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HomeMy WebLinkAboutAgreement A-19-329 with CDVA.pdfAgreement No. 19-329 STA-TE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES .---------------.---------------, STANDARD AGREEMENT STD 213 (Rev. 10/2018) AGREEMENT NUMBER 19XS0016 PURCHASING AUTHORITY NUMBER (if applicable) 1. This Agreement is entered into between the Contracting Agency and the Contractor named below: CONTRACTING AGENCY NAME Californi a Department of Veterans Affairs CONTRACTOR NAME County of Fresno 2. The term of this Agreement is: START DATE 07/01/2019 THROUGH END DATE 06/30/2020 3. The maximum amount of this Agreement is : $49,000.00 Forty nine thousand dollars and zero cents 4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference made a part of the Agreement. EXHIBITS TITLE PAGES Exhibit A Scope of Work 2 Exhibit A-1 Program Narrative 5 Exhibit B Budget Detail and Payment Provisions 3 Exhibit B-1 Budget Form/Narrative 3 ExhibitC* General Terms and Conditions-CCC-04/2017 * Exhibit D Special Terms and Conditions 6 Items shown with an asterisk(*), are hereby incorporated by reference and made part of this agreement as if attached hereto. These documents can be viewed at www.dgs.ca.gov/ols/resources/standardcontractlanguage.aspx IN WITNESS WHEREOF, THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO. CONTRACTOR CONTRACTOR NAME (if other than an individual, state whether a corporation, partnership, etc.) County of Fresno CONTRACTOR BUSINESS ADDRESS 2281 Tulare st. Suite 301 PRINTED NAME OF PERSON SIGNING Nathan Magsig CONTRACTING AGENCY NAME California Department of Veterans Affairs CONTRACTING AGENCY ADDRESS 1227 0 Street PRINTED NAME OF PERSON .SIGNING David Gerard CONTRACTING ENC AUTHORIZED ~GN ~RE au/ d 6(_'e'f...R..A.,u-.._J__ ATTEST : BERNICE E . SEIDEL Clerk of the Board of Supervisors County ot Fresno , State of California By ~$(>.tn fu~ Deputy STATE OF CALIFORNIA CITY Fresno TITLE STATE CA ZIP 93721 Chairman, Fresno County Board of Supervisors DATE SIGNED CITY Sacramento TITLE STATE CA ZIP 95814 Chief, Facilities and Business Services Division Page 1 of 2 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES ,--------------~-------------~ STANDARD AGREEMENT I AGREEMENT NUMBER I PURCHASING AUTHORITY NUMBER (if applicable) STD 213 (Rev . 10/2018) 19XS0016 CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL EXEMPTION , IF APPLICABLE SCM 1, 4.04A .2 Page 2 of 2 California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A - Scope of Work County of Fresno Page 1 of 2 VETERAN MENTAL HEALTH OUTREACH 1. INTRODUCTION/SERVICES A. This is an Agreement in which the County of Fresno, hereafter referred to as the Contractor shall provide mental health outreach services, as specified within Exhibit A-1, in accordance with the Mental Health Services Act (Proposition 63), for the California Department of Veterans Affairs, (CalVet). B. Contractor must be able to perform the tasks associated with providing services under the scope of their license. Contractor will provide services in accordance with federal and state laws and regulations and CalVet policies. C. Contractor is not authorized to disperse or promise any services as described in the Agreement until written approval has been obtained from CalVet Contract Manager and Contractor has received an executed Agreement from CalVet. Any delivery or performance of service commenced prior to Contractor obtaining all written approvals shall be considered voluntary on the part of Contractor. 2. CONTRACTOR’S RESPONSIBILITIES Contractor shall provide the following services: A. Expand and/or enhance mental health services to include treatment, and other related recovery programs to veterans currently residing in or returning to the community from their military service as they transition back to civilian life. B. Provide the following performance measures on a periodic and annual basis: 1. Provide four (4) periodic progress reports to include the following: a) Performance table that includes the goal for each performance measure and the source of collecting the performance measure (See Exhibit B – Budget Detail and Payment Provisions for periodic progress report/metric due dates). b) Any narrative related to Performance Assessment and Data. 2. Provide an annual progress report at the end of the funding period. The report must summarize information from the periodic reports, describe the accomplishments of the project, and describe the next steps for implementing any plans for additional work identified during the funding period. 3. INDEPENDENT CONTRACTOR STATUS A. Contractor shall be considered “Independent Contractors” in relation to CalVet and the State. Therefore, Contractor shall not be considered employee(s) of CalVet and shall not be entitled to any employee benefits from CalVet or the State including, but not limited to, the following: 1. Premium Pay, Overtime Pay, or Holiday Pay 2. Medical Insurance 3. Vacation or Sick Leave 4. Worker’s Compensation 5. Other employee benefits California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A - Scope of Work County of Fresno Page 2 of 2 4.CONTACT INFORMATION A.The Contract representatives during the term of this Agreement will be: 1.CalVet Home Representative: Veterans Services- Headquarters Phillip Leggett, Mental Health Coordinator 1227 O Street Sacramento, Ca. 95814 Phone: (916) 503-8327 Email: phillip.leggett@calvet.ca.gov 2.Contractor Representative: County of Fresno David Rose, CVSO 1320 E. Shaw Ave Ste. 105 Fresno, CA 93710 Phone: (559) 600-5436 Email Address: drose@fresnocountyca.gov B.Contract Representatives, addresses, and phone/fax numbers may be changed by issuing a 20-day prior written notification and shall not require a formal amendment to this Agreement. The notifying party shall provide complete contact information for the replacement Contract Representative including, name, title, mailing address, phone/fax numbers, and email address. All other changes require a formal written amendment to this Agreement. California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A-1 Program Narrative County of Fresno Page 1 of 5 Appendix A – Program Narrative Fresno Section A: Statement of Need Fresno County is one of the largest, fastest growing, and most diverse counties in the state of California with an estimated 989,255 residents, according to the California Department of Finance. Of the nearly one million residents in our County, approximately 45,000 are veterans along with approximately 4,000 residents that are in the Guard or are Reservists. Serving these veterans is one of the County’s top priorities. In FY 2017-18 the Fresno County Veterans Service Officer (CVSO) provided assistance for Mental Health Services (MHS) to approximately 1,400 veterans, 140 being women. Our CVSO, David Rose, and his adeptly trained staff, have made it their mission to reach out to the county’s veteran population and make early connections with those still in the National Guard, Air Guard and Reserves. The CVSO has designed his team to have the knowledge to identify veterans, newly discharged members and retirees that need support and access to MHS, and immediate care for those at high risk of a mental crisis, as well as thorough assistance with claims and benefits. The team