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HomeMy WebLinkAboutAgreement A-22-377 Second Amendment to Agmt. 21-427 w First 5 for CHT.pdf Agreement No. 22-377 County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 1 SECOND AMENDMENT TO PROGRAM SERVICES AGREEMENT Parties Commission: Children and Families Commission of Fresno County, California Contractor: County of Fresno Administrative Contract Number: 202021-2242 Recitals A. Commission and Contractor are parties to that certain Program Services Agreement(the"Agreement"), dated December 8,2020,the Term of which is from July 1,2020 to June 30,2021 (the"Original Term"). Commission and Contractor are also parties to First Amendment to the Agreement,dated November 19,2021,extending the Term of the Agreement to June 30,2022. B. The Parties now desire to amend the Agreement to provide for an extension of the Term and to modify the Services and Project Budget all as defined in the Agreement. C. All capitalized terms used in this Second Amendment to Program Services Agreement (this"Second Amendment") shall have the meanings provided for in the Agreement unless otherwise specified in this Second Amendment. Therefore,in consideration of the above recitals,which are incorporated into this Second Amendment by reference,the Parties agree as follows: 1. Term. This Second Amendment is made effective as of July 1,2022 (the "Effective Date"). Notwithstanding anything in the Agreement to the contrary,the original term of the Agreement is extended until June 30,2024,unless terminated earlier under the Agreement(the"Term"). 2. Amendment to Section 2.1 and 2.2. As of Effective Date,Exhibit A will be replaced with the Exhibit A,"FY 2022-2023 Revised Scope of Work and Budget" attached to this Second Amendment and incorporated herein by this reference. As of Effective Date,except as needed to interpret Contractor's responsibilities and obligations under the Agreement,the original and prior Exhibit A attached to the Agreement and prior Amendment will have no further force and effect. 3. Amendment to Section 4.1. Section 4.1 of the Agreement is deleted in its entirety and replaced with the following: o522(1&2) County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 2 4.1 Project Budget. Compensation for the Services is based on actual costs as described in Exhibit A. Compensation for the Services will in no event exceed the total aggregate amount of$R.581.276 (the"Contract Amount"). The Contract Amount includes compensation for Services remaining under the original term of the Agreement,as well as the Services to be performed under the Term,as defined in this Second Amendment. Compensation for Services provided prior to July 1,2022 shall be in accordance with the original Agreement and First Amendment. 4. Amendment to Section 4.2. The first sentence in Section 4.2 of the Agreement is deleted in its entirely and replaced with the following (the remainder of Section 4.2 is unaffected): Commission will reimburse Contractor for all necessary,reasonable, and justifiable expenses,as determined by Commission,incurred in accordance with Exhibit A for providing the Services on behalf of Commission in an amount not to exceed the Contract Amount. 5. Controlling Document; No Other Amendment. In the event of any conflict between the terms of this Second Amendment and the Agreement,the terms of this Second Amendment shall control. Except as amended by this Second Amendment, all terms of the Agreement shall remain in full force and effect,including,without limitation,all monitoring,evaluation,data collection,contract review,auditing, inspection,and record retention obligations set forth in the Agreement. 6. Binding Effect. The Agreement,as amended by this Second Amendment,is binding upon,and inures to the benefit of,the respective heirs,executors, administrators,successors,and assigns of the Parties. 7. Headings and Construction. The subject headings of the sections and paragraphs of this Second Amendment are included for purposes of convenience only and do not affect the construction or interpretation of any of its provisions. All words used in this Second Amendment include the plural as well as the singular number, and vice versa;words used in this Second Amendment in the present tense include the future as well as the present; and words used in this Second Amendment in the masculine gender include the feminine and neuter genders,whenever the context so requires. No provision of this Second Amendment will be interpreted for or against a Party because that Party or its legal representative drafted the provision, and this Second Amendment will be construed as if jointly prepared by the Parties. 