SFY14 GILA BEND EXECUTED IGA.PDF

INTERGOVERNMENTAL AGREEMENT
BETWEEN
MARICOPA COUNTY
ADMINISTERED BY ITS
HUMAN SERVICES DEPARTMENT
AND
TOWN OF GILA BEND
cY?-o--3-too
Contract Amount: $80,394.00
Contract Start Date: July 1, 2013
Contract Termination Date: June 30, 2014 (The contract term shalt include two options to renew for
one-year extensions, based on Contractor performance.)
Contract Number:
This Contract for Services Agreement ("Agreement") is entered into by and between Town of Gila
Bend, (hereinafter referred to as the "Contractor"), and Maricopa County, administered by its
Human Services Department, (hereinafter referred to as the "County"). The Contractor and County
are collectively referred to herein as the "Parties" and individually as a "Party."
WHEREAS, the County is empowered by Arizona Revised Statutes § 11-251 to enter into this
Agreement and has delegated the undersigned the authority to execute this Agreement on behalf of
the County.
WHEREAS, the Contractor is empowered by Arizona Revised Statutes 5 9-240 to enter into this
Agreement, and has by resolution, delegated the undersigned the authority to execute this
Agreement on behalf of the Contractor.
The Contractor, for and in consideration of the covenants and conditions set forth in this
Agreement, shall provide and perform the services set forth herein. All rights and obligations of the
Patties shall be governed by the terms of this Agreement, its exhibits, attachments, and appendices,
including any subcontracts, amendments, or change orders as set forth herein and in:
Section I — General Provisions
Section II — Special Provisions
Section III — Work Statement: Crisis Case Management and Financial
Assistance Services
Section IV — Compensation
Attachment A: Operating Budget
Section V — Contractor Hours of Operation & Service Area
Attachment B: Facility Location Chart
Attachment B-1: Gila Bend Community Service Area Map
Attachment B-2: Buckeye Community Service Area Map
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Contractor Representative: Rick Buss. Town Manager
Phone: 928-683-2255
Address: 694 West Pima Street, PO Box A. Gila Bend, AZ 85337
fbuss@gilabendaz.org
Maricopa County: Margarita Leyvas. Assistant Director
Phone: 602-506-5911
Address: 234 North Central. Suite 3000. Phoenix. AZ 85004
E-Mail: leyvasmemail.maricopa.gov
Notices under this Agreement shall be given by personal delivery or by registered or certified mail
postage prepaid and return receipt requested, to the persons at the addresses set forth above and
shall be effective three (3) days after being mailed, unless otherwise indicated in the notice.
This Agreement contains all the terms and conditions agreed to by the Parties. No other
understanding, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to
exist or to bind either Party hereto. Nothing in this Agreement shall be construed as consent to any
lawsuit or waiver of any defense in any lawsuit brought against the State of Arizona, the County, or
the Contractor in any State or federal court.
IN WITNESS THEREOF, the Parties have signed this Agreement:
Approved By:
TOWN 0
Mayor Chairman, Board of Supervisors
611 - 1.8 JUL 1 17 2013
DATE DATE
Attested to: Attested to:
/e,c)
Town Clerk ard of SEpeiVisors
4,• -14 JUL 19 2013
DATE DATE
IN ACCORDANCE WITH A.R.S. 5§ 11-952, 11-201, AND 11-251, THIS AGREEMENT HAS BEEN REVIEWED BY THE UNDERSIGNED
ATTORNEY(S) WHO HAS DETERMINED THAT THIS AGREEMENT IS IN PROPER FORM AND WITHIN THE POWER AND AUTHORITY GRANTED
UNDER THE LAWS OF THE STATE OF
APPRGATED AS TO APPROVED AS TO FORM:
Town Attorney Deputy County Attorney
1,1_?--
DATE I/ DATE (-3

Maricopa County
Human Services Department

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Section I General Provisions Page 1
A. EFFECT
To the extent that the Special Provisions are in conflict with the General Provisions, the
Special Provisions shall control. To the extent that the Work Statement is in conflict with the
General Provisions or the Special Provisions, the Work Statement shall control. To the extent
that the Compensation Provisions are in conflict with the General Provisions, Special
Provisions, or Work Statement, the Compensation Provisions shall control. Nothing herein
shall operate to increase the Operating Budget without a written amendment thereto.
B. DEFINITIONS
As used throughout this Agreement, the following words and terms shall have the following
meanings:
1. Agreement means this Intergovernmental Agreement between Maricopa County,
administered by its Human Services Department, and the Contractor.
2. Board of Supervisors means the Maticopa County Board of Supervisors.
3. Contract Administrator means the person administering this Agreement on behalf of
the Department.
4. Contractor means the person, firm or organization listed on the Cover Page of this
Agreement.
5. Contract Specialist means the liaison between the Department and the Contractor
the Contract Specialist is responsible for monitoring this Agreement and providing
technical assistance to the Parties.
6. County means Maxicopa County, a political subdivision of the State of Arizona.
7. Department means the Maricopa County Human Services Department.
8. Director means the Director of the Maticopa County Human Services Department.
9. Division means the Community Services Division of the Maricopa County Human
Services Department.
10. Fidelity Bond means a bond to indemnify the Contractor against losses resulting
from fraud or lack of integrity, honesty or fidelity of one or more employees, officers
or other persons holding a position of trust.
11. Juvenile means any person under the age of eighteen (18).
12. Payment Bond means a bond executed to ensure payment as required by law of all
persons performing work or providing materials in the execution of work provided
under this Agreement.
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Section 1 General Provisions Page 2
13. Performance Bond means a bond executed to secure fulfillment of all of the
Contractor's obligations under this Agreement.
14. Program Manager means the Assistant Director of the Community Services Division
of the Maricopa County Human Services Department.
15. Provider means the Contractor and any Subcontractor providing services under this
Agreement.
16. Public Agency has the meaning prescribed by A.R.S. § 11-951.
17. Subcontract means any contract entered into by the Contractor with a third party for
performance of any of the work or the provision of any of the services under this
Agreement.
18. Subcontractor means an entity employed by or funded through the Contractor to
perform any of the work or provide any of the services under this Agreement.
19. Work Statement means Section III of this Agreement which describes the services to
be delivered under this Agreement
C. GENERAL REOUIREMENTS
1. 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
Maricopa County, Arizona.
2. Contractor shall, without limitation, obtain and 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 insurance, and workers' compensation.
3. Contractor is an independent contractor in the performance of all work and the
provision of all services under this Agreement and Contractor shall not be considered
an officer, employee, representative, or agent of the County.
4. Contractor shall not make any payments, either directly or indirectly, to any person,
partnership, corporation, trust or other organization that has a substantial interest in
Contractor's organization or with which Contractor (or any of its directors, officers,
owners, trust certificate holders or a relative thereof) has a substantial interest, unless
Contractor has made full written disclosure of the proposed payments to the
Department and has received written approval therefore.
5. For purposes of this provision, the terms "substantial interest" and "relative" shall have
the meanings prescribed by A.R.S. § 38-502.
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Section I General Provisions Page 3
D. AMENDMENTS
All Amendments to this Agreement shall be in writing and signed by authorized signers for
both Parties.
E. ASSIGNMENT AND SUBCONTRACTING
No right, liability, obligation or duty under this Agreement may be assigned, delegated or
subcontracted, in whole or in part, by Contractor without the prior written approval of the
Contract Administrator. Contractor shall bear all liability under this Agreement, even if it is
assigned, delegated, or subcontracted, in whole or in part, unless the Department agrees
otherwise.
F. AVAILABILITY OF FUNDS
1. 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 Department for disbursement. The
Director shall be the sole authority in determining the availability of funds under this
Agreement and the Department shall keep the Contractor fully informed as to the
availability of funds.
2. If any action is taken by any State agency, federal department or any other agency or
instrumentality to suspend, decrease or terminate its fiscal obligation under, or in
connection with this Agreement, the Board of Supervisors may amend, suspend,
decrease or terminate its obligations under or in connection with this Agreement. In
the event of termination, the County shall be liable for payment only for services
rendered prior to the effective date of the termination, provided that such services
performed are in accordance with the provisions of this Agreement. The Department
shall give written notice of the effective date of any suspension, amendment, or
termination under this section at least ten (10) calendar days in advance.
G. BUDGET ADJUSTMENTS
Any requests for reasonable budget adjustments shall be submitted ninety (90) days prior to
the expiration date of this Agreement. Requests for financial adjustments to this Agreement
shall be supported by appropriate documentation. If the County agrees to the budget
adjustments, the County shall follow section D of this Agreement to amend this Agreement.
H. DISPUTES
1. Except as may otherwise be provided for in this Agreement, any dispute arising out of
this Agreement that is not resolved between the Parties within a reasonable period of
time, which shall not exceed one hundred twenty (120) days, shall be submitted in
accordance with the following dispute resolution process.
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2. Notice of the specific grounds of a dispute shall be in writing and filed with the
Contract Administrator, if one has been appointed, or, if not, with the County
Procurement Officer within ten (10) working days from the date Contractor knew or
should have known of the basis of the dispute. The Contract Administrator or County
Procurement Officer, as applicable, shall respond in writing to Contractor within
fourteen (14) working days. The decision of the Contract Administrator or County
Procurement Officer shall be final and conclusive unless, within seven (7) working
days from the date Contractor is served with the decision, Contractor files a written
notice of appeal with the County's Chief Procurement Officer, who shall provide
Contractor with a written response within fourteen (14) working days following receipt
of Contractor's notice of appeal. The decision of the Chief Procurement Officer shall
be final and not appealable.
3. Pending a final decision of the Chief Procurement Officer, the Contractor shall
proceed diligently with its performance of this Agreement in accordance with the
Contract Administrator or County Procurement Officer's decision.
I. DEFAULT
This Agreement may be immediately terminated by the County if Contractor fails to perform
any objective or breaches any obligation under this Agreement, or any event occurs that
jeopardizes Contractor's ability to perform any of its obligations under this Agreement. The
County reserves the tight to have service provided by persons other than Contractor if
Contractor is unable or fails to provide required services with the specified time frame.
J. TERMINATION
1. This Agreement is subject to cancellation by the County in accordance with the
provisions of A.R.S. § 38-511.
2. Either Party may terminate this Agreement at any time by giving the other Party at
least sixty (60) calendar days prior notice in writing (unless terminated by the Board of
Supervisors under the Availability of Funds provision). The notice shall be given by
personal delivery or by registered or certified mail, postage prepaid and return receipt
requested, to the persons at the addresses set forth on the Cover Page of this
Agreement.
3. This Agreement may be terminated by mutual written agreement of the Parties
specifying the termination date therein.
4. The County has the right to terminate this Agreement upon twenty-four (24) hour
notice when the County determines that the health or welfare of the service recipients
are endangered or the Contractor's non-compliance jeopardizes funding source
financial participation. If not terminated by one of the above methods, this
Agreement shall terminate upon the expiration of the term of this Agreement stated
on the Cover Page of this Agreement.
