IGA RE SCH HLTH INDEX WITH WASHINGTON ESD.PDF

INTERGOVERNMENTAL AGREEMENT
MARICOPA COUNTY
by and through the
DEPARTMENT OF PUBLIC HEALTH
4041 N. Central Avenue, #1400, Phoenix, Arizona 85012
1. Agreement No: C-86-16 2. Agreement Type:. Feefor Service
3. Agreement Amount: $8,000 4. Purpo6e:. Sbhobi Health Index (SHI)
5. Start Date: November 19, 2015 6. Expiration Date: May 31,. 2016
This Agreement Is entered into by and between the Washinoton Elementary - School District (referred to herein as "Contractor"),
and Maricope County ., by and through its Department of Public Health (referred to herein after as ."Cotinty"). Contractor and the
County are collectively referred to herein as the "Parties" and individually as a "Party" Contractor, for and in consideration Of
the covenants and conditions set forth herein, shall provide and perform the services as set forth below. All rights and
obligations Of the PartieS shall be Lgoverned by the terms of this Agreement, its exhibits, attachments, and appendices, including
any subcontracts or amendments as set forth herein and in:
Section I - General ProVisions Section ill Work Statement
SeCtion Cl - Special Provisions Section IV - Compensation
This Agreement Contains all the terms and conditions agreed to by the Parties.. NO other understanding, oral or Othetvvise,
regarding the subject matter of this Agreement shall be deemed to exist or to bind the Parties. Nothing in this Agreement shall
be construed as consent to any lawsuit or Waiver of any defense in a lawsuit brought against the County or the-Contractor in any
State or federal Catirt.
Legal Notice under this Agreement shall be .given by personal delivery or by registered or certified -Trial!, postage prepaid, return
receipt requested ., to the addresses :set forth below and .shall be effective upon receipt by the Party to whom addressed unless
otherwise indicated in the notice.
Notice to Contractor: Washington Elementary School District Phone (602) 347-2636
Address: Attn: Dr. Paul Stanton, Superintendent 4650 W Sweetwater Avenue, Glendale, Arizona 85304
Notice to Department: MCDPH Grants/Contract Unit Phone: (602) 506-1829
Address: 4041 North Central Avenue, Ste #1400, PhOeniX, Arizona 85012
IN WITNESS WHEREOF, the - parties enter Into this Agreement:
MARICOPA COUNTY BOARD OF SUPERVISORS
Signature Signature
Dr, Paul Stanton
Name Name
Superintendent
Title Title Chairman, Board of Supervisors
Date I a I I- I 5 Date
ATTEST:
Signature
Date
Pursuant to A.R,S. § 11-95Z the undersigned public agency Pursuant to A.R.S. § 11-952, the Attorney for the Board of
attorney has determined that this Intergovernmental Agreement Supervisors has determined that this Intergovernmental
is in proper form and is within the powers and authority granted Agreement Is within the powers and authority granted under the
under the laws of the State of Arizona. laws of the State of Arizona.
Signature Signature
Attorney for Maricopa County
Date Date

SECTION 1 GENERAL PROVISIONS -
t EFFECT
To the extent the Spedel Provisions are in conflict with the General PrOvisions, the
Special Provisions shall control, To the extent the Work Statement(s) and the Special or
General Provisions are in conflict, the Work Statement(s) shall control,
2. DEFINITIONS
As used throUghout this Agreement, the following terms shall have the following
meanings:
A. Agreement means this document and ail attachments and amendments hereto,
B. Contractor means the person, firm or organization listed on the Goiter Page of
this Agreement
County means Maricopa County, Arizona,
Department means the Maricopa County Department of Public Health,
E. Funding Source means any federal, State, or private agency funding source,
which may impose conditions on the funding that will be passed on to the
Contractor,
3. GENERAL REQUIREMENTS
A. The terms of this Agreement shall be construed in accordance with Arizona law,
Any lawsuit arising out of this Agreement shall be brought in the appropriate
court in IVIaricopa County,
B. The Contractor shill, without limitation, obtain ahd Maintain all liCenses„ permits,
and authority necessary to do business, render services, and perform_ work under
this Agreement, and shall Comply With all laws regarding . unemplOyMent
insurance, disability„ .and:workers' compensation.
C., The Contractor is an independent contractor in the performance of Work and the -
provision of services under this Agreement and is not be considered an officer,
employee, or agent of the County.
AMENDMENTS
All Amendments to this Agreement Must bp in writing - and signed. by authorized. persons
for both 'Parties. All amendments shall clearly state the. effeCtive date of the action :.
5. ADEQUACY OF RECORDS :.
If the Contractor's boOkS„,rebordSand other -documents related. to this Agreement are not
sufficient to support and document that allowable services were to eligible
clients. the Contractor shall reimburse the County for the services not adequately
supported and dOcurriented.

