HomeMy WebLinkAboutAgreement A-19-099 with CSU Fresno Foundation.pdfAgreement No. 19-099
1 IN WITNESS WHEREOF, he parties· hereto l'laye executed this Agreement as 'Of the day
2 and year first hereinabove written.
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4
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CONTRACT.OR:
CALIFORNIA STATE UNIVERSITY,
FBESNO 'FOUNDATION
7 (Authorized Signature)
8·
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10! ~. 4~· A/41/\'i
· u,;irnT\ i.ttarshall, Dean ofResearch.and'Gracluate
11 Studies
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13
14 (Authorized Signature)
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22
Keith·Kompsi,. Dir,ecfor of Foundationflnancial
.serviqes
Mailing Address
49,10N. Ohf}stnut Ave. M/S of 123
Fresno, CA 93726
Contact: Dr. J0hn Capitman
Phone: 559..:228:.2157
23 .FOR ACCOUNTING t;JSE ONLY:
24 ORG Ni:>.: 56201662
Account.No.: 7295
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JW
-14~
COUNTY OF FRESNO:
Natl'.ian.Magsig; Chairman·ofthe Board of
Supervisors of the County off res no
ATTEST:
Bern1ce E. Seidel
Clerk,ofthe Board et Supervisors
County ofFresno, State bf California
.By:~~-~
Depufy
Exhibit A
Page 1 of 3
SCOPE OF
WORK
The County of Fresno, on behalf of the Department of Public Health, requires qualif ied evaluators to provide com prehensive evaluation services for the NEOP program. The NEOP program goals include providing direct and indirect nutrition and physical activity education services and support for PSE changes to improve the nutritional status and prevent obesity among Supplemental Nutrition Assistance Program–Education (SNAP-Ed) eligible residents (≤185% federal poverty level) and other individuals living in six targeted low-income neighborhoods/areas. The NEOP evaluation is in line with the Western Region’s SNAP-Ed Evaluation Framework:
Nutrition, Physical Activity, and Obesity Prevention Outcomes. CONTRACTOR will lead evaluation of NEOP efforts to improve the nutritional status and prevent obesity among Fresno County residents living in the following six neighborhoods/areas (and their corresponding approved census tracts): Kerman, Lowell, Parlier, Reedley, Sanger, and West Fresno. T hese areas were selected based on USDA’s guidance f or SNAP-Ed eligible and participant population, years of potential life lost across zip code analys is, Am erican Community Survey 2011-2015, and vicinity to the twelve locally designated USDA f ood desert areas.
CONTRACTOR will provide input and expertise in the development of new , or adaptation of existing assessment tools and will analyze data to prioritize nutrition education services and PSE interventions to inform Department and NEOP planning, community engag ement, and education. CONTRACTOR will be responsible for ongoing data analysis, monitoring and reporting activities, will be consulted during the development of needs assessment tools to ensure data viability and program accountability , and will assist with the development of success stories . CONTRACTOR will be required to implement the activities and submit the deliverables described in Exhibit B.
NEOP Program Objectives
With support from the California Department of Public Health (CDPH) and the United States
Department of Agriculture (USDA) SNAP-Ed, the CDPH Nutrition Education Obesity Prevention
Branch (NEOPB) allocated NEOP funding to the Department to facilitate building and improving
community and agency policies, systems, and environments th at empower residents to make
healthy decisions in order to improve their health status . Some of these activities include :
Increase access to and consumption of fresh fruits and vegetables.
Increase access to and consumption of healthy beverages.
Increase physical activity rates and opportunities.
Increase school-based wellness strategies and PSE changes.
Additional information on NEOPB is available online at:
https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/NEOPB/Pages/Nutrition_Education_Obesi
ty_Prevention_Branch.aspx.
NEOP staff will work with CONTRACTOR to ensure access to all relevant data. The
contractor will be expected to maintain open and cooperative relationships with the
Department’s NEOP staff and subcontractors, as well as with Fresno County UC Cooperative
Extension (UCCE) CalFresh and Catholic Charities of California (CCC), and other local SNAP-
Ed f unded agencies. This may include attending regular meetings and trainings as appropriate
and cross-prom oting evaluation opportunities. During the first year, CONTRACTOR will also
Exhibit A
Page 2 of 3
work with NEOP staff, subcontractors, and other SNAP-Ed funded agencies to develop the
next three-year Integrated Work Plan and corresponding evaluation activities.
Program Evaluation
CONTRACTOR will begin with key informant interviews of NEOP staff and subcontractors to
learn the program and program services, status of activities, and will determine upcoming
evaluation needs to complete year 3 of the current 3-year grant. CONTRACTOR will then
develop an action plan to move forward and complete deliverables. Current NEOP
subcontractors work on the following interventions: 1. Nutrition Education - Cultiva LaSalud 2. School Wellness - Fresno County Superintendent of Schools 3. Healthy Retail and Worksite W ellness - California Health Collaborative
CONTRACTOR’s work will contribute to the following Fresno County NEOP overall three-
year objectives to be completed by September 30, 2019 . 1. Recruit, identify and engage at least 160 (70 existing + additional 30 annually) adult and 255 (105 existing +50 annually) youth Champions, through direct and indirect nutrition and physical activity education, and 18 (6 x 3 years) agency champions through collaboration, who will participate and/or lead at least 8 community-driven and built environment PSE strategies in the six local health department (LHD) targeted communities, and in CCC targeted sites, to increase access to healthy foods and physical activity opportunities. 2. Increase access to healthy foods of SNAP-Ed qualifying adults and/or children by making at least 7 food access sustainable environmental changes in LHD six targeted communities and CCC targeted sites. 3. Qualify and continue to partner with a total of 15 worksites (12 qualifying worksites and at least 3 qualifying school district worksites) to implement worksite wellness activities utilizing the Get Fit Business Kit and to create at least 2 policy, systems and environmental changes to support the healthy behavior changes of their employees, increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and increase physical activity practices among Fresno County SNAP-Ed eligible population through worksite environmental support in the six targeted communities in Fresno County. 4. At least 36 participating schools, will report successful implementation (put into practice) at least 1 policy system and environmental change that will support nutrition and physical activity education and opportunities to increase knowledge, skills, self-efficacy, and positive attitudes that promote healthy eating and physical activity, increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and increase physical activity practices among Fresno County SNAP-Ed eligible population.
The objectives and their corresponding evaluation activities are listed in Exhibit B.
Reporting CONTRACTOR is required to submit quarterly reports with documentation of deliverables detailed in Attachment A and contribute to reports required by the funder, California Department of Public Health Nutrition Education Obesity Prevention Branch (NEOPB). The Department will notify CONTRACTOR no less than 30 days in advance of reporting deadlines as the program progresses.
Exhibit A
Page 3 of 3
CONTRACTOR will only use approved NEOPB m aterials and evaluation tools unless otherwise directed by the Departm ent. T he NEOPB attribution language, NEOPB required logos, and Fresno County Department of Public Health logo and attribution language will be included on all developed materials f or public dissem ination with prior approval f rom the Departm ent. All reports, tools, etc., developed f or NEOP, remains property of the County of Fresno. At the County’s option, if the required services necessitate multiple revisions or corrections to work subm itted, evaluation services m ay be provided at no cost to the Departm ent’s NEOP Program.
Requirements CONTRACTOR shall abide by all applicable federal, state and local guidelines and regulations, including but not limited to: 1. SNAP-Ed Plan Guidance and Templates:
https://snaped.fns.usda.gov/administration/snap-ed-plan-guidance-and-templates 2. CDPH Guidelines:
https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/NEOPB/Pages/SNAP-
EdGuidanceLHD.aspx
3. 2015-2020 Dietary Guidelines for Americans: https://health.gov/dietaryguidelines/2015/
Subcontracting CONTRACTOR may not subcontract any part of the contract. However, with advance approval, the contractor may hire a consultant on an hourly, per-event or similar basis (e.g., translation services) as deemed necessary by NEOP Project Director.