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Section I General Provisions Page 5
K SEVERABILITY
Any provision 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.
L. STRICT COMPLIANCE
The Department's acceptance of Contractor's performance that is not in strict compliance
with the terms of this Agreement shall not be deemed to waive the requirements of strict
compliance for all future performance. All changes in performance obligations under this
Agreement shall be in writing and signed by both Parties.
M. NON-LIABILITY
The County, its officers, representatives, agents and employees shall not be liable for any act or
omission by Contractor, or any Subcontractor or any officer, representative, agent, or
employee of the Contractor or any Subcontractor that relates to this Agreement, and shall not
be liable for any purchases or contracts made by Contractor, any Subcontractor, or any officer,
representative, agent, or employee of Contractor or any Subcontractor, in connection with this
Agreement.
N. RECIPROCAL INDEMNIFICATION
Each Party (as "Indemnitor") agrees to indemnify, defend, and hold harmless the other Party
(as "Indernnitee") from and against all claims, losses, liability, costs, or expenses (including
reasonable attorneys' fees, expert witnesses' fees and other litigation costs) (hereinafter
collectively referred to as "Claims") arising out of bodily injury (including death) of any person
or property damage, but only to the extent that such claims, which result in vicarious liability
to the Indemnitee, are caused by the act, omission, negligence, misconduct, or other fault of
the Indemnitor, its officers, officials, agents, employees, or volunteers.
0. TECHNICAL ASSISTANCE
The Department shall provide reasonable technical assistance to Contractor to assist
Contractor in complying with State and federal laws, regulations, and accountability for diligent
performance and compliance with the terms of this Agreement and all applicable laws,
regulations and standards. However, this assistance shall not relieve Contractor of full liability,
responsibility and accountability for its actions and performance to comply with the terms of
this Agreement.
P. SINGLE AUDIT ACT REQUIREMENTS
Contractors in receipt of federal funds through the Department are subject to the federal audit
requirements of the Single Audit Act of 1984, as amended (Pub. L. No. 98-502) (codified at
31 U.S.C. § 7501, et seq.). Contractor shall comply with OMB Circular A-133. Upon
completion, such audits shall be made available for public inspection. Audits shall be
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Section I General Provisions Page 6
submitted within the twelve (12) months following the close of the fiscal year. Contractor
shall take corrective actions within six (6) months of the date of receipt of the reports. The
Department shall consider sanctions as described in OMB Circular A-133 if Contractor does
not comply with the audit requirements.
Q. AUDIT DISALLOWANCES
1. Contractor shall, upon written notice thereof, reimburse the County for any payments
made under this Agreement that are disallowed by a federal, State, or County audit in
the amount of the disallowance, as well as all court costs and attorney's fees the
County spends to pursue legal action relating to a disallowance. Court costs and
attorney's fees incurred shall be specifically identified as applicable to the recovery of
the disallowed costs in question.
2. If the County determines that a cost for which payment has been made is a disallowed
cost, the Department shall notify the Contractor in writing of the disallowance and the
required course of action, which shall be at the option of the Department to either
adjust any future claim submitted by Contractor by the amount of the disallowance or
to requite immediate repayment of the disallowed amount by the Contractor issuing a
check payable to the County.
R. STAFF AND VOLUNTEER TRAINING
The Department may make available to Contractor the opportunity to participate in any
applicable training activities conducted by the Department.
S. CLEAN AIR ACT
If the total face value of this Agreement exceeds $100,000, Contractor shall comply with all
regulations, standards and orders issued pursuant to the Clean Air Act of 1970, as amended
(42 U.S.C. 5s 7401, et seq.), to the extent any are applicable by reason of performance under
this Agreement.
T. LOBBYING
1. No federal appropriated funds have been paid or will be paid by or on behalf of
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, continuation, renewal,
amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
2. If any funds, other than federal appropriated funds, have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, an officer or employee of Congress, or an employee of
a member of Congress in connection with any federal contract, grant, loan or
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cooperative agreement, the Contractor shall complete and submit OMB Form-T
titled "Disclosure of Lobbying Activities," in accordance with its instructions and 31
U.S.C. § 1352.
U. RELIGIOUS ACTIVITIES
Contractor warrants that none of its costs and none of the costs incurred by any of its
Subcontractors will include any expense for any religious activity.
V. POLITICAL ACTIVITY PROHIBITED
None of the funds, materials, property or services contributed by the County or Contractor
under this Agreement shall be used for any partisan political activity, or to further the election
or defeat of any candidate for public office.
W. COVENANT AGAINST CONTINGENT FEES
Contractor warrants that no person or entity has been employed or retained by it to solicit or
secure this Agreement upon an agreement or understanding for a commission, percentage,
brokerage or contingent fee. For breach or violation of this warranty, the County may
immediately terminate this Agreement without liability.
X. SAFEGUARDING OF PARTICIPANT INFORMATION
The use or disclosure by Contractor of any information concerning an applicant for, or
recipient of, services under this Agreement is directly limited to the conduct of this
Agreement. Contractor and its agents shall safeguard the confidentiality of this information,
just as Contractor would safeguard its own confidential information. Contractor shall include
a clause to this effect in all Subcontracts related to this Agreement.
Y. 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 by law or applicable regulation. Each Party
shall supply to the other Party, upon request, any available information that is relevant to this
Agreement and to the performance hereunder.
Z. COPYRIGHTS
If this Agreement results in a book or other written material, the author is free to copyright the
work, but the County reserves a royalty-free, nonexclusive, perpetual and irrevocable license to
reproduce, publish, and otherwise use and to authorize others to use, all copyrighted material
and all material that may be copyrighted as a result of this Agreement.
AA. PATENTS
Any discovery or invention arising out of, or developed in the course of, work under this
Agreement shall be promptly and fully reported to the Department for determination as to
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Section I General Provisions Page 8
whether patent protection on such invention or discovery shall be sought and how the rights
in the invention or discovery, including rights under any patent issued thereon, shall be
disposed of and administered, in order to protect the public interest.
BB. CONTRACT COMPLIANCE MONITORING
The Department shall monitor Contractor's compliance with, and performance under, the
terms of this Agreement. On-site visits for compliance monitoring may be made by the
Department and/or its grantor agencies at any time during Contractor's normal business
hours, announced or unannounced. During an on-site visit, Contractor shall make all of its
records and accounts related to work performed and services provided under this Agreement
available to the Department for inspection and copying.
CC. CONTINGENCY RELATING TO OTHER CONTRACTS AND GRANTS
1. Contractor shall, during the term of this Agreement, immediately inform the Contract
Administrator in writing of the award of any other agreement or grant, including any
other agreement or grant awarded by the County, where the award may affect either
the direct or indirect costs being paid or reimbursed under this Agreement.
Contractor's failure to notify the Department of any such agreement shall be a breach
of this Agreement and the County may immediately terminate this Agreement without
liability.
2. The Contract Administrator may request, and Contractor shall provide within a
reasonable time, which shall not exceed ten (10) working days, a copy of all such other
agreements or grants, when, in the opinion of the Contract Administrator, the award
of the agreement or grant may affect the costs being paid or reimbursed under this
Agreement.
3. If the Contract Administrator determines that the award to Contractor of such other
agreement or grant has affected the costs being paid or reimbursed under this
Agreement, the Contract Administrator shall prepare an amendment to this
Agreement effecting a cost adjustment. If the Contractor disputes the proposed cost
adjustment, the dispute shall be resolved pursuant to the "Disputes" section of this
Agreement.
DD. MINIMUM WAGE REQUIREMENTS
Contractor warrants that it shall pay all its employees who are performing work or providing
services under this Agreement not less than the minimum wage specified under Section
206(a)(1) of the Fair Labor Standards Act of 1938, as amended (29 U.S.C. §5 201, et seq.).
EE. RECOGNITION OF DEPARTMENT SUPPORT
Contractor shall give recognition to the Department, the County, and the funding source for
their support when the Contractor publishes materials or releases public information that is
paid for in whole or in part with funds received by Contractor under this Agreement.
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FF. INSURANCE
Contractor shall have in effect at all times during the term of this Agreement insurance that is
adequate to protect the County, its officers and employees, participants, and equipment funded
under this Agreement against the losses set forth below. Contractor shall name the County as
an additional insured party. Contractor shall provide the Department with documentation of
insurance coverage by furnishing the Contract Administrator a certificate of insurance or a
certified copy of the insurance policy or other documentation that is required by the Contract
Administrator.
1. The following types and amounts of insurance are required as minimum:
a. Workers' Compensation according to statutory limits.
b. Unemployment Insurance as requited by Arizona Law.
c. Public Liability, Bodily Injury, and Property Damage;
1) General Liability, each occurrence, $1,000,000
2) Property Damage $1,000,000; or
3) Combined single limit, each occurrence, $1,000,000 minimum.
d. Automobile and Truck Liability, Bodily Injury, and Property Damages:
1) General Liability, each occurrence, $1,000,000
2) Property Damage $1,000,000; or
3) Combined single limit, each occurrence, $1,000,000 minimum.
e. Standard minimum deductible amounts are allowable. Any deductible
amounts are the responsibility of the Contractor and reimbursement, if any,
under this Agreement are subject to regulatory provisions of the funding
source(s) of this Agreement.
f. Property or equipment purchased or furnished through funds provided under
this Agreement shall be fully insured for the purchase or replacement cost of
such property or equipment.
2. If the Contractor provides professional or semi-professional personal services under
this Agreement for which malpractice or professional liability coverage is available,
such as medical, psychiatric, or legal services, Contractor shall carry minimum liability
coverage of $1,000,000 each occurrence and provide the Department with proof of
coverage.
GG. BONDING
1. Contractor shall not receive any initial reimbursements under this Agreement in an
amount greater than the Contractor's bonding limit. Contractor shall provide the
Contract Administrator with documentation of required bonding.
2. Contractor shall have fidelity bonding of not less than the maximum amount of cash
on hand or an amount equal to the initial reimbursement, whichever is greater.
3. Bonding requirements shall prevail throughout the term of this Agreement.
HH. GRIEVANCE PROCEDURE
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Contractor shall establish a system through which applicants for and recipients of services may
present grievances and may take appeals about eligibility and other aspects of Contractor's
work under this Agreement. The grievance procedure shall include provisions for notifying
the applicants for and recipients of services of their eligibility or ineligibility for service and
their right to appeal to the Department if the grievance is not satisfied by Contractor.
II. NONDISCRIMINATION
Contractor, in connection with any service or other activity under this Agreement, shall not in
any way discriminate against any person on the grounds of race, color, religion, sex, national
origin, age, disability, political affiliation, or belief. Contractor shall include this clause in all of
its Subcontracts related to this Agreement.
JJ. EQUAL EMPLOYMENT OPPORTUNITY
Contractor shall not discriminate against any employee or applicant for employment because
of race, age, disability, color, religion, sex or national origin. Contractor shall take affirmative
action to ensure 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.
