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HomeMy WebLinkAbout23-Parks & Recreation ORIGINAL CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION From: Kevin Hawkins, Director Subject: Resolution authorizing the City Manager to execute a contract with the Dept: Parks, Recreation, and Community County of San Bernardino Department of Services Aging and Adult Services (DAAS) to receive funding in the amount of $259,129 Date: May 23, 2007 to provide Senior Nutrition Services for the period of July 1, 2007 through June 30, 2008. MCC Date: June 4, 2007 Synopsis of Previous Council Action: 09/05/06 —Resolution was approved ratifying the execution of Amendment No. 4 of the 2004/05 Senior Nutrition contract. Recommended motion: Adopt Resolution. Signature Contact person: Curtis Brown Phone: 5130 Supporting data attached: Staff report,resolution,and contract. Ward: Citywide FUNDING REQUIREMENTS: Amount: $259, 129 in grant funding $18,076 in-kind grant match Source: (Acct.No.) 123-513-xxxx (Acct. Description) Finance: Council Notes: k16-7e 266 /JPO Agenda Item No. OZ-3 41� 67 CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION STAFF REPORT Subject: Resolution of the Mayor and Common Council of the City of San Bernardino authorizing the City Manager to execute a contract with the County of San Bernardino Department of Aging and Adult Services (DAAS) to receive funding in the amount of $259,129 to provide Senior Nutrition Services for the period of July 1, 2007 through June 30, 2008. Background: The Parks, Recreation, and Community Services Department has received funding from the County Department of Aging and Adult Services for twenty-eight years to provide Senior Nutrition Services for the County of San Bernardino. These services are offered at seven sites: 5th Street Senior Center, Perris Hill Senior Center, New Hope Family Life Center, Hernandez Community Center, Lighthouse for the Blind, Lytle Creek Community Center, and the Highland Senior Center. The program serves over 70,000 lunch meals to seniors annually. In January of this year, a proposal was submitted to the County requesting $285,000 in grant funding for 2007/08 to continue providing services at the same sites. The proposal included the addition of a pilot dinner program. In April, the County sent a letter of notification awarding the City $259,129 in funding to provide a total of 50,840 meals during next fiscal year, which includes funding for the pilot program. This contract is for the period of July 1, 2007 through June 30, 2008 and may be extended for two additional one-year periods by mutual agreement of the parties. The program budget is due to the County in August of this year. As with previous years, the budget will include funding for personnel, training, equipment, food, and other miscellaneous expenses. Financial Impact: The grant award amount is $259,129. There is an in-kind matching contribution requirement of $18,076 (11% of the Federal Title III portion amount of the grant award which is $162,703). This requirement is met though a percentage of personnel, building, and utility costs, all of which are funded in the Parks, Recreation, and Community Services operating budget. Recommendation: Adopt resolution. HUMAN SERVICES COUNTY OF SAN BERNARDINO UN H[0.NAAIN6 Linda Haugan Assistant County Administrator Reply to: Human Services Administration 150 S Lena Road San Bernardino, CA 92415-0515 May 23, 2007 Aaliyah Harkley 600 West 5t" Street San Bernardino, CA 92410 Subject: Contract to provide Senior Nutrition Services — Congregate Dear Ms. Harkley: Enclosed are three (3) copies of your contract to provide Senior Nutrition Services for FY 2007-2008. Please sign and date in blue ink page 28 of all three copies of the contract, as well as page 12 of Attachment A (Scope of Work), and Attachment D (Assurance of Compliance). All signature pages are flagged. Please return all three copies of the contract to me no later than Wednesday, June 6, 2007. Please don't hesitate to call me if you have any questions or if I can be of any further assistance. Thank you for your prompt attention to this matter! Sincerely, {\�� a Regina Dalton, Contract Analyst HS - Administrative Support Division Contracts Unit Ph: 909-388-0241 E-mail: rdalton hss.sbcounty.gov COPY 1 RESOLUTION NO. 2 3 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AUTHORIZING THE CITY MANAGER TO EXECUTE A 4 CONTRACT WITH THE COUNTY OF SAN BERNARDINO DEPARTMENT OF AGING AND ADULT SERVICES (DAAS) TO RECEIVE FUNDING IN THE AMOUNT 5 OF $259,129 TO PROVIDE SENIOR NUTRITION SERVICES FOR THE PERIOD OF JULY 1, 2007 THROUGH JUNE 30, 2008. 6 7 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY OF SAN BERNARDINO AS FOLLOWS: 8 SECTION 1. The Mayor and Common Council of the City of San Bernardino hereby 9 10 authorize the City Manager to execute a contract with the County of San Bernardino 11 Department of Aging and Adult Services (DAAS), a copy of which is attached hereto; marked 12 Exhibit A, to receive funding in the amount of$259,129 for the Senior Nutrition Program. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 7 RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE CITY 1 OF SAN BERNARDINO AUTHORIZING THE CITY MANAGER TO EXECUTE A CONTRACT WITH THE COUNTY OF SAN BERNARDINO DEPARTMENT OF 2 AGING AND ADULT SERVICES (DAAS) TO RECEIVE FUNDING IN THE AMOUNT OF $259,129 TO PROVIDE SENIOR NUTRITION SERVICES FOR THE PERIOD OF 3 JULY 1, 2007 THROUGH JUNE 30, 2008. 4 5 I HEREBY CERTIFY that the foregoing Resolution was duly adopted by the Mayor 6 and Common Council of the City of San Bernardino at a _ meeting thereof, held on the 7 day of , 2007, by the following vote, to wit: 8 , Council Members: AYES NAYS ABSTAIN ABSENT 9 ESTRADA 10 BAXTER 11 12 BRINKER 13 DERRY 14 KELLEY 15 JOHNSON 16 MCCAMMACK 17 18 19 City Clerk 20 The foregoing resolution is hereby approved this day of , 2007. 21 22 23 Patrick Morris, Mayor City of San Bernardino 24 Approved as to Form: 25 JAMES F. PENMAN, 26 City Attorney i n 27 By. G/ a 28 I HUMAN SERVICES COUNTY OF SAN BERNARDINO SAN BE4NAADINA Linda Haugan Assistant County Administrator Reply to: Human Services Administration 150 S Lena Road San Bernardino, CA 92415-0515 May 23, 2007 Aaliyah Harkley 600 West 5th Street San Bernardino, CA 92410 Subject: Contract to provide Senior Nutrition Services — Congregate Dear Ms. Harkley: Enclosed are three (3) copies of your contract to provide Senior Nutrition Services for FY 2007-2008. Please sign and date in blue ink page 28 of all three copies of the contract, as well as page 12 of Attachment A (Scope of Work), and Attachment D (Assurance of Compliance). All signature pages are flagged. Please return all three copies of the contract to me no later than Wednesday, June 6, 2007. Please don't hesitate to call me if you have any questions or if I can be of any further assistance. Thank you for your prompt attention to this matter! Sincerely, n 1 UAI/I `,! c) rA u Regina Dalton, Contract Analyst HS - Administrative Support Division Contracts Unit Ph: 909-388-0241 E-mail: rdaltonCcDhss.sbcounty.gov i FOR COUNTY USE ONLY X New Vendor Code Dept. Contract Number courrrr V SAN 6ERRURO>I Change C ITYOFS772 (\1 OOA Cancel County Department Dept. Orgn. Contractor's License No. Aging and Adult Services OOA NUT County Department Contract Representative Telephone Total Contract Amount County of San Bernardino Regina Dalton 388-0241 $259,129 F A S Contract Type ❑ Revenue ❑ Encumbered ❑ Unencumbered ❑ Other: STANDARD CONTRACT If not encumbered or revenue contract type, provide reason: Commodity Code Contract Start Date Contract End Date Original Amount Amendment Amount 95200 July 1, 2007 June 30, 2008 $259,129 Fund Dept. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount AAF OOA I NUT 200 2445 3C1SBY08 $162,703 Fund Dept. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount AAF OOA NUT 200 2445 NClSBY08 $34,844 Fund Dept. Organization Appr. Obj/Rev Source GRC/PROJ/JOB No. Amount AAF OOA NUT 200 2445 CFlSBY08 $61,582 Project Name Estimated Payment Total by Fiscal Year Senior Nutrition Services FY Amount I/D FY Amount I/D 07/08 $259,129 1 1, CONTRACT is entered into in the State of California by and between the County of San Bernardino, Department of Aging and Adult Services, hereinafter called the County, and Name City of San Bernardino hereinafter called Contractor Address 600 West 5th Street San Bernardino, CA 92410 Phone Birth Date (909) 384-5435 Federal ID No.or Social Security No. IT IS HEREBY AGREED AS FOLLOWS: WHEREAS,the County desires to provide nutrition programs for the elderly; and WHEREAS, the Older Americans Act of 1965 provides for assistance to State and local agencies to develop nutrition programs for the elderly; and WHEREAS, County has been allocated Older Americans Act funds by the California Department of Aging for the purpose of administering nutrition programs for the elderly;and WHEREAS,County finds Contractor qualified to provide nutrition programs for the elderly,and WHEREAS, County desires that such services be provided by Contractor and Contractor agrees to perform these services according to the specific terms and conditions provided by the Contract. I THEREFORE, in consideration of the mutual promises contained herein, County and Contractor mutually agree to the following terms ai— ;onditions: Page 1 of 28 TABLE OF CONTENTS I. DEFINITIONS..................................................................................................................................3 II. CONTRACTOR SERVICE RESPONSIBILITIES..............................................................................4 III. CONTRACTOR GENERAL RESPONSIBILITIES.......................................................................... 10 IV. COUNTY RESPONSIBILITIES...................................................................................................... 17 V. FISCAL PROVISIONS................................................................................................................... 18 VI. RIGHT TO MONITOR AND AUDIT.....................................................................................................21 VII. CORRECTION OF PERFORMANCE DEFICIENCIES AND APPEAL PROCEDURES.....................24 VIII. TERM...................................................................................................................................................25 IX. EARLY TERMINATION.......................................................................................................................26 X. GENERAL PROVISIONS....................................................................................................................26 KI. CONCLUSION.....................................................................................................................................27 ATTACHMENT A-WORK PLAN/SCOPE OF WORK ATTACHMENT B - BUDGET SUMMARY ATTACHMENT B-1 - BUDGET LINE ITEMS ATTACHMENT B-2 - BUDGET IN-KIND NARRATIVE ATTACHMENT B-3 -SCHEDULE OF PERSONNEL ATTACHMENT B-4 -SCHEDULE OF EQUIPMENT ATTACHMENT C - CLIENT COMPLAINT AND GRIEVANCE PROCEDURES ATTACHMENT D - ASSURANCE OF COMPLIANCE ATTACHMENT E - DISCLOSURE OF LOBBYING ACTIVITIES ATTACHMENT F- INFORMATION SHEET Page 2 of 28 i. DEFINITIONS A. Cash Match — Cash, other than program income, contributed to the project from local or State funds. With the exception of Community Development Block Grants (CDBG), Federal funds cannot be used as cash match. B. CDA— California Department of Aging C. CDA PM — Title III Program Manual for Area Agencies on Aging — This manual is based on Federal Regulations for Title III published March 31, 1980 (CRF, Chapter 8, Subchapter C, Part 1321), and pertinent parrs of 45 CFR Sub-title A, Part 74, published June 3, 1980. D. CFR— Code of Federal Regulations E. Congregate Nutrition Services (C-1) — Meals provided in a congregate setting for older individuals in an atmosphere that is pleasant and encourages socialization. F. Contract — The coversheet, the terms and conditions, work plan, budget display, budget summary, exhibits, attachments, addendums, and amendments, unless otherwise specified. G. Contractor— The entity to which funds are awarded under this Contract and which is accountable to DAAS for use of these funds and is responsible for executing its provision and services. H. Cost Reimbursement — Payment method based on cost of providing services which may include overhead, personnel, utilities, etc., and scopes of work and approved budget. I. CRFC — California Retail Food Code (Section 113700 et seq., California Health and Safety Code); replaces California Uniform Retail Food Facilities Law (CURFFL). J. DAAS — Refers to the County of San Bernardino Department of Aging and Adult Services, which is a County department that provides services to seniors and at-risk adults to improve or maintain choice, independence, and quality of life. DAAS works to ensure that seniors and adults with disabilities have the right to age in place in the least restrictive environment. K. Elderly—Any individual who is sixty (60) years of age or older; also "older individual." L. Equipment —Tangible personal property with a useful life of more than one year and an acquisition cost of$5,000 or more per unit. M. General Program Income — Meal income received in the form of contributions or donations made by the elderly for services rendered under this Contract. N. HACCP — Hazard Analysis Critical Control Point O. Home Delivered Nutrition Services (C-2) — Meals provided to older individuals who are homebound. P. HS — Refers to the County of San Bernardino Human Services, which is a system of integrated services where the programs and resources of eight County departments come together to provide a rich, more complete array of services to the citizens of San Bernardino County under one coordinated effort. Q. In-Kind Match — Refers to donated building space, volunteer time, donated equipment, etc. Cash contributions are not in-kind. Pane 3 of 28 R. In-Kind Contributions — Property, equipment, services (e.g. volunteer services) and supplies benefiting a CDA supported program or activity, which is contributed by non-Federal third parties without charge to the Contractor. S. Non-Expendable Personal Property — Tangible personal property having a useful life of more than one year and an acquisition cost of$500 or more per unit. T. Nutrition Services Incentive Program (NSiP) — The purpose of NSIP is to provide incentives and reward effective performance in the efficient delivery of nutrition meals to older individuals. Funding is based on the number of meals served in the prior year and available appropriation. U. OAA — Older Americans Act — Provides comprehensive, coordinated, community-based systems of service to persons age 60 and older to enable them to maintain health, personal dignity, and independence. V. Older Individual — Individual who is 60 years of age or older W. OMB — Office of Management and Budget X. Project Income — Any income earned by Contractor during the term of the Contract from activities supported in part or total by federal funds, including, but not limited to: • Income in the form of fees for services performed during the Contract period • Proceeds from the sale of tangible or real property • Proceeds from the sale of equipment and/or supplies acquired for use • Usage or rental fees • Interest • Patent or copyright royalties • Contribution or donations made by the elderly Y. Reimbursable Item —Allowable cost and compensable item Z. Service Area — Defines a geographic area to be served under this program. AA. State— State of California BB. Title II I —Title III of the Older Americans Act CC: USC— United States Code DD. USDA— United States Department of Agriculture EE. W & I —Welfare and Institutions Code II. CONTRACTOR SERVICE RESPONSIBILITIES A. Contractor shall, in a satisfactory manner as determined by DAAS, conduct, administer and provide the Nutrition Program for the elderly as defined in the Work Plan/Scope of Work FY 2007-2008 (Attachment A), attached hereto and incorporated by reference into this Contract. 