SECTION 1 GENERAL PROVISIONS
6. RETENTION OF RECORDS
This provision applies to all .financial and programmatic records, supporting
• documents, statistical records, and other records Of the Contractor that relate to
this Agreement
The Contractor .shall retain all financial bOoks, records, and other documents
related to. this Agreement for five. ($). years after final payment or until after the
resolution of any audit questions, Which Could be more than five (5) years,
whichever is longer. County, federal, or State. auditOrs, and any Other persons
duly authorized bythe County, Shall have full .access to and the right to examine,
copy and make use of any and all such financial books, records and other
documents,
T. ASSIGNMENT AND SUBCONTRACTING
NO rights, liability, obligations or duties under this Agreement may be assigned,
delegated, or subcontracted Without the prior written approval of the County.
8, AUDIT .DISALLOWANCES
A. The Contractor shall, upon written demand therefore, reimburse. the County for
any payments made under this Agreement that are diSallowed, .by a federal,.
.$tate or County audit in the amount of the disallowance, as well as court costs.
and attorney fees the County incurs to pursue legal action relating to a
disallowance..
B. if the County determines that a cost for which payment haS been made is a
•disallowed cost, the County shall notify the Contractor in writing of the
disallowance and the required course of action, which shall be at the option of
the County either to adjust any future claim submitted by the Contractor by the
.amount of the disallowance or to require immediate repayment of the disallowed
amount by the Contractor.
AGREEMENT COMPLIANCE' MONITORING
County shall monitor the Contractor's compliance with, and performance under, the
terms and conditions Of this Agreement. On-site visits for cOnipliande Monitoring' may be
Made by the County and/or its grantor agencies at any time during the Cantrattor'S
normal business hours, announced or unannounced During an on-site visit, the
Contractor shall make its records and documents related to work performed or Services
provided under this Agreement available to the County for inspection and copying.
10. AVAILABILITY OF FUNDS .
A. The provisions of this Agreement relating to the payment for' services shall
become effective when funds assigned for the purpose of compensating the
Contractor, as provided herein, are actually available to the County for
disbursement. The Department shall be the sole authority in determining the
availability of funds under this Agreement and the County shall keep the
Contractor fully infermed as to the availability of funds,
B. If any action is taken by any State agency; -federal departrnent„ -or any other
3

SECTION 1 GENERAL PROVISIONS
ageliCy OF instrumentality to suspend, decrease, or terminate its fiscal obligations
under or in connection with this Agreement, the County may amend, suspend,
decrease, or terminate its obligations under or in connection With this Agreernent,
If this Agreement is terminated, the County shall be liable for payment only fOr
services rendered prior to the effective date of the termination, provided that such
services are performed in accordance with the provisions Of this Agreement The
County shall give written notice of the effective date of any suspension,
amendment, or termination under this section at least ten (10) days in advance.
11. CONTINGENCY RELATINGTO OTHER CONTRACTS AND GRANTS
A. The Contractor shall, during the term of this Agreernent immediately inform the
County in writing of the award of any other contract or grant where the award of
such contract or grant may affect either the direct or indirect costs being paid or
reimbursed under this Agreement Failure by the Contractor to notify the County
of such award shall be considered a material breach of this Agreement and the
County may immediately terminate this Agreement without liability.
B. County may request, and the Contractor shall provide within a reasOnable time,
not exceeding ten (10) working days, a copy of such other contract or grant,
when, in the opinion of the Department, the award of the contract or grant "may
affect the costs being paid or reimbursed under this Agreement.
If the County determines that the award to the Contractor of such other contract
or grant has affected the costs being paid or reimbursed under this Agreement,
the County shall prepare an amendment to this Agreement effecting a cost
adjustment If the Contractqr disputes the proposed cost adjustment, the dispute
shall be resolved pursuant to the "Disputes!' clause section contained herein.
12. DEFAULT
The County may suspend, modify, or terminate this Agreement immediately upon giving
written notice to the Contractor if the Contractor fails to perform under or otherwise
breaches any obligation under this Agreement, or upon the occurrence of any event that
may jeopardize the ability of the Contractor to perform any of its obligations under this
Agreement.
TERMINATION
Either Party .rhay terminate this Agreement at any time by giving the other Party
at least thirty (30) calendar days prior Written notice. The notice shall be given by
personal delivery or by registered or certified mail, postage Prepaid, return
receipt requested.
B. This Agreement may be terminated by mutual written agreement: of the Parties
specifying the termination date therein,
C. The County may terminate this Agreement upon twenty-four (24) hours notice
when the County deems the Contractors non-compliance jeopardizes funding
source financial participation if not terminated by one of the above methods, this
Agreement will terminate upon the expiration date of this Agreement as stated on
the Cover Page of this Agreement
4