Contractor shall, to the extent such provisions apply, comply with Title VI and VII of the Civil
Rights Act of 1964, as amended (42 U.S.C. §§ 2000a, et seq.); the Rehabilitation Act of 1973, as
amended (29 U.S.C. §,§ 701, et seq.); the Age Discrimination in Employment Act of 1967, as
amended (29 U.S.C. §§ 621, et seq.); the Americans With Disabilities Act of 1990 (42 §§
12101, et seq.); and Arizona Executive Order 2009-09, which mandates that all persons shall
have equal access to employment opportunities.
TM FINANCIAL MANAGEMENT
Contractor shall establish and maintain a separate, interest-hearing bank account for money
provided under this Agreement, or shall establish an accounting system that assures the
safeguarding and accountability of all money and assets provided under this Agreement. No
part of the money deposited in the hank account shall be commingled with other funds or
money belonging to Contractor. All interest earned on the account shall be disbursed in a
manner specified by the County in accordance with applicable State and federal regulations.
Contractor shall provide a signed bank account agreement authorizing the County to obtain
information about the account. If an accounting system is used, it shall be in accordance with
generally accepted accounting principles.
LL. RETENTION OF RECORDS
1. This provision applies to all financial and programmatic records, supporting
documents, statistical records and other records of Contractor that relate to this
Agreement.
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2. Contractor shall retain all records related to this Agreement for six (6) years after final
payment or until after the resolution of any audit questions, which could be more than
six (6) years, whichever is longer. The Department, federal and State auditors, and any
other persons duly authorized by the Department shall have full access to and the right
to examine, copy and make use of any and all of the records.
MM. ADEQUACY OF RECORDS
If Contractor's books, records and other documents related to this Agreement are not
sufficient to support and document that allowable services were provided to eligible
participants, Contractor shall reimburse the County for the services not supported and
documented.
NN. COMPETITIVE BID REQUIREMENTS
1. Equipment
If this Agreement is with other than a Public Agency, Contractor shall obtain all
equipment to be utilized under this Agreement and purchased with funds provided
under this Agreement at the lowest practical cost pursuant to the following
competitive bidding system:
a. Procurements in excess of $300, but less than $1,000, require oral price
quotations from two (2) or more vendors. Contractor shall keep and maintain
a record of the vendors' verbal quotations. Contractor's award shall be made
to the lowest bidder meeting specification requirements concerning price,
conformity to specifications, and other purchasing factors.
b. Procurements exceeding an aggregate amount of $1,000 shall be approved by
the Contract Administrator. At least three (3) bidders shall be solicited to
submit written quotations. Contractor shall solicit written quotations by
issuing a Request for Quotation to at least three (3) vendors. The award shall
be made to the lowest bidder meeting specification requirements concerning
price, conformity to specifications, and other purchasing factors.
2. Supplies
If this Agreement is with other than a Public Agency, Contractor shall obtain all
supplies to be utilized under this Agreement and purchased with funds provided under
this Agreement at the lowest practical cost and pursuant to a system of written quotes
whenever the price is expected to be greater than $300, unless the Contractor obtains
the Contract Administrator's prior written approval to purchase supplies by an
alternate method.
3. Minority. Women and Small Business Enterprises
Contractor shall take affirmative steps to provide an opportunity for minorities,
women, and small businesses to compete in the procurement of equipment and
supplies under this Agreement.
4. If Contractor is a Public Agency, Contractor's own bidding procedures shall govern.
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5. Funding source requirements relating to competitive bid procedures may supersede
any or all subparts of this clause and will be specified in the Special Provisions Section
of this Agreement.
00. PROPERTY
Any property furnished or purchased pursuant to the terms of this Agreement shall be utilized,
maintained, repaired, and accounted for in accordance with instructions furnished by the
Department, and tide to all such property shall revert to the County upon the expiration or
termination of this Agreement, unless the Contract Administrator determines otherwise. The
costs to repair such property are the responsibility of Contractor within the limits budgeted
herein. Repair costs beyond the budgeted amount shall be approved by the Contract
Administrator.
PP. IMMIGRATION REFORM AND CONTROL COMPLIANCE
Contractor understands and acknowledges that the Immigration Reform and Control Act of
1986 (Pub. L. No.99-603) ("IRCA") applies to this Agreement. Contractor shall comply with
the IRCA in performing under this Agreement and shall grant the County access to inspect its
personnel records to verify such compliance.
QQ. DRUG FREE WORKPLACE ACT
Contractor shall comply with the Drug-Free Workplace Act of 1988 (41 U.S.C. 5§ 701, et seq.),
which requires that contractors and grantees of federal funds must certify that they will
provide drug-free workplaces. This certification is a precondition to receiving a grant or
entering into this Agreement.
RR. GOVERNOR'S EXECUTIVE ORDER NO. 88-26
Contractor shall use the Arizona Taxonomy of Human Services for reporting and contracting
purposes.
SS. EMPLOYMENT DISCLAIMER
This Agreement is not intended to constitute, create, give rise to, or otherwise recognize a joint
venture agreement, partnership, or other business association or organization of any kind
between the Parties, and the rights and obligations of the Parties shall be only those expressly
set forth in this Agreement.
The Parties agree that no individual performing under this Agreement on behalf of Contractor
may be considered a County agent, employee, or representative and that no rights of County
civil service, County retirement, or County personnel rules shall accrue to or apply to any such
individual. Contractor shall have total responsibility for all salaries, wages, bonuses, retirement,
withholdings, workers' compensation, occupational disease compensation, unemployment
compensation, other employee benefits, and all taxes and premiums appurtenant thereto
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Section I General Provisions Page 13
concerning such individuals and Contractor shall indemnify, defend and hold harmless the
County with respect thereto.
TT. CERTIFICATION REGARDING DEBARMENT, SUSPENSION INELIGIBILITY
AND VOLUNTARY EXCLUSION
The undersigned, by signing this Agreement, represents that he/she has the authority to bind
Contractor to the terms of this Certification. Contractor, as the primary participant in
accordance with 45 C.F.R. Part 76, certifies to the best of its knowledge and belief that it and
its principals:
1. Are not presently debarred, suspended, proposed for debarment, declored ineligible, or
voluntarily excluded from covered transactions by any federal department or agency;
2. Have not within a 3-year period preceding the Start Date of this Agreement, been
convicted of or had a civil judgment rendered against them for (1) 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
transaction; (2) the violation of any federal or State antitrust statutes or (3) the
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 a governmental
entity (federal, State, or local) with the commission of any of the offenses enumerated
in subparagraph 2 above;
4. Have not, within a three-year period preceding this Start Date of this Agreement, had
one or more public transactions (federal, State, or local) terminated for cause or
default;
5. Shall immediately notify the Department if, at any time during the term of this
Agreement, it is debarred, suspended, declared ineligible, or voluntarily excluded from
participation. The Department may pursue available remedies in the event of such
occurrence, including immediate termination of this Agreement without liability; and
6. Shall not enter into a subcontract or sub-recipient agreement with any person or
organization that is debarred, suspended, declared ineligible, or voluntnrtly excluded
from participation. The Department may pursue available remedies in the event of
such occurrence, including immediate termination of this Agreement without liability.
Contractor shall include, without modification, the language of this Certification, in all
agreements with all sub-recipients and other subcontractors; in all lower tier covered
transactions, and in all solicitations for lower tier covered transactions in accordance with 45
C.F.R. Part 76.
If Contractor is not able to provide this Certification, an explanation as to why shall be
immediately provided to the Department, Attention: Department Director at the address set
forth on the Cover Page of this Agreement.
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UU. VERIFICATION REGARDING COMPLIANCE WITH ARIZONA REVISED
STATUTES § 23-214 AND FEDERAL IMMIGRATION LAWS AND
REGULATIONS
By entering into this Agreement, Contractor represents and warrants that it is in compliance
with the Immigration and Nationality Act (8 U.S.C. §§ 1101, et seg.) and all other federal and
State immigration laws and regulations related to the immigration status of its employees.
Contractor shall obtain statements from its Subcontractors certifying such compliance and
shall furnish the statements to the Department upon request. These representations and
warranties shall remain in effect throughout the term of this Agreement. Contractor and its
Subcontractors shall also maintain Employment Eligibility Verification forms (1-9), as required
by the U.S. Department of Labor's Immigration Reform and Control Act of 1986 (Pub. L. No.
99-603), for all employees performing work under this Agreement. 1-9 forms are available for
download at USCIS.GOV. Contractor agrees to verify employee compliance using the E-
verify system and shall keep a record of the verification for the duration of the employee's
employment or at least three years, whichever is longer.
Contractor warrants that it is in compliance with A.R.S. § 41-4401 (e-verify requirements) and
further represents:
1. That 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(A);
2. That breach of the warranty under subparagraph 1 above shall be deemed a material
breach of this Agreement and the County may immediately terminate this Agreement
without liability; and
3. That the County and any contracting government entity retains the legal right to
inspect the papers and employment records of any Contractor or Subcontractor
employee who works under this Agreement to ensure that the Contractor and its
Subcontractor are complying with the warranty provided under subsection 1 above,
and that Contractor agrees to make all papers and employment records of said
employee(s) available to the County during normal working hours in order to facilitate
such an inspection.
VV. CONTRACTOR COMPLIANCE WITH AILS. §§ 35-391.06 AND 35-393.06
(SCRUTINIZED BUSINESS RELATIONS WITH SUDAN AND IRAN):
By entering into this Agreement, the Contractor certifies that it does not have scrutinized
business operations in Sudan or Iran. Contractor shall obtain statements from its
Subcontractors certifying compliance and shall furnish the statements to the County upon
request. These certifications shall remain in effect through the term of this Agreement.
The County may request verification of compliance from any Contractor or Subcontractor
performing work under this Agreement. If the County suspects or determines that the
Contractor or any of its Subcontractors are not in compliance, the County may pursue any and
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Section I General Provisions Page 15
all remedies allowed by law, including, but not limited to: suspension of work, immediate
termination of this Agreement for default, and the suspension and/or debarment of
Contractor. All costs necessary to verify compliance are the responsibility of Contractor.
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•

SECTION II
SPECIAL PROVISIONS
Maricopa County
Human Services Department
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Section II Special Provisions Page 1
A. PURPOSE
The purpose of this Agreement is to award funds to the Contractor to be used for the
provision of Crisis Case Management and Financial Assistance Services during SFY14 in the
Gila Bend Community Service Area and the Buckeye Community Service Area. These
services shall be pursuant to the Work Statement in Section III of this Agreement.
B. DEFINITIONS
1. Delete the following definitions from Section I, General Provisions:
a. Assistant Director
b. Subrecipient
2. The following terms shall have the associated meanings within this Agreement:
c. Assistant Director means the Assistant Director of the Community Services
Division of the Maricopa County Human Services Department.
d. ADES means the Arizona Department of Economic Security.
e. Agency means the Contractor's business operation.
f. MCHSD — means Maricopa County Human Services Depattment.
g. CSD — means Community Services Division of Malicopa County's Human
Services Department.
h. Chief Procurement Officer means the head of the County's Office of
Procurement Services.
i. Contract Administrator means Assistant Director, and that position's
program-related responsibilities within MCHSD/CSD
Vulnerable Adult means an individual who is eighteen years of age or older
and who is unable to protect himself from abuse, neglect or exploitation by
others because of a physical or mental impairment. Vulnerable adult includes
an incapacitated person as defined in A.R.S. 14-5101.
