATE OF LIABILITY INSURANCE I D:i;v;Ol~1 THIS CERTFICATE IS ISSUED AS A MATTER OF •., _ " ••!"ATIOfii 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 REPRESENrATIve OR PRODUCER, AND THE CERTIFICATE HOLDER. Im"v~I","I: If the ..... w ..__.w holder Is an AULlIIIUNAL ,the must be If~1 IIUN IS WAIVED, subject to conditions of the poliCY, may require an endorsement. A statement on this certificate does not confer rights to the .~ mlder In lieu of such PRODUCER Lumbermens Insurance / RiskPoint Ins Advisors ~541. 382.2421 I r~.Nol: 541. 38S. 3231 ------'-'."""'''''''''----~--I965 SW Emkay Drive PO Box 940 11::10"Bend. OR 97709 INSUR2D IINSURlRA: Philadelphia Ilty Ins Co Saving Grace, Imagine Life Without Violence INSURER.: 1425 NW Kingston Ave .INSURfRC: Bend, OR 97701-2133 ....-'IIlItPIt 1'1: INSURIR!: IINSURlRF: "'''H.,,''''''''''''' vC", l.iICATE NUMBER: MASTER 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. I~f: l'YI'E OF INSURANCE GENERAL LIABILITY ~LlMERCIAl GENERAlllA8IlilYL.LJ CLAlMS-!.IAOE ~1 OCCUR A 0 -____._~____ GEN'l AGGREGATe LIIMT APPLIES P£R:'Xl POliCY h m n LOC AUTOM08IU LlASILITY ~:=o.".. A i SCHEOUlED AUTOS ~HIRED AUTOS r-c!.. NON-OWNED AUTOS I UMBREUA LIAS r-EXCESS UA8 '--O£DIJCTlBLE RETENTION $ HOCCUR ClAIMS-MAOE ~RSCOMPENSAnoN INIR WVD AND EMPLOYERS' LlA8IUTY YIN AI« PROPRIETORIPARTNSRIEXECUTIVEDIOFFICERIMEMBER EXCLUDED? . N I A (MIIIIdIotoIy In l1li) , ~~~~lONSbeiOW PHPK7298S7 07/0112011 0110112012 EACH OCCURRENCE $ ~~~~II:I.I $ MED EXP (Anyone person) $ PERSONAL 6. ArN INJURY $ GENERAl. AGGREGATe $ PROOUCTS • COMP/OP AGG $ s PHPK72985 I 07/0112011 0110112012 COUBINEDSINGLELlIMT s (Ea accIdenI) BODilY INJURY (Per peqon) S BOOIlYINJURY (Per accIdenl) $ PROPERlY DAMAGE S(Pet accident) S S EACH OCCURRENCE S AGGREGATe $ $ $ 1~~tlUr¥sl l°.llt E.L.. EACH ACClOEHT $ E.L. DISEASE • EA Et.IPlOYEe S E.L. DISEASE • POlICY LIMIT S l,OOO,OOCl loo,OOCl 5,000 1 OOO,~ 2 000 OO~ 2 000 OO~ 1,000 000 Professional liability A PHPK729857 07101/2011 0110112012 $1,000,000 Occurrence $2,000,000 Aggregate DI!SCRJPJIPN OF OPERAIIQNS I LOCATIONS I VliHICLES (A~ACORD 101. Additional Renwks Schedule. If .......!J>'lCIO .. "'!I"lredt ert1~;cate Holder is added as Additional Insured as respects ~eral Llability and shall include Deschutes County, the Comanssion on Children & Families, their pfficers, agent and employees and volunteers per form attached. Re: Operations of the Named Insured subject to policy terms, conditions and exclusions. CERnFICATE HOLDER FAX: 541.315.1742 Deschutes County Commission on Children and Famil i es 1130 HW Harriman, Suite A Be~d. OR 97701 CANCELLATION SHOULD Nf'( OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROViSiONS. AIlTHOR1ZI!D REPRESEHTATIVI! /UN.I...~ Karen Ebert/lMCCA @ 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PHPK729857 COMMERCIAL GENERAL LIABILITY CG20 120509 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION -PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Deschutes County Collllllission on Children & Families Information required to complete this Schedule, if not shown above. will be shown in the Declarations. Section II -Who Is An Insured is amended to in clude as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au thorization. 2. This insurance does not apply to: a. "Bodily injury". "property damage" or "personal and advertising injury" arising out of operations performed for the federal government. state or municipality; or b. "Bodily injury- or "property damage" included within the "products-completed operations hazard". CG 20 12 05 09 © Insurance Services Office, Inc., 2008 Page 1 of1 Cl www.:self.com OREGON WORKE,RS COMPENSATION' asaifCERTIFICATE OF INSURANCE ~.~corporation MAIL TO: CERTIFICATE HOLDER: CENTRAL OREGON BATTERING AND RAPE DESCHUTES COUNTY COMMISSION ON SAVING GRACE:IMAGINE UFE W/OUT VIOLENCE CHILDREN & FAMIUES 1425 NW KINGSTON AVE ATTN: SARAH JOHNSON BEND, OR 97701 1130 NW HARRIMAN AVE. SUITE A . BEND, OR 97701 The polley of Insurance Jlsted below has been Issued to the'lnsured named below for the policy period Indicated. The Insurance afforded ,by the policy described herein Is subject ~o . all the terms, exclusions and conditions of such poncy. POLlCY NO. POLICY PERIOD ISSUE DATE 418410 10/01/2010 to 10/01/2011 11/16/2010 INSURED: BROKER OF RECORD: CENTRAL OREGON BATIERING AND RAPE ALLIANCE VICTIM ADVOCACf SAVING GRACE:IMAGINE LIFE W/OUT VIOLENCE 1425 NW KINGSTON AVE BEND, OR 97701 UMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease , $500,000 each employee Body Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS: IMPORTANT: The coverage described above Is In effect as of the Issue date of this certIficate. It Is subject to change at any time In the future. This certIficate Is Issued as a matter of Information only and confers no rights to the certificate holder. This cert1f1cate does not amend, extend or alter the coverage afforded by the policies above. AUTHORIZED REPRESENTATIVE ~rsrf't R.q4.iJ.--- President and CEO 400 High Street SE Salem, OR 97312 P; 800.285.8525 F; 503.373.8020