SECTIoN I GENERAL PROVISIONS
14. •SEVERABILITY
Any provisibil of this Agreement that is determined to be invalid, void, or illegal by • a
court shall in no way affect, impair, or invalidate any other provision hereof, and the
remaining provisions-shall remain in full force and effect.
15. STRICT COMPLIANCE
Acceptance. by the County a performance that is not in strict compliance with the terms
of this Agreement shall not be deemed to waive the requirement of strictoompliance for
eU future performance All changes in performance obligations Under this .Agreement
must be in writing and. signed by the Parties.
16. . NON-LIASILITY
The COunty an its officers, representatives, agents., and employees shalt not be liable-
for any act or omission by the Contractor or any subcontractor., employee, officer, agent;
or representative of the Contractor or any subcontractor occurring in the performance of
this Agreement, nor Shall they be liable for 'purchases or contracts Made by the
Contractor or any.sUbcontractor:in connection with. this Agreement.
17. INDEMNITY
Each. Party (as "Inderhnitor") agrees to indemnify, defend, and hold harmless the other'
Party- (as "Indemnitee") from and against all claims,- losses,. liability, costs, and expenses
(including reasonable attorneys' fees) (hereinafter collectively -referred to as
arising out of bodily injury Of any person (including death): or property damage, but only
to the extent that such -Claims, which result in vicarious liability to Indemnitee„ are
caused by the act, omission, -negligence, misconduct, or other fault of Inde.mnitor, its
officers., agents, employees; &Volunteers.
18. COVENANT AGAINST CONTINGENT FEES
The Contractor warrants that no person or entity has been employed or retained to solicit
.orsecure this Agreement agreement or understanding for commission,
percentage, brokerage, or contingent fee: For breach or violation of this warranty, the
County may immediately terrilinate this Agreement without liability,
19. SAFEGUARDING CLIENT INFORMATION
The use or disclosure by any Party of any information concerning an eligible individual
-served underthis Aoreement is directly limited to the performance oft's Agreement.
20. RIGHTS IN DATA
The Parties shall have the use of data and reports. resUlting from this Agreement without
cost-or other restriction, except as otherwise provided herein or by law, Each Party shall
supply to . the other Party,. upon . request, any available. information known to the
.supplying Party that is relevant to- this Agreement and to the performance. hereunder.
5

SECTION I GENERAL PROVISIONS
21. NON-DISCRIMINATION
The Contractor, in connection With any serVice or other activity under thig Agreement,
shall not in any way discriminate against any person on the grounds of race, color,
religion, sex, national Origin, age, disability, affiliation or befief, The Contractor shall
include this clause Fp all of its subcontraCts related tO this Agreement.
22, EQUAL EMPLOYMENT OPPORTUNITY
The Contractor shall not diScriminate against any employee, or applicant for employment
because of race; age ; disability, color; religion, sex, or national origin. The Contractor
shall take affirmative action to insure that applicants are employed and that employees
are treated during employment without regard to their race; age, disability, color, religion,
sex, or national origin-. Such action shall include, but is not limited to, the following:
employment, upgrading, demotion or transfer, recruitment or recruitment advertising, lay-
off or termination ; rates of pay or other forms of compensation, and selection for training,
including apprenticeship. The Contractor shall, to the extent such provisions apply,
comply with Titles VI and VII of the Civil Rights Act of 1964, as amended (42 U.S.C,
2000a, at seq.); the Rehabilitation Act of 1973, as amended .(29 U.S.C. §§ 701, at seq.);
the Age Discrimination in Employment Act of 1967. amended (29 §§ 621, at
seq.); the Immigration Reform and Control Ad Of 1986 (Pub. L. No 99-603) ('lliCA"),;
and Arizona Executive Order 2009-09, which mandates that all persons shall have equal
access to employment opportunities. The Contractor shall also comply with all
applicable provisions of the Americans With Disabilities Act of 1990 (42 U.S.G. §§ 12101,
et seq.).
21. RIGHT-OF PARTIAL CANCELLATION
If more than one activity is funded by this Agreement, the County reserves the right to
terminate this Agreement or any part thereof based on the Contractor's failure to perform
any part of this Agreement without impairing, invalidating or canceling the remaining
Work Statement obligations,
24, RIGHT TO EXTEND AGREEMENT
Subject to the availability of fund and acceptable Contractor performance, the
Contractor hereby acknowledges and agrees that the County shall have the right to
extend this Agreement for additional one-year periods, not to exceed a total extended
term of five (5) years, except that the cost will be Subject to renegotiation. Any extension
of this Agreement shall be in writing mutually acceptable to the Department And the
Contractor and signed by both Parties.
Z. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
A. The undersigned, an authorized representative of the Contractor, certifies, to the
best of his or her knowledge and belief, that the Contractor, defined as the
primary participant in accordance with 45 C.F.R. Part 76, and its. principals:
1) 'are not presently debarred, suspended, proposed for debarm'ent, declared
ineligible, Or voluntarily excluded from covered transactions by any federal
department or agency;
2) have not within the 3-year period preceding this Agreement been convicted of
6