C. GENERAL PROVISIONS
Delete the following paragraphs from Section I, General Provisions and replace in their
entirety within this Section:
N. RECIPROCAL INDEMNIFICATION
FF. INSURANCE
X. SAFEGUARDING OF PARTICIPANT INFORMATION
NN. COMPETITIVE BID REQUIREMENTS
D. EFFECT
To the extent that the Special Provisions are in conflict with the General Provisions, the
Special Provisions shall control. To the extent that the Work Statement is in conflict with
the General Provisions or the Special Provisions, the Work Statement shall control. To the
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Section II Special Provisions Page 2
extent that the Compensation Provisions are in conflict with the General Provisions, Special
Provisions, or Work Statement, the Compensation Provisions shall control.
E. STANDARDS
Contractor shall perform the work and provide the services as identified in Section III, the
Work Statement, and shall immediately notify the Contract Administrator whenever the
Contractor is unable to, or anticipates an inability to, perform any of the work or provide
any of the services required by the terms of this Agreement.
F. CHANGES ORIGINATED BY THE DEPARTMENT
Budget Adjustments: If changes do not result in an increase or reduction of the total
contract budget amount and result in more than a 10% change in a budget category, changes
will take place with budget change orders to be executed, approved and signed by both the
Department Assistant Director and Contractor agency director.
Changes that result in an increase or decrease in the total Agreement budget will require a
formal amendment pursuant to Section D of the General Provisions.
The MCHSD/CSD Assistant Director may, at any time, make changes to the general scope
of this Agreement in any or all of the following areas and methods including, but not limited
to, via written memorandums, which may consist of electronic communications:
1. Specific program rules, regulations, application procedures: These changes will be
communicated in writing to subcontractor agency directors through revisions to the
Maricopa County Human Services Department/Community Services Division
Program Policy & Procedure Handbook via written memorandums.
2. Minor work statement revisions: These changes will be communicated in writing to
the subcontractor agency directors through written memorandums.
3. Administrative requirements such as reporting criteria: These changes will be
communicated in writing to subcontractor agency directors through written
memorandums.
Any dispute or disagreement resulting from such written changes or budget change orders
shall constitute a dispute within the meaning of the dispute clause of the Agreement's General
Provisions and shall be adjusted accordingly.
G. COMPLIANCE WITH LAWS, RULES & REGULATIONS
Contractor shall comply with all applicable laws, rules, and regulations, without limitation, to
those designated within this Agreement.
H. AUDIT REQUIREMENTS
In accordance with A.R.S. § 11-624, the Contractor shall, at its own expense, file with the
Human Services Department, either:
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1. Audited financial statements prepared in accordance with federal single audit
requirements or,
2. Financial statements prepared in accordance with generally accepted accounting
principles audited by an independent certified public accountant.
I. INDEMNIFICATION
The Contractor shall, and shall cause any of its Subcontractors to, indemnify, defend save and
hold harmless the State of Arizona and Maricopa County, any jurisdiction or agency issuing
any permits for any work arising out of this Agreement, and their respective directors, officers,
officials, agents, and employees (hereinafter referred to as "Indemnitee") from and against any
and all claims, actions, liabilities, damages, losses, or expenses (including court costs, attorneys'
fees, and costs of claim processing, investigation and litigation) (hereinafter referred to as
"Claims") for bodily injury or personal injury (including death), or loss or damage to tangible
or intangible property caused, or alleged to be caused, in whole or in part, by the negligent or
willful acts or omissions of Contractor and any of its Subcontractors, or any of the directors,
officers, agents, or employees of Contractor and any of its Subcontractors. This indemnity
includes any claim or amount arising out of or recovered under the Workers' Compensation
Law or arising out of the failure of the Contractor or any of its Subcontractors to conform to
any federal, state or local law, statute, ordinance, rule, regulation or court decree. It is the
specific intention of the Patties that the Indemnitee shall, in all instances, except for Claims
arising solely from the negligent or willful acts or omissions of the Indemnitee, be indemnified
by the Contractor and any of its Subcontractors from and against any and all claims. It is
agreed that the Contractor and any of it Subcontractors will be responsible for primary loss
investigation, defense and judgment costs where this indemnification is applicable.
J. INSURANCE REQUIREMENTS
The Contractor and any of its subcontractors shall procure and maintain such insurance
requirements until all of their obligations have been discharged and any warranty periods
under this Contract are satisfied, including any claims for injury to persons or damage to
property which may arise from or in connection with the performance of the work
hereunder by the Contractor, its agents, representatives, employees or subcontractors.
The insurance requirements herein are minimum requirements for this Agreement and in no
way limit the indemnity covenants contained in this Agreement. The County and State of
Arizona in no way warrant that the minimum limits contained herein are sufficient to protect
the Contractor from liabilities that might arise out of the performance of the work under this
Agreement by the Contractor, his agents, representatives, employees or subcontractors, and
the Contractor is free to purchase additional insurance.
1. MINIMUM SCOPE AND LIMITS OF INSURANCE: Contractor shall
provide coverage with limits of liability not less than those stated below.
a. Commercial General Liability — Occurrence Form
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Policy shall include bodily injury, property damage, personal injury and broad
form contractual liability.
• General Aggregate $2,000,000
• Products — Completed Operations Aggregate $2,000,000
• Personal and Advertising Injury $1,000,000
• Blanket Contractual Liability — Written and Oral $1,000,000
• Fire Legal liability $ 50,000
• Each Occurrence $1,000,000
i. The policy shall be endorsed to include the following
additional insured language: "Maricopa County and the State of
Arizona, their departments, agencies, boards, commissions,
and their officers, officials, agents, and employees shall be
named as additional insureds with respect to liability arising
out of the activities performed by or on behalf of the
Contractor".
Policy shall contain a waiver of subrogation against
Maricopa County, the State of Arizona and their departments,
agencies, boards, commissions, and their officers, officials, agents,
and employees for losses arising from work performed by or on
behalf of the Contractor.
b. Business Automobile Liability
Bodily Injury and Property Damage for any owned, hired, and/or non-
owned vehicles used in the performance of this Contract.
Combined Single Limit (CSL) $1,000,000
i. The policy shall be endorsed to include the following additional
insured language: "Maricopa County and the State of Arizona,
their departments, agencies, boards, commissions, and their
officers, officials, agents, and employees shall be named as
additional insureds with respect to liability arising out of the
activities performed by or on behalf of the Contractor, involving
automobiles owned, leased, hired or borrowed by the
Contractor".
Policy shall contain a waiver of subrogation against Maricopa
County and the State of Arizona, their departments, agencies, boards,
commissions, and their officers, officials, agents, and employees for
losses arising from work performed by or on behalf of the
Contractor.
k. Worker's Compensation and Employers' Liability
Workers' Compensation Statutory
Employers' Liability
Each Accident $1,000,000
Disease — Each Employee $1,000,000
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Disease — Policy Limit $1,000,000
i. Policy shall contain a waiver of subrogation against Maticopa
County and the State of Arizona, their departments, agencies, boards,
commissions, and their officers, officials, agents, and employees for
losses arising from work performed by or on behalf of the
Contractor.
d. Professional Liability (Errors and Omissions Liability)
Each Claim $1,000,000
Annual Aggregate $2,000,000
i. In the event that the professional liability insurance required by
this Contract is written on a claims-made basis, the Contractor
warrants that any retroactive date under the policy shall precede the
effective date of this Contract; and that either continuous coverage
will be maintained or an extended discovery period will be exercised
for a period of two (2) years beginning at the time work under this
Contract is completed.
ii. The policy shall cover professional misconduct or lack of
ordinary skill for those positions defined in the Work Statement
under this Contract.
2. ADDITIONAL INSURANCE REQUIREMENTS: The policies, except
Worker's Compensation and Professional Liability insurance, are to contain, or be endorsed
to contain, the following provisions:
a. Maricopa County, the State of Arizona, and their respective departments, agencies,
boards, commissions, and their respective officers, officials, agents, and employees and the
Contractor shall be additional insureds to the full limits of liability purchased by the
Contractor, even if those limits of liability are in excess of those required by the Contract.
b. The Contractor's and its subcontractors' insurance coverage shall be primary insurance
with respect to all other available sources.
c. The Contractor's and its subcontractors' insurance shall apply separately to each insured
against whom claim is made or suit is brought, except with respect to the limits of the
insurer's liability. Coverage provided by the subcontractors shall not be limited to the
liability assumed under the indemnification provisions of their contracts with the Contractor.
3. NOTICE OF CANCELLATION: With the exception of (10) day notice of
cancellation for non-payment of premium, any changes material to compliance with this
contract in the insurance policies above shall require (30) days written notice to Maricopa
County. Such notice shall be sent directly to Maricopa County Human Services Department
(Attn: Community Services Division), 234 N. Central Avenue, Ste 3000, Phoenix, AZ
85004, and shall be sent by certified mail, return receipt requested.
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Section II Special Provisions Page 6
4. ACCEPTABILITY OF INSURERS: Insurance is to be placed with duly licensed
or approved non-admitted insurers in the State of Arizona with an "A.M. Best" rating of not
less than A VII. The County in no way warrants that the above-required minimum insurer
rating is sufficient to protect the Contractor from potential insurer insolvency.
If the social services program utilizes the Social Service Contractors Indemnity Pool (SSCIP)
or other approved insurance pool for insurance coverage, SSCIP or the other approved
insurance pool is exempt from the A.M. Best's rating requirement listed in this Contract. If
the Contractor or it Subcontractor chooses to use SSCIP or another approved insurance
pool as its insurance provider, the Contract or Contractor's Subcontract would be
considered in full compliance with insurance requirements relating to the A.M. Best rating
requirements.
5. VERIFICATION OF COVERAGE: Contractor shall furnish the County with
certificates of insurance (ACORD form or equivalent approved by the County) as required
by this Contract. The certificates for each insurance policy are to be signed by a person
authorized by that insurer to bind coverage on its behalf.
All certificates and endorsements are to be received and approved Maricopa County before
work commences. Each insurance policy required by this Contract must be in effect at or
prior to commencement of work under this Contract and remain in effect for the duration
of the Contract's contract term. Failure to maintain the insurance policies as required by this
Contract, or to provide evidence of renewal, is a material breach of contract.
All certificates required by this Contract shall be sent directly to Maricopa County Human
Services Department (Attn: Community Services Division), 234 N. Central Avenue, Ste
3000, Phoenix, AZ 85004. The County's Contract number is to be noted on the certificate
of insurance. The County reserves the right to require complete, certified copies of all
insurance policies required by this Contract at any time.
6. APPROVAL: Any modification or variation of these Insurance Requirements
under this Contract must have prior approval from Maricopa County Risk Management,
whose decision shall be final. Such action will not require a formal contract amendment, but
may be made by administrative action, as indicated in Clause F (Changes Originated by the
Department) and Clause M (Contractor Changes) of these Special Provisions, Section II
of this Agreement.
