TOWN OF GUADALUPE FINAL SFY14 IGA.DOCX

INTERGOVERNMENTAL AGREEMENT
BETWEEN
MARICOPA COUNTY
ADMINISTERED BY ITS
HUMAN SERVICES DEPARTMENT
AND
TOWN OF GUADALUPE
Contract Amount: $20,000.00
Contract Start Date: July 1, 2013
Contract Termination Date: June 30, 2014
Contract Number:
______________________________________________________________________________
This Contract for Services Agreement (“Agreement”) is entered into by and between
Town of Guadalupe, (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 §11-952 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 Parties 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: Community Service Area Map
_____________________________________________________________________________
Contractor Representative: xxxxxx
Phone: xxxxxxx
Address: 9241 South Avenida del Yaqui, Guadalupe, AZ 85283
E-Mail: xxxxxxxxx
Maricopa County: Margarita Leyvas, Assistant Director
Phone: 602-506-5911
Address: 234 North Central, Suite 3000, Phoenix, AZ 85004
E-Mail: leyvasm@mail.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 a 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: Approved By:
TOWN OF GUADALUPE MARICOPA COUNTY
______________________________________ _____________________________________
Mayor Chairman, Board of Supervisors
______________________________________ _____________________________________
DATE DATE
Attested to: Attested to:
______________________________ _______________________________
Town Clerk Clerk, Board of Supervisors
_____________________________________ ________________________________________
DATE DATE
IN ACCORDANCE WITH A.R.S. §§ 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 ARIZONA.
APPROVED AS TO FORM: APPROVED AS TO FORM:
_____________________________________ _________________________________________________
Town Attorney Deputy County Attorney

______________________________________ ___________________________________________________
DATE DATE
SECTION I
GENERAL PROVISIONS
Maricopa County
Human Services Department


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. Assistant Director means the Director of the Community Services Division
of the Human Services Department.
3. Board of Supervisors means the Maricopa County Board of Supervisors.
4. Contract Administrator means the person administering this Agreement on
behalf of the Department.
5. Contractor means the person, firm or organization listed on the Cover Page
of this Agreement.
Maricopa County Human Services Department

Section I General Provisions Page 2
6. 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.
7. County means Maricopa County, a political subdivision of the State of
Arizona.
8. Department means the Maricopa County Human Services Department.
9. Director means the Director of the Maricopa County Human Services
Department.
10. Division means the Community Services Division of the Maricopa County
Human Services Department.
11. 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.
12. Juvenile means any person under the age of eighteen (18).
13. 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.
14. Performance Bond means a bond executed to secure fulfillment of all of the
Contractor's obligations under this Agreement.
15. Program Manager means the Assistant Director of the Community Services
Division of the Maricopa County Human Services Department.
Maricopa County Human Services Department

Section I General Provisions Page 3
16. Provider means the Contractor and any Subcontractor providing services
under this Agreement.
17. Public Agency has the meaning prescribed by A.R.S. § 11-951.
18. 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.
19. 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.
20. Subrecipient means the Contractor when the County is the recipient of
HUD grant funding.
21. Work Statement means Section III of this Agreement which describes the
services to be delivered under this Agreement.
C. GENERAL REQUIREMENTS
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 unemploy-
ment insurance, disability insurance, and workers’ compensation.
Maricopa County Human Services Department

Section I General Provisions Page 4
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.
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
Maricopa County Human Services Department

Section I General Provisions Page 5
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
Maricopa County Human Services Department

Section I General Provisions Page 6
(120) days, shall be submitted in accordance with the following dispute
resolution process.
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 right 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
Maricopa County Human Services Department

Section I General Provisions Page 7
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.
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
Maricopa County Human Services Department

Section I General Provisions Page 8
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 “Indemnitee”) 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.
O. 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
Maricopa County Human Services Department

Section I General Provisions Page 9
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 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 require immediate repayment of the
disallowed amount by the Contractor issuing a check payable to the County.
R. STAFF AND VOLUNTEER TRAINING
Maricopa County Human Services Department

Section I General Provisions Page 10
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. §§ 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 cooperative agreement, the Contractor shall
complete and submit OMB Form-LLL, titled "Disclosure of Lobbying
Activities," in accordance with its instructions and 31 U.S.C. § 1352.
U. RELIGIOUS ACTIVITIES
Maricopa County Human Services Department