provides veterans with education of what services are available and a full assessment of symptoms to determine when veterans are suffering from Post-Traumatic Stress Disorder (PTSD), Military Sexual Trauma (MST) and Traumatic Brain Injury (TBI), so they can be referred to the proper mental health agency; primarily the CVSO refers to the local Vet Center or Veterans Affairs Medical Center (VA Hospital). The CVSO represents 15 towns/cities that spans at over 6,000 square miles making outreach to connect with the County veteran residence a priority, if veteran’s can’t get to the CVSO then the CVSO will go to them. To increase awareness of services the CVSO’s team attends events such as Yellow Ribbon, Stand Downs, The Women Veteran Stand Up, Job Fairs, Muster Briefings, and Armoires for National Guard Reserves Events and Homeless Program Presentations. The CVSO also visits the local colleges and attends Retirement Briefings at the local bases. In addition to outreach the CVSO also collaborates with others that work to assist veterans. Susan Basmajian, Fresno’s Veterans Justice Outreach (VJO) specialist, works with the CVSO to assist veterans with avoiding criminalization due to mental illness and together they assist the veteran in getting the mental health support needed. The County Veteran Service Office is located right next to the Fresno Vet Center which provides both offices easy access for working together to help veterans suffering mental health issues. In addition to the CVSO’s current contacts he also continues to work toward building relationships with other agencies that can provide mental health support for veterans. Working closely with the Central Valley Local Interagency Network Coordinator whose office is onsite, the CVSO has identified several key barriers veterans have with accessing veteran services which include stigma, legal matters, avoidance and concerns about career prospects. The CVSO and his team work with veterans to remove these barriers by building a relationship of trust and understanding so the veterans feel safe to talk to staff and get the help they need. Section B: Proposed Service/Project Project Goal: The CVSO and his team will identify and refer veterans and service members that are in need of MHS to the correct agency for assistance, acquire access to aid for high risk veteran and assist with barriers and/or claims veterans need assistance with in order to obtain the services that will help them return to the civilian world. Project Objectives: By June 30, 2020, the CVSO and his team will identify and assist veterans in need of MHS • Perform 2,000 screens for MHS • Provide 900 referrals timely and effectively to service providers in order to enhance the mental and physical healthcare of veterans with serious mental health issues. • Track referrals through a Referral Screening Tracking sheet which will identify the date, client name, case number, screening for PTSD /MST and TBI and whether and where the client was referred for services. California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A-1 Program Narrative County of Fresno Page 2 of 5 • Assist 1,000 veterans and their families in application/submittal of Service Related Disability Compensation claims & Non-Service Related Disability Pensions related to Mental Health Issues. • Attend outreach events throughout the county, conducting presentations consisting of sharing real life stories and educating the audience regarding the services available through the Veterans Service Office, VA hospital, Vet Center and local non-profit organizations. o Three Yellow Ribbon Reintegration Program events o Three Stand Downs, including a 3 day event in which the CVSO, and The Fresno County Misdemeanor Court, will hold a veteran court to eliminate misdemeanors and traffic cases, giving the veterans a second chance. o The Central Valley Women’s Stand Up, an event that hosts roughly 100 women veterans in Fresno County and is held the day before the 3 day Stand Down. This event will provide the CVSO and his team an opportunity to meet with the women and increase focus for them on MST issues. o Three well-structured Job Fairs for veterans that are large and well attended o Six events at the Armoires for National Guard and Reserves o Six Homeless veterans program presentations • Work with the Transition Goals, Plans, Success (TGPS) program to provide those discharging/retiring service members and their families the skills, tools and self-confidence necessary to successfully re-enter into the civilian work force and pursue higher education or technical training. o Attend Muster Briefings o Attend Retirement and Separation Briefings at local bases (National Guard & Air Guard) • Visit the local colleges once a month to provide presentations and meet students that are using their Military Education Benefits • Collaborate with the Veteran Justice Outreach (VJO) to assist 100 veterans with avoiding criminalization due to mental illness and referring those in need to the Fresno Veteran Treatment Court • Assist with the verification process of 100 MIL100 forms in collaboration with the VJO. • With the collaboration of the Vet Center the CVSO can refer veterans, service members and their families to obtain pro bono legal aid twice a month at the Vet Centers through its co-op with Central California Legal Services (CCLS). These legal services will help members remove legal barriers that are preventing access or continued maintenance of their mental healthcare. CCLS provides the following legal services to these members: o Housing o Employment o Discharge Upgrades o Criminal Law o Consumer Law o Civil Law • When applicable, shift qualifying veterans from Medi-Cal programs to the VA medical system for mental health related care. • Inform CalVet on issues of access to care, customer and clinician satisfaction, efficiency, and delivery of quality healthcare. • Build collaborations with other mental health agencies to create veteran mental health assessment days. • Build relationships with the veterans the CVSO’s team meets with to provide an environment of trust and understanding so the veterans feel safe to talk and be open with their needs/concerns and get the services needed to transition back to the civilian world. With these relationships the CVSO’s team intends to eliminate the stigma, avoidance and provide them the understanding that getting help is not a weakness but a strength to move forward. Section C: Proposed Implementation Approach California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A-1 Program Narrative County of Fresno Page 3 of 5 Experience and Anticipated Impact Transitioning from a military to a civilian lifestyle can be tough. Simply reconnecting with family and readjusting to home life can be difficult enough to prevent a search for MHS, factor in finding a job or recovering from an injury and the transition can become overwhelming. The Fresno County Veterans Service Office has years of experience working with veterans and their Families in Fresno County. The CVSO with his team conducts mental health outreach and refers veterans in need of care. Achievement of the outreach goals outlined in Section B have had meaningful and relevant results because more veterans have gotten the help they need, therefore helping