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 1 of 18
Three-Year SNAP-Ed Local Objective #1 (FFY 2017–FFY 2019):
By September 30, 2019, recruit, identify and engage at least 160 (70 existing + additional 30 annually) adult and 255 (105 existing +50 annually) youth
Champions, through direct and indirect nutrition and physical activity education, and 18 (6 x 3 years) agency champions through collaboration, who will
participate and/or lead at least 8 community-driven and built environment PSE strategies in the six LHD targeted communities, and CCC target sites, to increase
access to healthy foods and physical activity opportunities.
I. PSE Strategy(ies) that support the Three-Year SNAP-Ed Local Objective listed above:
Safe routes to school, school meal improvement, park improvement, joint use agreements, playground stencils, community and school gardens, hydration
stations, built environment (land use and planning), healthy food/beverage standards at parishes/parish wellness policies & increased access/opportunity to
community PA
II. Annual Objectives to support the Three-Year SNAP-Ed Local Objective listed above:
1. FFY 2017 (Year 1) Objective(s):
a. By September 30, 2017, in partnership with the Central Valley NEOP Project Directors, UCCE, and the Central Valley Health and Nutrition
Collaborative (CVHNC) Built Environment Workgroup, explore, identify and receive 3 training and education activities to build capacity
on development and implementation of land use and planning PSE efforts.
b. By September 30, 2017, provide training and support to an additional 30 adult, 50 youth and 6 agency new champions and existing
champions to complete community-driven nutrition and physical activity future PSE projects.
c. By September 30, 2017 conduct 2 community forums with champions and community partners in target communities where community
forums were previously conducted to reassess priorities identified by the community.
d. By September 30, 2017, conduct the Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX3)
neighborhood reassessment process in two Fresno County neighborhoods (Sanger and Kerman) in partnership with local Champions in
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 2 of 18
order to measure the nutrition and physical activity environments, measure any change since FFY 2014, and provide updated data to
drive future PSE work and community engagement in those neighborhoods.
e. By September 30, 2017, UCCE and LHD will provide direct education to 27,883 (UCCE=19,963 and LHD=7,920), and indirect education to
43,860 (UCCE=23,524 and LHD=20,336), SNAP-Ed eligible individuals throughout Fresno County.
2. FFY 2018 (Year 2) Objective(s):
a. By September 30, 2018, in partnership with adult, youth and/or agency champions, identify potential and develop plans in at least 1
built environment PSE strategies to increase access to healthy foods and physical activity opportunities.
b. By September 30, 2018, provide training and support to an additional 30 adult, 50 youth and 6 agency new champions and existing
champions to complete at least 2 community-driven and 1 faith based nutrition and physical activity PSE projects.
c. By September 30, 2018 conduct 2 community forums with champions and community partners in target communities where community
forums were previously conducted to reassess priorities identified by the community.
d. By September 30, 2018, UCCE, CCC and LHD will provide direct education to 6,449 (UCCE=1,835, CCC=560 and LHD=4,054), and indirect
education to 8,760 (UCCE=425, CCC=1,500 and LHD=6,835), SNAP-Ed eligible individuals throughout Fresno County.
3. FFY 2019 (Year 3) Objective(s):
a. By September 30, 2019, in partnership with adult, youth and/or agency champions, implement at least 1 built environment PSE
strategies that will increase access to healthy foods and physical activity opportunities.
b. By September 30, 2019, provide training and support to an additional 30 adult, 50 youth and 6 agency new champions and existing
champions to complete at least 3 community-driven and 4 faith based nutrition and physical activity PSE projects.
c. By September 30, 2019 conduct 2 community forums with champions and community partners in target communities where community
forums were previously conducted to reassess priorities identified by the community.
d. By September 30, 2019, conduct the Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX3)
neighborhood reassessment process in four Fresno County neighborhoods (Lowell, West Fresno, Parlier, and Reedley) in partnership
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 3 of 18
with local Champions in order to measure the nutrition and physical activity environments, measure any change since FFY 2016, and
provide updated data to drive future PSE work and community engagement in those neighborhoods.
e. By September 30, 2019, UCCE, CCC and LHD will provide direct education to 6,509 (UCCE=1,835, CCC=620 and LHD=4,054), and indirect
education to 8,760 (UCCE=425, CCC=1,500 and LHD=6,835), SNAP-Ed eligible individuals throughout Fresno County.
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019) Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Evaluation Activities (FFY 2017 - FFY 2019)
Activity
Number
Evaluation Activity Description Formative Process Outcome
or
Impact
Responsible
SNAP-Ed
Agency(ies)
Time Frame: Year
& Quarter**
Tool/Documentation
E.1.1 On an on-going basis, record SNAP-Ed
activities, sites, participants reached, and
other required elements for USDA’s SNAP-Ed
Education and Administration Reporting
System.
X
CWD
X LHD
AAA
UCCE
X CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
X PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other:
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 4 of 18
E.1.3 Monitor reach, effectiveness, adoption,
implementation, and maintenance of
champion-led and community-driven PSE
changes through policy review, surveys, key
informant interviews, and/or observational
assessments. SSC will lead.
X
X
CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
X PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Champion
Engagement System,
evaluation tools, exposure
surveys and related reports,
evaluation
summaries/reports
E.1.4 Monitor reach, effectiveness, adoption,
implementation, and maintenance of
champion-led organizational changes at faith-
based organizations through activity and
communications tracking (Champion
Engagement System), policy review, surveys,
key informant interviews, and/or
observational assessments. SSC will lead.
X X
CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Champion
Engagement System,
evaluation tools, evaluation
summaries reports
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 5 of 18
E.1.5 Monitor reach, effectiveness, adoption,
implementation, and maintenance of
champion-led PSE changes at schools through
activity and communications tracking
(Champion Engagement System), policy
review, surveys, key informant interviews,
and/or observational assessments. SSC will
lead.
X X CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Champion
Engagement System,
evaluation tools, evaluation
summaries/reports
E.1.6 Monitor reach, effectiveness, adoption,
implementation, and maintenance of
champion-led built environment (land use and
planning) PSE changes through activity and
communications tracking (Champion
Engagement System), policy review, surveys,
key informant interviews, and/or
observational assessments. SSC will lead.
X X CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Champion
Engagement System,
evaluation tools, evaluation
summaries/reports
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 6 of 18
E.1.7 Monitor and evaluate outcomes of direct
education activities with CDPH approved
evaluation curriculum evaluation tools. LHD
and SSC will lead.
X X CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Evaluation
summaries/reports
E.1.12 CX3 is a protocol for evaluating neighborhood
environments. As such, all methods and
deliverables are listed in the above table as
opposed to in a separate evaluation table.
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: CX3 Tools,
completed forms, maps,
data base
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 7 of 18
E.1.15 UCCE, LHD and SSC will implement a joint
outcome evaluation.
X X CWD
x LHD
AAA
x UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: UCCE and LHD
joint evaluation
summaries/reports
E.1.17 LHD will provide staff training on community
engagement framework in year 1 and conduct
3 trainings with champions in year 2 and 3
trainings with champions in year 3 using
community engagement framework materials.
SSC will take lead on evaluating trainings
x X CWD
X LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
X X X X
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Training
evaluation tools and
evaluation results
E.1.24 Present results back to stakeholders and
champions with in the respective participating
communities. From the results, champions
and stakeholders will identify priorities to
X CWD
X LHD
AAA
UCCE
Year 3
Q1 Q2 Q3 Q4
X X X X
EARS/ATF
PEARS
UC CalFresh
Workbook
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 8 of 18
increase access to physical activity
opportunities.