SECTION 1 GENERAL pROVIS1ONS
or had a iVit Judgment entered against them for the commission of-fraud or a
criminal offense in connection with obtaining, attempting to obtain, or performing
a public (federal, State or local) transaction or contract under a public
transattiok violation of federal or State antitrust statues or commission .. of
embezzlement, theft. forgery, bribery, "falsification Or destruction of records,
making false statements, or receiving stolen property;
3) are not presently indicted or otherwise criminally or civilly charged by 8
government entity (federal, State Or iota!) With the commission of any of the
offenses enumerated in ..paragraph (2) of MIS certification; and
4) have. not within the. 3-year period . preceding this Agreement had one or more
public transactions (federal, State oriocal) terminated for cause or default
B. If the Contractor is not able to provide this .certification„ an explanation as to Why
shall be attached to this Agreement.
C. The Contractor shall include, without modification, this Paragraph in. all lower tier
coVered transactions (ie., transactions with_ subcontractors) and • In all
solicitations for lower tier covered transactions related to this Agreement.
26. CIVIL SERVICES DIVISION
The parties to this agiternent acknoWledg -t that they are aware that the 'Civil Services
Division of the ivlaricopa County Attorney's Office (Civil Division) may be chosen as the
attorney for Other parties to this agreement, and the signing party acknowledges that it is
aware of a potential conflict of interest, and it waives any claim of conflict of interest,
which may arise by virtue of Civil Division's representation of other parties to this
agreement
27. E-VERIFICATION OF EMPLOYEES
The Contractor warrants that it is in compliance with A.R.S. § 41-4401 arid further
acknowledges:
A. That the Contractor and its subcontractors, if any, warrant their compliance with
all federal immigration laws and regulations that relate to their employees and
their compliance with A.R,S. § 23-214;
B. That a breach of the warranty under sUbseCtion A above shall be deemed a
'Material breach of this Agreement that entitles the County to, an -long other
things, immediately terminate this Agreement without liability;
G, That the .County and any contracting government entity retains the legal right, to
inspect the papers of any contract6r. Or subcontractor employee who works on
this Agreement to ensure that the .contractor or subcontractor is complying With
the warranty proVided 'under subsection A above and that the contractor agrees
to make all papers and employment records of said employee(s) available during
normal working hours iri order to facilitate such an Inspection;
D. That nothing herein shall make any contractor or subcontractor an agent or
employee of the County or contracting government entity.
7

SECTION II SPECIAL PROVISIONS
1... EFFECT •
To the extentthat the Special Provisions pre in conflict with the General Provisions, the
Special Provisions shall control, To the extent that the Work Statement(s) are in conflict
with the Special or General Provisions, the Work Statement(s) shall coritrOl.
2. DISPUTES
Except as othenkise provided by law; of Otherwise specifically agreed to by the Parties,
any dispute not involving a question of law arising out of this Agreement that is not
resolved between the Parties within a reasonable time, which shalt not exceed 120 days,
shall be resolved as follows:
1. Disputes must be filed with the person administering this Agreement
for the County, if one has been appointed, or If not, With the Procurement
Officer, within ten (10) days from the date the Contractor knew or should
have known the basis of the dispute.
2. The. person administering this Agreement Or the Procurement Officer,
as applicable, shall respond in Writing to the- dispute within fourteen (14)
days.
3. The Contractor may abide by the decision Of may appeal the decision
to the Director of the Department within seven (7) days.
This Paragraph shall not apply to Claims arising from bodily injury, death, or property
damage.
.3. CHANGES
A. The DepartMent may,. at any time, by written order„ Make changes Within the
fleral scope of -thisAgreementin. any •one, or ;more of the -following areas: •
1. Work Statement activities reflecting .changes In funding source- or County
re.gulatIons, policies, or requirements,
.2. Administrative requirements,, suth as changes in reporting periods,.
frequency of reports, or report formats, required by funding source or
County regulations, p.olicies, or -requirements,
3. Contractor reimbursement schedulesen .d./or program - bUdgets.,
B. The •o•rder will not Increase or decrease the Maki -Mum reimbursable amount lobe
paid the Contractor. Additionally, the order will not direct substantive changes in
services to be rendered by the Contradot
C„. Any dispute .or disagfeerneht caused 1)y $Agill order shall Constitute •a 'Dispute"
within the meaning of the Disputes Clause of the .Special Provisions Of this
Agreernentand. Shall be administered accordindy,