veterans avoid homelessness, potentially reducing crime, overcoming barriers to employment and striving toward a healthy lifestyle. By reaching out to veterans early and often at events, the CVSO’s team is conducting mental health outreach to a veteran audience who otherwise may have never come into the Fresno County Veterans Service Office. The outreach efforts are the first step in helping link this population to services to ensure the transition is successful. Additionally assisting veterans and their families in the application/submittal of PTSD claims may help the veteran become more self-reliant and helps inform the CalVet on issues of access to care, customer and clinician satisfaction, efficiency, and delivery of quality healthcare which should improve the delivery of services overall. CVSO’s team uses best practices, as identified within the Substance Abuse and MHS Administration National Registry of Evidence-Based Programs and Practices, to help Veterans assess VA and community resources and identify and/or address mental health/substance use issues. The CVSO’s team shows veterans how to effectively develop a plan and prioritize goals to be successful in meeting VA requirements for benefits to achieve rewards once they finish the treatment. As mentioned above, the CVSO’s team attends various outreach events and as a result of the information provided at these events, many veterans will request a follow up meeting. When meeting with veterans one-on- one, the CVSO or other team members ask a brief series of questions to determine whether a veteran may have an issue with PTSD, MST or TBI. The CVSO’s team also refers homeless veterans to the Fresno VA Hospital walk-in clinic or emergency room for immediate services. Combat vets with mental health issues are referred to the local Vet Center, which is co-located in the same complex as the County Veterans Service Office. With new VA mental health regulations, every veteran, regardless of discharge is able to be served and stabilized if necessary. Number of Participants Through this program, the Fresno County Veterans Service Office anticipates providing referrals to approximately 900 unduplicated clients for MHS. Out of the 900, approximately 100 incarcerated veterans are anticipated to receive assistance in avoiding criminalization due to mental illness and be referred to treatment in collaboration with the VJO. The 900 veterans will receive full services from the CVSO and staff in evaluating for PTSD/MST and TBI and will be referred to the best agency for their needs along with any application assistance. The CVSO is also currently collaborating with the county’s local bases which currently have 4,000 active members to provide early assistance to those returning to civilian life. Organization Partnerships Many eligible referrals are sent to the Vet Center that is housed in the same building complex. Due to the locations proximity, the CVSO has built a strong partnership with the Vet Center. Not only do veterans get referred over to the Vet Center, The Vet Center refers veterans in need to the CVSO. The Vet Center assists veterans and their families through many of the major adjustments in lifestyle that often occur after a veteran returns from combat. Services for a veteran at the center includes individual and group counseling in areas such as PTSD, MST, TBI, alcohol and drug assessment, and suicide prevention referrals. The Vet Center has also been a connection for legal services through their co-op with Central California Legal Services (CCLS). Twice a month CCLS is onsite at the Vet Center to provide pro bono legal service to veterans for issues in housing, employment, discharge upgrades, criminal law and consumer law. These services allow veterans to move forward with their lives. The CVSO has established a unique partnership with the Fresno VA hospital that grants regular access to Homeless Veteran Monthly Briefings, assessing for PTSD, TBI and MST, as well as other VA benefits issues. This regimented outreach is completed monthly and targets Mental Health, homeless issues and Lesbian, Gay, Bisexual and Transgender (LGBT) veterans. The CVSO is also a regular presenter at The Fresno VA Hospital New Employee Orientation to educate staff on what the Fresno County Veterans Service Office provides. The CVSO in partnership with the Veteran Justice Outreach (VJO) specialist work together to assist veterans with avoiding criminalization due to mental illness and assists the veteran in getting the mental health support they need. The VJO specialist provides direct outreach to incarcerated veterans and with the CVSO they assist California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A-1 Program Narrative County of Fresno Page 4 of 5 veterans with connecting to the proper mental health treatment. The CVSO will work with the veterans in completing any applications and submissions for claims. The CVSO serves as a Benefits Instructor, for California State University of Fresno. The CVSO conducts presentations, in a classroom setting, to veteran students six times per school year offering information on benefits, resources, and assistance available to aid them in the transition to civilian life. In addition, the CVSO performs outreach at Veteran Resource Centers at the three Community Colleges. The CVSO has established a working relationship with the not-for-profit organization, San Joaquin Valley Veterans, a project of WestCare (SJVV). SJVV has administered for the past 5 years the Supportive Services for Veterans and Families Grant. SJVV services include; life skills, education, employment readiness, family development and counseling for PTSD and MST. SJVV also manages two Transitional Housing Projects, one for women veterans and one for male veterans and a Homeless Veterans’ Reintegration Program (HVRP) housing complex. The CVSO conducts outreach to these three facilities and implements a two way referral system with SJVV. Another partnership the CVSO has created is with the Central Valley Veterans (CVV) organization; this is a non- profit organization that works with homeless veterans. CVV assists with delinquent bills that could cause veterans to be evicted or lose services. The organization also provides assistance with providing furniture, moving expenses, food and clothing. With this partnership the CVSO is involved with all PTSD, MST and TBI referrals that CVV comes into contact with on a daily basis, in turn the CVSO refers veterans to CVV for their services when needed. Potential Barriers The greatest potential barrier to the success of the proposed project is the lack of awareness. Many veterans do not have knowledge of the available services. In an effort to be proactive, the CVSO is focusing on attending Yellow Ribbon and Muster Briefing events so that soldiers are educated on resources before deployment rather than upon their return. In addition, at every outreach opportunity, the CVSO and staff are trained to identify and expertly refer all targeted veteran groups to appropriate resources. To further expand outreach, the CVSO will compile and distribute comprehensive information packets addressing Mental Health issues, Women Veteran Issues, Homeless and Lesbian, Gay, Bisexual and Transgender (LGBT) veteran issues at many other