CCC
Food
Behavior
Checklist
UC Intent to
Change
list of Identified priorities
from each of participating
communities
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Three-Year SNAP-Ed Local Objective #2 (FFY 2017–FFY 2019):
By September 30, 2019, increase access to healthy foods of SNAP-Ed qualifying adults and/or children by making at least 7 food access sustainable
environmental changes in targeted communities and sites.
I. PSE Strategy(ies) that support the Three-Year SNAP-Ed Local Objective listed above:
Healthy Retail, Community Gardens, Community Supported Agriculture (CSA), Farmers Market, Food Pantry Policy
II. Annual Objectives to support the Three-Year SNAP-Ed Local Objective listed above:
1. FFY 2017 (Year 1) Objective(s):
a. By September 30, 2017, in partnership with the LWCA and Healthy Retail Committee, increase the consumption of fruits and vegetables
and healthy beverages of SNAP-Ed qualifying adults and/or children by making 1 sustainable environmental system change within each
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 9 of 18
of at least 2 local retail stores within the six the targeted communities, to increase the promotion and purchase of fresh, locally sourced
produce and other healthy items.
b. By September 30, 2017, in partnership with Fresno Food Security Network (FFSN), explore local best practices for expanding access to
fruits and vegetables to identify at least 1 PSE project targeting SNAP-Ed eligible populations within the six targeted communities.
c. By September 30, 2017, recruit a total of at least 6 qualifying retail sites within the six targeted communities to reach a minimum of
7,500 SNAP-Ed eligible individuals using NEOPB Retail program activities and merchandising materials.
2. FFY 2018 (Year 2) Objective(s):
a. By September 30, 2018, in partnership with the LWCA and Healthy Retail Committee, increase the consumption of fruits and vegetables
and healthy beverages of SNAP-Ed qualifying adults and/or children by making 1 sustainable environmental system changes within at
least 2 additional LHD local retail stores within the six targeted communities and CCC will identify at least 1 food pantry and draft the
healthy food and beverage standards to increase the promotion and purchase of fresh, locally sourced produce and other healthy items.
b. By September 30, 2018, in partnership with Fresno Food Security Network (FFSN), establish partnerships and memorandum of
understandings (MOU’s) and secure additional resources needed to implement local best practices to expand access to fruits and
vegetables targeting SNAP-Ed eligible populations.
c. By September 30, 2018, maintain at least 4 retail sites and recruit a total of at least 3 additional qualifying retail sites within the six
targeted communities to reach a minimum of 15,600 (200 + 15,250 + 150) SNAP-Ed eligible individuals using NEOPB Retail program
activities and merchandising materials.
3. FFY 2019 (Year 3) Objective(s):
a. By September 30, 2019, in partnership with the LWCA and Healthy Retail Committee, increase the consumption of fruits and vegetables
and healthy beverages of SNAP-Ed qualifying adults and/or children by making 1 sustainable environmental system changes within at
least 2 additional LHD local retail stores within the six targeted communities and CCC will implement healthy food and beverage
standard policy for at least 1 food pantry to increase the promotion and purchase of fresh, locally sourced produce and other healthy
items.
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 10 of 18
b. By September 30, 2019, in partnership with Fresno Food Security Network (FFSN), to implement at least 1 local best practice to expand
access to fruits and vegetables targeting SNAP-Ed eligible populations.
c. By September 30, 2019, maintain at least 6 retail stores and recruit a total of at least 3 additional qualifying retail sites within the six
targeted communities to reach a minimum of 18,100 (200 + 17,750 + 150) SNAP-Ed eligible individuals using NEOPB Retail program
activities and merchandising materials.
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Evaluation Activities (FFY 2017 - FFY 2019)
Activity
Number
Evaluation Activity Description Formative Process Outcome
or
Impact
Responsible
SNAP-Ed
Agency(ies)
Time Frame: Year
& Quarter**
Tool/Documentation
E.2.1 On an on-going basis, record SNAP-Ed activities,
sites, participants reached, and other required
elements for USDA’s SNAP-Ed Education and
Administration Reporting System.
x
x
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other:
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 11 of 18
E.2.2 Use the PEARS to report on an annual basis
progress for Healthy Retail, Food Access, Food
Pantry Policy and Marketing Objective activity and
communications tracking, on-site nutrition
assessments, surveys and/or key informant
interviews of champions, funded staff, customers,
managers, and/or other stakeholders.
X
X
CWD
X LHD
AAA
UCCE
X CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Evaluation
tools, evaluation
summaries/reports
E.2.4 Use the PEARS to report on an annual basis
progress for the Fresno Food Security Network’s
local best practice to expand access to fruits and
vegetables through activity and communications
tracking, on-site nutrition assessments, surveys
and/or key informant interviews of champions,
funded staff, customers, and/or other
stakeholders.
x x CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Evaluation
tools, evaluation
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 12 of 18
Three-Year SNAP-Ed Local Objective #3 (FFY 2017–FFY 2019):
By September 30, 2019, qualify and continue to partner with a total of 15 worksites (12 qualifying worksites and at least 3 qualifying school district worksites) to
implement worksite wellness activities utilizing the Get Fit Business Kit and to create at least 2 policy, systems and environmental changes to support the healthy
behavior changes of their employees, increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and
increase physical activity practices among Fresno County SNAP-Ed eligible population through worksite environmental support in the six targeted communities in
Fresno County.
I. PSE Strategy(ies) that support the Three-Year SNAP-Ed Local Objective listed above:
Worksite Wellness
II. Annual Objectives to support the Three-Year SNAP-Ed Local Objective listed above:
1. FFY 2017 (Year 1) Objective(s):
a. By September 30, 2017, recruit and qualify at least 6 worksites and 1 school district worksites in the six targeted communities in Fresno
County to incorporate worksite wellness activities utilizing California Fit Business Kit that will increase the knowledge, skills, self-efficacy,
and positive attitudes of their employees that promote healthy eating and physical activity.
b. By September 30, 2017, work with participating worksites to each complete a minimum of 1 activity in the California Fit Business Kit and
identify policy, system and environmental changes to implement that will support the healthy behavior changes of their employees.,
increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and increase physical
activity practices among Fresno County SNAP-Ed eligible population through worksite environmental support.
2. FFY 2018 (Year 2) Objective(s):
a. By September 30, 2018, recruit and qualify at least 3 additional worksites and 1 additional school district worksites in the six targeted
communities in Fresno County to incorporate worksite wellness activities utilizing California Fit Business Kit that will increase the
knowledge, skills, self-efficacy, and positive attitudes of their employees that promote healthy eating and physical activity.
b. By September 30, 2018, work with participating worksites to each complete a minimum of 1 activity in the California Fit Business Kit and
identify policy, system and environmental changes to implement that will support the healthy behavior changes of their employees.,
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 13 of 18
increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and increase physical
activity practices among Fresno County SNAP-Ed eligible population through worksite environmental support.
c. By September 30, 2018, at least 1 participating worksite will develop and implement at least 1 policy, system environmental change that
support the healthy behavior changes of their employees, increase consumption of healthy foods and beverages, reduce consumption of
unhealthy foods and beverages, and increase physical activity practices among Fresno County SNAP-Ed eligible population through
worksite environmental support.
3. FFY 2019 (Year 3) Objective(s):
a. By September 30, 2019, recruit and qualify at least 3 additional worksites and 1 additional school district worksites in the six targeted
communities in Fresno County to incorporate worksite wellness activities utilizing California Fit Business Kit that will increase the
knowledge, skills, self-efficacy, and positive attitudes of their employees that promote healthy eating and physical activity.
b. By September 30, 2018, work with participating worksites to each complete a minimum of 1 activity in the California Fit Business Kit and
identify policy, system and environmental changes to implement that will support the healthy behavior changes of their employees.,
increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and increase physical
activity practices among Fresno County SNAP-Ed eligible population through worksite environmental support.
c. By September 30, 2019, at least 2 participating worksites will develop and implement at least 1 policy, system environmental change
that support the healthy behavior changes of their employees, increase consumption of healthy foods and beverages, reduce
consumption of unhealthy foods and beverages, and increase physical activity practices among Fresno County SNAP-Ed eligible
population through worksite environmental support.