1. Appropriate food containers and utensils for blind and handicapped participants shall be available on request. 2. All participants are to be permitted to eat in a leisurely fashion. Panes 4 of 98 3. Meals are to be served in a courteous and friendly manner. 4. The facility is to maintain adequate lighting and ventilation. The facility is to meet all applicable health, fire, safety, and sanitation regulations. 5. Contractor is to provide restrooms that are clean, adequate, and well equipped. 6. Contractor is to provide tables and chairs that are sturdy and appropriate for the participants. Tables are to be arranged to assure a pleasant atmosphere and to encourage socialization. 7. Contractor shall provide a sufficient number of tables surrounded by adequate aisle space (a minimum width of 3 feet, 8 inches) to allow for persons with canes, walkers, crutches, or wheelchairs to move with ease. 8. Contractor shall provide appropriate table settings. Disposable dinnerware shall be resistant to buckling, spillage, nonporous, sanitary, attractive, shall not melt, shall not bend, and shall not splinter during normal use. 9. Whenever two (2) or more persons manifest the symptoms of food borne illnesses within a similar time frame after consuming food served under the Nutrition Program, Contractor shall notify the local health authorities to initiate an investigation. Contractor shall notify DAAS within twenty-four (24) hours of such an occurrence. 10. Fire and health inspections are to be secured prior to beginning service provision and annually thereafter. Copies of all inspection reports shall be maintained on site for DAAS review. B. Contractor agrees to participate in appropriate employee training and development provided by DAAS, the CDA and the Administration on Aging. C. Contractor shall complete a written work performance evaluation annually on all paid and volunteer employees. D. Contractor shall insure all paid and volunteer employees/staff attend the Adult Abuse Reporting Training, and read and sign a certification of understanding of the Adult Abuse Reporting Act. E. In order to provide emergency assistance or continue services to at-risk elderly or dependent adults in the event of disaster, Contractor shall maintain accurate lists of all participants who are receiving home-delivered meals and/or other services due to impairments that render them at risk of serious injury or death. Contractor shall coordinate and report disaster services and issues with DAAS. F. Contractor understands that one of its responsibilities under this Contract is to ensure that preference shall be given to providing services to older individuals with the greatest economic or social needs, with particular attention to low-income minority individuals. The term "greatest economic need" means the need resulting from an income level at or below the poverty threshold established by the Bureau of the Census, and the term "greatest social need" means the need caused by non-economic factors which include physical or mental disabilities, language barriers, and cultural or social isolation, including that caused by racial or ethnic status which restricts an individual's ability to perform normal daily tasks or which threatens his or her capacity to live independently. G. Reports 1. Contractor, at such times and in such forms as DAAS may require, shall furnish q statements, records, reports, data and information requested by DAAS pertaining to Contractor's performance of services hereunder and other matters covered by this Contract. The forms shall be reviewed for timeliness, completeness, and correctness of the information submitted, by the Program Director or his/her designee, prior to submission to DAAS. Incomplete forms shall be returned to the Contractor for completion. (In the event of changes in these forms, DAAS shall advise the Contractor via written notice.) The Contractor shall develop and implement a process for ensuring quality control. 2. Contractor shall meet the following standards for the submission of required reports: a. Financial Reporting — Accurate, current and complete disclosure of the financial results of each program (i.e., congregate meals, or home-delivered meals) shall be made in accordance with the financial reporting requirements of the Contract. The following reports are to be submitted to DAAS when indicated: 1) Monthly • Monthly Nutrition Program Expenditure Report/Request for Reimbursement: Due to DAAS Administration by the 5th working day of the month following the month of service. Expense reimbursement shall be based on Budget Summary (Attachment B). 2) Semi-Annually— Budget Revisions, as needed • Budget Revision #1 (Due November 1) • Budget Revision #2 (Due March 31) 3) Annually • Financial Closeout Report (Due August 1) • Periodic Inventory (Due August 1 with Financial Closeout Report) • Audit Report (Due October 31) • Revised Financial Closeout Report (Due October 31 with Audit Report) b. Supplemental Budget Forms Due August 1, 2007 • Budget Line Items (Attachment B-1) • Budget In-Kind Narrative (Attachment B-2) • Schedule of Personnel (Attachment B-3) • Schedule of Equipment (Attachment B-4) Paoe 6 of 28 C. Program Reporting The following reports are to be submitted to DAAS when indicated: Monthly (Due by the 51h working day of each month) • Nutrition Monthly Service Unit Report Quarterly • Program modification request in writing to DAAS. Contractor shall describe, in detail, necessary program change(s) and the reason(s) for the requested modification. 3. DAAS may require financial reports more frequently than indicated above or with more detail (or both); upon written notice to the Contractor, until such time as DAAS determines that the financial management standards are met. 4. Contractor is required to work in conjunction with DAAS in developing and maintaining a client database. H. Records 1. The Contractor shall maintain complete records (which shall include, but not be limited to, accounting records, contracts, agreements, reconciliation of the "Financial Closeout Report" to the audited financial statements, a summary worksheet of results from the audit resolutions performed for all subcontractors with supporting documentation, letters of agreement, insurance documentation in accordance with this Contract, Memorandums and/or Letters of Understanding, patient or client records and electronic files) of its activities and expenditures hereunder in a form satisfactory to the County and/or State and shall make all records pertaining to this Contract available for inspection and audit by the County and/or State or its duly authorized agents, at any time during normal business hours. All such records must be maintained and made available by the Contractor; (a) until an audit has occurred and an audit resolution has been issued or unless otherwise authorized in writing by County, (b) for such longer period, if any, as is required by applicable statute, by any other clause of this Contract, or by Section II, Paragraph H, Items 2 and 3 of this Contract, and (c) for such longer period as County deems necessary. 2. In the event this Contract is either completely or partially terminated, the records relating to the work terminated shall be preserved and made available for the same periods as specified in Item 1 above. The Contractor shall ensure that any resource directories and all client records remain the property of DAAS upon termination of this Contract, and are returned to DAAS or transferred to another Contractor as instructed by DAAS. 3. In the event of any litigation, claim, negotiation, audit exception, or other action involving the records, all records relative to such action shall be maintained and made available until every action has been cleared to the satisfaction of the County and/or State and is stated so in writing to the Contractor. 4. Adequate source documentation of each transaction shall be maintained relative to the allowability of expenditures reimbursed by the County under this Contract. If the allowability of expenditures cannot be determined because records or documentation of the Contractor are nonexistent or inadequate according to Generally Accepted Accounting Principles and Pnoe 7 of 28 Procedures, the expenditures will be questioned in the audit and may be disallowed by the County and/or State during the audit resolution process. 5. After the authorized period has expired, confidential records shall be destroyed by shredding and disposed of in a manner that will maintain confidentiality. I. Property 1. Unless otherwise provided for in this Contract, property refers to all assets, capitalized or non-capitalized, used in operation of this Contract. Property that is capitalized is referred to as property, plant and equipment. Property includes land, buildings, improvements, machinery, vehicles, furniture, tools, and intangibles, etc. Property does not include consumable office supplies such as paper, pencils, typing ribbons, file folders, etc. 2. Property meeting all of the following criteria is subject to the capitalization requirements. Subject property must: a. Have a normal useful life of at least 1 year; b. Have a unit acquisition cost of at least $5000 (e.g., four identical assets which cost $3000 each, for a $12,000 total would not meet this capitalization requirement); and C. Be used to conduct business under this Contract. As used in this Contract, the term "equipment" shall refer only to capitalized property. 3. Non-capitalized properties are those items that do not meet all three requirements in Section II, Paragraph I, Item 2. 4. Additions, improvements, and betterments to assets meeting all of the conditions in Section II, Paragraph I, Item 2 must be capitalized. Additions typically involve physical extensions of existing units. Improvements and betterments typically do not increase the physical size of the asset. Instead, improvements and betterments enhance the condition of an asset (e.g., extend life, increase service capacity, and lower operating costs). Examples of assets that might be improved and bettered include roads, bridges, curbs and gutters, tunnels, parking lots, streets and sidewalks, drainage, and lighting systems. 5. Intangibles are property which lack physical substance but give valuable rights to the owner and can be capitalized or non-capitalized. Examples of intangible property include patents, copyrights, leases, and computer software. By contrast, hardware consists of tangible equipment (e.g., computer printer, terminal, etc.). Costs include all amounts incurred to acquire and to ready the intangible asset for its intended use. Typical intangible property costs include the purchase price, legal fees, and other costs incurred to obtain title to the asset. 6. The Contractor shall record the following information when property is acquired: a. Date acquired; b. Property description (include model number); C. Property identification number (serial number); d. Location of property; Page 8 of 28 e. Cost or other basis of valuation; f. Fund source; and g. Rate of depreciation (or depreciation schedule), if applicable. The Contractor shall keep track of property purchased with Contract funds, whether capitalized or not. The Contractor shall submit to the County, annually with the Financial Closeout Report, a current inventory of property furnished or purchased by the Contractor with funds awarded under the terms of this Contract or any predecessor contracts for the same purpose. The Contractor shall maintain an annual inventory of property furnished or purchased by the subcontractor, if any, with funds awarded under the terms of this Contract or any predecessor contract for the same purpose. The Contractor shall use the Report of Project Property Furnished/Purchased with Agreement Funds (CDA 32) to report property to the County. 7. Prior to disposal of any property purchased by the Contractor or the subcontractor with funds from the Contract, the Contractor must obtain prior written approval from the County regardless of the acquisition value disposition, which includes sale, trade-in, discarding, or transfer to another agency. The Contractor shall use the Request to Dispose of Property (CDA 248) to dispose of property. 8. The Contractor shall immediately investigate, and within five (5) days fully document and report to DAAS, the loss, destruction, or theft of such property. The County reserves title to all County-purchased or financed property not fully consumed in the performance of this Contract, unless otherwise required by federal law or regulations or as otherwise agreed by the parties. 9. Contractor shall exercise due care in the use, maintenance, projection, and preservation of such property during the period of the project, and shall assume responsibility for replacement or repair of such property during the period of the project and until the Contractor has complied with all written instructions from the County regarding the final disposition of the property. 10. In the event of the Contractor's dissolution or upon termination of this Contract, the Contractor shall provide a final property inventory to County. County reserves the right to require the Contractor to transfer such property to another entity, or to County. To exercise this right, the County will issue specific written disposition instructions to the Contractor no later than 120 days after termination of this Contract or notification of the Contractor's dissolution. 11. The Contractor shall use the property for the purpose for which it was intended under the Contract. When no longer needed for that use, the Contractor shall use it, if needed, and with written approval of the County, for other purposes in the following order: a. Another County program providing the same or similar service; or b. Another County-funded program; or C. County/State/Federally-funded program. r) n O of )A 12. The Contractor may share use of the property and equipment or allow use by other programs, upon written approval of the Director of DAAS. As a condition of the approval, County may require reimbursement under this Contract for its use. 13. The Contractor shall not use equipment or supplies acquired under this Contract for personal gain or to usurp the competitive advantage of a privately-owned business entity. 14. If purchase of equipment is a reimbursable item, the equipment to be purchased will be specified in the budget. 15. All equipment purchases of $500.00 or more require the written approval of the Director of DAAS or his/her designee prior to purchase. 16. All equipment, materials, supplies, or personal property of any kind purchased with Contract funds must be used to conduct business under this Contract, and if not fully expended or consumed prior to the termination of this Contract, shall be the property of the County, unless otherwise directed by the County. 17. Equipment that is worn beyond economical repair must be reported to DAAS on the monthly expense report. It shall be the responsibility of DAAS, after receiving this report, to instruct the Contractor as to the proper method of disposal. 