HomeMy WebLinkAboutDoc 482 - J Bar J Youth ServicesDeschutes 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 October 3, 2011
Please see directions for completing this document on the next page.
DATE: September 26,2011
FROM: Debi Harr CFC (541) 330-4692
TITLE OF AGENDA ITEM:
Consideration of Board Signature on Document # 2011-482, Contract for Subgrant between Deschutes
County Children & Families Commission and J Bar J Youth Services, Inc. dba Cascade Youth &
F ami! y Center
PUBLIC HEARING ON THIS DATE? No
BACKGROUND AND POLICY IMPLICATIONS:
Cascade Youth and Family Center has provided service to runaway and homeless youth through a
contractual arrangment with CFC for several years. Youth, ages 11-17, at high risk of family separation,
abandonment, runaway and/or homelessness are served by Cascade Youth and Family Center. Services
include: mobile outreach activities to multiple community sites, access to medical/dental, mental health
and substance abuse services, emergency shelter, transitional housing and long-term housing. In
addition, youth are provided with academic liaisons to enhance academic progress or re-engagement in
the educational process.
FISCAL IMPLICATIONS:
The total contract amount is $102,348, and is comprised of Oregon Commission on Children &
Families (OCCF) dedicated Youth Investment funds in the amount of$41,226, Oregon Department of
Human Services Runaway/Homeless Youth grant in the amount of $48, 122, and Board of County
Commissioner (BOCC) Community Grant Funds of$13,OOO. These grant funds were all included in
the 2011·2012 budget.
RECOMMENDATION & ACTION REQUESTED:
Approval and signature on Document # 2011-482, Contract for Subgrant between Deschutes County
Children & Families Commission and J Bar J Youth Services, Inc. dba Cascade Youth & Family Center
ATTENDANCE: Jessica Kelly or Debi Harr
DISTRIBUTION OF DOCUMENTS:
Please return originals to Debi Harr at 1130 NW Harriman, Ste A, Bend, OR 97701.
J
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: Quly 18, 2011/ Department: /cFcl
Contractor/Supplier/Consultant Name: Cascade Youth & Families
Contractor Contact: Ste hanie Alvstad Contractor Phone #:
1(541) 318-34361
'~ffl~ I 'f IJ q
Type of Document: Services Agreement
Goods and/or Services: Youth, ages 11-17, at high risk offamily separation,
abandonment, runaway and/or home less ness are served by Cascade Youth and Family
Center. Services include: mobile outreach activities to multiple community sites,
access to medical/dental, mental health and substance abuse services, emergency
shelter, transitional housing and long-term housing. In addition, youth are provided with
academic liaisons to enhance academic progress or re-engagement in the educational
process.
I
t Background &History: Cascade Youth and Family Center has provided service to
runaway and homeless youth through a contractual arrangment with CFC for several
years.
I Agreement Starting Date: Quly 1, 20111 Ending Date: Qune 30, 20121
Annual Value or Total Payment: /$102,348/
o Insurance Certificate Receivrtd (CleCk box)
Insurance Expiration Date: /1/12
Check all that apply: o RFP, Solicitation or Bid Process o Informal quotes «$150K) o Exempt from RFP, Solicitation or Bid Process (specify -see DCC §2.37)
Funding Source: (Included in current budget? 0 Yes o No
If No, has budget amendment been submitted? 0 Yes o No
Is this a Grant Agreement providing revenue to the County? 0 Yes 0 No
Special conditions attached to this grant: None
9/6/2011
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: 0 Yes 0 No
Contact information for the person responsible for grant compliance:
Name: Hilla Saraceno
Phone #: 317-3178
Departmental Contact and Title: Jessica Kelly Phone #:
(541 )330-4632
Deparbnent Director Approval: ~~
Si ature
CfUZ/Ut II
{ Date
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): ~ BOCC 0 Department Director (if <$25K)
o Administrator (if >$25K but < 150K; if >$150K, BOCC Order No . ____--l)
Legal Review Date 1-'2-0-11
Document Number 2011-482
916/2011
!l!ld~
DEPARTMENT HEAD
For Recording Stamp Only
Contract for Subgrant Under
The Deschutes County Children & Families Commission (CFC)
Contractor: Cascade Youth & Family Services
Project: Runaway & Homeless Youth Services
Contact: Stephanie Alvstad
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 "CFC", and J Bar J
Youth Services, Inc. dba CASCADE YOUTH & FAMILY SERVICES, an Oregon non-profit
corporation, Federal Tax ID # 93-0677650, 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.
Grant -The application, award, and incorporated documents constituting an agreement
between County and the Oregon Commission on Children & Families Youth Investment
grant, the State of Oregon Department of Human Services Runaway Homeless Youth grant
and Deschutes County Community Grant fund to carry out the Project, as defined in Exhibit
A.
Other granting 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
DC -2 011-4
Cascade Youth & Families -Doc. /I 2011-482 Page 1 of 25 Updated 9/22/2011
WHEREAS, in reliance upon Contractor's application, and expressed willingness and
capability 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 1st, 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
$102,348. 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.
Cascade Youth & Families -Doc. # 2011-482 Page 2 of 25 Updated 9/8/2011
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 (i)
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.
Cascade Youth & Families -Doc. # 2011-482 Page 3 of 25 Updated 9/8/2011
e. Justify all costs by properly executed payroll records, time records, invoices,
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 with a designated
Commission representative to discuss Work Plan (Exhibit A) progress.
Additional meetings may be required by the Commission.
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.