7. EXCEPTIONS: In the event the Contractor's subcontractor(s) is/are a public
entity, then the Insurance Requirements may, based upon the sole discretion of the County,
not apply. Such public entity may, based upon the sole discretion of the County, provide a
certificate of self-insurance to the Contractor and may be provided to the County upon
request.
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K BACKGROUND CHECKS FOR EMPLOYMENT THROUGH CENTRAL
REGISTRY
If providing direct services to children or vulnerable adults, the following shall apply:
1. The provisions of A.R.S. 5 8-804 (as may be amended) are hereby incorporated in its
entirety as provisions of this Agreement.
2. Contractor shall submit information directly to MCHSD CSD prior to employing or
following any person to volunteer who provides such direct services under this
Agreement. MCHSD will request ADES to conduct Central Registry Background
Checks on behalf of the Contractor. The results must indicate that the person has
no disqualifying acts that would prohibit him/her from providing services to clients.
If the Central Registry background check specifies any disqualifying act and the
person does not have a Central Registry exception, the person shall be prohibited
from providing direct services to clients.
3. The information contained in the Central Registry will be used as a factor to
determine qualifications for positions that provide direct service to juveniles or
vulnerable adults as follows:
a. Any person, their employees or volunteers who apply for a contract
with MCHSD; or
b. All employees/volunteers of the Contractor; or
c. A subcontractor of the Contractor and any subcontractor employees
or volunteers; or
d. Prospective employees/volunteer of the Contractor or its
subcontractor before being employed or volunteering.
4. The Contractor shall ensure all requirements of this Section are met in order to:
a. Protect Clients
b. Avoid Agreement cancellation or termination for cause by the
County.
c. Include any salary/employee-related expenses on the monthly
Financial Claim Form pertaining to any people included in clause
5.59.3 above.
5. Before being employed or volunteering in a position that provides direct services
to children or vulnerable adults under this Agreement, persons shall certify on forms
provided by ADES whether an allegation of abuse or neglect was made against them
and was substantiated.
6. A person who is disqualified because of a Central Registry Background Check may
apply to the Board of Fingerprinting for a Central Registry exception pursuant to
A.R.S. § 41-619.57. A person who is granted a Central Registry exception pursuant
to A.R.S. § 41-619.57 is not entitled to a contract, employment, licensure,
certification or other benefit because the person has been granted a Central Registry
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Section II Special Provisions Page 8
exception.
7. Results from ADES of the Central Registry background checks shall be submitted to
the Contractor within five (5) days of receipt by MCHSD/CSD.
8. The Contractor shall maintain the Central Registry Background Check results in a
confidential file for six (6) years after termination of the Contract, or resolution of
any audit issues, whichever is longer. This requirement is pursuant to the Retention
of Records section under this Contract.
L. FINGERPRINTING
The provisions of A.R.S. 5 46-141 (as may be amended) are hereby incorporated in their
entirety as provisions of this contract. For reference, these provisions include, but are not
limited to, the following:
1. Contractor and any subcontractor staff (pre-approved by the County) who are
required or allowed to provide services directly to juveniles or vulnerable adults
shall possess a fingerprint clearance card that meets Level One requirements as
described in ARS 41-1758.07. Such Contractor and subcontractor staff includes
current employees, whether paid or not, those who transfer into a direct service
position, volunteers, and new employees, whether paid or not.
2. If awaiting receipt of their clearance card, such staff shall provide services ONLY
under direct visual supervision and oversight of an employee who possesses a
fingerprint clearance card until staff is issued a valid fingerprint clearance card
that meets the Level One requirements.
3. Except as provided in A.R.S. § 46-141, this Contract may be cancelled or
terminated immediately if a person employed by the Contractor, and who has
contact with juveniles or vulnerable adults, certifies pursuant to the provisions of
A.R.S. § 46-141 (as may be amended) that the person is awaiting trial or has been
convicted of any of the offenses listed therein in this State, or of acts committed in
another state that would be offenses in this State, or if the person does not possess
or is denied issuance of a valid fingerprint clearance card.
4. Should a staffs fingerprint clearance card be revoked or suspended, such staff
shall immediately be prohibited from providing services under this Contract
unless granted a good cause exception pursuant to ARS 41-619.55. This
Contract may be cancelled or terminated immediately should it be discovered the
Contractor, or its subcontractor, did not prudently and immediately act upon such
information.
5. Contractor staff, whether paid or not, who are required or allowed to provide
services directly to juveniles, shall certify on forms provided by the Arizona
Department of Economic Security and notarized whether they:
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Section II Special Provisions Page 9
a. Are awaiting trial on or have ever been convicted of any of the
offenses described in A.R.S. § 46-141 (as may be amended); or
b. Ever committed any act of sexual abuse of a child, including
sexual exploitation and commercial sexual exploitation, or any act
of child abuse.
6. The Contractor shall assume the costs of fingerprint checks. The Department may
allow all or part of the costs of fingerprint clearance checks/cards to be included
as an allowable, reimbursable cost under this Contract.
7. Upon receiving the valid fingerprint clearance card, Contractor shall forward a
copy of the staff's card, front and back, to the MCHSD Community Services
Division.
M. CONTRACTOR CHANGES
The Contractor is required to notify the MCHSD Community Services Division's Assistant
Director, in writing, within fifteen (15) calendar days, of any changes in the following:
• Agency staff funded with this contract
• Agency authorized signatory
• Agency address, phone, fax or email addresses
• Person to whom Agreement notices should be sent
• any variation of insurance requirements as indicated in this Agreement
N. DEPARTMENT DETERMINATIONS
The Department reserves the right to increase or decrease contractor's budget or scope of
work based on over, under or non-performance resulting from program overview and
monitoring by MCHSD /Community Services Division staff.
0. ALLOCATION OF FUNDING
Should additional funds become available during the term of the contract period, the
Department reserves the tight to allocate these funds and proportionate services in this
Agreement. Allocations may be adjusted based on documented client need, census
determinations, or over, under or non-performance by the Contractor.
P. COMPUTER SOFTWARE POLICY
The contractor shall comply with Federal copyright laws applicable to software licenses. In
addition, all policies and agreements between the Department and the Contractor related to
contract equipment, software, internet accessible database system, and access shall be
implemented and monitored. Annvally, contractors will be required to submit an inventory of
all county provided hardware and software to the MCHSD Community Services Division
Assistant Director.
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Q. RESPONSIBILITY FOR REPAYMENT OF DIRECT SERVICE FUNDS
Should program monitoring or application quality assurance review result in findings related to
direct service funds being paid for ineligible individuals or in amounts above allowable
program limits, the Contractor shall repay those funds to the Department upon written
notification by the MCHSD/CSD Operations Manager or Assistant Director.
R. DATA COLLECTION AND MANAGEMENT
Eligibility determination and documentation shall be completed for all applicants/clients and
appropriate household members receiving services through this contract. The Contractor is
responsible for adhering to MCHSD data entry requirements and for the timely, accurate data
entry of information.
S. COOPERATION IN TRAINING, PLANNING, NEEDS ASSESSMENT,
OUTCOME MEASUREMENT INITIATIVES
The Contractor will be required to cooperate in needs assessments, training required by
MCHSD CSD and planning and outcome measurement initiatives.
T. REPORTING REOUIREMENTS
Unless otherwise provided in this contract, reporting shall adhere to the following schedule:
no later than the 10th working day following each month during the contract term, the
Contractor shall submit programmatic and financial reports to the Department in the form
set forth in this Agreement. Failure to submit accurate and complete reports by the 10 th
working day following the end of a month may result, at the option of the Department, in
retention of payment. Failure to provide such report within 45 calendar days following the
end of a month may result, at the option of the Department, in a forfeiture of such payment.
Contractor shall submit to the Department all final program and fiscal reports no later than
the designated date, to be determined by the Department, following the termination of this
contract. Failure to submit final program and fiscal reports within the designated time period
may result, at the option of the Department, in forfeiture of final payment.
U. CODE OF CONDUCT
The Contractor shall avoid any action that might create or result in the appearance of:
1. Inappropriate use or divulging of information gathered or discovered pursuant to the
performance of its duties under this Agreement.
2. Acted on behalf of the County without appropriate authorization.
3. Provided favorable or unfavorable treatment to anyone.
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Section It Special Provisions Page 11
4. Made a decision on behalf of the County that exceeded its authority, could result in
partiality, or have a political consequence for the County.
5. Misrepresent or otherwise impeded the efficiency, authority, actions, policies, or
adversely affect the confidence of the public or integrity of the Department.
6. Loss of impartiality when advising the Department.
V. CONTRACT TERM AND OPTION TO EXTEND
1. The term of the Agreement shall commence upon July 1, 2013, and shall remain in effect
for one (1) year or otherwise specified date, unless terminated, cancelled, or extended as
otherwise provided herein. The Contract term shall include two options to renew for
one-year extensions based on Contractor performance.
2. The Contractor shall not provide services prior to contract term commencing or after
the end date of the contract. (No billable activity outside of the effective dates).
3. Upon execution of this Agreement and incurring allowable expenses within the contract
term, the Contractor shall invoice the County per Section IV, Compensation, under this
Agreement.
W. LEVEL OF SERVICES
If the Contractor determines service recipient eligibility, the Contractor shall maintain and
regulate the units or services set forth in this contract to ensure continuity and availability of
services to eligible persons during the term of this Agreement and during any transition to a
subsequent Contractor.
The Department makes no guarantee to purchase specific quantities of goods or services or
to refer eligible persons as may be identified or specified herein. Further, it is understood
and agreed that this Agreement is for the sole convenience of the Department and that the
Department reserves the right to obtain like goods or services from its sources when such
need is determined necessary by the Department.
Services under this Agreement may be moved or expanded to other site locations within the
geographic area awarded only by a written amendment.
X. PANDEMIC CONTRACTUAL PERFORMANCE
1. The Department shall require a written plan that illustrates how the contractor shall
perform up to contractual standards in the event of a pandemic. The Department
may require a copy of the plan at anytime prior or post award of a contract. At a
minimum, the pandemic performance plan shall include:
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Section II Special Provisions Page 12
a. Key succession and performance planning if there is a sudden significant
decrease in contractor's workforce.
b. Alternative methods to ensure there are services or products in the supply
chain.
c. An up to date list of agency contacts and organizational chart.
2. In the event of a pandemic, as declared by the Governor of Arizona, U.S.
Government or the World Health Organization, which makes performance of any
term under this contract impossible or impracticable, The Department shall have the
following rights:
a. After the official declaration of a pandemic, the Department may temporally
void the contract(s) in whole or specific sections if the contractor cannot
perform to the standards agreed upon in the initial terms.
b. The Department shall not incur any liability if a pandemic is declared, and
emergency procurements are authorized by the Director of the Arizona
Department of Administration per A.R.S. § 41-2537 as may be amended of
the Arizona Procurement Code.
c. Once the pandemic is officially declared over and/or the contractor can
demonstrate the ability to perform, the Department, at its sole discretion may
reinstate the temporarily voided contract(s).
