HomeMy WebLinkAbout32122Exhibit A
Scope of Work
A.PRIORITIES IDENTIFIED BY CDPH AND LOCAL LEADERSHIP INCLUDING
COUNTY HEALTH EXECUTIVES ASSOCIATION OF CALIFORNIA AND
CALIFORNIA CONFERENCE OF LOCAL HEALTH OFFICERS
1-Public Health activities:
• Build local public health capacity and capability for response to infectious
diseases,with a focus on EVD,addressing the capabilities as stated in the
PHEP Supplemental for Ebola Preparedness and Response Activities
grant guidance,including:
o Community Preparedness;
o Public Health Surveillance and Epidemiological Investigation;
o Public Health Laboratory Testing;
o Non-Pharmaceutical Interventions;
o Responder Safety and Health;
o Emergency Public Information and Warning/Information Sharing;
and
o Medical Surge.
•Train LHD staff including non-nursing allied staff to assist with surveillance
and epidemiologic investigations,including basic contact investigation and
tracing,to provide surge capacity at the local level.
•Conduct active monitoring and direct active monitoring of travelers from
Ebola-affected countries.Jurisdiction will develop/maintain a written plan,
protocol,and/or procedure for traveler monitoring,including all elements
as defined in the CDPH document "Planning for and Management of
Travelers from Ebola-Affected Countries and U.S.Ebola Case Contacts
for Local Health Departments"(November 17,2014)and other CDC
recommendations for traveler monitoring.
•Enhance hospital readiness,capability,and capacity for management of
suspected/confirmed Ebola cases at all levels,including Ebola Frontline,
Assessment,and Treatment hospitals and community-based (e.g.,at
home)quarantine and isolation.
•Enhance/implement the CalREDIE Provider Portal within the jurisdiction to
allow local providers,especially Ebola treatment and assessment
hospitals/infection control,direct entry into the system for efficient and
timely reporting of Ebola suspected/confirmed cases and other infectious
diseases and the monitoring/reporting of healthcare workers post Ebola
patient care.
2.EMS related activities:
Exhibit A
Scope of Work
•Develop EMS safety and health guidance,protocols,and procedures for
transport of suspected/confirmed cases of Ebola and other infectious
diseases.
•Conduct training for EMS personnel for EVD and other infectious disease
transportation,including proper use,donning,and doffing of PPE,
interfacing with healthcare facilities,decontamination of the rigs,and
follow up monitoring should a case be confirmed for EVD.
•Conduct exercises that test coordination,communication and capability to
safely and effectively transport suspect/confirmed Ebola cases,and other
infectious disease cases,within and across jurisdictions,including State
and local and public health and medical (healthcare)partners.
•Improve labor intensive emergency medical dispatch systems including
consideration/implementation of new pre-arrival software and other
enhancements to the dispatching system.
B.LABORATORY TESTING/CAPACITY FUNDING CRITERIA (IF APPLICABLE)
Currently,there are four public health laboratories (PHLs)certified to perform Ebola RT-
PCR testing in California,including the CDPH Viral and Rickettsial Diseases Laboratory
(Richmond,CA),Sacramento County,Los Angeles County and Orange County.The
intent of the available funding for laboratory preparedness is to increase the number of
PHLs capable of testing for Ebola RT-PCR with a focus on enhancing geographic
distribution of laboratories to serve rural areas and assessment hospitals that will be
identified in the State.
Selection for LHDs for Ebola Supplemental laboratory funding will be prioritized based
on the following criteria:
• A public health laboratory located greater than 1-2 hours driving time from a PHL
currently able to conduct Ebola RT-PCR testing.
•Proximity of the PHL to an identified/proposed jurisdiction with an assessment
hospital.
•Jurisdictions with an Ebola Treatment hospital but without a PHL that is able to
conduct Ebola RT-PCR testing will be given higher priority.PHLs near the
currently certified labs may be considered for funding to enhance
Ebola/infectious disease capability within a region,on a case-by-case basis to
enhance overall capacity within the region/geographic area.
•While the highest priority for this funding is to expand current capacity,PHLs with
current capability for Ebola RT-PCR testing may apply for funding to sustain
and/or enhance current Ebola RT-PCR and other infectious disease capability
and capability.
Public Health Emergency Preparedness Supplemental Funding for Ebola
Preparedness and Response Funding
NON-SUPPLANTATION CERTIFICATION FORM
-•• i!i + 17,'''""'"'".,.""''""''""~-,--,· ..••
~arne of Local Entity: County of Fresno
As the duly authorized representative of the above-named County, I hereby certify as
follows:
1. The funds allocated by the California Department of Public Health (CDPH) under
the Agreement will not be used to supplant funding for existing levels of service
and shall only be used for the purposes specified in the Agreement.
2. Upon receipt, the funds will be deposited into an interest-bearing local public
health preparedness trust fund established solely for this purpose before the
funds are transferred or expended for any of the purposes allowed in the
Application Work Plan and Budget, as approved by the CDPH.
