HomeMy WebLinkAbout21-Parks and Rec
CITY OF SAN BERtaRDINO - REQUEST ~R COUNCIL ACTION
Fr.om: ANNIE F. RAMOS, DIRECTOR
RESOLUTION AUTHORIZING AN AGREEMENT
Subject: WITH THE EAST VALLEY REGIONAL COUNCIL
ON AGING FOR PROVIDING COMPANIONSHIP
AND PERSONAL SERVICES TO CLIENTS IN
THE EAST VALLEY BY THE CITY OF SAN
BERNARDINO SENIOR COMPANION PROGRAM.
Dept: Parks, Recreation and Community
Services Department
Date: October 22, 1991
Synopsis of Previous Council action:
January 23, 1991 - Adopted Resolution 91-14 authorizing Companion Se~vices. for
the East Valley Area for the period January 1 - June 30, 1991.
Recommended motion:
Adopt Resolution
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Contact person: Tom B09gs Phone: 5032
Supporting data attached: Staff Report, Resolution & Agreement Ward: N/A
FUNDING REQUIREMENTS:
Amount:
N/A
Source: (Acct. No.l No cos~ to Ci ty- City wi 11 be reimbursed
for servlces.
(Acct. DescriPtion)
Finance:
Council Notes:
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CITY OF SAN BERNQRDINO - REQUEST F()t COUNCIL ACTION
STAFF REPORT
RESOLUTION AUTHORIZING AN
AGREEMENT WITH THE EAST
VALLEY REGIONAL COUNCIL ON
AGING FOR PROVIDING COMPAN-
IONSHIP AND PERSONAL SERVICES
TO CLIENTS IN THE EAST VALLEY
BY THE CITY OF SAN BERNARDINO
SENIOR COMPANION PROGRAM.
The city of San Bernardino has the only SCP Program in this
region; consequently, other governmental agencies seek
assistance through our program to provide companions for their
areas. The East Valley Regional Council on Aging is one such
organization which has requested services of companions for
which they totally reimburse the city. There is no additional
cost to the city for recruiting and assigning the companion to
serve the Senior home and Health Care Clients.
Recommend adoption of the Resolution.
October 22, 1991
75.0264
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RESOLUTION NO.
RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
DIRECTOR OF PARKS, RECREATION AND COMMUNITY SERVICES DEPARTMENT
TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF SAN BERNARDINO AND
THE EAST VALLEY REGIONAL COUNCIL ON AGING, SAN BERNARDINO
COUNTY, FOR THE PURPOSE OF PROVIDING COMPANIONSHIP AND PERSONAL
SERVICES TO CLIENTS IN THE EAST VALLEY SERVICE AREA BY THE CITY
OF SAN BERNARDINO SENIOR COMPANION PROGRAM.
BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE CITY
OF SAN BERNARDINO AS FOLLOWS:
SECTION 1. The Director of Parks, Recreation and Community
Services Department of the city of San Bernardino is hereby
authorized and directed to execute for and on behalf of said
City an Agreement with the East Valley Regional Council on
Aging, San Bernardino county for the purpose of providing
companionship and personal services to clients in the East
Valley Service Area by the city of San Bernardino senior
Companion Program; a copy of said agreement is attached hereto
as Exhibit "A" and incorporated herein by reference as though
fully set forth at length.
I HEREBY CERTIFY that the foregoing resolution was duly
adopted by the Mayor and Common Council of the city of San
Bernardino at a
meeting thereof, held on the
day of
, 1991, by
the following vote, to wit:
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RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
DIRECTOR OF PARKS, RECREATION AND COMMUNITY SERVICES DEPARTMENT
TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF SAN BERNARDINO AND
THE EAST VALLEY REGIONAL COUNCIL ON AGING, SAN BERNARDINO
COUNTY, FOR THE PURPOSE OF PROVIDING COMPANIONSHIP AND PERSONAL
SERVICES TO CLIENTS IN THE EAST VALLEY SERVICE AREA BY THE CITY
OF SAN BERNARDINO SENIOR COMPANION PROGRAM.
COUNCIL MEMBERS:
ESTRADA
NAYS
ABSTAIN ABSENT
AYES
REILLY
HERNANDEZ
MAUDSLEY
MINOR
POPE-LUDLAM
MILLER
Rachel Krasney, City Clerk
The foregoing resolution is hereby approved this
day of
, 1991.