8. Counterparts. This Second Amendment may be signed by the Parties in different counterparts and the signature pages combined to create one document binding on all Parties. g. Signature AuthoritX. Each Party represents that it has capacity,full power, and authority to enter into this Second Amendment and perform under modified terms of the Agreement,and the person signing this Agreement on behalf of each 0522(1&2) County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 3 Party has been properly authorized and empowered to enter into this Second Amendment. Contractor must sign the signatory authorization,attached as Exhibit - B and incorporated into this Second Amendment. Contractor must complete and forward to Commission a new signatory authorization each time any name,title,or other information in the existing authorization is no longer current. 10. Electronic Signatures. Each Party acknowledges and agrees that this Second Amendment may also be executed by electronic signature,which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature.Without limitation,"electronic signature"shall include faxed versions of an original signature,electronically scanned and transmitted versions of an original signature,or an"e-signed"document(e.g.DocuSign). Signatures COMMISSION CONTRACTOR CHILDREN AND FAMILIES COMMISSION COUNTY OF FRESNO,a political OF FRESNO COUNTY subdivision of the State of California REVIEWED AND RECOMMENDED FOR AP R V By: L.Itgzed. epresentative By: Fa ola onz ez,E cutive irector Date of Signature: $-'X -'a Date of Signature: O� �ZZ Name: Sal Quintero Vice Chairman of the Board of Supervisors Title: of the County of Fresno APPROVED AS TO LEGAL-�RM r Federal Tax ID Number: BY ATTEST: Ken th Price, egal Counsel BERNICE E.SEIDEL r, Clerk of the Board of Supervisors Date of Signature: ! --- County of Fresno,State of California L By — Deputy By: Brian Pacheco,Commission Chair Date of Signature: 4 oS22(1&2) County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 4 EXHIBIT A FY 2022-2023 Revised Scope of Work and Budget Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. County of Fresno,Department of Public Health 202021-2242 Program Name: Community Health Teams I M $3,581,376 JECT Project Name Community Health Teams Contract Number 202021-2242 Agency Name County of Fresno,Department of Public Health Contract Amount $3,581,376 GL io-8602-00 Start Date-End Date July 1,2020-June 30,2024 Project ID 2242-20 ency Notice Contact Name David Luchini,PHN,RN FY2020-21 I $895,2o6 JActual 1 $673,519 1 Other 1 $338,082 Title Director FY2021-22 $895,390 Actual $o Other $414,720 Phone (559)600-3200 FY2022-23 I $895,390 Actual 1 $o 1 Other 1 $396,148 E-mail dluchini@fresnocountyca.gov FY2023-24 $895,390 Actual $o Other $396,148 Commission Approval Date: December 4,201g Total $3,581,376 Balance $2,go7,857 Tot.Other $1,545,099 Project Descriptio A cost-effective model pairing a public health nurse with teams of para-professionals from community based organizations to provide research-based home visitation services to underserved families without the eligibility guidelines of other federally and state funded programs. In this model Department of Public Health(DPH)will contract with multiple community-based organizations(CBOs)creating Community Health Teams in targeted Fresno County communities. DPH will contract with approximately four C80s to provide research-based or evidence-informed home visitation services to underserved families with children ages 0-5 in targeted Fresno County communities. The home visitation models selected must address one or more of the key challenges facing families as cited in the Commission's strategic plan. Secondary services that support the target population may also be included in the program model(e.g.socialization groups,parent support groups, etc.).Primary services must be completed in the home or similar setting. Teleconferencing can be used in lieu of in person visitation when COVID 19 restrictions are in place.Home visitors from the selected CBOs will be paired with a public health nurse,who