Chairperson, Board of Supervisors, Mayor of a City or designee:
Signature:
Printed Name: Deborah A. Poochigian
I Title: Chairman, Board of Supervisors
559-600-5000
Date:
Please return the original · ned certification with your PHEP Supplemental Funding for
Ebola Preparedness and Response Funding Agreement:
California Department Public Health
Emergency Preparedness Office
Attn: Local Management Unit
MS 7002
P.O. Box 997377
Sacramento, CA 95899-7377
Page 1 ofl
Fresno County
14-10891
Exhibit B
Budget Detail and Payment Provisions
1.Invoicing and Payment
A.Invoices shall include the Number of the Agreement Allocating Funds and shall be submitted
in not more frequently than monthly in arrears to:
ebolafunds@cdph.ca.gov
In the subject line,please identify "PHEP Ebola Invoice"and your County Name.
B.Invoices shall:
1) Be prepared on Awardee's letterhead.If invoices are not on produced letterhead,invoices
must be signed by an authorized official,employee or agent certifying that the expenditures
claimed represent activities performed and are in accordance with ExhibitA,Application and
Work Plan.
2)Bear the Awardee's name as shown on the Agreement Allocating Funds.
3) Identify the billing and/or performance period covered by the invoice.
4) Itemize costs for the billing period inthe same or greater level of detail as indicated in this
Award.Subject to the terms ofthis Award,reimbursement may only be sought for those
costs and/or cost categories expressly identified as allowable, and approved by CDPH.
2.Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years
covered under this Agreement Allocating Funds does not appropriate sufficient funds for the
program, this Award shall be of no further force and effect. Inthis event, the Department shall
have no liability to pay any funds whatsoever to Awardee or to furnish any other considerations
under this Award and Awardee shall not be obligated to perform any tasks or to fulfill any
provisions of this Award.
If funding for any fiscal year is reduced or deleted by the Budget Actfor purposes of this
program, the Department shall have the optionto either cancel this Agreement Allocating Funds
with no liability occurring to the Department, or offer an amendment to reflect a change in the
amount of the Award.
3.Prompt Payment Clause
Payment will be made in accordance with,and within the time specified in,Government Code
Chapter 4.5,commencing with Section 927.
4.Amounts Payable
A.The amounts payable under this Award shall not exceed:
1)$84,445.00 for the federal budget period of 07/01/15 through 09/30/16.
B.Payment allocations shall be made for allowable expenses up to the amount annually
encumbered commensurate with the Department's fiscal year in which the activities in the
Work Plan were conducted.
Page 1 of 2
Fresno County
14-10891
Exhibit B
Budget Detail and Payment Provisions
5.Timely Submission of Final Invoice
A. A final undisputed invoice shall be submitted for payment no more than thirty (30)calendar
days following the expiration or termination date of this Award,unless a later or alternate
deadline is agreed to inwriting by the program grant manager.Said invoice should be
clearly marked "Final Invoice", indicating that all payment obligations of the Department
under this Award have ceased and that no further payments are due or outstanding.
B. The Department may, at its discretion,choose not to honor any delinquent final invoice if the
Awardee fails to obtain prior written Department approval of an alternate final invoice
submission deadline.
6.Travel and Per Diem Reimbursement
Any reimbursement for necessary travel and per diem shall be at the rates currently in effect as
established by the California Department of Human Resources (CalHR).
Page 2 of 2
Exhibit C
STANDARD AWARD CONDITIONS
1.APPROVAL:This Award is of no force or effect until signed by both parties and
approved by the Department of General Services,if required.The Awardee may not
commence performance until such approval has been obtained
2.AMENDMENT:No amendment or variation of the terms of this Agreement
Allocating Funds shall be valid unless made in writing,signed by the parties,and
approved as required.No oral understanding or Agreement not incorporated in the
Award 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,Application and Work Plan.
3.ASSIGNMENT:This Award is not assignable by the Awardee,either
in whole or in part,without the written consent of the Award Manager in the
form of a written amendment to the Award.
4. AUDIT:Awardee 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 Award.
Awardee agrees to maintain such records for a possible audit for a minimumof
three (3)years after final payment or completion of the project funded withthis
Award,unless a longer period of records retention is stipulated.Awardee
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,Awardee agrees to include a
similar right of the Department to audit records and interview staff in any sub-
Award or contract related to the project.
5.CONFLICT OF INTEREST:Awardee certifies that it is in compliance
with all applicable state and/or federal conflict of interest laws.
6. INDEMNIFICATION:Awardee 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
supplyingwork 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 Awardee in the performance
of any activities related to the Project.
7.FISCAL MANAGEMENT SYSTEMS AND ACCOUNTING STANDARDS:
Awardee agrees that, at a minimum,itsfiscal control and accounting procedures
Page 1 of 3
Exhibit C
STANDARD AWARD CONDITIONS \
will be sufficientto permit tracing ofallAwardfunds to a levelof 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 Award.Awardee further
agrees that it will maintain separate Project accounts in accordance with generally
accepted accounting principles.
8. GOVERNING LAW:This Award is governed by and shall be interpreted in
accordance with the laws of the State of California.
9. INCOME RESTRICTIONS:Awardee agrees that any refunds,rebates,
credits,or other amounts (including any interest thereon)accruing to or
received by the Awardee under this Award shall be paid by the Awardee to the
Department,to the extent that they are properly allocable to costs for which the
Awardee has been reimbursed by the Department under this Award.
10.INDEPENDENT ACTOR:Awardee,and the agents and employees of
Awardee,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:Awardee shall notify the Department's Award
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 Awardee do not
intend to create any rights or remedies for any third-party as a beneficiary of
this Award or the project.