18. Once Contractor has received disposal authorization for a vehicle to be salvaged, Contractor shall ensure that all identifying lettering, signs, etc., are removed. 19. Any equipment purchased with Contract funds shall be subject to inspection, over the life of the equipment, and if under-used, misused, or not used, may be claimed by DAAS for redistribution to other DAAS projects. 20. Vehicles purchased with Contract funds shall also have the following language painted or affixed by other means on the vehicle: "Vehicle Purchased with Older Americans Act Funds." 21. Any equipment purchased shall be reported on the Expenditure Report/Request for Reimbursement for the month in which the equipment was purchased. DAAS shall verify approval for purchase was given prior to the purchase of the equipment. 22. Equipment shall be periodically inventoried by DAAS to ensure all equipment purchases are properly approved, documented, and recorded on the inventory. Significant violations may result in the imposition of sanctions. 23. The Contractor shall include the provisions contained in this Paragraph in all its subcontracts awarded through Contract funds. III. CONTRACTOR GENERAL RESPONSIBILITIES A. In the performance of this Contract, Contractor, its agents and employees, shall act in an independent capacity and not as officers, employees, or agents of the County of San Bernardino. B. Contractor certifies that it and its subcontractors: 1. Are not presently disbarred, suspended, proposed for disbarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. Page 10 of 28 2. Have not within a three-year period preceding this Contract been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection �W , with obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in Item 2 of this certification; and 4. Have not within a three-year period preceding this Contract had one or more public transactions (federal, state, or local) terminated for cause or default. C. Contractor shall report immediately to the County in writing any incidents or alleged fraud and/or abuse by either Contractor or Contractor's subcontractor(s). Contractor shall maintain any records, documents, or other evidence of fraud and abuse until otherwise notified by the County. D. Without the prior written consent of the Assistant County Administrator for Human Services, this Contract is not assignable by Contractor either in whole or in part. E. Contractor agrees to provide or has already provided information on former County of San Bernardino administrative officials (as defined below) who are employed by or represent Contractor. The information provided includes a list of former County administrative officials who terminated County employment within the last five years and who are now officers, principals, partners, associates or members of the business. The information also includes the employment with or representation of Contractor. For purposes of this provision, "County administrative official" is defined as a member of the Board of Supervisors or such officer's staff, County Administrative Officer or member of such officer's staff, County department or group head, assistant department or group head, or any employee in the Exempt Group, Management Unit or Safety Management Unit. F. If during the course of the administration of this Contract, the County determines that the Contractor has made a material misstatement or misrepresentation or that materially inaccurate information has been provided to the County, this Contract may be immediately terminated. If this Contract is terminated according to this provision, the County is entitled to pursue any available legal remedies. G. Subcontracts The Director of DAAS is designated the authority to approve one or more subcontracts, provided each subcontract meets the following terms and conditions: 1. The policies and procedures used in processing and awarding the subcontracts were: a. Organized and structured; b. Reasonable and equitable; C. Documented and approved by appropriate authorities; d. Consistent with applicable federal, state, and local procurement requirements; e. Uniformly applied; and 0--- 11 -f')Q If. Open for public review and scrutiny. 2. All subcontracts require the advance written approval of the Director of DAAS or his/her designee. 3. Any subcontractor shall be subject to the same provisions as Contractor. Contractor shall be fully responsible for the performance of any subcontractor. 4. Funds for this Contract shall not be obligated in subcontracts for services beyond the termination date of this Contract. 5. The Contractor shall have no authority to contract for, on behalf of, or incur obligations on behalf of the County. 6. ` Copies of subcontracts, memoranda and/or letters of understanding shall be on file with the Contractor and shall be made available for review at the request of the County. 7. A copy of the executed subcontract shall be submitted to the Director of DAAS. H. Contractor shall maintain all records and books pertaining to the delivery of services under this Contract and demonstrate accountability for contract performance. Said records shall be kept and maintained within the County of San Bernardino. County shall have the right upon reasonable notice and at reasonable hours of business to examine and inspect such records and books. Records, should include, but are not limited to, monthly summary sheets, sign-in sheets, and other primary source documents. Fiscal records shall be kept in accordance with Generally Accepted Accounting Principles and must account for all funds, tangible assets, revenue and expenditures. Fiscal records must also comply with the appropriate Office of Management and Budget (OMB) Circulars that state the administrative requirements, cost principles and other standards for accountancy. All records shall be complete and current and comply with all Contract requirements. Failure to maintain acceptable records per the preceding requirements shall be considered grounds for withholding of payments for billings submitted and for termination of the Contract. I. Contractor shall notify County in writing of any change in mailing address and/or physical location within ten (10) days of the change, and shall immediately notify County of changes in telephone or fax numbers. J. Contractor shall notify County of any continuing vacancies and any positions that become vacant during the term of this Contract that will result in reduction of services to be provided under this Contract. Upon notice of vacancies, the Contractor shall apprise County of the steps being taken to provide the services and to fill the position as expeditiously as possible. Vacancies and associated problems shall be reported to County on each periodically required report for the duration of said vacancies and/or problems. K. Contractor shall designate an individual to serve as the primary point of contact for the Contract. Contractor shall notify HS when the primary contact will be unavailable/out of the office for one (1) or more workdays. Contractor or designee must respond to County inquiries within two (2) County business days. L. Contractor shall ensure that staff and volunteers are knowledgeable on the Client Complaint and Grievance Procedures for Older Americans Act Programs (Attachment C), and ensure that any complaints by clients are referred to the County in accordance with the procedure. Contractor agrees to document, investigate, and resolve any and all client or potential client complaints relating to this program. The procedure must be in writing and posted in clear view of all recipients. Pane 12 of 28 INNER- M. Contractor shall notify County HS Contracts Unit of all upcoming meetings of the Board of Directors or I other governing party and shall keep County apprised of any and all actions taken by its Board of Directors which may impact on the Contract. All Board of Directors' minutes shall be submitted to County with the monthly report submitted in the month following approval of the minutes. Further, a County representative shall have the option of attending Board meetings during the term of this Contract. N. Contractor shall protect from unauthorized use or disclosure names and other identifying information concerning persons receiving services pursuant to this Contract, except for statistical information not identifying any participant. The Contractor shall not use or disclose any identifying information for any other purpose other than carrying out the Contractor's obligations under this Contract, except as may be otherwise required by law. This provision will remain in force even after the termination of the Contract. Contractor and their employees shall sign a confidentiality statement and complete the annual training posted on CDA's website, www.aging.ca.gov, within thirty days from the effective date of this contract. O. Contractor agrees to and shall comply with the County's Elder and Dependent Adult Abuse Reporting requirements: 1. Contractor will ensure that all known or suspected instances of elder or dependent adult abuse are reported in writing to DAAS Adult Protective Services. 2. In accordance with W & I Code Section 15630, all employees of the Contractor and its subcontractors are mandated reporters of elder and dependent adult abuse. Contractor assures all employees, agents, consultants or volunteers who perform services under this Contract and are mandated to report elder and dependent adult abuse will sign a statement, upon the commencement of their employment, acknowledging their reporting requirements and their compliance with them. 3. Mandated reporters are required to report all instances of known or suspected abuse of the elderly and dependent adults by telephone immediately or as soon as practically possible, under the following circumstances: a. When the mandated reporter has observed or has knowledge of an incident that reasonably appears to be physical abuse, abandonment, isolation, financial abuse, or neglect; or b. When the mandated reporter is told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse, abandonment, isolation, financial abuse, or neglect; C. A written "Report of Suspected Dependent Adult/Elder Abuse" (SOC 341) must be submitted within two (2) working days of making the telephone report to the responsible agency, as defined below in Item 4. 4. Incidents of elder and dependent adult abuse must be reported to the correct agency as follows: a. If the abuse has occurred in a long term care facility, except a state mental hospital or state developmental center, the report shall be made to the local Long-Term Care Ombudsman or local law enforcement; Paae 13 of 28 b. If the abuse has occurred in a state mental hospital or state developmental center, the report shall be made to the designated investigators of the State Department of Mental Health or the State Department of Developmental services or to the local law enforcement; C. If the abuse occurred anywhere other than a long-term care facility or State mental hospital or State developmental center, the report shall be made to Adult Protective Services or local law enforcement. 5. Under the terms of this Contract, as changes in the Elder and Dependent Adult Reporting Laws are enacted, the Contractor is bound to comply with the most current regulations. P. Any Contractor who provides home delivered meals shall obtain from the Department of Justice (DOJ) records of all convictions involving any sex crimes, drug crimes, or crimes of violence of a person who is offered employment or volunteers for all positions in which he or she would have contact with a minor, the aged, the blind, the disabled or a domestic violence client, as provided for in Penal Code Section 11105.3 prior to providing any services. This includes licensed personnel who are not able to provide documentation of prior Department of Justice clearance. A copy of a license from the State of California is sufficient proof. County must be immediately notified of any records showing a conviction. The County may instruct Contractor to take action to deny/terminate employment or terminate internship and/or volunteer services where the records show the person is unsuitable for employment, internship, or volunteer services. O. Contractor shall notify County of any staff member, paid intern or volunteer who is knowingly or negligently employed who has been convicted of any crime of violence or of any sexual crime. Contractor shall investigate all incidents where an applicant, employee, intern or volunteer has been arrested and/or convicted for any crime listed in Penal Code Section 11105.3 and shall notify County. In the County's discretion, the County may instruct Contractor to take action to either deny/terminate employment or terminate internship and/or volunteer services where the investigation shows that the underlying conduct renders the person unsuitable for employment, internship, or volunteer services. Contractor shall immediately notify HS concerning the arrest and/or conviction, for other than minor traffic offenses, of any paid employee, agent, consultant, intern, or volunteer staff, when such information becomes known to Contractor. R. Contractor shall make every reasonable effort to prevent employees, consultants or members of its governing bodies from using their positions for purposes that are or give the appearance of being motivated by a desire for private gain for themselves or others, such as those with whom they have family, business, or other ties. In the event County determines a conflict of interest exists, any increase in costs associated with the conflict of interest may be disallowed by County and such conflict may constitute grounds for termination of the Contract. This provision shall not be construed to prohibit employment of persons with whom Contractor's officers, agents, or employees have family, business or other ties so long as the employment of such persons does not result in increased costs over those associated with the employment of any other equally qualified applicants and such persons have successfully competed for employment with other applicants on a merit basis. S. Contractor agrees to and shall comply with the following indemnification and insurance requirements: 1. Indemnification - The Contractor agrees to indemnify, defend, and hold harmless the County and its authorized officers, employees, agents and volunteers from any and all claims, actions, losses, damages, and/or liability arising out of this Contract from any cause whatsoever, including the acts, errors or omissions of any person and for any costs or expenses incurred by the County on account of any claim therefore, except where such indemnification is prohibited by law. Do 1^ -f W 2. Insurance — Without in anyway affecting the indemnity herein provided and in addition thereto, the Contractor shall secure and maintain throughout the Contract the following types of insurance with minimum limits as shown: a. Worker's Compensation - A program of Workers' Compensation insurance or a State- approved Self Insurance Program in amount or form to meet all applicable requirements of the Labor Code of the State of California, including Employer's Liability with $250,000 limits, covering all persons providing services on behalf of the Contractor and all risks to such persons under this Contract. If Contractor has no employees, it may certify or warrant to County that it does not currently have any employees or individuals who are defined as "employees" under the Labor Code and the requirement for Workers' Compensation coverage will be waived by the County's Risk Manager. With respect to Contractors that are non-profit corporations organized under California or Federal law, volunteers for such entities are required to be covered by Workers' Compensation insurance. If the County's Risk Manager determines that there is no reasonably priced coverage for volunteers, evidence of participation in a volunteer insurance program may be substituted. b. Comprehensive General and Automobile Liability Insurance - This coverage to include contractual coverage and automobile liability coverage of owned, hired and non- owned vehicles. The policy shall have combined single limits for bodily injury and property damage of not less than one million dollars ($1,000,000). 