local events such as Job Fairs for veterans. Other barriers will also occur but the staff are ready to assist veterans to overcome their issues or concerns. The CVSO has worked to build an environment that not only will provide information and assistance with claims but a relationship of trust and safety. These relationships will help veterans open themselves up to talking which can provide staff information to decipher on what is not being said if a veteran is afraid of admitting they need care or when they seem to be feeling that getting help is a sign of weakness. Talking will also open the veteran up to discussing if there are any legal concerns they may have, at which point the CVSO’s team can help by referring them for legal aid with Central California Legal Services (CCLS) that was mentioned above as a partner through the Vet Center. Mental Health Service Future Plan Once the funding period ends the CVSO and his team will continue to provide outreach for veterans at many major events listed above. The CVSO has also created a new website that will provide veterans access to Mental Health resources and request for referrals as a new method for outreach. The CVSO will continue to work on establishing new and stronger partnerships with organizations to provide MHS to veterans. The Veterans Service Office has also been spending time developing cross training and procedures so that when there is any staff changes they are prepared to continue services without any adverse effects to veterans. Section D: Proposed Implementation Approach The CVSO will use multiple methods to track MHS provided to veterans using logs and VetPro. The CVSO and Staff will utilize a referral tracker and update on a weekly basis, all incoming and outgoing referrals, describing the action taken. The goal is to inform and assist veterans in getting the services they need, which will be tracked using event logs and referral screening logs. Event Log Throughout the year the CVSO team will be attending at least 40 outreach events to provide presentations to veterans and service members returning to the civilian world. During the events veterans and service members will be informed about what services are available to them and how the CVSO team can assist with accessing the services and completing claims for services. At each event staff will keep a log which includes event information such as date, event title, type of event, number of veterans participating, CVSO staff attending and time spent. California Department of Veterans Affairs Agreement Number: 19XS0016 Exhibit A-1 Program Narrative County of Fresno Page 5 of 5 With the log staff are able to analyze the reach of how many veteran/service members are being seen. The CVSO has enough experience to anticipate effective outreach events and to target outreach appropriately, however, if an event is not productive for mental health assessments, an analysis will be conducted with partners for improvements. In addition to the log providing CVSO data on how many veterans/service members are seen this information will be used, if awarded this grant, to report hours spent at outreach events and the cost associated to attend the event. Referral Screening All referrals for health care services will the tracked in the VetPro system. This will include referrals for MHS such as PTSD, MST and TBI. Staff will also complete a referral screening log for each veteran/service member in which a referral for MHS is completed. Each staff member will complete the log when an assessment is completed with the date, veteran name, last 4 of the Social Security Number, Branch of Service, Type of Screening given (PTSD/MST/TBI), indicating that referral was done and who the veteran was referred to. This log will assist with evaluating if expectations are being met of the number of veterans screened (goal 2000) and referred (goal 900). With the evaluation of success the CVSO can review whether action is needed to improve outreach for getting the veterans in for screening and assistance. In addition this information will be used, if awarded this grant, to report hours spent completing screenings (30 minutes per a veteran) and the cost associated in completing the MHS screening. VetPro The CVSO will assist 900 veterans and their families in application/submittal of Service Related Disability Compensation claims & Non-Service Related Disability Pensions related to PTSD. These claims will be filed on VetPro which data will be collected via an adhoc report that will indicate the number of PTSD claims that are filed for a period of time. The CVSO will assist 100 veterans along with the VJO in avoiding criminalization due to mental illness with MHS. Along with working in assisting this population with MHS claims the CVSO will also assist with verifying the completion of the MIL100 forms. Claims for this population will be recorded in VetPro in which data will be provided on an adhoc report from VetPro indicating the number of veterans that are incarcerated and track the MIL100 forms. Financial System The tracking method for costs related to the CVSO will be recorded in Fresno’s PeopleSoft financial system. Administrative Staff will use the labor distribution for each quarter to determine the CVSO hourly rate related to an event and referral participation cost. Any cost for travel & supplies will be tracked using cost account types. Support staff cost will also use the labor distribution for each quarter to determine the staff members hourly rate that will support the CVSO for 3 hours a week with phone calls, photocopies, follow-ups and any other receptions needs in office for the veterans in need of MHS. California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B - Budget Detail and Payment Provisions County of Fresno Page 1 of 3 1. STANDARD BUDGET DETAIL AND PAYMENT PROVISIONS A. Invoicing and Payment 1. For services satisfactorily rendered, and upon receipt and approval of the invoices, the CalVet agrees to compensate Contractor for services rendered in accordance with the rate specified in Exhibit B-1- Budget Form/Narrative. a) Total cost of the contract is $49,000.00. b) The first quarterly payment shall be made upon approval of the contract in the amount of $12,250.00, the remaining three payments shall be made upon receipt of quarterly invoices by the CalVet Contract Manager. c) Quarterly invoices shall be submitted no later than the following dates: July 1, 2019 Contract Begins Term: July 1, 2019 – June 30, 2020 October 31, 2019 1st Quarter Invoice/Metrics Due 1st Quarter (07/01/2019 – 9/30/2019) January 30, 2020 2nd Quarter Invoice/Metrics Due 2nd Quarter (10/01/2019 – 12/31/19) April 28, 2020 3rd Quarter Invoice/Metrics Due 3rd Quarter (01/01/2020 – 03/31/2020) July 31, 2020 Annual Progress Reports Counties must summarize information from the periodic reports, describe the accomplishments of the project and describe next steps for implementing any plans for additional work identified during the funding period. (Annual Progress Reports are due with 4th Quarter invoices and metrics.) 