13. NOTICE:Awardee shall promptly notify the Department's Award
Manager in writing of any events,developments or changes that could affect
the completion of the project or the budget approved for this Award.
14.PROFESSIONALS:Awardee agrees that only licensed professionals
will be used to perform services under this Award where such services are
called for.
Page 2 of 3
Exhibit C
STANDARD AWARD CONDITIONS j
15.RECORDS:Awardee certifies that it will maintain Project accounts
in accordance with generally accepted accounting principles.Awardee
further certifiesthat it will comply with the following conditionsforan Award as
set forth in the Request forApplications (Exhibit D)and the Award Application
(Exhibit A).
•Establish an officialfilefor 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 Award funds
received under this Award;
•Establish separate accounts which will adequately depict all income
received which is attributable to the Project,especially including any income
attributable to Award funds disbursed under this Award;
•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 Awardee use funds from
any disbursement under this Award to pay for costs associated with any litigation
between the Awardee and the Department.
17.RIGHTS IN DATA:Awardee 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,Application and
Work Plan,in the performance of the Project funded by this Award shall be in the
public domain.Awardee 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.Awardee shall not utilize the materials submitted to the
Department (except data)for any profit making venture or sell or Award 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 Awardee agree that any action arising
out of this Award shall be filed and maintained in the Superior Court,County
of Sacramento,California.Awardee waives any existing sovereign immunity
for the purposes of this Award,if applicable.
Page 3 of 3
Fresno County
14-10891
Exhibit D
Additional Provisions
1.Additional Incorporated Documents
A.The following documents and any subsequent updates are not attached,but are
incorporated herein and made a part hereof by this reference.These documents may be
updated periodically by Department, as required by program directives.Department shall
provide the Awardee with copies ofsaid documents and any periodic updates thereto,under
separate cover. Department will maintain on file,all documents referenced herein and any
subsequent updates.
1.Request for Application (RFA)15-0001.
2.Public healthEmergencyPreparedness (PHEP)Ebola Supplemental Agreement (CDC-
RFA-TP12-12010302SUPP15).
2.Cancellation /Termination
A. This Award may be cancelled byDepartment without cause upon thirty (30)calendar days
advance written notice to the Awardee.
B.Departmentreserves the right to cancel orterminatethis Award immediately for cause.The
Awardee may submit a written request to terminate this Award only if Department
substantially fails to perform its responsibilities as provided herein.
C.The term "for cause"shall mean that the Awardee fails to meet the purpose,conditions,
and/or responsibilities ofthis agreement.Causes for termination include,butare not limited
to the following occurrences:
1)If the Awardee knowingly furnishes any statement,representation,warranty, or
certification in connection with the agreement,which representation is materially false,
deceptive,incorrect,or incomplete.
2)If theAwardee fails to perform any material requirement ofthis Award ordefaults in
performance of this Award.
3)If theAwardee files for bankruptcy,or if Department determinesthat the Awardee
becomes financially incapable of completing this agreement.
D.Award termination or cancellation shall be effective as of the date indicated in Department's
notificationto the Awardee. The notice shall stipulate any final performance,invoicing or
payment requirements.
E.In the event of early termination or cancellation, the Awardee shall be entitled to
reimbursement forservices performed satisfactorily under this award and expenses incurred
upto the date of cancellation and any non-cancelable obligations incurred in support of this
Award.
F. In the event of termination, and at the request of Department,the Awardee shall furnish
copies of all proposals,specifications,designs, procedures,layouts,copy,and other
Page 1 of 3
Fresno County
14-10891
Exhibit D
Additional Provisions
materials related to the services or deliverables provided under this Award,whether finished
or in progress on the termination date.
G.The Awardee will not be entitled to reimbursement for any expenses incurred for services
and deliverables pursuant to this Award after the effective date of termination.
H. Upon receipt of notification oftermination ofthis Award, and except as otherwise specified
by Department,the Awardee shall:
1)Place no further order or sub-Awards for materials,services,or facilities.
2) Settle alloutstanding liabilities and all claims arising out of such termination of orders
and sub-Awards.
3) Uponthe effective date of termination ofthe Award and the payment by Department of
all items properly chargeable to Department hereunder, Awardee shall transfer, assign
and make available to Department all property and materials belonging to Department,
all rights and claims to any and all reservations, Awards, and arrangements with owners
of media/PR materials,or others,and shall make available to Department all written
information regarding Department's media/PR materials, and no extra compensation is
to be paid to Awardee for its services.
4) Take such action as may be necessary,or as Department may specify,to protect and
preserve any propertyrelated to this agreement which is in the possession ofthe
Awardee and in which Department has or may acquire an interest.
I.Department may,at its discretion,requirethe Awardeeto cease performanceofcertain
components ofthe Work Plan as designated byDepartmentand complete performanceof
other components prior to the termination date of the Award.
Avoidance of Conflicts of Interest by Awardee
A.Department intends to avoid any realor apparent conflict ofinterestonthe partofthe
Awardee,sub-Awardees,or employees, officersand directors ofthe Awardee or sub-
Awardees. Thus, Department reserves the right to determine, at itssole discretion,whether
any information,assertion or claim received from anysource indicatesthe existence ofa
real or apparent conflict of interest;and,if a conflict is found to exist,to require the Awardee
to submit additional informationor a plan for resolving the conflict,subject to Department
review and prior approval.
B.Conflicts of interest include,but are not limited to:
1)An instance wherethe Awardee or any ofits sub-Awardees,or any employee,officer,or
director ofthe Awardee or any sub-Awardee or has an interest, financial or otherwise,
whereby the use or disclosureof information obtained while performing services under
the Award would allowfor private or personal benefit or for any purpose that is contrary
to the purposes,goals and objectives of the Award.
Page 2 of 3
Fresno County
14-10891
Exhibit D
Additional Provisions
2) An instance where the Awardee's or any sub-Awardee's employees,officers,or directors
use their positions for purposes that are,or give the appearance of being,motivated by a
desire for private gain for themselves or others,such as those with whom they have
family,business or other ties.
C. If Department is or becomes aware of a known or suspected conflict of interest,the
Awardee will be given an opportunity to submit additional information or to resolve the
conflict. An Awardee with a suspected conflict of interest will have five (5) working days
from the date of notification of the conflict by Department to provide complete information
regarding the suspected conflict.Ifa conflict of interest is determined to exist by
Department and cannot be resolved to the satisfaction of Department,the conflict will be
grounds for terminating the Award.Department may, at its discretion upon receipt of a
written request from the Awardee,authorize an extension of the timeline indicated herein.
Page 3 of 3
State of California-Health and HumanServices Agency California Department of PublicHealth
Exhibit F
Federal Terms and Conditions
(For federally funded Grant agreements)
The use of headings or titles throughout this exhibit is for convenience only and shall not be used to interpret or to
govern the meaning of any specific term or condition.
The terms "Grantee"and "SubGrantee"shall also mean,"agreement","grant", "grant agreement","Grantee"and
"Subgrantee"respectively.
The terms "California Department of Public Health"and "CDPH" shall have the same meaning and refer to the
California State agency that is a party to this Agreement.
This exhibit contains provisions that require strict adherence to various contracting laws and policies.
Index of Special Terms and Conditions
1.Federal Funds
2.Federal Equal Employment Opportunity Requirements
3.Debarment and Suspension Certification
4.Covenant Against Contingent Fees
5. Air or Water Pollution Requirements
6. Lobbying Restrictions and Disclosure Certification
7.Additional Restrictions
(Rev.7/14)Page 1of8
Exhibit F
1.Federal Funds
(Applicable only to that portion of an agreement funded in part or whole with federal funds.)
a. It is mutually understood between the parties that this Grant may have been written before ascertaining
the availability of congressional appropriation of funds, for the mutual benefit of both parties,in order to
avoid program and fiscal delays which would occur if the Grant were executed after that determination
was made.
b. This Grant is valid and enforceable only if sufficient funds are made available to the State by the United
States Government for the fiscal years covered by the term of this Grant.In addition, this Grant is subject
to any additional restrictions,limitations, or conditions enacted by the Congress or any statute enacted by
the Congress which may affect the provisions,terms or funding of this Grant in any manner.
c. It is mutually agreed that ifthe Congress does not appropriate sufficient funds for the program,this Grant
shall be amended to reflect any reduction in funds.
d.CDPH has the option to invalidate or cancel the Grant with 30-days advance written notice or to amend
the Grant to reflect any reduction in funds.
2.Federal Equal Opportunity Requirements
(Applicable to all federally funded grants entered into by the California Department of Public Health (CDPH)
formerly known as California Department of Health Services (CDHS).)
a.The Grantee will not discriminate against any employee or applicant for employment because of race,
color, religion,sex,national origin,physical or mental handicap,disability,age or status as a disabled
veteran or veteran of the Vietnam era.The Grantee will take affirmative action to ensure that qualified
applicants are employed,and that employees are treated during employment,without regard to their race,
color, religion,sex,national origin,physical or mental handicap,disability,age or status as a disabled
veteran or veteran of the Vietnam era.Such action shall include,but not be limited to the following:
employment,upgrading,demotion or transfer;recruitment or recruitment advertising;layoff or termination;
rates of pay or other forms of compensation;and career development opportunities and selection for
training,including apprenticeship.The Grantee agrees to post in conspicuous places,available to
employees and applicants for employment,notices to be provided by the Federal Government or CDPH,
setting forth the provisions of the Equal Opportunity clause,Section 503 of the Rehabilitation Act of 1973
and the affirmative action clause required by the Vietnam Era Veterans'Readjustment Assistance Act of
1974 (38 U.S.C.4212).Such notices shall state the Grantee's obligation under the law to take affirmative
action to employ and advance in employment qualified applicants without discrimination based on their
race,color, religion,sex,national origin physical or mental handicap,disability,age or status as a disabled
veteran or veteran of the Vietnam era and the rights of applicants and employees.
b.The Grantee will,in all solicitations or advancements for employees placed by or on behalf of the Grantee,
state that all qualified applicants will receive consideration for employment without regard to race,color,
religion,sex,national origin physical or mental handicap,disability,age or status as a disabled veteran or
veteran of the Vietnam era.
c.The Grantee will send to each labor union or representative of workers with which it has a collective
bargaining agreement or other contract or understanding a notice, to be provided by the Federal
Government or the State,advising the labor union or workers'representative of the Grantee's
commitments under the provisions herein and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
d.The Grantee will comply with all provisions of and furnish all information and reports required by Section
503 of the Rehabilitation Act of 1973,as amended,the Vietnam Era Veterans'Readjustment Assistance
Act of 1974 (38 U.S.C.4212)and of the Federal Executive Order No.11246 as amended,including by
Executive Order 11375,'Amending Executive Order 11246 Relating to Equal Employment Opportunity,'
and as supplemented by regulation at 41 CFR part 60, "Office of the Federal Contract Compliance
Programs,Equal Employment Opportunity,Department of Labor,"and of the rules,regulations,and
relevant orders of the Secretary of Labor.
(Rev.7/14)Page 2 of 8
Exhibit F
e. The Grantee will furnish all information and reports required by Federal Executive Order No.11246 as
amended,including by Executive Order 11375, 'Amending Executive Order 11246 Relating to Equal
Employment Opportunity,'and as supplemented by regulation at 41 CFR part 60, "Office of the Federal
Contract Compliance Programs,Equal Employment Opportunity,Department of Labor," and the
Rehabilitation Act of 1973,and by the rules, regulations, and orders of the Secretary of Labor,or pursuant
thereto,and will permit access to its books,records,and accounts by the State and its designated
representatives and the Secretary of Labor for purposes of investigation to ascertain compliance with such
rules,regulations,and orders.
f.In the event of the Grantee's noncompliance with the requirements of the provisions herein or with any
federal rules, regulations, or orders which are referenced herein, this Agreement may be cancelled,
terminated,or suspended in whole or in part and the Grantee may be declared ineligible for further federal
and state contracts in accordance with procedures authorized in Federal Executive Order No.11246 as
amended and such other sanctions may be imposed and remedies invoked as provided in Federal
Executive Order No.11246 as amended,including by Executive Order 11375,'Amending Executive Order
11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60,
"Office of the Federal Contract Compliance Programs,Equal Employment Opportunity,Department of
Labor," or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law.
g. The Grantee will include the provisions of Paragraphs a through g in every subcontract or purchase order
unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Federal
Executive Order No.11246 as amended,including by Executive Order 11375,'Amending Executive Order
11246 Relating to Equal Employment Opportunity,' and as supplemented by regulation at 41 CFR part 60,
"Office of the Federal Contract Compliance Programs,Equal Employment Opportunity,Department of
Labor," or Section 503 of the Rehabilitation Act of 1973 or (38 U.S.C.4212)of the Vietnam Era Veteran's
Readjustment Assistance Act, so that such provisions will be binding upon each SubGrantee or vendor.
The Grantee will take such action with respect to any subcontract or purchase order as the Director of the
Office of Federal Contract Compliance Programs or CDPH may direct as a means of enforcing such
provisions including sanctions for noncompliance provided,however, that in the event the Grantee
becomes involved in, or is threatened with litigation by a SubGrantee or vendor as a result of such
direction by CDPH, the Grantee may request in writing to CDPH, who, in turn, may request the United
States to enter intosuch litigation to protect the interests ofthe State and of the UnitedStates.
Debarment and Suspension Certification
a.By signing this Grant, the Grantee/Grantee agrees to comply with applicable federal suspension and
debarment regulations including,but not limited to 7 CFR Part 3017, 45 CFR 76, 40 CFR 32 or 34 CFR
85.
b.By signing this Grant,the Grantee certifies tothe best ofits knowledge and belief,that it and its principals:
(1) Are not presently debarred,suspended,proposed for debarment, declared ineligible,or voluntarily
excluded by any federal department or agency;
(2) Have not within a three-year period preceding this application/proposal/agreement been convicted of
or had a civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining,attempting to obtain, or performing a public (Federal,State or local)
transaction or contract under a public transaction;violation of Federal or State antitrust statutes or
commission of embezzlement,theft, forgery, bribery, falsification or destruction of records,making
false statements,or receiving stolen property;
(3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State or local)with commission of any ofthe offenses enumerated in Paragraph b(2)herein;
and
(4) Have not within a three-year period preceding this application/proposal/agreement had one or more
public transactions (Federal,State or local)terminated for cause or default.
(5) Shall not knowingly enter into any lower tier covered transaction with a person who is proposed for
debarment under federal regulations (i.e., 48 CFR part 9,subpart 9.4),debarred,suspended,declared
ineligible,or voluntarily excluded from participation in such transaction, unless authorized bythe State.
(Rev.7/14)Page 3 of8
Exhibit F
(6)Will include a clause entitled,"Debarment and Suspension Certification"that essentially sets forth the
provisions herein,in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
c.If the Grantee is unable to certify to any ofthe statements in this certification,the Grantee shall submit an
explanation to the CDPH Program Contract Manager.
d.The terms and definitions herein havethe meanings set out in the Definitions and Coverage sections of
the rules implementing Federal Executive Order 12549.
e.If the Grantee knowingly violates this certification,in addition to other remedies available to the Federal
Government,the CDPH may terminatethisAgreement for cause or default.
4.Covenant Against Contingent Fees
The Grantee warrants that no person or selling agency has been employed or retained to solicit/secure this
Grant upon an agreement of understanding for a commission,percentage,brokerage,or contingent fee,
except bona fide employees or bona fide established commercial or selling agencies retained by the Grantee
for the purpose of securing business.For breach or violation of this warranty,CDPH shall have the right to
annul this Grant without liability or in its discretion to deduct from the Grant price or consideration,or otherwise
recover,the full amountofsuch commission,percentage, and brokerageor contingent fee.
5.Air or Water Pollution Requirements
Any federally funded grant and/or subgrants in excess of $100,000 must comply with the following provisions
unless said grant is exempt under 40 CFR 15.5.
a.Government Grantees agree to comply with all applicable standards,orders,or requirements issued
under section 306ofthe Clean Air Act [42 U.S.C.1857(h)],section 508ofthe Clean Water Act (33 U.S.C.
1368),Executive Order 11738,and Environmental Protection Agency regulations (40 CFR part 15).
b.Institutions of higher education,hospitals,nonprofit organizations and commercial businesses agree to
comply with all applicable standards,orders,or requirements issued under the Clean Air Act (42 U.S.C.
7401 et seq.),as amended,and the Federal Water Pollution Control Act (33 U.S.C.1251 et seq.),as
amended.
6.Lobbying Restrictions and Disclosure Certification
(Applicable to federally funded grants in excess of $100,000 per Section 1352 of the 31,U.S.C.)
a.Certification and Disclosure Requirements
(1)Each person (or recipient)who requests or receives a grant,subgrant,which is subject to Section
1352 ofthe 31,U.S.C,and which exceeds $100,000 at any tier,shall file a certification (in the form
set forth in Attachment 1,consisting ofone page,entitled "Certification Regarding Lobbying")that the
recipient has not made,and will not make,any payment prohibited by Paragraph b of this provision.
(2)Each recipient shall file a disclosure (in the form set forth in Attachment 2,entitled "Standard Form-
LLL 'disclosure of Lobbying Activities'")if such recipient has made or has agreed to make any
payment using nonappropriated funds (to include profits from any covered federal action)in
connection with a grant or any extension or amendment of that grant,which would be prohibited under
Paragraph bofthis provision if paid for with appropriated funds.
(3)Each recipient shall file a disclosure form at the end of each calendar quarter in which there occurs
any event that requires disclosure or that materially affect the accuracy of the information contained in
any disclosure form previously filed by such person under Paragraph a(2)herein.An event that
materially affects the accuracyofthe information reported includes:
(a)A cumulative increase of $25,000 or more in the amount paid or expected to be paid for
influencing or attempting to influence a covered federal action;
(Rev.7/14)Page 4 of 8
Exhibit F
(b)A change in the person(s)or individuals(s)influencing or attempting to influence a covered federal
action;or
(c)A change in the officer(s),employee(s),or member(s)contacted for the purpose of influencing or
attempting to influence a covered federal action.
(4)Each person (or recipient)who requests or receives from a person referred to in Paragraph a(1)of
this provision a grant or subgrant exceeding $100,000 at any tier under a grant shall file a certification,
and a disclosure form, if required,to the next tier above.
(5)All disclosure forms (but not certifications)shall be forwarded from tier to tier until received by the
person referred to in Paragraph a(1)of this provision.That person shall forward all disclosure forms
to CDPH Program Contract Manager.
b.Prohibition
Section 1352 of Title 31,U.S.C,provides in part that no appropriated funds may be expended by the
recipient ofa federal contract or agreement,grant,loan,or cooperative agreement to pay any person for
influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an
officer or employee of Congress,or an employee ofa Member of Congress in connection with any ofthe
following covered federal actions:the awarding of any federal contract or agreement,the making of any
federal grant,the making of any federal loan,entering into of any cooperative agreement,and the
extension,continuation,renewal,amendment, or modification ofany federal contractoragreement,grant,
loan,or cooperative agreement.
Additional Restrictions
Grantee shall comply with the restrictions under Division F,Title V,Section 503ofthe Consolidated
Appropriations Act,2012 (H.R. 2055), which provides that:
"SEC.503.(a)No part ofany appropriation contained in this Act ortransferred pursuant to
section 4002 of Public Law 111-148 shall be used,other than for normal and recognized
executive-legislative relationships,for publicity orpropagandapurposes,for the preparation,
distribution,oruse ofany kit,pamphlet,booklet,publication,electronic communication,radio,
television,or video presentation designedto support ordefeatthe enactmentof legislation
before the CongressoranyStateor local legislature or legislative body,except in presentation
tothe CongressoranyStateor local legislature itself,or designed to support ordefeat any
proposed or pending regulation,administrative action,or order issued by the executive branch
of any State or local government,except in presentation tothe executive branch ofany Stateor
local government itself.
(b)No part ofany appropriation contained in this Act or transferred pursuant to section
4002 of Public Law 111-148 shall be used to pay the salary or expenses of any grant or
contract recipient,oragent acting for such recipient,related toany activity designed to
influence the enactment of legislation,appropriations,regulation,administrative action,or
Executive order proposed or pending before the Congress oranyState government,State
legislature or local legislature or legislative body,other than for normal and recognized
executive-legislative relationships or participation by an agency or officer ofa State,local or
tribal government in policymaking and administrative processes within the executive branch of
that government.
(c)The prohibitions in subsections (a)and (b)shall include any activity to advocate or promote any
proposed,pending or future Federal,State or local tax increase,or any proposed,pending,or future
requirement or restriction on any legal consumer product,including its saleor marketing,including but not
limited to the advocacy or promotion of gun control."
(Rev.7/14)Page 5of8
STATE OF CALIFORNIA
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH
CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
Exhibit F
Attachment 1
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to
any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,
an officer or employee of Congress, or an employee of a Member of Congress in connection with the making,
awarding or entering into of this Federal contract, Federal grant, or cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of this Federal contract, grant, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency of the United States Government, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, or cooperative agreement, the undersigned shall complete and submit
Standard Form LLL, "Disclosure of Lobbying Activities" in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subGrantees, subgrants, and contracts under grants and
cooperative agreements) of $100,000 or more, and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction
imposed by Section 1352, Title 31, U.S.C., any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
County of Fresno
Name of Grantee
14-10891
Contract I Grant Number
Date
by or on behalf of Grantee, please return to:
California Department of Public Health
Program
P.O. Box 997377, MS XXX
Sacramento, CA 95899-XXX.X
Deborah A. Poochigian
Printed Name of Person Signing for G
Signature of Person Signing for Grantee
Chairman, Board of Supervisors
T1tle
ATTEST:
BERNICE E. SEIDEL, Clerk
Board of Supervisors
.,(hQr.·. ~~
e8 ty
CDPH reserves the right to notifiy the Grantee in writing of an alternate submission address.
(Rev. 7/14) Page 6 of 8
Exhibit F
Attachment 2
CERTIFICATION REGARDING LOBBYING
Complete this form to disclose lobbying activities pursuant to 31 U.S.C.
(See reverse for publicburden disclosure)
1352
Approved by OMB
0348-0046
Type of Federal Action:
[ ] a.contract
b.grant
c.cooperative agreement
d.loan
e.loan guarantee
f.loan insurance
Status of Federal Action:
[ ] a. bid/offer/application
Report Type:
[ ] a.initial filing
b.material change
For Material Change Only:
b.
c.
initial award
post-award
4.Name and Address of Reporting Entity:
• Prime
•Subawardee
Tier , if known:
Congressional District,If known:
6.Federal Department/Agency
8.Federal Action Number,if known:
10.a.Name and Address of Lobbying Registrant
(Ifindividual,last name,first name,Ml):
11.Information requested through this form is authorized by title 31
U.S.C. section 1352.This disclosure of lobbying activities is a material
representation of fact upon which reliance was placed by the tier
above when this transaction was made or entered into. This
disclosureis required pursuant to 31 U.S.C.1352.This information
will be available for public inspection,required disclosure shall be
subject toa notmorethan $100,000 foreach such failure.
FederaKUse Only
(Rev.7/14)
Year .quarter.
date of last report.
5.If Reporting Entity in No.4 isSubawardee,EnterName
and Address of Prime:
Congressional District, Ifknown:
Federal Program Name/Description:
CDFA Number,if applicable:
Award Amount,if known:
b.Individuals Performing Services (including address if different from
10a.
(Lastname, Firstname,Ml):
Signature:
Print Name:
Title:
Telephone No.:Date:
Authorized for Local Reproduction
Standard Form-LLL (Rev. 7-97)
Page 7 of 8
Exhibit F
INSTRUCTIONS FOR COMPLETION OF SF-LLL,DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed bythe reporting entity,whether subawardeeor prime Federal recipient,at the initiation or receipt ofa covered Federal action,or a
material change toa previous filing,pursuant to title 31 U.S.C section 1352.The filing ofa form is required for each payment or agreement to make payment to any lobbying
entity for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,oran employee ofa Member
of Congress in connection with a covered Federal action.Complete all items that apply for both the initial filing and material change report.Refer tothe implementing guidance
published bythe Officeof Management and Budget foradditional information.
1 Identify thetypeof covered Federal action for which lobbying activity isand/orhas beensecuredto influence the outcome ofa covered Federal action.
2. Identify the status of the covered Federal action.
3.Identify the appropriate classification of this report.If this isa follow-up report caused by a material change tothe information previously reported,entertheyearand
quarterin which thechange occurred.Enter thedateofthelast previously submitted report bythis reporting entity for thiscovered Federal action.
4 Enter the full name,address,city,Stateand zip codeofthe reporting entity.Include Congressional District,if known.Check the appropriate classification ofthe
reporting entity that designates ifit is,or expects tobea prime or subaward recipient.Identify the tier ofthe subawardee,e.g.,the first subawardee ofthe prime is
the 1st tier.Subawards include but are not limited to subcontracts,subgrants and contract awards under grants.
5.If the organization filing the report in item 4 checks "Subawardee,"then enterthe full name,address,city,Stateand zip codeofthe prime Federal recipient.Include
Congressional District, ifknown.
6.Enter thenameofthe Federal agency making the award or loan commitment.Include at leastone organizational level below agency name,if known.Forexample,
Department of Transportation,United States Coast Guard.
7.Enter the Federal program name or description for the covered Federal action (item 1).If known,enter the full Catalog of Federal Domestic Assistance (CFDA)
number for grants,cooperative agreements,loans, and loan commitments.
8.Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g.,Request for Proposal (RFP)number;Invitation for Bid
(IFB)number;grant announcement number;the contract,grant,or loan award number;the application/proposal control number assigned by the Federal agency).
Include prefixes,e.g.,"RFP-DE-90-001."
9. Fora covered Federalactionwhere there has been an awardor loan commitment bythe Federal agency,enter the Federalamountofthe award/loan commitment
for the prime entity identified in item 4 or 5.