Y. PAYMENT RECOUPMENT
The Contractor shall reimburse the Department upon demand, or the Department may
deduct from future payments, the following:
1. Any amounts received by the Contractor from the Department for contract services
which have been inaccurately reported or are found to be unsubstantiated.
2. Any amounts paid by the Contractor to a subcontractor not authorized in writing by
the Department.
3. Any amount or benefit paid directly or indirectly to an individual or organization not
in accordance with the Substantial Interest section of these terms and conditions.
4. Any duplicate amounts paid by the Department for services covered or reimbursed
by other specific grants, contracts, or payments.
5. Any amounts expended for items or purposes determined unallowable by the
Department upon reimbursement by the Department; see the "Unallowable Costs"
clause of these Special Provisions.
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Section II Special Provisions Page 13
6. Any amounts paid by the Department for which the Contractor's books, records,
and other documents are not sufficient to clearly substantiate that those amounts
were used by the Contractor to perform contract services.
7. Any amounts received by the Contractor from the Department which are identified
as a financial audit exception.
8. Any amounts paid or reimbursed in excess of the contract or service reimbursement
ceiling.
9. Any payments made for services rendered before the contract begin date or after the
contract termination date.
Z. PERSONNEL
The Contractor's personnel working under this Agreement shall be qualified to carry out all
duties and requirements set forth in this Agreement. Contractor shall ensure services are
provided as reflected in Attachment B as set forth in this Agreement. Such services include
performing client application intake activities in the Buckeye Community Service Area (as
reflected in Attachment B-2) a minimum of, and equivalent to, two eight-hour days.
AA. TRANSITION OF ACTIVITIES
In the event that a contract is awarded to a new contractor for services similar to those being
performed by Contractor under this Agreement, there shall be a transition of services period.
During this period, the contractor, under this contract, shall work closely with the new
contractor's personnel and/or Department staff to ensure a smooth and complete transfer
of duties and responsibilities. The Department's authorized representative will coordinate all
transition activities. A transition plan will be developed in conjunction with the existing
contractor to assist the new contractor and/or Department staff to implement the transfer
of duties. The Department reserves the right to determine which projects/service delivery
nearing completion will remain with the current Contractor of record.
BB. UNALLOWABLE COSTS
The cost principles set forth in the Code of Federal Regulations, 48 CFR, Chapter 1,
Subchapter e, Part 31, (October 1, 1991), including later amendments and editions on file
with the Arizona Secretary of State and incorporated by this reference, shall be used to
determine the allow ability of incurred costs for the purpose of reimbursing costs under
contract provisions that provide for the reimbursement of costs. Those costs which are
specifically defined as unallowable therein will not be submitted for reimbursement by the
Contractor and may not be reimbursed with Department funds. In addition, the Contractor
shall comply with the following publications (including subsequent revisions), as applicable:
1. OMB Circular A-122 (now relocated to 2 CFR, Part 230) for private non-profit
organizations other than institutions of higher education, hospitals or others specified in A-
122.
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Section II Special Provisions Page 14
2. OMB Circular A-133 for audits of institutions of higher education and other non-
profit institutions.
CC. SUBSTANTIAL INTEREST DISCLOSURE
Contractor shall not make any payments, either directly or indirectly, to any person,
partnership, corporation, trust, or any other organization which has a substantial interest in
Contractor's organization or with which Contractor (or one of its directors, officers, owners,
trust certificate holders or a relative thereof) has a substantial interest, unless Contractor has
made a full written disclosure of the proposed payments, including amounts, to the
Department.
Leases or rental agreements of property shall be in writing and accompanied by an
independent commercial appraisal of fair market rental, lease, or purchase value, as
appropriate.
For the purpose of this Section, "relative" shall have the same meaning as in A.R.S. P8-502
as may be amended.
DD. SAFEGUARDING OF PARTICIPANT INFORMATION
The use or disclosure by Contractor of any information concerning an applicant for, or
recipient of, services under this Agreement is directly limited to the conduct of this
Agreement. Contractor and its agents shall safeguard the confidenti2lity of this information,
just as Contractor would safeguard its own confidential information. Contractor shall include
a clause to this effect in all Subcontracts related to this Agreement
The Contractor shall comply with the requirements of the Arizona Address Confidentiality
Program, A.R.S. § 41-161 et. seq. MCHSD/CSD will advise the Contractor as to applicable
policies and procedures ADES has adopted for such compliance.
EE. COMPETITIVE BID REQUIREMENTS
Procurement of equipment with funds received under this Agreement, and for a cost equal
to or greater than $1000, is prohibited under this Agreement.
Procurement of equipment with a cost less than $1000 is considered materials and supplies.
Individual procurements, purchased with funds provided under this Agreement, of less than
$300 require oral price quotations from two or more vendors. The Contractor shall keep
and maintain a record of the vendors' verbal quotations.
Individual procurements equal to or in excess of $300, but less than $1000, and purchased
with funds provided under this Agreement, are subject to a system of written quotes.
Contractor shall keep and maintain a record of the vendors' written quotations.
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Section II Special Provisions Page 15
The Contractor shall take affirmative steps to provide an opportunity for minorities,
women, and small businesses to compete in the procurement of equipment, materials and
supplies under this Agreement.
Maricopa County Human Services Department
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Section III Work Statement Page 1
WORK STATEMENT
for
CRISIS CASE MANAGEMENT
and
FINANCIAL ASSISTANCE SERVICES
1.0 SERVICE DESCRIPTION:
1.1 Crisis Case Management Services are provided to individuals and/or families in
order to enhance their self-sufficiency and/or involvement in the community, and
through which the needs and eligibility of the individuals applying for/receiving
financial services are determined. For those individuals eligible, appropriate services
are identified, obtained or provided, and recorded. Information and referral services
will be provided as appropriate.
1.2 Financial Assistance Services are provided to stabilize the immediate and emergent
needs of the client including basic needs. Financial services may include, but are not
limited to: emergency rent and mortgage assistance, first month's rent and rental
deposit assistance, utility payment assistance, utility deposit assistance, food boxes,
etc.
2.0 UNIT OF SERVICE:
Units of service may vary depending on the types of activities conducted.
3.0 STANDARDS/LICENSURE/PROGRAM INFORMATION:
3.1 Contractor will comply with all federal, state and county regulations related to
specific funding sources used. Additionally, all contractors will comply with the
Maricopa Couno Human Services Doartmentl Community Services Division Policy & Procedure
Handbook and will be responsible for keeping the handbook updated as program
regulations and guidelines change.
3.2 Federal, State, and County regulations will be the responsibility of the Contractor to
follow and may include, but are not limited to:
3.2.1 Federal Low Income Home Energy Assistance Program regulation as well as
the State of Arizona Low Income Home Energy Assistance Program State
Plan. Title XXVI- Low Income Home Energy Assistance Program Omnibus
Budget Reconciliation Act of 1981.
3.2.2 Federal Social Services Block Grant
3.2.3 Federal Emergency Solutions Grant
3.2.4 Federal Community Services Block Grant
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Section III Work Statement Page 2
3.2.5 Utility, Repair, Replacement and Deposit Assistance Guidelines.
3.2.6 State Short Term Crisis Services Program
3.2.7 Federal Temporary Assistance to Needy Families (TANF) as related to the
provision of Emergency Assistance.
3.2.8 State and Federal Client Confidentiality Laws and Regulations.
3.2.9 Maricopa County Human Services Department/Community Services
Division Policy & Procedures Handbook.
3.2.10 Community Services Block Grant Legislation as amended.
3.3 Crisis case management is the process by which eligibility for financial assistance
with basic and emergent needs is determined and received. Available resources are
categorized as follows:
3.3.1 Financial Assistance (i.e. rent, utility, mortgage assistance)
3.3.2 Information and Referral
3.3.3 Utility and Telephone Discount Programs (enrollment)
3.3.4 Goods and materials provided (i.e. food boxes, clothing)
3.3.5 Home Repair/Weathetization (i.e. application intake or referral to home
repair programs i.e. weatherization)
3.3.6 Non-Financial Assistance (i.e. face-to-face provision of services i.e. case
management, energy conservation education, assistance with forms
completion such as for AHCCCS)
3.4 Maricopa Casino Human Services Doartment/ Communio Services Division Polig & Procedure
Handbook provides detailed information on services that can be provided, client
eligibility regulations and guidelines, application and documentation procedures and
service dollar limits for Maxicopa County funded financial assistance.
3.5 Financial assistance service funds are not included in Contractor
agreements/contracts. These funds will be retained by Maricopa County Human
Services Department (MCHSD) and are made available to contractors through the
HSD Online Client Data System. Applications for MCHSD funded financial
assistance must be completed via the HSD Online Client Data System. MCHSD will
make payments directly to vendors (i.e. utility companies, landlords, mortgage
companies, etc.) upon authorization by MCHSD.
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•
Section III Work Statement Page 3
4.0 SERVICE REQUIREMENTS:
Contractor shall:
4.1 Provide services that are appropriate to the language, culture and geographic location
of the target population.
4.2 Provide on-site financial assistance services at a location(s) within the specified
service area, as determined during contract negotiations.
4.3 Provide personnel, supervision, staff training, equipment, materials and supplies
necessary to perform and provide crisis case management and financial assistance
services.
4.4 Utilize the HSD Online Client Data System to document and record all services
provided and supported by MCHSD funds. This includes financial assistance
services and non-financial services provided by Contractor staff/volunteers
supported with MCHSD funds.
4.5 Data entry of all services and/or applications must be complete by the 5 th business
day of the following month.
4.6 Ensure that applications for MCHSD funded assistance are reviewed for quality
assurance prior to submission to MCHSD for payment authorization.
4.7 Ensure that completed applications for financial assistance are submitted to MCHSD
within five days of application intake.
5.0 SERVICE GOALS:
5.1 To assist low income individuals or households reduce or eliminate barriers to initial
or continuous employment.
5.2 To assist households in improving housing conditions and lowering utility costs
through home weadierization, repair or replacement of utility related appliances,
home repairs.
5.3 To reduce homelessness and help families move from unaffordable or unsafe
housing by assisting with first month rent, rental security deposits and/or utility
deposits.
5.4 To prevent homelessness by assisting families with eviction prevention rent
assistance, mortgage foreclosure assistance and/or utility assistance.
5.5 To assist low-income families in accessing or maintaining telephone service through
enrollment in telephone discount programs.
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Section III Work Statement Page 4
5.6 To ensure that individuals know about and can access other community resources
and programs through provision of community information and referral.
5.7 To reduce immediate hunger by providing food boxes or referrals to sources of
immediate food.
5.8 To assist low-income energy burdened households maintain self-sufficiency through
enrollment in various utility discount programs.
5.9 To support households in maintaining or achieving self-sufficiency through crisis
case management to meet the household's immediate and basic needs.
5.10 To assist low-income individuals and/or households in achieving an increase in
financial assets and/or financial skills to achieve or maintain self-sufficiency.
