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HomeMy WebLinkAboutDoc 655 - Subgrant - Family Access Network❑ -< Deschutes County Board of Commissioners 1300 NW Wall St., Suite 200, Bend, OR 97701 -1960 (541) 388 -6570 - Fax (541) 385 -3202 - www.deschutes.org AGENDA REQUEST & STAFF REPORT For Board Business Meeting of December 9, 2009 Please see directions for completing this document on the next page. DATE: December 2, 2009. FROM: Sarah Johnson Commission on Children & Families Phone #322 -7461 TITLE OF AGENDA ITEM: Consideration of Board Signature of Document No. 2009 -655, Contract for Subgrant of $238,000 w th Family Access Network Foundation PUBLIC HEARING ON THIS DATE? No BACKGROUND AND POLICY IMPLICATIONS: The Board of County Commissioners routinely asks Deschutes County Departments for their priority federal legislative requests. Since 2004, the Commission on Children & Families has submitted an appropriation request for Family Access Network (FAN). In 2009, the appropriation request was recommended for funding and Congress appropriated the fiscal year 2009 budgets for federal agenc ies, which includes the Oregon federal appropriations request for FAN. The FAN "project" was recommended for funding at $238,000 for social service programs. Family Access Network is unique to Deschutes County and supported by a network of community partners who collaborate to ensure children attend school ready to learn. Partnering with the three Deschutes County school districts, FAN places family advocates in local schools, providing a direc , convenient way to connect those in need with the proper services. Through one dedicated advocate. a student or parent is referred for dental work, job opportunities, clothing, rent assistance, health insurance and more. The Commission on Children & Families has been providing funding for FAN since 2004. This project will fund 4.44 FTE Family Access Network (FAN) advocates working in eleven K -12 public school sites in Bend, Redmond and Sisters. Each FAN advocate will serve up to 250 childre and family members at a school location each year, connecting families to basic -need services sucl as food, shelter, housing, clothing and more. FISCAL IMPLICATIONS: This grant agreement transfers the appropriation from Deschutes County Commission on Children & Families to the Family Access Network Foundation for their services to children and families in th public school sites. This grant was not included in the 2009 -2010 budget. The amount to be receiv xd in the 2009/2010 year is $142,800, so a budget resolution in that amount will be submitted. The remaining $95,200 of the contract amount will be included in the budget for the 2010/2011. RECOMMENDATION & ACTION REQUESTED: Approval and signature on document # 2009 -655, Contract for Subgrant of $238,000 to the Family Access Network Foundation. ATTENDANCE: Sarah Johnson DISTRIBUTION OF DOCUMENTS: Two originals back to Debi Harr, Commission on Children & Families, 1130 NW Harriman, Suite A, Bend, OR 97701. DESCHUTES COUNTY DOCUMENT SUMMARY (NOTE: This form is required to be submitted with ALL contracts and other agreements, regardless of whether the document is to be on a Board agenda or can be signed by the County Administrator or Department Director. If the document is to be on a Board agenda, the Agenda Request Form is also required. If this form is not included with the document, the document will be returned to the Department. Please submit documents to the Board Secretary for tracking purposes, and not directly to Legal Counsel, the County Administrator or the Commissioners. In addition to submitting this form with your documents, please submit this form electronically to the Board Secretary.) Date: Please complete all sections above the Official Review line. November 5, 2009 Contractor /Supplier /Consultant Name: Contractor Contact: Julie Lyche Type of Document: Contract Department: CCF Family Access Network Foundation Contractor Phone #: 693 -5677 Goods and /or Services: This project will fund 4.44 FTE Family Access Network (FAN) advocates working in eleven K -12 public school sites in Bend, Redmond and Sisters. Each FAN advocate will serve up to 250 children and family members at Ischool locationsach year, connecting families to basic -need services such as food, shelter, housing, clothing and more. Background & History: Family Access Network is unique to Deschutes County and supported by a network of community partners who collaborate to ensure children attend school ready to learn. Partnering with the three Deschutes County school districts, FAN places family advocates in local schools, providing a direct, convenient way to connect those in need with the proper services. Through one dedicated advocate, a student or parent is referred for dental work, job opportunities, clothing, rent assistance, health insurance and more. The Commission on Children & Families has been providing funding for FAN since 2004. Agreement Starting Date: 31, 2010 October 1, 2009 Annual Value or Total Payment: $238,000 Ending Date: ® Insurance Certificate Received (check box) Insurance Expiration Date: Check all that apply: RFP, Solicitation or Bid Process ❑ Informal quotes ( <$150K) ® Exempt from RFP, Solicitation or Bid Process (specify — see DCC §2.37) N/A� December Funding Source: (Included in current budget? I Yes ® No If No, has budget amendment been submitted? I l Yes ® No 11/6/2009 Is this a Grant Agreement providing revenue to the County? ❑ Yes ® No Special conditions attached to this grant: Exhibit 1 - Subcontractor delegation to Bend - LaPine School District, High Desert Education Service District, Redmond School District, and Sisters School District. Deadlines for reporting to the grantor: Financial Reports due on the 15th of the month following the end of the quarter. Program Reports due 30 days following the end of second and fourth quarters (every six months) during the project period. 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: ❑ Yes I 1 No Contact information for the person responsible for grant compliance: Name: Hillary Saraceno Phone #: 317 -3178 Departmental Contact and Title: Sarah Johnson, Community Project Coordinator Phone #: 322 -77461 Department Director Approval: ///2 3 �� 7 Sign. ure Date/ Distribution of Document: Who gets the original document and /or copies after it has been signed? Include complete information if the document is to be mailed. Sarah Johnson 322 -7461 Official Review: County Signature Required (check one): El BOCC El Department Director (if <$25K) ❑ Administrator (if >$25K but <$150K; if >$150K, BOCC Order No. ) Legal Review Date Document Number 11/6/2009 REVIEWED LEGAL COUNSEL VIED EPARTMENT HEAD For Recording Stamp Only Contract for Subgrant Under The Deschutes County Commission on Children & Families Contractor: Family Access Network Foundation Project: Family Access Network Contact: Julie Lyche 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 Commission on Children & Families, hereinafter called "Commission" or "CCF ", and Family Access Network Foundation, , an Oregon non - profit corporation, Federal Tax ID # 20- 3534560, hereinafter referred to as "Contractor :" DEFINITIONS Application - The proposal provided by an applicant agency seeking funding. The applicaticn 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 Commission on Children & Families or the Director's designee. Grant - The application, award, and incorporated documents constituting an agreement between County and Department of Health and Human Services, Administration for Children and Families to carry out the Project. Other granting organizations - Any entity providing resources (to the Commission) that provide funds for this contract. Commission - The Deschutes County Commission on Children & Families. Work Plan - The attached document that details the performance measures which Contractcr must satisfy in order to qualify for payment under this Contract. RECITALS WHEREAS, Contractor has submitted to Commission its application for a Subgrant award t undertake the Project, (in accordance with County's Community Plan) as more specifically set S: \CCFamilies\Grants12009- 201112009 2010\Provider Contracts \FAN.doc — Document # 2009 -655 1 forth in Exhibit A (Work Plan) and Exhibit B (Budget);and 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, October 1, 2009, 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 December 31, 2010. 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, 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 Director. 4. Consideration. The maximum consideration authorized under this Contract is $238,000. 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). S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 2 6. Subcontractor Delegation. The parties understand and agree that Contractor will delegate the responsibility for providing those services more fully described on Exhibit 1 by separate written agreements to the High Desert Education Service District, the Bend LaPine School District, the Redmond School District and the Sisters School District. No other delegation of responsibility shall occur unless first approved in writing by the Commission on Children and Families. a. Any delegation, subcontract, assignment, or transfer without the prior written conselt of County shall constitute a material breach of this Contract. b. Any such assignment or transfer, if approved, is subject to such conditions add provisions, as the County may deem necessary. c. No approval by the County of any assignment or transfer of interest shall be deemed :o create any obligation of the County to increase rates of payment or the maximu n Contract consideration. d. Prior written approval shall not be required for the purchase by the Contractor >>f 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 and all subcontracts authorized by this Contract or that the County may authorize, shall be subject to and contain all requirements of this Contract. Contractor shall Le responsible for the performance of each 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. 