W.R. Holcomb, Mayor
City of San Bernardino
Approved as to form and legal content:
JAMES F. PENMAN
City Attorney
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10/22/91
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NOTIFICATION OF CONTRACT AWARD
CONTRACT NUMBER
TO:
SENIOR COMPANION PROGRAM
BY:
EAST VALLEY
.:';",.
JULY
REGIONAL COUNCIL ON AGING
THIS AGREEMENT, is made on the 1st day of
, 19~, by and between the Regional
hereinafter called the RCA and
Council on Aging,
SENIOR COMPANION PROGRAM
,
direct
service
provider, hereinafter called "Contractor."
The Older Americans Act of 1965, as Amended, provides
for assistance to state and local agencies to develop social
supportive services to meet the needs of older persons.
The California Department of Aging has allotted funds
to the County of San Bernardino Office on Aging acting as
the Area Agency on Aging, hereinafter called the Office
on Aging or "OoA", for the purpose of administering a certain
portion of said funds pursuant to said act i and for the
purpose of planning service programs and activities for
older persons.
WHEREAS, the RCA desires to use Office on Aging monies
to fund, and the Contractor desires to operate and execute
a Regional Program, this contract is executed to reduce
to writing, the specific terms and conditions covering the
funding, execution and operation of the program provided
by this contract.
THEREFORE, in consideration of the mutual promises
and covenants contained herein, the RCA and the Contractor
agree as follows:
1. DEFINITIONS: CDA PM means "Title III Program Manual
for Area Agencies on Aging." This manual is based on
Federal regulations for Title III published March 31,
1980 (CFR, Chapter 8, Subchapter C, Par. 1321).
Pertinent parts of 45 CFR, Sub-title A, Part 74,
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published June 3, 1980, have also been used. A copy
of the manual is available at the San Bernardino County
Office on Aging during regular office hours.
WORK TO BE PERFORMED: The Contractor shall, in a
satisfactory manner as determined by the RCA and OoA,
conduct, administer and provide Regional services for
the elderly as defined in the attached WORK PROGRAM
(Exhibits A and A-l) and PROGRAM BUDGET (Exhibit B).
The aforementioned and all other exhibits are, by this
reference, made a part of this contract as if fully
set forth herein.
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3.
PERFORMANCE STANDARDS AND REMEDIES: If for any reason
the Contractor's service falls below 5% or exceeds 25%
of the contracted level during any calendar quarter,
the Contractor will submit to the RCA within thirty
(30) calendar days an analysis of the problem and the
actions being taken to -correct the problem. If the
problem persists, the RCA, and the Contractor will
jointly prepare a written corrective plan with time
lines for completion. If the Contractor fails to carry
out the corrective action in the required time frame,
sanctions will be invoked as described in the OoA
Sanction Policy. Continued lack of corrective action
will be cause for termination of contract. If, after
all appropriate actions have been taken, the service
level still falls below 5% or exceeds 25% of the
contracted level, the RCA may in its sole discretion
revise the contracted level of service and the budget,
as appropriate.
TERM: The term of this Agreement will begin on the
1st day of JULY , 1991 ,and
terminate on the
19 92 ,subject,
herein provided.
COMPENSATION/SCHEDULE OF PAYMENTS: The maximum amount
of funds awarded under this
4.
30th day of JUNE
however, to early termination as
,
5.
contract
shall be
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, and shall be subject to receipt
from the California Department of Aging and
$ 2,000.00
of funds
the OoA.
Contractor shall provide assurance that all funds
received' by the Contractor from the RCA shall be
accounted for separat~~y in the Contractor's accounting "
system and segregated from all other funds under the
Contractor's control. Any funds received by the
Contractor from the RCA which have not been obligated
prior to the termination of this Agreement shall be
returned to the RCA immediately thereafter.
The initial advance payment to the Contractor shall
be $ 333.33 after which payments shall
be based upon the units of service delivered during
the previous sixty (60) day period and cash balance
on hand and shall not exceed $ 333.33 per
sixty (60) day period unless approved in writing by
the RCA and the OoA Director. Contractor must be bonded
6.
in order to receive an advance.
The initial payment to the Contractor shall be made
wi thin sixty (60) days of the commencement of service
and thereafter payment for each sixty (60) day period
of services will be made no later than the 30th day
of the following month subject to the availability of
funds from the OoA.