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 14 of 18
Evaluation Activities (FFY 2017 - FFY 2019)
Activity
Number
Evaluation Activity Description Formative Process Outcome
or Impact
Responsible
SNAP-Ed
Agency(ies)
Time Frame: Year
& Quarter**
Tool/Documentation
E.3.1 On an on-going basis, record SNAP-Ed
activities, sites, participants reached, and
other required elements for USDA’s SNAP-Ed
Education and Administration Reporting
System
x
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other:
E.3.2 Use the PEARS to report on an annual basis
progress for Worksite Wellness Objective, for
worksites and school districts, with specific
indicators of reach, effectiveness, adoption,
implementation and maintenance through
pre- and post-assessments (Check for Health
survey in the Get Fit Business Kit), activity and
communications tracking, interviews with
staff, worksite policy review, and
environmental observations where
appropriate. LHD and SSC will lead.
x
x
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
X PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Evaluation
tools, evaluation
summaries/reports
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 15 of 18
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Three-Year SNAP-Ed Local Objective #4 (FFY 2017–FFY 2019):
By September 30, 2019, at least 36 participating schools, will report successful implementation (put into practice) at least 1 policy system and environmental
change that will support nutrition and physical activity education and opportunities to increase knowledge, skills, self-efficacy, and positive attitudes that
promote healthy eating and physical activity, increase consumption of healthy foods and beverages, reduce consumption of unhealthy foods and beverages, and
increase physical activity practices among Fresno County SNAP-Ed eligible population.
II. PSE Strategy(ies) that support the Three-Year SNAP-Ed Local Objective listed above:
School Wellness Policies, Smarter Lunchrooms, School Gardens, New/Improved access to structured PA programs
III. Annual Objectives to support the Three-Year SNAP-Ed Local Objective listed above:
1. FFY 2017 (Year 1) Objective(s):
a. By September 30, 2017, at least 2 (UCCE=1, LHD=1) participating schools will implement at least 1 school wellness policy (SWP) and
make at least 1 environmental or policy change that may include school garden, structured PA, etc., at the site.
b. By September 30, 2017, UCCE staff will work with school staff at 3 participating Child Development Centers (CDC’s) and LHD will work
with food service staff and/or youth at 1 participating school to successfully implement the Smarter Lunchrooms Movement (SLM).
c. By September 30, 2017, at least 22,000 (LHD=4,000 + UCCE= 18,000) participating youth will receive direct nutrition and physical activity
education in the form of USDA approved lessons in qualifying school sites.
d. By September 30, 2017, at least 24,500 (LHD=5,000 + UCCE=19,500) parents and at least 5,400 (LHD=2,100 + UCCE 3,300) youth will
receive indirect nutrition and physical activity education utilizing USDA approved materials.
2. FFY 2018 (Year 2) Objective(s):
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 16 of 18
a. By September 30, 2018, at least 4 additional (UCCE=3, LHD=1) participating school districts or schools will implement at least one school
wellness policy (SWP) or make at least 1 environmental or policy change that may include school garden, structured PA, etc., at the site.
b. By September 30, 2018, UCCE staff will work with food service staff and/or youth at 8 additional participating Fresno County District
schools and LHD will work with food service staff and/or youth at 1 additional participating school to successfully implement the Smarter
Lunchrooms Movement.
c. By September 30, 2018, at least 24,200 (LHD=5,200 + UCCE=19,000) participating youth will receive direct nutrition and physical activity
education in the form of USDA approved lessons in qualifying school sites.
d. By September 30, 2018, at least 25,000 (LHD=5,500 + UCCE=19,500) parents and at least 4,450 (LHD=2,200 + UCCE=2,250) youth will
receive indirect nutrition and physical activity education utilizing USDA approved materials.
3. FFY 2019 (Year 3) Objective(s):
a. By September 30, 2019, at least 6 additional (UCCE=5, LHD=1) participating school districts or schools will implement at least one school
wellness policy (SWP) or make at least one environmental or policy change that may include school garden, structured PA, etc., at the
site.
b. By September 30, 2019, UCCE staff will work with food service staff and/or youth at 10 additional participating Fresno County District
schools and LHD will work with food service staff and/or youth at 1 additional participating school to successfully implement the Smarter
Lunchrooms Movement.
c. By September 30, 2019, at least 26,700 (LHD=6,700+ UCCE=20,000) participating youth will receive direct nutrition and physical activity
education in the form of USDA approved lessons in qualifying school sites.
d. By September 30, 2019, at least 26,500 (LHD=6,000 + UCCE=20,500) parents and at least 5,000 (LHD=2,500 + UCCE=2,500) youth will
receive indirect nutrition and physical activity education utilizing USDA approved materials.
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 17 of 18
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Evaluation Activities (FFY 2017 - FFY 2019)
Activity
Number
Evaluation Activity Description Formative Process Outcome
or
Impact
Responsible
SNAP-Ed
Agency(ies)
Time Frame: Year
& Quarter**
Tool/Documentation
E.4.1 On an on-going basis, record
SNAP-Ed activities, sites,
participants reached, and other
required elements for USDA’s
SNAP-Ed Education and
Administration Reporting
System.
x
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other:
E.4.2 Use the PEARS to report on an
annual basis progress for
School Wellness Objective with
specific indicators of reach,
effectiveness, adoption,
implementation and
maintenance through activity
and communication tracking,
surveys, interviews, policy
X
X
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
x PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Fresno County Three-Year
Integrated Work Plan
Evaluation Activities
FFY 2017–2019
Exhibit B
Rev. 3/31/2018
Exhibit B Page 18 of 18
review and/or school
environmental observations.
List other: Evaluation tools, evaluation
reports/summaries
E.4.3 Provide Impact outcome
Evaluation (IOE) surveys to 100
6th grade-8th grade students
and achieve at least 100
matched pre and post surveys
using the approved Harvest of
the Month Workbook survey to
measure changes in knowledge
and behavior. SSC will provide
data entry analysis support.