3. Additional Named Insured — All policies, except for Workers' Compensation, shall contain additional endorsements naming the County and its officers, employees, agents and volunteers as additional named insured with respect to liabilities arising out of the performance of services hereunder. 4. Waiver of Subrogation Rights — Contractor shall require the carriers of the above-required coverages to waive all rights of subrogation against the County, its officers, employees, agents, volunteers, contractors and subcontractors. 5. Policies Primary and Non-Contributory -All policies required above are to be primary and non- contributory with any insurance or self-insurance programs carried or administered by the County. 6. Proof of Coverage - Contractor shall immediately furnish certificates of insurance to the County Department administering the Contract evidencing the insurance coverage, including endorsements, above required prior to the commencement of performance of services hereunder, which certificates shall provide that such insurance shall not be terminated or expire without thirty (30) days written notice to the Department, and Contractor shall maintain such insurance from the time Contractor commences performance of services hereunder until the completion of such services. Within sixty (60) days of the commencement of this Contract, the Contractor shall furnish certified copies of the policies and all endorsements. 7. Insurance Review - The above insurance requirements are subject to periodic review by the County. The County's Risk Manager is authorized, but not required, to reduce or waive any of the above insurance requirements whenever the Risk Manager determines that any of the above insurance is not available, is unreasonably priced, or is not needed to protect the interests of the County. In addition, if the Risk Manager determines that heretofore unreasonably priced or unavailable types of insurance coverage or coverage limits become reasonably priced or available, the Risk Manager is authorized, but not required, to change Panes 15 of 7R the above insurance requirements, to require additional types of insurance coverage or higher coverage limits, provided that any such change is reasonable in light of past claims against the County, inflation, or any other item reasonably related to the County's risk. 8. Any such reduction or waiver for the entire term of the Contract and'any change requiring additional types of insurance coverage or higher coverage limits must be made by amendment to this Contract. Contractor agrees to execute any such amendment within thirty (30) days of receipt. T. Contractor shall comply with all applicable laws, statutes, ordinances, administrative orders, rules or regulations relating to its duties, obligations and performance under the terms of the Contract and shall procure all licenses and pay all fees and other charges required thereby. Contractor shall maintain all required licenses during the term of this Contract. Failure to comply with the provisions of this section may result in immediate termination of this Contract. U. Contractor shall comply with all applicable local health and safety clearances, including fire clearances, for each site where services are provided under the terms of this Contract. V. Contractor agrees to and shall comply with the County's Equal Employment Opportunity Program and Civil Rights Compliance requirements: 1. Equal Employment Opportunity Program: The Contractor agrees to comply with the provisions of the Equal Employment Opportunity Program of the County of San Bernardino and rules and regulations adopted pursuant thereto: Executive Order 11246, as amended by Executive Order 11375, 11625, 12138, 12432, 12250, Title Vii of the Civil Rights Act of 1964 (and Division 21 of the California Department of Social Services Manual of Policies and Procedures and California Welfare and Institutions Code, Section 10000), the California Fair Employment and Housing Act, and other applicable Federal, State, and County laws, regulations and policies relating to equal employment or social services to welfare recipients, including laws and regulations hereafter enacted. The Contractor shall not unlawfully discriminate against any employee, applicant for employment, or service recipient on the basis of race, color, national origin or ancestry, religion, sex, marital status, age, political affiliation or disability. Information on the above rules and regulations may be obtained from County HS Contracts Unit. 2. Civil Rights Compliance: The Contractor shall develop and maintain internal policies and procedures to assure compliance with each factor outlined by State regulation. These policies must be developed into a Civil Rights Plan, which is to be on file with County HIS Contracts Unit within 30 days of awarding of the Contract. The Plan must address prohibition of discriminatory practices, accessibility, language services, staff development and training, dissemination of information, complaints of discrimination, compliance review, and duties of the Civil Rights Liaison. Upon request, HS shall supply a sample of the Plan format. The Contractor shall be monitored by HS for compliance with provisions of its Civil Rights Plan. 3. Contractor shall complete and submit Assurance of Compliance (Attachment D) in accordance with its instructions. W. Contractor agrees to comply with all applicable provisions of the Americans with Disabilities Act (ADA). X. Contractor shall observe the mandatory standards and policies relating to energy efficiency in the State Energy Conservation Plan (Title 20, Division 2, California Code of Regulations). Pane 16 of 28 Y. If the amount available to Contractor under the Contract exceeds $100,000, Contractor shall comply with all applicable orders or requirements issued under the following laws: a. Clean Air Act (42 USC 7606) b. Section 508 of the Clean Water Act (33 USC 1368) C. Federal Water Pollution Control Act, as amended (33 USC 1251 et seq.) d. Environmental Protection Agency Regulations (40 CFR, Part 32 and Executive Order 11738) Z. Contractor shall use recycled and recyclable products, whenever practicable, in fulfilling the terms of this Contract. Recycled printed products shall include a symbol identifying the recycled material. AA. Contractor understands and agrees that any and all legal fees or costs associated with lawsuits concerning this Contract against the County shall be the Contractor's sole expense and shall not be charged as a cost under this Contract. In the event of any Contract dispute hereunder, each Party to this Contract shall bear its own attorney's fees and costs regardless of who prevails in the outcome of the dispute. BB. Contractor shall complete and submit Information Sheet (Attachment F) in accordance with its instructions. CC. Contractor agrees any books, reports, pamphlets, papers, articles, or other materials published or transferred, including newspaper reports, based on activities funded by this Contract, must: 1. Carry an acknowledgement of funding by the San Bernardino County DAAS. The following language should be used: "These materials or products are the result of a project funded in part or in whole by the County of San Bernardino Department of Aging and Adult Services through the Older Americans Act, as amended," and 2. Give the name of the entity, the address, and telephone number at which the supporting data is available; and 3. Include a statement that the conclusions and opinions expressed may not be those of the State, the County, and/or DAAS and that the publication may not be based upon or inclusive of all raw data. IV. COUNTY RESPONSIBILITIES A. The County agrees to monitor and evaluate the performance of the Contractor in meeting the terms of the Contract and the quality and effectiveness of services provided based on the criteria as determined by the County. B. The County is to provide consultation and technical assistance in monitoring the terms of this Contract. C. The County shall approve an audit firm, selected by the Contractor, to conduct a fiscal and program audit as specified in Section VI. D. The County agrees to compensate Contractor for approved expenses in accordance with Section V of this Contract. Pena 17 of 7R FISCAL PROVISIONS A. The maximum amount funds available under this Contract shall not exceed $259,129, of which $197,547 may be federally funded, and shall be subject to availability of funds to the County. The consideration to be paid to Contractor, as provided herein, shall be in full payment for all Contractor's services and expenses incurred in the performance hereof, including travel and per diem. B. Contractor shall be compensated on a cost reimbursement basis as established in Budget Summary (Attachment B). C. Contractor will provide a completed Expenditure Report/Request for Reimbursement form to DAAS by the 5th working day of the month following the month of service, to the address below: DAAS Administration Attn: Nutrition Services Fiscal Clerk 686 East Mill Street San Bernardino, CA 92415-00640 The County shall pay the Contractor for the authorized services of the previous month. Under normal conditions, Contractor shall expect payment approximately 30 days after submission of a correctly prepared invoice. D. County shall not approve any request for payment of funds until Contractor has properly filed completed reports as required under this Contract. If Contractor is not in compliance with any provision of this Contract, DAAS may withhold payment of any invoice submitted to DAAS by Contractor until such time as suitable documentation is submitted to DAAS and/or Contractor is deemed to be in compliance by DAAS. E. Upon written demonstration of need by Contractor and at the option of County, up to 10% of the Title III funds may be advanced to Contractor by County upon approval of the Director of DAAS. Any such advance shall cause the amounts payable to Contractor in subsequent months to be reduced to the amount determined by dividing the balance left by the number of months remaining in the Contract term. No advance will increase the amount shown in Section V, Paragraph A. F. If, as a result of advanced income, the project earns interest on funds awarded by DAAS, that interest shall be identified as income to the program and used for program expenditures, with full documentation on file. G. Contractor shall be compensated with the remainder of the Title III funds monthly. The calculation of the monthly disbursement amount will be based on the year-to-date expenditures identified in the Expenditure Report/Request for Reimbursement form compared to the year-to-date advanced funds. H. NSIP funds shall be paid to Contractor on the 15`h of each month from August through June, based upon the percentage of meals served among all current DAAS contractors. I. Contractor shall expend all funds received hereunder in accordance with this Contract. NOW J. Contractor shall ensure that all expenditures are supported by properly executed payroll, time records, invoices, contracts, vouchers, orders and any other accounting documents pertaining in whole or in part to this Contract. Such documents shall be clearly identified and readily accessible to DAAS staff, as may be required. i Page 18 of 28 K. DAAS reserves the right to refuse payment to the Contractor or later disallow costs for any expenditure determined by DAAS and/or CDA not to be in compliance with this Contract, or inappropriate to such activities, or for which there is inadequate supporting documentation presented, or for which prior approval is required but not granted. L. Contractor shall return to DAAS, immediately upon written demand, any funds provided under this Contract which are not payable for goods or services delivered prior to the termination, cancellation, or expiration of this Contract, or the dissolution of the entity. M. Contractor must return any unspent funds with submittal of revised year-end Financial Closeout Report, based on independent audit. N. Contractor shall maintain accounting records to account for the funds received under the terms and conditions of this Contract separate from any other funds administered by the Contractor. Contractor shall maintain records in accordance with generally accepted accounting principles. O. Costs for services under the terms of this Contract shall be incurred during the Contract period except as approved by County. Contractor shall not use current year funds to pay prior or future year obligations. P. Contractor is encouraged to seek contributions/donations from the elderly participating in the program. The program income goal for contributions/donations should be twenty-five percent (25%) or more of the total expenditures identified in the attached budget display. Q. General program income shall be used to increase the number of elderly served by a project, to facilitate access to such meals, and to provide supportive services directly related to nutrition as defined in the Work Plan/Scope of Work (Attachment A). General program income shall be used within the program in which it was earned. R. Deferred Income Program income not utilized for current year expenditures in excess of the budgeted program income shall be identified as "deferred income". This income will be expended by September 30th of the following fiscal year. In addition, this income must be identified on page 6 of the year-end Financial Closeout Report and then carried forward as a budget item in the new fiscal/contract year. Use of the deferred income must be reported in the Expenditure Report/Request for Reimbursement reports as spent, by September 30 of the following fiscal year. When the amount of the deferred income is determined through the audit, Contractor shall revise the deferred income figure, previously reported, by adjusting the following month's expense report claim for reimbursement and shall submit a new budget reflecting the revisions. Deferred income will be used for general program expenditures, to increase the number of elderly served by the Nutrition Program, and to provide supportive services directly related to nutrition. Deferred income will be used within the program (i.e., congregate meal or home-delivered meal) in which it was earned. I S. The Contractor, by signing this Contract, hereby certifies to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of the Contractor, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, Paoe 19 of 28 continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress or an employee of a Member of Congress in connection with this federal contract, grant, loan or cooperative agreement, the Contractor shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities" (Attachment E), in accordance with its instructions. T. Matching Contributions 1. The Contractor shall provide in-kind matching contributions of a minimum of $18,076, which is the Title III portion of the Contract multiplied by 11.11%. 