Section I General Provisions Page 11
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
Maricopa County Human Services Department

Section I General Provisions Page 12
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 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
Maricopa County Human Services Department

Section I General Provisions Page 13
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. §§ 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
Maricopa County Human Services Department

Section I General Provisions Page 14
information that is paid for in whole or in part with funds received by Contractor
under this Agreement.
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 required 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
Maricopa County Human Services Department

Section I General Provisions Page 15
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
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.
Maricopa County Human Services Department

Section I General Provisions Page 16
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 U.S.C. §§ 12101, et seq.);
and Arizona Executive Order 2009-09, which mandates that all persons shall have
equal access to employment opportunities.
KK. FINANCIAL MANAGEMENT
Contractor shall establish and maintain a separate, interest-bearing 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
Maricopa County Human Services Department

Section I General Provisions Page 17
under this Agreement. No part of the money deposited in the bank 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.
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
Maricopa County Human Services Department

Section I General Provisions Page 18
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.
Maricopa County Human Services Department

Section I General Provisions Page 19
4. If Contractor is a Public Agency, Contractor's own bidding procedures shall
govern.
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.
OO. 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 title 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.
§§ 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.
Maricopa County Human Services Department

Section I General Provisions Page 20
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 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:
Maricopa County Human Services Department

Section I General Provisions Page 21
1. Are not presently debarred, suspended, proposed for debarment, declared
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
voluntarily excluded from participation. The Department may pursue
available remedies in the event of such occurrence, including immediate
termination of this Agreement without liability.
Maricopa County Human Services Department

Section I General Provisions Page 22
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.
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 seq.)
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 (I-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. I-
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:
Maricopa County Human Services Department

Section I General Provisions Page 23
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 A.R.S. §§ 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 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.
Maricopa County Human Services Department

SECTION II
SPECIAL PROVISIONS
Maricopa County
Human Services Department
Maricopa County Human Services Department

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 Guadalupe 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 Department.
g. CSD – means Community Services Division of Maricopa 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
j. 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.
Maricopa County Human Services Department

Section II Special Provisions Page 2
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:
J. TERMINATION
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 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
Maricopa County Human Services Department

Section II Special Provisions Page 3
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 or email:
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 and through
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.
Maricopa County Human Services Department

Section II Special Provisions Page 4
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:
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
To the extent permitted by law, 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
Maricopa County Human Services Department

Section II Special Provisions Page 5
conform to any federal, state or local law, statute, ordinance, rule, regulation or
court decree. It is the specific intention of the Parties 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
Policy shall include bodily injury, property damage, personal injury
and broad form contractual liability.
Maricopa County Human Services Department

Section II Special Provisions Page 6
 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".
ii. 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.
Maricopa County Human Services Department

Section II Special Provisions Page 7
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".
ii. 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.
c. Worker's Compensation and Employers' Liability
Workers' Compensation Statutory
Employers' Liability
Each Accident
$1,000,000
Disease – Each Employee
$1,000,000
Disease – Policy Limit
$1,000,000
i. Policy shall contain a waiver of subrogation against
Maricopa County and the State of Arizona, their
departments, agencies, boards, commissions, and their
Maricopa County Human Services Department

Section II Special Provisions Page 8
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.
Maricopa County Human Services Department

Section II Special Provisions Page 9
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.
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.
Maricopa County Human Services Department

Section II Special Provisions Page 10
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.
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
Maricopa County Human Services Department

Section II Special Provisions Page 11
discretion of the County, provide a certificate of self-insurance to the Contractor
and may be provided to the County upon request.
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. § 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
Maricopa County Human Services Department

Section II Special Provisions Page 12
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 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.
Maricopa County Human Services Department

Section II Special Provisions Page 13
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. § 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
Maricopa County Human Services Department

Section II Special Provisions Page 14
fingerprint clearance card.
4. Should a staff’s 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:
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
Maricopa County Human Services Department

Section II Special Provisions Page 15
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.
O. ALLOCATION OF FUNDING
Should additional funds become available during the term of the contract period,
the Department reserves the right 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. Annually, contractors will
be required to submit an inventory of all county provided hardware and software to
the MCHSD Community Services Division Assistant Director.
Maricopa County Human Services Department

Section II Special Provisions Page 16
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 REQUIREMENTS
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 10th 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
Maricopa County Human Services Department