x
CWD
x LHD
AAA
UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
x x x x
EARS/ATF
PEARS
UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Harvest of the Month
Workbooks, Survey results
E.4.8 Community Assessment:
Smarter Lunchrooms Self-
Assessment Scorecard
X CWD
x LHD
AAA
X UCCE
CCC
Year 3
Q1 Q2 Q3 Q4
X X X X
EARS/ATF
x PEARS
X UC CalFresh
Workbook
Food
Behavior
Checklist
UC Intent to
Change
List other: Smarter Lunchrooms
Scorecards, Smarter Lunchrooms Site
Plans, Photos, Success Stories
* Responsible SNAP-Ed Agency(ies)
CWD=California Welfare Department; LHD = Local Health Department; AAA = Area Agency on Aging; UCCC = University of California Cooperative Extension; CCC = California Catholic Charities
**Time Frame: Year & Quarter:
Year 1 (FFY 2017); Year 2 (FFY 2018); Year 3 (FFY 2019)
Qtr. 1 (Oct. 1-Dec. 31); Qtr. 2 (Jan. 1-March 31); Qtr. 3 (Apr. 1-Jun. 30); Qtr. 4 (Jul. 1-Sept.30)
Organization Name:
YEAR ONE
1. Staffing: Salary/Benefits:
% of SNAP-Ed
Time spent on
Mgmt/Admin
Duties
% of SNAP-Ed
Time spent on
Direct SNAP-Ed
Delivery
1 John Capitman 0.02 156,000.00$ $3,120.00 53.00%$1,653.60 $4,773.60 $4,774
2 Emanuel Alcala 0.30 45,760.00$ $13,728.00 38.00%$5,216.64 $18,944.64 $18,945
3 Hayam Megally 0.53 49,920.00$ $26,457.60 32.00%$8,466.43 $34,924.03 $34,924
4 Yesenia Silva 0.05 32,800.00$ $1,640.00 35.00%$574.00 $2,214.00 $2,214
5 Mayra Lemus Rangel 0.05 38,000.00$ $1,900.00 32.00%$608.00 $2,508.00 $2,508
6 Rachel Doherty 0.20 37,440.00$ $7,488.00 10.00%$748.80 $8,236.80 $8,237
7 Maggie Flores 0.20 32,136.00$ $6,427.20 35.00%$2,249.52 $8,676.72 $8,677
8 $0.00 $0.00 $0.00 $0
9 $0.00 $0.00 $0.00 $0
10 $0.00 $0.00 $0.00 $0
11 $0.00 $0.00 $0.00 $0
12 $0.00 $0.00 $0.00 $0
13 $0.00 $0.00 $0.00 $0
14 $0.00 $0.00 $0.00 $0
15 $0.00 $0.00 $0.00 $0
16 $0.00 $0.00 $0.00 $0
17 $0.00 $0.00 $0.00 $0
18 $0.00 $0.00 $0.00 $0
19 $0.00 $0.00 $0.00 $0
20 $0.00 $0.00 $0.00 $0
21 $0.00 $0.00 $0.00 $0
1.35 Total Staffing: Salary/Benefits:$60,761 $19,517 $80,278 $80,278
Organization Name:
2. Non-Capital Equipment/Supplies:
FTE Cost per Item # of
Items Total
1 1.35 $108.00 7 $1,021
2 1.35 $100.00 2 $270
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
1 $0Position #Project Manager
Health Education Specialist
Position Title Name
California Statue University Foundation, Fresno on behalf of the Central Valley Health Policy Institute
Benefit
Rate
Total
SNAP-Ed
Benefits
Project Director
Research Assistant
Research Analyst
Research Analyst
Program Assistant
SNAP-Ed Admin
Costs
Total SNAP-
Ed Funded
Salary and
Benefits
FTE Total SNAP-
Ed Salary
SNAP-Ed Time Spent
Annual Salary
Benefits include all mandated federal and state/local payroll taxes, such as FICA, Worker's Compensation, Unemployment
Insurance and Medicare. Additional benefits for salaried employees include health, vision, dental and life insurance and a 401K
contribution. Benefits are calculated at the actual rates.
Definition and basis for calculations of benefit rate(s):
Describe what is covered in the benefit rate for your agency.
Toner
California Statue University Foundation, Fresno on behalf of the Central Valley Health Policy Institute
Theft-sensitive equipment/supplies that are less than $5,000 (Computers, printers, projectors, etc.)
Description/Justification
ink, pens, pencils, paper, and desk supplies
Copier toner to make copies for meeting
Budget Item
Office Supplies
Exhibit C
Exhibit C, Page 1 of 10
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
1.35 Total Supplies:$1,291
3. Materials:
# of
Items Total
1 5 $800
2 422 $211
3 1 $336
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
Total Materials:$1,347
4. Travel:
Location Trips FTE Days Nights Per Diem Lodging Air Miles
@ $.58 Reg. Fee Other Total
1
Fresno County /Regional
Travel 1 1.00 0 0 $0.00 $0.00 0 2,400 $0.00 $57.00 $1,449
2 Sacramento 1 2.00 1 1 $46.00 $110.00 0 400 $0.00 $25.00 $416
8 $0
9 $0
10 $0
11 $0
12 $0
13 $0
14 $0
18 $0
1 $0
2 $0
3 $0
4 $0
#$0
$1,865
Position Title/Name
Project Director/ John
Capitman,Project Manager/
Emanel Alcala, Health Education
Specialsih/Hayam Megally,
Research Assistant/ Yesenia Silva,
Research Analyst/Mayra Lemus &
Rachel Doherty, Program
Assistant/Maggie Flores
Description/ Justification
Mileage, Other = Parking
downtown
NEOP Training/Meeting,
Other = parking
Project Manager/ Emanuel Alcala,
Health Education
Specialist/Hayam Megally
In-State
Budget Item
evaluation software Licensing
Transcription
Printing
Cost per Item
160
0.5
336
Total Travel:
Out-of-State
Description/Justification
Key informant interviews
Training and evaluation materials
Licensing evaluation software for SPSS
Exhibit C, Page 2 of 10
5. Building/Space:
FTE Cost per
Month
# of
Mo(s).Total
1
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
Total Building/Space:$0
6. Maintenance:
FTE # of
Mo(s).Total
1 1.35 8 $1,620
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$1,620
7. Equipment and Other Capital Expenditures:
FTE # of
Items Misc.Total
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$0
8. Indirect Costs:
Total
1 $21,600
$21,600
$86,400.0025.00%
Calculation Method Indirect Cost Rate Total Admin/Program
Dollars
Total Indirect Costs:
Total Year 1 Budget:$108,000
Total Maintenance:
Budget Item Description/Justification Cost per Item
Location Name/Address Calculation Description Cost per Month
Communications Phone, fax, and internet $150.00
Calculation DescriptionLocation Name/Address
Exhibit C, Page 3 of 10
Organization Name:
YEAR TWO
1. Staffing: Salary/Benefits:
% of SNAP-Ed
Time spent on
Mgmt/Admin
Duties
% of SNAP-Ed
Time spent on
Direct SNAP-Ed
Delivery
1 John Capitman 0.02 156,000.00$ $3,120.00 53.00%$1,653.60 $4,773.60 $4,774
2 Emanuel Alcala 0.40 45,760.00$ $18,304.00 38.00%$6,955.52 $25,259.52 $25,260
3 Hayam Megally 0.35 49,920.00$ $17,472.00 32.00%$5,591.04 $23,063.04 $23,063
4 Yesenia Silva 0.30 32,800.00$ $9,840.00 35.00%$3,444.00 $13,284.00 $13,284
5 Mayra Lemus Rangel 0.05 38,000.00$ $1,900.00 32.00%$608.00 $2,508.00 $2,508
6 Rachel Doherty 0.15 37,440.00$ $5,616.00 10.00%$561.60 $6,177.60 $6,178
7 Maggie Flores 0.10 32,136.00$ $3,213.60 35.00%$1,124.76 $4,338.36 $4,338
8 $0.00 $0.00 $0.00 $0
9 $0.00 $0.00 $0.00 $0
10 $0.00 $0.00 $0.00 $0
11 $0.00 $0.00 $0.00 $0
12 $0.00 $0.00 $0.00 $0
13 $0.00 $0.00 $0.00 $0
14 $0.00 $0.00 $0.00 $0
15 $0.00 $0.00 $0.00 $0
16 $0.00 $0.00 $0.00 $0
17 $0.00 $0.00 $0.00 $0
18 $0.00 $0.00 $0.00 $0
19 $0.00 $0.00 $0.00 $0
20 $0.00 $0.00 $0.00 $0
21 $0.00 $0.00 $0.00 $0
1.37 Total Staffing: Salary/Benefits:$59,466 $19,939 $79,404 $79,404
Organization Name:
2. Non-Capital Equipment/Supplies:
FTE # of
Items Total
1 1.35 7 $869
2 1.35 2 $432
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
1 $0
Theft-sensitive equipment/supplies that are less than $5,000 (Computers, printers, projectors, etc.)