MATCHING SHARE: The Contractor will contribute a cash
match of $ -0- and/or an in-kind match
of $ 222.00 for a total match of ten (10)
percent of all expended RCA/OoA and matching funds.
Allowable match shall be in accordance with CDA Program
Manual, Part I, Section 200, Non-Federal resources.
FISCAL RESPONSIBILITY: The Contractor agrees to strictly
adhere to the approved budget, listed in Exhibit B.
Contractor will ensure that all expenditures are
supported by properly executed payroll, time records,
invoices, contracts, vouchers, orders, and any other
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7.
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1 accounting documents pertaining in whole or in part
2 to this contract. Such documents shall be clearly
3 identified and readily accessible to the RCA Board and
4 the OoA staff, as may be required.
5 8. AUDIT: Within 90 days after the termination of this
6 contract, Contractor shall perform an audit and submit :.:
, information as required'in the OoA Final Program Report.
. Requirements of the Final Program Report will be in
, accordance with instructions found in the OoA
10 Contractor's Manual. In the event of an audit exception!
11 all documents referred to in Paragraph 7, FISCAL
12 RESPONSIBILITY, shall be maintained and kept available
13 until every exception has been cleared to the
1. satisfaction of RCA and OoA.
15 9. INDEMNIFICATION: The Contractor agrees to indemnify,
16 defend and hold harmless the County and its authorized
11 agents, officers, volunteers and employees against any
18 and all claims or actions arising from Contractor's
19 acts, errors or omissions in performing services pursuant
20 to this contract and for any costs or expenses incurred
21 by the County on account of any claim therefore.
22 10. INSURANCE: In order to accomplish the indemnification
23 herein provided for, but without limiting the
24 indemnification, the Contractor shall secure and maintain
25 throughout the term of the contract the following types
26 of insurance issued by companies acceptable to the Risk
2' Manager with limits as shown:
28 - Workers' Compensation A program of Workers'
29 Compensation insurance or a state-approved
30 Self-Insurance Program in an amount and form to meet
31 all applicable requirements of the Labor Code of the
32 State of California, including Employer's Liability
33 with $250,000 limits, covering all persons providing
34 services on behalf of the Contractor and all risks
35 to such persons under this Agreement.
36 - Comprehensive General and Automobile Liability
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Insurance This coverage to include contractual
coverage and automobile liability coverage for 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
($1,000,0001.
- Errors and Omissions Liabilitv Insurance
single limits of $1,000,000 for bodily
property damage or
Professional Liabilitv Professional
insurance with limits of at least $1,000,000
and in the aggregate.
ADDITIONAL NAMED INSURED - All policies, except for
the Workers' Compensation coverage and Errors and
Omissions or Professional Liabili ty, shall contain
additional endorsements naming the County employees,
agents, volunteers and officers as additional named
insured with respect to liabilities arising out of the
performance of services hereunder. For Professional
Liability coverage the County shall be named as a
designated person referencing this agreement' s Contract
No. on the policy.
WAIVER OF SUBROGATIONS RIGHTS - Contractor shall require
the carriers of the above required coverages to waive
all rights of subrogation against the County, its
officers, volunteers, employees, contractors and
subcontractors.
- Combined
injury and
liabili ty
per claim
POLICIES PRIMARY AND NON-CONTRIBUTORY - All policies
required above are to be primary and non-contributory
wi th any insurance or self-insurance programs carried
or administered by the County.
PROOF OF COVERAGE - Contractor shall immediately furnish
certificates of insurance to the Department evidencing
the insurance coverage above required prior to the
commencement of performance of services hereunder.
These certificate~ shall provide that such insurance
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1 shall not be terminated or expire without thirty (30)
2 days written notice to the County. Wi thin sixty (60)
1 days of the commencement of this Agreement the Contractor
4 shall furnish certified copies of the policies and
5 endorsements.
6 INSURANCE REVIEW The above insurance requirements ....
1 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
10 requirements whenever the Risk Manager determines that
11 any of the above insurance is not available, is
12 unreasonably priced, or is not needed to protect the
13 interests of the County. In addition, if the Risk
14 Manager determines that heretofore unreasonably priced
15 or unavailable types of insurance coverage or coverage
16 limits become reasonably priced or available, the Risk
11 Managaer is authorized, but not required, to change
18 the above insurance requirements to require additional
1t types of insurance coverage or higher coverage limits,
20 provided that any such change is reasonable in light
21 of past claims against the County, inflation, or any
22 other item reasonably related to the County's risk.