10.(a)Enter the full name,address,city,State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity
identified in item 4 to influence the covered Federal action.
(b)Enter the full names of the individual(s)performing services,and include full address if different from 10 (a).Enter Last Name,First Name,and Middle Initial
(Ml).
11.The certifying official shall sign and date the form,printhis/her name, title,and telephone number.
According tothe Paperwork Reduction Act,as amended,no persons are required to respond toa collection of information unless it displays a valid
OMB Control Number.The valid OMB control number for this information collection is OMB No.0348-0046. Public reporting burden for this
collection of information is estimatedto average 10 minutes per response,including timefor reviewing instructions,searching existing data sources,
gathering and maintaining thedata needed,and completing and reviewing the collection of information.Send comments regarding the burden
estimate or any other aspect of this collection of information,including suggestions for reducing this burden,tothe Office of Management and
Budget, Paperwork Reduction Project (0348-0046), Washington, DC20503.
(Rev.7/14)Page8of8
LETTER OF ACCEPTANCE
I, (insert name of official) an appointed officer of the (LHD) am duly authorized by the (LHD)
Board of Supervisors to accept these federal PHEP funds to build and sustain capability
development under the allowable Capabilities as identified in the federal funding
announcement including the associated planning, personnel, equipment, training, exercises,
and healthcare coalition development to assure readiness and response capability to respond
to Ebola virus disease (EVD).
Dated: 1M I(Q I JJ)jiJ
Deborah A. Poochigian, Chai
(Insert name and title of official)
City/County of Fresno
Supervisors
ATTEST:
BERNICE E. SEIDEL, Clerk
::·t£r·t~
uty
CCC-307
CERTIFICATION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listed below. This
certification is made under the laws of the State of California.
Contractor/Bidder Firm Name (Printed)
County of Fresno
Federal ID Number
94-6000-512
ATTEST:
Printed Name and Title of Person Signing
Deborah A. Poochigian, Chairman,
BERNICE E. SEIDEL, Clerk
Board of Supervisors . \
Executed in the County of
Fresno
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requirements. (Gov. Code § 12990 (a-f) and CCR, Title 2,
Section 8103) (Not applicable to public entities.)
2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement notifying employees that unlawful manufacture, distribution,
dispensation, possession or use of a controlled substance is prohibited and specifying
actions to be taken against employees for violations.
b. Establish a Drug-Free Awareness Program to inform employees about:
1) the dangers of drug abuse in the workplace;
2) the person's or organization's policy of maintaining a drug-free workplace;
3) any available counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
1) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply with these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State agreements if the department determines that any of the
following has occurred: the Contractor has made false certification, or violated the
certification by failing to carryout the requirementsas noted above. (Gov. Code §8350et
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 withan orderof a Federal court,which
orders Contractorto comply with an order of the National Labor Relations Board. (Pub.
Contract Code §10296) (Not applicableto publicentities.)
4.CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE-PRO BONO
REQUIREMENT: Contractor hereby certifies that contractor will comply with the
requirements ofSection 6072 ofthe Business and Professions Code,effective January 1,
2003.
Contractor agrees to makea goodfaithefforttoprovidea minimum numberof hours of
probono legal services during each year ofthe contract equal to thelessorof 30
multiplied bythe number of full time attorneys inthefirm's offices inthe State,withthe
number ofhoursproratedonan actual daybasisforany contractperiodof lessthana full
year or 10%of its contract with the State.
Failureto make a good faith effort may be cause for non-renewal ofa state contract for
legal services,andmaybe 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 ofan 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 Contractorscontracting forthe procurementor laundering of apparel, garmentsor
corresponding accessories,orthe procurement of equipment,materials,or supplies,other
than procurement related toa public works contract,declare under penalty of perjury that
no apparel,garments or corresponding accessories,equipment,materials,or supplies
furnishedtothe state pursuant to the contract have been laundered or produced in whole
orin 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 benefitof sweatshoplabor,forced labor,convictlabor,indentured laborunder
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 agreesto cooperate fully inproviding reasonable accessto the
contractor's records,documents,agentsor employees,or premisesif 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 underparagraph(a).
7. DOMESTIC PARTNERS: For contracts over $100,000 executed or amended after
January 1,2007,the contractor certifies that contractor isin compliance with Public
Contract Code section 10295.3.
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.ContractCode §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 asa condition of regular state employment.
2).No officer or employee shall contract on his or her own behalf as an independent
contractorwithanystate 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 boardsand commissions areexemptfromthissectionif they do not receive
payment other than payment ofeach meeting ofthe 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 StateAir ResourcesBoardor an air pollution control district; (2) subjectto 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.
AGREEMENT BETWEEN THE COUNTY OF FRESNO AND THE STATE OF CALIFORNIA
No.:California Dept.of Public Health
Emergency Preparedness Office:
Ebola Preparedness and Response
APPROVED AS TO LEGAL FORM:
DANIEL C.CEDERBORG,
COUNTY COUNSEL
^/Wd*By.
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW,C.P.A.,AUDITOR-CONTROLLER/
TREASURER -TAX COLLECTOR
By id.
REVIEWED AND RECOMMENDED FOR APPROVAL:
By./4.'fp*/
David Pomaville
Director
Department of Public Health
Fund/Subclass:0001/10000
Organization #:56201620
Revenue:4380
ks
Term:July 1.2015 -Sept.30.2016