Office Supplies ink, pens, pencils, paper, and desk supplies
Benefits include all mandated federal and state/local payroll taxes, such as FICA, Worker's Compensation, Unemployment
Insurance and Medicare. Additional benefits for salaried employees include health, vision, dental and life insurance and a 401K
contribution. Benefits are calculated at the actual rates.
$92.00
Toner Copier toner to make copies for meetings $160.00
Definition and basis for calculations of benefit rate(s):
California Statue University Foundation, Fresno on behalf of the Central Valley Health Policy Institute
Budget Item Description/Justification Cost per Item
California Statue University Foundation, Fresno on behalf of the Central Valley Health Policy Institute Position #Position Title Name Annual Salary Total SNAP-
Ed Salary
Benefit
Rate
Total
SNAP-Ed
Benefits
SNAP-Ed Admin
CostsFTE
SNAP-Ed Time Spent
Total SNAP-
Ed Funded
Salary and
Benefits
Research Analyst
Program Assistant
Project Director
Project Manager
Health Education Specialist
Research Assistant
Research Analyst
Exhibit C, Page 4 of 10
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$1,301
3. Materials:
# of
Items Total
1 5 $800
2 524.66 $262
3 1 $336
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$1,398
4. Travel:
Location Trips FTE Days Nights Per Diem Lodging Air Miles
@ $.58 Reg. Fee Other Total
1
Fresno County /Regional
Travel 1 1.00 0 0 $0.00 $0.00 0 2,400 $0.00 $58.00 $1,450
2 Sacramento 1 2.00 1 1 $46.00 $110.00 0 400 $0.00 $25.00 $416
3
4
5
6
7
8
9
#$0
#$0
#$0
#$0
#$0
#$0
#$0
#$0
#$0
Project Director/ John
Capitman,Project Manager/
Emanel Alcala, Health Education
Specialsih/Hayam Megally,
Research Assistant/ Yesenia Silva,
Research Analyst/Mayra Lemus &
Rachel Doherty, Program
Project Manager/ Emanuel Alcala,
Health Education
Specialist/Hayam Megally
Total Materials:
Position Title/Name Description/ Justification
Mileage, Other = Parking
downtown
NEOP Training/Meeting,
Other = parking
Printing Training and evaluation materials 0.5
evaluation software Licensing Licensing evaluation software for SPSS 336
Total Supplies:
Budget Item Description/Justification Cost per Item
Transcription Key informant interviews 160
In-State
Out-of-State
Exhibit C, Page 5 of 10
1 $0
2 $0
3 $0
4 $0
#$0
$1,866
5. Building/Space:
FTE # of
Mo(s).Total
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
$0
6. Maintenance:
FTE # of
Mo(s).Total
1 1.35 12 $2,430
2
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$2,430
7. Equipment and Other Capital Expenditures:
FTE # of
Items Misc.Total
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$0
8. Indirect Costs:
Total
1 $21,600
$21,600
25.00%$86,400.00
Total Indirect Costs:
Total Year 2 Budget:$108,000
Total Equipment:
Calculation Method Indirect Cost Rate Total Admin/Program
Dollars
Total Maintenance:
Budget Item Description/Justification Cost per Item
Communications Phone, fax, and internet $150.00
Total Building/Space:
Location Name/Address Calculation Description Cost per Month
Calculation Description Cost per Month
Total Travel:
Location Name/Address
Exhibit C, Page 6 of 10
Organization Name:
YEAR THREE
1. Staffing: Salary/Benefits:
% of SNAP-Ed
Time spent on
Mgmt/Admin
Duties
% of SNAP-Ed
Time spent on
Direct SNAP-Ed
Delivery
1 John Capitman 0.02 156,000.00$ $3,120.00 53.00%$1,653.60 $4,773.60 $4,774
2 Emanuel Alcala 0.40 45,760.00$ $18,304.00 38.00%$6,955.52 $25,259.52 $25,260
3 Hayam Megally 0.35 49,920.00$ $17,472.00 32.00%$5,591.04 $23,063.04 $23,063
4 Yesenia Silva 0.30 32,800.00$ $9,840.00 35.00%$3,444.00 $13,284.00 $13,284
5 Mayra Lemus Rangel 0.05 38,000.00$ $1,900.00 32.00%$608.00 $2,508.00 $2,508
6 Rachel Doherty 0.15 37,440.00$ $5,616.00 10.00%$561.60 $6,177.60 $6,178
7 Maggie Flores 0.10 32,136.00$ $3,213.60 35.00%$1,124.76 $4,338.36 $4,338
8 $0.00 $0.00 $0.00 $0
9 $0.00 $0.00 $0.00 $0
10 $0.00 $0.00 $0.00 $0
11 $0.00 $0.00 $0.00 $0
12 $0.00 $0.00 $0.00 $0
13 $0.00 $0.00 $0.00 $0
14 $0.00 $0.00 $0.00 $0
15 $0.00 $0.00 $0.00 $0
16 $0.00 $0.00 $0.00 $0
17 $0.00 $0.00 $0.00 $0
18 $0.00 $0.00 $0.00 $0
19 $0.00 $0.00 $0.00 $0
20 $0.00 $0.00 $0.00 $0
21 $0.00 $0.00 $0.00 $0
1.37 Total Staffing: Salary/Benefits:$59,466 $19,939 $79,404 $79,404
Organization Name:
2. Non-Capital Equipment/Supplies:
FTE # of
Items Total
1 1.35 7 $869
2 1.35 2 $432
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
Office Supplies ink, pens, pencils, paper, and desk supplies $92.00
Toner Copier toner to make copies for meetings $160.00
Budget Item Description/Justification Cost per Item
Benefits include all mandated federal and state/local payroll taxes, such as FICA, Worker's Compensation, Unemployment
Insurance and Medicare. Additional benefits for salaried employees include health, vision, dental and life insurance and a 401K
contribution. Benefits are calculated at the actual rates. Definition and basis for calculations of benefit rate(s):
California Statue University Foundation, Fresno on behalf of the Central Valley Health Policy Institute Position #Position Title Name Annual Salary Total SNAP-
Ed Salary
Benefit
Rate
Total
SNAP-Ed
Benefits
SNAP-Ed Admin
Costs
Total SNAP-
Ed Funded
Salary and
Benefits
FTE
SNAP-Ed Time Spent
Research Analyst
Program Assistant
Project Director
Project Manager
Health Education Specialist
Research Assistant
Research Analyst
Exhibit C, Page 7 of 10
9 $0
10 $0
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$1,301
3. Materials:
# of
Items Total
1 5 $800
2 524.66 $262
3 1 $336
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$1,398
4. Travel:
Location Trips FTE Days Nights Per Diem Lodging Air Miles
@ $.54 Reg. Fee Other Total
1
Fresno County /Regional
Travel 1 1.00 0 0 $0.00 $0.00 0 2,400 $0.00 $58.00 $1,450
2 Sacramento 1 2.00 1 1 $46.00 $110.00 0 400 $0.00 $25.00 $416
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
11 $0
12 $0
13 $0
Project Director/ John
Capitman,Project Manager/
Emanel Alcala, Health Education
Specialsih/Hayam Megally,
Research Assistant/ Yesenia Silva,
Project Manager/ Emanuel Alcala,
Health Education
Specialist/Hayam Megally
Total Materials:
Position Title/Name Description/ Justification
Mileage, Other = Parking
downtown
NEOP Training/Meeting,
Other = parking
In-State
Printing Training and evaluation materials 0.5
evaluation software Licensing Licensing evaluation software for SPSS 336
Budget Item Description/Justification Cost per Item
Transcription Key informant interviews 160
Total Supplies:
Theft-sensitive equipment/supplies that are less than $5,000 (Computers, printers, projectors, etc.)