will provide guidance and support on medically challenging cases and complete joint home visits as needed. These Community Health Teams will meet on a regular basis for trainings,case consultations and other program issues. Services must directly serve families with children ages 0-5 who are not being served by other home visitation programs(e.g. Nurse-Family Partnership,Healthy Families America,and Early Head Start). Agency Information Phone:559-600-3330 Mailing Address(if different from left):N/A Website:www.fcdph.org Address:1221 Fulton Street Fresno,CA 93721 Program Contact Finance Contact (Operations Supervisor/Coordinator) (Submits budgets,financial reports,invoices) Name:Megan Gunn Name:Michael Chu Title:Supervising Public Health Nurse Title:Senior Accountant Phone:559-600-3330 Phone:559-600-6426 E-mail:mgunn@fresnocountyca.gov E-mail:mchu@fresnocountyca.gov Program Contact Financial Approval (Enters programmatic data) (Submits budgets,financial reports,invoices) 7Name,Chriastina Wyrick Name:Megan Gunn Technician Title:Supervising Public Health Nurse oe00-3330 Phone:559-600-3330 E-mail:cwyrick@fresnocountyca.gov E-mail:mgunn@fresnocountyca.gov Program Contact Financial Approval (Enters programmatic data) (Submits budgets,financial reports,invoices) Name:Megan Gunn Name:Aphivanh Xayavath Title:Supervising Public Health Nurse Title:Staff Analyst III Pho2e:559-600-3330 Phone:559-600-3330 E-mail:mgunn@fresnocountyca.gov E-mail:axayavath@fresnocountyca.gov Data system Data Approval (Submits programmatic data) 7N.me:Megan Gunn Supervising Public Health Nurse Phone:559-600-3330 ©FIRST5 FRESNO COUNTY Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. ©FIRST5 FRESNO COUNTY Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(FSFC)staff and Service Provider during a development meeting. County of Fresno,Department of Public Health Program Name: Community Health Teams Contract Number: 202021-2242 Contract Amo $3,581,376 Agency Service Locations List all physical addresseT1PPR@FFF5FC services take place. If more than three sites,please include in this document by adding another row. Refer to the Fresno County website to find the correct County District for each service location. Location District 1 1221 Fulton Street Fresno,CA 93721 3 Click here to access the Fresno County district lookup page. ypes of Clients Served and Projected Numbers: Please note that these fields reflect the c ient type options in the contract management database and not family relationships.Include all client level and aggregate clients included in sections C and D. Number of Clients Type of Client FY2020-21 FY2021-22 FY2022-23 FY2023-24 Child 0<3 80 80 100 100 Child 3-5 8o 8o 100 100 Parent 160 160 200 zoo Prenatal 0 0 0 0 Other(please specify): 0 0 0 0 Total 320 320 400 400 Provider Category Number of Clients FY2020-21 FY2021-22 FY2o22-23 FY2023-24 Center-based ECE Providers 0 0 0 0 Home/Family-based ECE Providers 0 0 0 0 Health Care Providers 0 0 0 0 Mental Health Providers 0 0 0 0 Internal Program Staff 0 0 0 0 Interns/Students/Volunteers 0 0 0 0 Other(specify: CBO Home Visitors) 12 12 12 12 Total 12 12 12 12 Geographical Location of Clients to be Served Fiscal Year FY2020-21 FY2021-22 I FY2022-23 FY2023-24 Percent Urban 70% 70% 70% 70% Percent Rural 30% 30% 30% 30% Total#of Clients Countywide 332 332 412 412 ©FIRST5 FRESNO COUNTY Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(FSFC)staff and Service Provider during a development meeting. Agency: County of Fresno,Department of Public Health Program Name: Community Health Teams Contract Number- 202021-2242 Contract Amoui$3,581,376 Projected Numbers Served in Each Geographic Region: Use the countywide box for programs providing services throughout the county. Geographical Location of Clients to Number of Clients be Served FY2020-21 FY2021-22 FY2022-23 FY2023-24 1 County Wide 332 332 412 412 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total 3321 3321 412 412 or Description of"Other" E]FIRST5 FRESNO COUNTY Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(FSFC)staff and Service Provider during a development meeting Ag Country of Fresno,Department of Public Health Program N Com umty Health Teams Contract N 202021-2242 Contra $3,581,376 Investment Area per Budget Amount FSFC Strategic Plan FYzozo-z1 FY2021-2z FY2022-23 FY2023-24 Families $895,206.00 $895,390.00 $895,390.00 $895,390.00 