23 Any such reduction or waiver for the entire term of
24 the Agreement and any change requiring additional types
25 of insurance coverage or higher coverage limits must
26 be made by amendment to this Agreement. Contractor
27 agrees to execute any such amendment within thirty (30)
28 days of receipt.
2. 11. LICENSURE: Where the State or local public jurisdiction
30 wi thin the State requires licensure for the provision
31 of services, the Contractor will, in performing the
32 services stipulated in this contract, obtain all
33 necessary licenses, and maintain such licenses throughout
34 the term of this contract.
35 12. REPORTS: Contractor, at such times and in such forms
36 as the RCA and OoA may require, shall furnish RCA and
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1 OoA statements, records, reports, data and information
2 as RCA and OoA may request pertaining to Contractor
3 performance of services hereunder and other matters
. covered by this Agreement.
S 13. INSPECTIONS: Contractor shall make available to RCA,
6 OoA, State or Federal.. officials, its records and data ".
1 with respect to all matters covered by this Agreement
I for inspection and audit. Said inspection and audit
, may be made at any time during normal business hours
10 after reasonable notice (CDA PM, Part G, Section 93.21
11 N 8).
12 14. MONITORING AND ASSESSMENT: Contractor shall permit
13 RCA, OoA, State or Federal officials to monitor, assess
14 or evaluate Contractor's performance under this
15 agreement. Said monitoring, assessment or evaluation
16 shall include, but not be limited to, project site visits
17 and interviews with Contractor's employees and agents
18 providing the service under this Agreement and recipients
l' thereof. Contractor will ensure cooperation and shall
20 attend all meetings mandated by the RCA and OoA.
21 15. PROPERTY MANAGEMENT SYSTEM: All equipment, materials,
22 supplies or property of any kind purchased with OoA
23 funds provided herein shall be in accordance with CDA
24 PM, Part G, Section 93.19, and if not fully expended
25 or consumed prior to termination of this contract shall
26 be the property of the RCA, unless otherwise directed
27 by the OoA Director. The Contractor shall be held liable
28 for all losses of or damage to non-expendable equipment
2' or material resulting from negligence or improper
10 implementation of safeguards. The disposal, loss and/or
31 destruction of property or equipment shall be fully
12 documented by the Contractor with copies thereof provided
33 to the OoA with the monthly report for the month in
34 which it occurred. Loss by vandalism or theft must
35 be immediately reported to the police. The OoA Director
36 shall be notified of the loss wi thin seventy-two (72)
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hours of discovery of the loss. Equipment that is worn
beyond economical repair may be turned in to the OoA
for accountability purposes. Replacement of the item
shall require OoA authorization. Any equipment purchased
will be subject to review over the life of the equipment,
and if not used, unde;rused or misused, may be claimed
by the OoA for redistribution to other OoA projects.
16. AMENDMENTS TO THE CONTRACT: This Agreement constitutes
the entire Agreement between the Contractor and the
RCA with respect to the subject matter of this Agreement.
There are no other or further written or oral
understandings or agreements with respect to this
Agreement. No variation or modification of this
Agreement and no waivers of its provisions shall be
valid unless in writing and signed by the parties.
17. CONDITIONS FOR TERMINATION:
a) The RCA may terminate this Agreement and be relieved
of the payment of any consideration to Contractor
should Contractor fail to perform the covenants
herein contained at the time and in the manner herein
provided. In the event of such termination, the
RCA and the OoA may proceed with the work in any
manner deemed proper by the RCA and/or the OoA.
The cost to the RCA and the OoA shall be deducted
from any sum due the Contractor under this Agreement,
and the balance, if any, shall be paid to the
Contractor upon demand.
b) Without the prior written consent of the RCA and
the OoA, this Agreement is not assignable by the
Contractor either in whole or in part.
c) The consideration to be paid to Contractor, as
provided herein, shall be in full payment for all
Contractor I s services and expenses incurred in the
performance hereof.
d) If the grant or other funding under which this
contract is made is terminated, the RCA and the
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OoA shall have cause to immediately terminate this
contract. Notice of the termination shall be in
writing to the Contractor.
e) Reclamation and Closure: In the event of
termination, all funds, property, finished or
unfinished docume~ts, data, supplies, and reports
'.
obtained or prepared by the Contractor under this
contract shall remain the property of the RCA unless
otherwise directed by the OoA Director.
f) The Contractor shall be entitled compensation for
satisfactory performance or allowable expenses
necessarily incurred under this contract.
g) RCA and/or OoA and/or Contractor may terminate this
contract upon thirty (30) days written notice to
the other party.
