HomeMy WebLinkAboutA-20-340 Dept of State Hospitals Diversion Funding (2).pdfSC O ID: 4440-2079001000 Agreement No. 20-340
STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES ...-------------~-------------~
STANDARD AGREE MEN T
STD 213 (Rev. 03 /2019)
AGREEMENT NUMBER
20-79001-000
PURCHASING AUTHORITY NUMBER (If App l icable)
4440
1. This Agreement is entered into between the Contracting Agency and the Contractor named below:
CONTRACTING AGENCY NAME
Department of State Hospitals
CONTRACTOR NAME
County of Fresno
2 . The term of this Agreement is :
START DATE
Ju ly 1, 2020
THROU GH END DATE
June 30, 2023
3. The maximum amount of this Agreement is :
$5,843,700 .00
Five Million Eight Hundred Forty Three Thousand Seven Hundred Dollars and Zero Cents
4. The parties agree to comply with the terms and conditions of the following exhibits, which are by this reference made a part of the Agreement.
Exhibits Title
Exhibit A Scope of Work
Exhibit B Budget Detail and Payment Provisions
Exhibit C General Terms and Conditions
+ -Exhibit D Special Terms and Conditions -
+ -Exh ibit E Confidentiality and Information Security Provisions -
+ -Exhibit F Information Privacy and Security Requirements (N o n-H IPPA /HITECH Act Contracts) -
+ -Exhibit G Insurance Requirements -
+ -Exhibit H Federal Emergen cy Management Agency Provisi o ns -
Items shown with an asterisk(*), are hereb incor orated b' reterence and made art ot this a reement as it attached hereto. y p y p g
These documents can be viewed at https://www.dqs.ca.gov/OLS/Resources
IN WITNESS WHEREOF, THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO .
CONTRAC TOR
CO NTRACTOR NAME (if other th an an individual, state whether a co rporation , part nersh ip, etc.)
County of Fresno
CO NTRACTOR BUSINESS ADDRESS
1925 E. Dakota
CITY
Fresno
TITLE
Pages
6
4
4
8
0
10
0
0
STATE ZIP
CA 93726
PR INTED NAME OF PERSON SIGNING
Ernest Buddy Mendes Cha i rman of the Board of Supervisors
CONTRACTOR AUTHORIZED SIGNATURE DATE SIGNED
ATTEST:
BERNICE E . S EIDE L
Clerk of the Board of S upe rvisors
County Fresqo , State of California
Pag e 1 of 2
for
10/15/2020
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Scope of Work
Page 1 of 6
EXHIBIT A
SCOPE OF WORK
1.CONTRACTED PARTIES:
A.The County of Fresno and/or their authorized designee, hereafter referred to as “Contractor,”
agrees to provide services (as defined in Section 5) pursuant to the terms and conditions of this
Agreement.
2.PROJECT REPRESENTATIVES:
A.The project representatives during the term of this Agreement shall be:
DSH Contract Manager: DSH Administrative Contact:
Section/Unit:
Forensic Services Division
Section/Unit:
Forensic Services Division
Attention: Ashley Breth
Staff Services Manager I, Specialist
Attention: Ashley Breth
Staff Services Manager I, Specialist
Address: 1600 9th Street, Room 410
Sacramento, CA 95814
Address: 1600 9th Street, Room 410
Sacramento, CA 95814
Phone:
(916)654-4187
Fax:
(916)651-1168
Phone:
(916)654-4187
Fax:
(916)651-1168
Email:
Ashley.Breth@dsh.ca.gov
Email:
Ashley.Breth@dsh.ca.gov
Fresno County Contract Manager:
Section/Unit:
Department of Behavioral Health
Attention: Dawan Utecht, Director
Address: 1925 E. Dakota
Fresno, CA 93726
Phone:
(559)600-9192
Fax:
Email:
dutecht@fresnocountyca.gov
Either party may make changes to the contact names or information above by giving written notice to
the other party. Said changes shall not require an amendment to this Agreement.
3.PROJECT SUMMARY:
A.Contractor shall administer a pre-trial jail felony mental health diversion program for individuals
charged with felony offenses in Fresno County. Program participants are individuals with serious
mental disorders who have committed certain felony crimes and found by a Court of competent
jurisdiction, to qualify for diversion services pursuant to Penal Code section 1001.36 hereafter
referred to as “Felony Mental Health Diversion Clients.” Contractor shall provide clinically
appropriate or evidence-based mental health treatment and wraparound services across a
continuum of care, as appropriate, to meet the individual needs of Felony Mental Health Diversion
Clients. For purposes of this section, “wraparound services” means services provided in addition to
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Scope of Work
Page 2 of 6
the mental health treatment necessary to meet the individual’s needs for successfully managing his
or her mental health symptoms and to successfully live in the community.
4.PROGRAM IMPLEMENTATION FUNDS:
A.The DSH shall distribute up to 25% of total funds to Contractor for initial program implementation
costs incurred under this Agreement. Contractor shall submit to the DSH a written program plan
including an outline of the use of the program implementation funding as a deliverable prior to
payment of funds. Program implementation costs shall include, but are not limited to:
a.Initial procurement and set up of diversion client housing
b.Initial administrative operating expenses and equipment
c.Initial training and technical assistance activities
d. Development of operational guidelines, policies and procedures
e.Recruitment, hiring, and orientation activities supporting new staff
5.CONTRACTOR RESPONSIBILITIES:
A.The estimated total number of unduplicated Felony Mental Health Diversion Clients to be served by
Contractor during the term of this agreement is 42. Felony Mental Health Diversion Clients must
maintain participation in the Diversion program for a minimum of 30 days to be counted towards the
Contractor’s target population goals required for distribution of funds as outlined in Exhibit B,
Budget Detail. If a participating Felony Mental Health Diversion Client successfully completes the
program in less than 30 days, the Contractor may account for the Felony Mental Health Diversion
Client in the total reported to DSH for purposes of meeting target population goals required for
distribution of funds.
B.Contractor shall collaborate with community stakeholders and other partner agencies in the
planning and implementation of the diversion program as outlined in the required program plan
document. Collaborative partners include but are not limited to the following county-specific groups:
behavioral health, community-based treatment providers, housing providers, courts, Public
Defender, District Attorney, probation and Sheriff/jail administrator.
C.Contractor shall thoroughly assess and identify which Felony Mental Health Diversion Clients are
clinically appropriate for admission into the community-based jail diversion program based upon
statutory criteria (Welf. & Inst. Code, § 4361, subd. (c)(1)(A)-(C)). Additionally, Contractor shall
initiate and maintain treatment while the Felony Mental Health Diversion Clients are incarcerated
and awaiting release from jail and placement in the community.
D.To the extent not prohibited by Federal law, Contractor shall provide DSH with data no less than
quarterly including but not limited to statutory requirements detailed in AB1810 (2018) and Welfare
and Institutions Code section 4361 (Section 4361) for individual Felony Mental Health Diversion
Clients. DSH shall have the right to modify, reduce, or add data elements or outcome measures at
any time in its discretion consistent with Section 4361, subdivision (g). Exhibit A Attachment 1
details the statutory data elements that are required. Data shall be submitted in the method and
format set forth by the DSH. Contractor shall identify any data in the dataset subject to the rules of
42 Code of Federal Regulations part 2 upon submission to DSH. DSH shall use this data and
outcome measures to perform program evaluation to assess the efficacy and resource allocation of
the program, for monitoring of the program to ensure that services outlined in law and the proposal
were provided, to provide reports to the Legislature and other stakeholders, and to perform
research related to provision of improved services to the target population.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Scope of Work
Page 3 of 6
E.Felony Mental Health Diversion Clients housed in community-based diversion programs shall
remain under the legal and physical supervision of Contractor. Contractor is responsible for full
range of services and supports including but not limited to medical care, transportation, and
patients-rights services.
F. Contractor retains the right to exclude specific individual Felony Mental Health Diversion Clients
from the community-based diversion program based on the terms and conditions set forth in the
Client’s Diversion plan or based on the criteria agreed upon by collaborative partner agencies at
any point during participation in the program.
G.Contractor shall submit a written document outlining the program plan developed and agreed to by
all county collaborative partners. Said document shall identify roles and responsibilities, describe
the program from initial identification of potential Felony Mental Health Diversion Clients to program
completion, and list all services to be provided in the program. Plan shall also include a detailed
program flowchart depicting all stages of the program; an itemized budget plan identifying
personnel and operation and equipment costs, county match, and other fund sources; and an
outline of program implementation costs as detailed in section 4 of this exhibit. The final county
plan must be approved by DSH prior to program implementation. Any changes to this plan must be
agreed to in writing by both parties.
H.Contractor shall connect individuals to services in the community after they have completed
diversion as defined in this agreement. Contractor shall be responsible for coordinating with
behavioral health programs for continued mental health care, crisis intervention, ongoing counseling
and care, and psychotropic medication compliance for the Felony Mental Health Diversion Clients.
I.Contractor will track Diversion expenditures and shall provide a report itemizing Diversion
expenditures and required match contributions, by funding source, to DSH within sixty days after
the close of the months of December and June on a bi-annual basis during the term of this
agreement. A final report itemizing Diversion expenditures and required match contributions, by
funding source, shall be due within sixty days after the termination of the agreement.
J.Contractor shall report in writing via email to the DSH Contract Manager or designee if a current
Felony Mental Health Diversion Client is absent without leave (AWOL) or is involved in a Special
Incident. Such reporting to DSH will take place within forty-eight (48) hours of such an incident.
A “Special Incident” is a significant patient occurrence or any event which has the potential of
adversely affecting the operation of the program. The following occurrences qualify as Special
Incidents:
i.Suicide or attempt;
ii.Death or serious injury of, or by, patient;
iii.Criminal behavior (including arrests, with or without conviction);
iv.Any incident which may result in public or media attention to the program.
K.If Contractor is unable to serve the total number of unduplicated Felony Mental Health Diversion
Clients stated in provision 5.A. due to actual client costs exceeding the level of funds available,
Contractor shall notify the DSH Contract Manager or designee in writing no less than 180 days prior
to the expiration of this Agreement; and shall provide an updated plan to include: 1) an explanation
of the reasons for the cost increases; 2) the revised number of Felony Mental Health Diversion
Clients to be served by the community-based diversion program; and 3) the revised budget, not to
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Scope of Work
Page 4 of 6
exceed the maximum amount set forth in this Agreement. Upon approval of the revised plan by the
DSH, an amendment to this Agreement shall be initiated.
L. Contractor and its subcontractors shall procure and keep in full force and effect during the term of
this Agreement all permits, registrations, and licenses necessary to accomplish the work specified
in this Agreement and shall give all notices necessary and incident to the lawful prosecution of the
work. Contractor shall provide proof of any such license(s), permits(s), and certificate(s) upon
request by the DSH. Contractor agrees that failure by itself or its subcontractors to provide evidence
of licensing, permits, or certifications shall constitute a material breach for which the DSH may
terminate this Agreement with cause.
M.Contractor shall provide services as outlined in this Agreement. Contractor shall be responsible to
fulfill the requirements of this Agreement and shall incur expenses at its own risk and invest
sufficient amount of time and capital to fulfill the obligations as contained herein.
N.Contractor and its subcontractors shall keep informed of, observe, comply with, and cause all its
agents and employees to observe and to comply with all prevailing Federal, State, and local laws,
rules, and regulations made pursuant to pertinent Federal, State, and local laws. If any conflict
arises between provisions of the plans and specifications and any such law above referred to, then
Contractor shall immediately notify the DSH in writing.
O.Unless otherwise specified, this Agreement may be canceled at any time by Contractor, in writing,
with 50 days advance notice. The DSH may terminate the Agreement pursuant to section 7 of
Exhibit C if Contractor or its subcontractors fails to comply with a federal, state, or local law and the
noncompliance, based on the facts and circumstances, would constitute a material breach of this
Agreement under California law.