Cascade Youth & Families Doc. # 2011-482 Page 4 of 2S Updated
m. Assurances: The Contractor attests that the information provided to
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
Cascade Youth &Families -Doc. # 2011-482 Page 50f25 Updated 9/8/2011
forth in Exhibit A, which are undertaken by, timely completed and properly
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 2796.220, 2796.230 and 2796.235, 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 (6); 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
Cascade Youth & Families -Doc. # 2011-482 Page Gof2S Updated 9/8/2011
Accountability and Transparency Act (FFATA) of 2006, (P.L.. 109-282),
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 l 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 l (i) all federal laws requiring reporting of client
abuse, (j) the Americans with Disabilities Act of 1990 (codified at 42 USC 12131
et. seq')1 as amended, in the construction l remodeling, maintenance and
operation of any structures and facilities, and in the conduct of all programsl
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'l 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 fundsl the
additional federal and state requirements applicable to Child Care and
Development block grant funds in 42 USC 9858 et seq'l 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 C1 d l 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
Cascade Youth & Families -Doc. If 2011-482 Page 70f25 Updated
recipients recelvmg more than $100,000 in federal funds, language reqUiring
the recipient to comply with the federal laws and to report all Violations thereof
to County. OMB Circular A-102, 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.100 to 659A.409, 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 §
Cascade Youth & Families -Doc. # 2011-482 Page 8 of 2S Updated 9/8/2011
6081 et. seq.).
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 (5) 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
Cascade Youth & Families -Doc. /I 2011-482 Page 90f 2S Updated 9/8/2011
program by any employee who is so convicted as required by Section 5154 of
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, officer, 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, 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 grant,
the source will be marked Exhibit E, attached hereto and incorporated herein by
this reference. I
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 I
authorized or required.
a. Unauthorized Expenditures: Any funds expended for unauthorized purposes
shall be deducted from funds otherwise payable to Contractor, or otherwise
subject to recovery by County and refunded to the State, 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 indemnify, 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). I
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
Cascade Youth & Families -Doc. 1# 2011·482 Page 10 of 25 Updated 9/8/2011
resulting from or arising out of, or relating to the activities of County or its
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
cascade Youth & Families -Doc. # 2011-482 Page 110f2S Updated 9/8/2011
Contractor, may immediately terminate the whole or any part of this Contract
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.
Cascade Youth & Families -Doc. # 2011-482 Page 120f 2S Updated 9/8/2011
b. If this Contract is terminated under subparagraph 14 d of this Contract, County
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.
16. 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
Cascade Youth & Families -Doc. # 2011-482 Page 13 of 25 Updated
shall not affect County's right to recover from Contractor, in accordance with the
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 I
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. I
Cascade Youth & Families -Doc. # 2011·482 Page 14 of25 Updated
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.
Cascade Youth & Families -Doc. If 2011·482 Page 15 of 25 Updated 9/8/2011
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 such 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
Cascade Youth & Families -Doc. II 2011-482 Page 16 of 25 Updated
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one week, when the work week is five consecutive days, Monday through
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 Sunday.
(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(l)(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
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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.
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29. Contractor Not an Agent of County. It is agreed by and between the parties that f
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 lunder this Contract or exercise any control over the activities of Contractor. l
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 f• no obligation with respect to Contractor's debts or any other liabilities of each and
every nature.
Cascade Youth & Families -Doc. If 2011-482 Page 17 of 25 Updated 9/8/2011
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
property damage.
per person, $500,000 per occurrence, $100,000
c. A" 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
commencement of the Contract.
from the Contractor is required prior to the
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
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Cascade Youth & Families -Doc. # 2011·482 Page 18 of 25 Updated 9/8/2011
District of Oregon. CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY
CONSENTS TO THE IN PERSONAM JURISDICTION OF SAID COURTS. The parties agree
that the UN Convention on International 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/html/chapter2.37.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 concerning 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
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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 •f
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.
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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:
Stephanie Alvstad Hillary Saraceno, Director
Cascade Youth&. Family Services The Children & Families Commission
62895 Hamby Road 1130 NW Harriman, Suite A
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.
Cascade Youth & Families -Doc. 112011-482 Page 19 of 25 Updated 9/8/2011
Dated this ___ of _____, 2011 FOR DESCHUTES COUNTY
Erik Kropp, Interim County Administrator
CONTRACTOR:
DATED this __day of September, 2011
By: Stephanie Alvstad
Cascade Youth & Family Services
Cascade Youth & Familie s -Doc . /I 2011-482 Page 20 of 25 Updated 9/8/2011
EXHIBIT A -Part One
1. 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 ll programs l 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. Sustainability: 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. Sustainability -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 fundraising 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.
Cascade Youth & Families Doc. # 2011-482 Page 21 of 25 Updated 9/8/2011 \
i
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.
Cascade Youth & Families -Doc. # 2011-482 Page 22 of 25 Updated 9/8/2011
13. Contractor's Reporting Requirements: Contractor is required to submit the
following:
D Quarterly Work Plan Report
D Quarterly CFC Demographics report
D Quarterly Funds Request
D Ongoing reporting into Comet data system. Submit to CFC quarterly.
D Program Data submitted to CFC staff semi-annually
D Monthly MDS Report (due by the 10th of the month)
Quarterly reporting due dates:
October 17, 2011
January 17, 2012
April 16, 2012
July 16, 2012
Cascade Youth & Families -Doc. It 2011-482 Page 23 of 25 Updated 9/8/2011
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 (CFC). 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 I
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 i
time to re-order supplies, funded programs shall include modifications in published materials to lcomply with this policy. As an alternative to reprinting, funded partners may add stickers n
identifying CFC on current brochures. In the future, the CFC may furnish the stickers.
f
The CFC has set very specific guidelines for community partner use of the CFC logo. Here are a t
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" Ishould 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 I
retains its shape.
3. The recommended minimum width is .75 inches wide. t
4. The logo must always be printed in the same color as your publication, i.e., if you Iare 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 i
at www.deschutes.org/CFC. 1
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.
