HomeMy WebLinkAboutAgreement A-19-324 with CDPH.pdf Agreement No. 19-324
State of California—Health and Human Services Agency—California Department of Public Health
CDPH 1229(12/2017)
CALIFORNIA SEXUALLY TRANSMITTED DISEASES PROGRAM
STD Program Management
Awarded By
THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, hereinafter "Department"
TO
County of Fresno, hereinafter "Grantee"
Implementing the project "Congenital Syphilis Prevention," hereinafter "Project"
GRANT AGREEMENT NUMBER 18-10698
The Department awards 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 131085(a).
PURPOSE: The Department shall provide a grant to and for the benefit of the Grantee. The
purpose of the grant is to implement congenital syphilis (CS) prevention activities to ensure
investigation, case management, linkage to treatment, and partner services for pregnant women
with syphilis; ensure delivery outcomes are documented and neonates exposed to syphilis
receive appropriate case management, testing, and treatment; conduct CS Morbidity and
Mortality Reviews on syphilis cases with missed opportunities for prevention; partner with
correctional settings to conduct syphilis screening in jails; conduct provider detailing to improve
provider awareness about CS; participate in a local quality improvement event to improve local
processes for syphilis investigation; and participate in state CS meetings, including a joint
meeting with Maternal, Child, and Adolescent Health partners to build capacity and enhance
cross-jurisdictional communication.
GRANT AMOUNT: The maximum amount payable under this grant shall not exceed seven
hundred thousand dollars ($700,000).
TERM OF GRANT AGREEMENT: The term of the grant shall begin on January 1, 2019 and
terminates on December 31, 2023. No funds may be requested or invoiced for work performed
or costs incurred after December 31, 2023.
Page 1 of 4
State of California—Health and Human Services Agency—California Department of Public Health
CDPH 1229(12/2017)
PROJECT REPRESENTATIVES: The Project Representatives during the term of this grant will
be:
California Department of Public Health Grantee: County of Fresno
Name: Karlo Estacio Name: Mario Hernandez
Chief, Business Operations Staff Analyst I
Support Section
Address: P.O. Box 997377, MS 7320 Address: 1221 Fulton Street
City, Zip: Sacramento, CA 95899-7377 City, Zip: Fresno, CA 93721
Phone: (916) 552-9820 Phone: (559) 600-9307
Fax: (916) 440-5106 Fax: (559) 600-7601
Email: Karlo.Estacio(a-)-cdph.ca.gov Email: mariohernandez(g7fresnocountyca.gov
Direct all inquiries to:
California Department of Public Health Grantee: County of Fresno
STD Control Branch
Attention: Christine Johnson Name: Mario Hernandez
Grant Manager Staff Analyst I
Address: P.O. Box 997377, MS 7320 Address: 1221 Fulton Street
City, Zip: Sacramento, CA 95899-7377 City, Zip: Fresno, CA 93721
Phone: (916) 552-9796 Phone: (559) 600-9307
Fax: (916) 636-6454 Fax: (559) 600-7601
Email: Christi ne.Johnson(a-)_cd ph.ca.gov Email: mariohernandez(a-)-fresnocountyca.gov
Either party may change its Project Representative upon written notice to the other party.
Page 2 of 4
State of California—Health and Human Services Agency—California Department of Public Health
CDPH 1229(12/2017)
All payments from CDPH to the Grantee shall be sent to the following address:
Grantee: County of Fresno
Attention "Cashier:"Bruna Chavez
DPH Business Manager
Address: P.O. Box 11800
City, Zip: Fresno, CA 93775-1800
Phone: (559) 600-6438
Fax: (559) 600-7692
Email: dphboap(a)fresnocountyca.gov
STANDARD PROVISIONS. The following exhibits are attached and made a part of this grant
by this reference:
Exhibit A SCOPE OF WORK
Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS
Exhibit C STANDARD GRANT CONDITIONS
Exhibit D ADDITIONAL PROVISIONS
Exhibit F FEDERAL TERMS AND CONDITIONS
Exhibit G CONTRACTOR'S RELEASE
GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions
of this grant, including those stated in the Exhibits incorporated by reference above. The
Grantee(s) shall fulfill all assurances and commitments made in the application, declarations,
other accompanying documents, and written communications (e.g., e-mail, correspondence)
filed in support of the request for grant funding. The Grantee(s) shall comply with and require its
contractors and subcontractors to comply with all applicable laws, policies, and regulations.
Page 3 of 4
State 011 California—HAMM and Hurnan Services Agam.y—CzVorma Department of Public HeaNh
COPH 1229(12120171,
IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below.
Executed By;
Date:
ATTEST: Nathan Magsig, Chairperson
BERNICE E.SEIDEL Board of Supervisors
Clerk of the Board of Supervaors County of Fresno
County of Fresno,State of California 2281 Tulare Street, Room 301
By Fresno, CA 93721
Deputy
Date:
Marshay Gregory, Chief o c
Contracts Management Unit
California Department of Public Health
1616 Capitol Avenue, Suite 74.262
P,O, Box 997377, MS 1800- 18G4
Sacramento, CA 95899-7377
Page 4 of 4
County of Fresno
18-10698
Page 1 of 4
Exhibit A
Scope of Work
1. Service Overview
The Grantee will implement evidence-based public health activities to proactively address the rise
in congenital syphilis (CS)cases within the local health jurisdiction.
Key strategic targets for CS prevention and control include: robust case management for
pregnant females with syphilis and CS cases; conducting Morbidity and Mortality Reviews of CS
cases to identify missed opportunities for prevention; collaborating with CDPH program staff on a
quality improvement project aimed at improving health department syphilis processes; partnering
with correctional facilities to implement syphilis screening in jails; and providing education to
priority prenatal care providers and birthing hospitals to enhance screening and treatment
practices.
2. Service Location
The services shall be performed at applicable facilities in the County of Fresno.
3. Service Hours
The services shall be primarily provided Monday through Friday, from 8:00 a.m. to 5:00 p.m. and
include evenings, weekends, and holidays as needed.
4. Services to be Performed
Activities Performance Indicators/Deliverables Timeline
*Indicators that CDPH will monitor.
A. Conduct comprehensive case . Number of pregnant females with syphilis 01/01/19 —
management for pregnant females who receive case management. 12/31/23
with syphilis and infants exposed to . Description of collaboration with local
or infected with syphilis (e.g. assist Maternal, Child, and Adolescent Health
women throughout pregnancy and (MCAH) program on case management
ensure their infants receive for high-risk pregnant women with syphilis
appropriate evaluation and and their infants.
treatment for syphilis and linkage to . Proportion of females with syphilis with
needed health and social services): pregnancy status documented (not
1. Follow pregnant females with missing or unknown).*
syphilis until delivery and . Proportion of pregnant female syphilis
document birth outcome. cases (all stages)with documentation of
2. Link pregnant females with pregnancy outcome, either from the
syphilis to prenatal care and female case's clinical tab or via linkage
other services, as appropriate, with a CS case report form.*
throughout pregnancy. . Proportion of pregnant female syphilis
3. Confirm all neonates potentially cases who did not deliver a baby with CS
exposed to syphilis are (CS Prevention Ratio).*
evaluated with a quantitative . Proportion of congenital syphilis cases
rapid plasma reagin (RPR)and (confirmed and probable) treated with 10
have a comprehensive physical days of IV penicillin.*
examination for evidence of CS,
County of Fresno
18-10698
Page 2 of 4
Exhibit A
Scope of Work
Activities Performance Indicators/Deliverables Timeline
*Indicators that CDPH will monitor.
per CDC STD Treatment . Proportion of congenital syphilis cases
Guidelines, and are (stillbirth, confirmed,and probable) with
appropriately treated. appropriate infant clinical evaluation per
4. Follow neonates potentially CDC recommendations.*
exposed to syphilis to confirm . Proportion of congenital syphilis cases
and document follow-up (confirmed and probable) with appropriate
quantitative RPR testing, until infant treatment per CDC
tests become nonreactive. recommendations.*
5. Collaborate with local MCAH
program to determine if
pregnant females with syphilis
and their infants are eligible for
existing MCAH case
management programs, and
ensure non-duplicated case
management for high-risk
pregnant women across STD
and MCAH programs.
B. Partner with program staff at CDPH . Description of collaborative QI project(s).* 01/01/19 —
to identify and implement at least . Description of QI project(s) associated 12/31/23
one quality improvement (QI) outcomes.*
project to improve outcomes
related to congenital syphilis
prevention.