WORK STATEMENT RESPONSES
6.0 ADMINIS ERATIVE:
6.1 Describe the agency's policies, procedures and training for staff and/or volunteers in
regards to the confidentiality of clients and client related information. Include how
and when the training occurs and where the training is documented.
All new staff and related volunteers are required to attend an orientation on policies
and procedures including the confidentiality of clients and client related
information. The attendees ate requited to sign a statement of understanding
regarding the confidentiality policy. At the annual staff training held in July staff
reviews the policy and the importance of privacy and confidentiality
procedures/processes. The last training was held on July 26, 2012. A copy is kept
on file with the CAP Director.
6.2 Describe the agency's training of staff and volunteers in regards to the agency
grievance/problem solving procedures of the agency.
All staff and related volunteers are trained on the agency 'grievance and problem
solving procedures during the annual staff training held in July. The grievance
procedure is also posted in each CAP staff office and is available to all clients.
6.3 Describe the training of staff on the agency's non-discrimination policy.
The non-discrimination policy is a component of the annual staff training, held in
July, and new staff/volunteer orientation. This policy is a part of the Town of Gila
Bend's employee handbook.
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Section III Work Statement Page 5
6.4 Describe the procedure that ensures equal access to programs and services for
individuals with disabilities, and the reasonable accommodations that ensure
compliance with the Americans with Disabilities Act.
Clients with disabilities are respected the same rights as all clients, with sensitivity to
the client's special needs. Home visits are provided on an as-need basis, special
transportation is provided as needed and other accommodations are provided
according to the need of the client. Services are provided in respect for and in
accordance with the Americans with Disabilities Act. The building where CAP is
housed is ADA compliant.
6.5 Describe how the agency will ensure that services are available to non-English
speaking, hearing impaired, and vision impaired individuals and how services are
appropriate to the language, culture, and geographic location of the target
population.
Services are provided in the appropriate language for the area. Staff members read,
write, speak, and translate in the Spanish language. The predominant non-English
language in the area is Spanish, with some Tohono O'Oclharn language being the
predominant language is some families. An interpreter is available and on call for
anyone needing translation in the Tohono O'Odharn language. Because the
geographical area covers a very large area, staff is prepared to complete home visits
to outlying areas. Staff also conducts outreach to seek out and identify persons in
need in these hard to reach geographical areas.
Accessibility for persons with disabilities, hearing impaired and visually impaired
individuals will be accommodated assistance upon request. They may contact the
Town of Gila Bend, the Community Action Program or 1-800-367-8939 (Arizona
Relay Service) seventy-two hours in advance for accommodations.
6.6 Indicate sources of agency funding and amounts from entities other than MCHSD
that support administration and operating costs of the agency including the
value of in-kind contributions.
Insert response here. Box expands.
ENTITY FUNDING IN-KIND IN-KIND TYPE
AMOUNT $ VALUE
Town of Gila Bend 17600.00 Building Space
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Section III Work Statement Page 6
Town of Gila Bend $ 40,842.00
TOTAL $ 40,842.00 $17,600.00
6.7 Describe how the agency will ensure that no direct services, utilizing MCHSD
operations or financial assistance funds, will be provided to clients by agency staff
and/or volunteers until all appropriate background checks for employment through
Central Registry have been conducted and satisfactory results received by the
County.
All Staff and Volunteers are required to receive background checks through the
Central Registry prior to employment/volunteering. A satisfactory result must be
obtained prior to providing direct services to any client. A copy of the result will be
kept in the staff/volunteer file.
7.0 PROCEDURES FOR CRISIS CASE MANAGEMENT AND FINANCIAL
ASSISTANCE SERVICES:
7.1 Describe agency procedures for how clients are scheduled for application intake
ensuring that people in crisis situations, including those who are homeless, about to
become homeless, or have impending utility shutoff, are given priority in the
scheduling process.
Buckeye--The receptionist screens all calls for urgent need. Clients that do not have
an emergency are instructed to contact our dedicated phone line set up for utility
and rental appointments. Calls are taken on the first Wednesday of every month
and responded to in the order they came in. In emergency situations the client is
instructed as to the documentation needed for the process and an immediate
appointment is set. Staff works with the client to stabilize the situation and to
complete the necessary paperwork in order to find housing or prevent eviction.
Gila Bend-The client speaks to the receptionist and sets an appointment
immediately or as needed.
7.2 Describe how the agency accommodates clients who require an appointment outside
of regular business hours.
When a client is unable to come to the office during regular business hours, staff
will make arrangement to either make a home visit or to meet with the client at a
convenient time for the client.
7.3 Describe how agency ensures program access for persons who are homebound.
If a client is homebound, frail and/or elderly, disabled, or for other reasons unable
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Section III Work Statement
to come to the center to receive assistance the client will receive assistance by
means of a home visit.
7.4 Describe the services in place to assist individuals when MCHSD financial assistance
service funds have been depleted.
When MCHSD funds are depleted staff make referrals to the Salvation Army, St.
Vincent De Paul, other social service organizations and local churches that have
partnered with CAP to assist those in need, via referral from CAP, for emergency
services.
7.5 Describe the process for documenting client crisis reason, needs, service(s)
requested, services provided, and staff time spent with or on behalf of the client into
the HSD Online Client Data System.
At the time of the application, clients must produce the required verification
documents requested during pre-screening. Staff is required to place the proper
documentation in the case file. All services and support documentation are entered
into the HSD online data base immediately upon completion of the application. All
pending application must be completed in a timely matter. Upon completion of the
application staff data enters time spent with the client, all referrals made on behalf
of the client and case management time spent on behalf of the client, using the
codes provided by MCHSD.
7.6 Describe agency process and procedures for obtaining and retaining all required
client verification and documentation in client file.
Application is taken only when all documentation has been presented to the case
worker. Copies of the proper documentation are copies and placed in the client
file. Verifications are documented in the case file as visually verified, collateral
copy, or hard copy. All documentation and verifications are subject to the MCHSD
Policies and Procedures Manual, as required. All client files and information
pertaining to the files is kept in a locked storage for no less than six years as
required by MCHSD.
8.0 MCHSD- FUNDED FINANCIAL ASSISTANCE:
8.1 Describe agency process and procedures for notifying and advising all applicants of
their rights, responsibilities, the agency grievance/problem solving procedures,
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Section III Work Statement "law
including the provision to each client the approval/denial/appeal for services form
provided by MCHSD.
At the time the appointment is set, a copy listing all required documents and a copy
of the rights and responsibilities are sent via email to the client for review. The
Rights and Responsibilities form states the client has the right to request a copy of
the Town of Gila Bend Community Action Program Grievance Procedure. Just
prior to the client interview a hard copy of the Rights and Responsibilities form is
given to the client for signature.
Normal procedure for distributing the denial/approval letter is immediately after
taking the application, but no later than 10 days as stated in the MCHSD handbook.
8.2 Describe the agency application quality assurance review process and the staff
position(s) responsible for application quality assurance review prior to submittal to
MCHSD.
The CAP Director is responsible for the completion of quality assurance prior to
submitting the application to MCHSD. Upon completion of the application, staff
provides the application to the Director for quality assurance review. Upon
completion of the quality assurance review, the Director signs the transmittal log
indicating that quality assurance is complete.
8.3 Describe agency process and procedure for responding in a timely manner to
MCHSD when notified to clarify and/or correct client application or data entry
errors. Include staff position(s) responsible for responding to these requests.
All application clarifications and/or corrections are responded to immediately upon
receipt of the request from MCHSD. Requests for both clarification and/or
corrections are to be completed no later than three days as stated in the MCHSD
Policies and Procedures Manual. Each staff member is required to make their own
corrections and forward a copy of the correction to the CAP Director. If an issue
is not resolved with-in three days, the CAP Director will take responsibility for the
corrective action/response and ensure the information is sent to MCHSD.
8.4 Describe agency process and procedures for the appropriate security, completion
and issuance of MCHSD Financial Assistance Vouchers. MCHSD Financial
Assistance Vouchers shall be treated as currency and kept secure. The agency shall
determine which staff are authorized to sign completed vouchers, and provide
MCHSD with the list of authorized staff, and update as needed.
All vouchers are kept in a secured office and distributed by the CAP Director. The
CAP Director is responsible for safeguarding and issuing vouchers. In the event
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Section III Work Statement Page 9
the CAP Director is absent, the Case Manager, Gray Faupel, may sign and submit
the voucher.
8.5 Describe agency procedures for making and documenting utility assistance
guarantees consistent with the criteria below:
8.5.1 Crisis assistance is provided within 48 hours after a household applies, if the
household is eligible for such assistance;
It is our policy to make guarantees immediately upon completion of the application
with the understanding that the guarantee must be completed no later than 48
hours. Staff has an excellent working relationship with the vendors. We work well
with our vender and make special circumstances a priority in the event of crisis
situation.
8.5.2 Crisis assistance is provided within 18 hours after a household applies, if a
life-threatening situation exists and the household is determined eligible for
such assistance.
(If a utility vendor agrees to wait for payment or accepts a guarantee, this will address
the criteria above. Documentation of arrangement or guarantee is required.)
In the event of a life-threatening situation and the client qualifies for the programs
avsilable, the client will be given first priority and a guarantee will be made
immediately upon completion of the application. Staff has an excellent working
relationship with the vendors we work with and special circumstances are honored
in the event of crisis situation.
8.6 Describe agency process or procedure for the provision of energy conservation
education to all applicants receiving utility assistance.
It is standard procedure for all staff to provide energy education to all clients
applying for utility assistance. This information is not limited to energy clients and
staff is encouraged to share this vital information with all clients. As part of an
ongoing education energy education is presented to the elderly at the senior center
annually. The energy information provided by staff is from the Energy Saver Tip
Pamphlet.
8.7 Describe agency process to ensure all clients receive energy education, and that at
least 50% of clients receiving LIHEAP-funded utility assistance receive targeted
energy-saving activities education, an Energy Savers Brochure, and is documented as
required in the HSD Online Client Data System.
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Section III Work Statement Page 10
One hundred percent of clients applying for energy assistance receive a copy of the
Energy Saver Tip Pamphlet. Energy education (EEO) is documented in the
MCHSD Online database in the client file.
9.0 INFORMATION & REFERRAL:
9.1 Describe agency process or procedure for providing community information and
referral to clients, facilitating or coordinating those referrals with agencies, and
documenting, as appropriate and required, in the HSD Online Client Data System.
Staff has a wide data base of services they are informed about. Staff provides this
information and makes referrals to/for clients as a need is identified. All referrals
are entered into the HSD Online database.
9.2 Describe agency process or procedure for the referral, via application, of individuals
to the weatherization program and the repair/replacement of utility-related
appliances program and for obtaining all required client verification and
documentation.
A Weatherization application is only taken when the client produces the proper
verifications and documentation required by MCHSD. The application is entered
into the HSD Online data base and the application is sent to MCHSD within the 5
days required.