2. Allowable match shall be in compliance with the following requirements: a. Matching in-kind contributions must be for allowable costs as determined by CDA PM. Allowable costs include but are not limited to rent, utilities, supplies, and volunteers. b. To qualify as a matching in-kind contribution, indirect or Contractor allocated overhead expenses must be supported by a documented cost allocation plan. C. Matching in-kind contributions in excess of the minimum required in one service component may be used to match another service component within the Older Americans Act. As an example, match exceeding the minimum requirement in a transportation program may be used to offset an under match in in-home supportive services. d. Contractor shall provide by August 1, 2007 a Budget In-Kind Narrative statement (Attachment B-2) to DAAS identifying the type, rates applied and, if applicable, source/location of in-kind to be used as match for the period of the Contract. The identified in-kind match shall be reported monthly on the monthly expense reports. 1) Services of volunteers shall be valued at rates consistent with those ordinarily paid for similar work by the Contractor. If the Contractor does not have similar work, the rate shall be consistent with those in the labor market. In either case, a reasonable amount of employee benefits may be included. 2) All other in-kind contributions shall be valued at current market value. U. Budget and Budget Revisions 1. The Contractor shall be reimbursed for expenses only as itemized in the budget approved by DAAS and supported by the completed Budget Line Items for FY 2007-2008, Budget In- Kind Narrative, Schedule of Personnel, and Schedule of Equipment, which must be submitted to DAAS by August 1, 2007, 2. The budget must set forth in detail the reimbursable items, unit rates, and extended total amounts for each line item. The Contractor's budget shall include, at a minimum, the following items when reimbursable under this Contract: a. Direct and overhead costs; b. Rental reimbursement items should specify the unit rate, such as the rate per square foot; C. If purchase of equipment is a reimbursable item, the equipment to be purchased should be specified; d. Any travel outside the State of California. 3. Budget and budget revisions shall adhere to any other provisions contained in the CDA PM. 4. The County Board of Supervisors delegates the authority to the Director of DAAS to make budget revisions provided the revisions do not result in the amount of the Contract exceeding the previously Board approved amount. Contractor shall submit in writing any request for budget changes, including line item changes, to the Director of DAAS. V. Costs for services under the terms of this Contract shall be incurred during the contract period except as approved by County. Contractor shall not use current year funds to pay prior or future year obligations. W. Funds made available under this Contract shall not supplant any federal, State or any governmental funds intended for services of the same nature as this Contract. Contractor shall not claim reimbursement or payment from County for, or apply sums received from County with respect to that portion of its obligations that have been paid by another source of revenue. Contractor agrees that it will not use funds received pursuant to this Contract, either directly or indirectly, as a contribution or compensation for purposes of obtaining funds from another revenue source without prior written approval of the County. X. County is not liable for the payment of any taxes, other than applicable sales or use tax, resulting from this Contract however designated, levied or imposed, unless County would otherwise be liable for the payment of such taxes in the course of its normal business operations. VI. RIGHT TO MONITOR AND AUDIT A. County shall have the absolute right to monitor the performance of Contractor in the delivery of services provided under this Contract. B. County or any subdivision or appointee thereof, and the State of California or any subdivision or appointee thereof, including the Auditor General, shall have absolute right to review and audit all records, books, papers, documents, corporate minutes, and other pertinent items as requested, and shall have absolute right to monitor the performance of Contractor in the delivery of services provided under this Contract. Full cooperation shall be given by Contractor in any auditing or monitoring conducted. C. Contractor shall cooperate with County in the implementation, monitoring and evaluation of this Contract and comply with any and all reporting requirements established by this Contract. D. All records pertaining to service delivery and all fiscal, statistical and management books and records shall be available for examination and audit by County, Federal and State representatives for a period of three years after final payment under the Contract or until all pending County, State and Federal audits are completed, whichever is later. Records of the Contractor which do not pertain to the services under this Contract may be subject to review or audit unless provided in this or another Contract. Technical program data shall be retained locally and made available upon the County's reasonable advance written notice or turned over to County. If said records are not made available at the scheduled monitoring visit, Contractor may, at County's option, be required to reimburse County for expenses incurred due to required rescheduling of monitoring visit(s). Such reimbursement will Paoe 21 of 28 not exceed $50 per hour (including travel time) and be deducted from the following month's claim for reimbursement. E. Contractor shall provide all reasonable facilities and assistance for the safety and convenience of County's representatives in the performance of their duties. All inspections and evaluations shall be performed in such a manner as will not unduly delay the work of the Contractor. F. Upon County request, Contractor shall hire a licensed Certified Public Accountant, approved by the County, who shall prepare and file with County, within 60 days after the termination of the Contract, a certified fiscal audit of related expenditures during the term of the Contract and a program compliance audit. G. Contractor agrees that County and CDA, or their designated representatives shall, at all times, have the right to review and to copy any records and supporting documentation pertaining to the performance of contracted services. 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 CDA and DHS to audit records and interview staff in any subcontract related to performance of contracted services. (GC 8546.7, PCC 10115 et seq., CCR Title 2, Section 1896). H. Audit 1. Pursuant to OMB Circular A-133, Contractors expending $500,000 or more in federal funds within the Contractor's fiscal year must have a single audit performed. A copy of the audit performed in accordance with OMB Circular A-133 shall be submitted to: Department of Aging and Adult Services 686 East Mill Street San Bernardino, CA 92415-0640 Contractors expending less than $500,000 in total federal funds are exempt from federal audit requirements but records must be available for review. 2. The following closely related programs identified by the Catalog of Federal Domestic Assistance (CFDA) number are to be considered as an "Other cluster' for purposes of determining major programs or whether a program specific audit may be elected. The contractor shall communicate this information to the independent auditor conducting the organization's single audit. This subsection applies to Title IIINII only. 93.045 Special Programs for the Aging-Title III, Part C-Nutrition Services (Title III-C) 93.053 Nutrition Services Incentive Program (NSIP) 3. Single audit reports must meet OMB Circular A-133 requirements and must be: a. Performed timely — The audit is required to be completed not later than 9 months after the end of the subcontractor's fiscal year. The audit report is due to DAAS not later than 30 days after the completion of the audit. b. Properly procured — Use OMB Circular A-110 procurement standards and provide maximum opportunities to small and minority audit firms. C. Performed in accordance with Government Auditing Standards — The audit shall be performed by an independent auditor and be organization-wide. Pa4e 22 of 28 d. All inclusive — The audit includes an audit of the financial statements; an assessment of internal controls, including tests of transactions; and a determination of compliance with laws and regulations of all major federal programs and selected non-major program transactions. Audits shall be performed in accordance with requirements applicable to this program as identified in OMB Circular A-133 Compliance Supplement. The County shall have access to all audit reports and supporting work papers, and the County has the option to perform additional work, as needed. All audits shall consider the programs identified in Section VI, Paragraph H, Item 2 as a cluster for purposes of determining major programs or whether a program specific audit may be elected. 4. To ensure that OMB Circular A-133 requirements are met, the audit report shall consist of the following parts: a. A report on the financial statements, a schedule of federal awards, which must report in-kind match, along with the auditor's opinion on the financial statements; b. A report on the entity-wide internal control systems based on the auditor's understanding of the internal control structure and the assessment of control risk (made as part of a financial statement audit); a report on internal controls (accounting and administrative) designed to provide reasonable assurance of compliance with laws and regulations applicable to federal assistance or federal awards, including tests of transactions (including program income and expenditures); C. A report on compliance with laws and regulations that may be material to financial statements; an opinion on compliance with laws and regulations applicable to each major federal program and a statement of positive assurance of those items that were tested (including program income) for compliance and negative assurance for those items not listed. These requirements may be met by the following: 1) A report on compliance with general requirements applicable to federal programs drawn from the relevant OMB Compliance Supplement; 2) An opinion on compliance with specific requirements applicable to each major program. The opinion should specify whether information contained in federal financial reports is supported by books and records and amounts claimed and used for matching meet applicable cost principles. d. A report on fraud, abuse, illegal acts or indications of such act, if necessary; e. A schedule of reportable conditions (including material weaknesses) for internal control findings and a schedule of findings and questioned costs for compliance findings (if not included in the internal control or compliance reports); a management letter; separate communication of nonmaterial findings relative to federal programs. 5. Contractor shall include in all contracts with auditors selected to perform audits that include monies awarded through this Contract, language clearly stating the auditors will comply with all applicable audit requirements, and permit access by the County and State to the work papers of the independent auditor. ID-74 of W 6. Audits to be performed shall be minimally financial and program compliance audits, and may include economy and efficiency and/or program results audits. 7. Unless prohibited by law, the cost of audits made in accordance with provisions of thy. Single Audit Act Amendments of 1996, are allowable charges to federal awards. The costs may be considered a direct cost or an allocated indirect cost, as determined in accordance with provisions of applicable OMB cost principle circulars. Contractor may not charge to federal awards the cost of any audit under the Singe Audit Act Amendments of 1996, not conducted in accordance with the Act. 8. Contractor shall notify DAAS of the time and location of scheduled entrance and exit conferences with independent auditors so that appropriate County staff may participate. 9. The auditor of record, hired by the Contractor, shall prepare and file with the County, a draft copy of the independent audit within 90 days after termination of this Contract and prior to the exit conference. Within 120 days after the termination or expiration of this Contract, the final independent audit report of related expenditures during the term of this Contract, shall also be filed with the County. 10. Contractor shall assist and comply with audit resolution requirements as required by DAAS, including submitting to DAAS at the exit conference a corrective action plan for any findings or recommendations, identified in the draft audit. 11. Contractor must take appropriate action to correct instances of non-compliance with federal laws and regulations within six (6) months after DAAS has received the audit report. VII. CORRECTION OF PERFORMANCE DEFICIENCIES AND APPEAL PROCEDURES A. Correction of Performance Deficiencies 1. Failure by Contractor to comply with any of the provisions, covenants, requirements or conditions of this Contract shall be a material breach of this Contract. 2. In the event of a non-cured breach, County may, at its sole discretion and in addition to any other remedies available at law, in equity, or otherwise specified in this Contract: a. Afford Contractor thereafter a time period within which to cure the breach, which period shall be established at sole discretion of County; and/or b. Discontinue reimbursement to Contractor for and during the period in which Contractor is in breach, which reimbursement shall not be entitled to later recovery; and/or C. Withhold funds pending duration of the breach; and/or d. Offset against any monies billed by Contractor but yet unpaid by County those monies disallowed; and/or e. Terminate this Contract immediately and be relieved of the payment of any consideration to Contractor. In event of such termination, the County may proceed with the work in any manner deemed proper by the County. The cost to the County shall be deducted from any sum due to the Contractor under this Contract and the balance, if any, shall be paid by the Contractor upon demand. Page 24 of 28 3. The Contractor agrees that any remedy provided in this Contract is in addition to and not in derogation of any other legal or equitable remedy available to the County as a result of breach of this Contract by the Contractor, whether such breach occurs before or after the termination of the Contract. B. Appeal Procedures If Contractor disagrees with any decision or action taken by the County or DAAS related to this Contract, Contractor may choose to file a formal grievance by following the procedures below: 1. The Contractor shall file a formal written grievance with the DAAS Deputy Director of Administrative Services ("DAAS Deputy Director") within fifteen (15) business days after the Contractor is aware of the factors or conditions precipitating the contract dispute. The written grievance shall set forth the subject of the grievance, identify the specific clause in dispute and shall provide a detailed statement of the grievance, including dates, names, places, and the specific remedy or action requested. The filing address is 686 East Mill Street, San Bernardino, California, 92415-0640. The DAAS Deputy Director shall provide a written response to Contractor within fifteen (15) business days of receipt of the grievance. 