C. Maintain CS Morbidity and Mortality . Meeting frequency 01/01/19 —
(M&M) Review Boards: . Description of staff in attendance 12/31/23
1. Analyze all CS cases and . Number of cases reviewed
prepare for discussion. Proportion of cases reviewed
2. Coordinate monthly meetings to Description of local criteria used for case
conduct M&M case review with selection
key staff, Grantee leadership, Number of missed opportunities
and partners. identified
3. Prepare follow-up action plan Description of missed opportunities
after each meeting and ensure identified
follow-through of action items Number of action items identified
are identified. Description of action items identified
4. Collaborate with local MCAH to •
determine if congenital syphilis Number of follow-up items conducted
cases are eligible to be Description of collaboration with local
included in existing Fetal Infant MCAH program on congenital syphilis
Mortality Reviews (FIMR) and case reviews
share resources between CS
M&M review boards & FIMR.
County of Fresno
18-10698
Page 3 of 4
Exhibit A
Scope of Work
Activities Performance Indicators/Deliverables Timeline
*Indicators that CDPH will monitor.
D. Strengthen partnerships with local . Data elements delineated in the data 01/01/19 —
correctional settings to enhance dictionary for syphilis screening and 12/31/23
syphilis case finding. treatment activities.
1. Enhance awareness of . Proportion of females of childbearing
correctional staff regarding age who are screened for syphilis in jail
syphilis and CS increases, facility.*
highlighting links to correctional . Proportion of females of childbearing
setting. age who are positive for syphilis in jail
2. Implement routine syphilis facility.*
screening for females of . Proportion of females of childbearing
childbearing age booked into age who are identified to be new syphilis
local jail facilities. infections via matching to surveillance
data.*
• Proportion of females of childbearing
age who are treated for syphilis in jail
facility.*
• Treatment timeliness and adequacy
among females of childbearing age in jail
facility.*
E. Enhance awareness and the • Number of providers engaged 01/01/19 —
quality of care for syphilis and CS . Description of provider selection criteria 12/31/23
in high priority prenatal care clinics . Type of providers visited
and birthing hospitals. . Change in provider knowledge/practices
1. Collaborate with STD Control . Description of collaboration with local
Branch in the development of a MCAH program on provider engagement
provider engagement and efforts
targeted evaluation plan. . Proportion of females with timely and
2. Implement provider adequate syphilis treatment, pre-post
engagement including, but not intervention*
limited to, provider detailing, in-
service or grand rounds
presentations, and/or clinical
trainings.
3. Evaluate the activities through
mechanisms such as
monitoring surveillance
outcomes pre-post intervention
and surveying providers to
assess changes in knowledge
and practice.
4. Collaborate with local MCAH
program to include
Comprehensive Perinatal
Services Program (CPSP)
County of Fresno
18-10698
Page 4 of 4
Exhibit A
Scope of Work
Activities Performance Indicators/Deliverables Timeline
*Indicators that CDPH will monitor.
providers in provider
engagement efforts.
F. Participate in syphilis and Attendance of at least one 01/01/19 —
congenital syphilis prevention representative at annual, statewide in- 12/31/23
forums,trainings and web meetings person meetings (e.g., Syphilis Summit,
in order to build capacity and joint meetings with Maternal, Child and
enhance cross-jurisdictional Adolescent Health partners).*
communication. Number of cross-jurisdictional
communications (e.g., informal
meetings, work group meetings).*
5. Summary of Required Reports and Data
Frequency Timeframe Deadline Activities
Annual 01/01/2019 — 12/31/2019 01/31/2020 A-F
01/01/2020 — 12/31/2020 01/31/2021
01/01/2021 — 12/31/2021 01/31/2022
01/01/2022 — 12/31/2022 01/31/2023
01/01/2023 — 12/31/2023 12/31/2023
County of Fresno
18-10698
Page 1 of 2
Exhibit B
Budget Detail and Payment Provisions
1. Invoicing and Payment
A. Upon completion of project activities as provided in Exhibit A, Scope of Work,
and upon receipt and approval of the invoices, the State agrees to reimburse the
Grantee for activities performed and expenditures incurred in accordance with
the costs specified herein.
B. Invoices shall include the grant number and shall be submitted not more
frequently than quarterly in arrears to:
Christine Johnson
California Department of Public Health
STD Control Branch
MS 7320
P.O. Box 997377
Sacramento, CA 95899-7377
C. Invoices shall:
1) Be prepared on Grantee letterhead. If invoices are not on produced
letterhead, invoices must be signed by an authorized official, employee,
or agent certifying that the expenditures claimed represent activities
performed and are in accordance with Exhibit A, Scope of Work, under
this grant.
2) Bear the Grantee's name as shown on the grant.
3) Identify the billing and/or performance period covered by the invoice.
4) Itemize costs for the billing period in the same or greater level of detail as
indicated in this grant. Subject to the terms of this grant, reimbursement
may only be sought for those costs and/or cost categories expressly
identified as allowable in this agreement and approved by CDPH.
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any
subsequent years covered under this agreement does not appropriate sufficient
funds for the program,this agreement shall be of no further force and effect. In
this event, the State shall have no liability to pay any funds whatsoever to the
Grantee or to furnish any other considerations under this agreement and the
Grantee shall not be obligated to fulfill any provisions of this agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes
of this program, the State shall have the option to either cancel this agreement
with no liability occurring to the State, or offer an agreement amendment to the
Grantee to reflect the reduced amount.
County of Fresno
18-10698
Page 2 of 2
Exhibit B
Budget Detail and Payment Provisions
3. Prompt Payment Clause
Payment will be made in accordance with, and within the time specified in, Government
Code Chapter 4.5, commencing with Section 927.
4. Amounts Payable
The amount payable under this grant shall not exceed $700,000.
5. Timely Submission of Final Invoice
A. A final undisputed invoice shall be submitted for payment no more than sixty (60)
calendar days following the expiration or termination date of this grant, unless a
later or alternate deadline is agreed to in writing by the program Grant Manager.
Said invoice should be clearly marked "Final Invoice," indicating that all payment
obligations of the State under this grant have ceased and that no further
payments are due or outstanding.
B. The State may, at its discretion, choose not to honor any delinquent final invoice
if the Grantee fails to obtain prior written State approval of an alternate final
invoice submission deadline.
6. Travel and Per Diem Reimbursement
Any reimbursement for necessarytravel and per diem shall be at the rates currently in
effect as established by the California Department of Human Resources (CaIHR).
7. Use of Funds/Supplanting
A. These funds shall be used to supplement and enhance existing local STD
program activities and services and shall not replace existing services and
activities or prevent the addition of new services and activities, and does not
duplicate reimbursement of costs and services received from local funds or other
sources.
County of Fresno
Grant 18-10698
Pagel of 4
EXHIBIT C
STANDARD GRANT CONDITIONS
1. APPROVAL: This Grant is of no force or effect until signed by both parties and approved by
the Department of General Services, if required. The Grantee may not commence
performance until such approval has been obtained
2. AMENDMENT: No amendment or variation of the terms of this Grant shall be valid unless
made in writing, signed by the parties, and approved as required. No oral understanding or
Agreement not incorporated in the Grant is binding on any of the parties. In no case shall
the Department materially alter the scope of the Project set forth in Exhibit A.
3. ASSIGNMENT: This Grant is not assignable by the Grantee, either in whole or in part,
without the written consent of the Grant Manager in the form of a written amendment to the
Grant.
4. AUDIT: Grantee agrees that the Department,the Bureau of State Audits, or their designated
representative shall have the right to review and to copy any records and supporting
documentation pertaining to this Grant. Grantee agrees to maintain such records for a
possible audit for a minimum of three (3) years after final payment or completion of the
project funded with this Grant, unless a longer period of records retention is stipulated.
Grantee agrees to allow the auditor(s) access to such records during normal business hours
and to allow interviews of any employees who might reasonably have information related to
such records. Further, Grantee agrees to include a similar right of the State to audit records
and interview staff in any subcontract related to the project.
5. CONFLICT OF INTEREST: Grantee certifies that it is in compliance with all applicable state
and/or federal conflict of interest laws.
6. INDEMNIFICATION: Grantee agrees to indemnify, defend and save harmless the State, its
officers, agents and employees from any and all claims and losses accruing or resulting to
any and all contractors,subcontractors, suppliers, laborers, and any other person,firm or
corporation furnishing or supplying work services, materials,or supplies in connection with
the project, and from any and all claims and losses accruing or resulting to any person, firm
or corporation who may be injured or damaged by Grantee in the performance of any
activities related to the Project.
7. FISCAL MANAGEMENT SYSTEMSAND ACCOUNTING STANDARDS: Grantee agrees
that, at a minimum, its fiscal control and accounting procedures will be sufficient to permit
tracing of all grant funds to a level of expenditure adequate to establish that such funds have
not been used in violation of any applicable state or federal law, or the provisions of this
Grant. Grantee further agrees that it will maintain separate Project accounts in accordance
with generally accepted accounting principles.