9. 3 Describe agency process or procedure for the enrollment of eligible individuals in
appropriate utility and telephone discount programs, such as the Telephone
Assistance Program (TAP), Southwest Gas Discount Program (LIRA), APS E-3
Discount Program, SRP Economy Price Plan Discount and the Lifeline Telephone
Assistance Program.
As an ongoing outreach to assist the client, staff offers all clients applying for
electric assistance energy saving tips and signs them up for the E-3 utility discount
program. Clients that have Southwest Gas are offered discount application
opportunity through LIRA. Clients that are experiencing issues with their health
are informed about TAP.
9.4 Describe agency process for assisting individuals with completion of forms for
federal and state social service programs such as AHCCCS or SNAP (supplemental
nutrition assistance program, formerly food stamps).
The Gila Bend CAP is now located at the Cate First Gila Bend Resource Center for
purpose of rental and utility assistance. Helping Families In Need (HFIN) is a Sub-
Contractor for First Things First who is one of our funders at the Resource Center.
HFIN is housed at the Resource Center with CAP. All individuals seeking
assistance AHCCCS, SNAP and/or CA are referred to HFIN. HFIN has access to
an online database in order to assist in the application process for these DES
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Section III Work Statement Page 11
programs. For the Buckeye area, staff makes referrals directly to the Buckeye DES
Office.
10.0 MATERIALS/SERVICES PROVIDED BY MCHSD:
10.1 Maticopa County Human Services Department/ Community Services Division Polig & Procedure
Handbook.
10.2 HSD Online Client Data System.
10.3 Training and technical assistance on:
• MCHSD funded crisis case management and financial assistance services
• Use of the HSD Online Client Data System
• Required Reports and Forms
10.4 Fiscal monitoring, program monitoring and client file review.
10.5 MCHSD Financial Assistance Vouchers.
10.6 Other forms as necessary.
11.0 REPORTING REQUIREMENTS:
MCHSD reserves the right to add, remove, or revise reporting requirements at its discretion.
Contractor shall submit the following to MCHSD/CSD:
11.1 Results Oriented Management and Accountability (ROMA) data and/or reports no
later than the 10th business day after the end of each quarter of the fiscal year.
11.2 Annual Leveraging Report no later than 45 days after the end of the contract year.
The report is to include agency funding and amounts received by agency from
entities other than Maricopa County Human Services Department that support
administration and operating costs of the Contractor, including the value of in-kind
contributions.
11.3 Submit other reports as required by MCHSD.
11.4 Reports will be submitted to:
Maricopa County Human Services Department
Community Services Division
234 N. Central Avenue, Suite 3000
Phoenix, AZ 85004
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Section IV Compensation Page 1
A. COMPENSATION
Subject to the availability and authorization of funds for the explicit purposes set forth in this
Agreement, County shall pay the Contractor compensation for services rendered.
B. REIMBURSEMENT
1. Effective July 1, 2013 through June 30, 2014, Contractor shall be reimbursed as set forth under
this Agreement.
2. During the term of this Agreement, the maximum amount of compensation due to the
Contractor from the County, for any and all services performed by the Contractor for the
obligations and duties herein, shall not exceed the amount(s) in Attachment A.
C. METHOD OF PAYMENT
Subject to receipt of a proper invoice and upon approval by the County during the term of this
Agreement, County shall pay the Contractor no more than monthly and based on performance of
the duties described herein by the Contractor as follows:
1. Subject to the availability of funds, the Department shall reimburse the Contractor for all
allowable costs associated with the performance of work and the provision of services under
this Agreement. Reimbursement for this Contract shall be limited to the total amount of the
Contract award and per Attachment A.
2. On or before the tenth (10`h) working day of the month following a month of service delivery
by the Contractor, the Contractor shall submit to the MCHSD Community Services Division,
a Financial Claim Form (Claim) as the Contractor's invoice for allowable costs incurred during
the billing period. A template Claim form shall be provided by the MCHSD/CSD to the
Contractor for its use. Sufficient backup shall also be attached to this Claim, such as a General
Ledger excerpt or detailed Expenditure Report, with the included charges circled or
highlighted.
The Financial Claim and backup will be submitted to MCHSD/CSD before payment(s) can be
made by the County as provided for under this Agreement.
3. Provided that the maximum reimbursable amount is not exceeded, the Contractor may deviate,
plus or minus 10% from the amounts identified in the Contract itemized service budget
category subtotals.
4. Changes exceeding the above stated deviation from itemized service budget category subtotals
will require a Change Order as specified in Special Provisions' Section F, Changes Originated
by the Department clause, or a formal Amendment, as specified in General Provisions' Section
D, Amendments, of this Agreement.
•
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Section IV Compensation Page 2
5. Should the MCHSD Community Services Division make a disallowance in the claim, the claim
shall be processed for the reduced amount. If the Contractor protests the amount or the
reasons for a disallowance, the protest shall be construed as a dispute concerning a question of
fact within the meaning of General Provisions' Section I, Disputes, of this Agreement.
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Section IV Compensation Page 3
Insert Attachment A, Operating Budget here
Maricopa County Human Services Department I

Areas 80,394.00 80,394.00 80,091.00 303.00 80,394.00
SFY14 Service
for
BUDGET Community to:
2014 Services Services. limited
30, Buckeye not
OPERATING June and are
- 2013 to Bend Assistance basis but
A 1, Gila Services Department/Financial include, CSBG
July for Financial monthly may and
ATTACHMENT Bend and Supplies/Operating on a utilized Funds
MCHSD of Gila internally Services funds
- Town Management & Human County
Budget Case Revenues / ERE Travel/Materials Expenses allocated availability, LIHEAP,
Operating Crisis Sources MCHSD* Total Categories Personnel Total will be County fund
CONTRACTOR: Maricopa on TANF,
Contract Service: Revenue Budget *Funding Based SSBG,
by

Section IV C omaensation
---- -
TOWN OF GILA BEND SERVICE BUDGET
CONTRACT SERVICE: Crisis Case Management and Financial Assistance Services
CONTRACT PERIOD: 7/0112013 to 613012014
PROVIDER NAME: Town of Gila Bend for Gila Bend Community Service Area
RCS ---- Rate Chargeable to Service
I PERSONNEL ,
TOTAL
Positio PTE Level
n TOTAL TOTAL salary for for
Numb FTE Period Contract Cost of Contract
er Level Position Title 7/1/13 - 6/30/2014 Service TOTAL COST for Service to Other Proposed Cost
1 1.00 Executive Director $63,876.33 0.33 Contract Service Resources to MCHSD
2 1.00 CASE MANAGER $32,611.86 1.00 $21,079 $0 $21,079
3 1.00 Trans./Food Prog. Coord $28,210.00 0.20 $32,612 $0 $32,612
$5,642 $0 $5,642
Total FTE's dedicated to this contract: 1.53 TOTAL: $59,333
$0 $59,333
II EMPLOYEE RELATED EXPENSES
ITEM BASIS TOTAL COST MCHSD COST
Average Fringe
Various Fringe Benefits Rate Percentage
$20,758 $0 $20,758
34.9850%
TOTAL: $20,758 $0 $20,758
III PROFESSIONAL AND OUTSIDE SERVICES
ITEM BASIS TOTAL COST MCHSD COST
TOTAL: $0 $0 $0
IV TRAVEL
ITEM BASIS TOTAL COST MCHSD COST
Conferences, Training Based on past history $1,750 $1,750
Fuel Costs Actual Fuel Costs $0
Vehicle Maintenance & Repairs Actual Repairs $7,345 $7,345 $0
$2,300 $2,300 $0
V SPACE TOTAL: $11,395 $11,395 $0
ITEM BASIS TOTAL COST MCHSD
COST.
In Kind Office Space Building - based on actual cost $17,600
Public Liability Insurance $17,600 $0
UtIlties/ Gas and Electric $9,000 $9,000
Maint of equipment or repair $6,000 $6,000
$1,750 $1,750
TOTAL: $34,350 $34,350 $0
VI MATERIALS AND SUPPLIES
ITEM BASIS TOTAL COST MCHSD COST
Operational Materials & Supplies
$3,000 $3,000 $0
TOTAL: $3,000 $3,000 $0
VI/ OPERATING SERVICES
ITEM BASIS TOTAL COST MCHSD COST
Telephone
Other services and charges $4,000 $3,697 $303
$6,000 $6,000 $0
TOTAL: $10,000 $9,697 $303
, 1 ,61, 1141. %.01.142.1 It r"r 1.110/POW61
Contract Other Cost to
Service Resources MCHSD
Inn IDTAL Costs per Column: $138,836 i $58,442 I $80,394 1
Total of Other Total Proposed
Resources Cost to
Revenue Revenue(s) MCI-ISO
MCHSD (proposed) IIIE.80 394
Town of Gila Bend $58,442
IX TOTAL REVENUES: 1 8, 5 442 0, 94

CONTRACTOR HOURS OF OPERATION & SERVICE AREA
Maricopa County
Human Services Department
Maricopa County Human Services Department

1 as and 4
Area B-1, area as B-2
COMMUNITY Day
Service Service Day Day
THE AREA Attachment Attachment Veteran's Thanksgiving Christmas
1 OF SERVICE Community map Community map El El
Page
DESCRIPTION in in
Bend
Gila indicated Buckeye indicated
indicated.
B
operation OPERATION of —
Area ATTACHMENT hours of OF p.m. p.m. Wednesday a.m. p.m.
the 8:30
Service during HOURS thru a.m.-4:30 thru a.m.-4:30 4th — thtu a.m.-6:00 Day Christmas
and — & & 3'd month p.m. holiday): Day
CHART available DAYS Monday Friday 8:00 Monday Friday 8:00 , 2nd each 4:00 Monday Thursday 7:00 Independence Day Before
Operation be applicable Memorial Labor Day
and will SUB N/A for El El El
of LOCATION below box
Hours (darken
specified SERVICE(S) Management Assistance Management Assistance Management Assistance
below
contractor FACILITY locations marked Day
CONTRACT Case Financial Case Financial Case Financial
facilities and Crisis and Services Crisis and Services Crisis and Services holidays President's
the those E/
at AND BE on
V only PHONE WILL Center be open Department
delivered not Birthday
Section be ADDRESS, SERVICE(S) Resource 85337 Center 85337 Center will JR's Services
shall PROVIDED Location(s)/Office(s) 85326 faxes: phone Office 85337 above Day King HOLIDAYS: Thanksgiving Human
Services FACILITY, WHERE Bend St. Arizona Community Arizona Community Ave. Arizona and fax Bend St. Arizona phone fax listed Year's Luther After County
Contract OF NO. Gila Pima Euclid Centre calls 683-6502 683-6511 Gila Pima 683-2255 683-6430 facility(s) New Martin OTHER Day
NAME FAX Service l't E. Bend, Bend N. Bend, Buckeye E. Buckeye, phone Administrative of W. Bend, The El El Maricopa
Care 303 Gila Gila 202 Gila 201 All (928) (928) Town 640 Gila (928) (928)

Area
Service
and
Operation
of
Hours
Contractor
Department
Services
Human
County
Maricopa

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