Cascade Youth & Families -Ooc. # 2011-482 Page 24 2S Updated \
Exhibit D
Compliance with provisions, requirements of funding source and Federal and State
laws, 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 Contract create no potential or actual conflict of interest as defined by ORS 244 and no rules or
regulations 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
Form-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 all liability 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. !Jii~\\fJ~ Cj !/9 /11
Contractor $ignature 'Date
Cascade Youth & Families -Doc . /I 2011·482 Page 2S of 2S Updated 9/8/2011
Children & Families Commission
Program/Project Work Plall/Quarterly Report
Exhibit A
Provider:
Contact(s):
Proj8CVActivit)':
Contract Period:
CYFC
Pat Gundy
Runaway & Homeless
7/01/11 to 6/30/12
Focus area:
School Success
OUtcome (HlO):
participants will be reconnected witll family Ol I_'~u 1_'
a stable living Situation befOle leaving tile ..
program. 1.01.04
--Report above serves unOupliC8led clients between BoCC anO CFC funding
S:\cCf.mU..\Qranta\2011~2012\OriglMl Providet ~\cYfS RHY 11w12 wkbk fiNAL.x!uwp ~rpt
REVENUE -Source Amount %
BoCC $ 13,000.00 80%
User Fees/Program Fees 0%
Other: County General Funds (do not include this proposed grant) 0%
0%
Other: Federal Funds-RHY $ 1,300.00 8%
0%
Other: Public Funds-United Way $ 1,300.00 8%
0%
Other: Private Grants 0%
0%
In Kind 0%
Donations-J Bar J Horse Show $ 650.00 4%
Vounteer Hours ( hours @ 21.36 /hr) 0%
Total Revenue $ 16,250.00 100%
BUDGET EXHIBIT B
Program Name: CYFC/Runaway & Hornless Program
Budget Period: 7/1/11 to 6/30/12
I
BUDGET EXHIBIT B
Program Name: CYFC/Runaway & Hornless Program
Budget Period: 7/1/11 to 6/30/12
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. Gash match is defined
as funds derived by fund raising activities, grants or any source other than state general fund or
Federal Medicaid resources.
REVENUE Source Amount %
CFC $ 89,348.00
I
80%j
User Fees/Program Fees 0%
Other: County General Funds (do not include this proposed grant) 0%
0% ,
Other: Federal Funds-RHY $ 8,935.00 8%1
0%1
Other: Public Funds-United Way $ 8,935.00 8%
0%
Other: Private Grants 0%
0%
In Kind 0%
Donations-J Bar J HorseShow $ 4,565.00 4%
Vounteer Hours ( hours @ 21.36/hr) 0%
Total Revenue $ 111,783.00 100%
BUDGET -Expenses EXHIBIT "B" Cont.
Program Name: Cascade Youth and Family Center
Runaway and Homeless Youth (CFC and BoCC funding)
Contract Period: 7/1/11 to 6/30/12
Administration Cost-
Indirect Charges for
Program Administration
Admin" cannot exceed 8%
Proposed Expendi·
tures from CFC
funding
Proposed Expendi
tures from BOCC
funding
Proposed
Expenditures
from other sources
Total Program Cost
$ 4,700.00 $ 684.00 $ 5,384.00
Direct Service Personnel
Ust # of people and
FTE for each person $ 50,180.00 $ 7,301.00 $ 17,970.00 $ 75,451.00
1.0 FTE caseworker $ -
.25 FTE Host Home Certifier $
$ -
$ -
$ -
$
SubcontratorsjConsultants $ 27,340.00 $ 3,977.00 $ 7.715.00 $ 39,032.00
Materials & Services $ 3,358.00 $ 488.00 $ 3,846.00
Office Supplies/Expenses $ -
capital Equipment $ -
Other-Host Home Training $ 3,770.00 $ 550.00 $ 4,320.00
Volunteer Resources $
TOTAL: $ 89,348.00 $ 13,000.00 $ 25,685.00 $ 128,033.00
I
I ~
I
CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED
REPRESEN'1ATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER.
the must be endorsed. If IS WAIVED. subject to
POllCIElil may require an endorsement. A statement on this certificate does not confer rights to the
PRODUCER
Beecher Carlson Insurance Agency, LLC
296 SW Columbia St, Suite D
INSURED
J Bar J Youth Services, Inc.
62895 Hamby Road
Bend OR 97701
COVERAGES CERTIFICATE NUMBER'CL11627 03511 REVISION NUMBER'
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.
rf:J lYPE OF INSURAHCE i:~;I: POLICY NUMBER ~BMg~II:~~I -
UMrrs
~ GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000iilCOjERCtAl GENE~L LIABILITY ~~:;~J?~~E~nce\ '$ 100,000
MCPKG01l4702 7/1/2011 7/1/2012 -- -
A ~ClJ<IMS-MADE l.xJ OCCUR X MED EXP (~one person) $ 10,000
PERSONAl. & ADV INJURY $ 1,000,000H GENERAl AGGREGATE 3,000,000~N'L AGGREnE LIMIT APAS PER:
$
I r PRODUCTS· COMP/OP AGG $ 3,000,000
X , POLICY ~C-i?T ' LOC
I Professional Liability $ 1,000,000
AUTOMoelLE lIABILITY COMBINED SINGLE LIMIT $ 1,000,000I'X"1 ANY AUTO
(Ee accident)
h ALL OWNED AUTOS NCAAtITOl14702 7/1/20ll 7/1/2012 i BODILY INJURY (Per person) $
A iC SCHEDULED AUTOS
i BODILY INJURY (Per accident) $
I PROPERTY DAMAGE $ ~HIRED AUTOS I (Per accident)
I X , NON'()WNED AUTOS
I
I PIP-Basic $ 15,000 -
1,000,000Non-owned & Hired Auto $
UMBRELLA UAB }j OCCUR EACH OCCURRENCE $-
EXCESSUAB CLAIMS-MAOE AGGREGATE $
I DEDUCTIBLE $
I RETENTION $ I $
WORKERS COMPENSATION I
I I
iT~~T~JUsi I~'AND EMPLOYERS' lIABILITY YIN I
ANY PROPRIElORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? 0 N I A
E.L. DISEASE • EA EMPLOYEE $(Mandatory In NH)
I ii Ifrss. describe under I I E.L. DISEASE· POLICY LIMIT ' $o SCRIPTION OF OPERATIONS below '
A I Professional Liability I ! l'ICPKGOl14702 /1/2011 rr/1/2012 EechClaim 1,000,000
I I I IAggregate 3,000,000j
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Auach ACORD 101. Adidltlonal Rematb Schedule. If more apace II required)
Deschutes county. Its agents. officers, employees and volunteers are listed as Additional Insured per form 00 GL0295
00 10 06 per written contract. for operations by the Named Insured. This applies to General Liability only. This
certificate is subject to policy limitations. conditions & exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DEUVERED IN
Deschutes County Commission
ACCORDANCE WITH THE POLICY PROVISIONS.