8. GOVERNING LAW: This Grant is governed by and shall be interpreted in accordance with
the laws of the State of California.
County of Fresno
Grant 18-10698
Page 2 of 4
9. INCOME RESTRICTIONS: Grantee agrees that any refunds, rebates, credits,or other
amounts (including any interest thereon) accruing to or received by the Grantee under this
Grant shall be paid by the Grantee to the Department,to the extent that they are properly
allocable to costs for which the Grantee has been reimbursed by the Department under this
Grant.
10. INDEPENDENT CONTRACTOR: Grantee, and its agents and employees of Grantee, in the
performance of the Project, shall act in an independent capacity and not as officers,
employees or agents of the Department.
11. MEDIA EVENTS: Grantee shall notify the Department's Grant Manager in writing at least
twenty(20)working days before any public or media event publicizing the accomplishments
and/or results of the Project and provide the opportunity for attendance and participation by
Department's representatives.
12. NO THIRD-PARTY RIGHTS: The Department and Grantee do not intend to create any
rights or remedies for any third- party as a beneficiary of this Grant or the project.
13. NOTICE: Grantee shall promptly notify the Department's Grant Manager in writing of any
events, developments or changes that could affect the completion of the project or the budget
approved for this Grant.
14. PROFESSIONALS:Grantee agrees that only licensed professionals will be used to perform
services under this Grant where such services are called for.
15. RECORDS: Grantee certifies that it will maintain Project accounts in accordance with
generally accepted accounting principles. Grantee further certifies that it will comply with the
following conditions for a grant award as set forth in the Grant.
A. Establish an official file for the Project which shall adequately document all
significant actions relative to the Project;
B. Establish separate accounts which will adequately and accurately depict all
amounts received and expended on this Project, including all grant funds received
under this Grant;
C. Establish separate accounts which will adequately depict all income received which
is attributable to the Project, especially including any income attributable to grant
funds disbursed under this Grant;
D. Establish an accounting system which will adequately depict final total costs of the
Project, including both direct and indirect costs; and,
E. Establish such accounts and maintain such records as may be necessary for the
state to fulfill federal reporting requirements, including any and all reporting
requirements under federal tax statutes or regulations.
16. RELATED LITIGATION: Under no circumstances may Grantee use funds from any
disbursement under this Grant to pay for costs associated with any litigation between the
Grantee and the Department.
County of Fresno
Grant 18-10698
Page 3 of 4
17. RIGHTS IN DATA: Grantee and the Department agree that all data, plans, drawings,
specifications, reports, computer programs, operating manuals, notes, and other written or
graphic work submitted under Exhibit A in the performance of the Project funded by this Grant
shall be in the public domain. Grantee may disclose, disseminate and use in whole or in part,
any final form data and information received, collected,and developed under this Project,
subject to appropriate acknowledgment of credit to the Department for financial support.
Grantee shall not utilize the materials submitted to the Department(except data) for any profit
making venture or sell or grant rights to a third-party who intends to do so. The Department
has the right to use submitted data for all governmental purposes.
18. VENUE: The Department and Grantee agree that any action arising out of this Grant shall be
filed and maintained in the Superior Court, California. Grantee waives any existing sovereign
immunityfor the purposes of this Grant, if applicable.
19. STATE-FUNDED RESEARCH GRANTS:
A. Grantee shall provide for free public access to any publication of a department-funded
invention or department-funded technology. Grantee further agrees to all terms and
conditions required by the California Taxpayer Access to Publicly Funded Research Act
(Chapter 2.5 (commencing with Section 13989) of Part 4.5 of Division 3 of Title 2 of the
Government Code).
B. As a condition of receiving the research grant, Grantee agrees to the following terms and
conditions which are set forth in Government Code section 13989.6 ("Section 13989.E"):
1) Grantee is responsible for ensuring that any publishing or copyright agreements
concerning submitted manuscripts fully com ply with Section 13989.6.
2) Grantees shall report to the Department the final disposition of the research grant,
including, but not limited to, if it was published, when it was published, where it was
published, when the 12-month time period expires, and where the manuscript will be
available for open access.
3) For a manuscript that is accepted for publication in a peer-reviewed journal, the
Grantee shall ensure that an electronic version of the peer-reviewed manuscript is
available to the department and on an appropriate publicly accessible database
approved by the Department, including, but not limited to, the University of California's
eScholarship Repository at the California Digital Library, PubMed Central, or the
California Digital Open Source Library, to be made publicly available not later than 12
months after the official date of publication. Manuscripts submitted to the California
Digital Open Source Library shall be exempt from the requirements in subdivision (b)
of Section 66408 of the Education Code. Grantee shall make reasonable efforts to
complywith this requirement by ensuring that their manuscript is accessible on an
approved publicly accessible database,and notifying the Department that the
manuscript is available on a department-approved database. If Grantee is unable to
ensure that their manuscript is accessible on an approved publicly accessible
database, Grantee may comply by providing the manuscript to the Department not
later than 12 months after the official date of publication.
County of Fresno
Grant 18-10698
Page 4 of 4
4) For publications other than those described inparagraph 6.3 above„ including
meeting abstracts, Grantee shall comply by providing the manuscript to the
Department not later than 12 months after the official date of publication.
5) Grantee is authorized to use grant money for publication costs, including fees charged
by a publisher for color and page charges,or fees for digital distribution.
CCC 04/2017
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am
duly authorized to legally bind the prospective Contractor to the clause(s) listed
below. This certification is made under the laws of the State of California.
Contractor/Bidder Firm Name (Printed) Federal ID Number
County of Fresno 94-6000512
o By (Authorized Sign1\ t
y � 3
U '
ao Q
`� �° Panted Name and
e i
w o U, nd Title of Person Signing
FU o N Nathan Magsig, Chairman of the Board of Supervisors of the County of Fresno
m _._.............._...........__ --_..____. ._.___..____. _.__.._._......._.........._..___.___-._.....____
Ww o nExecuted Executed in the County of
r- ,e - 9 - Fresno
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CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted,
complied with the nondiscrimination program requirements. (Gov. Code
§12990 (a-f) and CCR, Title 2, Section 11102) (Not applicable to public
entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply
with the requirements of the Drug-Free Workplace Act of 1990 and will
provide a drug-free workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture,
distribution, dispensation, possession or use of a controlled
substance is prohibited and specifying actions to be taken against
employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees
about:
1) The dangers of drug abuse in the workplace;
2) The person's or organization's policy of maintaining a drug-
free workplace;
3) Any available counseling, rehabilitation and employee
assistance programs; and,
4) Penalties that may be imposed upon employees for drug
abuse violations.
C. Every employee who works on the proposed Agreement will:
1) Receive a copy of the company's drug-free workplace policy
statement; and,
2) Agree to abide by the terms of the company's statement as a
condition of employment on the Agreement.
Failure to comply with these requirements may result in suspension of
payments under the Agreement or termination of the Agreement or both
and Contractor may be ineligible for award of any future State agreements
if the department determines that any of the following has occurred: the
Contractor has made false certification, or violated the certification by
failing to carry out the requirements as noted above. (Gov. Code §8350 et
seq.)
3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor
certifies that no more than one (1) final unappealable finding of contempt
of court by a Federal court has been issued against Contractor within the
immediately preceding two-year period because of Contractor's failure to
comply with an order of a Federal court, which orders Contractor to
comply with an order of the National Labor Relations Board. (Pub.
Contract Code §10296) (Not applicable to public entities.)
4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO
REQUIREMENT: Contractor hereby certifies that Contractor will comply
with the requirements of Section 6072 of the Business and Professions
Code, effective January 1, 2003.
Contractor agrees to make a good faith effort to provide a minimum
number of hours of pro bono legal services during each year of the
contract equal to the lessor of 30 multiplied by the number of full time
attorneys in the firm's offices in the State, with the number of hours
prorated on an actual day basis for any contract period of less than a full
year or 10% of its contract with the State.
Failure to make a good faith effort may be cause for non-renewal of a
state contract for legal services, and may be taken into account when
determining the award of future contracts with the State for legal services.
5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not
an expatriate corporation or subsidiary of an expatriate corporation within
the meaning of Public Contract Code Section 10286 and 10286.1, and is
eligible to contract with the State of California.
6. SWEATFREE CODE OF CONDUCT:
a. All Contractors contracting for the procurement or laundering of
apparel, garments or corresponding accessories, or the
procurement of equipment, materials, or supplies, other than
procurement related to a public works contract, declare under
penalty of perjury that no apparel, garments or corresponding
accessories, equipment, materials, or supplies furnished to the
state pursuant to the contract have been laundered or produced in
whole or in part by sweatshop labor, forced labor, convict labor,
indentured labor under penal sanction, abusive forms of child labor
or exploitation of children in sweatshop labor, or with the benefit of
sweatshop labor, forced labor, convict labor, indentured labor under
penal sanction, abusive forms of child labor or exploitation of
children in sweatshop labor. The contractor further declares under
penalty of perjury that they adhere to the Sweatfree Code of
Conduct as set forth on the California Department of Industrial
Relations website located at www.dir.ca.gov, and Public Contract
Code Section 6108.
b. The contractor agrees to cooperate fully in providing reasonable
access to the contractor's records, documents, agents or
employees, or premises if reasonably required by authorized
officials of the contracting agency, the Department of Industrial
Relations, or the Department of Justice to determine the
contractor's compliance with the requirements under paragraph (a).
7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor
certifies that Contractor is in compliance with Public Contract Code section
10295.3.
8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor
certifies that Contractor is in compliance with Public Contract Code section
10295.35.
DOING BUSINESS WITH THE STATE OF CALIFORNIA
The following laws apply to persons or entities doing business with the State of
California.
1. CONFLICT OF INTEREST: Contractor needs to be aware of the following
provisions regarding current or former state employees. If Contractor has
any questions on the status of any person rendering services or involved
with the Agreement, the awarding agency must be contacted immediately
for clarification.
Current State Employees (Pub. Contract Code §10410):
1). No officer or employee shall engage in any employment, activity or
enterprise from which the officer or employee receives
compensation or has a financial interest and which is sponsored or
funded by any state agency, unless the employment, activity or
enterprise is required as a condition of regular state employment.
2). No officer or employee shall contract on his or her own behalf as an
independent contractor with any state agency to provide goods or
services.
Former State Employees (Pub. Contract Code §10411):
1). For the two-year period from the date he or she left state
employment, no former state officer or employee may enter into a
contract in which he or she engaged in any of the negotiations,
transactions, planning, arrangements or any part of the decision-
making process relevant to the contract while employed in any
capacity by any state agency.
2). For the twelve-month period from the date he or she left state
employment, no former state officer or employee may enter into a
contract with any state agency if he or she was employed by that
state agency in a policy-making position in the same general
subject area as the proposed contract within the 12-month period
prior to his or her leaving state service.
If Contractor violates any provisions of above paragraphs, such action by
Contractor shall render this Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they
do not receive payment other than payment of each meeting of the board
or commission, payment for preparatory time and payment for per diem.
(Pub. Contract Code §10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be
aware of the provisions which require every employer to be insured
against liability for Worker's Compensation or to undertake self-insurance
in accordance with the provisions, and Contractor affirms to comply with
such provisions before commencing the performance of the work of this
Agreement. (Labor Code Section 3700)
3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that
it complies with the Americans with Disabilities Act (ADA) of 1990, which
prohibits discrimination on the basis of disability, as well as all applicable
regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101
et seq.)
4. CONTRACTOR NAME CHANGE: An amendment is required to change
the Contractor's name as listed on this Agreement. Upon receipt of legal
documentation of the name change the State will process the amendment.
Payment of invoices presented with a new name cannot be paid prior to
approval of said amendment.
5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:
a. When agreements are to be performed in the state by corporations,
the contracting agencies will be verifying that the contractor is
currently qualified to do business in California in order to ensure
that all obligations due to the state are fulfilled.
b. "Doing business" is defined in R&TC Section 23101 as actively
engaging in any transaction for the purpose of financial or
pecuniary gain or profit. Although there are some statutory
exceptions to taxation, rarely will a corporate contractor performing
within the state not be subject to the franchise tax.
C. Both domestic and foreign corporations (those incorporated outside
of California) must be in good standing in order to be qualified to do
business in California. Agencies will determine whether a
corporation is in good standing by calling the Office of the Secretary
of State.
6. RESOLUTION: A county, city, district, or other local public body must
provide the State with a copy of a resolution, order, motion, or ordinance
of the local governing body which by law has authority to enter into an
agreement, authorizing execution of the agreement.
7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the
Contractor shall not be: (1) in violation of any order or resolution not
subject to review promulgated by the State Air Resources Board or an air
pollution control district; (2) subject to cease and desist order not subject
to review issued pursuant to Section 13301 of the Water Code for violation
of waste discharge requirements or discharge prohibitions; or (3) finally
determined to be in violation of provisions of federal law relating to air or
water pollution.
8. PAYEE DATA RECORD FORM STD. 204: This form must be completed
by all contractors that are not another state agency or other governmental
entity.
County of Fresno
18-10698
Page 1 of 4
Exhibit D
Additional Provisions
1. Cancellation/Termination
A. This grant may be cancelled by CDPH without cause upon thirty (30) calendar
days advance written notice to the Grantee.
B. CDPH reserves the right to cancel or terminate this grant immediately for cause.
The Grantee may submit a written request to terminate this grant only if CDPH
substantially fails to perform its responsibilities as provided herein.
C. The term "for cause"shall mean that the Grantee fails to meet the terms,
conditions, and/or responsibilities of this agreement. Causes for termination
include, but are not limited to, the following occurrences:
1) If the Grantee knowingly furnishes any statement, representation,
warranty, or certification in connection with the agreement, which
representation is materially false, deceptive, incorrect, or incomplete.
2) If the Grantee fails to perform any material requirement of this grant or
defaults in performance of this agreement.
3) If the Grantee files for bankruptcy, or if CDPH determines that the
Grantee becomes financially incapable of completing this agreement.
D. Grant termination or cancellation shall be effective as of the date indicated in
CDPH's notification to the Grantee. The notice shall stipulate any final
performance, invoicing, or payment requirements.
E. In the event of early termination or cancellation, the Grantee shall be entitled to
compensation for services performed satisfactorily under this agreement and
expenses incurred up to the date of cancellation and any non-cancelable
obligations incurred in support of this grant.
F. In the event of termination, and at the request of CDPH,the Grantee shall furnish
all proposals, specifications,designs, procedures, layouts, copy, and other
materials related to the services or deliverables provided under this grant,
whether finished or in progress on the termination date.
G. The Grantee will not be entitled to reimbursementfor any expenses incurred for
services and deliverables pursuant to this agreement after the effective date of
termination.
County of Fresno
18-10698
Page 2 of 4
Exhibit D
Additional Provisions
H. Upon receipt of notification of termination of this grant, and except as otherwise
specified by CDPH,the Grantee shall:
1) Place no further order or subgrants for materials, services,or facilities.
2) Settle all outstanding liabilities and all claims arising out of such
termination of orders and subgrants.
3) Upon the effective date of termination of the grant and the payment by
CDPH of all items properly chargeable to CDPH hereunder, Grantee shall
transfer, assign,and make available to CDPH all property and materials
belonging to CDPH, all rights and claims to any and all reservations,
grants, and arrangements with owners of media/PR materials, or others,
and shall make available to CDPH all written information regarding
CDPH's media/PR materials, and no extra compensation is to be paid to
Grantee for its services.
4) Take such action as maybe necessary, or as CDPH may specify, to
protect and preserve any property related to this agreement which is in
the possession of the Grantee and in which CDPH has or may acquire an
interest.
I. CDPH may, at its discretion, require the Grantee to cease performance of certain
components of the Scope of Work as designated by CDPH and complete
performance of other components prior to the termination date of the grant.
2. Avoidance of Conflicts of Interest by Grantee
A. CDPH intends to avoid any real or apparent conflict of interest on the part of the
Grantee, subgrants, or employees, officers, and directors of the Grantee or
subgrants. Thus, CDPH reserves the right to determine, at its sole discretion,
whether any information, assertion, or claim received from any source indicates
the existence of a real or apparent conflict of interest; and, if a conflict is found to
exist, to require the Grantee to submit additional information or a plan for
resolving the conflict, subject to CDPH review and prior approval.
B. Conflicts of interest include, but are not limited to:
1) An instance where the Grantee or any of its subgrants, or any employee,
officer, or director of the Grantee or any subgrant has an interest,
financial or otherwise, whereby the use or disclosure of information
obtained while performing services under the grant would allow for private
or personal benefit or for any purpose that is contrary to the goals and
objectives of the grant.
County of Fresno
18-10698
Page 3 of 4
Exhibit D
Additional Provisions
2) An instance where the Grantee's or any subgrant's employees, officers,
or directors use their positions for purposes that are, or give the
appearance of being, motivated by a desire for private gain for
themselves or others, such as those with whom they have family,
business or other ties.
C. If CDPH is or becomes aware of a known or suspected conflict of interest, the
Grantee will be given an opportunity to submit additional information or to resolve
the conflict. A Grantee with a suspected conflict of interest will have five (5)
working days from the date of notification of the conflict by CDPH to provide
complete information regarding the suspected conflict. If a conflict of interest is
determined to exist by CDPH and cannot be resolved to the satisfaction of
CDPH, the conflict will be grounds for terminating the grant. CDPH may, at its
discretion upon receipt of a written request from the Grantee, authorize an
extension of the timeline indicated herein.
3. Dispute Resolution Process
A. A Grantee grievance exists whenever there is a dispute arising from CDPH's
action in the administration of an agreement. If there is a dispute or grievance
between the Grantee and CDPH,the Grantee must seek resolution using the
procedure outlined below.
1) The Grantee should first informally discuss the problem with the CDPH
Program Grant Manager. If the problem cannot be resolved informally,
the Grantee shall direct its grievance together with any evidence, in
writing, to the program Branch Chief. The grievance shall state the
issues in dispute, the legal authority or other basis for the Grantee's
position and the remedy sought. The Branch Chief shall render a
decision within ten (10) working days after receipt of the written grievance
from the Grantee. The Branch Chief shall respond in writing to the
Grantee indicating the decision and reasons therefore. If the Grantee
disagrees with the Branch Chief's decision, the Grantee may appeal to
the second level.
2) When appealing to the second level, the Grantee must prepare an appeal
indicating the reasons for disagreement with Branch Chief's decision.
The Grantee shall include with the appeal a copy of the Grantee's original
statement of dispute along with any supporting evidence and a copy of
the Branch Chief's decision. The appeal shall be addressed to the
Deputy Director of the division in which the branch is organized within ten
(10) working days from receipt of the Branch Chief's decision. The
Deputy Director of the division in which the branch is organized or his/her
designee shall meet with the Grantee to review the issues raised. A
written decision signed by the Deputy Director of the division in which the
County of Fresno
18-10698
Page 4 of 4
Exhibit D
Additional Provisions
branch is organized or his/her designee shall be directed to the Grantee
within twenty(20)working days of receipt of the Grantee's second level
appeal.
B. If the Grantee wishes to appeal the decision of the Deputy Director of the division
in which the branch is organized or his/her designee, the Grantee shall follow the
procedures set forth in Division 25.1 (commencing with Section 38050) of the
Health and Safety Code and the regulations adopted thereunder. (Title 1,
Division 2, Chapter 2, Article 3 (commencing with Section 1140) of the California
Code of Regulations).
C. Disputes arising out of an audit, examination of an agreement or other action not
covered by subdivision (a) of Section 20204, of Chapter 2.1, Title 22, of the
California Code of Regulations, and for which no procedures for appeal are
provided in statute, regulation or the Agreement, shall be handled in accordance
with the procedures identified in Sections 51016 through 51047, Title 22,
California Code of Regulations.
D. Unless otherwise stipulated in writing by CDPH, all dispute, grievance and/or
appeal correspondence shall be directed to the CDPH Grant Manager.
E. There are organizational differences within CDPH's funding programs and the
management levels identified in this dispute resolution provision may not apply in
every contractual situation. When a grievance is received and organizational
differences exist, the Grantee shall be notified in writing by the CDPH Grant
Manager of the level, name, and/or title of the appropriate management official
that is responsible for issuing a decision at a given level.
County of Fresno
18-10698
Exhibit F
Federal Terms and Conditions
(For Federally Funded Grant Agreements)
The use of headings or titles throughout this exhibit is for convenience only and shall not be used to interpret or to
govern the meaning of any specific term or condition.
This exhibit contains provisions that require strict adherence to various contracting laws and policies.
Index of Special Terms and Conditions
1. Federal Funds
2. Federal Equal Employment Opportunity Requirements
3. Debarment and Suspension Certification
4. Covenant Against Contingent Fees
5. Air or Water Pollution Requirements
6. Lobbying Restrictions and Disclosure Certification
7. Additional Restrictions
8. Human Subjects Use Requirments
9. Financial and Compliance Audit Requirements
10. Audit and Record Retention
11. Federal Requirements
CDPH(rev.07/16) Page 1 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
1. Federal Funds
(Applicable only to that portion of an agreement funded in part or whole with federal funds.)
a. It is mutually understood between the parties that this Grant may have been written before ascertaining the
availability of congressional appropriation of funds, for the mutual benefit of both parties, in order to avoid
program and fiscal delays which would occur if the Grant were executed after that determination was made.
b. This Grant is valid and enforceable only if sufficient funds are made available to the State by the United
States Government for the fiscal years covered by the term of this Grant. In addition, this Grant is subject
to any additional restrictions, limitations, or conditions enacted by the Congress or any statute enacted by
the Congress which may affect the provisions, terms or funding of this Grant in any manner.
c. It is mutually agreed that if the Congress does not appropriate sufficient funds for the program, this Grant
shall be amended to reflect any reduction in funds.
d. CDPH has the option to invalidate or cancel the Grant with 30-days advance written notice or to amend the
Grant to reflect any reduction in funds.
2. Federal Equal Opportunity Requirements
(Applicable to all federally funded grants entered into by the California Department of Public Health (CDPH)
formerly known as California Department of Health Services (CDHS).)
a. The Grantee will not discriminate against any employee or applicant for employment because of race, color,
religion, sex, national origin, physical or mental handicap, disability, age or status as a disabled veteran or
veteran of the Vietnam era. The Grantee will take affirmative action to ensure that qualified applicants are
employed, and that employees are treated during employment, without regard to their race, color, religion,
sex, national origin, physical or mental handicap, disability, age or status as a disabled veteran or veteran
of the Vietnam era. Such action shall include, but not be limited to the following: employment, upgrading,
demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms
of compensation; and career development opportunities and selection for training, including apprenticeship.
The Grantee agrees to post in conspicuous places, available to employees and applicants for employment,
notices to be provided by the Federal Government or CDPH, setting forth the provisions of the Equal
Opportunity clause, Section 503 of the Rehabilitation Act of 1973 and the affirmative action clause required
by the Vietnam Era Veterans' Readjustment Assistance Act of 1974 (38 U.S.C. 4212). Such notices shall
state the Grantee's obligation under the law to take affirmative action to employ and advance in employment
qualified applicants without discrimination based on their race, color, religion, sex, national origin physical
or mental handicap, disability, age or status as a disabled veteran or veteran of the Vietnam era and the
rights of applicants and employees.
b. The Grantee will, in all solicitations or advancements for employees placed by or on behalf of the Grantee,
state that all qualified applicants will receive consideration for employment without regard to race, color,
religion, sex, national origin physical or mental handicap, disability, age or status as a disabled veteran or
veteran of the Vietnam era.
c. The Grantee will send to each labor union or representative of workers with which it has a collective
bargaining agreement or other contract or understanding a notice, to be provided by the Federal
Government or the State, advising the labor union or workers' representative of the Grantee's commitments
under the provisions herein and shall post copies of the notice in conspicuous places available to
employees and applicants for employment.
d. The Grantee will comply with all provisions of and furnish all information and reports required by Section
503 of the Rehabilitation Act of 1973, as amended, the Vietnam Era Veterans' Readjustment Assistance
Act of 1974 (38 U.S.C. 4212) and of the Federal Executive Order No. 11246 as amended, including by
Executive Order 11375, 'Amending Executive Order 11246 Relating to Equal Employment Opportunity,'
and as supplemented by regulation at 41 CFR part 60, "Office of the Federal Contract Compliance
Programs, Equal Employment Opportunity, Department of Labor," and of the rules, regulations, and
relevant orders of the Secretary of Labor.
CDPH(rev.07/16) Page 2 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
e. The Grantee will furnish all information and reports required by Federal Executive Order No. 11246 as
amended, including by Executive Order 11375, 'Amending Executive Order 11246 Relating to Equal
Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60, "Office of the Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of Labor," and the
Rehabilitation Act of 1973, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant
thereto, and will permit access to its books, records, and accounts by the State and its designated
representatives and the Secretary of Labor for purposes of investigation to ascertain compliance with such
rules, regulations, and orders.
f. In the event of the Grantee's noncompliance with the requirements of the provisions herein or with any
federal rules, regulations, or orders which are referenced herein, this Agreement may be cancelled,
terminated, or suspended in whole or in part and the Grantee may be declared ineligible for further federal
and state contracts in accordance with procedures authorized in Federal Executive Order No. 11246 as
amended and such other sanctions may be imposed and remedies invoked as provided in Federal
Executive Order No. 11246 as amended, including by Executive Order 11375, 'Amending Executive Order
11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60,
"Office of the Federal Contract Compliance Programs, Equal Employment Opportunity, Department of
Labor," or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law.
g. The Grantee will include the provisions of Paragraphs a through g in every subcontract or purchase order
unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Federal
Executive Order No. 11246 as amended, including by Executive Order 11375, 'Amending Executive Order
11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60,
"Office of the Federal Contract Compliance Programs, Equal Employment Opportunity, Department of
Labor," or Section 503 of the Rehabilitation Act of 1973 or (38 U.S.C. 4212) of the Vietnam Era Veteran's
Readjustment Assistance Act, so that such provisions will be binding upon each subGrantee or vendor.
The Grantee will take such action with respect to any subcontract or purchase order as the Director of the
Office of Federal Contract Compliance Programs or CDPH may direct as a means of enforcing such
provisions including sanctions for noncompliance provided, however, that in the event the Grantee becomes
involved in, or is threatened with litigation by a subGrantee or vendor as a result of such direction by CDPH,
the Grantee may request in writing to CDPH, who, in turn, may request the United States to enter into such
litigation to protect the interests of the State and of the United States.
3. Debarmentand Suspension Certification
a. By signing this Grant, the Grantee agrees to comply with applicable federal suspension and debarment
regulations including, but not limited to 7 CFR Part 3017, 45 CFR 76, 40 CFR 32 or 34 CFR 85.
b. By signing this Grant, the Grantee certifies to the best of its knowledge and belief, that it and its principals:
(1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded by any federal department or agency;
(2) Have not within a three-year period preceding this application/proposal/agreement been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State or local)
transaction or contract under a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
(3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State or local)with commission of any of the offenses enumerated in Paragraph b(2) herein;
and
(4) Have not within a three-year period preceding this application/proposal/agreement had one or more
public transactions (Federal, State or local)terminated for cause or default.
(5) Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for
debarment under federal regulations (i.e.,48 CFR part 9, subpart 9.4), debarred, suspended, declared
ineligible, or voluntarily excluded from participation in such transaction, unless authorized by the State.
CDPH(rev.07/16) Page 3 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
(6) Will include a clause entitled, "Debarment and Suspension Certification" that essentially sets forth the
provisions herein, in all lower tier covered transactions and in all solicitations for lower tier cored
transactions.
c. If the Grantee is unable to certify to any of the statements in this certification, the Grantee shall submit an
explanation to the CDPH Program Contract Manager.
d. The terms and definitions herein have the meanings set out in the Definitions and Coverage sections of the
rules implementing Federal Executive Order 12549.
e. If the Grantee knowingly violates this certification, in addition to other remedies available to the Federal
Government, the CDPH may terminate this Agreement for cause or default.
4. Covenant Against Contingent Fees
The Grantee warrants that no person or selling agency has been employed or retained to solicit/secure this
Grant upon an agreement of understanding for a commission, percentage, brokerage, or contingent fee, except
bona fide employees or bona fide established commercial or selling agencies retained by the Grantee for the
purpose of securing business. For breach or violation of this warranty, CDPH shall have the right to annul this
Grant without liability or in its discretion to deduct from the Grant price or consideration, or otherwise recover,
the full amount of such commission, percentage, and brokerage or contingent fee.
5. Air or Water Pollution Requirements
Any federally funded grant and/or subgrants in excess of$100,000 must comply with the following provisions
unless said grant is exempt under 40 CFR 15.5.
a. Government Grantees agree to comply with all applicable standards, orders, or requirements issued under
section 306 of the Clean Air Act[42 U.S.C. 1857(h)], section 508 of the Clean Water Act(33 U.S.C. 1368),
Executive Order 11738, and Environmental Protection Agency regulations (40 CFR part 15).
b. Institutions of higher education, hospitals, nonprofit organizations and commercial businesses agree to
comply with all applicable standards, orders, or requirements issued under the Clean Air Act (42 U.S.C.
7401 et seq.), as amended, and the Federal Water Pollution Control Act (33 U.S.C. 1251 et seq.), as
amended.
6. Lobbying Restrictions and Disclosure Certification
(Applicable to federally funded grants in excess of$100,000 per Section 1352 of the 31, U.S.C.)
a. Certification and Disclosure Requirements
(1) Each person (or recipient) who requests or receives a grant, subgrant, which is subject to Section 1352
of the 31, U.S.C., and which exceeds $100,000 at any tier, shall file a certification (in the form set forth
in Attachment 1, consisting of one page, entitled "Certification Regarding Lobbying") that the recipient
has not made, and will not make, any payment prohibited by Paragraph b of this provision.
(2) Each recipient shall file a disclosure (in the form set forth in Attachment 2, entitled "Standard Form-LLL
`disclosure of Lobbying Activities"') if such recipient has made or has agreed to make any payment
using nonappropriated funds (to include profits from any covered federal action) in connection with a
grant or any extension or amendment of that grant, which would be prohibited under Paragraph b of
this provision if paid for with appropriated funds.
(3) Each recipient shall file a disclosure form at the end of each calendar quarter in which there occurs any
event that requires disclosure or that materially affect the accuracy of the information contained in any
disclosure form previously filed by such person under Paragraph a(2) herein. An event that materially
affects the accuracy of the information reported includes:
(a) A cumulative increase of$25,000 or more in the amount paid or expected to be paid for influencing
or attempting to influence a covered federal action;
CDPH(rev.07/16) Page 4 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
(b) A change in the person(s) or individuals(s) influencing or attempting to influence a covered federal
action; or
(c) A change in the officer(s), employee(s), or member(s) contacted for the purpose of influencing or
attempting to influence a covered federal action.
(4) Each person (or recipient) who requests or receives from a person referred to in Paragraph a(1) of this
provision a grant or subgrant exceeding $100,000 at any tier under a grant shall file a certification, and
a disclosure form, if required, to the next tier above.
(5) All disclosure forms (but not certifications) shall be forwarded from tier to tier until received by the
person referred to in Paragraph a(1) of this provision. That person shall forward all disclosure forms to
CDPH Program Contract Manager.
b. Prohibition
Section 1352 of Title 31, U.S.C., provides in part that no appropriated funds may be expended by the
recipient of a federal contract or agreement, grant, loan, or cooperative agreement to pay 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 any of the
following covered federal actions: the awarding of any federal contract or agreement, the making of any
federal grant, the making of any federal loan, entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any federal contract or agreement, grant, loan, or
cooperative agreement.
7. Additional Restrictions
Grantee shall comply with the restrictions under Division F, Title V, Section 503 of the Consolidated
Appropriations Act, 2012 (H.R. 2055), which provides that:
"SEC. 503.(a) No part of any appropriation contained in this Act or transferred pursuant to
section 4002 of Public Law 111-148 shall be used, other than for normal and recognized
executive-legislative relationships, for publicity or propaganda purposes,for the preparation,
distribution, or use of any kit, pamphlet, booklet, publication, electronic communication, radio,
television, or video presentation designed to support or defeat the enactment of legislation
before the Congress or any State or local legislature or legislative body, except in presentation
to the Congress or any State or local legislature itself, or designed to support or defeat any
proposed or pending regulation, administrative action, or order issued by the executive branch
of any State or local government, except in presentation to the executive branch of any State or
local government itself.
(b) No part of any appropriation contained in this Act or transferred pursuant to section
4002 of Public Law 111-148 shall be used to pay the salary or expenses of any grant or
contract recipient, or agent acting for such recipient, related to any activity designed to influence
the enactment of legislation, appropriations, regulation, administrative action, or Executive order
proposed or pending before the Congress or any State government, State legislature or local
legislature or legislative body, other than for normal and recognized executive-legislative
relationships or participation by an agency or officer of a State, local or tribal government in
policymaking and administrative processes within the executive branch of that government.
(c) The prohibitions in subsections (a) and (b) shall include any activity to advocate or promote any
proposed, pending or future Federal, State or local tax increase, or any proposed, pending, or future
requirement or restriction on any legal consumer product, including its sale or marketing, including but not
limited to the advocacy or promotion of gun control."
8. Human Subjects Use Requirements
(Applicable only to federally funded agreements in which performance, directly or through a
subcontract/subaward, includes any tests or examination of materials derived from the human body.)
CDPH(rev.07/16) Page 5 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
By signing this Agreement, Contractor agrees that if any performance under this Agreement or any subcontract
or subagreement includes any tests or examination of materials derived from the human body for the purpose
of providing information, diagnosis, prevention, treatment or assessment of disease, impairment, or health of a
human being, all locations at which such examinations are performed shall meet the requirements of 42 U.S.C.
Section 263a (CLIA) and the regulations thereunder.
9. Financial and Compliance Audit Requirements
By signing this Agreement, the Contractor/Subcontrac for agrees to abide by all requirements specified in 2
CFR 200, et seq., 2 CFR 400, et seq., and 45 CFR, 75, et seq., as applicable, including but not limited to
obtaining an annual audit, and any subsequent federal regulatory additions or revisions.
a. The definitions used in this provision are contained in Section 38040 of the Health and Safety Code, which
by this reference is made a part hereof.
b. Direct service contract means a contract or agreement for services contained in local assistance or
subvention programs or both (see Health and Safety [H&S] Code section 38020). Direct service contracts
shall not include contracts, agreements, grants, or subventions to other governmental agencies or units of
government nor contracts or agreements with regional centers or area agencies on aging (H&S Code
section 38030).
c. The Contractor, as indicated below, agrees to obtain one of the following audits:
(1) If the Contractor is a nonprofit organization (as defined in H&S Code section 38040) and receives
$25,000 or more from any State agency under a direct service contract or agreement; the Contractor
agrees to obtain an annual single, organization wide, financial and compliance audit. Said audit shall
be conducted according to Generally Accepted Auditing Standards. This audit does not fulfill the audit
requirements of Paragraph c(3) below. The audit shall be completed by the 15th day of the fifth month
following the end of the Contractor's fiscal year, and/or
(2) If the Contractor is a nonprofit organization (as defined in H&S Code section 38040) and receives less
than $25,000 per year from any State agency under a direct service contract or agreement, the
Contractor agrees to obtain a biennial single, organization wide financial and compliance audit, unless
there is evidence of fraud or other violation of state law in connection with this Agreement. This audit
does not fulfill the audit requirements of Paragraph c(3) below. The audit shall be completed by the
15th day of the fifth month following the end of the Contractor's fiscal year, and/or
(3) If the Contractor is a State or Local Government entity or Nonprofit organization (as defined in 2CFR
Part 200) and expends $750,000 or more in Federal awards, the Contractor agrees to obtain an annual
single, organization wide, financial and compliance audit according to the requirements specified in
2CFR Part 200. An audit conducted pursuant to this provision will fulfill the audit requirements outlined
in Paragraphs c(1) and c(2)above. The audit shall be completed by the end of the ninth month following
the end of the audit period. The requirements of this provision apply if:
(a) The Contractor is a recipient expending Federal awards received directly from Federal awarding
agencies, or
(b) The Contractor is a subrecipient expending Federal awards received from a pass-through entity
such as the State, County or community based organization.
(4) If the Contractor submits to CDPH a report of an audit other than a single audit, the Contractor must
also submit a certification indicating the Contractor has not expended $750,000 or more in federal funds
for the year covered by the audit report.
d. Two copies of the audit report shall be delivered to the CDPH program funding this Agreement. The audit
report must identify the Contractor's legal name and the number assigned to this Agreement. The audit
report shall be due within 30 days after the completion of the audit. Upon receipt of said audit report, the
CDPH Program Contract Manager shall forward the audit report to CDPH's Audits and Investigations Unit
if the audit report was submitted under Section 16.c(3), unless the audit report is from a City, County, or
Special District within the State of California whereby the report will be retained by the funding program.
CDPH(rev.07/16) Page 6 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
e. The cost of the audits described herein may be included in the funding for this Agreement up to the
proportionate amount this Agreement represents of the Contractor's total revenue. The CDPH program
funding this Agreement must provide advance written approval of the specific amount allowed for said audit
expenses.
f. The State or its authorized designee, including the Bureau of State Audits, is responsible for conducting
agreement performance audits which are not financial and compliance audits. Performance audits are
defined by Generally Accepted Government Auditing Standards.
g. Nothing in this Agreement limits the State's responsibility or authority to enforce State law or regulations,
procedures, or reporting requirements arising thereto.
h. Nothing in this provision limits the authority of the State to make audits of this Agreement, provided however,
that if independent audits arranged for by the Contractor meet Generally Accepted Governmental Auditing
Standards, the State shall rely on those audits and any additional audit work and shall build upon the work
already done.
i. The State may, at its option, direct its own auditors to perform either of the audits described above. The
Contractor will be given advance written notification, if the State chooses to exercise its option to perform
said audits.
j. The Contractor shall include a clause in any agreement the Contractor enters into with the audit firm doing
the single organization wide audit to provide access by the State or Federal Government to the working
papers of the independent auditor who prepares the single organization wide audit for the Contractor.
k. Federal or state auditors shall have "expanded scope auditing" authority to conduct specific program audits
during the same period in which a single organization wide audit is being performed, but the audit report
has not been issued. The federal or state auditors shall review and have access to the current audit work
being conducted and will not apply any testing or review procedures which have not been satisfied by
previous audit work that has been completed.
The term "expanded scope auditing" is applied and defined in the U.S. General Accounting Office (GAO)
issued Standards for Audit of Government Organizations, Programs, Activities and Functions, better known
as the "yellow book".
10. Audit and Record Retention
(Applicable to agreements in excess of$10,000.)
a. The Contractor shall maintain books, records, documents, and other evidence, accounting procedures and
practices, sufficient to properly reflect all direct and indirect costs of whatever nature claimed to have been
incurred in the performance of this Agreement, including any matching costs and expenses. The foregoing
constitutes "records" for the purpose of this provision.
b. The Contractor's facility or office or such part thereof as may be engaged in the performance of this
Agreement and his/her records shall be subject at all reasonable times to inspection, audit, and
reproduction.
c. Contractor agrees that CDPH, the Department of General Services, the Bureau of State Audits, or their
designated representatives including the Comptroller General of the United States shall have the right to
review and to copy any records and supporting documentation pertaining to the performance of this
Agreement. Contractor agrees to allow the auditor(s) access to such records during normal business hours
and to allow interviews of any employees who might reasonably have information related to such records.
Further, the Contractor agrees to include a similar right of the State to audit records and interview staff in
any subcontract related to performance of this Agreement. (GC 8546.7, CCR Title 2, Section 1896).
d. The Contractor shall preserve and make available his/her records (1) for a period of three years from the
date of final payment under this Agreement, and (2) for such longer period, if any, as is required by
applicable statute, by any other provision of this Agreement, or by subparagraphs (1) or (2) below.
(1) If this Agreement is completely or partially terminated, the records relating to the work terminated shall
CDPH(rev.07/16) Page 7 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
be preserved and made available for a period of three years from the date of any resulting final
settlement.
(2) If any litigation, claim, negotiation, audit, or other action involving the records has been started before
the expiration of the three-year period, the records shall be retained until completion of the action and
resolution of all issues which arise from it, or until the end of the regular three-year period, whichever
is later.
e. The Contractor shall comply with the above requirements and be aware of the penalties for violations of
fraud and for obstruction of investigation as set forth in Public Contract Code § 10115.10, if applicable.
f. The Contractor may, at its discretion, following receipt of final payment under this Agreement, reduce its
accounts, books and records related to this Agreement to microfilm, computer disk, CD ROM, or other data
storage medium. Upon request by an authorized representative to inspect, audit or obtain copies of said
records, the Contractor and/or Subcontractor must supply or make available applicable devices, hardware,
and/or software necessary to view, copy and/or print said records. Applicable devices may include, but are
not limited to, microfilm readers and microfilm printers, etc.
g. The Contractor shall, if applicable, comply with the Single Audit Act and the audit reporting requirements
set forth in Title 2 of the Code of Federal Regulations, Part 200 (2CFR Part 200).
11. Federal Requirements
Grantor agrees to comply with and shall require all subgranteers, if any, to comply with all applicable Federal
requirements including but not limited to the United States Code, the Code of Federal Regulations,
the Funding Opportunity Announcement, the Notice of Award, the funding agreement, and any memoranda
or letter regarding the applicable Federal requirements.
CDPH(rev.07/16) Page 8 of 11
Califomia Department of Public Health—Federal Terms and Conditions Exhibit F
Attachment 1
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in connection with the making,
awarding or entering into of this Federal contract, Federal grant, or cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of this Federal contract, grant, or cooperative agreement.
(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 of the United States Govemment, 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, or cooperative agreement, the undersigned shall complete and submit Standard
Form LLL, "Disclosure of Lobbying Activities" in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers (including subGrantees, subgrants, and contracts under grants and cooperative
agreements) of$100,000 or more, and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by Section 1352, Title 31, U.S.C., 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.
County of Fresno Nathan Magsig
Name of Grantee Printed Name of Person Signing for Grantee
18-10698
Contract/Grant Number Signature of Person Signing for Gran ee
Chairman of the Board of Supervisors of the
`7-0�- County of Fresno
Date Title
ATTEST:
BERNICE E.SEIDEL
After execution by or on behalf of Grantee, please return to: Clerk of the Board of Supervisors
County of Fresno, State of California
California Department of Public Health B
STD Control Branch y SO�M De
Deputy
P.O. Box 997377, MS 7320
Sacramento, CA 95899-7320
CDPH reserves the right to notify the Grantee in writing of an altemate submission address.
CDPH(rev.07/16) Page 9 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
Attachment 2
CERTIFICATION REGARDING LOBBYING Approved by OMB
Complete this form to disclose lobbying activities pursuantto 31 U.S.C. 1352 0348-0046
(See reverse for public burden disclosure)
1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
[ ] a. contract [ ] a. bid/offer/application [ ] a. initial filing
b. grant b. initial award b. material change
c. cooperative agreement c. post-award For Material Change Only:
d. loan
e. loan guarantee Year quarter
f. loan insurance
date of last report
4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subaw ardee,Enter Name
and Address of Prime:
❑ Prime ❑ Subaw ardee
Tier _, if known:
Congressional District, If known:
Congressional District, If known:
6. Federal Department/Agency 7. Federal Program Name/Description:
CDFA Number, if applicable:
8. Federal Action Number, if know n: 9. Award Amount,if known:
10.a. Name and Address of Lobbying Registrant b. Individuals Perforrning Services(including address if different from
(If individual,last name,first name,MI): 10a.
(Lastname,Firstname,MI):
11. Information requested through this form is authorized by title 31 U.S.C.
section 1352. This disclosure of lobbying activities is a material Signature:
representation of fact upon which reliance was placed by the tier above
when this transaction was made or entered into.This disclosure is Print Name:
required pursuantto31 U.S.C.1352.This informationwill be available
for public inspection.required disclosure shall be subject to a not more Title:
than$100,000 for each such failure. Telephone No.: Date:
Federal Use Only Authorized for Local Reproduction
Standard Form-LLL(Rev.7-97)
CDPH(rev.07/16) Page 10 of 11
California Department of Public Health — Federal Terms and Conditions Exhibit F
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of a covered Federal action,or a
material change to a previous filing,pursuant to title 31 U.S.C.section 1352.The filing of a form is required for each payment or agreement to make payment to any lobbying
entity forinfluencing orattempting to influence an officer or employee of any agency,aMemberof Congress,an officer or employee of Congress,oran employee of a Member
of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Referto the implementing guidance
published by the Officeof Management and Budget foradditional information.
1. Identify the ty pe of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report.If this is a follow-up report caused by a material change to the information previously reported,enter the year and
quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name,address,city,State and zip code of the reporting entity. Include Congressional District,if known. Check the appropriate classification of the
reporting entity that designates if it is,or expects to be a prime or subaward recipient. Identify the tier of the subawardee,e.g.,the first subawardee of the prime is
the 1st tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks"Subawardee," then enter the full name,address,city,State and zip code of the prime Federal recipient.Include
Congressional District,if known.
6. Enter the name of the Federal agency making the award or loan commitment.Include at least one organizational level below agency name,if known. Forexample,
Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance(CFDA)
number forgrants,cooperative agreements,loans,and loan commitments.
8. Enter the most appropriate Federal identifying number available forthe Federal action identified in item 1 (e.g., Request for Proposal (RFP)number; Invitation for
Bid(IFB)number;grant announcement number;the contract,grant,or loan award number;the application/proposal control number assigned by the Federal agency).
Include prefixes,e.g.,'RFP-DE-90-001."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enterthe Federal amount of the award/loan commitment
for the prime entity identified in item 4 or 5.
10. (a) Enter the full name,address,city,State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity
identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the indiv idual(s)performing sery ices,and include full address if different from 10(a). Enter Last Name, First Name,and Middle Initial
(MI).
11. The certify ing official shall sign and date the form,print his/her name,title,and telephone number.
According to the Paperwork Reduction Act,as amended,no persons are required to respond to a collection of information unless it displays a valid
OMB Control Number.The valid OMB control numberforthisinformation coll ection i s OM B No.0348-0046.Public reporti ng burden forthiscollection
of information is estimated to average 10 minutes per response, including time for reviewing instructions,searching existing data sources,gathering
and maintaining the data needed,and completing and reviewing the collection of information.Send comments regarding the burden estimate or any
other aspect of this collection of information,including suggestionsfor reducing this burden,to the Office of Management and Budget,Paperwork
Reduction Project(0348-0046),Washington,DC 20503.
CDPH(rev.07/16) Page 11 of 11
State of California—Health and Human Services Agency
California Department of Public Health
Exhibit G
Contractor's Release
Instructions to Contractor:
With final invoice(s) submit one (1)original and one (1)copy. The original mustbearthe original signature ofa person
authorized to bind the Contractor. The additional copymay bear photocopied signatures.
Submission of Final Invoice
Pursuantto contract number 18-10698 entered into between the State of California Departmentof Public Health
(CDPH)and the Contractor(identified below),the Contractordoes acknowledge thatfinal paymenthas been requested via
invoice number(s) , in the amounts) of$ and dated
If necessary,enter"See Attached" in the appropriate blocks and attach a listof invoice numbers,dollar amounts and invoice dates.
Release of all Obligations
By signing this form,and upon receiptof the amountspecified in the invoice number(s)referenced above,the Contractor does
hereby release and discharge the State,its officers,agents and employees of and from any and all liabilities,obligations,claims,and
demands whatsoever arising from the above referenced contract.
Repayments Due to Audit Exceptions /Record Retention
By signing this form,Contractor acknowledges thatexpenses authorized for reimbursement does notguarantee final allowabilityof
said expenses. Contractor agrees thatthe amountofany sustained audit exceptions resulting from anysubsequent audit made
after final paymentwill be refunded to the State.
All expense and accounting records related to the above referenced contract must be maintained for audit purposes for no less than
three years beyond the date of final payment,unless a longerterm is stated in said contract.
Recycled Product Use Certification
By signing this form,Contractor certifies underpenaltyof perjurythat a minimum of0%o unless otherwise specked in writing of post
consumer material,as defined in the Public Contract Code Section 12200,in products,materials,goods,orsupplies offered orsold
to the State regardless ofwhetherit meets the requirements of PublicContractCode Section 12209. Contractor specifies that
printeror duplication cartridges offered orsold to the State complywith the requirements of Section 12156(e).
Reminderto Return State Equipment/Property (If Applicable)
(Applies only if equipment w as provided by CDPH or purchased with or reimbursed by contractfunds)
Unless CDPH has approved the continued use and possession of State equipment(as defined in the above referenced contract)for
use in connection with another CDPH agreement,Contractor agrees to prom ptlyinitiate arrangements to accountfor and return said
equipmentto CDPH,at CDPH's expense,if said equipmenthas notpassed its useful life expectancyas defined in the above
referenced contract.
Patents/Other Issues
By signing this form,Contractor further agrees,in connection with patent matters and with any claims thatare not specifically
released as setforth above,that it will complywith all of the provisions contained in the above referenced contract,including,butnot
limited to,those provisions relating to notification to the State and related to the defense orprosecution of litigation.
ONLY SIGN AND DATE THIS DOCUMENT WHEN ATTACHING TO THE FINAL INVOICE
Contractor's Legal Name (as on contract): County of Fresno
Signature of Contractor or Official Designee: Date:
Printed Name/Title of Person Signing:
CDPH Distribution: Accounting(Original) Program
CDPH 2352(7/07)
STATE OF CALIFORNIA DEPARTMENT OF GENERAL SERVICES
CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT OFFICE OF LEGAL SERVICES
DGS OLS 04(Rev.01/17)
Pursuant to Public Contract Code section 2010, a person that submits a bid or proposal to, or
otherwise proposes to enter into or renew a contract with, a state agency with respect to any
contract in the amount of$100,000 or above shall certify, under penalty perjury, at the time the
bid or proposal is submitted or the contract is renewed, all of the following:
1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts executed or renewed after January 1,
2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil
Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code);
and
2. EMPLOYER DISCRIMINATORY POLICIES: For contracts executed or renewed after
January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples
recognized by the United States government, the Contractor certifies that such policies are not
used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair
Employment and Housing Act (Section 12960 of the Government Code).
CERTIFICATION
r--------------------------------------------------------r-----------------------I
I, the official named below, certify under penalty of perjury under i Federal ID Number
the laws of the State of California that the foregoing is true and
correct.
94-6000512
Proposer/Bidder Firm Name (Printed)
County of Fresno
'---------------------------------------------------
-----L----------------------�
By(Authorized Signature) - -
---------- ------ ----- ----------------------------------------------�
Pnnted Name and Title of Person Signing
Nathan Magsig, Chairman of the Board of Supervisors of the County of Fresno
Date ExPruited i Executed in the County and State of -i
r7 -0( -lq Fresno California
L------------------------------ ---L----------------------------------------------1
ATTEST:
BERNICE E. SEIDEL
Clerk of the Board of Supervisors
County of Fresno,State of California
By ((�
Deputy
Agreement Between the County of Fresno and the California Department of
Public Health
Agreement Name: CDPH California Sexually Transmitted Disease Program — STD
Program Management Congenital Syphilis Prevention Agreement No. 18-10698
Fund/Subclass: 0001/10000
Organization #: 56201661
Revenue Account #: 3530