HomeMy WebLinkAboutAgreement A-23-248 Amendment No. 22-10163 A01 with CDPH.pdf Agreement No. 23-248
State of California — Health and Human Services Agency— California Department of Public Health
CDPH 1229A (Rev. 09/2022)
CALIFORNIA Oral Health PROGRAM
Moving California Oral Health Forward
Awarded By
THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, hereinafter "Department"
TO
County of Fresno, hereinafter "Grantee"
Implementing the project, "Fresno County Local Oral Health Program," hereinafter
"Project"
AMENDED GRANT AGREEMENT NUMBER 22-10163, A01
The Department amends this Grant and the Grantee accepts and agrees to use the Grant
funds as follows:
AUTHORITY: The Department has authority to grant funds for the Project under[Health and
Safety Code, Section 104750 &131085 and Revenue and Taxation Code 30130.57.
PURPOSE FOR AMENDMENT: The purpose of the grant amendment is to reallocate a
portion of funding from the previously awarded grant to allow the grantee to continue school-
based/school-linked activities the grantee was unable to complete in the previous term due to
extenuating circumstances related to school closures and staff redirection which caused
significant delays.
Amendments are shown as: Text additions are displayed in bold and underline. Text
deletions are displayed as strike through text (i.e., Stroke).
AMENDED GRANT AMOUNT: this amendment is to increase the grant by $68,000.00 and
is amended to read: Two MilliOR Sox uURdred Forty Four Theusand Two HYRdredEighty
Dollars ($2 644 290 nn) $2,712,280.00 (Two Million Seven Hundred Twelve Thousand
Two Hundred Eighty Dollars and Zero cents).
Exhibit A- Document B is replaced in its entirety.
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State of California — Health and Human Services Agency— California Department of Public Health
CDPH 1229A (Rev. 09/2022)
PROJECT REPRESENTATIVES. The Project Representatives during the term of this Grant
will be:
California Department of Public Health Grantee: County of Fresno
Name: David James Name: Melanie R Va'Gaba, Claudia Sandoval,
Division Manager
Address: MS 7218, 1616 Capitol Avenue, Address: 1221 Fulton Street
Suite 74.420
City, ZIP: Sacramento, CA, 95814 City, ZIP: Fresno, 93721
Phone: (916) 440-7197 Phone: 559-600-6449
Fax: N/A Fax:
E-mail: David.James@cdph.ca.gov E-mail: clsandoval(c_fresnocountyca.gov
Direct all inquiries to:
California Department of Public Health, Grantee: County of Fresno
Office of Oral Health
Attention: David James, Grant ManagerAttention: Allegra Chacon, Health Educator
Address: MS 7218, 1616 Capitol Avenue, Suite Address: 1221 Fulton Street
74.420
City, Zip: Sacramento, CA, 95814 City, ZIP: Fresno, 93721
Phone: (916) 440-7197 Phone: 559-600-6449
Fax: N/A Fax:
E-mail: David.James@cdph.ca.gov E-mail: alchacon(a)fresnocountyca.gov
All payments from CDPH to the Grantee; shall be sent to the following address:
Remittance Address
Grantee: County of Fresno
Attention "Cashier": Bruna C"a Irene Parada
Address: P.O. Box 11867
City, Zip: Fresno, 93775
Phone: 559-600-6415
Fax-
E-mail. dphboap(a�fresnocount�gov
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State of California— Health and Human Services Agency— California Department of Public Health
CDPH 1229A(Rev. 09/2022)
Either party may make changes to the Project Representatives, or remittance address, by
giving a written notice to the other party, said changes shall not require an amendment to this
agreement but must be maintained as supporting documentation. Note: Remittance address
changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity
Taxpayer ID Form or STD 204 Payee Data Record Form and the STD 205 Payee Data
Supplement which can be requested through the CDPH Project Representatives for
processing.
All other terms and conditions of this Grant shall remain the same.
IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below.
Executed By:
Date:
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Sal rQTnf@ro
ERNIC;
B E E.SEIDEL off the Board of
EftNIC
Clerk of the Board of Supervisors Supervisors of the County of Fresno
County of Fresno,State of California 1221 Fulton Street, Fresno, CA 93721
By_ Deputy
Angela Digitally signed
by Angela Salas
Date: Date: 2023.06.16
kas,Ange ahief
Contracts & Purchasing Section
California Department of Public Health
1616 Capitol Avenue, Suite 74.317, MS
1802
P.O. Box 997377
Sacramento, CA 95899-7377
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Agreement Between the County of Fresno and the California Department of
Public Health
Agreement Name: CDPH Local Oral Health Program Agreement No. 22-10163, A01
Fund/Subclass: 0001/10000
Organization #: 56201553
Revenue Account #: 4380