18. TRAINING AND MANPOWER DEVELOPMENT: The Contractor agrees
to participate in appropriate staff training and
development provided by the RCA, OoA, the California
Department of Aging and the Administration on Aging.
19. CONFIDENTIALITY: The Contractor will take steps to
ensure that no information about, or obtained from an
individual, and in the possession of the Contractor,
will be discussed in a form identifiable with the
individual, without the individual's informed consent.
20. PUBLICATIONS: Any books, reports, pamphlets, papers
or articles based on activities funded by this contract
must be approved by OoA prior to publication and must
contain an acknowledgement of funding by the San
Bernardino County Office on Aging, and the Regional
Council on Aging.
21. COPYRIGHTS: If the contract results in a book or other
copyrightable materials, the author is free to copyright
the work, but the RCA and the OoA reserve a royalty-
free, non-exclusive and irrevocable license to reproduce,
publish, or otherwise use, and to authorize others to
use, all copyrighted material and all material which
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1 can be copyrighted resulting from the contract ICDA
2 PM, Part G, Section 93.19 X. 1. and 2.).
3 22. CONTRACT INDEPENDENCE: The Contractor and the agents
4 and employees of the Contractor in the performance of
5 this Agreement shall act in an independent capacity
6 and not as officers, or. . employees or agents of the State '
7 of California, County of San Bernardino, the OoA or
1 the RCA.
. 23. UNAUTHORIZED ACTIVITIES: All activities not expressly
10 authorized by this Agreement shall be prohibited without
11 the express written permission of the RCA and the OoA
12 Director or his authorized agent.
13 24. BINDING CONTRACT: In the event any portion of the
14 contract is found to be invalid, the remaining portions
15 shall continue to constitute a valid and binding
16 contract.
11 25. PLANNING EFFORT: The Contractor agrees to cooperate
11 with the RCA and the OoA in their efforts toward
1. developing a comprehensive and coordinated system of
20 services for the elderly by participating in joint
21 planning efforts and other activities mutually agreed
22 upon to meet this goal ICDA PM, Part H, Section 107.5).
23 26. CONTRIBUTION FOR SOCIAL SERVICES: The Contractor will
24 provide older persons rece1v1ng such services the
25 opportunity to contribute to all or part of the social
26 services . provided. Each individual recipient will
21 determine what he is able to contribute toward the cost
21 of the social service. No older person will be denied
2. a social service because of his failure to contribute.
3D No fee shall be required of the recipient. Methods
31 of rece1v1ng contributions from recipients shall be
32 handled in such a manner so as not to differentiate
33 among the individuals contributions publicly.
.34 I California Department of Aging, Program Manual, Part
35 H., Section III.l).
36 27. GREATEST ECONOMIC. OR SOCIAL NEED: The Contractor
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1 understands that one of its responsibilities under this
2 contract is to insure that "preference will be given
] to providing services to older individuals with the
.. greatest economic or social needs (Older Americans Act
5 of 1965 as Amended, Amendments of 1988, Public Law 98-
6 459, 306(a)(5) (A) (ii.l (I) (II))." "The term 'greatest ::
1 economic need' means the need resulting from an income
8 level at or below the poverty threshold established
9 by the Bureau of the Census, and the term 'greatest
10 social need' means the need caused by non-economic
11 factors which include physical and mental disabi li ties,
12 language barriers, and cultural or social isolation
13 including that caused by racial or ethnic status which
14 restricts an individual's ability to perform normal
15 daily tasks or which threatens his or her capacity to
16 live independently." (Older Americans Act of 1965 as
11 Amended, Amendments of 1988, Public Law 98-459, 306
18 (a) (5) (B) . ) Minimum program goals relating to
11 minori ties is determined for the census tracts served
20 by this contract by computing the percentage of minority
21 individuals sixty (60) years of age and older within
22 the total population sixty (60) years of age and older.
23 28. RELIGIOUS ACTIVITY PROHIBITED: There shall be no
24 religious worship, instruction, or proselytization as
25 part of, or in connection with, the performance of this
26 contract.