on Children & Pamilies
1130 NW Harriman, Suite A AUTHORIZED REPRESENTATIVE
Bend, OR 97701
J Hammond, ClC, CRM/N~~.R~
ACORD 25 (2009/09) @1988-2009 ACORD CORPORATION. All rights reserved.
INS025 (200909) The ACORD name and logo are registered marks of ACORD
Additional Named Insureds
Other Named Insureds
Big Brothers, Big Sisters of Central Oregon Doing Business As
dba Cascade Youth & Family Center Doing Business As
dba J bar ~ Boys Ranch Doing Business As
dba Pathways Doing Business As
The Academy at Sisters DOing Business As
The Learning Center DOing Business As
The Loft Doing Business As
OFAPPINF (0212007) COPYRIGHT 2007. AMS SERVICES INC
THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY.
SOCIAL SERVICES PREMIER GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
It Is Underatood and agreed that the lbIIowIng menslons Oflly apply In the !MInt thet no other specillc
coverage lor the IndICllta:lIoss expo!Iures are provided under !hIs p<lIIcy. If I!IUCh specIIIc coverage applies,
the terms. <XIndItlons. and Ifmfts d that eowrage are the sole and excIlJIIiIIe COIIeI8ge applicable under !his
POHey.
Throughout this endorsement the words "yOU' and "yoU!" refer to the "Named Insunld" shawn In the
DeclerlltiOns. The words "We', 'us", and 'CUI" refer 10 the 'Company' proIIIcIIng!h1s insurance.
This endon!lement modIIies InSurance provided under the following:
COMMERCIAL CJENERAL LIABILITY COVERAGE FORM
The 'oIlowing is a 8ln1l1/11y d the Limits d Insurance and Additional Coverage provided by this endorsement.
For complete details Ofl specIIIc coverage'll, coneul the pelley contract wording.
A) Medical Payment -Limit Inereesed 10 $20,000
8) Su!lP!ementary PIIyments -Ball bondIIlncreased to $3,000 I LOM d Earnings Increased to $1,000
each day
C) LegalllabIliIy Extension -For lire, IIghtnng llICpIosIon, smoke, and leekll from sprIn!denlllml
Increased to $500,000
0) Broadened dellnIIIon d\'\lho 18 an Insured
E) Knor.1edge or Nottce d C»:umInce
F) Broadened dellnllion d AdYertI8ing Injury Inc/I.JdeS teIeIIIt;ed or videotaped publlc8tfon
G) Amended delinllon d BodIly lI1Ury to Include mental anguISh
H) Amended UI ill tel ttIoIl8I Fllllure to DIacIose Hazards
I) Amended Uberallzatlon CIeuee
J) Property Damage -RemcMII d exclusion lor "Property Damage" resulting from the UtIe d reasonable
fon:e to pmtect pet!IOI'II8 or property
Kl Premt_ Sold or .Ab8ndon!!d by You
L) Added BIIInkIet Addltlonl!llinsured· Funding ~
M) Added BIenket AddIIlonaIlnsured· Managers or Ie&8onI 01 ~
N) AdcIItlonaIlmued -By ContIllCt, Agreement or Permit
0) General Aggregate UmiI Per Locattan
P) Blanloet Spedal E'o>enIII Coverage
0) Non-Owned Wlllelcralt Co\IerIIge • Length Is Increased to 65 feet
R) BIankIII W8tver d subrogation
5) Wailler d Immunity
T) ViaIatIon d RfghIa d Rasiden19 Co\IerIIge (PaIlent's Rights)
ll) Liquor Ullbllily Ext:epHon 10 ExcIuIIIon
AI MEDICAL PAYMENTS
If Medical Paymenta Coverage (Coverage C) Is nat otherwise eliCluded from this coverage part:
1) The Medlcll Elopense Umlt Is Incraased, 8U1lject 10 III the terms d Limits d Insurance
(Sedion III) to $20,000
2) The requirement in the Ina~Agreement d CoYeraga C, that expenses must be Incurred
and reported to us within 'one year' d the acckfent dI1Ite is changIId to "three yeana.·
3) Elduslon d Coverage III your option, does not apply to your YCIunteer W'O!Icer8 or any parson
or organtzallon under your direct lI~on and cortnJI.
B) SUPPLEMIINTMY PAYMI!HTS
Coverage" A. and a proMaions:
1) The limit for the coat d bel bonds fa changed from $2fiO \0 $3,(l00
2) The limit for lose 01 eamlngs Is changed from $250 per day to 51,000 per day.
00 GL0295 00 10 06 Page1d7
C) LEGAl. LIABILITY EXTENSION -FIRE, LklHTNING, EXPLOSION, SMOI<I!, AND LEAKS FROM
SPRINKLERS
1. The last peragr:aph d Iec:tIon 1-Coverages A -2. Exclusion, Is deleted and replaced by the
following:
Exduelons c. tlmJgh n. does nat apply to:
e. cl8m8ge by lire, lightning. I!lCpbIIon, smo!G! or leaks from automatiC lire protectille syslems; end
b. damage caused by II rtIIkfent;
to premlsea rented to you or temporarily occupied by you with the pennlselon d the owner.