2. If Contractor is not satisfied with the DAAS Deputy Director's response, Contractor may file a written grievance appeal, which shall include a statement by the Contractor as to why the DAAS Deputy Director's response is not satisfactory, to the Director of DAAS within fifteen (15) business days of receipt of the DAAS Deputy Director's response. The filing address is 686 East Mill Street, San Bernardino, California, 92415-0640. The Director of DAAS shall provide a written response to Contractor within fifteen (15) business days. The Director of DAAS shall have final authority for the decision on the grievance except as provided below. c 3. If Contractor is not satisfied with the DAAS Director's response, Contractor may file a written grievance appeal, which shall include a statement by the Contractor as to why the DAAS Director's response is not satisfactory, to the Assistant County Administrator (ACA) of the Human Services within fifteen (15) business days of receipt of the DAAS Director's response. The filing address is 385 North Arrowhead Avenue, Fifth Floor, San Bernardino, California, 92415-0128. The Assistant County Administrator shall provide a written response to Contractor within fifteen (15) business days. The Assistant County Administrator shall have final authority for the decision on the grievance except as provided below. 4. For those appeals which involve CDA programmatic policies and directives issued to the County and contained within this Contract, the following applies. If Contractor is not satisfied with the ACA's decision, the written grievance may be registered in writing with the CDA, Case Management Branch, 1300 National Drive, Suite 200, Sacramento, California, 95834, within fifteen (15) business days following receipt of the Director of DAAS' decision. Contractor shall submit to CDA the original written grievance along with a copy of the DAAS Deputy Director's written response, the Contractor's appeal to the Director of DAAS, the Director of DAAS' decision, the Contractor's appeal to the Assistant County Administrator, and the Assistant County Administrators' decision. CDA shall have final authority for the decision on the grievance. VIII. TERM This Contract is effective as of July 1, 2007, and expires June 30, 2008, but may be terminated earlier in accordance with provisions of Section IX of the Contract. The Contract term may be extended for two additional one-year periods by mutual agreement of the parties. Paae 25 of 28 IX_ EARLY TERMINATION 0 A. The County may terminate the Contract immediately under the provisions of Section VII, Paragraph A, Item 2e of the Contract. In addition, the Contract may be terminated without cause by the County by serving a written notice to the Contractor thirty (30) days in advance of termination. The Assistant County Administrator — Human Services is authorized to exercise the County's rights with respect to any termination of this Contract. B. Contractor shall only be reimbursed for costs and uncancelable obligations incurred prior to 'the date of termination. Contractor shall not be reimbursed for costs incurred after the date of termination. Any remaining balance of an advance payment is immediately due and payable to the County. X. GENERAL PROVISIONS A. When notices are required to be given pursuant to this Contract, the notices shall be in writing and mailed to the following respective addresses listed below. Contractor: City of San Bernardino 600 West 5th Street San Bernardino, CA 92410 County: County of San Bernardino Human Services Attn: Contracts Unit 150 S. Lena Road San Bernardino, CA 92415-0515 B. Nothing contained in this Contract shall be construed as creating a joint venture, partnership or employment arrangement between the Parties hereto, nor shall either Party have the right, power or authority to create an obligation or duty, expressed or implied, on behalf of the other Party hereto. C. Contractor shall not offer (either directly or through an intermediary) any improper consideration such as, but not limited to, cash, discounts, service, the provision of travel or entertainment, or any items of value to any officer, employee or agent of the County in an attempt to secure favorable treatment regarding this Contract. The County, by written notice, may immediately terminate any Contract if it determines that any improper consideration as described in the preceding paragraph was offered to any officer, employee or agent of the County with respect to the proposal and award process. This prohibition shall apply to any amendment, extension or evaluation process once a Contract has been awarded. Contractor shall immediately report any attempt by a County officer, employee or agent to solicit (either directly or through an intermediary) improper consideration from Contractor. The report shall be made to the supervisor or manager charged with supervision of the employee or to the County Administrative Office. In the event of a termination under this provision, the County is entitled to pursue any available legal remedies. D. The State and County shall have all ownership rights in software or modifications thereof and associated documentation designed, developed or installed with Federal financial participation. The Federal Government (DHHS and FCS) reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use and to authorize others to use for Federal Government purposes, such software modification, and documentation. Proprietary software packages that are sold or leased to the general public are not subject to the ownership provisions. onno 7R of 7R E. County shall have Power of Attorney to pay delinquent debts and unpaid wages for work provided under this Contract from accounts payable to Contractor in the event debts and wages have not been paid on a current basis. F. No waiver of any of the provisions of the Contract shall be effective unless it is made in a writing which refers to provisions so waived and which is executed by the Parties. No course of dealing ' and no delay or failure of a Party in exercising any right under the Contract shall affect any other or future exercise of that right or any exercise of any other right. A Party shall not be precluded from exercising a right by its having partially exercised that right or its having previously abandoned or discontinued steps to enforce that right. G. Any alterations, variations, modifications, or waivers of provisions of the Contract, unVss specifically allowed in the Contract, shall be valid only when they have been reduced to writing, duly signed and approved by the Authorized Representatives of both parties as an amendment to this Contract. No oral understanding or agreement not incorporated herein shall be binding on any of the Parties hereto. H. If any provision of the Contract is held by a court of competent jurisdiction to be unenforceable or contrary to law, it shall be modified where practicable to the extent necessary so as to be enforceable (giving effect to the intention of the Parties) and the remaining provisions of the Contract shall not be affected. I. This Contract shall be governed by and construed in all aspects in accordance with the laws of the State of California without regard to principles of conflicts of laws. The Parties agree to the exclusive jurisdiction of the federal court located in the County of Riverside and the State court located in the County of San Bernardino, for any and all disputes arising under this Contract, to the exclusion of all other federal and State courts. XI. CONCLUSION A. This Contract, consisting of 28 pages and Attachments A, B, B-1, B-2, B-3, B-4, C, D, E, and F, is the full and complete document describing services to be rendered by Contractor to County including all covenants, conditions and benefits. B. The signatures of the Parties affixed to this Contract affirm that they are duly authorized to commit and bind their respective institutions to the terms and conditions set forth in this document. 1)o C. IN WITNESS WHEREOF, the Board of Supervisors of the County of San Bernardino has caused this Contract to be subscribed to by the Clerk thereof, and Contractor has caused this Contract to be subscribed in its behalf by its duly authorized officers, the day, month and year written. NTY OF SAN BERNARDINO City of San Bernardino (Print or type name of corporation, company,contractor,etc.) ► By Do- Paul Biane, Chairman, Board of Supervisors (Authorized signature-sign in blue ink) Dated Name Fred Wilson (Print or type name of person signing contract) SIGNED AND CERTIFIED THAT A COPY OF THIS DOCUMENT HAS BEEN DELIVERED TO THE Title City Manager CHAIRMAN OF THE BOARD (Print or Type) Clerk of the Board of Supervisors Dated of the County of San Bernardino. By Address 600 West 51h Street Deputy San Bernardino, CA 92410 Approved as to Legal Form Reviewed by Contract Compliance Presented to BOS for Signature ► ► ► Phebe W.Chu, Deputy County Counsel Lori Ciabattini, HS Contracts Unit Colleen Krygier, Director Date I Date Date Auditor/Controller-Recorder APPROVED AS TO FORM: '!se Only 0 Contract Database. 0:FAS, Input Date Keyed By James F. Penman, City Attorney By: 1�1rWrllrrerrur rr ATTACHMENT A WORK PLAN/SCOPE OF WORK FY 2007-2008 This work plan/scope of work contains the measurable objectives mandated by DAAS of the Nutrition Contractor. The work plan specifies and establishes time frames either on an annual basis or where required by State regulations on a quarterly basis. The work plan constitutes the primary document for on-going monitoring and Annual Program Performance Review/Fiscal Audit, and will be used to measure the Contractor's efforts towards providing quality nutrition services. Contractor: City of San Bernardino Region: East Valley Area I. Program Description A. Purpose/Definition of the Program Purpose The purpose of the Elderly Nutrition Program is to provide nutrition services as described in the Older Americans Act (OAA) of 1965, as amended, and to assist older individuals in California to live independently, by promoting better health through improved nutrition, and reduced isolation through programs coordinated with nutrition-related supportive services. Definition Nutrition Services means the procurement, preparation, transport, and service of meals, nutrition education, nutrition screening, and nutrition counseling, to eligible individuals at congregate sites or in their homes. B. Target Population The Nutrition Provider shall target individuals who are sixty (60) years old or older, minorities, low income and living in rural areas of the County of San Bernardino. C. Eligibility for Nutrition Services 1. Congregate Meals (C-1): Individuals eligible to receive a meal at a congregate nutrition site are: a. Any older individual who is 60 years old or older. b. The spouse of any older individual. C. A person with disability, under the age of sixty (60) who resides in a housing facility occupied primarily by older individuals at which congregate nutrition services are provided. d. A disabled individual who resides at home and accompanies an older individual who participates in the program. ATTACHMENT A 2. Home Delivered Meals (C-2): Individuals eligible to receive a home-delivered meal are: a. Any older individual who is frail, as defined in Title 22 Section 7119, and homebound by reason of illness, disability, or isolation. b. A spouse of an individual described in Section I, Paragraph C, Item 2a, regardless of age or condition, if an assessment concludes that is in the best interest of the homebound older individual. C. An individual with a disability who resides at home with older individuals if an assessment concludes that it is in the best interest of the homebound older individual who participates in the program. d. Priority shall be given to older individuals. 3. The Nutrition Contractor who is providing home delivered meals shall: a. Maintain a waiting list. b. Develop a written Policy and Procedure for the implementation of the program that includes the manner in which clients will be prioritized. C. Follow the above eligibility criteria listed in Section I, Paragraph C, Item 2. If the C-2 provider chooses to add or subtract additional requirements, the criteria shall be approved by DAAS prior to implementation. d. Have a designated staff member that completes the initial and quarterly re- assessments. e. Screen the clients for eligibility by phone and in home visits within two weeks of the beginning of the meal service. f. Maintain appropriate documentation on each client. Documentation shall be kept on file and monitored by DAAS. g. Provide an emergency home delivered meal for a minimum of five (5) working days until the assessment can be completed. D. Service Area The geographic area served by this contractor covers the city of San Bernardino and surrounding areas. II. Program Outcomes A. Total Number of Meals to be Served: 55,840 Program # of days Number of Meals C-1 255 50,840 C-1 Pilot Dinner Program 5,000 D­ 7 -f 17 ATTACHMENT A A minimum of 95% of the total nurn,oer of meals is to be provided. The Director of DAAS must approve provision of less than 95% of the total number of meals to be provided. All such requests must be in writing. B. Sites to be served: C-1 Sites 5 Snior Center Perris Hill Senior Center Hernandez Community Center Lytle Creek Community Center New Hope Family Life Center Highland Senior Center Light House for the Blind 111. Staffing A. Manager or Director 1. The Contractor shall have a manager or staff who conducts the day-to-day management and administrative functions on the program and has one of the following: a. Possess an associate degree in institutional food service management, or a closely related field, such as, but not limited to, restaurant management, plus two (2) years experience as a food service supervisor. b. Demonstrate experience in food service, such as, but not limited to, cooking at a restaurant, and within twelve (12) months of hire successfully complete a minimum of twenty (20) hours specifically related to food service management, business administration, or personnel management at a college level. Prior to completion of meeting the hours, this individual's performance shall be evaluated through quarterly monitoring by a Registered Dietitian. C. Two years experience managing food services. Such experience shall be verified and approved by a Registered Dietitian prior to hire. 2. The Contractor shall maintain documentation on file of the qualifications of the Program Manager or staff. 3. If the Contractor has more than one site, the Manager/Director shall monitor the sites on a regular basis. The bi-monthly visit should not only monitor the food service practices of the employees, but also the implementation of the program requirements at the site level. Documentation of each visit shall be maintained on file for DAAS review. B. Food Service Personnel 1. There shall be sufficient qualified paid staff or volunteer staff with the appropriate education and experience to carry out the requirements of the Program. The total number of staff should be based on the method and level of services provided and size of the service area. 2. Contractor is encouraged to hire multi-lingual/multi-cultural staff to increase low-income and ethnic minority program participation in accordance with federal mandates. Pans Z of 10 EEL- ATTACHMENT A 0 3. Contractor shall recruit for vacant positions in an open and competitive application process free of discriminatory questions. Written job descriptions for all paid and volunteer employees shall be maintained. 