4th Quarter (04/01/20 – 06/30/20) 2. Quarterly payments shall only be approved upon periodic invoices that shall include the Agreement Number, County name, address and telephone number. Quarterly invoices shall also be accompanied by the quarterly reports identified in Exhibit A – Scope of Work, and shall be submitted in duplicate not more frequently than listed above to: 3. Invoices shall include the Agreement Number and shall be submitted in not more frequently than monthly in arrears to: Original Invoice Approval Copy Department of Veterans Affairs CalVet Accounting Office 1227 O Street, Room 402 Sacramento, CA 95814 Department of Veterans Affairs Attn: Phillip Leggett 1227 O Street Sacramento, CA 95814 B. Budget Contingency Clause 1. 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 form and effect. In this event, the State shall have no liability to pay any funds California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B - Budget Detail and Payment Provisions County of Fresno Page 2 of 3 whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement. 2. 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 Contractor to reflect the reduced amount. C. 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. 2. SPECIAL BUDGET DETAIL AND PAYMENT PROVISIONS A. Submissions of Invoices/Claims 1. All invoices/claims must be completed thoroughly and legibly, with all applicable fields completed. Invoices/claims that are submitted to the appropriate location but have been altered, or are inaccurate, or do not provide all necessary information will not be accepted and will be returned to the Contractor for correction. 2. Any changes to this provision relating to the invoice/claim submittal process, including but not limited to an address, form, or process change, shall be an administrative change managed through the appropriate designated CalVet office and shall not require a contract amendment. 3. Invoices/claims submitted shall include the following information in order to be considered complete and acceptable for processing, or the invoice/claim will be returned: a) Contractor’s Company name b) Contractor’s Company address, phone number and e-mail c) Date of invoice/claim d) Invoice/claim number e) CalVet location where services were performed f) Agreement Number g) Date(s) of Service h) Total dollar amount being billed i) First and Last name of Contractor or Provider performing services, if applicable j) Contractor’s or Provider’s Classification, whichever is applicable k) When applicable, contractors shall include the following information on the invoice/claim submitted for hourly reimbursement: 1. Hourly Rate 2. Time in and time out 3. Total hours worked California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B - Budget Detail and Payment Provisions County of Fresno Page 3 of 3 4. Any other information or documentation reasonably required to verify and substantiate the provision of services and the charges for such services. California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B- Budget Form/Narrative County of Fresno Page 1 of 3 BUDGET FORM/NARRATIVE The Budget Form/Narrative may not represent the actual dollar amount allotted for this Agreement. The Budget Form is the Contractor’s response to Program’s Request for Application and shall be attached as a reference for Contractor’s proposal of how expenses will be addressed as part of this agreement. Appendix B – Budget Form Fresno County Veterans Service Office Veterans Outreach Proposition 63 Budget Form A. Personnel Position Hourly Wage Hrs/Mo Spent on Program Mo/Yr Spent on Program Cost County Veterans Service Officer (CVSO) $ 41.94 37 12 $ 18,621.36 Veterans Service Representative (VSR) II $ 20.86 5 12 $ 1,251.60 Total $ 19,872.96 B. Fringe Benefits Component Rate Annual Wage Cost SDI (CVSO) 7.41% $ 18,621.36 $ 1,379.84 UIB & WC (CVSO) 0.07% $ 18,621.36 $ 13.03 Retirement (CVSO) 48.55% $ 18,621.36 $ 9,040.67 Health/Life (CVSO) 9.10% $ 18,621.36 $ 1,694.54 SDI (VSR) 6.63% $ 1,251.60 $ 82.98 UIB & WC (VSR) 0.15% $ 1,251.60 $ 1.88 Retirement (VSR) 55.45% $ 1,251.60 $ 694.01 Health/Life (VSR) 22.54% $ 1,251.60 $ 282.11 Total $ 13,189.06 C. Travel Location Purpose Rate (Mileage Only) Cost Various Outreach Locations Outreach $ 0.54 $ 5,196.75 Various Collaborative Events Collaborative $ 0.54 $ 2,598.38 Total $ 7,795.13 D. Supplies Items Rate (Cost x Months) Cost Printing Cost for Brochures $109*12 $ 1,308.00 Mailing Costs $53*12 $ 636.00 Promotional Items $123*12 $ 1,476.00 Total $ 3,420.00 E. Contracting Name Service Rate (Cost/Individual x Individual x Days) Cost N/A Total F. Other Item Rate Cost Support Staff Cost $35.90*156 $ 5,600.40 Total $ 5,600.40 Totals Section A: Personnel $ 19,872.96 Section D: Supplies $ 3,420.00 Section B: Fringe Benefits $ 13,189.06 Section E: Contracting $ 0.00 Section C: Travel $ 7,795.13 Section F: Other $ 5,600.40 California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B- Budget Form/Narrative County of Fresno Page 2 of 3 Appendix C – Budget Narrative Fresno County Veterans Service Office Veterans Outreach Proposition 63 Budget Narrative Section A: Personnel CVSO (David Rose) and VSR’s (Joshua Christopherson, Rebecca Hawkins, Theresa Reese and Aimee Taylor) salary cost for 504 outreach hours which consist of 275 hours of outreach at Yellow Ribbon Reintegration Program events, Stand Downs, Job Fairs, Muster Briefings, Retirement Briefings, local college presentations, homeless veterans program presentations and National Guard Reserve Armories events/presentations in the area and 168 hours of one-on-one follow up with veterans and 61 hours of preparation and planning. Section B: Fringe Benefits The CVSO & VSR’s benefit cost for 480 outreach hours. Benefits include Retirement, Unemployment and State Disability Insurance, Workers’ Compensation, Life and Health Insurance and Administrative Benefits. Rates used to calculate benefit cost are based off of the County’s benefit rates for FY 2018-19. Section C: Travel Travel is required because the events are held outside of the Veterans Service Office. Travel costs include mileage cost (at the current Fresno County rate) for the CVSO to attend approximately 55 outreach events including but not limited to: Yellow Ribbon Reintegration Program events, Stand Downs/Up, Job Fairs, Muster Briefings, Retirement Briefings, local college presentations, homeless veterans program presentations and National Guard Reserve Armories events/presentations. Section D: Supplies Supply cost for the printing of tri-fold color brochures and business cards to be distributed at the various outreach events. Promotional items costs (pens, pencils, bags, banners, tarps, etc.) to be given away at outreach events to promote the VSO mental health outreach activities. Postage cost for mailing follow up materials, appointment letters and informational flyers. The calculation for these totals are based on the average of actuals divided by the percent of time spent on mental health outreach and collaborative events (23%). Section E: Contracting N/A Section F: Other Total Requesting $ 49,877.55 California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit B- Budget Form/Narrative County of Fresno Page 3 of 3 Average support staff salary and benefit cost ($35.90 per hour) for 3 hours of administrative support a week (e.g. phone calls, photocopies, follow-up). California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 1 of 6 1. EXCISE TAX The State of California is exempt from Federal Excise Taxes, and no payment will be made for any taxes levied on employees' wages. The State will pay for any applicable State of California or local sales or use taxes on the services rendered or equipment or parts supplied pursuant to this Contract. California may pay any applicable sales or use tax imposed by another state. 