2. Paragraph II. d Iec:tIon In -LImfts of In_Is deleted end replaced by the following:
•• &.tlject to II. alxM!o, the Damage To Premlsea Rented To You LIm~ Is the most -we v.111 pal' under
COVERACJE Afordamagell because d'property damage':
a. reeUIlng from 1Ire, lightning, explosion, III'T1d<e or IeaIG from automatic fire proteotille
~_,01' any combinatiOn thereof; and
b. caused by a neeldent;
10 premises, !enled to you or temporarily occupied by you wfth the permission d the owner.
Damage To PremIses Rented To You Urniis the greater d:
a. $500,000 tor damages due 10 11,., IIghIntIg, explosion, smo!G! 01' leaks from automatic fire
protectfYe systems, or any comblnalion there cf; or
b. The Damage To Premlsea Rented To You Limit IlI'Iown In the Dect/lrations.
DI WHO IS AN INSURED
Faragraph 2. d Iec:tIon 11-WIIo I. An Insured is deleted and replaced by the IoRawing:
2. ElICh d the tbhawing Is also an 1nlKlred, but only while WOI1cIng within the IlOCpe d their dulles
tor the InlKlred:
(II) 'Employees';
(b) 'Vdunteer WorkIIrs";
(e) Independert Contractor.
However, no 'employees', 'VolunteerWO!kenl' or Independent conttaclo!s are insured's for:
(1) 'Bodily InjtJI'y" or 'pentanal and advertising InjtJI'y":
Cal To you, to your partners or memilenI (II you IlIe a partnership or joint venture). to your
members (if you are aillmited llIbiIty company), to a co-'empIoyee' while In the course
d his or her employment or pettbrmlng drtles related to the condu::t d your busln_, or
to your other 'WlIunteer wor1<ers' whde pertbrmlng drtles reillted to the conduct d your
bualnes8;
(b) To the spou&e, child, parent, broIher or lieter d that co-'employee' or 'YOlunleer worker'
IJS a OIlnII8qIJence d Faragreph (1 lea) above;
Ccl For which there Is any obligation to ahare damages wfth or repay someona else who
must pay damages bec:IIU8e d the Injury described In Faregrapha (1 )(a) or (b) alxM!o; or
Cdl Arising out d his or her PfO\IIdIng or I'aIIng to prO\IIde professional health care services.
C21 "Property damage' \0 property:
ca) Owned, occupied or UIIed by,
(b) Rented 10, In the care, CUIItody or control d, or aver which phy$Icaf oontnJI is being
exert:IIIedforanypurpose by you, anydyour'emplov-', '\IOlunleerWllOOml', any
partner or member (lIyou era II partnership Q( jOint wonture), or any member (lIyou are a
limited IlabIIIty company).
b. Medical dlreek:n and admlnlslralora, including professional pen!On8;
c. If you are an organtzaIion other than a partnership or joint VI!!1Iure. your manager. and
supervteore are IIlso lnaured ..;
00 GL0295 00 10 06 Page2d7
d. If you are a IIm_ed llablllly company your members are Insured's, but only wtth respect to their
duties related to the conduct df your bus~;
shsll not In itself constitute knaMedge by you, unless 8 corporate officer cl yours shan have received
notlce from said agent, _nt, emplcyse or any other pen!OI1.
e. Any organi2Blion and subsid1llry thereof which you control and actively manage on the e1Teotive
dale cl this endonIernent;
Any person or organlzatlon that h. ftnanoial control of you or 0\M18, maintains or controls
preml$e$ occupied by you and requile<ll you to name them as en additional insured but only with
2) Your IaMure to give fInIt n!port Of a claim to U8 ehall not Invalidate COlIer. under this
policy If the loss WllBlnlIdIIartently reported 10 another Insurer. However, you shal report
any such 'OooJnence' to us within a reasonable time once you becoma awan! 01 sUch elTOr.
respect to their liability arlalng out df:
(1) Their finaoolal conInlI df you; or
(2) Premiseslhey own maintain or control while you lease or OOOUP'l these premlsell.
F) ADVI!RTISING INJURY TELI!M8ED OR VIDEOTAPED PUBLlCAnON
1) The deftnnion of 'Personal and AdIIertlslng Injury Items 14. (d), (e), (I) and (g) are changed
to read:
This Insufllnce does net apply 10 atruclural alten!llone, ~con1IIrucIlon and demolMlon 'PImIonal and AdYertlslng Injury' means InJury arising out 01 one or more 01 the foltow!ng
operations performed by or for that person or organi2Bllon. oIIenses:
g. Any state or PolIIIcaI SUbdl\llslon subject to 1he foIIaMng provision:
Thill inSUIlll1Ce appllee only with respect to 1he ~hazaTdll for which the sIBle or political
subdl\llslon has I88Ued a penni In eonneGtIon wtth premlsell you own, rent. or confrol end to
which this InSUrance appIIea:
(1) The eJdsIence. maintenance, repair, construction, erection. or remtMll of IIdve!tl8lng eigns,
awning!!, canoplea, cellar entrances. ooaI holes, drivewayll, _nholes, marquees, holsll!1N1l'f
openingll, sidewalk vaults, street banners, or decorations and simIlar exposures; or
a)
b)
c)
d)
Oral, Wlilten, teleWled, or Y\deQtaped pubQoatlon cl material thalslanders or libels a
person or organization or dispe!llges a person's or organization's goods, products, or
services'
Oral, wntten, televised, orYldeotaped publleallon cl materl8l thalllkllates a person's
right df privacy;
MlsappropI1ation cl adYe!tislng Ideas or st}te df doing business; or
Infringement 01 copyright, title, or slogan.