6.DSH RESPONSIBILITIES:
A.DSH shall distribute funds to Contractor in accordance with the schedule outlined in Exhibit B,
Budget Detail.
B.The DSH shall provide a data collection process to Contractor. Contractor shall submit data to the
DSH no less than quarterly per statutory requirements. The Contractor shall collect the data
elements listed in Exhibit A Attachment 1. Additional elements may be added by DSH in
accordance with Section 4361.
C.Upon receipt of the statutory data requirements (Exhibit A Attachment 1) from Contractor, DSH will
analyze data for the purpose of program evaluation, monitoring, reporting, and research.
D.DSH will provide a quarterly report to Contractor summarizing the statutory data requirements and
outcome measures.
7.PERFORMANCE MEASURES:
A.Complete and Timely Provision of Services
i.Expectations: Contractor is expected to provide all services, including any and all required
reports, in a timely manner—in accordance with timelines established in this Scope of Work.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Scope of Work
Page 5 of 6
ii.Penalties: Should Contractor not provide all services, including any and all required reports in a
timely manner, the DSH may choose to terminate this Agreement. Additionally, the DSH may
find Contractor to be not responsible in provision of services and evaluate this in future
contracting opportunities.
8.AMENDMENTS:
A.The parties reserve the right to amend this Agreement for two additional terms of up to one year
each, and to add funding sufficient for these periods. This right to amend is in addition to the right
to amend for other reasons contained in this Agreement or noted in the solicitation that resulted in
this Agreement, if applicable. Any amendment shall be in writing and signed by both parties.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit A, Attachment 1, Statutory Outcome Data Requirements
Page 6 of 6
EXHIBIT A, ATTACHMENT 1
STATUTORY OUTCOME DATA REQUIREMENTS
The DSH shall provide a data collection process to the Contractor. Contractor shall complete and submit the
required data to the DSH no less than quarterly. Contractor shall identify any data in the dataset subject to the
rules of 42 Code of Federal Regulations part 2 upon submission to DSH. The data collection process shall
capture, but is not limited to, the following data elements:
1.The number of individuals that the Court ordered to post-booking diversion and the length of time for
which the defendant has been ordered to Felony Mental Health Diversion (Diversion).
2.The number of individuals originally declared IST on felony charges that the Court ultimately ordered to
Diversion.
3.The number of individuals participating in Diversion.
4.The name, social security number, date of birth, and demographics of each individual participating in
Diversion.
5.The length of time in Diversion for each participating individual.
6.The types of services and supports provided to each individual participating in Diversion.
7.The number of days each individual was in jail prior to placement in Diversion.
8.The number of days that each individual spent in each level of care facility.
9.The diagnoses of each individual participating in Diversion.
10.The nature of the charges for each individual participating in Diversion.
11.The number of individuals who completed Diversion.
12.The name, social security number and birthdate of each individual who did not complete Diversion and
the reasons for not completing Diversion.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit B, Budget Detail and Payment Provisions,
Attachment 1 – Sample Invoice
Page 1 of 4
EXHIBIT B
BUDGET DETAIL AND PAYMENT PROVISIONS
1.INVOICING AND PAYMENT
A.For services satisfactorily rendered, upon implementation of the pre-trial Felony Mental Health
Diversion program and upon receipt and approval of invoices submitted as described herein, the
DSH agrees to compensate Contractor in accordance with the schedule of payments specified in
section 5, Budget Detail.
B.Contractor shall submit a single invoice for all initial program implementation costs associated with
and pertaining to the written plan submitted to DSH in accordance with Exhibit A, Scope of Work,
section 4, “Program Implementation Funds.”
C.Contractor shall submit supporting documentation for each invoice to validate outcomes achieved
by the Contractor as specified in Exhibit B, Provision 5.
D.The DSH shall not be responsible for services performed by Contractor outside of this agreement,
or for services performed other than as outlined in Exhibit A, Scope of Work.
2.INSTRUCTIONS TO CONTRACTOR:
A.To expedite the processing of invoices submitted to the DSH for distribution of funds, all invoice(s)
shall be submitted to the DSH for review and approval at either:
Department of State Hospitals
Attention: Accounting Office
1600 Ninth Street, Room 141
Sacramento, CA 95814
OR
DSHSAC.AccountsPayable@dsh.ca.gov
B.Contractor shall submit one original and three copies of each invoice, unless emailed.
C.Contractor shall type, not handwrite, each invoice on company letterhead. The DSH may provide an
invoice template, if requested, which may be used in lieu of company letterhead.
D.Contractor shall clearly note Contractor’s name and address on each invoice. The name on the
invoice must match the Payee Data Record (Std. 204) and the name listed on this Agreement.
E.Contractor shall list and itemize in accordance with the Budget Detail, all services or deliverables
provided on each invoice.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit B, Budget Detail and Payment Provisions,
Attachment 1 – Sample Invoice
Page 2 of 4
F.Contractor shall include the following on each submitted invoice:
i.Date(s) during which the services or deliverables were provided and the date in which the
invoice was generated.
ii.Agreement number, which can be found on the Standard Agreement Form (Std. 213).
iii.Small Business certification number, if applicable
iv.Professional license number, if applicable
v.Invoice total
3.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 does not appropriate sufficient funds for the program, this Agreement shall no
longer be in full force and effect. In this event, the State shall have no liability to pay any funds
whatsoever to Contractor or to furnish any other considerations under this Agreement and
Contractor shall not be obligated to perform any provisions of this Agreement.
B.If funding for any Fiscal Year is reduced or deleted by the Budget Act for purposes of this program,
the State shall have the option to either cancel this Agreement with no liability occurring to the
State, or offer an Agreement amendment to Contractor to reflect the reduced amount.
C.If this Agreement overlaps Federal and State fiscal years, should funds not be appropriated by
Congress or approved by the Legislature for the Fiscal Year(s) following that during which this
Agreement was executed, the State may exercise its option to cancel this Agreement.
D.In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted
by Congress or the Legislature which may affect the provisions or terms of funding of this
Agreement in any manner.
4.PROMPT PAYMENT CLAUSE:
A.Payment shall be made in accordance with, and within the time specified in, Government Code §
927 et seq.
5.BUDGET DETAIL:
A.The maximum amount of this Agreement shall not exceed $5,843,700.00.
B.Funds awarded to the County pursuant to this contract shall be distributed in a total of six (6)
installments as outlined below.
C.Upon contract execution, as well as receipt and approval of the single submitted invoice, the DSH
shall disburse one-time program implementation funds to Contractor not exceed $ 1,460,925 (up to
25% of total awarded).
D.Upon successful admission of 4 total unduplicated Felony Mental Health Diversion Clients with a
minimum length of stay of 30 days (10% of Contractor’s target population goal), the DSH shall
disburse program funds to Contractor not to exceed $ 584,370.00 (10% of total awarded).
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit B, Budget Detail and Payment Provisions,
Attachment 1 – Sample Invoice
Page 3 of 4
Supporting documentation required for distribution of funds shall be an itemized list of clients served
by the program including admission date and if applicable, discharge date.
E.Upon successful admission of 11 total unduplicated Felony Mental Health Diversion Clients with a
minimum length of stay of 30 days (25% of Contractor’s target population goal), DSH shall disburse
program funds to Contractor not to exceed $ 876,555.00 (15% of total awarded). Supporting
documentation required for distribution of funds is an itemized list of clients served by the program
including admission date and if applicable, discharge date.
F. Upon admission of 21 total unduplicated Felony Mental Health Diversion Clients with a minimum
length of stay of 30 days (50% of Contractor’s target population goal), DSH shall disburse the
remaining funds to Contractor not to exceed $ 1,168,740.00 (20% of total awarded). Supporting
documentation required for distribution of funds is an itemized list of clients served by the program
including admission date and if applicable, discharge date.
G.Upon admission of 32 total unduplicated Felony Mental Health Diversion Clients with a minimum
length of stay of 30 days (75% of Contractor’s target population goal), DSH shall disburse the
remaining funds to Contractor not to exceed $ 876,555.00 (15% of total awarded). Supporting
documentation required for distribution of funds is an itemized list of clients served by the program
including admission date and if applicable, discharge date.
H.Upon admission of 42 total unduplicated Felony Mental Health Diversion Clients with a minimum
length of stay of 30 days (100% of Contractor’s target population goal), DSH shall disburse the
remaining funds to Contractor not to exceed $ 876,555.00 (15% of total awarded). Supporting
documentation required for distribution of funds is an itemized list of clients served by the program
including admission date and if applicable, discharge date.
I.At the sole discretion of the DSH and for the purposes of accounting, the DSH may adjust the total
proposed expenditure for each fiscal year as needed. In no event will this change the contract price
for the services actually rendered.
J.Contractor shall submit all invoices within a reasonable time but, no later than 12 months from the
date that services were provided. If Contractor fails to provide invoices within 12 months of the date
services are rendered, the DSH may elect to reject the invoices for payment as untimely and
Contractor will be deemed to have waived any right to payment of the late invoices.
K.Contractor shall contribute a 20% or $ 1,168,740.00 match in local county funds. The county match
may be cash, in-kind, or a combination thereof. Local county funds allowable include but are not
limited to 1991 Realignment, 2011 Realignment, and county general fund. Funding from other state
or federal sources, including Medi-Cal federal financial participation, shall not be counted towards
the required county match.
L. Contractor shall utilize Peoplesoft Financial System to track Diversion expenditures and shall
provide a report itemizing Diversion expenditures and required match contributions to DSH within
sixty days after the close of the months of December and June on a bi-annual basis during the term
of this Agreement. A final report itemizing Diversion expenditures and required match contributions
shall be due within sixty days after the termination of the agreement.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit B, Budget Detail and Payment Provisions,
Attachment 1 – Sample Invoice
Page 4 of 4
EXHIBIT B, ATTACHMENT 1
SAMPLE INVOICE
THIS IS A SAMPLE.
[Insert Contractor's Department company logo/address]
INVOICE
DATE INVOICE #
Department of State Hospitals
Attn: Accounting Office
1600 9th Street, Room 141
Sacramento, CA 95814
AGREEMENT #
DSH Diversion Funding Disbursement Request
Disbursement Program Benchmark Total Disbursement Requested
☐One Program
Implementation $_____________
☐Two Admission of 10% of
clients $_____________
☐Three Admission of 25% of
clients $_____________
☐Four Admission of 50% of
clients $_____________
☐Five Admission of 75% of
clients $_____________
☐Six Admission of 100% of
clients $_____________
PLEASE MAKE REMITTANCE PAYABLE TO:
[Insert Contractor's Department billing contact/address]
Prepared By: [Signature here]_____
[Insert name/title here]
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit C, General Terms and Conditions
Page 1 of 4
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1.APPROVAL: This Agreement is of no force or effect until signed by both parties and approved by the
Department of General Services, if required. Contractor may not commence performance until such
approval has been obtained.
2.AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid unless made in
writing, signed by the parties and approved as required. No oral understanding or Agreement not
incorporated in the Agreement is binding on any of the parties.
3.ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in part, without the
consent of the State in the form of a formal written amendment.
4.AUDIT: Contractor agrees that the awarding department, the Department of General Services, 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 the performance of this Agreement. Contractor agrees to
maintain such records for possible audit for a minimum of three (3) years after final payment, unless a
longer period of records retention is stipulated. Contractor 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, Contractor agrees to include a similar right of the State
to audit records and interview staff in any subcontract related to performance of this Agreement. (Gov.
Code §8546.7, Pub. Contract Code §10115 et seq., CCR Title 2, Section 1896)
5.DISPUTES: Contractor shall continue with the responsibilities under this Agreement during any dispute.
6.TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of any payments
should the Contractor fail to perform the requirements of this Agreement at the time and in the manner
herein provided. In the event of such termination the State may proceed with the work in any manner
deemed proper by the State. All costs to the State shall be deducted from any sum due the Contractor
under this Agreement and the balance, if any, shall be paid to the Contractor upon demand.
7.INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor, in the
performance of this Agreement, shall act in an independent capacity and not as officers or employees or
agents of the State.