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 tD 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 b a submitted electronically using forms /templates approved by the Commission. The number of payments will be based upon the number of calendar quarters contained i 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 cr County in accordance with the terms and conditions of the Grant and Scope of Work. b. Obtain prior Commission approval of all revisions to the Budget as detailed is l Exhibit B that are in excess of ten percent (10 %) of the amount of the contracted amount, and obtain prior approval of all contracts and procurements involvinil S:1CCFamilies\Grants12009- 2011\2009 20101Provider Contracts\FAN.doc — Document # 2009 -655 3 aggregate sums in excess of $500 for personal services. c. Document and report cash or in -kind match in the amounts shown in Exhibit B. d. Prepare and furnish such plans, data, descriptive information and reports as may be requested by County, as needed to comply with County, State and or Federal requirements. Contractor agrees to, and does hereby grant the County and any other granting organizations the right to reproduce, use, and disclose all or any part of the reports, data, and technical information furnished under this Contract. e. Justify all costs by properly executed payroll records, time records, invoices, 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 D. h. Meet at least once during the Contract period with a designated Commission representative to discuss program progress. Additional meetings may be required by the Commission. i. When actual performance varies significantly from Exhibit A and the agreed upon Work Plan, 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. 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 S: \CCFamilies \Grants12009- 2011 \2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 4 the Director and, depending on the severity of the non - compliance, as determined by the Director, by the Commission's Child Abuse and Family Functioning Action Teem 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 reduci.ig funding, withholding payment of funds and, in Commission's sole discreticn, reallocation of grant funds for distribution to other contractors or programs. m. Assurances: The Contractor attests that the information provided to Commission to determine Contractor eligibility for payment, including all required reports, is true acid accurate to the best of the Contractor's knowledge. The Contractor's representati ie 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 substantia ly 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 in printed and electronic versions of program reports, flyers, media coverage, announcements including web site applications. Contractor shall first notify and discuss with Commission's Director any concerns or issues Contractor may have Deschutes County or the Commission's programs or processes. Such concerns or issues shall not be addressed in published materials or the media. Significant issues or concerns should be outlined in writing and directed to the Commission Chairperson. o. Family Violence Policy: No later than the end of the Contract term (or, if more then 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 shell 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 are available during the contract term, Contractor shall participate. S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 5 s. Contractor shall not expend nor request County reimbursement of any grant funds for Activities and Services, including allowable costs, other than those set forth in Exhibit A, which are undertaken by, timely completed and properly 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, execut ve orders, codes and ordinances applicable to the Contract or to the conduct of activit es under this Contract. Without limiting the generality of the foregoing, Contrac:or 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 tze extent that they are applicable to the Contract. Contractor shall comply with tie provisions of ORS 279B.220, 279B.230 and 279B.235, which are incorporated 'y 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 (B); 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 ary 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 Contrac:. Without limiting the generality of the foregoing, Contractor expressly agrees to comply with the following laws, regulations and executive orders: (a) Titles VI and V I of the Civil Rights Act of 1964, as amended, (b) Sections 503 and 504 of th e 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) th9 Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended, (e) the S : \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 7 Federal Funding 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, and (g) all regulations and administrative rules established pursuant to the foregoing laws, (h) all other applicable requirements of federal civil rights and rehabilitation statutes, rules and regulations, (i) all federal laws requiring reporting of client abuse, (j) the Americans with Disabilities Act of 1990 (codified at 42 USC 12131 et. seq.), as amended, in the construction, remodeling, maintenance and operation of any structures and facilities, and in the conduct of all programs, services and training associated with Contractor's programs and activities. These laws, regulations and executive orders are incorporated by reference herein to the extent that they are applicable to the Contract and required by law to be so incorporated. No federal funds may be used to conduct activities in violation of 42 USC 14402. f. When utilizing federal Title IV -B2 Family Preservation and Support Services funds, the additional federal requirements applicable to Title IV -B2 Family Preservation and Support Services funds in 42 USC 629 et seq., including but not limited to: maintaining and providing to County such documentation as the County shall require to comply with federal reporting requirements; 45 CFR Part 92; and the limitations on the use of Title IV -B2 funds in 42 USC 629d. g. When utilizing federal Child Care and Development block grant funds, the additional federal and state requirements applicable to Child Care and Development block grant funds in 42 USC 9858 et seq., and 45 CFR Part 98, including but not limited to: maintaining and providing to County such documentation as the County shall require to comply with federal reporting requirements; and the limitations on the use of such funds in 42 USC 9858d and 45 CFR 98.54 and OAR 423 - 010 - 0024(2). h. With respect to federal funds under this Contract, Contractor agrees to comply with the provisions of the OMB Circular A -87, Revised "Cost Principles for State, Local and Indian Tribal Governments." Federal funds received by Contractor under this Contract from the sources identified in paragraphs c, d, f and g of this Section 9 are subject to the audit requirements under the Single Audit Act Amendments of 1996 and OMB Circular A -133, Revised, "Audits of Institutions of Higher Education, and Other Non - Profit Organizations." i. All mandatory standards and policies that relate to resource conservation and recovery pursuant to the Resource Conservation and Recovery Act (codified at 42 USC 6901 et. seq.). Section 6002 of that Act (codified at 42 USC 6962) requires that preference be given in procurement programs to the purchase of specific products containing recycled materials identified in guidelines developed by the Environmental Protection Agency. Current guidelines are set forth in 40 CFR Parts 247 -253. J• The following environmental laws: (1) all applicable standards, orders or requirements issued under the Clean Air Act (codified at 42 USC 7401 et. seq.) and the Federal Water Pollution Control Act, as amended (codified at 33 USC 1251 et. seq.), (2) Executive Order No. 11,738 of the President of the United States and (3) Environmental Protection Agency regulations set forth in 40 CFR Part 15. Contractor shall promptly report all violations of the federal laws to County. Contractor shall include and require the inclusion in all contracts with recipients receiving more than S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 8 $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 Servi :e Administration's "List of Parties Excluded from Federal Procurement or No-i- 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 t "e names of parties debarred, suspended, or otherwise excluded by agencies, and contractors declared ineligible under statutory authority other than Executive Ord 2r 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 tl•e awarding of any federal contract, the making of any federal grant, the makirg of any federal loan, the entering into of any cooperative contract, and tl-e extension, continuation, renewal, amendment, or modification of any feder �l 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 th s 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 th,s 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 Tess 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 (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 Employmer t Opportunity," as amended by Executive Order 11375, and as supplemented i 1 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 § 608 et. seq.). S: \CCFamilies \Grants\2009- 2011 \2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 9 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 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 S: \CCFamilies \Grants\2009- 2011\2009 2010\ Provider Contracts\FAN.doc — Document # 2009 -655 10 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 employe:, 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 regardirg Lobbying; Debarment, Suspension and Other Responsibility Matters; and Drug -FrEe Workplace Requirements, marked Exhibit C 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. By signing this contract, Contractor agrees to the terms and conditions of that certai i grant agreement by and between the County and the United States Department of Health & Human Services, Administration for Children and Families, a copy of which is marked Exhibit E, attached hereto and incorporated by reference. 