(2) The oonstructlon, erection, or _,df elewlora; or
(3) The ownerahlp. maintenance, or uee cl any elellatOl'6 covared by thltl lneuranoa.
2) ExolusionB a. (2) and a (3) 01 CowIrage B., Personal and AcMmlslng InjlJry LlabttllV, are
changed to read:
HoweIIer, the insul'lll1Oe IIIfa'ded for any organization end subsidiary thereof net named in the
Declarations 811 a Named Insured, does not apply 10 injIJry or damage With respect to which an
Insured under thle end!nement 18 8Iao an Insured under another policy, or would be an Insured
under such poRey but for Ita termination or the elChaustion of Ita RmItB df Insurance.
al
b)
(2) Artaing out cl oral, Wlilten, telellised, or videotaped publication 01 materiel, If done
bY,; or at the direction 01 the Insured with knaMedge ollis falsity;
(3) Artaing out cl oral, WIIlIen, telellised, or videotaped publication cl material Whose
ftl1ll publloatlon took place before the beglmlng of the polley period.
h.
j.
k.
StUdenla In IreinIng, but not for 'bodily Injury' or 'property damage' arising out df hie or her
rendering or failure to render proI'essIona1 services to patienb!;
Your members blt only with respect to their IlabRity for your I!CIMI/es or acti\lities they perform on
your behalf.
Your trustees or members of the board df goYemors while acting within the scope of lhelr duties
• such on your behalf;
Any entity you are required In a WI1lten contract (hereinafter c;alled Additionat Insured) to name as
G) BODILY INJURY MENTAL ANGUISH
The datinftion df 'bodily InJury' Is changed to n!ad:
'BodIly Injury':
a) Bodily InjlJry, sickness, or dlsellse _talned by a person, and Includes mental anguleh
resulting from any df Itae; and
b) Exoept 1'01" mental angUleh, Includes death -1..IIth1l from the foregotng (Item aba\le) at any
time.
an Insured 18 an Insured but only wfth respect 10 liability ari8ing out df your premlsell, 'your woIk'
for the Additional Insured, or acts or omlulana df 1he Additional Insured In connection with the
general supeMe10n of 'your worl<' to the extent set forth beloW:
Insurance does not apply 10 "bodIly Injury,' 'property damage' or 'personal and acMmleing Injury'
ariSing out df the rendering or IaRum 10 render any profes&lonal6eMce& by or for you, InchJdIng:
H) UNIN'T1!NTIONAL·FAlLURI! TO DISCLose HAZARDS
It Is agreed that, bfted on our n!nanoa on your representations as to existing hazards, If you ehould
unlntenllonefty lallib dlsclo8e an euch hazards prior to the beginning 01 the policy period of this
CoIIerage Part, we/shan not deny COIIerage under this CowIrage Part because 01 such failure.
(1) The preperlng, appn:l\lfng, or lalnng to prepII!I! or approYe, mapa, shop drawings,
opinions. reports, suM!!'J8, fteld orders, change ordIIfII, or drawings and speciflcllllons;
and
(2) SupeMsors, inspection, or engineering &eMce&.
I) LIBERALIZATION
Ifwe adopt a change In our forms or rules whleh woold broaden your ClMlrag8 without an addftlonal
premium charge. your poley wiD automatlcafty provide the additionat COYerage's as cl the date the
Any ClMlrege provided under thle pltNleIon shall be eJ«:eS8 over any other valid and revision is elfective in your state.
COllectible Insurance _Uable 10 the AddMlonal Insured(s) whether pllmary, exceea,
contingent or on any other basis unle8a a conffIIct epeeIIIpaIIy requires that thla Inwrance be J) EXTENDED ~PROioeRTY DAMAGE"
primary or you request that Rapply on a primary basis. SECTlON 1-CtM!rage$, CoYBrage A, 2. Exoluslons I!. Is deleted and replaced by the following:
Paragraph 4.8. df 8ectIon n -Who Is An Insured 18 deleted and replaoed by the following:
e. CcNerage under thIS prtlIIisIon la, subjecllo (1) and (2) below: .
(1) Eft'active on 1he !ICqJlIllon or formation date; and
(2) AtI'orded only untlt the end 01 the polley period of this Covemge Part or the next annlwrsary
1) Expe(:ted or Intended Injury;
'BodIly InjlJry' or 'Property Damage' eJiPecIlId or Intended from the
standpoint df the Insured. Thle exclusion does not apply to "bodily injlJry' or 'property
damage' ~Ing from 1he uae 01 reasonable force to protect persons or property.
of lis Inception date, whichelll!r Is earlier. K) PREMISES SOLD OR ABANDONED BY YOU
Ela:Iuslon j. of the General Uabillly exclusions Is amended as follows:
E) KNOWLEDOI! OR NOTtel! OF OCCURRENce
1) As _peets any I08Il reporting requiremem under this poley, ~ III undeflltood and agreed that
knov.1edge of an accident or Incident by an agent, seMlnt or emplOyee of yours or any other person
Paragraph (2) Is replaoed by the foIlowlng:
(2) Premr-you sen, give away. or abandon, If 1he 'property damage' arises out df any part of
those premlaes, and occurred from hazaTdll that were known by you or should have
00 GL0295 00 1006 Page 301 7 00 Gl0295 00 10 06 Page'! 017
reasonably been knCMl"l b'f you, at the lime the property was transferred or abandoned. 4) Regan:11e8s of whether other Jnsuranoe Ie eNallabie to en additional Insured on a primary
basis, this Insurance will be primary and ~if a W!ilten oonIrI!Ict between you
L) ADDITIONAL INSURED -FUNDING SOURCE and the addlllOnallrnlunld apecIfIcaIly requires that this Insurence be primary.
Under SECTION II -Who Is an Insured the following Is added:
2) An{ pereon or organization with respect to their liability wing out d: 0) OENERAL AOOREGATE LlMtr PER LOCATION
a)
b)
Thelr nnanclal control of you; or
Premtses they own, rnafntain, or control while you leoe or oc:cupy
these premItIes.