2. STATUTORY AND REGULATORY PROVISIONS A. This Contract shall be governed and construed in accordance with all applicable statutory and regulatory provisions including, but not limited to: 1) Title XVIII of the Federal Social Security Act 2) Title XIX of the Federal Social Security Act 3) Chapters 7 and 8 (commencing with Section 14000), Part 3, Division 9, Welfare and Institutions Code 4) Division 3, Title 22, California Code of Regulations (CCR) 5) Health and Safety Code Section 1340 et seq. 6) All applicable Federal provisions which regulate the administration of health care programs and budget revisions, as contained in the Code of Federal Regulations (CFR), Title 42, and Title 45, Part 74, Title 42 United States Code, Sections 1395 et seq. and 1396 et seq. 7) Sub-chapter 13 (commencing with Section 6800), Chapter 4, Part 1, Title 17, CCR; and 8) All other applicable laws and regulations. B. Any provision of this Contract in conflict with the applicable laws and regulations is hereby amended to conform to the provisions of those laws and regulations. Such amendment of the Contract shall be effective on the effective date of the statutes or regulations necessitating it, and shall be binding on the parties even though the amendment may not have been reduced to writing and formally agreed upon and executed by the parties. If, due to amendment in laws of regulations, Contractor is unable or unwilling to comply with the provisions of the amendment(s), State or Contractor may terminate this Contract in accordance with the Termination provision of this Contract. 3. EXAMINATION AND AUDIT A. Contractor shall allow the State and its related entities, the Comptroller General of the United States, Department of Justice (DOJ), and the Bureau of Medi-Cal Fraud, or their duly authorized representatives, to inspect or otherwise evaluate the quality, appropriateness, and timeliness of services performed under this Contract, and to inspect, evaluate, and audit any and all books, records, and facilities maintained by the Contractor and Subcontractors pertaining to services under this Contract at any time during normal business hours. B. Contractor shall be subject to the examination and audit of the State Auditor for a period of three (3) years after final payment under this Contract in accordance with Government Code, Section 85467.7. The examination and audit shall be confined to those matters directly connected with the performance of the contract, including, but not limited to, the costs of administering the Contract. C. Books and records include, but are not limited to, all physical records originated or prepared pursuant to the performance under this Contract, including working papers, reports, financial records, and books of account, Medical Records, prescriptions files, Subcontracts, and any other documentation pertaining to California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 2 of 6 medical and non-medical services for residents of the Home. Upon request, at any time during the term of this Contract, the Contractor shall furnish any record or copy. 4. RESOLUTION OF DISPUTES A. The Contractor may dispute and appeal a decision or action by the State arising out of the Interpretation or administration of this Contract. A written dispute notice shall be submitted to the Contract Manager within thirty (30) calendar days from the date the Contractor receives notice of the decision or action in dispute. The Contractor’s dispute notice shall state the following, based on the most accurate information available to the Contractor: 1) That it is a dispute pursuant to this Section. 2) The date, nature, and circumstances of the conduct, which is the subject of dispute. 3) The names, telephone numbers, function, and activity of each contractor, subcontractor, State official, or employee involved in or knowledgeable about the conduct. 4) The identification of any documents and the substance of any oral communications involved in the conduct. Copies of all identified documents shall be attached. 5) The reason why the Contractor is disputing the conduct. 6) The cost impact to the Contractor directly attributable to the alleged conduct, if any. 7) The Contractor’s desired remedy. B. The State and the Contractor agree to try to resolve all contractual issues by negotiation and mutual agreement at the Contract Manager level. The parties recognize that the implementation of this policy depends on open-mindedness, and the need for both sides to present adequate supporting information on matters in question. The Contract Manager, in a written decision stating the factual basis for the decision, will decide any disputes concerning performance of this Contract. Before issuance of the Contract Manager’s decision, informal discussions between the parties by the individuals who have not participated substantially in the matter in dispute will be considered by the parties in efforts to reach mutual agreement. C. The Contract Manager will render a decision or request additional substantiating documentation from the Contractor within thirty (30) days of receipt of the Contractor’s appeal. A copy of the decision will be provided to the Contractor. The decision shall be final and conclusive unless, within thirty (30) days from the date of the decision, the Contractor files a written appeal addressed to the Undersecretary, California Department of Veterans Affairs. D. The Undersecretary’s decision shall be final and conclusive unless the decision is arbitrary, capricious, grossly erroneous or if any determination of fact is unsupported by substantiating evidence. The Undersecretary’s decision will be in writing and may encompass facts, interpretations of the Contract, and determination or application of law. The Contractor may, prior to the Undersecretary’s decision, present oral or documentary evidence, and arguments in support of the Contractor’s appeal. The decision will either: 1) Find in favor of the Contractor, in which case the Undersecretary may: a) Countermand the earlier conduct which caused the Contractor to file a dispute; or b) Reaffirm the conduct and, if there is a cost impact sufficient to constitute a change in obligations pursuant to the payment provisions, direct the State to comply with that Section. California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 3 of 6 2) Deny the Contractor’s dispute and, where necessary, direct the manner of future performance; or 3) Request additional substantiating documentation in the event the information in the Contractor’s dispute or appeal is inadequate to permit a decision to be made under paragraphs (1) or (2) above, advise the Contractor as to what additional information is required, and establish how that information will be furnished. The Contractor shall have thirty (30) days to respond to the Undersecretary’s request for further information. Upon receipt of this additional requested information, the Undersecretary will have thirty (30) days to respond with a decision. Failure to supply additional information required by the Undersecretary within the time period specified above shall constitute waiver by the Contractor of all claims. E. Attorney’s fees and costs for any dispute or subsequent trial shall be borne by the respective parties. Both parties waive trial by jury, and any trial in superior or municipal court shall be by a judge alone. Any litigation arising out of this Contract shall be conducted in a California Court pursuant to California law. F. Contractor shall continue with the responsibilities under this Contract during any dispute. 