21 29. OTHER STATUTORY PROVISIONS: Contractor agrees to fully
28 comply with the laws and programs (including regulations
29 issued pursuant thereto) which are listed following
30 this paragraph. Such compliance is required to the
31 extent that such laws, programs and their regulation
J2 are, by their own terms, applicable to this contract.
33 Contractor warrants that he will make himself thoroughly
34 familiar with the applicable provisions of said laws,
35 programs and regulations prior to commencing performance
J6 of the contract. Copies of said laws, programs, and
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regulations are available upon request from the San
Bernardino County Contract Compliance Officer, 686 East
Mill Street, San Bernardino, California 92415-0640.
To the extent applicable the provisions of said laws i
programs and regulations are deemed to be a part of
this contract as if fully set forth herein. :'.:
A. The San Bernardino County Affirmative Action
Compliance Program (See Exhibit C).
B. Vietnam Era Veterans' Readjustment Assistance Acts
of 1972 and 1974, as amended. Pub. L. 92540, Title
V Section 503 (a), Pub. L-93508, Title IV, as
amended, Section 402. (38 USCA 2011-2013).
C. Rehabilitation Act of 1973, as amended (handicapped)
Pub. L. 93-112, amended.
D. California Fair Employment Practice Act, Labor Code
Section 1410 et. seq.
E. Civil Rights Act of 1964, as amended (42 USCA 2000a
to 2000h-6) and Executive Order No. 11246, September
24, 1965, as amended by Executive Order 11375 and
as supplemented in Department of Labor regulations
(41 CFR, Part 60). (See Exhibit C.)
F. Clean Air Act of 1970 (42 USC 1858 Section 306(h),
et. seq.) and the Federal Water Pollution Control
Act, (33 USC Section 508, et. seq.) as amended,
and Executive Orders 1368, 11738, and U.S.
Environment Protection Agency regulations (40 CFR
Part 15).
G. Provisions against lobbying are as follows: The
following statutory provision (part of Sec. 407
of Pub. L. 95-480, 92 Stat. 1589) has applied to
all Health and Human (HHS) appropriations beginning
with those for Fiscal Year 1979 and is likely to
continue to apply to any future appropriations.
"No part of any appropriation contained in this
Act shall be used to pay the salary or expenses
of any grant ,or contract or contract recipient or
Page 12 of 14
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.IL
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o
o
agent acting for such recipient to engage in any
activity designed to influence legislation or
appropriation pending before Congress."
This means that the costs of attempting to influence
legislation pending before Congress may not be
charged either as...direct or indirect costs to any <:.'
HHS grant awarded from funds subject to the
provision. Attempting to influence legislation
is commonly called lobbying.
This notice concerns only the charging of certain
costs to Older Americans Act grants including the
matching share. Nothing in this notice is intended
in any way to inhibitor discourage any party from
exercising its lawful rights to attempt to influence
legislation pending before Congress as long as the
costs are not charged to the grant.
30. ENTIRE AGREEMENT: This Agreement constitutes the entire
Agreement between the Contractor and the RCA with respect
to the subject matter of this Agreement. There are
no other or further written or oral understandings or
agreements with respect to this Agreement. No variation
or modification of this Agreement and no waivers of
its provisions shall be valid unless in writing and
signed by the parties.
FOR THE REGIONAL COUNCIL ON AGING FOR THE CONTRACTOR
~~. ~:1ouj
Ie - -1 J
DATE DATE
,APPROVeD AS TO FORM
Ai'~'Ci ~,_:3'!-..~. CG1..:rENT.
.'::'1:,<<:::. :;',,;"i1lili:::.n,
Page 13 of 14
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CERTIFICATION SHEET
Individual 11 ~ be a member of the governing board,
identified as such.. Two separate individuals are to be
involved. One individual..: is to sign the contract itself, :.,'
and a second individual is to sign this certificate.
I,
certify that
(Individual 11)
I am
of the
(Position/Office)
Corporation named as Contractor in the foregoing Contract i
that
who
signed
(Individual 12)
said Contract on behalf of the Contractor was/were then
of said Corporationi
(Position/Office)
said Contract was signed for
Corporation by authority of
within the scope of its
of this Contract is contained
meeting held on
and in behalf of said
its governing body and is
corporate powers. Approval
in the minutes of the Board
Page 14 of 14
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o
SENIOR COMPANION PROGRAM
EXHIBIT A
WORK PROGRAM
FY 1991-92
In order to assist functionally impaired older persons to remain
in their homes, the Senior Companion Program shall expend funds to
provide services in the home to maintain independent living or provide
respite for the primary caregiver.