Exhibit C, Page 8 of 10
14 $0
15 $0
16 $0
18 $0
19 $0
20 $0
21 $0
22 $0
$1,866
5. Building/Space:
FTE # of
Mo(s).Total
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
$0
6. Maintenance:
FTE # of
Mo(s).Total
1 1.35 12 $2,430
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$2,430
7. Equipment and Other Capital Expenditures:
FTE # of
Items Misc.Total
1 $0
2 $0
3 $0
4 $0
5 $0
6 $0
7 $0
8 $0
9 $0
10 $0
$0
8. Indirect Costs:
Total
1 $21,60025.00%$86,400.00
Calculation Method Indirect Cost Rate Total Admin/Program
Dollars
Total Maintenance:
Budget Item Description/Justification Cost per Item
Communications Phone, fax, and internet $150.00
Total Building/Space:
Location Name/Address Calculation Description Cost per Month
Location Name/Address Calculation Description Cost per Month
Total Travel:
Out-of-State
Exhibit C, Page 9 of 10
$21,600
$108,000
Total Indirect Costs:
Total Year 3 Budget:
Exhibit C, Page 10 of 10
SECTION 1. STAFFING
Position Title:Identify the employee's position title.
Name:Identify the employee's name associated with the title. If vacant, enter "vacant." Once the
position is filled, insert a name and submit to the funding agency.
FTE:Enter full-time equivalent prorated based on percentage of time they will work throughout the
funding year. Note: if an employee does not work an entire 12 months, or is not employed full
time, their FTE should not be 1.0.
SNAP-Ed Time Spent:Identify percent SNAP-Ed time spent on direct delivery and on administrative duties. These two
columns must equal 100%, even for less than 1.0 FTE employees.
Administrative duties include processing purchase orders, preparing invoices, collecting time
and effort reports, and general clerical services such as answering phones, ordering supplies,
preparing correspondence, etc.
Direct delivery duties include nutrition education in the classroom, food demonstrations,
community outreach activities, physical activity promotion, nutritional aspects of gardening, etc.
Annual Salary:Identify salary only, not including benefits. When converting a monthly, weekly, hourly, etc.,
salary, use the standard 52 week year or 2080 hours/year to make the calculation.
Total SNAP-Ed Salary:This will automatically calculate based on annual salary and FTE.
Benefit Rate:Enter the percentage rate of benefits. This can be different for individual positions. Identify what
costs are included in the benefit rate beneath the staffing table.
Total SNAP-Ed Benefits:This will automatically calculate based on total SNAP-Ed salary and benefit rate.
SNAP-Ed Admin Costs:This will automatically calculate based on FTE, percent SNAP-Ed time spent on
management/administrative duties, and total SNAP-Ed funded salary and benefits.
Total SNAP-Ed Funding Salary
and Benefits:
This will automatically calculate based on total SNAP-Ed salary and benefits.
SECTION 2. NON-CAPITAL EQUIPMENT/SUPPLIES
Common items:Office supplies, postage, theft-senstive equipment <$5,000 (e.g., computers, projectors,
printers, copiers)
Budget item:This should be simple and to the point (e.g. Computers).
Description/ Justification:Summarize the budget item (e.g., Computer to complete activities outlined in the scope of
work). List employee(s) associated with the item.
FTE:Costs must be prorated based on FTE of associated employee(s).
Number of Items:Enter the total number of items or items per FTE
SECTION 3. MATERIALS
Common items:Items to be distributed to the community (e.g., publications, printing costs, educational
materials, garden supplies, food for taste testing)
Budget item:This should be simple and to the point (e.g. Food Demonstration Cart).
Description/ Justification:Summarize the budget item and use. Provide a cost breakdown of all expenses including cost,
number of items/participants, number of events and time.
SECTION 4. TRAVEL AND PER DIEM
Refer to CalHR Travel information for allowable costs and maximum rates.
The following may be left blank if appropriate:
Per Diem:Enter daily per diem rate (not total).
Lodging:Enter nightly lodging rate, including tax.
Air:Enter the total amount of airfare, including tax.
NEOP Nutrition Education Budget Instructions Exhibit C
Miles:Enter the number of miles for each travel line item. The formula will calculate based on the
current mileage reimbursement rate of $0.54.
Registration (Reg.) Fee:Enter the registration fee of conference, etc. for one person. The formula will calculate based on
the FTE provided in the line item.
Other:May include train fare, parking, tolls, taxi, etc. Provide details in Description/Justification
column.
SECTION 5. BUILDING/SPACE
Common items:Office space rent, storage units
Calculation Description:Summarize the approved monthly rental space area and cost per unit area (e.g., 200 sq. ft. x
$2.50/sq. ft. = $500 per FTE).
FTE:Enter total FTE from Section 1. Staffing.
Cost per month:Enter monthly cost as specified in the Calculation Description.
SECTION 6. MAINTENANCE
Common items:Utilities, phones, internet, security, insurance, janitorial
Calculation Description:Describe the service and enter the monthly rate for the line item.
FTE:Enter total FTE from Section 1. Staffing if the calculation is per FTE. Otherwise, enter "1."
Cost per month:Enter monthly cost as specified in the Calculation Description.
SECTION 7. EQUIPMENT AND CAPITAL EXPENDITURES
Common items:Items with a useful life of more than one year and a unit cost of $5,000 or more. Requires a
written justification and prior approval.
Misc:Enter the dollar amount for shipping and handling and any other related costs. Provide details in
the Description/Justification column.
SECTION 8. CONSULTANTS
Organization Name:Enter the consultant name. If the organization will be determined at a later time, enter "vacant."
Once the position is filled, enter the name and submit to the funding agency.
Description of Services:Summarize the work that will be performed by the consultant and provide a justification.
INDIRECT COSTS
Calculation Method:Describe the basis of calculation (e.g., total personnel, total direct costs)
Indirect Cost Rate:Enter your organization's standard indirect cost rate.
Total Admin/Program
Dollars:
Enter the total amount identified in the Calculation Method.
Subcontracting is not allowed under this RFP. Bidders may, however, list consultants that provide services on an hourly, per-
Common Position Titles Description
Accountant/Finance
Analyst
Serves as internal auditor and controller. Assists with processing purchase orders, invoices, preparation of vouchers for payment as
related to the Network program, as well as monitoring the budgets.
Administrative Coordinator Provides administrative and office support for the project staff and is responsible for the reporting requirements.
Administrator (e.g.,
Director of Programs)
Administer the nutrition education grant agreement and budget, supervising nutrition education staff, attend nutrition education and
scope of work related meetings, program planning and participating in the Regional collaborative. Coordinate grant agreement reporting
requirements.
After School
Coordinator/Assistant
Plan and facilitate nutrition education activities for recreation programming, in after school setting for different age groups of children;
seniors, teen; special populations, such as mothers with young children and families; nutrition education for special events and
workshops. Prepare instructional plans for youth camps and field trips; and nutrition education for special events and workshops. Prepare
instructional plans for nutrition activities, collect data related to nutrition education programming, prepare documentation for nutrition
education grant agreement; and help prepare interim and final progress report.
Chief Executive Officer Provides overall guidance for the operations, personnel, and fiscal responsibilities required by the nutrition project.
Community Liaison
Conducts nutrition education, physical activity promotion interventions in the community setting. Works with Community Based
Organizations to increase the reach of nutrition education interventions to Nutrition Education Obesity Program eligible.
Computer Specialist The Computer Specialist will provide assistance with the nutrition database and tracking system.
Contract Manager
Manages the nutrition education grant agreement including budgets, invoices, local share documentation reports, time studies, fiscal
reporting and adherence to funding requirements.
Coordinator of Other
Program (e.g., Teen
program, Healthy Start,
etc.)