10. Under Expenditure of Funds. Funds determined by County to be under expended cr unexpended, or unencumbered for authorized expenditures, shall be withheld by County from payment, refunded to the State, or reallocated by County as may be authorized cr required. a. Unauthorized Expenditures: Any funds expended for unauthorized purposes shall be deducted from funds otherwise payable to Contractor, or otherwise subject t3 recovery by County and refunded to the State, or reallocated by County as may b?. authorized or required. 12. Equipment. All equipment 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. 13. Indemnity. a. Contractor shall indemnify, save harmless and defend the State of Oregon, the Commission, its officers, agents and employees, and the County, its officers, agent; and employees from and against any and all claims, lawsuits, or actions for damages, costs, losses and expenses, arising from Contractor torts, as the term tort is defined in ORS 30.260(8). b. To the extent permitted by Article XI, Section 10, of the Oregon Constitution and the Oregon Tort Claims Act, ORS 30.260 through 30.300, to the extent the Act is applicable,_County shall defend, save, hold harmless, and indemnify Contractor and it: officers, employees and agents from and against all claims, suits, actions, losses, damages, liabilities, costs and expenses of any nature resulting from or arising out of, or relating to the activities of County or its officers, employees, contractors, or agents S: \CCFamilies \Grants\2009 - 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 11 under this Contract, except for liability arising solely out of the wrongful acts of employees or agents of the Contractor. S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts 1FAN.doc — Document # 2009 -655 12 14. 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. 15. 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 n 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 r o 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 reascn 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 th s 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 b y County. S: \CCFamilies \Grants \2009- 2011 \2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 13 d. Contractor Default or Breach. The County, by written notice to the 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. S: \CCFamilies \Grants12009- 2011\2009 2010 \Provider Contracts \FAN,doc — Document # 2009 -655 14 16. Payment on Early Termination. Upon termination pursuant to paragraph 15, payment shall be made as follows: a. If terminated under subparagraphs 15 a through 15 c of this Contract, the County shall pay Contractor for work performed prior to the termination date if such work was performed in accordance with the Contract. County shall not, however, pay Contractor for any obligations or liabilities incurred by Contractor after Contractor receives written notice of termination. b. If this Contract is terminated under subparagraph 15 d of this Contract, Coun :y obligations shall be limited to payment for services provided in accordance with this Contract prior to the date of termination, Tess any damages suffered by the County. c. If terminated under subparagraph 15 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 tt e Contract. 17. Remedies. In the event of breach of this Contract the parties shall have the followirg remedies: a. Termination under subparagraphs 15 a through 15 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 15 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 al 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 th 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 15 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 unde- 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 b� fire, civil unrest, labor unrest, riot, acts of God, or war where such cause was beyonc reasonable control of County or Contractor, respectively. Contractor shall, however S: \CCFamilies \Grants12009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 15 g. 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. The passage of this Contract expiration date shall not extinguish or prejudice the County's or Contractor's right to enforce this Contract with respect to any default or defect in performance that has not been cured. Specifically, but without limiting the generality of the preceding sentence, termination of this Contract shall not affect County's right to recover from Contractor, in accordance with the 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 . 18. 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. 19. 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. 20. 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. 21. 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. 22. 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. S: \CCFamilies \Grants \2009 - 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 16 23. Expense Reimbursement. If the consideration under this Contract provides for tie reimbursement of Contractor for expenses, County shall only reimburse Contractor for expenses reasonably and necessarily incurred in the performance of this Contract. Expenses reimbursed shall be at the actual cost incurred, including any taxes paid, and shall not include any mark -up unless the mark -up on expenses is specifically agreed to in this Contract. The cost of any subcontracted work approved in this Contract shall not be marked up. Contractor shall not bill County for any time expended to complete the documents necessary for reimbursement of expenses or for payment under this Contract. 24. Criminal Background Investigations. a. Contractor understands that Contractor is subject to periodic criminal backgrourd 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 is subcontractors' employees and agents do not present a substantial risk of harm to children who receive services from contractor or its subcontractors. Such precautiors 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. 25. 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. 26. Access to Records - Audit. Contractor shall maintain fiscal records and all other record; 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 Contrac: 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 authorizes 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 conductinc audits and examinations and making copies, excerpts and transcripts. These record! also include licensed software and any records in electronic form, computer hart 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 Federa S:1CCFamilies \Grants\2009- 201112009 20101Provider Contracts\FAN.doc — Document # 2009 -655 17 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. 27. 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. 28. Materials. At all times, Contractor shall make reasonable efforts to use recycled materials in the performance work required under this Contract. 29. Constraints. Pursuant to the requirements of ORS 279B.220 though 2796.235, 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. S: \CCFamilies \Grants\2009- 2011\2009 20101Provider Contracts \FAN.doc — Document # 2009 -655 18 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 wth 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 any one day, or forty (40) hours in any one week, except in cases of necessity, emergency, or where t ie 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 any one day or 40 hours in any one week, when the work week is five consecutive days, Monday through Friday; or (2) For all overtime in excess of 10 hours in any one 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 cf 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 any applicable collective bargaining agreement or in ORS 279B.020(1)(b)(B) to (G) and for all time worked in excess of 10 hours in any one day or in excess cf 40 hours in any one week. d. 