4. Contractor shall complete a written work performance evaluation on all paid and volunteer employees. C. Volunteers 1. Volunteers shall be recruited and used in any phase of the program operation where qualified. 2. Volunteers shall be screened and selected through a formal process that assesses their capabilities. 3. Volunteers shall receive the same training as paid staff. 4. Volunteers that will be handling food must be in possession of a current Food Handlers Card issued by the local community colleges. 5. Volunteers that are paid through other job training programs are not considered volunteers and must be paid the agreed upon rate charged for regular paid staff. 6. The Contractor shall maintain a written Volunteer policy that describes how volunteers are recruited, screened, what topics they are taught at orientation and how often their performance is evaluated. D. Registered Dietitian 1. Each Senior Nutrition Provider shall establish and administer nutrition services with the advice of a Registered Dietitian in accordance with Section 339 of the OAA, and follow the general requirements in Title 22, Division 1.8, and Section 7500. 2. The Registered Dietitian will provide the following activities to meet the mandated requirements: a. At a minimum, quarterly monitor for safe food handling and sanitation practices of food facilities. b. Review and approve the content of staff training prior to presentation. C. Develop, or review and approve the monthly or cycle menus. d. Develop, or review and approve the nutrition education plan for participants. e. Provide the nutrition education to seniors or staff training if the Provider and Registered Dietitian determine that is the best choice. f. Provide technical support and assistance as needed. ATTACHMENT A IV. Staff Training Activities A. A yearly written plan for staff in-service shall be developed in collaboration with the Contract Registered Dietitian. B. The Contract Registered Dietitian shall review and approve the content of the plan prior to present:•tion. C. The training plan must identify who is to be trained, who will conduct the training, content of the training and when it is scheduled. D. A copy of the written plan must be sent to DAAS by September 4, 2007. E. All Paid staff and volunteers shall be provided annually a minimum of four (4) hours of training. F. Paid staff and volunteers attending the training shall be provided the opportunity to evaluate the training session. G. The provider shall maintain on file documentation of each training session. Documentation includes, but is not limited to, sign-in-sheets, agendas, handouts and completed evaluations. H. New paid staff or volunteers shall be oriented and trained to perform their assigned responsibilities and tasks. Training shall include: 1. Food safety, prevention and food-borne illness, and HACCP principles. 2. Accident prevention, instruction on fire safety, first aid, choking, earthquake preparedness, and other emergency procedures. 3. All staff shall be trained on the Elder Abuse Law and reporting procedures. V. Senior Participants A. Satisfaction Survey The provider shall conduct a client satisfaction survey at least once a year. The survey instrument must be approved by DAAS prior to its use, and all findings from the surveys must be used to improve services. The completed surveys and the tabulated results must be kept on file. A copy of the tabulated results must be received by DAAS by March 3, 2008. B. Complaint Procedure 1. Each provider shall have a written complaint procedure. 2. The complaint procedure will be available for the participants and will provide them the opportunity to provide positive as well as negative feedback to the Program Manager. 3. The Contractor shall have an assessment tool readily accessible for the seniors attending the congregate site or receiving a home delivered meal. Pana 5 of 19 ATTACHMENT A C. Nutrition Education for Seniors 1. The provider shall provide one nutrition education presentation quarterly, including appropriate handouts that have been approved by the Contract Registered Dietitian. 2. The provider in conjunction with the Contract Registered Dietitian shall conduct a needs assessment of the seniors attending the congregate site and/or seniors receiving a home delivered meal. 3. Results of the needs assessment will provide information for the development of the Nutrition Education Plan for seniors. 4. The Nutrition Education Plan for seniors is due to DAAS September 4, 2007. 5. Units of Service: # of sites # of nutrition education activities Total number per year 7 4 28 VI. Menu Planning Guidelines/Menu Requirements A. A minimum of a 4-week cycle shall be planned. B. Menu cycles shall include the availability of seasonal foods. C. Health, cultural, ethnic and regional dietary practices shall be considered in menu planning, food selection and meal preparation. D. The menu cycle shall be approved by the Contract Registered Dietitian and upon approval forwarded to the DAAS Nutritionist for certification. Allow a minimum of two (2) weeks for the menu certification process. Contractor is encouraged to plan ahead and have menus ready for certification prior to the implementation date. All signatures on the menu shall be original signatures. E. A copy of the certified menu must be posted in a spot conspicuous to clients at each congregate site. F. Copies of the menus shall be made available to the participants. G. When planning the menus, the California Daily Food Guide and the Dietary Guidelines for Americans are to be considered. Menu shall conform to the following criteria: 1. Provide an average of 600-800 calories per meal. 2. Limit fat to no more than 25-30 % of the calories averaged for the week. 3. Use salt sparingly, if at all, in cooking. 4. Include good sources of dietary fiber at least 4 times a week. 5. Food items shall not be repeated two days in a row or the same days of consecutive weeks. D-o R -f 4 7 ATTACHMENT A 6. Include a variety of foods and preparation methods with consideration to color, combinations, texture, size, shape, taste and appearance. H. The meal shall consist of the following: 1. Three (3) ounces of cooked edible portion of meat, fish, poultry, eggs, cheese, or the protein equivalent daily. 2. Two (2) one-half (1/2) cup servings, drained weight or volume, of different vegetables or fruits or their juices. 3. One serving of whole grain or enriched bread, or bread alternatives. 4. ° Eight (8) ounces of fortified-fat free milk, low-fat milk or buttermilk. 5. One-half (1/2) cup serving of a dessert. 6. Each meal shall provide a food containing a minimum of 30 milligrams of Vitamin C. 7. The weekly menu shall contain food(s) containing a minimum of 300 micrograms of Vitamin A at least three times per week for a five (5) days per week menu or four (4) times per week for a seven (7) days per week menu. I. Menu/Meal Analysis 1. A meal analysis conducted and/or approved by a Registered Dietitian shall be done to ensure compliance with Title 22, Division 1.8, Section 7638.5. 2. Menu cycle shall be analyzed on a regular basis and documentation maintained for DAAS review. VII. Food Procurement A. Food procurement procedures shall comply with Title 22, CRFC standards and HACCP best practices guidelines. B. All food shall be of good quality and shall be obtained from sources which conform to Federal, State and local regulatory standards for quality, sanitation and safety. C. To the extent possible, providers are encouraged to participate in group food purchasing. D. A comparative cost analysis shall be performed either by the provider or its group purchasing organization on an on-going basis to obtain the highest quality food for the lowest price available. VIII. Food Storage A. Food storage procedures shall comply with Title 22, CRFC standards and HACCP best practices guidelines. B. Adequate and suitable space free from vermin, dirt and contamination or adulteration shall be provided for the storage of food and beverages, and cooking, serving and eating supplies. Donn 7 of 10 ATTACHMENT A Food Production A. Food production procedures shall comply with Title 22, CRFC standards and HACCP best practices guidelines. B. Food production and meal service shall be under the supervision of a trained staff in food service management to ensure food service sanitation and the practice of hygienic food handling techniques are followed. This person shall function with the advice of the Contract Registered Dietitian. C. Meals shall be served as indicated on the certified menus. 1. ' The Contract Registered Dietitian must approve all menu substitutions. 2. A menu substitution form must be completed and signed by the Contract Registered Dietitian. 3. The completed menu substitution form shall be kept on file for DAAS review. D. Production Control 1. Production schedules or worksheets must be available in the food preparation area. 2. Food shall be prepared in sufficient quantities to serve all participants. Careful planning shall minimize leftover food and prevent waste. 3. Standardized recipes shall be used to ensure consistency of quality and quantity and adherence to menu guidelines. 4. Appropriate utensils for correct and consistent portion control shall be available and used at each site. E. Meal Service/Temperature Monitoring 1. All food for congregate sites shall be packaged and transported in a manner which protects it from potential contamination and maintains appropriate hot and cold food temperatures. 2. Meal shall be served to seniors "Offer versus Serve", meaning participants are to be given an opportunity to decline a menu item. Food trays shall not be served ahead of time. 3. Temperature Checks: a. Congregate food temperature shall be taken daily prior to delivery, upon arrival and prior to service at the satellite congregate site. b. All hot, cold and frozen potentially hazardous meal components, including milk, shall be checked at satellite congregate sites upon delivery and immediately before meal service. C. The provider must have written procedures for monitoring food temperature. d. The provider must have a form to document food temperature daily. ATTACHMENT A e. The provider shall have a staff member review the completed temperature logs at random a minimum of every other month. If problems are discovered, an action plan must be developed to resolve the issue. f. All completed food temperature logs must be maintained on file for - AAS review. 4. To maintain quality in prepared foods, holding times shall be kept to a minimum. Long periods of holding hot foods at required temperatures diminishes the nutrient content and palatability of foods. 5. Holding time shall not exceed 2 hours between the end of production and the beginning of food service at the congregate site. 6. ° Milk and milk products shall be provided in individual, commercially filled containers, or shall be poured directly from commercially filled bulk containers into the glass or cup from which it is consumed. 7. Single service utensils and tableware shall be used one time only and then discarded. 8. Safety of the food after it has been served at the congregate site and then removed by the participant from the congregate site is the sole responsibility of the participant and may be consumed by the participant as he/she deems it appropriate. 9. The Provider shall have a sign posted in the congregate site stating, "Food removed from the congregate site is at your own risk." X. Food Service Requirements The Contractor shall ensure that the following forms are available and/or completed daily at the nutrition sites: A. Food Temperature Log — one should be available for congregate and one for home delivered meals if hot foods are delivered to the client. B. Cleaning Schedule C. Equipment Temperature Log D. Production Schedule — applicable only if food is cooked at the site. E. The current environmental health inspection shall be available at the site for review. F. Staff and volunteers who are handling food should possess a current food handlers' card that shall be available for review. XI. Program Requirements A. Client Intake Forms The Contractor will assure that each participant shall complete the Client Intake Sheet form (provided by DAAS) to determine his or her level of nutritional risk. Forms shall be completed at the beginning of service for the home delivered meal participants and once a year for congregate meal participants. Pane Q of 17 ATTACHMENT A B. Outreach/Marketing Activities Provide outreach in the community through community organizations, and other groups. All outreach and marketing activities shall be documented and kept on file for the Annual Program Performance Review. The Contractor shall develop and have on hand handouts, brochures or signs in languages other than English and posted in locations such as churches, community service locations and small stores serving the minority communities. C. Emergency Procedures 1. Each Contractor shall have a written Emergency/Disaster Plan. 2. Each nutrition site shall have an evacuation plan posted identifying the emergency exits and assembly areas. 3. Staff must be knowledgeable of emergency procedures, and evacuation drills shall be conducted as appropriate. 4. The emergency plan shall include a day or week's supply of emergency food depending on the availability of space. D. Donations and Confidentiality 1. The provider shall establish written procedures to protect contributions and fees from loss, mishandling, and theft. Such procedures shall be kept on file for DAAS review. 2. The provider shall provide each participant the opportunity to contribute to the meal. 3. The provider shall develop a suggested contribution/donation. When developing the contribution amount, the income ranges of the older individuals in the community and the provider's other sources of income shall be considered. 4. A sign indicating the suggested contribution for eligible individuals, and the fee for guests shall be posted near the contribution container at each congregate meal site. The guest fee shall cover all meal costs. 5. No eligible individual shall be denied participation because of failure or inability to contribute. 6. The provider shall ensure that the amount of eligible participant's contribution is kept confidential. 7. All contributions and fees shall be identified as program income and used to increase the number of meals served, to facilitate access to such meals, and to provide nutrition-related supportive services. 8. The Contractor will not in any way employ tactics, which could be viewed as coercion, embarrassing and/or obligatory to the meal being provided to the participant. 9. The Contractor shall encourage the participant to place their donation in the box by themselves in strict confidentiality. ATTACHMENT A 10. The Contractor shall ensure that the donation box is not right in front of the hostess or in view of the other participants. E. "No Soliciting" Signs The Contractor shall ensure that a "No Soliciting" sign is posted on the door leading to the congregate nutrition site. No soliciting of any kind is permitted on the premises during the lunch hours for services or goods promoted by businesses. F. Coordination 1. If applicable, develop a fair and equitable policy and procedure for referring elderly participants to the appropriate transportation provider for securing public transportation to and from nutrition sites and have the policy fully in place. 2. Include the following statement on all advertising, brochures, posters, etc., "Funding for this service has been provided by the San Bernardino County Department of Aging and Adult Services through a grant award from the California Department of Aging." 