5. AGENCY LIABILITY (Applies only to Federally Funded Contracts) The Contractor warrants by execution of this Contract, that no person or selling agency has been employed or retained to solicit or secure this Contract upon Contract or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide established commercial or selling agencies maintained by the Contractor for the purpose of securing business. For breach or violation of this warranty, the State shall, in addition to other remedies provided by law, have the right to annul this Contract without liability, paying only for the value of the work actually performed, or otherwise recover the full amount of such commission, percentage, brokerage, or contingent fee. 6. POTENTIAL SUBCONTRACTORS For all Agreements, with the exception of Interagency Agreements and other governmental entities/auxiliaries exempt from bidding, nothing contained in this Contract or otherwise shall create any contractual relation between the State and any subcontractors, and no subcontract shall relieve the Contractor of Contractor’s responsibilities and obligations hereunder. The Contractor agrees to be as fully responsible to the State for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by any of them, as it is for the acts and omissions of persons directly employed by the Contractor. The Contractor's obligation to pay its subcontractors is an independent obligation from the State’s obligation to make payments to the Contractor. As a result, the State shall have no obligation to pay or enforce the payment of any moneys to any subcontractor. 7. INSURANCE REQUIREMENTS A. Upon contract award, contractor must furnish to the State an original certificate(s) of insurance stating that the contractor has the following types of coverage, if applicable: 1) Commercial General Liability: Combined Single Limit (CSL) for no less than $1,000,000 per occurrence for bodily injury and property damage. The policy must include coverage for liabilities arising out of premises, operations, independent contractors, products/completed operations, personal & advertising injury, and liability assumed under an insured contract. This insurance shall apply separately to each insured against whom claim is made or suit is brought subject to the contractor’s limit of liability. 2) Professional Liability: (Applies to any contract in which the work is of a professional nature such as, but not limited to, physicians, architects, engineers, accountants, or consultants) Covering any California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 4 of 6 damages caused by an error, omission, or any negligent acts. Limits of not less than $1,000,000 per occurrence and $3,000,000 aggregate. 3) Automobile Liability (Applies to any contract in which the contractor will likely use a vehicle to complete the project or drive a vehicle onto State property): Limits of not less than $1,000,000 per accident. Such insurance shall cover liability arising out of an automobile including owned, hired, and non-owned autos. a) MCS90 endorsement on the Automobile policy (required whenever contractor will be transporting Hazardous materials i.e. Pest Control and Waste contracts.) 4) Pollution Liability/Environmental Impairment Liability (Applies only to Pollution Contracts – i.e. Pest Control and Waste Contracts): In addition, the certificate evidencing general liability must include evidence of one of the following if applicable to the service: a) Pesticide/Herbicide Endorsement, OR b) An endorsement deleting the general liability pollution exclusion, OR c) A separate environmental/pollution liability policy with limits not less than $1,000,000 covering bodily injury and property damage from pollution and related clean-up costs incurred arising out of the work or services to be performed under this contract. 5) Workers’ Compensation (Mandatory for all Contractors who have at least one employee): Contractor shall maintain workers’ compensation and employer’s liability coverage for all its employees who will be engaged in the performance of the contract, including special coverage extensions where applicable. Contractor shall furnish a certificate for Workers’ Com pensation issued by an insurance carrier licensed to write Workers’ Compensation insurance in the State of California, including the name of the carrier and the date of expiration of insurance, or a Certificate of Consent to Self-Insure issued by the Department of Industrial Relations. 6) Fidelity Bond/Crime Insurance: (Applies only to contracts handling State money or securities – i.e. Armored Car Service Contracts) Contractor shall maintain Employee Dishonesty and, when applicable, Inside/Outside Money & Securities coverages for state-owned property in the care, custody and control of the Contractor. Coverage limits shall not be less than the amount scheduled in the contract. The policy shall include as Contractor. Coverage limits shall not be less than the amount scheduled in the contract. The policy shall include as loss payee the California Department of Veterans Affairs 7) The certificate(s) of insurance shall be on an ACORD form, or equivalent, and must show “occurrence” coverage. The certificates of insurance must also contain all of the following provisions: a) Name and address of the insurance company, policy number, and beginning and ending dates of the policy. b) Statement that the insurer will not cancel the insured’s coverage without 30 days prior written notice to the State. c) Statement that the State of California, its officers, agents, employees, and servants are included as additional insured on the policy, but only insofar as the operations under this contract. 8) Contractor agrees that any insurance herein provided shall be in full force and effect at all times during the term of the contract. In the event said insurance coverage expires at any time during the term of this contract, Contractor agrees to provide, at least ten (10) days prior to said expiration date, a new certificate of insurance evidencing insurance coverage as provided for herein for not California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 5 of 6 less than the remainder of the term of the contract, or for a period of not less than one (1) year. In the event contractor fails to keep in effect at all times insurance coverage herein provided, State may, in addition to any other remedies it may have, terminate the contract upon the occurrence of such event, subject to the provisions of the contract. 