8.RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of perjury, the
minimum, if not exact, percentage of post-consumer material as defined in the Public Contract Code
Section 12200, in products, materials, goods, or supplies offered or sold to the State regardless of whether
the product meets the requirements of Public Contract Code Section 12209. With respect to printer or
duplication cartridges that comply with the requirements of Section 12156(e), the certification required by
this subdivision shall specify that the cartridges so comply (Pub. Contract Code §12205).
9.NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, Contractor and its
subcontractors shall not deny the contract’s benefits to any person on the basis of race, religious creed,
color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information,
marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and
veteran status, nor shall they discriminate unlawfully against any employee or applicant for employment
because of race, religious creed, color, national origin, ancestry, physical disability, mental disability,
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit C, General Terms and Conditions
Page 2 of 4
medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age,
sexual orientation, or military and veteran status. Contractor shall insure that the evaluation and treatment
of employees and applicants for employment are free of such discrimination. Contractor and
subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code
§12900 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2, §11000 et seq.), the
provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Gov. Code
§§11135-11139.5), and the regulations or standards adopted by the awarding state agency to implement
such article. Contractor shall permit access by representatives of the Department of Fair Employment and
Housing and the awarding state agency upon reasonable notice at any time during the normal business
hours, but in no case less than 24 hours’ notice, to such of its books, records, accounts, and all other
sources of information and its facilities as said Department or Agency shall require to ascertain compliance
with this clause. Contractor and its subcontractors shall give written notice of their obligations under this
clause to labor organizations with which they have a collective bargaining or other agreement. (See Cal.
Code Regs., tit. 2, §11105.)
Contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts
to perform work under the Agreement.
10.CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES contained in the document
CCC 04/2017 are hereby incorporated by reference and made a part of this Agreement by this reference
as if attached hereto.
11.TIMELINESS: Time is of the essence in this Agreement.
12.COMPENSATION: The consideration to be paid Contractor, as provided herein, shall be in compensation
for all of Contractor's expenses incurred in the performance hereof, including travel, per diem, and taxes,
unless otherwise expressly so provided.
13.GOVERNING LAW: This contract is governed by and shall be interpreted in accordance with the laws of
the State of California.
14.ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if these services or
goods are obtained by means of a competitive bid, the Contractor shall comply with the requirements of the
Government Codes Sections set out below.
a.The Government Code Chapter on Antitrust claims contains the following definitions:
1)"Public purchase" means a purchase by means of competitive bids of goods, services, or materials
by the State or any of its political subdivisions or public agencies on whose behalf the Attorney
General may bring an action pursuant to subdivision (c) of Section 16750 of the Business and
Professions Code.
2)"Public purchasing body" means the State or the subdivision or agency making a public purchase.
Government Code Section 4550.
b.In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted,
it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may
have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2
(commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code),
arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit C, General Terms and Conditions
Page 3 of 4
pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing
body tenders final payment to the bidder. Government Code Section 4552.
c.If an awarding body or public purchasing body receives, either through judgment or settlement, a
monetary recovery for a cause of action assigned under this chapter, the assignor shall be entitled to
receive reimbursement for actual legal costs incurred and may, upon demand, recover from the public
body any portion of the recovery, including treble damages, attributable to overcharges that were paid
by the assignor but were not paid by the public body as part of the bid price, less the expenses incurred
in obtaining that portion of the recovery. Government Code Section 4553.
d.Upon demand in writing by the assignor, the assignee shall, within one year from such demand,
reassign the cause of action assigned under this part if the assignor has been or may have been
injured by the violation of law for which the cause of action arose and (a) the assignee has not been
injured thereby, or (b) the assignee declines to file a court action for the cause of action. See
Government Code Section 4554.
15.CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of $100,000, the contractor
acknowledges in accordance with Public Contract Code 7110, that:
a.The contractor recognizes the importance of child and family support obligations and shall fully comply
with all applicable state and federal laws relating to child and family support enforcement, including, but
not limited to, disclosure of information and compliance with earnings assignment orders, as provided in
Chapter 8 (commencing with section 5200) of Part 5 of Division 9 of the Family Code; and
b.The contractor, to the best of its knowledge is fully complying with the earnings assignment orders of all
employees and is providing the names of all new employees to the New Hire Registry maintained by
the California Employment Development Department.
16.UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is unenforceable or
held to be unenforceable, then the parties agree that all other provisions of this Agreement have force and
effect and shall not be affected thereby.
17.PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of $200,000, the
Contractor shall give priority consideration in filling vacancies in positions funded by the Contract to
qualified recipients of aid under Welfare and Institutions Code Section 11200 in accordance with Pub.
Contract Code §10353.
18.SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING REQUIREMENTS:
a.If for this Contract Contractor made a commitment to achieve small business participation, then
Contractor must within 60 days of receiving final payment under this Contract (or within such other time
period as may be specified elsewhere in this Contract) report to the awarding department the actual
percentage of small business participation that was achieved. (Govt. Code § 14841.)
b.If for this Contract Contractor made a commitment to achieve disabled veteran business enterprise
(DVBE) participation, then Contractor must within 60 days of receiving final payment under this
Contract (or within such other time period as may be specified elsewhere in this Contract) certify in a
report to the awarding department: (1) the total amount the prime Contractor received under the
Contract; (2) the name and address of the DVBE(s) that participated in the performance of the
Contract; (3) the amount each DVBE received from the prime Contractor; (4) that all payments under
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit C, General Terms and Conditions
Page 4 of 4
the Contract have been made to the DVBE; and (5) the actual percentage of DVBE participation that
was achieved. A person or entity that knowingly provides false information shall be subject to a civil
penalty for each violation. (Mil. & Vets. Code § 999.5(d); Govt. Code § 14841.)
19.LOSS LEADER: If this contract involves the furnishing of equipment, materials, or supplies then the
following statement is incorporated: It is unlawful for any person engaged in business within this state to
sell or use any article or product as a “loss leader” as defined in Section 17030 of the Business and
Professions Code. (PCC 10344(e).)
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 1 of 8
EXHIBIT D
SPECIAL TERMS AND CONDITIONS
1.SUBCONTRACTS:
A.Except for subcontracts identified in accordance with the solicitation, Contractor shall submit any
subcontracts in connection with this Agreement to the DSH for its prior written approval. No work
shall be subcontracted without the prior written approval of the DSH. Upon the termination of any
subcontract, the DSH shall be notified immediately. Any subcontract shall include all the terms
and conditions of this Agreement and its attachments.
B.Nothing contained in this Agreement shall create any contractual relationship between the DSH
and any subcontractors, and Contractor is solely responsible for payment of any and all fees,
expenses, salaries and benefits of subcontractor. No subcontract shall relieve Contractor of its
responsibilities and obligations hereunder. Contractor is fully responsible to the DSH for the acts
and omissions of its subcontractors and of persons either directly or indirectly employed or acting
as an agent by any of them. Contractor agrees to indemnify and hold the DSH harmless for any
costs, losses or claims, including reasonable attorney fees, resulting from its subcontractors.
2.PUBLICATIONS AND REPORTS:
A.The DSH reserves the right to use and reproduce all publications, reports, and data produced or
delivered pursuant to this Agreement. The DSH further reserves the right to authorize others to
use or reproduce such materials, provided the author of the report is acknowledged in any such
use or reproduction.
B.If the publication and/or report are prepared by non-employees of the DSH, and the total cost for
such preparation exceeds $5,000, the publication and/or report shall contain the numbers and
dollar amounts of all agreements and subcontracts relating to the preparation of the publication
and report in a separate section of the report (Gov. Code, §7550).
3.PROGRESS REPORTS:
A.If progress reports are required by the Agreement, Contractor shall provide a progress report in
writing, or orally if approved by the DSH Contract Manager, at least once a month to the DSH
Contract Manager. This progress report shall include, but not be limited to, a statement that the
Contractor is or is not on schedule, any pertinent reports, and any interim findings if applicable.
Contractor shall cooperate with and shall be available to meet with the DSH to discuss any
difficulties or special problems, so that solutions or remedies can be developed as soon as
possible.
4.PRESENTATION:
A.Upon request, Contractor shall meet with the DSH to present any findings, conclusions, and
recommendations required by the Agreement for approval. If set forth in the Agreement,
Contractor shall submit a comprehensive final report for approval. Both the final meeting and the
final report shall be completed on or before the date indicated in this Agreement.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 2 of 8
5.DEPARTMENT OF STATE HOSPITALS STAFF:
A.The DSH’s staff shall be permitted to work side-by-side with Contractor’s staff to the extent and
under conditions as directed by the DSH Contract Manager. In this connection, the DSH’s staff
shall be given access to all data, working papers, etc., which Contractor seeks to utilize.
6.CONFIDENTIALITY OF DATA AND DOCUMENTS:
A.Contractor shall not disclose data or documents or disseminate the contents of the final or any
preliminary report without written permission of the DSH Contract Manager. However, all public
entities shall comply with California Public Records Act (Gov. Code, §6250 et seq.).
B.Permission to disclose information or documents on one occasion shall not authorize Contractor
to further disclose such information or documents on any other occasion except as otherwise
provided in the Agreement or required by law.
C.Contractor shall not comment publicly to the press, or any other media, regarding the data or
documents generated, collected, or produced in connection with this Agreement, or the DSH’s
actions on the same, except to the DSH’s staff, Contractor’s own personnel involved in the
performance of this Agreement, or as required by law.
D.If requested by the DSH, Contractor shall require each of its employees or officers who will be
involved in the performance of this Agreement to agree to the above terms in a form to be
approved by the DSH and shall supply the DSH with evidence thereof.
E.After any data or documents submitted has become a part of the public records of the DSH,
Contractor may at its own expense and upon written approval by the DSH Contract Manager,
publish or utilize the same data or documents but shall include the following Notice:
LEGAL NOTICE
This report was prepared as an account of work sponsored by the Department of State Hospitals
(Department), but does not necessarily represent the views of the Department or any of its employees
except to the extent, if any, that it has formally been approved by the Department. For information
regarding any such action, communicate directly with the Department at P.O. Box 952050,
Sacramento, California, 94252-2050. Neither said Department nor the State of California, nor any
officer or employee thereof, or any of its contractors or subcontractors makes any warranty, express or
implied, or assumes any legal liability whatsoever for the contents of this document. Nor does any
party represent that use of the data contained herein, would not infringe upon privately owned rights
without obtaining permission or authorization from any party who has any rights in connection with the
data.
7.PROVISIONS RELATING TO DATA:
A.“Data” as used in this Agreement means recorded information, regardless of form or
characteristics, of a scientific or technical nature. It may, for example, document research,
experimental, developmental or engineering work; or be usable or be used to define a design or
process; or support a premise or conclusion asserted in any deliverable document called for by
this Agreement. The data may be graphic or pictorial delineations in media, such as drawings or
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 3 of 8
photographs, charts, tables, mathematical modes, collections or extrapolations of data or
information, etc. It may be in machine form, as punched cards, magnetic tape, computer
printouts, or may be retained in computer memory.
B.“Generated data” is that data, which Contractor has collected, collated, recorded, deduced, read
out, or postulated for utilization in the performance of this Agreement. Any electronic data
processing program, model or software system developed or substantially modified by Contractor
in the performance of this Agreement at the expense of the DSH, together with complete
documentation thereof, shall be treated in the same manner as generated data.
C.“Deliverable data” is that data which under terms of this Agreement is required to be delivered to
the DSH. Such data shall be property of the State of California and the DSH.
D.Prior to the expiration of any legally required retention period and before destroying any data,
Contractor shall notify the DSH of any such contemplated action; and the DSH may within
30 days of said notification determine whether or not this data shall be further preserved. The
DSH shall pay the expense of further preserving this data. The DSH shall have unrestricted
reasonable access to the data that is preserved in accordance with this Agreement.
E.Contractor shall use best efforts to furnish competent witnesses to testify in any court of law
regarding data used in or generated under the performance of this Agreement.
F.All financial, statistical, personal, technical and other data and information relating to the DSH’s
operation, which are designated confidential by the State or the DSH and made available to carry
out the Agreement, or which become available to Contractor in order to carry out this Agreement,
shall be protected by Contractor from unauthorized use and disclosure.
G.If the DSH determines that the data and information are inadequately protected by Contractor or
its subcontractors, the DSH shall provide notice of its determination and Contractor and/or its
subcontractors shall improve the protections to the DSH’s satisfaction which shall be evidenced
by written approval of the protections implemented.
8.APPROVAL OF PRODUCT:
A.Each product to be approved under this Agreement shall be approved by the Contract Manager.
The DSH’s determination as to satisfactory work shall be final, absent fraud or mistake.
9.SUBSTITUTIONS:
A.Contractor’s key personnel as indicated in its proposal may not be substituted without the
Contract Manager’s prior written approval.
10.NOTICE:
A.Notice to either party shall be given by first class mail, by Federal Express, United Parcel Service
or similar carrier, properly addressed, postage fully prepaid, to the address beneath the name of
each respective party. Alternatively, notice may be given by personal delivery by any means
whatsoever to the party and such notice shall be deemed effective when delivered.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 4 of 8
11.WAIVER:
A.All remedies afforded in this Agreement are cumulative; that is, in addition to every other remedy
provided therein or by law. The failure of the DSH to enforce any provision of this Agreement,
shall not waive its right to enforce the provision or any other provision of the Agreement.
12.GRATUITIES AND CONTINGENCY FEES:
A.Contractor shall not provide gratuities to any officer or employee of the DSH or the State to secure
an agreement or favorable treatment with respect to an agreement, the occurrence of which shall
constitute a material breach of this Agreement. The DSH, by written notice to Contractor, may
terminate this Agreement with cause if it is found that gratuities were offered or given by
Contractor or any agent or representative of the Contractor to any officer or employee of the State
or the DSH with a view toward securing an agreement or securing favorable treatment with
respect to the awarding, amending, or performance of such agreement.
B.In the event this Agreement is terminated as provided in the paragraph above, the DSH shall be
entitled (a) to pursue the same remedies against Contractor as it could pursue in the event of the
breach of the Agreement by Contractor, and (b) as a predetermined amount of liquidated
damages, Contractor shall pay an amount which shall not be less than three times the cost
incurred by Contractor in providing any such gratuities to any such officer or employee.
C.The rights and remedies of the DSH provided in this clause shall not be exclusive and are in
addition to any other rights and remedies provided by law or under this Agreement.
D.Contractor warrants by execution of this Agreement that no person or selling agency has been
employed or retained to solicit or secure this Agreement for a commission, percentage, brokerage
or contingent fee, excepting bona fide employees of Contractor, for the purpose of securing
business. For breach or violation of this warranty, the DSH shall, among other rights, have the
right to rescind this Agreement without liability, paying only for the values of the work actually
returned, or in its discretion to deduct from the Agreement price or consideration, or otherwise
recover, the full amount of such commission, percentage, brokerage, or contingent fee.
13.INTEGRATION CLAUSE:
A.The parties agree that this Agreement, including only the State standard form 213 and all exhibits,
constitute the entire agreement of the parties and no other understanding or communication,
whether written or oral, shall be construed to be a part of this Agreement.
14.CAPTIONS:
A.The clause headings appearing in this Agreement have been inserted for the purpose of
convenience and ready reference. They do not purport to and shall not be deemed to define, limit
or extend the scope or intent of the clauses to which they pertain.
15.PUBLIC HEARINGS:
A.If public hearings on the subject matter dealt with in this Agreement are held within one year from
the Agreement expiration date, Contractor shall make available to testify the personnel assigned
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 5 of 8
to this Agreement at the hourly rates specified in Contractor’s proposed budget. The DSH shall
reimburse Contractor for travel of said personnel at the Agreement, or if none, at State rates for
such testimony as may be requested by the DSH.
16.FORCE MAJEURE:
A.Neither the DSH nor Contractor shall be deemed to be in default in the performance of the terms
of this Agreement if either party is prevented from performing the terms of this Agreement by
causes beyond its control, which shall include without being limited to: acts of God; interference,
rulings or decision by municipal, Federal, State, or other governmental agencies, boards or
commissions; any laws and/or regulations of such municipal, State, Federal, or other
governmental bodies; or any catastrophe resulting from flood, fire, explosion, earthquakes, or
other similar environmental causes beyond the control of the defaulting party. If any of the stated
contingencies occur, the party delayed by force majeure shall immediately give the other party
written notice of the cause of delay. The party delayed by force majeure shall use reasonable
diligence to correct the cause of the delay, if correctable.
17.LITIGATION:
A.The DSH, promptly after receiving notice thereof, shall notify Contractor in writing of the
commencement of any claim, suit, or action against the DSH or its officers or employees.
Contractor shall immediately notify the DSH of any claim or action against it which affects, or may
affect, this Agreement, the terms or conditions hereunder, the DSH, and shall take such action
with respect to said claim or action which is consistent with the terms of this Agreement and the
interest of the DSH.
B.Contractor shall be in default of this Agreement (i) upon the institution by or against Contractor of
insolvency, receivership or bankruptcy proceedings or any other proceedings for the settlement of
Contractor’s debts, (ii) upon Contractor making an assignment for the benefit of creditors, (iii)
upon either party’s dissolution or ceasing to do business or (iv) when the facts and circumstances
indicate that Contractor is insolvent. For purposes of this Agreement, Contractor shall be deemed
insolvent if: (i) Contractor has failed to pay salaries, overtime or benefits required by law of
agreement, (ii) Contractor has failed to pay a subcontractor amounts owed pursuant to its
agreements with a subcontractor, or (iii) Contractor has failed to pay a vendor amounts Contractor
owes the vendor for more than 90 days the past due date for payment.
18.DISPUTES:
A.Contractor shall first discuss and attempt to resolve any dispute arising under or relating to the
performance of this Agreement, which is not disposed of by the Agreement, informally with the
DSH Contract Manager. If the dispute cannot be disposed of at this level, then the dispute shall
be decided by the DSH Deputy Director of Administration. All issues pertaining to this dispute
shall be submitted in written statements and addressed to the Deputy Director of Administration,
Department of State Hospitals, 1600 9th Street, Room 101, Sacramento, California 95814. Such
written notice must contain the Agreement Number. Within ten days of receipt of the written
grievance report from Contractor, the Deputy Director of Administration, or his/her designee, shall
meet with Contractor and the Project Manager for the purposes of resolving the dispute. The
decision of the Deputy Director shall be final. During the dispute process, Contractor shall
proceed diligently with the performance of the Agreement. Neither the pendency of a dispute, nor
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 6 of 8
its consideration by the Deputy Director of Administration, shall excuse Contractor from full and
timely performance of the services required in accordance with the terms of this Agreement.
19.EVALUATION OF CONTRACTOR’S PERFORMANCE:
A.The DSH shall evaluate Contractor’s performance under this Agreement using standardized
evaluation forms which shall be made available to every state agency pursuant to Public Contract
Code §10367.
20.AUDITS, INSPECTION AND ENFORCEMENT:
A.Contractor agrees to allow the DSH to inspect its facilities and systems, and make available for
review its books and records to enable the DSH to monitor compliance with the terms of this
Agreement and audit invoices submitted to the DSH.
B.Contractor shall promptly remedy any violation of any provision of this Agreement to the
satisfaction of the DSH.
C.The fact that the DSH inspects, or fails to inspect, or has the right to inspect Contractor’s facilities,
systems, books and records does not relieve Contractor of its responsibility to independently
monitor its compliance with this Agreement.
D.The DSH’s failure to detect or the DSH’s detection of any unsatisfactory practices, but failure to
notify Contractor or require Contractor’s remediation of the unsatisfactory practices does not
constitute acceptance of such practice or a waiver of the DSH’s enforcement rights under the
Agreement.
21.USE OF STATE FUNDS:
A.Contractor, including its officers and members, shall not use funds received from the DSH
pursuant to this Agreement to support or pay for costs or expenses related to the following:
i.Campaigning or other partisan activities to advocate for either the election or defeat of any
candidate for elective office, or for or against the passage of any proposition or ballot
measure; or,
ii.Lobbying for either the passage or defeat of any legislation.
B.This provision is not intended and shall not be construed to limit any expression of a view,
opinion, or position of any member of Contractor as an individual or private citizens, as long as
State funds are not used; nor does this provision limit Contractor from merely reporting the results
of a poll or survey of its membership.
22.CANCELLATION PROVISIONS:
A.Unless otherwise specified, this Agreement may be canceled at any time by the DSH, in writing,
with thirty (30) days advance notice. If canceled, payment shall be made only for the provision of
services expressly authorized by this Agreement until the date of cancellation and only at the
rates set forth in Exhibit B, Budget Detail. In the case of early termination, a final payment will be
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 7 of 8
made to Contractor upon receipt of an invoice covering all authorized costs, at the rates set forth
in Exhibit B, incurred prior to the date of cancellation or termination. The DSH shall not be
responsible for unamortized costs, overhead or capital costs or any other related costs, including
but, not limited to costs incurred in connection with the cancellation of leases or contracts
pertaining to facilities, equipment or supplies, labor and employee benefits costs, and
expenditures incurred after the date of notice of cancellation.
B.If the DSH determines that Contractor has breached a material term of the Agreement and has
not cured the breach or ended the violation within the time specified by the DSH, the DSH may
terminate the contract by providing notice to Contractor. The DSH Information Security Officer
shall report as required HIPAA violations to the Secretary of the U.S. Department of Health and
Human Services.
C.Failure to comply with section 1 or 6 of this Exhibit, or a violation of section 12 of this Exhibit, shall
be deemed a material breach of this Agreement.
23.EMPLOYMENT PROVISIONS:
A.Contractor acknowledges and agrees that neither Contractor, their personnel, subcontractors, nor
other service providers through this Agreement are employees of the DSH. Contractor and its
independent contractors shall be solely responsible for:
i.Paying any and all payroll taxes, including, but not limited to Social Security and Medicare
taxes,
ii.Federal or state income tax withholding,
iii.Providing unemployment insurance and workers compensation insurance, and
iv.Paying compensation to its employees in accordance with federal and state labor laws,
including overtime pay unless otherwise specified in this Agreement, as well as penalties that
may be imposed for failure to comply with these laws. Contractor agrees to indemnify and
hold harmless the DSH for any damages, losses, expenses, including reasonable attorney
fees, in connection with its failure to pay salary or overtime, or provide benefits, including, but
not limited to health care benefits or retirement benefits, to its employees, or its failure to
provide to comply with federal or state labor laws.
24.LIABILITY FOR LOSS AND DAMAGES:
A.Any damages by Contractor, their personnel, subcontractors, and other service providers through
this Agreement to the DSH’s facility, including equipment, furniture, materials, or other State or
DSH property, shall be repaired or replaced by Contractor to the satisfaction of the DSH at
Contractor’s expense. The DSH, at its option, may repair any such damage and deduct the cost
thereof from any sum due Contractor under this Agreement.
25.SECURITY CLEARANCE/FINGERPRINTING/TUBERCULIN SKIN TESTING:
A.The DSH reserves the right to conduct fingerprinting, drug testing, and/or security clearance
through the Department of Justice, Bureau of Criminal Identification and Information (BCII), prior
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit D, Special Terms and Conditions
Page 8 of 8
to award and at any time during the term of the Agreement, in order to permit Contractor, their
personnel, subcontractors, and other service providers through this Agreement access to State
premises. The DSH further reserves the right to terminate this Agreement should a threat to
security, by Contractor, their personnel, subcontractors, and other service providers through this
Agreement, be determined.
B.At the sole discretion of the DSH, and in accordance with each facility’s Infection Control Policy,
the Contractor, their personnel, subcontractors, and anyone else affiliated with this Agreement
providing services may be required to provide the DSH with Tuberculin (TB) test results. These
test results shall indicate completion of the two-step TB testing process using the Mantoux
method. The first step is a tuberculin skin test (TST) completed within the last 12 months prior to
the date the tested person is to provide services to a DSH facility. The second step is a TST
which must be completed within the 30 days prior to the date the tested person is to provide
services to a DSH facility, unless otherwise specified.
C.If both of the documented results of the TST provided ≤ 0-9/mm of induration, then the tested
person may be cleared to provide services. However, if the documented result of the TST is ≥
10/mm of induration, then they shall be subject to additional testing and/or clearances before he
or she is allowed to work at a DSH facility.
D.The DSH reserves the right, in its sole and absolute discretion, to take measures to minimize the
transmission of influenza. Contractor, their personnel, subcontractors, and other service providers
through this Agreement may be required to either a) show written proof that they have received an
influenza vaccine, or b) complete an Influenza Declination Form, which will be provided upon
request. In addition, all non-vaccinated providers may be required to wear a mask. In its sole and
absolute discretion, DSH may elect to provide free influenza vaccines to Contractor, their
personnel, subcontractors, and other service providers through this Agreement.
26.PHYSICIAN OWNERSHIP AND REFERRAL ACT OF 1993:
A.For applicable medical services contracts, and in accordance with the Physician Ownership and
Referral Act of 1993, Contractor shall not refer any patient to any health care provider or health-
related facility if the Contractor has a financial interest with that health care provider or health-
related facility.
B.Contractor may make a referral to or request consultation from a sole source health care provider
or health-related facility in which financial interest is held if Contractor is located where there is no
alternative provider of service within either twenty-five (25) miles or forty (40) minutes travel time,
subject to the prior approval of the DSH. Contractor shall disclose, in writing, as well as on a
continuous basis, to the DSH, its financial interest at the time of referral or request for
consultation. In no event, will this prohibit patients from receiving emergency health care
services.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 1 of 10
EXHIBIT F
Information Privacy and Security Requirements
(For Non-HIPAA/HITECH Act Contracts)
This Information Privacy and Security Requirements Exhibit (For Non-HIPAA/HITECH Act Contracts)
(hereinafter referred to as “this Exhibit”) sets forth the information privacy and security requirements Contractor
is obligated to follow with respect to all personal and confidential information (as defined herein) disclosed to
Contractor, or collected, created, maintained, stored, transmitted or used by Contractor for or on behalf of the
California Department of State Hospitals (hereinafter “DSH”), pursuant to Contractor’s agreement with DSH.
(Such personal and confidential information is referred to herein collectively as “DSH PCI”.) DSH and
Contractor desire to protect the privacy and provide for the security of DSH PCI pursuant to this Exhibit and in
compliance with state and federal laws applicable to the DSH PCI.
I.Order of Precedence: With respect to information privacy and security requirements for all DSH PCI,
the terms and conditions of this Exhibit shall take precedence over any conflicting terms or conditions
set forth in any other part of the agreement between Contractor and DSH, including Exhibit A (Scope of
Work), all other exhibits and any other attachments, and shall prevail over any such conflicting terms or
conditions.
II.Effect on lower tier transactions: The terms of this Exhibit shall apply to all contracts, subcontracts, and
subawards, and the information privacy and security requirements Contractor is obligated to follow with
respect to DSH PCI disclosed to Contractor, or collected, created, maintained, stored, transmitted or
used by Contractor for or on behalf of DSH, pursuant to Contractor’s agreement with DSH. When
applicable the Contractor shall incorporate the relevant provisions of this Exhibit into each subcontract
or subaward to its agents, subcontractors, or independent consultants.
III.Definitions: For purposes of the agreement between Contractor and DSH, including this Exhibit, the
following definitions shall apply:
A.Breach: “Breach” means:
1.the unauthorized acquisition, access, use, or disclosure of DSH PCI in a manner which
compromises the security, confidentiality or integrity of the information; or
2.the same as the definition of "breach of the security of the system" set forth in California Civil
Code section 1798.29(f).
B.Confidential Information: “Confidential information” means information that:
1.does not meet the definition of “public records” set forth in California Government Code
section 6252(e), or is exempt from disclosure under any of the provisions of Section 6250, et
seq of the California Government Code or any other applicable state or federal laws; or
2.is contained in documents, files, folders, books or records that are clearly labeled, marked or
designated with the word “confidential” by DSH.
C. Disclosure: “Disclosure” means the release, transfer, provision of, access to, or divulging in any
manner of information outside the entity holding the information.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 2 of 10
D. PCI: “PCI” means “personal information” and “confidential information” collectively (as these terms
are defined herein).
E.Personal Information: “Personal information” means information, in any medium (paper,
electronic, oral) that:
1.directly or indirectly collectively identifies or uniquely describes an individual; or
2.could be used in combination with other information to indirectly identify or uniquely describe
an individual, or link an individual to the other information; or
3.meets the definition of “personal information” set forth in California Civil Code section 1798.3,
subdivision (a); or
4.is one of the data elements set forth in California Civil Code section 1798.29, subdivision
(g)(1) or (g)(2); or
5.meets the definition of “medical information” set forth in either California Civil Code section
1798.29, subdivision (h)(2), or California Civil Code section 56.05, subdivision (j); or
6.meets the definition of “health insurance information” set forth in California Civil Code section
1798.29, subdivision (h)(3); or
7.is protected from disclosure under applicable state or federal law.
F.Security Incident: “Security Incident” means:
1.an attempted breach; or
2.the attempted or successful unauthorized access or disclosure, modification or destruction of
DSH PCI, in violation of any state or federal law or in a manner not permitted under the
agreement between Contractor and DSH, including this Exhibit; or
3.the attempted or successful modification or destruction of, or interference with, Contractor’s
system operations in an information technology system, that negatively impacts the
confidentiality, availability or integrity of DSH PCI; or
4.any event that is reasonably believed to have compromised the confidentiality, integrity, or
availability of an information asset, system, process, data storage, or transmission.
Furthermore, an information security incident may also include an event that constitutes a
violation or imminent threat of violation of information security policies or procedures, including
acceptable use policies.
G.Use: “Use” means the sharing, employment, application, utilization, examination, or analysis of
information.
IV.Disclosure Restrictions: The Contractor and its employees, agents, and subcontractors shall protect
from unauthorized disclosure any DSH PCI. The Contractor shall not disclose, except as otherwise
specifically permitted by the agreement between Contractor and DSH (including this Exhibit), any DSH
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 3 of 10
PCI to anyone other than DSH personnel or programs without prior written authorization from the DSH
Program Contract Manager, except if disclosure is required by State or Federal law.
V.42 C.F.R. Part 2 compliance: DSH shall receive patient identifying substance use disorder treatment
information for program evaluation and auditing purposes. In accordance with 42 C.F.R. part 2.53, DSH
agrees to:
(i)Maintain and destroy patient identifying information and records covered by 42 C.F.R. Part 2 in a
manner consistent with the policies and procedures established under 42 C.F.R. part 2.16;
(ii) Retain records in compliance with applicable federal, state, and local record retention laws; and
(iii) Comply with the limitations on disclosure and use in 42 C.F.R. part 2.53(d).
VI.Use Restrictions: The Contractor and its employees, agents, and subcontractors shall not use any
DSH PCI for any purpose other than performing the Contractor's obligations under its agreement with
DSH. DSH and its employees, agents, and subcontractors shall not use any data received from
contractor for any purpose other than noted in this agreement, Welfare and Institutions Code section
4361, or Assembly Bill 1810.
VII.Research compliance: DSH is a covered entity under the Health Insurance Portability and
Accountability Act of 1996 (HIPAA). DSH may receive protected health information and patient
identifying substance use disorder treatment information for research purposes so long as disclosure is
consistent with federal and state laws. Without limiting the generality of the foregoing, in accordance
with 42 C.F.R. part 2.52(a) and 45 C.F.R. part 164.512(i), Contractor shall only disclose the data to
DSH for research purposes after DSH obtains approval from the State of California’s Institutional
Review Board, the California Health and Human Services’ Committee for the Protection of Human
Subjects, and furnishes documentation to Contractor. DSH shall follow all of its internal policies and
procedures for obtaining approval for research using data reported by contractor. DSH agrees to
comply with HIPAA and 42 C.F.R. Part 2 regarding all requirements including retention and destruction.
VIII.Safeguards: The Contractor shall implement administrative, physical, and technical safeguards that
reasonably and appropriately protect the privacy, confidentiality, security, integrity, and availability of
DSH PCI, including electronic or computerized DSH PCI. At each location where DSH PCI exists under
Contractor’s control, the Contractor shall develop and maintain a written information privacy and
security program that includes administrative, technical and physical safeguards appropriate to the size
and complexity of the Contractor’s operations and the nature and scope of its activities in performing its
agreement with DSH, including this Exhibit, and which incorporates the requirements of Section VII,
Security, below. Contractor shall provide DSH with Contractor’s current and updated policies within five
(5)business days of a request by DSH for the policies.
IX.Security: The Contractor shall take any and all steps reasonably necessary to ensure the continuous
security of all computerized data systems containing DSH PCI. These steps shall include, at a
minimum, complying with all of the data system security precautions listed in the Contractor Data
Security Standards set forth in Attachment 1 to this Exhibit.
X.Security Officer: At each place where DSH PCI is located, the Contractor shall designate a Security
Officer to oversee its compliance with this Exhibit and to communicate with DSH on matters concerning
this Exhibit.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 4 of 10
XI.Training: The Contractor shall provide training on its obligations under this Exhibit, at its own expense,
to all of its employees who assist in the performance of Contractor’s obligations under Contractor’s
agreement with DSH, including this Exhibit, or otherwise use or disclose DSH PCI.
A.The Contractor shall require each employee who receives training to certify, either in hard copy or
electronic form, the date on which the training was completed.
B.The Contractor shall retain each employee’s certifications for DSH inspection for a period of three
years following contract termination or completion.
C.Contractor shall provide DSH with its employee’s certifications within five (5) business days of a
request by DSH for the employee’s certifications.
XII.Employee Discipline: Contractor shall impose discipline that it deems appropriate (in its sole discretion)
on such employees and other Contractor workforce members under Contractor’s direct control who
intentionally or negligently violate any provisions of this Exhibit.
XIII.Breach and Security Incident Responsibilities:
A.Notification to DSH of Breach or Security Incident: The Contractor shall notify DSH immediately
by telephone call plus email or fax upon the discovery of a breach (as defined in this Exhibit),
and within twenty-four (24) hours by email or fax of the discovery of any security incident (as
defined in this Exhibit), unless a law enforcement agency determines that the notification will
impede a criminal investigation, in which case the notification required by this section shall be
made to DSH immediately after the law enforcement agency determines that such notification will
not compromise the investigation. Notification shall be provided to the DSH Program Contract
Manager, the DSH Privacy Officer and the DSH Chief Information Security Officer, using the
contact information listed in Section XI(F), below. If the breach or security incident is discovered
after business hours or on a weekend or holiday and involves DSH PCI in electronic or
computerized form, notification to DSH shall be provided by calling the DSH Information Security
Office at the telephone numbers listed in Section XI(F), below. For purposes of this Section,
breaches and security incidents shall be treated as discovered by Contractor as of the first day on
which such breach or security incident is known to the Contractor, or, by exercising reasonable
diligence would have been known to the Contractor. Contractor shall be deemed to have
knowledge of a breach if such breach is known, or by exercising reasonable diligence would have
been known, to any person, other than the person committing the breach, who is an employee or
agent of the Contractor.
Contractor shall take:
1.prompt corrective action to mitigate any risks or damages involved with the breach or security
incident and to protect the operating environment; and
2.any action pertaining to a breach required by applicable federal and state laws, including,
specifically, California Civil Code section 1798.29 and 1798.82.
B.Investigation of Breach and Security Incidents: The Contractor shall immediately investigate such
breach or security incident. As soon as the information is known and subject to the legitimate
needs of law enforcement, Contractor shall inform the DSH Program Contract Manager, the DSH
Privacy Officer, and the DSH Chief Information Security Officer of:
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 5 of 10
1.what data elements were involved, and the extent of the data disclosure or access involved in
the breach, including, specifically, the number of individuals whose personal information was
breached; and
2.a description of the unauthorized persons known or reasonably believed to have improperly
used the DSH PCI and/or a description of the unauthorized persons known or reasonably
believed to have improperly accessed or acquired the DSH PCI, or to whom it is known or
reasonably believed to have had the DSH PCI improperly disclosed to them; and
3.a description of where the DSH PCI is believed to have been improperly used or disclosed;
and
4.a description of the probable and proximate causes of the breach or security incident; and
5.whether Civil Code section 1798.29 and 1798.82 or any other federal or state laws requiring
individual notifications of breaches have been triggered.
C.Written Report: The Contractor shall provide a written report of the investigation to the DSH
Program Contract Manager, the DSH Privacy Officer, and the DSH Chief Information Security
Officer as soon as practicable after the discovery of the breach or security incident. The report
shall include, but not be limited to, the information specified above, as well as a complete, detailed
corrective action plan, including information on measures that were taken to halt and/or contain
the breach or security incident, and measures to be taken to prevent the recurrence or further
disclosure of data regarding such breach or security incident.
D.Notification to Individuals: If notification to individuals whose information was breached is
required under state or federal law, and regardless of whether Contractor is considered only a
custodian and/or non-owner of the DSH PCI, Contractor shall, at its sole expense, and at the sole
election of DSH, either:
1.make notification to the individuals affected by the breach (including substitute notification),
pursuant to the content and timeliness provisions of such applicable state or federal breach
notice laws. Contractor shall inform the DSH Privacy Officer of the time, manner and content
of any such notifications, prior to the transmission of such notifications to the individuals; or
2.cooperate with and assist DSH in its notification (including substitute notification) to the
individuals affected by the breach.
E.Submission of Sample Notification to Attorney General: If notification to more than 500 individuals
is required pursuant to California Civil Code section 1798.29 or 1798.82, and regardless of
whether Contractor is considered only a custodian and/or non-owner of the DSH PCI, Contractor
shall, at its sole expense, and at the sole election of DSH, either:
1.electronically submit a single sample copy of the security breach notification, excluding any
personally identifiable information, to the Attorney General pursuant to the format. content and
timeliness provisions of Section 1798.29, subdivision (e), or 1798.82, subdivision
(f). Contractor shall inform the DSH Privacy Officer of the time, manner and content of any
such submissions, prior to the transmission of such submissions to the Attorney General; or
2.cooperate with and assist DSH in its submission of a sample copy of the notification to the
Attorney General.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 6 of 10
F.DSH Contact Information: To direct communications to the above referenced DSH staff, the
Contractor shall initiate contact as indicated herein. DSH reserves the right to make changes to
the contact information below by verbal or written notice to the Contractor. Said changes shall not
require an amendment to this Exhibit or the agreement to which it is incorporated.
DSH Program Contract
Manager
DSH Privacy Officer DSH Chief Information
Security Officer
See the Scope of Work
exhibit for Program
Contract Manager
Chief Privacy Officer (A)
Office of Legal Services
California Dept. State Hospitals
1600 9th Street, Room 433
Sacramento, CA 95814
Email:
yamin.scardigli@dsh.ca.gov
Telephone: (916) 562-3721
Chief Information Security
Officer
Information Security Office
1600 9th Street, Suite 250
Sacramento, CA 95814
Email:iso@dsh.ca.gov and
security@dsh.ca.gov
Telephone: 916-654-4218
XIV.Documentation of Disclosures for Requests for Accounting: Contractor shall document and make
available to DSH or (at the direction of DSH) to an Individual such disclosures of DSH PCI, and
information related to such disclosures, necessary to respond to a proper request by the subject
Individual for an accounting of disclosures of personal information as required by Civil Code section
1798.25, or any applicable state or federal law.
XV.Requests for DSH PCI by Third Parties: The Contractor and its employees, agents, or subcontractors
shall promptly transmit to the DSH Program Contract Manager all requests for disclosure of any DSH
PCI requested by third parties to the agreement between Contractor and DSH (except from an
Individual for an accounting of disclosures of the individual’s personal information pursuant to
applicable state or federal law), unless prohibited from doing so by applicable state or federal law.
XVI.Audits, Inspection and Enforcement: DSH may inspect the facilities, systems, books and records of
Contractor to monitor compliance with this Exhibit. Contractor shall promptly remedy any violation of
any provision of this Exhibit and shall certify the same to the DSH Program Contract Manager in writing.
XVII.Return or Destruction of DSH PCI on Expiration or Termination: Upon expiration or termination of the
agreement between Contractor and DSH for any reason, Contractor shall securely return or destroy the
DSH PCI. If return or destruction is not feasible, Contractor shall provide a written explanation to the
DSH Program Contract Manager, the DSH Privacy Officer and the DSH Chief Information Security
Officer, using the contact information listed in Section XI(F), above.
A.Retention Required by Law: If required by state or federal law, Contractor may retain, after
expiration or termination, DSH PCI for the time specified as necessary to comply with the law.
B.Obligations Continue Until Return or Destruction: Contractor’s obligations under this Exhibit shall
continue until Contractor destroys the DSH PCI or returns the DSH PCI to DSH; provided
however, that on expiration or termination of the agreement between Contractor and DSH,
Contractor shall not further use or disclose the DSH PCI except as required by state or federal
law.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 7 of 10
C.Notification of Election to Destroy DSH PCI: If Contractor elects to destroy the DSH PCI,
Contractor shall certify in writing within 30 days of the expiration or termination of the agreement
to the DSH Program Contract Manager, the DSH Privacy Officer and the DSH Chief Information
Security Officer, using the contact information listed in Section XI(F), above, that the DSH PCI has
been securely destroyed. The notice shall include the date and type of destruction method used.
XVIII.Amendment: The parties acknowledge that federal and state laws regarding information security
and privacy rapidly evolves and that amendment of this Exhibit may be required to provide for
procedures to ensure compliance with such laws. The parties specifically agree to take such
action as is necessary to implement new standards and requirements imposed by regulations and
other applicable laws relating to the security or privacy of DSH PCI. The parties agree to promptly
enter into negotiations concerning an amendment to this Exhibit consistent with new standards
and requirements imposed by applicable laws and regulations.
XIX.Assistance in Litigation or Administrative Proceedings: Contractor shall make itself and any
subcontractors, workforce employees or agents assisting Contractor in the performance of its
obligations under the agreement between Contractor and DSH, available to DSH at no cost to
DSH to testify as witnesses, in the event of litigation or administrative proceedings being
commenced against DSH, its director, officers or employees based upon claimed violation of laws
relating to security and privacy, which involves inactions or actions by the Contractor, except
where Contractor or its subcontractor, workforce employee or agent is a named adverse party.
XX.No Third-Party Beneficiaries: Nothing express or implied in the terms and conditions of this
Exhibit is intended to confer, nor shall anything herein confer, upon any person other than DSH or
Contractor and their respective successors or assignees, any rights, remedies, obligations or
liabilities whatsoever.
XXI.Interpretation: The terms and conditions in this Exhibit shall be interpreted as broadly as
necessary to implement and comply with regulations and applicable State laws. The parties
agree that any ambiguity in the terms and conditions of this Exhibit shall be resolved in favor of a
meaning that complies and is consistent with federal and state laws and regulations.
XXII.Survival: If Contractor does not return or destroy the DSH PCI upon the expiration or termination
of the Agreement, the respective rights and obligations of Contractor under Sections VI, VII and XI
of this Exhibit shall survive the completion or termination of the agreement between Contractor
and DSH.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 8 of 10
Attachment 1
Contractor Data Security Standards
1.General Security Controls
A.Confidentiality Statement. All persons that will be working with DSH PCI must sign a
confidentiality statement. The statement must include at a minimum, General Use, Security and
Privacy safeguards, Unacceptable Use, and Enforcement Policies. The statement must be
signed by the workforce member prior to access to DSH PCI. The statement must be renewed
annually. The Contractor shall retain each person’s written confidentiality statement for DSH
inspection for a period of three (3) years following contract termination.
B.Background check. Before a member of the Contractor’s workforce may access DSH PCI,
Contractor must conduct a thorough background check of that worker and evaluate the results to
assure that there is no indication that the worker may present a risk for theft of confidential data.
The Contractor shall retain each workforce member’s background check documentation for a
period of three (3) years following contract termination.
C.Workstation/Laptop encryption. All workstations and laptops that process and/or store DSH
PCI must be encrypted using a FIPS 140-2 certified algorithm, such as Advanced Encryption
Standard (AES), with a 128bit key or higher. The encryption solution must be full disk unless
approved by the DSH Information Security Office.
D.Server Security. Servers containing unencrypted DSH PCI must have sufficient administrative,
physical, and technical controls in place to protect that data, based upon a risk
assessment/system security review.
E.Minimum Necessary. Only the minimum necessary amount of DSH PCI required to perform
necessary business functions may be copied, downloaded, or exported.
F.Removable media devices. All electronic files that contain DSH PCI data must be encrypted
when stored on any removable media or portable device (i.e. USB thumb drives, floppies,
CD/DVD, smart devices tapes etc.). PCI must be encrypted using a FIPS 140-2 certified
algorithm, such as Advanced Encryption Standard (AES), with a 128bit key or higher
G.Antivirus software. All workstations, laptops and other systems that process and/or store DSH
PCI must install and actively use a comprehensive anti-virus software solution with automatic
updates scheduled at least daily.
H.Patch Management. All workstations, laptops and other systems that process and/or store DSH
PCI must have operating system and application security patches applied, with system reboot if
necessary. There must be a documented patch management process which determines
installation timeframe based on risk assessment and vendor recommendations. At a maximum,
all applicable patches must be installed within 30 days of vendor release.
I.User IDs and Password Controls. All users must be issued a unique user name for accessing
DSH PCI. Username must be promptly disabled, deleted, or the password changed upon the
transfer or termination of an employee with knowledge of the password. Passwords are not to be
shared. Must be at least eight characters. Must be a non-dictionary word. Must not be stored in
readable format on the computer. Must be changed every 60 days. Must be changed if revealed
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 9 of 10
or compromised. Must be composed of characters from at least three of the following four groups
from the standard keyboard:
•Upper case letters (A-Z)
•Lower case letters (a-z)
•Arabic numerals (0-9)
•Non-alphanumeric characters (punctuation symbols)
J.Data Sanitization. All DSH PCI must be sanitized using NIST Special Publication 800-88
standard methods for data sanitization when the DSH PCI is no longer needed.
2.System Security Controls
A.System Timeout. The system must provide an automatic timeout, requiring reauthentication of
the user session after no more than 20 minutes of inactivity.
B.Warning Banners. All systems containing DSH PCI must display a warning banner each time a
user attempts access, stating that data is confidential, systems are logged, and system use is for
business purposes only. User must be directed to log off the system if they do not agree with
these requirements.
C.System Logging. The system must maintain an automated audit trail which can identify the user
or system process which initiates a request for DSH PCI, or which alters DSH PCI. The audit trail
must be date and time stamped, must log both successful and failed accesses, must be read only,
and must be restricted to authorized users This logging must be included for all user privilege
levels including, but not limited to, systems administrators. If DSH PCI is stored in a database,
database logging functionality must be enabled. Audit trail data must be archived for at least 3
years after occurrence.
D.Access Controls. The system must use role based access controls for all user authentications,
enforcing the principle of least privilege.
E.Transmission encryption. All data transmissions of DSH PCI outside the contractor’s secure
internal network must be encrypted using a FIPS 140-2 certified algorithm, such as Advanced
Encryption Standard (AES), with a 128bit key or higher. Encryption can be end to end at the
network level, or the data files containing DSH PCI can be encrypted. This requirement pertains
to any type of DSH PCI in motion such as website access, file transfer, and E-Mail.
F.Intrusion Detection. All systems involved in accessing, holding, transporting, and protecting
DSH PCI that are accessible via the Internet must be protected by a comprehensive intrusion
detection and prevention solution.
3.Audit Controls
A.System Security Review. All systems processing and/or storing DSH PCI must have at least an
annual system risk assessment/security review which provides assurance that administrative,
physical, and technical controls are functioning effectively and providing adequate levels of
protection. Reviews shall include vulnerability scanning tools.
Department of State Hospitals County of Fresno
Agreement Number: 20-79001-000
Exhibit F, Information Privacy and Security Requirements
Page 10 of 10
B.Log Reviews. All systems processing and/or storing DSH PCI must have a routine procedure in
place to review system logs for unauthorized access.
C.Change Control. All systems processing and/or storing DSH PCI must have a documented
change control procedure that ensures separation of duties and protects the confidentiality,
integrity and availability of data.
4.Business Continuity / Disaster Recovery Controls
A.Disaster Recovery. Contractor must establish a documented plan to enable continuation of
critical business processes and protection of the security of electronic DSH PCI in the event of an
emergency. Emergency means any circumstance or situation that causes normal computer
operations to become unavailable for use in performing the work required under this agreement
for more than 24 hours.
B.Data Backup Plan. Contractor must have established documented procedures to securely
backup DSH PCI to maintain retrievable exact copies of DSH PCI. The backups shall be
encrypted. The plan must include a regular schedule for making backups, storing backups offsite,
an inventory of backup media, and the amount of time to restore DSH PCI should it be lost. At a
minimum, the schedule must be a weekly full backup and monthly offsite storage of DSH data.
5.Paper Document Controls
A.Supervision of Data. DSH PCI in paper form shall not be left unattended at any time, unless it is
locked in a file cabinet, file room, desk or office. Unattended means that information is not being
observed by an employee authorized to access the information. DSH PCI in paper form shall not
be left unattended at any time in vehicles or planes and shall not be checked in baggage on
commercial airplanes.
B.Escorting Visitors. Visitors to areas where DSH PCI is contained shall be escorted and DSH
PHI shall be kept out of sight while visitors are in the area.
C.Confidential Destruction. DSH PCI must be disposed of through confidential means, using
NIST Special Publication 800-88 standard methods for data sanitization when the DSH PSCI is no
longer needed.
D.Removal of Data. DSH PCI must not be removed from the premises of the Contractor except
with express written permission of DSH.
E.Faxing. Faxes containing DSH PCI shall not be left unattended and fax machines shall be in
secure areas. Faxes shall contain a confidentiality statement notifying persons receiving faxes in
error to destroy them. Fax numbers shall be verified with the intended recipient before sending.
F.Mailing. DSH PCI shall only be mailed using secure methods. Large volume mailings of DSH
PHI shall be by a secure, bonded courier with signature required on receipt. Disks and other
transportable media sent through the mail must be encrypted with a DSH approved solution, such
as a solution using a vendor product specified on the CALIFORNIA STRATEGIC SOURCING
INITIATIVE.
GTC 04/2017
EXHIBIT C
GENERAL TERMS AND CONDITIONS
1.APPROVAL: This Agreement is of no force or effect until signed by both parties and
approved by the Department of General Services, if required. Contractor may not commence
performance until such approval has been obtained.
2.AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid
unless made in writing, signed by the parties and approved as required. No oral understanding or
Agreement not incorporated in the Agreement is binding on any of the parties.
3.ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in
part, without the consent of the State in the form of a formal written amendment.
4.AUDIT: Contractor agrees that the awarding department, the Department of General Services,
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 the performance of this
Agreement. Contractor agrees to maintain such records for possible audit for a minimum of three
(3) years after final payment, unless a longer period of records retention is stipulated. Contractor
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, Contractor agrees to include a similar right of the State to audit records and interview
staff in any subcontract related to performance of this Agreement. (Gov. Code §8546.7, Pub.
Contract Code §10115 et seq., CCR Title 2, Section 1896).
5.INDEMNIFICATION: Contractor 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 performance
of this Agreement, and from any and all claims and losses accruing or resulting to any person,
firm or corporation who may be injured or damaged by Contractor in the performance of this
Agreement.
6.DISPUTES: Contractor shall continue with the responsibilities under this Agreement during
any dispute.
7.TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of
any payments should the Contractor fail to perform the requirements of this Agreement at the
time and in the manner herein provided. In the event of such termination the State may proceed
with the work in any manner deemed proper by the State. All costs to the State shall be deducted
from any sum due the Contractor under this Agreement and the balance, if any, shall be paid to
the Contractor upon demand.
8.INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor,
in the performance of this Agreement, shall act in an independent capacity and not as officers or
employees or agents of the State.
9.RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of
perjury, the minimum, if not exact, percentage of post consumer material as defined in the Public
Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the
State regardless of whether the product meets the requirements of Public Contract Code Section
12209. With respect to printer or duplication cartridges that comply with the requirements of
Section 12156(e), the certification required by this subdivision shall specify that the cartridges so
comply (Pub. Contract Code §12205).
10.NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, Contractor
and its subcontractors shall not deny the contract’s benefits to any person on the basis of race,
religious creed, color, national origin, ancestry, physical disability, mental disability, medical
condition, genetic information, marital status, sex, gender, gender identity, gender expression,
age, sexual orientation, or military and veteran status, nor shall they discriminate unlawfully
against any employee or applicant for employment because of race, religious creed, color,
national origin, ancestry, physical disability, mental disability, medical condition, genetic
information, marital status, sex, gender, gender identity, gender expression, age, sexual
orientation, or military and veteran status. Contractor shall insure that the evaluation and
treatment of employees and applicants for employment are free of such discrimination.
Contractor and subcontractors shall comply with the provisions of the Fair Employment and
Housing Act (Gov. Code §12900 et seq.), the regulations promulgated thereunder (Cal. Code
Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2
of the Government Code (Gov. Code §§11135-11139.5), and the regulations or standards
adopted by the awarding state agency to implement such article. Contractor shall permit access
by representatives of the Department of Fair Employment and Housing and the awarding state
agency upon reasonable notice at any time during the normal business hours, but in no case less
than 24 hours’ notice, to such of its books, records, accounts, and all other sources of information
and its facilities as said Department or Agency shall require to ascertain compliance with this
clause. Contractor and its subcontractors shall give written notice of their obligations under this
clause to labor organizations with which they have a collective bargaining or other agreement.
(See Cal. Code Regs., tit. 2, §11105.)
Contractor shall include the nondiscrimination and compliance provisions of this clause in all
subcontracts to perform work under the Agreement.
11.CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES
contained in the document CCC 04/2017 are hereby incorporated by reference and made a part
of this Agreement by this reference as if attached hereto.
12.TIMELINESS: Time is of the essence in this Agreement.
13.COMPENSATION: The consideration to be paid Contractor, as provided herein, shall be in
compensation for all of Contractor's expenses incurred in the performance hereof, including
travel, per diem, and taxes, unless otherwise expressly so provided.
14.GOVERNING LAW: This contract is governed by and shall be interpreted in accordance
with the laws of the State of California.
15.ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if
these services or goods are obtained by means of a competitive bid, the Contractor shall comply
with the requirements of the Government Codes Sections set out below.
a.The Government Code Chapter on Antitrust claims contains the following definitions:
1) "Public purchase" means a purchase by means of competitive bids of goods, services, or
materials by the State or any of its political subdivisions or public agencies on whose behalf the
Attorney General may bring an action pursuant to subdivision (c) of Section 16750 of the
Business and Professions Code.
2) "Public purchasing body" means the State or the subdivision or agency making a public
purchase. Government Code Section 4550.
b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is
accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of
action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the
Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the
Business and Professions Code), arising from purchases of goods, materials, or services by the
bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to the bidder.
Government Code Section 4552.
c.If an awarding body or public purchasing body receives, either through judgment or
settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor
shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand,
recover from the public body any portion of the recovery, including treble damages, attributable
to overcharges that were paid by the assignor but were not paid by the public body as part of the
bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code
Section 4553.
d. Upon demand in writing by the assignor, the assignee shall, within one year from such
demand, reassign the cause of action assigned under this part if the assignor has been or may
have been injured by the violation of law for which the cause of action arose and (a) the assignee
has not been injured thereby, or (b) the assignee declines to file a court action for the cause of
action. See Government Code Section 4554.
16.CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of $100,000, the
contractor acknowledges in accordance with Public Contract Code 7110, that:
a.The contractor recognizes the importance of child and family support obligations and shall
fully comply with all applicable state and federal laws relating to child and family support
enforcement, including, but not limited to, disclosure of information and compliance with
earnings assignment orders, as provided in Chapter 8 (commencing with section 5200) of Part 5
of Division 9 of the Family Code; and
b. The contractor, to the best of its knowledge is fully complying with the earnings assignment
orders of all employees and is providing the names of all new employees to the New Hire
Registry maintained by the California Employment Development Department.
17.UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is
unenforceable or held to be unenforceable, then the parties agree that all other provisions of this
Agreement have force and effect and shall not be affected thereby.
18.PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of
$200,000, the Contractor shall give priority consideration in filling vacancies in positions funded
by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200
in accordance with Pub. Contract Code §10353.
19.SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING
REQUIREMENTS:
a.If for this Contract Contractor made a commitment to achieve small business participation,
then Contractor must within 60 days of receiving final payment under this Contract (or within
such other time period as may be specified elsewhere in this Contract) report to the awarding
department the actual percentage of small business participation that was achieved. (Govt. Code
§ 14841.)
b.If for this Contract Contractor made a commitment to achieve disabled veteran business
enterprise (DVBE) participation, then Contractor must within 60 days of receiving final payment
under this Contract (or within such other time period as may be specified elsewhere in this
Contract) certify in a report to the awarding department: (1) the total amount the prime
Contractor received under the Contract; (2) the name and address of the DVBE(s) that
participated in the performance of the Contract; (3) the amount each DVBE received from the
prime Contractor; (4) that all payments under the Contract have been made to the DVBE; and (5)
the actual percentage of DVBE participation that was achieved. A person or entity that
knowingly provides false information shall be subject to a civil penalty for each violation. (Mil.
& Vets. Code § 999.5(d); Govt. Code § 14841.)
20.LOSS LEADER:
If this contract involves the furnishing of equipment, materials, or supplies then the following
statement is incorporated: It is unlawful for any person engaged in business within this state to
sell or use any article or product as a “loss leader” as defined in Section 17030 of the Business
and Professions Code. (PCC 10344(e).)
CCC 04/2017
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.
r --=--=-'-'-.. --.. -·-=--=--······· --. -J Contractor/Bidder Firm Name (Printed)
----
Federal ID Number
' i County of Fresno :t . -. . -
_;_
f By (,,jut horized Signature) ,
:I. ~ ----. ------·-------·--------_____ _J ij Printed Name and Title of Per on Signing ,
,I Ernest Buddy Mendes, Chairman of the Board of Supervisors of the County of Fresno i
1
'1 -----------. -----------------------------------------. _J
Fate Executed I Executed in the Coun fy, ATTEST
! ~~ dd .;lt;$o : Fresno BERNICE E SEIDEL
. _ __ .JL. __ Clerk of the Board of Supervisors
County esno , plate of Cali ornia
By ____ _1,...t:,;,.&..l!!!:!...:~::::'.:::~~-
Deputy
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 11102) (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 carry out the requirements as noted above. (Gov. Code §8350 et
seq.)
3.NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies
that no more than one (1) final unappealable finding of contempt of court by a Federal
court has been issued against Contractor within the immediately preceding two-year
period because of Contractor's failure to comply with an order of a Federal court, which
orders Contractor to comply with an order of the National Labor Relations Board. (Pub.
Contract Code §10296) (Not applicable to public entities.)