3. Coordinate service with other county departments and local agencies by providing time for presentations or special activities that promote a Community Based System of Care for the elderly participants attending their sites. All such activities must be documented and kept on file for review by DAAS. G. Reporting 1. Report all fiscal and meal counts monthly. The reports are due the 5th working day of every month. DAAS will provide training as needed. 2. The provider shall maintain support files including, but not limited to, invoices, payroll, and other supporting documents to substantiate the monthly report. 3. Report all known or suspected cases of elder abuse to DAAS Adult Protective Services or law enforcement immediately, or as soon as possible, by telephone, and send a written report within two (2) working days. Abuse of an elder or dependent adult means physical abuse, neglect, intimidation, cruel punishment, fiduciary abuse, abandonment, isolation or other treatment with resulting physical harm or pain or mental suffering or the deprivation by a care custodian of goods or services which are necessary to avoid physical harm or mental suffering. 4. Maintain records, by month, that support claimed in-kind expenditures. 5. Report expenditures funded with Deferred Income by September 30, 2008. 6. Develop and have on hand for review by DAAS, a cost allocation plan which explains the methods used to allocate costs between Congregate and Home Delivered Meals or any other program funded by DAAS, such as Home Repairs. In the event additional funds become available, the Contractor will use the funds to increase the number of meals being provided to elderly participants by either increasing the number of individuals attending its present sites, or by opening new sites in communities not already served by the Contractor. Exceptions to this requirement must be fully documented in writing and submitted to the department for prior approval. n,....._ 4 A _c 4 n ATTACHMENT A 7. Other Reporting Requirements: a. Computerized Client Tracking System: 1} The following reports are to be completed and submitted to DAAS by the 5th working day of the month following the month of service if the Contractor is serving less than 500 clients per month: • DAAS NAPIS Client Intake Sheets • Meal Rosters 2) Contractors that are serving more than 500 clients shall be responsible for entering the data into an Internet based client tracking system. The Contractor shall secure the appropriate licensing, have a dedicated staff responsible for maintaining the client tracking software, obtain and maintain an Internet service provider and the appropriate hardware that can support the program. 3) The Contractor shall update the Internet based Client Tracking system on a monthly basis. DAAS will monitor to ensure that the information is maintained and current. 4) DAAS shall provide training and technical support and assistance. b. Nutrition Monthly Service Unit Report The Nutrition Monthly Service Unit Report is a tool that is used to report the number of actual meals served and the number of seniors served per site. This report is to be completed and submitted to DAAS by the 5'h working day of the month. H. Disposal of Equipment 1. If the Contractor has equipment that was purchased with Nutrition grant funding and wishes to discard it, a letter should be submitted to DAAS stating the equipment type, the serial number, the location of the equipment and the reason for disposal. 2. Contractor shall submit a list of equipment purchased with grant funding by location. Contractor's signature Date APPROVED AS TO FORM: James F. Penman, City Attorney By: � � ATTACHMENT B BUDGET SUMMARY FY 2007- 2008 CITY OF SAN BERNARDINO FY 07-08 FUNDING REVENUES: Title III, Older Americans Act C-1 162,703 C-2 -0- 162,703 Nutrition Services Incentive Program C-1 34,844 C-2 -0- 34,844 County Funds C-1 61,582 C-2 -0- 61,582 TOTAL FUNDS AWARDED 259,129 Page 1 of 1 ATTACHMENT B-1 BUDGET LINE ITEMS FOR NUTRITION SERVICES FY 2007 - 2008 CONGREGATE SITES C1 ® FDME DELIVERED MEALS C2 El EXPENDITURE CATEGORY FundinF4 Match j Less Match Cash In-Kind TOTAL L PERSONNEL 2. STAFF TRAVEL I 3. STAFF TRAINING 4.EQUIPMENT 5. CONSULTANTS 6. FOOD COSTS 7. COMSUMMABLE SUPPLIES i j & INSURANCE 9. REPAIRS 8, MAINTENANCE 10. RENT/BUILDING SPACE —11. UTILITIES 12. VEHICLE OPERATIONS 13. VOLUNTEER EXPENSES 14. OTHER Total Expenditure i Less Match Match Cash i Match In-Kind Less Funding Non Match NSIP Non Match Cash/CSBG Program Income Deferred Income TOTAL FUNDING REQUEST date of Submission: INITIAL BUDGET PROVIDER NAME: REVISED BUDGET ❑ SAN BERNARDINO COUNTY-DAAS Form 312A 02/13/98 ATTACHMENT B-1 BUDGET LINE ITEMS FOR NUTRITION SERVICES FY 2007 - 2008 CONGREGATE SITES Cl ❑ FDME DELIVERED MEALS C2 ❑ EXPENDITURE CATEGORY Funding Match Less Match Cash In-Kind TOTAL 1. PERSONNEL 2. STAFF TRAVEL 3. STAFF TRAINING 4.EQUIPMENT 5. CONSULTANTS 6. FOOD COSTS 7. COMSUMMABLE SUPPLIES 8. INSURANCE 9. REPAIRS & MAINTENANCE 10. RENT/BUILDING SPACE 11. UTILITIES 12. VEHICLE OPERATIONS 13. VOLUNTEER EXPENSES 14. OTHER (Total Expenditure iLess Match Match Cash Match In-Kind Less Funding F_ Non Match NSIP Non Match Cash/CSBG Program Income Deferred Income !TOTAL FUNDING REQUEST gate of Submission: INITIAL BUDGET ❑ PROVIDER NAME: REVISED BUDGET ❑ SAN BERNARDINO COUNTY—DAAS Form 312A 02/13/98 ATTACHMENT B-2 Budget In-Kind Narrative Provide information regarding specific in-kind to be used as match. Include site location, if applicable, descriptions, rates Viand other relevant information. The Total should equal the amount of in-kind reported as match or your budget summary. i Description" Site/Location Rate Total In-Kind Match i `(Identify type of in-kind: rent, volunteer services, etc.) DATE OF SUBMISSION PROVIDER NAME San Bernardino County-DAAS Form 332 Revised 01/08/2001 M `- w m O Z CD co Q Q � 0 C J W L E Z z Z p � o Cn@ � 0c 0 c W Q a LL L OM W J 0 0 E -0 O N W m " o cu S U ' c ♦ cn o c I = o I � o I w � ° c ) o @ o o m U °6 O o C C O o x ° °c co (n U) O O d Q O (6 O m n ATTACHMENT B-4 SCHEDULE OF EQUIPMENT Item Budgeted Total Description Quantity Cost Costs I Provider Name: San Bernardino County-DAAS Form 316 Revised 01/08/2001 ATTACHMENT C CLIENT COMPLAINT AND GRIEVANCE PROCEDURES Older Americans Act Programs CONTRACTOR: CITY OF SAN BERNARDINO (Instructions: The service recipient is to read, sign, and receive a copy of this form. The original of the form is to be filed in the service recipient's case file maintained by contractor. The reverse side of this form may be used to file a complaint or grievance with the contractor/service provider.) If you believe you have been discriminated against, or that there has been a violation of any laws or regulations, or if you have a problem regarding services received, you have the right to file a grievance. The fol!owing procedures are to be followed when filing a grievance: 1. Identify the complaint/grievance in writing and discuss it with the contractor/service provider. Time frame: Within 1 week of discrimination/violation/problem. If resolved at this level, no further action is required. If no resolution is apparent within 15 business days, proceed with Step 2. 2. Forward the written complaint/grievance to the Deputy Director of Administration at the following address: Department of Aging and Adult Services 686 East Mill Street San Bernardino, CA 92415-0640 ATTN: Deputy Director Time frame: Within 1 week of Step 1. olved at this level, no further action is required. If no resolution is apparent within 15 business days, proceed with SLcp 3. 3. If no solution is apparent after Steps 1-2 have been exhausted, forward copy of written grievance to: Human Services Group, Contract Administrator 150 S. Lena Road San Bernardino, CA 92415-0515 You will be contacted within 15 business days of any actions being taken. Please note: Each of these steps must be completed in the sequence shown. If you believe that your civil rights have been violated, please contact: Deputy Director, Administration Department of Aging and Adult Services 686 East Mill Street San Bernardino, CA 92415-0640 GRIEVANCE PROCEDURE CERTIFICATION This is to certify that I have read, understood, and received a copy of the Client Complaint and Grievance Procedures for Older Americans Act Programs. Signature of Service Recipient Date Page 1 of 2 ATTACHMENT C GRIEVANCE NOTICE Your Name: i Date of Occurrence: Approximate Time of Occurrence: Name of Service Provider: Address of Service Provider: Nature of Grievance: Resolution: Resolved by: Signature Date Signature of Service Recipient Date Page 2 of 2 ATTACHMENT D ASSURANCE OF COMPLIANCE ASSURANCE OF COMPLIANCE WITH ALL APPLICABLE LAWS RELATING TO NONDISCRIMINATION IN STATE AND FEDERALLY ASSISTED PROGRAMS CITY OF SAN BERNARDINO CONTRACTOR HEREBY AGREES THAT it will comply with Title VI and VII of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, as amended, the Age Discrimination Act of 1975, the Food Stamp Act of 1977- Section 272.6, The Americans with Disabilities Act of 1990, Government Code (GC) Section 11135 and California Code of Regulations (CCR) Title 22 Section 98000-98413, Title 24 of the California Code of Regulations, Section 3105A(e) and other applicable federal and state laws, as well as their implementing regulations (including 45 CFR, Parts 80, 84, and 91, 7 CFR Part 15, and 28 CFR Part 42), by ensuring that employment practices and the administration of public assistance and social services programs are nondiscriminatory, to the effect that no person shall because of race, color, national origin, political affiliation, religion, marital status, sex, age or disability be excluded from participation in or be denied the benefits of, or be otherwise subject to discrimination under any program or activity receiving federal or state assistance; and HEREBY GIVES ASSURANCE THAT, it will immediately take any measures necessary to effectuate this agreement. THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all federal and state assistance; and THE AGENCY HEREBY GIVES ASSURANCE THAT administrative methods/procedures which have the effect of subjecting individuals to discrimination will be prohibited. E_ CCEPTING THIS ASSURANCE, the agency agrees to compile data, maintain records and submit reports as required, to permit effective enforcement of the aforementioned laws and regulations and permit authorized County, state and/or federal government personnel, during normal working hours, to review such records, books and accounts as needed to ascertain compliance. If there are any violations of this assurance, County shall have the right to invoke fiscal sanctions or other legal remedies in accordance with Welfare and Institutions Code Section 10605, or Government Code Section 11135-39, or any other laws, or the issue may be referred to the appropriate federal agency for further compliance action and enforcement of this assurance. THIS ASSURANCE is binding on the agency directly or through contract, license, or other provider services, as long as it receives federal or state assistance; and shall be submitted annually with the required Civil Rights Plan Update. DATE SIGNATURE CITY OF SAN BERNARDINO ORGANIZATION 600 West 5,h Street, San Bernardino, CA 92410 ADDRESS APPROVED AS TO FORM: James F. Penman, City Attorney Page 1 of 1 ATTACHMENT E DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract 0 a. bid/offer/application 0 a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year quarter f. loan insurance date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name ❑ Prime ❑ Subawardee and Address of Prime: Tier if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a) (last name, first name, MI) (attach Continuation Sheets SF-LLLA, if necessary) 11.Amount of Payment (check all that apply): 13. Type of Payment(check all that apply): $ ❑ actual ❑ planned ❑ a. retainer ❑ b. one-time fee ❑ c. commission 12. Form of Payment (check all that apply): ❑ d. contingent fee ❑ a. cash ❑ e. deferred ❑ b. in-kind;specify: nature r-1 f. other; specify: value 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s)SF-LLLA, if necessary) 15. Continuation Sheet(s) SF-LLLA attached: c ❑ Yes El No 16. Information requested through this form is authorized by title 31 U.S.C. Signature: section 1352.This disclosure of lobbying activities is a maleria!representation of Print Name: fact upon which reliance was placed by the tier above when this transaction was made or entered into.This disclosure is required pursuant to 31 U.S.C.1352.This Title: information will be reported to the Congress semi-annually and will be available Telephone No.: Date: for public inspection.Any person who fails to file the required disclosure shall be ,blect to a civil penalty of not less that$10,000 and not more than$100,000 for :h such failure. Federal USe'Onl Authorized for Local Reproduction y Standard Form LLL(Rev.7-97) Page 1 of 2 ATTACHMENT E INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES sclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Fevcral action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLLA Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. 3. Identify the appropriate classification of this report. If this is a follow up report caused by a material change to the Information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee,e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee,"then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance(CFDA)number for grants,cooperative agreements,loans,and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal(RFP)number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number ,ssigned by the Federal agency). Include prefixes,e.g.,"RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s)performing services,and include full address if different from 10(a). Enter Last Name, First Name,and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made(actual)or will be amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es).Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s)of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal official(s)or employee(s)contacted or the officer(s),employee(s),or Member(s)of Congress that were contacted. 15. Check whether or not a SF-LLLA Continuation Sheet(s)is attached. 16. The certifying official shall sign and date the form, print his/her name,title,and telephone number. According to the Paperwork Reduction Act, as amended,no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 30 minutes per response,including time for reviewing instructions, searching existing data sources, gathering and maintainingthe data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0046).Washington, 1503. Page 2 of 2 ATTACHMENT F INFORMATION SHEET (one Information: 'sheet per Vendor) CONTRACTOR SHALL COMPLETE SECTION I OF THIS FORM AND RETtTRN TO: SAN BE___RNARDINO COUNTY Department of Aging and Adult Services Attn: CONTRACTS SECTION I: CONTRACTOR INFORMATION Contractor Name: Address(including City,State and Zip Code): Phone Web Site: Email: Fax: Site Name for Services(if Different from Contractor) Address(including City,State and Zip Code): Phone. Web Site: Email: Fax Clinic Contact Title: Contract Signature Authority: Name: Name: Title: Title: Signature: Signature: Phone N E-Mail Phone#: E-Mail: Claim Signature Authority: Name: Name: Title: Title: Signature: Signature Phone N: E-Mail: Phone#: E-Mail: SECTION II: DAAS INFORMATION Contract Mailing Address: Contracts Unit: San Bernardino County Department of Aging and Adult Services Unit Fax #: 909-891-9150 Contracts Unit 686 E. Mill Street San Bernardino, CA 92415-0920 Page 1 of 1