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. e. This Contract is expressly subject to the debt limitation of Oregon counties set forth it Article XI, Section 10, of the Oregon Constitution, and is contingent upon funds beinc appropriated therefore. Payment under this Contract is also subject to the County': 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. S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 19 30. Contractor Not an Agent of County. It is agreed by and between the parties that Contractor is not carrying out a function on behalf of County, and County does not have the right of direction or control of the manner in which Contractor delivers services under this Contract or exercise any control over the activities of Contractor. 31. Partnership. County is not, by virtue of this Contract, a partner or joint venturer with Contractor in connection with activities carried on under this Contract, and shall have no obligation with respect to Contractor's debts or any other liabilities of each and every nature. 32. 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 Commission on Children and Families, and their officers, agents, employees and volunteers as an additional insured. b. Contractor shall maintain automobile liability insurance, if applicable, of not less than the limits set forth below. Insurance shall provide coverage for any motor vehicle driven during the course of providing services under this Contract. (1) $500,000, combined single limit, or (2) Split limits of $250,000 per person, $500,000 per occurrence, $100,000 property damage. c. All insurance policies shall be written on an occurrence basis and be in effect for the term of this Contract. Authorization from Deschutes County is required for any policy written on a Claims Made basis. d. Proof of Workers Compensation from the Contractor is required prior to the commencement of the Contract. e. Prior to executing this Contract, the Contractor shall provide County the Certificates of Insurance, and upon County's request, certified copies of Insurance policies and declarations. f. Contractor shall immediately notify County if any insurance coverage required by this Contract will be canceled, not renewed, or modified in any way. g. Thirty -day cancellation notice is required on all policies. h. 33. 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 15c of this Contract. 34. 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. S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts\FAN.doc — Document # 2009 -655 20 35. 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 remed es provided herein are cumulative and not exclusive of any remedies provided by law. 36. 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 tie Circuit Court of Deschutes County for the State of Oregon; provided, however, if a Cla m shall be brought in federal forum, then it shall be brought and conducted solely a,id exclusively within the United States District Court for the 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 Internatioral Sales of Goods shall not apply. 37. Severability. If any term or provision of this Contract is declared by a court of compete it 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 ar;d 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, cr amended in any manner except by written instrument signed by both parties. 41. Notice. Except as otherwise expressly provided in this Contract, any communications between the parties hereto or notices to be given hereunder shall be given in writing, t) Contractor or County at the address or number set forth below or to such other addresses or numbers as either party may hereafter indicate in writing. Delivery may be by personal delivery, facsimile, or mailing the same, postage prepaid. a. Any communication or notice by personal delivery shall be deemed delivered when actually given to the designated person or representative. b. Any communication or notice sent by facsimile shall be deemed delivered when thi transmitting machine generates receipt of the transmission. To be effective agains: County, such facsimile transmission shall be confirmed by telephone notice to County' ; Director of Administrative Services. S: \CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 21 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: Kristi Allardyce Family Access Network Foundation 2125 NE Daggett Lane Bend, OR 97701 To County: Hillary Saraceno, Director The Commission on Children & Families 1130 NW Harriman, Suite A Bend, OR 97701 43. Survival. All rights and obligations shall cease upon termination or expiration of this Contract, except for the rights and obligations set forth in Sections 16 and 17. S:\ CCFamilies \Grants\2009- 2011\2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 22 Dated this of , 2009 BOARD OF COUNTY COMMISSIONERS ATTEST: TAMMY BANEY, CHAIR DENNIS R. LUKE, VICE CHAIR Recording Secretary ALAN UNGER, COMMISSIONER DATED this day of December, 2009 CONTRACTOR: %1. By: Kristi Allardyce Family Access Network Foundation S: \CCFamilies \Grants \2009 - 2011 \2009 2010 \Provider Contracts \FAN.doc — Document # 2009 -655 23 EXHIBIT I I. Contractor shall meet all performance outcomes as outlined in the attached Work Plan (see Exhibit A attachment) and perform the following scope of work: Role of FAN Foundation Board - The FAN Foundation and its Board of Directors will ensure that the contract is completed and the workplan outcomes /outputs are successfully met. The FAN Foundation is responsible for fund obligations if the school districts do not meet contract requirements. The FAN Foundation will use fund allocation as leverage to seeking other financial support within the community. Advocates will also receive a small amount of emergency funds for each site through the FAN Foundation. Emergency funds can be used to leverage other partner support when families need assistance with housing, food, heating or other basic - needs. Role of School Districts - Bend/La Pine School District will hire and conduct direct supervision of 2.44 FTE, at the following schools: Elk Meadow, La Pine Elementary, Mt View High, Marshall, Ponderosa, and Buckingham Elementary over an 15 -month period. Advocates will connect our most disadvantaged families to basic -need services such as food, shelter, healthcare and more. Advocates will work between August and June of each school year. Redmond School District will hire and conduct direct supervision of 1.66 FTE at the following schools: Terrebonne, Vern Patrick, John Tuck, and Tom McCall, over an 15- month period. Advocates will connect our most disadvantaged families to basic -need services such as food, shelter, healthcare and more. Advocates will work between August and June of each school year. Sisters School District will hire and conduct direct supervision of .34 FTE, to focus on working with families at Sisters Elementary school over an 15 -month period. Advocates will connect our most disadvantaged families to basic -need services such as food, shelter, healthcare and more. Advocates will work between August and June of each school year. Role of High Desert ESD - The High Desert ESD will provide services from the FAN Program Director to support FAN advocates in schools. Advocates will receive on- going training, oversight, and support through the program. The Program Director will provide collaborative work with community partners to generate services for families, overall programmatic oversight and connections with schools. Commission on Children & Families Program /Project Work Plan /Quarterly Report Provider: Contact(s): Project/Activity: Contract Period: Family Access Network Foundation Julie Lyche Family Access Network October 1, 2009 to December 31, 2010 Exhibit A Focus area: Family Functioning Outcome (HLO): Reduce Child Maltreatment Activities Outputs Outcomes Q1 Q2 Q3 Q4 10/1.12/31 1/1.3/31 4/1.6/30 7/1.9/30 Q5 10/1 - 12/31 Total Measurement Tool Refer children and family members to basic -need services. Sisters Schools .34 FTE, Bend = 2.44 FTE, Elk Meadow, La Pine ES Mt View, Marshall, Ponderosa, Buckingham Redmond =1.66 FTE, Terrebonne, Vern Patrick, John Tuck, Tom McCall 2750 individuals (children and family members) will be served at 11 school sites 90% of individuals served will be connected to appropriate community resources. Target: 2475 1.02.01 served As measured by quarterly site reports. #assessed #successful % successful 0% 0 °fa, 0 °fo 0 °fo °fo 75% of individuals surveyed at FAN sites will report that the referrals made improved their situation. 1.03.07 Served 0 ,:: As measured by client feedback survey, conducted with all clients seen on two randomly chosen Y dates per year. #assessed 0 #successful 0 % successful �. ��. Q°fa' +is, :0% . .' 