Supervises, coordinates, and facilitates nutrition education activities, workshops, special events related to the recreation and community
center planning and working together with other community center groups. Supervises staff implementing the nutrition education grant
agreement, prepares invoices, prepares and collects documentation, prepares progress reports
Curriculum Specialist Develops curriculum for nutrition education and physical activity interventions in a variety of different channels/venues.
Database Coordinator Develops database used to track nutrition education, physical activity and food stamp promotion interventions in a variety of channels.
Dental/Medical Assistant Conduct one-on-one nutrition education interventions prior to primary care visit.
Dietician
Oversees and supervises the nutrition education program including project administration, project coordination, the development of the
nutrition education component and materials and other nutrition and physical activity promotion programs.
Family Advocate
Provides nutrition education to students and their families, and recruits NEOP eligible for group nutrition/cooking classes. Provides
nutrition, physical activity and food stamp promotion resources to students and their parents.
Food Service Worker (e.g.,
Director, Manager, Asst.,
Server, Cook)
Assists with planning and preparing healthy food taste tests in the school setting in conjunction with classroom based nutrition education
intervention. Works with teachers to increase student, teacher and parent knowledge of the importance of consuming more servings of
fruits and vegetables and being active daily. Compiles documentation on taste testing activities and all reporting required for nutrition
grants. In some cases, supervises staff that carries out activities.
Graphic Illustrator
Develop local promotional nutrition education materials such as community flyers/ newsletters and/or to develop local nutrition/physical
activity promotional/educational materials under the direction of the nutrition staff.
Health Educator (including
Health Aide, Health
Promotion Instructor, etc.)
Develop materials and facilitate health education in both group and individual settings. Teaches general nutrition, the importance of fruits
and vegetables, and health benefits of proper nutrition and physical activity.
Legal Counsel
Assist with development of policies, approval of grant agreements and Memorandums of Understanding and providing legal advice
specifically related to the implementation of nutrition education and physical activity promotion
Medical Assistant
Demonstrates safe food handling and personal hygiene to prevent food borne illness; provide nutrition-related services to staff, parents,
and students and promotes physical activity within the context of nutrition education. (This does not include any medical nutrition
therapy).
Nurse/Nurse
Supervisor/Nurse Aide RN
Provides nutrition and physical activity promotion to students enrolled in nutrition education programs and their families. Supports
nutrition education goals through interventions; local, regional, and statewide collaboration and interventions. (This does not include any
medical nutrition therapy).
Nutritionist/Nutrition
Educator/Nutrition Aide
Provides nutrition education to the SNAP eligible population. Specific duties include: one-on-one general nutrition education, delivery of
general nutrition education in a classroom or group setting, staffing health fairs and other community or promotional events where
nutrition education messages are delivered, distribution of linguistically and culturally appropriate nutrition education materials,
documentation of educational and other encounters, assisting with writing project reports and preparation of quarterly reports,
maintaining program reporting and tracking systems.
Office
Manager/Secretary/Admin
Assistant
Provides general clerical support to the Program. Assists in development and maintenance of a data collection system with emphasis on
fiscal information. Arranges meetings and trainings, orders supplies and materials, creates correspondence, photocopies, etc.
Pharmacist
Promotes nutrition education and physical activity to NEOP eligible population through displays, distributing literature, and supervising
staff to update nutrition education bulletin board.
Physician
Supervises professional staff including Dieticians, Nurses and Nutrition/Project Coordinators that provide nutrition education and
promotes physical activity to SNAP eligible in a variety of channels. Provides direction on strategic planning of nutrition and physical
activity programs to NEOP eligible clients. In some cases, provides nutrition education to SNAP eligible. (This does not include any medical
nutrition therapy).
Professor
Coordinates, facilitates, modifies, develops, and demonstrates lessons on nutrition and promotes physical activity for the NEOP eligible
community, and students with their families. Supports nutrition education Program goals and local, regional, and statewide collaboration.
Program Assistant
Assists the Project Coordinator with nutrition education program planning and development. Under the direction of Project Coordinator,
works directly with individuals and small groups providing curriculum-based, prevention-oriented general nutrition education and physical
activity targeted to SNAP eligible.
Project Coordinator
Coordinate program staff and nutrition education activities; plan and follow through on outreach and educational events at health fairs,
schools, and other promotional activities; work with schools, churches, farm worker organizations, and community organizations in
planning and promoting good health through dissemination of nutrition education materials; actively acquire and develop culturally and
linguistically competent nutrition curriculum and educational materials; to promote existing and/or to develop new physical activity
promotional components of nutrition education; and expand our existing community outreach program to encompass nutritional
components to increase community awareness and knowledge of good nutrition and healthy active lifestyles.
Promotora
Works with the Project Coordinator in NEOP communities to conduct nutrition education interventions and participate in local events to
promote health eating and physical activity for SNAP eligible.
Recreation Leader
Mentors and trains staff on integration of physical activity into nutrition education interventions. Coordinates one-time physical activity
demonstrations. Chooses nutrition and physical activity resources to distribute with nutrition education interventions.
Research Specialist
Evaluates nutrition education, and physical activity promotion interventions in a variety of community channels. Methods can include
process and impact evaluations, pre and post tests, surveys, focus/discussion roundtables, photo documentaries, case studies, etc.
School Administrator (e.g.,
Principal, Superintendent)Provides oversight and coordination of the nutrition education conducted in participating classrooms of all schools.
Teacher/Student
Aide/Assistant
Assists the Nutritionists, Health Educators, and Project Coordinator with nutrition education activities and community events that
promote healthy eating and physical activity for low-income families, the target population, Food Stamp recipients and other similar
households. 100% direct delivery of educational services.
Teacher (preK-12
Classroom, PE, Speech,
etc.)
Coordinates, facilitates, modifies, develops, and demonstrates lessons on nutrition and promotes physical activity for students and their
families. Supports nutrition education program goals through promotion; local, regional, and statewide collaboration; and close
coordination with the Registered Dietitian to train staff.
Translator
Translates approved curriculum and materials into Spanish or other languages. Reviews translation for cultural appropriateness. Interprets
nutrition education interventions (one-on-one and group) in the community for dieticians, health educators and others.
Tutor Assist teachers and/or students with nutrition education and physical activity promotion.
Web Designer Develops and maintains website containing nutrition education resources, gardening and health related topics and issues.
County of Fresno
16‐10139
Page 1 of 3
EXHIBIT D
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.
County of Fresno
16‐10139
Page 2 of 3
7. FISCAL MANAGEMENT SYSTEMS AND 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.
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 GRANTEE: 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.
County of Fresno
16‐10139
Page 3 of 3
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 Request for Applications (Exhibit D) and the Grant Application
(Exhibit A).
Establish an official file for the Project which shall adequately document all
significant actions relative to the Project;
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;
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;
Establish an accounting system which will adequately depict final total
costs of the Project, including both direct and indirect costs; and,
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.
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, County of
Sacramento, California. Grantee waives any existing sovereign immunity for
the purposes of this Grant, if applicable.
Exhibit E
Page 1 of 2
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as “County”),
members of a contractor’s board of directors (hereinafter referred to as “County Contractor”), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
“A self-dealing transaction means a transaction to which the corpora tion is a party and in which one
or more of its directors has a material financial interest .”
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member’s name, job title (if applicable), and dat e this disclosure is being made.
(2) Enter the board member’s company/agency name and address.
(3) Describe in detail the nature of the self -dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the Corporation has the transaction;
and
b. The nature of the material financial interest in the Corporation’s transaction that the
board member has.
(4) Describe in detail why the self -dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self -dealing transaction
described in Sections (3) and (4).
Exhibit E
Page 2 of 2
(1) Company Board Member Information:
Name: Date:
Job Title:
(2) Company/Agency Name and Address:
(3) Disclosure (Please describe the nature of the self-dealing transaction you are a party to):
(4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233 (a):
(5) Authorized Signature
Signature: Date: