HomeMy WebLinkAboutAgreement A-22-229 with CalMHSA.pdf DocuSign Envelope ID:1016EB7A-E598-4A65-93C4-D45BE465E457 Agreement No. 22-229
Agreement No.703-CVSPH-2021-FC-Al
CALIFORNIA MENTAL HEALTH SERVICES AUTHORITY
PARTICIPATION AGREEMENT AMENDMENT
COVER SHEET
1. Fresno County("Participant") desires to participate in the Program identified below.
Name of Program:Central Valley Suicide Prevention Hotline (CVSPH)
2. This Participant Agreement Amendment increases the original funding amount by$3,940
($3,615 for the Program and $325 for CaIMHSA 9%Admin Fee).The maximum amount payable
under this Agreement is$425,948.
3. The parties agree that this Agreement may be executed by electronic signature as provided in
this section.An "electronic signature" means any symbol or process intended by an individual
signing this Agreement to represent their signature, including but not limited to (1)a digital
signature; (2) a faxed version of an original handwritten signature; or(3) an electronically
scanned and transmitted (for example by PDF document)of a handwritten signature. Each
electronic signature affixed or attached to this Agreement(1)is deemed equivalent to a valid
original handwritten signature of the person signing this Agreement for all purposes, including
but not limited to evidentiary proof in any administrative or judicial proceeding,and (2) has the
same force and effect as the valid original handwritten signature of that person.The provisions
of this section satisfy the requirements of Civil Code section 1633.5,subdivision (b),in the
Uniform Electronic Transaction Act(Civil Code, Division 3, Part 2,Title 2.5, beginning with
section 1633.1). Each party using a digital signature represents that it has undertaken and
satisfied the requirements of Government Code section 16.5,subdivision (a), paragraphs (1)
through (5),and agrees that each other party may rely upon that representation.This
Agreement is not conditioned upon the parties conducting the transactions under it by
electronic means and either party may sign this Agreement with an original handwritten
signature.
4. All other terms of Participation Agreement No. 703-CVSPH-2021-FC, not cited in this
Participation Agreement Amendment,shall remain in full force and effect.
5. Authorized Signatures
CaIMHSA DOCUSigned by:
Signed_145351085C7E348A...amtt, Name(Printed): Amie Miller, Psy.D., MFT
Title: Executive Director Date: 5/19/2022
Participant: Fresn ounty
Signed: Name(Printed): Brian Pacheco
Title:Chairman of the Board of Supervisors of the County of Fresno Date:
Fresno County Participation Agreement Amendment ATTEST:
BERNICE E.SEIDEL
Page 1 of 2 Clerk of the Board of Supervisors
County of Fresno,State of California
By
Dea v
DocuSign Envelope ID: 1016EB7A-E598-4A65-93C4-D45BE465E457
Agreement No. 703-CVSPH-2021-FC-Al
AMENDMENT TO PARTICIPATION AGREEMENT BETWEEN THE COUNTY OF FRESNO
AND
CALIFORNIA MENTAL HEALTH SERVICES AUTHORITY
Agreement No.: 703-CVSPH-2021-FC-Al Term: July 1, 2021 through June 30, 2022
FOR FRESNO COUNTY ACCOUNTING USE ONLY:
Fund/Subclass: 0001/10000
Organization: 56304776 ($425,948.00)
Account/Program: 7295/0
Fresno County Participation Agreement Amendment
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