Strategyer FSFC Strategic Plan FYz0zo-z1 2021-zz FY2022-23 FY2023-24 Sill Building $895,206.00 $895,390.00 $895,390.00 $895,390.00 State Result Area/Outcome Improved Child Health Refer to the Annual Report&Readiness Appendices for the Fiscal Year State Service Area Perinatal and Earl Childhood Home Vision Is this an evidence based or research based program? Research Based C.Aggregate Services and Narrative e information in the table below will remain the same for the full contract term(from one fiscal year to the next)unless otherwise specified or modified through a contract amendment request.Service Provider is required to maintain back-up documentation Data due Quarterly.Please note,total unduplicated number of clients are captured per deliverable.Quarterly breakdown of clients may overlap Upload to Core Client Aggregate Service Target Verification Method Aggregate Service Type Description Frequency Evaluation Method m State Report Type FY2020-21 FY2021-22 FY2022-23 FY2023-24 (Documentation) Quarter 1 12 12 12 12 Home visitors from the selected community-based Quarter z 12 12 1 12 12 organizations will be paired with a public health nurse, who will provide guidance and support on medically Yes Collaborative meetings challenging cases,creating Community Health Teams. provider z limes a month per CHT Reporting database S n sheets g Each team will meet on a regular basis for trafnings,case Quarter 3 12 12 12 12 p system data Sign-in consultations and other program issues.These meetings will be captured through this deliverable.Approximately 3 CBO staff per CHT=approximately 12 CBO staff. Quarter 4 12 12 12 12 12(unduplicated 12(unduplicated 12(unduplicated 12(unduplicated count,same staff cunt,same staff per count,same staff per count,same staff per quarter) quarter) quarter) Total per quarter) D.0. All services listed in section D are required to be entered in the reporting databases system on a monthly basis,refer to the Funded Partner Manual for details.All clients served by FSFC funds must meet age and residency requirements.Service Provider is required to maintain back-up documentation.The information in the table below will remain the same for the full contract term(from one fiscal year to the next)unless otherwise specified or modified through a contract amendment request.Please note,total unduplicated number of clients are captured per deliverable. Quarterly breakdown of clients may overlap. Service T Description Core Client T Core Client Target n FrequencyEvaluation Method Verification Method Type P Type FY2020-21 FY2021-22 FY2022-23 FY2023-24 Quarter 40 40 50 50 Home visitors from CBOs will provide research-based or —den -informed homevisitation services.Each home Quarter z 80 8o so so visitor will carry a case load of approximately 15-25 Quarter 3 80 8o So 50 families with at least 1 parent/caregiver attending each visit and lasting between 6mo-1yr per case, Quarter 4 80 80 50 50 ©FIRSTS 5 Direct Services Face Sheet Scope of Work This document will be completed with First s Fresno County(FSFC)staff and Service Provider during a development meeting Parent partnership home approximately 1-2 home visits a month.Services must be culturally and linguistically relevant to the identified Parent Approximately month home Reporting database Service logs visit target population.Specific target numbers and visits a month system data ge popu peci ge program models will be detailed in executed agreements between Zoo unduph—d. Zoo unduplicated. DPH and each CBO.CBOS include:1)Fresno Economic 260na$d.ph"ared, 160 a.duph"aeed: lamdies(at lean... lamdies(atleastone Opportunities Commission,2)Central Valley Childress over melC6! chess me carved parent/caregrverper parent/caregrverper Services Network,3)Centro Is Familia and 4) qunnerspe e.matupie quavers famay)arecam a famed,v ay)arecamedov Exceptional Parents Unlimited. multiple quarters mukeple quarters e Total Service Type Description 1W Core Client Type Core Client Target n Frequency Evaluation Method Verification Method FY2020-21 FY2021-22 I FY2022-23 FY2023-24 Each child client ages 0-5 will receive an ASO and Quarter 1 40 40 so So ASQ:SE developmental screening unless they have Quarter2 40 40 so so Reporting database already received a screening through an alternate Developmental screening Child Quarter 40 40 so so Annually and as needed system data Completed ASQ/ASQ:SE Provider. Quarter 40 40 so So Total 16o 16o 200 200 Service T e Core Client T Core Client Target tt Type FY2020-21 FY2021-22 FY2022-23 FY2023-24 Evaluation Me ae 4 4 7 7 4 4 7 7 Developmental referral Based on screening results,children will be linked to Child 4 4 8 8 As needed Reporting databaseReferral form needed resources. 4 4 8 8system data16 16 30 30 Service Type escnpho Core Client Type Core Client Target# Frequency a nation Met oil Verification Method FY2020-21 FY2021-22 FY2022-23 FY2023-24 Quarter 20 20 25 25 Based on home visitor needs assessments,families—11 Quarter z 20 20 25 25 Reporting database Other referral be linked to needed resources(e.g.housing,food, Parent Quarter 3 20 20 25 25 As needed Referral form Q system data assistance programs,etc.). nailer 4 20 20 25 25 Total 80 80 100 100 Service T Descri tion Core Client T Core Client Target tt FrequencyEvaluation Method Verification Method Type P Type FY2020-21 FY2021-22 FY2022-23 FY2023-24 Quarterl 40 40 40 40 Quarter 80 8o 80 80 Quarter 8o 80 80 8o CBOs may select a secondary service to complement Quarter 4 80 8o 80 80 Follows the implementation Reporting database Family event primary home visitation services.This may include Other model of each individual Sign-in sheets parent education,parent-child socialization groups,etc. CBO system data 160 undupdcated: "Lents are carved 160 undupdcated: 160 undupdcated: 160 undupdcated: over multiple "dents are earned "dents are carved over "dents are earned over Total quarter "Itipie quarters multiple quarters mukeple quarters ©FIRST5 6 Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. County of Fresno,Department of Public Health Program Nam Community Health Teams Contra 202021-2242 Conti $3.581,376 CONTRACT BUDGET ML Justification for FY 2020-2021 and FY 2021- Justification for FY2022-2023 7..dg.tLine Items FY2020-21 FY2o2o-21 Actuals FY2021-22 FY2022-23 FY2023'24 2022 and FY 2023-2024 PERSONNEL EXPENSES Full Time Positions Base Rate FTE The PHN II provides guidance and support to CBO home visitor teams forming Community The PHN II provides guidance Health Teams. and support to CEO home visitor teams forming Community Health 'Note:The base rate and FTE reflect FY 2021-22 Teams.The base rate$106,436 and numbers.The base rate for FY 2020-21 was FTE 0.4288 represents FY 2022-23 Public Health Nurse II $ 1o6,436.0o 0.429 $48,546.00 $ 32,931.00 $ 45,814.96 $ 45,645.55 $ 45,645.55 $80,91o.00 with an FTE of.6 and 2023-24. $ $ $ $ $ $ $ $ $ $ $ $ Total Full Time Salaries $ 48,546.00 $ 32,931.00 $ 45,814.96 $ 45,645-55 $ 45,645.55 Estimated benefits rate reflect Unemployment Insurance (0032718),Retirement(.5141-.6527), OASDI(0765),Health Insurance Note:the Benefits percentage reflect FY 2021- ($96o5-$12476 per FTE per year) 22 numbers.The benefit rate for FY 2020-21 and Benefits Administration($122 Personnel Benefits enter as%of FT salaries 74.072% $ 30,528.15 $ 22,480.00 $ 33,628.02 $ 33,810.40 $ 33,810.40 was 62.885%. per FTE per year). Taxes(enter as%of FT salaries) 7.65% $ 3,713-77 $ 2,457.00 $ 3,SO4-84 $ 3,491.88 $ 3,491.88 Part Time Personnel PERSONNEL EXPENSES SUBTOTAL $ 82,787.92 $ 57,868.00 $ 82,947.82 $ 82,947.83 $ 82,947.83 OPERATING EXPENSES Facilities Costs $ - $ - $ - $ - $ - O erational Su lies $ - $ - $ - $ - $ - Training/Travel $ - $ - $ - $ - $ - OPERATING EXPENSES SUBTOTAL $ $ $ $ $ ROGRAM EXPENSES Materials and Supplies PROGRAM EXPENSES SUBTOTAL Is - $ $ $ $ ISCELLANEOUS EXPENSES Subcontracts with four CBOs providing home visitation Subcontracts with four CBOs providing home services,forming Community visitation services,forming Community Health Health Teams(EPU Children's Teams(EPU Children's Center,Centro La Center,Centro La Familia,Fresno Familia,Fresno EOC and Central Valley EOC and Central Valley Children's Professional Services $800,000.00 $ 6o6,971.00 $800,000 $ 800,000.00 $ 800,000.00 Children's Services Network). Services Network). MISCELLANEOUS EXPENSES SUBTOTAL $ 800,000.00 $ 606,971.00 $ 800,000.00 $ 800,000.00 $ 800,000.00 ©FIRST5 FRESNO COUNTY Direct Services Face Sheet Scope of Work This document will be completed with First 5 Fresno County(F5FC)staff and Service Provider during a development meeting. ALL EXPENSES SUBTOTAL $ 882,787.92 $ 664,839.00 $ 882,947.82 $ 882,947.83 $ 882,947.83 For this contract,indirect was For this contract,indirect was calculated using calculated as a percentage of