-
ftLI!'OIlNIA D!:PARTMEN'l' OF A~
'1'I~II MANAGEMEN'l' INFOBMA'1'IoN-,ySTEMS
DIVJ:SION (000 -- UNIT OF SDVJ:CE MEASUREMENTS
,
PROGRAM NO.. 8 - IN-HOME SDVICES (Rev. 10/89)
((08
Goal: '1'0 assist functionally-impaired older persons to remain in
their homes.
Definition: In-Home Services. consist of those services provided
in the home whiCh assist 014er persons to maintain
independent living or p;ovide respite for the
primary caretaker. '1'hese services are:
- heavy household tasks;
cooking, shopping or light housekeeping:
bathing, dressing, feeding and personal hygiene:
- telephone reassurance; and ..
- friendly visiting.
Units of Service:
REQUIRED
(at least one)
(OS) Chore .
fl() Housekeeping/Homemaking
(20) Personal Care
(28) Telephoning
(31) Visiting
((1) In-Home Services Registry
O'1'HD(SI
( 19) OUtreach
(SO). Shopping
assistance
-----------------------------------------------------------------
(MIS Unit No.)
Definition
(OS)
Chore: '1'0 provide periodic maintenance for a household such
as heavi cleaning, washing windows, trimming trees, and
mowing awns. .
UNIT: one hour
Hous.kee~inalHomemak1na1 '1'0 provide light routine
maintenance ot a houiiJiOld, including such support as
dusting, vacuuming, laundry, meal preparation, or shopping.
UNI'1': one hour
(l()
-----------------------------------------------------------------
'1'L ~S . 13
Division (000 Page 18 ISSUED: Pebruary 1991
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EXHIBIT C
ASSURANCE 11 COMPL:IUCE WITH THE DBPAR~ OF
REALTH ARD Il1JMAR SERVICES RBGOLPoTI01IIS mmER
'!r:ITLE VI: OF THE C:IV:IL lUGBTS ACT OF 1964
City of San Bernardino Senior Companion Program
(Name of Grantee or Contractor)
(herein after called the -Recipient of Award-), IIBRBBY AGREES that
it will comply with Title VI of the Civil Rights Act of 1964 (P.L.
33-352) and all requirements impose4 by or pursuant to the RegulationsJ
of the Department of Health and Human Services (45CPR, Part 80) issued.
pursuant to that title, to the end that, in accordance with Title
VI of that Act and the regulation, no person in the United states
shall, on the ground of race, color, sex, age, or national origin,
be excluded from participation in, be denied the benefits of or be
otherwise subjected to discrimination ul\der any program or activity
for which the Recipient of Award received federal financial assistance
from the San Bernardino CoQDty Office on AQinlll: a recipient of federal
financial assistance from the Department 1 and IIBRBBY GIVES ASSURANCE
that it will immediately take any measures necessary to effectuate
this agreement.
If any real property or structure thereon is provided or improved
with the aid of federal financial assistance extended to the Recipient
of Award by the Area Agency on Aging, this assurance shall obligate
the Recipient of Award or in the case of any transfer of such property,
any transferree, for the period during which the real property or
structure is used for a purpose for which the federal financial
assistance is extended or for another purpose involved in the provision
of similar services or benefits. If any personal property is so
proyided, this assurance shall obligate the Recipient of Award for
the period during which the federal financial assistance is extended
to it by the Area Agency on Aging.
'1'HIS ASSURANCE is given in consideration of and for the purpose of
obtaining all federal grants, loans, contracts, property, discounts
or other federal financial assistance extended after the date hereof
to the Recipient of Award by the Area Agency on Aging, including
installment payments after such data on account of applications for
federal financial assistance which were approved before such date.
The Recipient of Award recognizes and agrees that such federal financial
assistance will be extended in reliance on the representations and
agreements made in this assurance. This assurance is binding on the
Recipient of Award, its successors, transferrees and assignees, and
the person or persons whose signature appear below are authorized
.to sign this assurance on behalf of the Recipient of Award.
City of san Bernardino
Senior Companion Program
(Recipient of Avard'-
600 West Fifth Street
Maress
San Bernardino, CA 92410
BY:
~ITLE: DIRECTOR, Parks, Recreation and
Community Services Department
DATED:
San Bernardino County
OoA - Form 09
6/88