SECTION II SPECIAL PROVISIONS
AUDIT REQUIREMENT
A. If the Contractor expends $500,000 or More in a year in federal awards, the
Contractor shall have a single audit conducted for that year according to the
Single Audit Act of 1984 (Pub. L. No. 98-502) (codified at 31 U..S.C. §§ 7501, et
seq.), and the Single Audit Act Amendments Of 1996 (Pub.. L. No 104-156). The
Contractor shall comply with OMB Circulars A-133, A-87, A-102, and A-110, as
epplicable. The audit report shall be subrnittecl to the County for review Within
nine (9) months following the close of the fiscal year. The Contractor shall take
any necessary corrective action to remedy any material weaknesses and/or
reportable conditions identified in the audit report within six (6) months after the
release date of the report. The County may consider sanctions as described in §
.225 of OMB Circular A-133 for contractors not in compliance with the audit
requirements. Al! books and records shall be maintained in accordance with
Generally Accepted Accounting Principles (GAO).
B. The Contractor Oa schedule an annual financial audit to be submitted to the
County for review within twelve (12) months following the close of the program's
fiscal year. Contractor understands that its failure to meet this reqUirement may
result in the loss of current funding and disqualification from consideration for
future County-administered funding.
C, -Comply with the requirement of the Federal Office of Management and Budget
(OMB") Circular A-133. The Contractor is responsible for having an audit
performed in accordance with, and when required, by OMB Circular A-133, and
for sending a copy of the report issued as a result of the audit to the County
within thirty (30) days of issuence. The County reserves the right to engage an
auditor, at the Contractors expense, to perform an OMB Circular A-133 audit of
the contractor in the event that the Contractor fails to engage an auditor or the
County rejects or disapproves of the auditor engaged by the Contractor
5. INSURANCE,
A. The Contractor shall have in effect at all times during the term of this Agreement
insurance at comparable self-insurance that is adequate to protect the County,
its officers, employees, property, and equipment against the losses set forth
below. The Contractor shall provide the County with a certificate of insurance or
a certified copy of the insurance policy naming the County as an additional
insured, or, if the Contractor is self-insured, shall provide the County with a letter
indicating that it is self-insured.
8, The following types and amounts of insurance are required as minimums:
1. Workers' compensation and unemployment insurance as required by law.
2. Unemployment insurance as required by Arizona. law,
3. Public liability, bodily injury, and property damage policies that Insure
against claims for liability for the Contractor's negligence or maintenance
of unsafe vehicles, facilities, or equipment brought by clients receiving
services pursuant to this Agreement and by lawful visitors of such clients,
The limits of the policies shall not: be less than $2,000,000 per occurrence.
9

SECTION II SPECIAL PROVISIONS
and $4,000,000 aggregate.
C. Automobile and Truck Liability, Bodily ijury ,and Property Damages:
1, deneral liability, eaCh occurrence; stoo,poo
2. Property .damage; $4,000,000
3. Combined single limit; $1,0.00,000
D. Standard minimum deductible arnaints are allowablP. Any tosses applied
against insurance deductible are the sole•reSpbnSibility of the Contractor.
E. professional Liability:
1, Insurance for the COntractor and it agents, employees;, and other staff
shall be maintained with coverage limits of one Million dollars
($1,000,000) per person, three million dollars ($3,000,000) per
occurrence.
2 The Contractor agrees that, iri the event it, or any of its agents,
employees, and other staff working under this Agreement, is named as a
defendant in litigation, be is identified in a written notice of claim, wherein
professional misconduct is alleged, the Contractor Will promptly notify the
Department in writing, The duty to notify under this paragraph applies
whether or not the County is ;alleged to be involved, Is named as a party
to the matter, or could be jootentially liable as a party;
F. The Contractor Shall immediately infarm the Department of any cancellation of its
insurance or any decrease in its :lines of coverage at least thirty (30) days before
such action takes place,
G. Commercial. General Liability — Occurrence Form
Policy shall include bodily injury, property damage and broad form contractual
liability coverage,
1. The policy shall be endorsed to include coverage for physical/sexual
abtise arid rnoleStation.
2. The policy shall be endorted to include the following additional insured
language: "Maricopa County Department Of Public Health, its subsidiary,
parent, associated and/or affiliated entitiesisuccessors, or assigns, its
elected officials, trustees, employees, agents, and volunteers shall be
named as additional insureds With respect to liability arising out of the
activities performed by, or on behalf of the Contractor",
Minimum Limits:
Oeneral Aggregate $ 2,000,000
Products/Completed Operations Aggregate $ 4,000,000
Each Occurrence Limit $ 2,000,000
10