0�f Q° ; Explanation: Problems Describe any deviations or departures from the original project plan B -02(4) As reported by Program Director Explanation: Dissemination activities Describe project related inquiries and information dissemination activities. itemize and include a copy of any newspaper, newsletter, or other published materials considered relevant to project activities. B -04(4) As reported by Program Director Explanation: Other activities Briefly describe B -05(4) As reported by Program Director Explanation: Activities planned for next reporting period Briefly describe B -06(4) As reported by Program Director Federal Progress Report Due Dates: 4/30/2010.10/31 /2010.4/30/2011 BUDGET EXHIBIT B The budget must contain at least 25% or $20,000 (whichever is less) of project funds in the form of cash. The match must come from sources other than the Commission. Cash match is defined as funds derived by fundraising activities, grants or any source other than state general fund or Federal Medicaid resources. Program Name: Family Access Network Contract Period: October 1, 2009 - December 31, 2010 REVENUE - Source Amount % Amount Requested from CCF $ 238,000 17.6% User Fees /Program Fees $ - 0.0% Other: County General Funds (do not include this proposed grant) $ - 0.0% 0.0% Other: Federal Funds Medicaid $ 646,678 47.8% Other: Public Funds School Dist. General Fund $ 145,894 10.8% Other: Private Grants FAN Foundation fundraising - grants $ 125,375 9.3% 0.0% In Kind 0.0% Donations $ 184,373 13.6% Volunteer Hours (x hours @ $20.25) $ 13,163 1.0% Total Revenue $ 1,353,483 100.0°J) BUDGET - Expenses Program Name: Contract Period: EXHIBIT B Cont. Family Access Network October 1, 2009 - December 31, 2010 TOTAL $1,353,483 Proposed Expendi- tures from CCF Expenditures from other sources Total Program Cost: Administration Cost - Indirect Charges for Program Administration Admin °A° cannot exceed 8% $ 11,500.00 $11,50! Direct Service Personnel List # of people and FTE for each person $238,000 828,570 $1,066,5711 B /IP = 2.44 FTE -- Elk Meadow, LaPine ES, Mt. View, Marshall, Ponderosa, Buckingham $(1 Redmond =1.66 FTE - Terrebonne, Vern Patrick, John Tuck, Tom McCall $11 FAN Program Director =.24 FTE Sisters Schools= .34 FTE $(1 Subcontractors /Consultants $ 32,700.00 $ 32,700.0 +) Materials & Services $22,625 $22,623 Office Supplies /Expenses $20,925 $ 20,925.0') Capital Equipment $+) Other (Explain):volunteer hrs $ 13,163 $13,163 Scholarships /Emergency funds $ 31,250.00 $31,25) Travel/Training $18,513 $18,513 EXPENSE TOTAL $238,000 $ 979,245.47 $1,217,245 Donor Designated Carry- forward $ - $136,238 $ 136,238.03 TOTAL $1,353,483 Exhibit C 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 $1 1,000 and not more than $100,000 for each failure. Contract If 1. A ( 11 (6 cl r Signature Date Exhibit "D" Contractor's Reporting Requirements Contractor is required to submit the following: ® Quarterly work plan report ® Quarterly CCF Demographics report ® Quarterly Funds request ❑ Program Data submitted to CCF staff semi - annually ❑ Monthly MDS Report (due by the 10th of the month) CCF Quarterly reporting due dates: January 15, 2010 April 15, 2010 July 15, 2010 October 15, 2010 1.RECIPIENT Department of Health and Human Services Administration for Children and Families Financial Assistance Award (FAA) SEP 2 42009 SAI NUMBER: PMS DOCUMENT NUMBER: 90XP036201 EXHIBIT E 1. AWARDING OFFICE: Ofc Of Ping Resch And Evaluation 2. ASSISTANCE TYPE: Discretionary Grant 3. AWARD NO.: 90XP0362/01 4. AMEND. NO.: 5. TYPE OF AWARD: OTHER 6. TYPE OF ACTION: New 7. AWARD AUTHORITY SEC 413 SSA /SEC 1110 SSA 8. BUDGET PERIOD: 09/30/2009 THRU 02/28/2011 9. PROJECT PERIOD: 09/30/2009 THRU 02/28/2011 10. CAT NO.: 93647 11. RECIPIENT ORGANIZATION: Deschutes County Commission on Children and Families 1300 NW Wall Street, Suite 200 Bend, OR 97701 1960 Tammy Baney, Deschutes County Board of Commissioners, Chair 12. PROJECT / PROGRAM TITLE: (Earmark: ACF /OCS) Family Access Network 13. COUNTY: DESCHUTES 14. CONGR. DIST: 02 15. PRINCIPAL INVESTIGATOR OR PROGRAM DIRECTOR: Sarah Johnson , Community Project Coordinator 16. APPROVED BUDGET: Personnel $ 178,945 Fringe Benefits $ 59,055 Travel... $ 0 Equipment $ 0 Supplies $ 0 Contractual $ 0 Facilities /Construction $ 0 Other $ 0 Direct Costs $ 238,000 17. AWARD COMPUTATION: A. NON - FEDERAL SHARE $ 0 0.00 o/c B. FEDERAL SHARE $ 238,000 100.00 % 18. FEDERAL SHARE COMPUTATION: A. TOTAL FEDERAL SHARE $ 238,000 B. UNOBLIGATED BALANCE FEDERAL SHARE $ C. FED. SHARE AWARDED THIS BUDGET PERIOD$ 238,0(0 19. AMOUNT AWARDED THIS ACTION: $ 238,0( 0 20. FEDERAL $ AWARDED THIS PROJECT PERIOD: $ 238,000 21. AUTHORIZED TREATMENT OF PROGRAM INCOME: ADDITIONAL COSTS Indirect Costs $ 0 At % of $ In Kind Contributions $ 0 22. APPLICANT EIN: 1-936002292 -A4 23. PAYEE EIN: 1- 936002292 -A4 24. OBJECT CLASS: 41.51 Total Approved Budget(**)1$ 238,000 25. FINANCIAL INFORMATION: ORGN DOCUMENT NO. APPROPRIATION CAN NO. OPRE 90XP036201 75 -9 -1536 2009 G998035 DUNS: 180729097 NEW AMT. UNOBLIG. NONFED % $238,000 26. REMARKS: (Continued on separate sheets) Paid by DHHS Payment Management System (PMS), see attached for payment information. This award is subject to the requirements of the HHS Grants Policy Statement (HHS GPS) that are applicable to you based on your recipient type and the purpose of this award. This includes requirements in Parts I and II (available at http: //www.hhs.gov /grantsnet /adminis /gpd /index.htm) of the HHS GPS. Although consistent with the HHS GPS, any applicable statutory or regulatory requirements, including 45 CFR Part 74 or 92, directly apply to this award apart from any coverage in the HHS GPS. This award is subject to the requirements of Section 106 (g) of the Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104). For the full text of the award term, go to http: / /www.acf.hhs.gov /grants /award_term.html. 27. SIGNATURE - ACF GRAN 0 CER Timothy Chappelle //) /l✓�% 29. SIGNATURE AND TITLE - PRO M OFFICIAL(S) Naomi C. Goldstein, Director, OPR DGCM -3 -785 (Rev. 86) DATE: 28. S)GNATURE(S) CERTI deltraud P. ernandei UND AVAILABILITY / �/1 DATE: / /0, :P) 1.RECIPIENT DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATION FOR CHILDREN AND FAMILIES FINANCIAL ASSISTANCE AWARD SAI NUMBER: EXHIBIT E PMS DOCUMENT NUMBER: 90XP036201 1. AWARDING OFFICE: Ofc Of Ping Resch And Evaluation 2. ASSISTANCE TYPE: Discretionary Grant 5. TYPE OF AWARD: OTHER 6. TYPE OF ACTION: New 3. AWARD NO.: 4. AMEND. NO. 90XP0362/01 7. AWARD AUTHORITY SEC 413 SSA /SEC 1110 SSA 8. BUDGET PERIOD: 09/30/2009 THRU 02/28/2011 9. PROJECT PERIOD: 09/30/2009 THRU 02/28/2011 10. CAT NO.: 93647 11. RECIPIENT ORGANIZATION: Deschutes County Commission on Children and Families 26. REMARKS: (Continued from previous page) This grant is subject to the requirements as set forth in 45 CFR Part 87. This grant is subject to the requirements set forth in 45 CFR part 74 (for non - profit organizations and educational institutions) or 45 CFR Part 92 (for state, local, and federally recognized tribal governments). Initial expenditure of funds by the grantee constitutes acceptance of this award. No future support is anticipated.(") Reflects only federal share of approved budget. PLEASE NOTE: Progress and Financial Reports (SF -269) are due every six months throughout the project period (Reporting Requirements Instructions are enclosed). Failure to submit these reports when due, will be indicative of noncompliance with the terms and conditions of the award. Questions concerning the programmatic aspects of this award should be directed to Marsha Werner at (202- 401 -5281) and questions concerning the financial aspects of this award should be directed to Ruth Morris at (202- 205 - 4783). DGCM -3 -785 (Rev. 86) (XP) Page : of 2 ACO CERTIFICATE OF LIABILITY INSURANCE DATE (MM DDIYYYY) 10/2512009 PRODUCER (503) 227 -0491 FAX: (503) 227 -0927 Gales Creek Insurance Service Inc 800 NW 6th, Suite 335 Portland OR 97209 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Family Access Network Foundation 2125 NE Daggett Lane Bend OR 97701 INSURER A: Alliance of Nonprofits for INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH: TAN DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE I: SUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION: OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR' DD'L LTR kNSRf)i TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM/DDIYYYY I POLICY EXPIRATION DATE (MM /DD/YYYY1 LIMITS A X GENERAL LIABILITY I COMMERCIAL GENERAL LIABILITY 2009 -19851 8/8/2009 8/8/2010 EACH OCCURRENCE 1 $ 1,000,000 J X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50, 000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 I PERSONAL BADVINJURY $ 1,000,000 f J GENII_ GENERAL AGGREGATE $ 2,000,000 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ ;,000,000 I X j POLICY 1 I t r 1 1 LOC j I AUTOMOBILE LIABILITY ANY AUTO 1 ALL OWNED AUTOS 1 SCHEDULED AUTOS ! HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ I i-1-1 BODILY INJURY (Per person) $ _ BODILY INJURY (Per accident) $ j PROPERTY DAMAGE (Per accident) $ I GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ — AUTO ONLY: AGG $ I. EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 1 I CLAIMS MADE DEDUCTIBLE RETENTION $ AGGREGATE $ $ $ I I $ I WORKERS AND EMPLOYERS' ANY PROPRIETOR/PARTNER OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION LIABILITY Y / N WC STATU- I IOTH- I TORY LIMITS I FR E.L. EACH ACCIDENT $ /EXECUTIVE - EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ in NH) under PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Deschutes County, its officers, agents, employees, and volunteers are named as Additional Insured with regarl to activities emanating out of use of premises, and activities identified in a contract or use agreement, subje :t to policy terms, conditions and exclusions. Additional Insured endorsement is attached * except 10 days for non - payment of premium CERTIFICATE HOLDER CANCELLATION Deschutes County 1340 NW Wall Street Bend, OR 97701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T IE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE Ti DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, I 'S AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Logan Forsberg /LOGAN ACORD 25 (2009/01) INS025 (200901) © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2009 -19851 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Deschutes County, its officers, agents, employees, and volunteers Information required to complete this Schedule. if not shown above, will be shown in the Declarations. Section II — Who is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury' caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations: or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ CERTIFICATE OF LIABILITY INSURANCE PRODUCER Western States Ins. - Madras PO Box 680 910 SW HWY 97, Suite 300 Madras OR 97741 Phone:541- 475 -2249 Fax:541- 475 -6842 OP ID CW SISTE -B DATE (MM /DDIVYYY) 10/23109 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOK ATIOF ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAII: # INSURED Sisters School District #6 525 E Cascade Ave Sisters OR 97759 INSURER A: PACE INSURER 8: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTA MDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED O 2 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF E UCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD •L LTR D TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYYYY) POLICY EXPIRATION M/ DATE (MDD/YYYY) LIMITS A INSR GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 24P60193287 07/01/09 07/01/10 EACH OCCURRENCE $ 500 000 X S 'r' E i0 RtN I tU PREMISES(Eaoccurence) $ ICLAIMS MADE XI OCCUR MED EXP (Any one person) $ X Public Officials PERSONAL BADVINJURY $ X Employment Practi GENERAL AGGREGATE $20,)00,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ X I POLICY I PI � , i LOC A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS ' SCHEDULED AUTOS I HIRED AUTOS i NON -OWNED AUTOS 24P60193287 07/01/09 I 07/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 500 ro00 `-I X BODILY INJURY (Per person) $ X BODILY ident) ( ) $ __X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY '; ANY AUTO AUTO ONLY - EA ACCIDENT $ � OTHER THAN EA ACC $ I AUTO ONLY: AGG $ A EXCESS / UMBRELLA LIABILITY OCCUR ! CLAIMSMADE DEDUCTIBLE RETENTION $ 24P60193287 07/01/09 07/01/10 EACH OCCURRENCE $9,500,000 X [ AGGREGATE $20,000,000 $ I $ I $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below WC STATU- j 011- TORY LIMITS j ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holdr is Additional Participant with regard to activities emanating out of use of premises, and activities identified in a contract or use agreement, subject to policy terms, conditions and exclusions, but only with respects to negligence claims for bodily injury or property damage where the Named Participant is deemd to have liability. CERTIFICATE HOLDER CANCELLATION Deschutes County, its officers agents, employees and volunteers 1340 NW Wall St Bend OR 97701 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORI THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE 7 ) DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE/4 , ©1988 -22OO ACOCATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) b. Cherry pickers and similar devices mounted on automobiles or truck chassis and used to raise or lower workers; and c. Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting or well servicing equipment. R. Named Participant means the organization formed under the laws of the State of Oregon identified as the Named Participant in the Named Participant's Declarations. S. Occurrence means: 1. with respect to bodily injury and property damage, an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 2. with respect to personal injury, an offense or series of related offenses. Offenses means any of the offenses included in the definition of personal injury. T. Participant means: 1. The Named Participant and each of the following while acting within the course and scope of their duties as such: a. Members of the Board. b. Executive Officers. c. Employees. d. Volunteers and Agents. e. Registered Students whose course study includes on-the-job training, but only while acting under directions and within the scope of their activities performed while in training. f. Student Organizations, Parent Teacher Organizations, Booster Clubs and Foundations under the jurisdiction and supervision of the governing board. Any person, entity or any organization the Named Participant is required by an insured contract to include as a Participant. This coverage will be limited to the extent of coverage and Limits of Liability required by the insured contract and will not increase the limits stated in SECTION V. — LIMITS OF LIABILITY or alter any of the terms of coverage stated in this Coverage Document. The insured contract must be effective and executed prior to a covered occurrence or wrongful act. In no event shall PACE Liability Coverage\pocament - 7/1/2009 Page 38 of 56 coverage under this Coverage Document extend to any party for any claim, suit or action, however or whenever asserted, arising out of such party's sole negligence. (1) 2. With respect to: The term "Additional Insured" if used in an insured contract shall be understood to mean the same as Additional Participant. Mobile equipment or any auto, any person is a Participant while driving such auto or mobile equipment with a Named Participant's permission. Any person, entity, or organization responsible for the conduct of such person is also a Participant, but only with respect to bodily injury or property damage arising out of the operation of the auto or mobile equipment. However, the owner or anyone else from whom a Named Participant hires or borrows an auto is a Participant only if that auto is a trailer connected to an auto a Named Participant owns. However, no person, entity, or organization is a Participant under this paragraph 2. with respect to: a. Property damage to property owned by a Named Participant or the employer of any person who is a Participant under this provision; b. Any auto a Named Participant hires or borrows from one of a Named Participant's employees, volunteers or members of their households, if they are the owner of such auto, unless acting within the scope of their duties on a Named Participant's behalf; c. Any auto being used by a person employed in the business of selling, servicing, repairing, or parking autos unless they are a Named Participant's employees; or d. The movement of property to or from an auto except a Named Participant, a Named Participant's employees, lessees or borrowers of such auto, and any employee of the lessees or borrowers. U. Personal Injury means injury, other than bodily injury arising out of one or more of the following offenses: 1. False arrest, detention or imprisonment; 2. Malicious prosecution; 3. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person PACE Liability Coverage Document - 7/1/2009 Page 39 of 56 saifcorporation Information Page Carrier No: 20001 Policy No: 74194 Employer Identification Number: 93 -60 )0398 Item 1. The Insured: Entity Type: SISTERS SCHOOL DISTRICT #6 POLITICAL SUBDIVISION: SCHOOL Mailing address: SISTERS SCHOOL DISTRICT #6 525 E CASCADE AVE SISTERS, OR 97759 Other workplaces not shown above: SISTERS HIGH SCHOOL, 1700 W MCKINNEY BUTTE, SISTERS, OR 97759 SISTERS ELEMENTARY SCHOOL, 611 E CASCADE, SISTERS, OR 97759 SISTERS MIDDLE SCHOOL, 15200 MCKENZIE HWY, SISTERS, OR 97759 DISTRICT OFFICE, 525 E CASCADE, SISTERS, OR 97759 711 E CASCADE, SISTERS, OR 97759 Item 2. The policy period is from 07 -01 -2009, 12:01 A.M. to 07 -01 -2010, 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 Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Bodily Injury by Disease $500,000 policy limit C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: NONE D. This policy includes these endorsements and schedules: WC000421C Catastrophe (other than Certified Acts of Terrorism) Premium End WC000422A Terrorism Risk Insurance Prog Reauthorization Act Disclosure End WC000414 Notification of Change in Ownership Endorsement WC000406A Premium Discount Endorsement WC360406 Premium Due Date Endorsement WC000310 Political Subdivision Volunteers WC000310 Political Subdivision Volunteers WC000310 Political Subdivision Volunteers WC000310 Political Subdivision Volunteers WC360301 Oregon Unsafe Equipment Exclusion Endorsement WC990616 Confidentiality Endorsement ACORD CERTIFICATE OF LIABILITY INSURANCE DATE ($11A/DD/TYYY) 11 /17 11/17/2009 TYPE OF INSURANCE POLICY NUMBER PRODUCER Broderick- Pierce -AIC Insurance 847 SW 6th St Redmond, OR 97756 Phone: 541- 548 -8161 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Deschutes County SD NO. 2J Redmond School District 145 SE Salmon St. Redmond, OR 97756 07/01 /2009 INSURER A: PACE EAACH OCCURRENCE INSURERS: X INSURER C: $ Included INSURER D: CLAIMS MADE X OCCUR INSURER E: $ 5,000 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQU IREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSU _D OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADM_ INSRQ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE1MMDD(YY1 POUCY EXPIRATION DATE(MMIDDIYY) LNNTS ,JTR A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 24P60060 -101 07/01 /2009 07/01/2010 EAACH OCCURRENCE $ 10,000,400 X � PREMISES (Ea oCCtirence) $ Included CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL d ADV INJURY $ 10,0001)00 GENERAL AGGREGATE $ 20,000,)00 GEML AGGREGATE LIMIT APPLIES PER: 1 POLICY PRO JECT - LOC PRODUCTS - COMP/OP AGG $ 20,000, )00 X A AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 24P60060 -101 07/01/2009 07/01/2010 COMBINED SINGLE LIMIT (Ea accident) $ 10,000,000 X BODILY INJURY (Per moo') $ X X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE UABILfTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA UABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? Eyes, describe under SPECIAL PROVISIONS below WC STATU- OTH- TORY LIMITS ER E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Deschutes County, its officers, agents, employees and volunteers are named as Additional Insureds with regard to activities emanating out of use of premises, and activities identified in a contract or use agreement, subject to policy terms, conditions and exclusions. Additional Insured description per attached PACE Liability/Auto Coverage Document. CERTIFICATE HOLDER CANCELLATION Deschutes County 1340 NW Wall Street Bend, OR 97701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE k XPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO D 180 SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS - ,GENTS OR REPRESENTATIVES. AUTHOR SENTATNE (BNM) ACORD 25 (2001108) © ACORD CORPORATION 1988 Printed by BNM on November 17, 2009 at ` 1:51AM b. Cherry pickers and similar devices mounted on automobiles or truck chassis and used to raise or lower workers; and c. Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting or well servicing equipment. R. Named Participant means the organization formed under the laws of the State of Oregon identified as the Named Participant in the Named Participant's Declarations. S. Occurrence means: 1. with respect to bodily injury and property damage, an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 2. with respect to personal injury, an offense or series of related offenses. Offenses means any of the offenses included in the definition of personal injury. T. Participant means: 1. The Named Participant and each of the following while acting within the course and scope of their duties as such: a. Members of the Board. b. Executive Officers. c. Employees. d. Volunteers and Agents. e. Registered Students whose course study includes on-the-job training, but only while acting under directions and within the scope of their activities performed while in training. f. Student Organizations, Parent Teacher Organizations, Booster Clubs and Foundations under the jurisdiction and supervision of the governing board. Any person, entity or any organization the Named Participant is required by an insured contract to include as a Participant. This coverage will be limited to the extent of coverage and Limits of Liability required by the insured contract and will not increase the limits stated in SECTION V. — LIMITS OF LIABILITY or alter any of the terms of coverage stated in this Coverage Document. The insured contract must be effective and executed prior to a covered occurrence or wrongful act. In no event shall PACE Liability Coverage Document - 711/2008 Page 39 of 57 coverage under this Coverage Document extend to any party for any claim, suit or action, however or whenever asserted, arising out of such party's sole negligence. (1) The term "Additional Insured" if used in an insured contract shall be understood to mean the same as Additional Participant. 2. With respect to: Mobile equipment or any auto, any person is a Participant while driving such auto or mobile equipment with a Named Participant's permission. Any person, entity, or organization responsible for the conduct of such person is also a Participant, but only with respect to bodily injury or property damage arising out of the operation of the auto or mobile equipment. However, the owner or anyone else from whom a Named Participant hires or borrows an auto is a Participant only if that auto is a trailer connected to an auto a Named Participant owns. However, no person, entity, or organization is a Participant under this paragraph 2. with respect to: a. Property damage to property owned by a Named Participant or the employer of any person who is a Participant under this provision; b. Any auto a Named Participant hires or borrows from one of a Named Participant's employees, volunteers or members of their households, if they are the owner of such auto, unless acting within the scope of their duties on a Named Participant's behalf; c. Any auto being used by a person employed in the business of selling, servicing, repairing, or parking autos unless they are a Named Participant's employees; or d. The movement of property to or from an auto except a Named Participant, a Named Participant's employees, lessees or borrowers of such auto, and any employee of the lessees or borrowers. U. Personal Injury means injury, other than bodily injury arising out of one or more of the following offenses: 1. False arrest, detention or imprisonment; 2. Malicious prosecution; 3. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person PACE Liability Coverage Document - 7/1/2008 Page 40 of 57 OREGON WORKERS' COMPENSATION CERTIFICATE OF INSURANCE CERTIFICATE HOLDER: DESCHUTES COUNTY 1340 NW WALL STREET BEND, OR 97701 AIL saiF lcorporation The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. 742486 POLICY PERIOD 07/01/2009 TO 07/01/2010 ISSUE DATE 11/17/2009 INSURED: BROKER OF RECORD: DESCHUTES COUNTY SCHOOL AIC INSURANCE AGENCY - REDMOND DISTRICT 2J 847 SW 6TH ST 145 S SALMON STREET REDMOND, OR 97756 -3102 REDMOND, OR 97756 -8427 LIMITS OF LIABILITY: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Bodily Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS /LOCATIONS /SPECIAL ITEMS: IMPORTANT: The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time in the future. This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. AUTHORIZED REPRESENTATIVE 3r President and CEO © SAIF CORPORATION 1 400 High St SE 1 Salem, OR 97312 1 P: 800.285.8525 1 www.saif.com PACE CERTIFICATE. OF COVERAGE Certificate #: AGENT This is a certificate issued as a matter of information only and cc nfers no rights upon the certificate holder other than those provided in the Coverage Document. This certificate does not amend, extend o alter the coverage afforded by the coverage documents listed herein. Beecher Carlson Insurance /Portland 220 N.W. Second Ave, Ste 800 Portland, OR 97209 -3951 NAMED PARTICIPANT COMPANIES AFFORDING COVERAGE Bend -La Pine School District #1 520 NVV Wall Street Bend, OR 97701- Company A — Property and Casualty Coverage for Education (F' 4CE) Company B — Genesis Insurance Company Company C — Lexington Insurance Company COVERAGES This is to certify that coverage documents listed herein have been issued to the Named Participant herein for the coverage period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which the certificate may be issued or ma■, pertain, the coverage afforded by the coverage documents listed herein is subject to all the terms, conditions and exclusions of such coverage documen s. CO LTR Type of Coverage Policy Number Effective Date Expiration Date Limits A General Liability 24P60003 -12 7/1/2009 7/1/2010 Each Occurrence $500,00C X General Liability X Public Officials Liability X Employment Practices X Occurrence A Automobile Liability 24P60003 -12 7/1/2009 7/1/2010 Each Occurrence $500,00( X Fleet Autos X Hired Autos X Non -Owned Autos X Occurrence A Auto Physical Damage 24P60003 -12 7/1/2009 7/1/2010 Each Occurrence $500,00( X Scheduled Autos X Hired Autos X Non -Owned Autos A Excess Liability 24P60003 -12 7/1/2009 7/1/2010 Each Occurrence $9,500,C )0 X General Liability Annual Aggregate $20,000 )00 X Public Officials Liability X Employment Practices X Automobile Liability A B Property 24P60003 -12 7/1/2009 7/1/2010 Each Occurrence X Scheduled Property Description Deschutes County, its officers, agents, employees; and volunteers are named as additional participant as respects distr :t's business but only with respects to negligence claims for bodily injury or property damage where the named participant is deemed to have liability with regard to activities emanating out of use of premises, and activities identified in a contract or use agreement, subject to policy terms, conditions and exclusions regarding the contract agreement between Deschutes County and the FAN Foundation with funds being directed to Bend /LaPine School District for FAN advocate salaries /benefits. Certificate Holder CANCELATION: Should any of the coverage documents herein be can :elled before the expiration date thereof, PACE will endeavor to mail written nc tice to the certificate holder named herein, but failure to mail such notice shall imp, se no obligation or liability of any kind upon PACE, its agents or representative s, or the issuer of this certificate. Deschutes County Commission on Children & Families Attn: Debi Harr 1130 NW Harriman, Suite A Bend, OR 97701 J r r, p.. . By: �% Date: 10 /27/09 b. Cherry pickers and similar devices mounted on automobiles or truck chassis and used to raise or lower workers; and c. Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting or well servicing equipment. R. Named Participant means the organization formed under the laws of the State of Oregon identified as the Named Participant in the Named Participant's Declarations. S. Occurrence means: 1. with respect to bodily injury and property damage, an accident, including continuous or repeated exposure to substantially the same general harmful conditions. with respect to personal injury, an offense or series of related offenses. Offenses means any of the offenses included in the definition of personal injury. T. Participant means: 1. The Named Participant and each of the following while acting within the course and scope of their duties as such: a. Members of the Board. b. Executive Officers. c. Employees. d. Volunteers and Agents. e. Registered Students whose course study includes on-the-job training, but only while acting under directions and within the scope of their activities performed while in training. f. Student Organizations, Parent Teacher Organizations, Booster Clubs and Foundations under the jurisdiction and supervision of the governing board. g. Any person, entity or any organization the Named Participant is required by an insured contract to include as a Participant. This coverage will be limited to the extent of coverage and Limits of Liability required by the insured contract and will not increase the limits stated in SECTION V. — LIMITS OF LIABILITY or alter any of the terms of coverage stated in this Coverage Document. The insured contract must be effective and executed prior to a covered occurrence or wrongful act. In no event shall PACE Liability Coverage Document - 7/1/2008 Page 39 of 57 2 coverage under this Coverage Document extend to any party for any claim, suit or action, however or whenever asserted, arising out of such party's sole negligence. (1) The term "Additional Insured" if used in an insured contract shall be understood to mean the same as Additional Participant. With respect to: Mobile equipment or any auto, any person is a Participant while driving such auto or mobile equipment with a Named Participant's permission. Any person, entity, or organization responsible for the conduct of such person is also a Participant, but only with respect to bodily injury or property damage arising out of the operation of the auto or mobile equipment. However, the owner or anyone else from whom a Named Participant hires or borrows an auto is a Participant only if that auto is a trailer connected to an auto a Named Participant owns. However, no person, entity, or organization is a Participant under this paragraph 2. with respect to: a. Property damage to property owned by a Named Participant or the employer of any person who is a Participant under this provision; b. Any auto a Named Participant hires or borrows from one of a Named Participant's employees, volunteers or members of their households, if they are the owner of such auto, unless acting within the scope of their duties on a Named Participant's behalf; c. Any auto being used by a person employed in the business of selling, servicing, repairing, or parking autos unless they are a Named Participant's employees; or d. The movement of property to or from an auto except a Named Participant, a Named Participant's employees, lessees of borrowers of such auto, and any employee of the lessees of borrowers. Personal Injury means injury, other than bodily injury arising out of one or more of the following offenses: 1. False arrest, detention or imprisonment; Malicious prosecution; 3. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person PACE Liability Coverage Document - 7/1 /2008 Page 40 of 5 ' ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE (M M /DD/YYYY) 11/30/2009 PRODUCER 503.239.4116 LaPorte & Associates, Inc. 5515 S.E. Milwaukie Avenue Portland, OR 97202 FAX 503.231.9021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAZI: # INSURED Bend LaPine Public Schools 520 NW Wall Street Bend, OR 97701 INSURER A: SAIF Corporation INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWIT 1STANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUI' :.D OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION: OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I R DPOLICY LT R INSRD TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE (MM /DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE (RENTED PREMISES (Ea occurrence) i $ I CLAIMS MADE ` OCCUR MED EXP (Any one person) $ yj GEN'L 1 I-11 PERSONAL & ADV INJURY a $ GENERAL AGGREGATE $ AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ r -- POLICY I PECOT- � LOC AUTOMOBILE ` 1 �_r LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ; '� COMBINED SINGLE LIMIT j, $ (Ea accident) rt BODILY INJURY (Per person) $ L___11 BODILY INJURY (Per accident) PROPERTY DAMAGE $ (Per accident) [ GARAGE LIABILITY ANY AUTO i i 1 AUTO ONLY - EA ACCIDENT 1$ OTHER THAN EA ACC $ AUTO ONLY: AGG . $ EXCESS / UMBRELLA LIABILITY OCCUR I CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE I RETENTION $ rt $ I $ $ A WORKERS AND EMPLOYERS' ANYIPRO MEMBER (Mandatory If yes describe SPECIAL PROVISIONS COMPENSATION LIABILITY Y / N 940144'i 7 / 01 2009 0 / i 07/01/2010 X WC STATU- ,I I OTH -j TORY LIMITS j ER E.L. EACH ACCIDENT �1 $ 500,001 /EXRLNDRD XECUTIVE E.L. DISEASE - EA EMPLOYEE $ 500,001 in NH) under below E.L. DISEASE - POLICY LIMIT $ 500,001 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS. CERTIFICATE HOLDER CANCELLATION Deschutes County 1340 NW Wall Street Bend, OR 97701 ACORD 25 (2009/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 IAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE T I DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITf AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Phil Dollar, ARM /JANET © 1988 -2009 ACORD CORPORATION. All rigl is reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009101) United c cols Insurance Program of Oregon CERTIFICATE OF IN TRANCE DATE. 01.3UL -2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOE NOT AMEND, E7(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ......... COMPANIIII ......... ....................... COWRAGE . :. Pubic Risk Underwriters of the Northwest, Inc. 451 Diamond Drive Ephrata, WA 98823 509 -754 -2027 Fax - 509 -754 -3406 High Desert ESD 145 SE Salmon Ave, Suite B Redmond, OR 97756 ININERAL UAI N TPY USIPO / Munich Re America AUTOMONLE MUTT USIPO / Munich Re America PROPERTY USIPO / Munich Re America MINE 1 NNW EMPLOYEE DISHONESTY USIPO / Munich Re America THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE[i, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 012 MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH P01 IES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. row LHStlRANc*.: .. PO ucY NUMBER Poucy EFf M04fIyY DPI " 4MINrS . 0111110tAL LIABUTY COMMEROAL GENERAL LIABILITY OCCURRENCE FORM DfOOt0E7iZXX USIP0091040868 07/01/2009 07/01/2010 GENERAL AGGREGATE PRODUCT- COMP/OP AGG PERSONAL 8 ADV. INJURY EACH OCCURRENCE ANNUAL POOL AGGREGATE (LIABILITY IS SUBJECT TO A 550,000 SIR PAYABLE FROM POOL FUNDS) AUTOMOSL:E "LIA81TTY 520,000,000 520,000,000 $10,000,000 510,000,000 9100,000,000 ANY AUTO 1JS1P0091040868 07/01/2009 07/01/2010 (LIABILITY IS SUBJECT TO A 550,000 SIR PAYABLE FROM POOL FUNDS) moPetn COMBINED SINGLE LIMIT ANNUAL POOL AGGREGATE $10,000,000 Included with GL US1P0091040868 07/01/2009 07/01/2010 ALL RISK PER OCC EXCL EQ8 FL EARTHQUAKE PER OCC FLOOD PER OCC ANNUAL POOL AGGREGATE (PROPERTY IS SUBJECT TO A $25,000 SIR PAYABLE FROM POOL FUNDS) CRIME / PUBLIC D IPLOM DISHONESTY 5200,000,000 $10,000,000 55,000,000 5500.000.000 U51P0091040868 07/01/2009 07/01/2010 PER LOSS 5500,000 DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES / SPEcW. MINS Deschutes County, its officers, agents, employees and volunteers are named as Additional Insured with regard to activities emanating out of use of premises, and activities identified in a contract or use agreement, subject to policy terms, conditions and exclusions. Additional Insured endorsement is attached. [ CANCELLATION J U L — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOF TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT FAILURE TO MAIL SUCH NOT I sIt asvaury OR CBLIGATIOY I OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Deschutes County 1340 NW Wall Street Bend, OR 97701 A2A24-) 2294469 POLICY NUMBER: USIP0091040866 COMMERCIAL GENERAL LIABILITY CG 20260704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: SCHEDULE COMMERCIAL GENERAL LIABILITY COVERAGE PART Nsrne Of Additional Insured Person(s) Or Organization(s) Deschutes County 1340 NW Wall Street Bend, OR 97701 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to fiabifity for 'bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 2294469 e ISO Properties. Inc., 2004 Page 1 of I 0 saifcorporation 400 High Street SE Salem, OR 97312 -1000 Toll Free 1- 800 - 285 -8525 MAIL TO: DESCHUTES COUNTY COMMISSION ON CHIL ATTN: SARAH JOHNSON 1130 NW HARRIMAN AVE, SUITE A BEND , OR 97701 OREGON WL..KERS COMPENSATION CERTIFICATE OF INSURANCE CERTIFICATE HOLDER: DESCHUTES COUNTY COMMISSICN ON CH ATTN: SARAH JOHNSON 1130 NW HARRIMAN AVE, SUITE A BEND , OR 97701 The policy of insurance listed below has been issued to the insured named below for the policy period indicated. The insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy. POLICY NO. 246652 INSURED: HIGH DESERT EDUCATION SERVICE DISTR 145 SE SALMON SUITE A REDMOND, OR 97756 -8427 POLICY PERIOD ISSUE DATE 07/01/2009 to 07/01/2010 06/26/2009 BROKER OF RECORD: LIMITS OF LIABILITY Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 each employee Bodily Injury by Disease $500,000 policy limit DESCRIPTION OF OPERATIONS /LOCATIONS /SPECIAL ITEMS: I M PORTANT: The coverage described above is in effect as of the issue date of this certificate. It is subject to change at any time in the future. This certificate is issued as a matter of information only and confers no rights to the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies above. AUTHORIZED REPRESENTATIVE 3r; President and CEO NANOVE