HomeMy WebLinkAboutOn file with Clerk - Agreement A-17-10306-A02.pdfState of California – Health and Human Services Agency – California Department of Public Health
CDPH 1229A (Rev. 09/2019)
1
CALIFORNIA IMMUNIZATION PROGRAM
Awarded By
THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, hereinafter “Department”
TO
Fresno County Department of Public Health, Immunization Program, hereinafter “Grantee”
Implementing the project, “To assist local health departments (LHDs) in preventing and
controlling vaccine-preventable diseases (VPDs) in the local health jurisdiction (LHJ),”
hereinafter “Project”
AMENDED GRANT AGREEMENT NUMBER 17-10306, A02
The Department amends this Grant and the Grantee accepts and agrees to use the Grant funds as
follows:
AUTHORITY: The Department has authority to grant funds for the Project under Health and Safety
Code, Section 120325-120380 of the Health & Safety Code, which requires immunizations against
childhood diseases prior to school admittance and Federal Grant numbers 6 NH23IP922612-01-01,
5 NH23IP922612-02-00 and 6 NH23IP922612-02-01.
PURPOSE FOR AMENDMENT: The purpose of the Grant amendment is to increase funding in the
amount of $524,899 for FY2020-21 to augment and enhance efforts around influenza vaccination
coverage as well as perform Coronavirus Disease 2019 (COVID-19) vaccination planning and
implementation.
Amendments are shown as: Text additions are displayed in bold and underline. Text deletions are
displayed as strike through text (i.e., Strike).
AMENDED GRANT AMOUNT: this amendment is to increase the grant by $524,899 and is
amended to read: $2,835,301 (Two Million Eight Hundred Thirty-Five Thousand Three Hundred
One Dollars) $2,310,402 (Two Million Three Hundred Ten Thousand Four Hundred Two Dollars).
Exhibit B – Budget Detail and Payment Provisions, paragraph 4.A is hereby replaced as shown below.
4. Amounts Payable
A. The amounts payable under this Grant shall not exceed $2,310,402 $2,835,301.
State of California – Health and Human Services Agency – California Department of Public Health
CDPH 1229A (Rev. 09/2019)
2
PROJECT REPRESENTATIVES. The Project Representatives during the term of this Grant will be:
California Department of Public Health,
Immunization Branch
Grantee: Fresno County Department of Public
Health, Immunization Program
Name: Noemi Marin Name: Scotti Blanks, MSN, PHN, FNP-BC, RN
Address: 850 Marina Bay Pkwy., Bldg. P, 2nd Floor Address: 1221 Fulton Street
City, ZIP: Richmond, CA 94804 City, ZIP: Fresno, CA 93721
Phone: (510) 620-3737 Phone: (559) 600-3567
Fax: (510) 620-3774 Fax: (559) 600-7606
E-mail: Noemi.Marin@cdph.ca.gov E-mail: sblanks@fresnocountyca.gov
Direct all inquiries to: California Department of Public Health,
Immunization Branch
Grantee: Fresno County Department of Public
Health, Immunization Program
Attention: Robina Escalada Attn: Scotti Blanks, MSN, PHN, FNP-BC, RN
Address: 850 Marina Bay Pkwy., Bldg. P, 2nd Floor Address: 1221 Fulton Street
City, Zip: Richmond, CA 94804 City, Zip: Fresno, CA 93721
Phone: (510) 620-3729 Phone: (559) 600-3567
Fax: (510) 620-3774 Fax: (559) 600-7606
E-mail: Robina.Escalada@cdph.ca.gov E-mail: sblanks@fresnocountyca.gov
All payments from CDPH to the Grantee; shall be sent to the following address:
Remittance Address
Grantee: Fresno County Department of Public
Health, Immunization Program
Attention “Cashier”: Bruna Chavez
Address: 1221 Fulton Street
City, Zip: Fresno, CA 93721
Phone: (559) 600-6415
Fax:
E-mail: dphboap@fresnocountyca.gov Either party may make changes to the Project Representatives, or remittance address, by giving a
written notice to the other party. Said changes shall not require an amendment to the agreement. Note:
State of California – Health and Human Services Agency – California Department of Public Health
CDPH 1229A (Rev. 09/2019)
3
Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental
Entity Taxpayer ID Form or STD 204 Payee Data Record Form which can be requested through the
CDPH Project Representatives for processing.
All other terms and conditions of this Grant shall remain the same.
IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below.
Executed By:
Date:
Steve Brandau
Chairman of the Board of Supervisors
Fresno County Department of Public Health,
Immunization Program
P.O. Box 11867
Fresno, CA 93775
Date:
Jeff Mapes, Chief
Contracts Management Unit
California Department of Public Health
1616 Capitol Avenue, Suite 74.262, MS 1802
P.O. Box 997377
Sacramento, CA 95899-7377
AGREEMENT BETWEEN THE COUNTY OF FRESNO AND THE STATE OF CAIFORNIA
California Department of Public Health
No./Name: State Grant Agreement No. 17-10306, Amendment A02 / Assist local health
departments in preventing and Controlling vaccine-preventable diseases in the local health
jurisdiction
Term: July 1, 2017 – June 30, 2022
Fund/Subclass: 0001/10000
Organization #: 56201657
Revenue Account #: 4380