SECTION 111 -UIlIis of Insurance, paragraph 2. IS emended to the following:
1he General Aggregate Limit Is the most we \MIl pay for the 8I.rTl of:
1) MedICIlI expenses uooer C<MIrags C;
M)
lhls InslJl1!l'1lle doe8 not apply to atruclural aIIelllllona, nell/' constl'UCl.ion, aoo demolition operations
performed b'f or for that peraon or orgenfzllllOn.
ADDITIONAL INSURED MANAOERS OR LESSORS OF PREMISI!II
Under SECTION" -Who 18 an Insured the following Is added: .
1) Arry person or organfzatlon with respect to their liability arising ou! of the
2) Damages under CcM!rage A, eccepI damages becl!lUIe of 'bodily Injury" or 'property
damage' Included In the 'pmdt.Iots-compI operaIIOna hl!lZ8rd, I!Ird
3) Damages under C<MIrags B.
A seperete Location General Aggregate Limft llppllea to ea<;h 'locaIIon' and that IImH Is equal to the
amount of the General Aggregate limit shown In the Declarations.
ownenIhip. maintenance, or UIe of that part of the premlaee Iened to you, subjecl to the
tbflowlng addIIIonaI 8)CCJua1ons:
lhill Insurance doe8 not apply to:
a) Arry 'occurrence" which 1Il1ce8 place lifter you cease to be a tenant
SECTION V -CEFiNITtONS, Is I!I11eIlded t:1f adding the following:
'LocatIon" means premises t'MlMng the same or connecting IDIIl, or prernlsea whose connection Is
1n!emJpted OOIy b'f a street, roadway. waterway or r1ghI4-WIIY of a ranroad.
N)
In that premlsee.
b) structural aItenIIIon, new construction, or demolItIOn opet'lI!Iona
perbrmed b'f or on behalf of that person or organization.
ADDITIONAL INSUREDS -IIY CONTRACT. AQREEMINT OR PaMIT
1) An{ person or organization Is an lmiured with whom you are required to add lIS an
addlllonallrnlunld to 11118 policy by a wrttten contnIet or wrttten agreement, or permit that Is:
PJ BLANKET SPECIAl. EVENTS
1) ThIs Insurahce applies to "BodIly Injury,' "Property Damage.' and 'Personal and Advertising
Injury" IIl'IIUlg out of al your special e¥enI8 WITH THE FOLLONINGl EXCEPTIONS:
a) Paf8ies
b) AkcnrIt
c) I.tolllmycle runs aoo automobile ralll!!8
a)
b) .
cunentIy In eIrect or becoming eIIec:ltYe dl.l1ng the term ofthis policy; and
II!lI!8OIJted pI10r to the 'bodily Injury,' 'pmperty damage,' 'peraonaland acM!ltlsing
d)
e)
FIrework&
Rrearms
Injury. f)
g)
An1ma18
Caml¥als and fairs wtth meehanlcal rides
2) lhls Insurance pIlMded to the addltlonallmlured by this endonIementappllee n tbflowS:
8) 1ha! person or organimtlon Is only an addiIlonaIlrnIunId wtth respect to liabilfty
C8Iaed by your negligent acts or ornlsalons at or rmm:
(1) Premises you own, rent, 1-.or occupy, or
(2) 'four ongoing operations performed for the additional Insured at the Job
Indloated b'fwrttten contract or written ag_nt
b) 1he limits of Insurance appllOIIbIe to the additional Insured are those specllled In the
h)
I)
D
k)
I)
m)
Concerts
EYIInIs including corIact sports
Rocleoa
Porllical rallies
ArYf event JtwIing more then three (3) days (including otherwiae acceptable events)
An{ event wtth greater than 500 people In attendance (including oIherwise
acceptable events).'.
written contract or Written agreement or in the Declalllllona of this peNCV wh~Is
leu. n-11mb of Insuranoe ere Ir!clIusNe 01 and not In addItIOn to the 11mb of
Insurance IIhowI'IIn the Declarations.
Seperete coverage may be available at the company's dlsorelton for the events el<Cluded
Bbc:Mt. Possible additional <:hI!IIges may apply If <XM!I'Bge Ie provided.
Q) NON-OWNED WATEl\CRAI'T
3) Vv1th respect to the 1_afforded these additional Insured's, the tbflowlng additional SECTiON 1-Coverages. 2. 8a:1usIona, paragraph g.(2)leameOOed to read 118 tbflow8:
8)CCJuaIona epJlIy.
a) lhls Insurance does not apply to 'Bodily InJuty" or 'property damllQll" occun1ng !liter:
(1) all work, including rnaIertaII, p8I!II or equlpnent fumished In oonnecIIon with
8UClIl work, on the project (ofher than aeNlce, maintenance or repail8) to be
1) A watercraft you do not own that Is:
a) ..... than 65 feet long, and
b) Not being used to C8I!Y pen!IOOII or property for a charge;
This prouIaIon appIlea to arry peraon, who wtth your consent, either ute8 or Is responsible for the uae
perbrmed b'f or on behalf ofthe I!IddIIlonalln8Ull!d(8) at the aile of the ~
opeiatlOn8 has been COflllIeIed; or
of a watercraft.
lhls Insurance 1& ~OIIIIr arry other 1IlI1k! and collectible Insurance _liable to the Insured
(2) . that portion of 'your W!lI1<" out of which the Injury or damage ans. hl!l8 been
put to b inIanded UIe t:1f arry peraon or organiZ8llon other than another
whether primBIY, elCCeS8, or contingent.
conIrI!IcIor or auboOntnlCta' engaged In performing operations on or at the R) WAIVER OF SUBROOATION
b)
same projeet.