SECTION II SPECIAL PROVISIONS:
Personal/Advertising Injury ,000,000
Sexual Abuse/Molestation 1,000,000
6. SPECIAL REQUIREMENTS
A. If the use of subcontractors is approved by the County, the Contractor agrees to
use written subcontracts or consultant agreements that conform to federal and
State laws and regulations and the requirements of this Agreement appropriate
to the service or activity covered by the 'subcontract, These provisions apply with
equal force to the subcontract as if the subcontractor were the Contractor. The
Contractor is responsible for performance under this Agreement whether or not
any subcontractors are used. The Contractor shall submit a •copy of each
subcontract to the County Within fifteen (15) days of its effective date.
B. The Contractor shall include in any 'subcontracts a provision to the effect that the
subcontractor agrees that the County shall have access to the subcontractor's
facilities and the right to examine any books, documents, and records of the
subcontractor involving transadions related to the subcontract, and that such
books, documents, and records shall riot be disposed of except as provided
herein.
7. REPORTING REQUIREMENTS
If requested by the County, the Contractor shall submit monthly, quarterly, and annual
progress reports on or before the third (3rd) day of the month following the end of the
reporting period, In addition, a quarterly expenditure report will be submitted with the
quarterly progress report.
STATUTORY RIGHT OF CANCELLATION FOR CONFLICT OF INTEREST .
Pursuant to A.R.S..§ 38-511, the County May cancel this Agreement without penalty or
further obligation, within three years after execution of this Agreement, if any person
significantly involved in initiating, negotiating, securing, drafting, or creating this
Agreement on behalf of the County is, at any time while this Agreement or any extension
of this Agreement is in effect, an employee or agent of any other Party to this Agreement
in any capacity or is a consultant to any other Party to this Agreement with respect to the
subject matter of this Agreement, In addition, the County may recoup any fee or
commission paid or due to any person significantly involved in initiating, negotiating,
securing, drafting, or creating this Agreement on behalf of the County from any other
Party to this Agreement arising as the result of this Agreement.
9. POLICY ON CONFIDENTIALITY
The Contractor and the County understand and agree. that this Agreement is subject to
all State and federal laws protecti-ng client confidentiality of medical, behavioral health
and drug treatment inforrnation.
10. LAWS, RULES AND REGULATIONS
The Contractor and the County understand and agree that this Agreement is subjett to
all State and federal laws, rules, and regulations that pertain hereto,

SECTION II - SPECIAL. PROVISIONS
11. SPONSORSHIP ACKNOWLEDGMENT
M promotional materials, brochures, and flyers prepared by the Contractor shall include
the following statement, J‘Sponsoted by Marioopa County Department of Public Health,"

SECTION HI WORK STATEMENT
1. DEFINITIONS.
A. DEPARTMENT refers to the ZMaricopa County Department of PubliC Health
(MCDPH) and includes the Maricopa County Office of Tobacco & Chronic
Disease Prevention,
B. CONTRACTOR refers to the School District listed on the front page of this
Agreement.
C. COUNTY refers to MariCopa County, Arizona:
D. MCTCDP is an acronym for the. Maricopa County Tobacco & Chronic Disease
Prevention.
E. CDC refers to the centers for Disease Control and Prevention.
F. STIPEND refers to the funds allocated to the School and Coordinator who is
leading the completion of the School Health Index (SHI).
G. MATERIAL refers to non-stipend related expenses,
H. SHI refers to School Health Index, a comprehensive health and Wellness
aSsessment for K-12 schools consisting of 8 modules Which assist in the
development of an action plan to help support the improvement of school health
and wellness policies and practices. The SHI is a tool developed by the CDC.
1. SHAC refers to School Health Advisory Council refers: to a coUncii comprised Of
school staff, parents and community members to help guide and inform the work
on both the SHI and SHIP.
J. SHIP School Health Implementation Plan refers to the health improvement plan
developed after the completion of the SHI to make tangible improvements to the
schools health and wellness policieS and practices. The SHIP is a tool
developed by the CDC.
K. DELIVERABLES: defined as the essential program outcomes as outlined by the
program description, Le. educational projects, Outreach -events, reporting, and:
technical -assistance.
2. PURPOSE
The purpose of this 1GA is to provide funding to schools to implement the School Health
Index Program. The County agrees to provide funding from its Arizona State Grant for
Program, and the School District: agrees to distribute funds to School and coordinators
and provide reports on individual school progress toward Program goals.
3. (SW) SERVICE GOALS
Contractor agrees to act as a pay agent and pass through total funds in the amount of
$2,000 to each school.
A. A stipend of $1,000 will be provided per school listed in Section IV to be paid by
13