4.CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO
REQUIREMENT: Contractor hereby certifies that Contractor will comply with the
requirements of Section 6072 of the Business and Professions Code, effective January 1,
2003.
Contractor agrees to make a good faith effort to provide a minimum number of hours of
pro bono legal services during each year of the contract equal to the lessor of 30
multiplied by the number of full time attorneys in the firm’s offices in the State, with the
number of hours prorated on an actual day basis for any contract period of less than a full
year or 10% of its contract with the State.
Failure to make a good faith effort may be cause for non-renewal of a state contract for
legal services, and may be taken into account when determining the award of future
contracts with the State for legal services.
5.EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an
expatriate corporation or subsidiary of an expatriate corporation within the meaning of
Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the
State of California.
6.SWEATFREE CODE OF CONDUCT:
a.All Contractors contracting for the procurement or laundering of apparel, garments or
corresponding accessories, or the procurement of equipment, materials, or supplies, other
than procurement related to a public works contract, declare under penalty of perjury that
no apparel, garments or corresponding accessories, equipment, materials, or supplies
furnished to the state pursuant to the contract have been laundered or produced in whole
or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal
sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or
with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under
penal sanction, abusive forms of child labor or exploitation of children in sweatshop
labor. The contractor further declares under penalty of perjury that they adhere to the
Sweatfree Code of Conduct as set forth on the California Department of Industrial
Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108.
b. The contractor agrees to cooperate fully in providing reasonable access to the
contractor’s records, documents, agents or employees, or premises if reasonably required
by authorized officials of the contracting agency, the Department of Industrial Relations,
or the Department of Justice to determine the contractor’s compliance with the
requirements under paragraph (a).
7.DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies
that Contractor is in compliance with Public Contract Code section 10295.3.
8.GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that
Contractor is in compliance with Public Contract Code section 10295.35.
DOING BUSINESS WITH THE STATE OF CALIFORNIA
The following laws apply to persons or entities doing business with the State of
California.
1.CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions
regarding current or former state employees. If Contractor has any questions on the
status of any person rendering services or involved with the Agreement, the awarding
agency must be contacted immediately for clarification.
Current State Employees (Pub. Contract Code §10410):
1). No officer or employee shall engage in any employment, activity or enterprise from
which the officer or employee receives compensation or has a financial interest and
which is sponsored or funded by any state agency, unless the employment, activity or
enterprise is required as a condition of regular state employment.
2). No officer or employee shall contract on his or her own behalf as an independent
contractor with any state agency to provide goods or services.
Former State Employees (Pub. Contract Code §10411):
1). For the two-year period from the date he or she left state employment, no former state
officer or employee may enter into a contract in which he or she engaged in any of the
negotiations, transactions, planning, arrangements or any part of the decision-making
process relevant to the contract while employed in any capacity by any state agency.
2). For the twelve-month period from the date he or she left state employment, no former
state officer or employee may enter into a contract with any state agency if he or she was
employed by that state agency in a policy-making position in the same general subject
area as the proposed contract within the 12-month period prior to his or her leaving state
service.
If Contractor violates any provisions of above paragraphs, such action by Contractor shall
render this Agreement void. (Pub. Contract Code §10420)
Members of boards and commissions are exempt from this section if they do not receive
payment other than payment of each meeting of the board or commission, payment for
preparatory time and payment for per diem. (Pub. Contract Code §10430 (e))
2.LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the
provisions which require every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions, and
Contractor affirms to comply with such provisions before commencing the performance
of the work of this Agreement. (Labor Code Section 3700)
3.AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it
complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits
discrimination on the basis of disability, as well as all applicable regulations and
guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.)
4.CONTRACTOR NAME CHANGE: An amendment is required to change the
Contractor's name as listed on this Agreement. Upon receipt of legal documentation of
the name change the State will process the amendment. Payment of invoices presented
with a new name cannot be paid prior to approval of said amendment.
5.CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA:
a. When agreements are to be performed in the state by corporations, the contracting
agencies will be verifying that the contractor is currently qualified to do business in
California in order to ensure that all obligations due to the state are fulfilled.
b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any
transaction for the purpose of financial or pecuniary gain or profit. Although there are
some statutory exceptions to taxation, rarely will a corporate contractor performing
within the state not be subject to the franchise tax.
c. Both domestic and foreign corporations (those incorporated outside of California) must
be in good standing in order to be qualified to do business in California. Agencies will
determine whether a corporation is in good standing by calling the Office of the Secretary
of State.
6.RESOLUTION: A county, city, district, or other local public body must provide the
State with a copy of a resolution, order, motion, or ordinance of the local governing body
which by law has authority to enter into an agreement, authorizing execution of the
agreement.
7.AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor
shall not be: (1) in violation of any order or resolution not subject to review promulgated
by the State Air Resources Board or an air pollution control district; (2) subject to cease
and desist order not subject to review issued pursuant to Section 13301 of the Water
Code for violation of waste discharge requirements or discharge prohibitions; or (3)
finally determined to be in violation of provisions of federal law relating to air or water
pollution.
8.PAYEE DATA RECORD FORM STD. 204: This form must be completed by all
contractors that are not another state agency or other governmental entity.
STATE OF CALIFORNIA
CALIFORNIA CIVIL RIGHTS LAWS ATTACHMENT
DGS OLS 04 (Rev . 01/17)
DEPARTMENT OF GENERAL SERVICES
OFF ICE OF LEGAL SERV ICES
Pursuant to Public Contract Code section 2010 , a person that submits a bid or proposal to , or
otherwise proposes to enter into or renew a contract with, a state agency with respect to any
contract in the amount of $100 ,000 or above shall certify , under penalty of perjury , at the time
the bid or proposal is submitted or the contract is renewed, all of the following :
1. CALIFORNIA CIVIL RIGHTS LAWS : For contracts executed or renewed after
January 1, 2017 , the contractor certifies compliance with the Unruh Civil Rights Act (Section
51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the
Government Code); and
2. EMPLOYER DISCRIMINATORY POLICIES : For contracts executed or renewed after
January 1, 2017 , if a Contractor has an internal policy against a sovereign nation or
peoples recognized by the United States government, the Contractor certifies that such
policies are not used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code)
or the Fair Employment and Housing Act (Section 12960 of the Government Code).
CERT! f lCATION
I, the official named below, certify under penalty of perjury under the laws of the State of
California that the foregoing is true and correct.
Proposer/Bidder Firm Name (Printed) Federal ID Number
County of Fresno
By (Authorized Signature)
ATTEST:
c . ,.., BERNICE E . SEIDEL
e,____;:r-,A_ ~ ~ Clerk of the Board of Supervisors
=--==--==..c'---..,e;....w::==-,.._=::c ___ =-=--~::;__..:........::::::........:,===--=-'------County q_f f;resno , ,State of Californ ia
Printed Name and Title of erson Signing ~ ~j _
By Deputy U
Ernest Buddy Mendes, Chairman of the Board of Supervisors of the County of Fresno
Executed in the County of Executed in the State of
Fresno CA
Date Executed
September 22, 2020
IRA N CO NTRACTI NG ACT
(Public Contract Code sections 2202-2208)
Prior to bidding on , submitting a proposal or executing a contract or renewal for a State of California
contract for goods or services of $1 ,000 ,000 or more , a vendor must either : a) certify it is not on the
current list of persons engaged in investment activities in Iran created by the California Department of
General Services ("DGS ") pursuant to Public Contract Code section 2203 (b) and is not a financial
institution extending twenty million dollars ($20,000 ,000 ) or more in credit to another person , for 45 days
or more, if that other person will use the credit to provide goods or services in the energy sector in Iran
and is identified on the current list of persons engaged in investment activities in Iran created by DGS ; or
b) demonstrate it has been exempted from the certification requirement for that solicitation or contract
pursuant to Public Contract Code section 2203(c) or (d).
To comply with this requirement, please insert your vendor or financial institution name and Federal ID
Number (if available) and complete one of the options below . Please note : California law establishes
penalties for providing false certifications , including civil penalties equal to the greater of $250,000 or
twice the amount of the contract for which the false certification was made ; contract termination; and
three-year ineligibility to bid on contracts . (Public Contract Code section 2205 .)
OPTION #1 -CERTIFICATION
I, the official named below , certify I am duly authorized to execute this certification on behalf of the
vendor/financial institution identified below , and the vendor/financial institution identified below is not on
the current list of persons engaged in investment activities in Iran created by DGS and is not a financial
institution extending twenty million dollars ($20 ,000 ,000) or more in credit to another person/vendor , for
45 days or more , if that other person/vendor will use the credit to provide goods or services in the energy
sector in Iran and is identified on the current list of persons engaged in investment activities in Iran
created by DGS .
11 Vendor Name/Fin~ncial l ~stitution .(Printed) -=-===-
County of Fresno
I: Federal ID Number (or nl a)
-~,J
,I
~1 By (Authorized Signa ture) ·---
i=f:,,, ~J«kk L ~~= ~
:f Printed Name and Title of Peo n Signing
J 1 ·7 1
1 Ernest Buddy Mendes , Chairman of the Board of Superv isors of the Co 1 ,nh, ,-,f i::,ocnr,
·-.. ---. ... . = ..., .. ATTEST r Date Executed I Executed in BERNICE E. SEIDEL
1
~ '":) 'l ~ I! Fresno , CA Clerk of the Board of Supervisors
, · ---. -=-=~= -.b -----. ~:unt~~Sate ofCalifornia
OPTION #2 -EXEMPTION Deputy
Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a vendor/financial
institution engaged in investment activities in Iran , on a case -by-case basis , to be eligible for , or to bid on ,
submit a proposal for , or ente rs into or renews , a contract for goods and services.
If you have obtained an exemption from the certification requirement under the Iran Con tracting Act ,
please fi ll out the information below , and attach documentation demonstrating the exemption approval.
. Vendor Name/Financial Institution (Printed)
l --. -~~~= ........ =s~-~== . --·~=
r By -(Authorized Signat ure)
___ J Fede:al ID Nu ~ber (or nla) _J
i
I
----. ·--·1
-·----~~-----~--~
Printed Name and Title of Person Signing Date Executed
DARFUR CONTRACTING ACT CERTIFICATION
Public Contract Code Sections 10475 -10481 applies to any company that currently or within the
previous three years has had business activities or other operations outside of the United
States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company
that has been granted permission by the Department of General Services to submit a proposal.
If your company has not, within the previous three years, had any business activities or other
operations outside of the United States, you do not need to complete this form.
OPTION #1 - CERTIFICATION
If your company, within the previous three years, has had business activities or other operations
outside of the United States, in order to be eligible to submit a bid or proposal, please insert
your company name and Federal ID Number and complete the certification below.
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective
proposer/bidder named below is not a scrutinized company per Public Contract Code 10476;
and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This
certification is made under the laws of the State of California.
Company/Vendor Name (Printed) Federal ID Number
By (Authorized Signature)
Printed Name and Title of Person Signing
Date Executed Executed in the County and State of
OPTION #2 – WRITTEN PERMISSION FROM DGS Pursuant to Public Contract Code section 10477(b), the Director of the Department of General
Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a
proposal for a contract with a state agency for goods or services, if it is in the best interests of
the state. If you are a scrutinized company that has obtained written permission from the DGS
to submit a bid or proposal, complete the information below.
We are a scrutinized company as defined in Public Contract Code section 10476, but we have
received written permission from the Department of General Services to submit a bid or
proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission
from DGS is included with our bid or proposal.
Company/Vendor Name (Printed) Federal ID Number
Initials of Submitter
Printed Name and Title of Person Initialing
COUNTY OF FRESNO
Fresno, CA
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STATE OF CALIFORNIA
DEPARTMENT OF STATE HOSPITALS
AGREEMENT NO. 20-79001-000
PRE-TRIAL JAIL FELONY MENTAL HEALTH
DIVERSION PROGRAM
FOR ACCOUNTING USE ONLY:
Fund/Subclass: 0001/10000
ORG No.: 56302361 ($7,012,440)
Account No.: 3530