.Thls Insuranoe doe8 not apply to 'bodily Injury,' 'property damage,' 'personal and
adverlllling Injwy' caused b'f the rendeI1ng of or failure to render arry profeseional
We wlh waive our right of subrogation h the event of a loss. We must be advised, prior to the 1088, of
your intention to waive subrogalton. We also I11lJIIt knCIw whom subfogatlon will be waived against. If
your request meeIa the UI"ICIerwIiIIn criteria • will be done at no additional charge.
seMces.
00 Gl.ll295 00 10 06 Page 5 of7 00 GL0295 00 10 06 Pag116 of7
S) WAIVER OF IMMUNITY
We will waive, boIh In the adjuslmeJt rif elalma lind In defense rif 'suits' against the tll!lUl'ed, any
charitable or govemmentallrrmunlty rif the II18UIed, lJ'l1ess the insured requem, in writing, that we
nat do so.
Waiver rif Immunity, 118 II deft!nae. win not IIUbjeet us to lability for any poIlton of a Claim or Judgment,
In eccess, ~the applleeble fimlt rif Inaurance.
T) VIOLATION OF RIGHTS OF REsIDENTS CPATlENT'S RlGtfTS)
1) The !bllowlng III added to Seotion 1 -Ctwerages -Co\Ierage A, paragraph 1, InllU~ng
Agreement: , ,
'Bodily Injury" damages af18Ing out rif the violation rif'Rlghts rif Residents: shal be deemed an
'oeeurTenCe.'
2) As respecta the CO\Ierage proYlded In paragraph A 1. ~this endorsement, the fIlIky,Mng
mduIsIons are added to Seotion 1-CcM!rages -Cc:NerlIge 11.-2. EJduslons:
This Insuranee does not applV to:
a) L~11ty 8If8Ing out rif the wlllM or intentional violation of "Rights ~Resldenls."
b) Anes or penalties ~bV a court or reguiatOly authority.
c) Llilbility IIriaIng out rif any act or omlaalon In the fumlshlng, or failure to fumish,
pro(eIIslonlllllelVlces In the medlcallreatment rif "ratilldenIs.'
3) As respecta the violation ~"Rights ~ReeldenIs" Co\Ierege, the !blowing definition Is added
to SeetIOn V -DefInitions:
'Rights rif residents" means:
II. ArI'f right granted to a A!6Ident tmder any atata law reguIatlng yoor busnees as a
heath CIIIlI facility.
b, The 'Rights rif Re8Iden!s" as Included In the United states Department ~Heatth and
Welfare regulatIOns gm.oemlng patllcipatton ~IntermedlBItl Care Facilities and SlIilled
Nursing Fac:IItIea, reganIIesII fA vmether yoor faclfity Is subjeet to those regulatIOns.
U. UQUOR UABIUTY EXCI.USION -EXCEPTION FOR FUNDRAISING EVENnI
Paragraph c. rif 2. Exclusions, COVERAGE A (SECTION 1) Is emended bV adding the following
8Ubparagraph:
ThiS elCCluston does not applV to "bodily Injury" or 'property damage" arising out rif the seiling,
serving or fumiShlng rif alcdlolto beYerages at any fundralslng events.
All other terms end condI!ions rif this Policy remain unchanged.
Endonlemer1t Number;
Pelloy Number:
Named tneured:
This endorsement Is eII'ectIIIe on the Inceptton date rif this PeRcy unless otherwise stsltld herein:
Endonlement Elle<:tllle Date:
00 GUl295 00 10 06 Page7rif7
JUL-t7-2011 08:38AM FROMo-J BAR J YOUTH SERVICES 541 388 8348 T-060 P. 0021002 F-645
salfcorporation Carrier No: 20001Infonnatlon Page
Policy No: 373613
Employer Identification Number: 93-0577650
Item 1, The Insured: Entity Type:
J BAR J YOIJTl; SERVICES INC NON-PROFIT CORPORATION
Mailing address:
J BAR J YOUTH SERVICES INC
62895 HAMBY
BEND, OR 97701-9575
Other workplaGea not shown above:
2'25 NE DAGGET LANE. BEND. OR eno1
63325 SILVIS ROAD. BEND. OR rmo1-9743
~HAMBY RD. BEND. Oft en01-SS75
ACADEMY AT slsreRS LODGE. 16161 BURGESS RD. LAPINE. OR 97739
19 SW CENTURY DR, BEND, OR 97702
Item 2. The poUcy period is from 01-O'~2011. 12:01 A.M. to 01-01-2012,12:01 A.M. at the insured's mailing
address
Item 3. A. Workers COmpensation Insurance: Part One of the policy applies to the Workers
Compensation Law of the states listed here: OREGON
B. Employers liability '..",ranee: Part Two of the policy applies to work in each state listed in
Item 3A The limits of our liability under Part Two are:
Bodily Injury by Accident $500,000 each accident
Bodily Injury by Dlseese $SOO,OOOeach employee
Bodily Injury by Disease $500,000 policy limit
C. Other States Insurance: ,.rt Thme at the poliCy applIes to the states, if any, listed here:
NONE
D. Tbis policy Includes these endorsements and schedules:
WC360601E Oregon CanoaJlation Endorsement
WCOOO421C catastraphe (ather thIIn Certified Acts of Terrorism) Premium End
WC000422A T8ITOrism RIsk ItISUt'B.nC:e Prog ReauIhorization Act Oisclo8ure End
WCOOO414 NotIfication of Change in Ownership Endorsement
WCOOO406A Premium Diacaunt Endcnament
WC36040G Premium Due Date Endorsement
WC990602 Subject 0fIic:er p.yrdI Requirement -Non-Profit Corporation
WC360301 Oregon Unsafe Equipment Exclusion Enclorsement
WC990818 Confidentiality Endorsement
Item 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. Tne premium and rates and the experience rating modification factor, If any, may change on
your anniversa'Y rating date of 01-01-2012. All information required below is subject to verification and
change by audit.