SECTION III WORK STATEMENT
the school district or charter for the School Health Index.
B. A stipend of $1,000 will be provided per school level coordinator to be paid
directly to coordinator B.
C. Technical assistance, training, end other prevention related Material, Will be
prOvided by MCTCDP,
(S Hi) SERVICE OBJECTIVES/ACTIVITIES
Contractor agrees that to be eligible for paymentof the stipend, each school is rectuired
to provide the following Services':
2nd Quarter (Oct 1 —Dec-. 31),
Contractor to designate a School Site Coordinator for the School Health
Index (SHI) Prior to 12/31/15,
11, School Health index (SH1) School Site Coordinatorwill attend a MCTCDP
sponsored .SHl Orientation. Prior to 1231/15
iii, 80 School Site coordinator will recruit SHAG (School Health Advisory
Council) members, following COG recommendations to attain multk
disciplinary participation and guidance provided by MQTCDP
Representative
iv SHI School Site . Coordinator will schedule a meeting With the SHAG for
an orientation with the MCICDP Representative in regards to the
purpose, completion, and their role in participating on the SHAG team.
SH1 School. Site coordinator will assign and distribute the module
completion forms to members and Coiled module discussion question's
and score cards for all SHAG teem .nneeting(s),
3rd dUarter (Jan 1 — Mar 31)
vi, SHi School Site Coordinator will schedule meeting date(s) and time(s)
With the SHAG team and MCTCDP representative, to complete the SH1.
SH1 coordinator will enter data from score cards intO electronic forms
provided by the IIVICTCDP representative once completed,
SHI School Site .Coordinator in collaboration with MCTCDP
representative will begin the Planning for Improvement Instrument
vii. SH1 School Site Coordinator will enter Planning for InnproVement
Instrument via eleotronic form provided by IVICTCDP representative.
Si-11 School Site CoOrdinetor will submit a Program Completion Report via
electronic form to MCTCDP representative Once SHI deliverables are
completed. All SW program deliverables must be completed by the end of
the contract period fisted on the cover page of this Agreement.
14

SECTION HI WORK STATEMENT
Quarter( Apr 1 —June 31)
viU. .Upon -satidadtply completion of SHI deliverables and receipt of Program
Completion Report s .SHI Coordinator will Work • with MCDPH
representative to Complete the School Health Improvement Plan (SHIP)
via electronic. fornri. Upon approval of SHIP . by MCDPH representative,
each school is eligible for the 2 nci year contract and additional funds for
SHIP Implementation. Only a school that OoMPletes the SH.I is eligible to.
participate in the SHIP;
S. (SHI) OTHER REQUIREMENTS.
A. Contractor shall proVide written quarterly reports electronically on the progress of
SHI completion, SHIP Planning and SHAC meeting. Opportunities to submit
partial invoices each quarter are available as long as quarterly report has been
received by MCDPH representative.
B. Payment reqUests must be submitted by the Contractor on school letterhead and
include the following information from Attachment A (Invoice Sample) and the
total amount requested. Submit payment requests via email to the assigned
MCTCDP contract representative.
C. Contractor shall respond to all additional requests for information solicited by
MCTCDP when they are submitted in writing and allow for a minimum of 72
hours to respond.
D. Final invoices must be submitted within 30 days of the expiration of the contrabt
period.
E. Contractor agrees to participate in randomly generated site visits in accordance
with the fiduciary responsibility delegated to us by State grantor, the Arizona
Department of Health Services. During the site visits, we will check for supporting
documentation for submitted charges.
15

SECTION IV COMPENSATION
COMPENSATION
SUblect tO the. availability of funds, COUritY shall pay. the Contractor for the .services
described herein for a sum not-to-exceed the Contract Amount listed on the cover page
of this Agreement The payment request/invoice will also include the following
information from Attachment A:(participating school, amount per school and total amount
req tlested),
The District must submit :the - invoice ion behalf. Of the 'SchdoiS that have:. completed the
SHI.
METHOD OF PAYMENT
Contractor shall submits payment request. This: payment request must be On
sOhool letterhead and Contain the following:
Signature authorizing the request
• Invoice number
• Schobl Name
• Amount
• Date
B. Subject to the eVailability of funds; the. CoOr4 will;within -thirty working days
from the date of receipt of the fully executed. 10A, process - and remit, to the
Contractor, a warrant for payment Up to the maximum total allowable for services.
provided, Should the County make a disallowance in the claim, the .claim Shell be
processed for the reduced 'amount. if the Contractor protests the a-Mount or the
reason for a disallowance, the protest shall be construed as a dispute concerning
a question of fact within the meaning . of the "Disputes': clause of the Special
Provisions of this Agreerrient,
C; The Contractor understands and agrees that the. County will not honor any claim
for payment submitted six - (6) months after the date. of service, The Contractor
understands and .agrees that the County Will not process any claim for payment -.
for services rendered priorto the expiration date that is submitted sixty (60) days.
after the expiration date Without .approval Of the. County.
D Payments made by the County to the Contractor are conditioned upon the timely
receipt of applicable,: accurate, and complete monthly .reports and sufficient
invoice documentation submitted by the Contractor, The Contractor forfeits the
right to reimbursement for costs incurred in any month for which it falls to meet
the deadline for submitting the monthly reports, .except if such failure is b -eyond
the reasonable control Of the ContraCtor. The Contractor also forfeits its right to
reimbursement for costs incurred in whiCh a paid 'invoice or proof olexperiditUrO
is non-existent.
E. Invoices may be submitted via eteotronic form, em-ail or regular mail to the:
designated MOTCDP Prevention SpecialiSt.
3. NOTICE
Any notice given under this ContraCt Shall be sent to the attention of the folloWing:
-16

SECTION IV COMPENSATION
Maticopa County Department of Public Maricopa County Department of Pubtic
Health, Office of Tobacco & Chronic Health, Grants and Contracts Unit
Disease
Estella Sanchez Contract Coordinator Grants and Contracts Administrator
4041 N. Central Avenue, Suite 1400 4041 N. Central Aventie, Suite 1400
Phoenix, Arizona 85012 Phoenix, Arizona 85012
Phone No.: 602-372-8443
Email: EstellaSanchez@mail.maricopa,gov
17

ATTACHMENT A SCHOOLS .
Schad Health InctexProgearn
School District or Charter: Washington El ..S - 'POltritilett
District Contact: PiOtiiiiiiiiWatkirien-.. .:. (.', ,,'f ,-.-.,
Titie; Mbithat*diiiitbi'•.',.-:`, , 7,:h..-.:1'-',5::::"{
Ernafl DbFEAV:WiiikiiiV/6iiigefiabk'iait,'. -.::, ,,:::
Phone: 602 $47 2036 .' '' ' 3" '-' ''':',: ;:?'::;:''': . :
Mail Contract to:
Tiff%
• ;:
Address :city State Zip
Address 4.P.5.011V. SvvoeWeiterAiien(te" .? ; ; 010: AZ I 135.4Q4..
hooli)
Add-rats State zip Amount
:Nporpmitootaittegtgoopp -:4 1:34214..9pymongo, - , ,...j.,,-:,..:2: ,:-... i.,,,:. :...n ...., Bizi0111.$4,::',..;::"'....1*,1 AZ •iA45P.9, - 12,000
2 A41.:01147-..PA., , ;01PRV/i4;i7j1-4V, P-AcqL#PAt,-*.4.040:-Ztle-P.;4.:5,1fi:'.:V.44,P.I r .R..4000r4;4n:'.,?,, ,_,'..-:':',' AZ 85,91.5:. 12,0-00 -
3 T0t,r.k1,0*.:04-tgl_0010.0,41,V-ti4 4001 WL;P.14.r9.1"44.T.1q:!;,..frl:',e:7 ,3,'.,,;.. , - f.y,':.:...1 Rifi.0.0.0,LIM....,W,-:-.V.:Y .::, AZ ...'...i.',O.PRg,-, $2 000
4 POOgr,E1.6;t0r,A4,1",PrOti0.0r0 46 ..2,6 y.loylopotoomok,-g-04::.:,::..,: ...7...: .::,:t-it,:*;:r ploidgl*.:4A -N-Jgi.,,'.i.; AZ ', .-',i.;pp..,p $2,..000.
_:-- :-.".3''''.::,-::14:::iXn;;'-:;t'.: ...:i';'1.‘:',. -.p.):•5*-' IMIIIREZI1 211 t;.';:',1;:0:::':::.i...`;Z=.';.:%:'''.': =II :;:.''1,4=g'''..`, -:grL MEM
•i-',.-:?:i:L... .4.,'..•..t=e,'.',-::.L:j::::,:-i':'i;' .:.:''. .1701-A:Vy:;',!';',i'.;:: '.',.',., Ma T8,00.0