9) Contractor shall notify the State within five (5) days if any insurance coverage identified in the contract is altered in any way. 8. RIGHT TO TERMINATE A. The State reserves the right to terminate this Contract subject to thirty (30) days written notice to the Contractor. Contractor may submit a written request to terminate this Contract only if the State should substantially fail to perform its responsibilities as provided herein. However, the Contract can be immediately terminated for cause. The term “for cause” shall mean that the Contractor fails to meet the terms, conditions, and/or responsibilities of the contract. In this instance, the contract termination shall be effective as of the date indicated on the State’s notification to the Contractor. B. This Contract may be suspended or cancelled without notice, at the option of the Contractor, if the Contractor or State’s premises or equipment are destroyed by fire or other catastrophe, or so substantially damaged that it is impractical to continue service, or in the event the Contractor is unable to render service as a result of any action by any governmental authority. 9. FORCE MAJEURE: Neither party shall be liable to the other for any delay in or failure of performance, nor shall any such delay in or failure of, performance constitute default, if such delay or failure is caused by “Force Majeure.” As used in this section, “Force Majeure” is defined as follows: Acts of war and acts of god such as earthquakes, floods, and other natural disasters such that performance is impossible. 10. EVALUATION OF CONTRACTOR: Performance of the Contractor under this Agreement will be evaluated. The evaluation shall be prepared on Contract/Contractor Evaluation Sheet (STD 4), and maintained in the Agreement file. For consultant agreements, a copy of the evaluation will be sent to the Department of General Services, Office of Legal Services, if it is negative and over $5,000. 11. SB/DVBE PARTICIPATION: In accordance with requirements set forth by the State, the CalVet shall enforce all laws, rules, and regulations pertaining to this program. It is the Contractors responsibility to provide CalVet with all required documents as outlined in this agreement. The CalVet reserves the right to contact each SB and DVBE identified by the Contractor to verify compliance. Failure to meet SB/DVBE requirements under Exhibit B, and Exhibit C (GTC 610), paragraphs 19.a and 19.b. may deem the Contractor to be non-responsible and rejected from future bid and contract opportunities with the CalVet. 12. LICENSES AND PERMITS: The Contractor shall be an individual or firm licensed to do business in California and shall obtain at his/her expense all license(s) and permit(s) required by law for accomplishing any work required in connection with this contract. If you are a Contractor located within the State of California, a business license from the city/county in which you are headquartered is necessary; however, if you are a corporation, a copy of your incorporation documents/letter from the Secretary of State’s Office can be submitted. If you are a Contractor outside the State of California, you will need to submit to the California Department of Veterans Affairs a copy of your business license or incorporation papers for your respective State showing that your company is in good standing in that state. California Department of Veterans Affairs Agreement Number 19XS0016 Exhibit D – Special Terms and Conditions County of Fresno Page 6 of 6 In the event any license(s) and/or permit(s) expire at any time during the term of this contract, Contractor agrees to provide agency a copy of the renewed license(s) and/or permit(s) within 30 days following the expiration date. In the event the Contractor fails to keep in effect at all times all required license(s) and permit(s), the State may, in addition to any other remedies it may have, terminate this contract upon occurrence of such event. 13. CONSULTANT – STAFF EXPENSES The Contractor represents that it has or shall secure at its own expense, all staff required to perform the services described in this Agreement. Such personnel shall not be employees of or have any contractual relationship with any governmental entity. 14. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION For the purpose of this contract, contractor shall comply with the federal Health Insurance Portability and Accountability Act (HIPAA), as well as State and Federal requirements for privacy protection. The definitions and obligations required by the HIPAA Standards for Privacy of Individually Identified Health Information (U.S.C. 1320d et seq.), and implementing regulations including but not limited to 45 Code of Federal Regulations parts 142, 160, 162, and 164, hereinafter referred to as the Privacy Rule, remain enforce and applicable for access to protected health information, including electronic protected health information. 15. LEGAL CONTRACTS (applies only to Legal Services Contracts) In accordance with (Public Contract Code Section (10353.5), the Contractor shall: A. Agree to adhere to legal cost and billing guidelines designated by the State. B. Adhere to litigation plans designated by the state agency. C. Adhere to case phasing of activities designated by the state agency. D. Submit and adhere to legal budgets as designated by the state agency. E. Maintain legal malpractice insurance in an amount not less than the amount designated by the state agency. F. Submit to legal bill audits and law firm audits if requested by the state agency. The audits may be conducted by employees and designees of the state agency or by any legal cost control providers retained by the state agency for purpose. G. Submit to a legal cost and utilization review, as determined by the state agency. CCC 04/2017 CERTIFICATION I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am dul y authorized to legall y bind th e prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California . Contractor/Bidder Firm Nam e (Printed) Federal ID N umb er County of Fresno 94 -6000512 By (Authorized Signature) _) --~~ '--~ Printed N ame and Title of Person Signing Nathan Magsig , Chairman , Fresno County Board of Supervisors Date Executed Ex ecuted in the County of ')~q-\9 Fresno C ONTRACT OR CERTIFICATI O N CLAUSES 1. STATEMENT OF COMPLIANCE: Contractor has , un less exempted , complied with the nondiscrimination program requirements . (Gov . Code§ 12990 (a-t) and CCR , Title 2 , Section 11102) (Not applicable to pub lic entitie s .) 2 . DRUG -FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and wil l provide a drug-free workplace by taking the following actions: a. Pub lish a statement notifying employees that unlawful manufacture , distribution , dispensation , possession or use of a controlled substance is prohibited and specifying actions to be taken agai nst employees for vio lations . b. Estab lish 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 counse ling, rehabi litation and emp loyee assistance programs ; and , 4) penalties that may be imposed upon employees for drug abuse vio lations. · 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 t he Agreement. Fai lure to comp ly w ith t hese requirements may result in suspens ion of payments under the Agreement or terminat ion 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 fo ll owing has occurred: the Contractor has made false certificat ion , 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.