only Indirect Costs Max 15% 15,00% $12,418.19 $ 8,680.00 $ 12,442.17 $ 12,442.17 $ 12,442.17 only the Personnel expenses subtotal the Personnel expenses subtotal TOTAL F5FC BUDGET $ 895,2o6.11 $ 673,519.00 $ 895,390.00 $ 895,390.00 $ 895,390.00 F5FC Budget Amount $895,390.00 $ 895,206.11 $895,390.00 $895,390.00 $895,390.00 Vanance $ 183.89 $ 221,687.11 $ 0.00 $ $ Other Funding $338,082.44 $ - $414,720.13 $ 396,148.00 $ 396,148.00 Estimated leveraged dollars Total Funding All Sources $ 1,233,288.55 $ 673,519.00 $ 1,310,110.13 $ 1,291,538.00 $ 1,291,538.00 ©FIRSFRESNO T5 8 Service Provider Staff ConfidentialityAgreement&Request for Reporting Database System User L ogon All staff members of F5FC funded programs and projects (Service Providers)who are responsible for gathering or maintaining confidential information and records must adhere to this agreement. Responsibilities During the performance of Service Provider assigned duties related to the FSFC project,Service Provider might have access to confidential client information and records required for effective coordination and delivery of services to children and their families.All confidential discussions,deliberations,records,and information generated or maintained in connection with these activities shall be disclosed only to persons who have the need to know and authority to access confidential consumer information or records.This includes information obtained and conveyed through all media including the reporting database system. Service Provider must not disclose any confidential client information to any third party without the written authorization from the client or legally authorized representative. Legal Liabilities Service Provider must adhere to the following: • Notice:All applicable employees,agents,and subcontractors shall be notified of state requirements for confidentiality and also notified that any person knowingly or intentionally violating the provisions of the state law is guilty of a misdemeanor. • Records pertaining to any individual recipient of F5FC will be confidential and will not be open to examination for any purpose not directly connected with the administration of local evaluation. • No person will publish,disclose,use,or permit the use of,or cause to be published,disclosed or used,any confidential information pertaining to any individual recipient of F5FC services. Prohibition of Re Disclosing Confidential Client Information Employment Confidentiality Agreement This notice accompanies a disclosure of confidential information concerning a consumer of services funded by the F5FC.The above referenced agency is prohibited from making any further disclosure of this confidential information unless further disclosure is expressly permitted by the written authorization to release the information of the person to whom it pertains or as otherwise permitted by these regulations.A general authorization for the release of confidential information is NOT sufficient for this purpose. Acknowledgement of Confidentiality and Prohibition of Re Disclosing Confidential Client Information Employment Confidentialit7Agreement The Agency acknowledges responsibility not to divulge any confidential information or records concerning clients of F5FC funded services without proper written authorization. By signing the Direct Services Agreement,the Agency accepts confidentiality and prohibition of re-disclosing confidential funding requirements. VIFIFRESNORST5 COUNTY County of Fresno,Department of Public Health Community Health Teams Contract#202021-2242 Page 5 EXHIBIT B Signatory Authority I CERTIFY THE AGENCY OFFICIAL LISTED BELOW IS AUTHORIZED AND EMPOWERED TO SIGN AND ENTER INTO THIS SECOND AMENDMENT ON BEHALF OF THE AGENCY (CONTRACTOR)AND BY VIRTUE OF THAT PERSON'S SIGNATURE, BIND THE AGENCY. ORGANIZATION/AGENCY County of Fresno NAME (CONTRACTOR): SIGNATURE OF GOVERNING BODY OFFICIAL: DATE SIGNED: 8-,,_a PRINTED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the County &-aesno SIGNATURE OF AUTHORIZED AGENCY OFFICIAL: DATE SIGNED: TYPED NAME: Sal Quintero TITLE: Vice Chairman of the Board of Supervisors of the Counly of Fresno NOTE: SHOULD CIRCUMSTANCES REQUIRE A CHANGE IN THE ABOVE, A NEW SIGNATORY AUTHORIZATION MUST BE COMPLETED AND FORWARDED TO THE COMMISSION. ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors County of Fresno,State of California By Deputy