Section II Special Provisions Page 17
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.
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
Maricopa County Human Services Department

Section II Special Provisions Page 18
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..
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
Maricopa County Human Services Department

Section II Special Provisions Page 19
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:
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).
Maricopa County Human Services Department

Section II Special Provisions Page 20
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 of such costs to
the Contractor; see the “Unallowable Costs” clause of these Special
Provisions.
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.
Maricopa County Human Services Department

Section II Special Provisions Page 21
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.
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
Maricopa County Human Services Department

Section II Special Provisions Page 22
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.
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. §38-502 as may be amended.
DD. SAFEGUARDING OF PARTICIPANT INFORMATION
Maricopa County Human Services Department

Section II Special Provisions Page 23
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.
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.
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.
FF. TERMINATION
1. Each Party may cancel this Agreement in accordance with the provisions of
A.R.S. § 38-511.
Maricopa County Human Services Department

Section II Special Provisions Page 24
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.
Maricopa County Human Services Department

SECTION III
WORK STATEMENT
Maricopa County
Human Services Department
Maricopa County Human Services Department

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 Contractors will comply with all federal, state and county regulations
related to specific funding sources used. Additionally, all contractors will
comply with the Maricopa County Human Services
Maricopa County Human Services Department

Section III Work Statement Page 2
Department/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
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.
Maricopa County Human Services Department

Section III Work Statement Page 3
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/Weatherization (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 County Human Services Department/Community Services
Division Policy & 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
Maricopa 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
Maricopa County Human Services Department

Section III Work Statement Page 4
vendors (i.e. utility companies, landlords, mortgage companies, etc.) upon
authorization by MCHSD.
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 5th
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.
Maricopa County Human Services Department

Section III Work Statement Page 5
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 weatherization, 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.
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.
Maricopa County Human Services Department

Section III Work Statement Page 6
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 ADMINISTRATIVE:
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.
The Guadalupe CAP staff is trained annually on the Client Confidentiality
Policy and Procedures, and documentation of training is placed in the
employee file.
6.2 Describe the agency’s training of staff and volunteers in regards to the
agency grievance/problem solving procedures of the agency.
The Guadalupe CAP staff is trained annually on the Grievance Policy &
Procedures. This training is documented in the employee’s file.
Volunteers are also trained and informed on the policy and procedures
which are posted in a visible area for all volunteers and clients to view.
Maricopa County Human Services Department

Section III Work Statement Page 7
6.3 Describe the training of staff on the agency’s non-discrimination policy.
Upon hire, each Town of Guadalupe employee reviews, signs and receives
a copy of the acknowledgement of Discrimination Policy. The
acknowledgement is filed in each employees file. Staff reviews the policy
annually.
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.
To ensure access to Town of Guadalupe CAP services, home visits are
made to homebound or disabled individuals. For those with vision
challenges, all information and documents are read aloud to the
individual. For the hearing impaired, all communication is in writing.
Accommodations are also made using outside resources to assist persons
with disabilities. The CAP office is physically accessible to persons in
wheelchairs and to those who use mobile devices. Handicapped bathroom
facilities are available to persons who are physically disabled.
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.
Maricopa County Human Services Department

Section III Work Statement Page 8
The Guadalupe CAP provides all resources to non-English speaking
individuals in Spanish through brochures, and one-on-one translation.
The hearing and vision impaired will be referred and assisted in
contacting the TDD line to accommodate those clients with disabilities.
Spanish and English are the primary languages within the Guadalupe
community. The Yaqui language is spoken by many clients, but most also
speak Spanish and/or English. If a Yaqui interpreter is needed the
Director is fluent in Yaqui and will assist those clients.
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.
The CAP receives support from the Town of Guadalupe for operating and
administration of the CAP office. The cash support includes operating
expenses of $66,954.00 and in-kind support for office space in the amount
of $24,000.
ENTITY FUNDING IN-KIND IN-KIND TYPE
AMOUNT $ VALUE
Town of Guadalupe $ 66,954.00 $
Town of Guadalupe $ $24,000.00 Office Space
$ $
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.
Maricopa County Human Services Department

Section III Work Statement Page 9
All agency staff and /or volunteers must have background checks
completed through Central Registry prior to hire. Once background
checks results have returned satisfactorily through Central Registry, new
staff and volunteers may provide direct services to clients.
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.
Clients who are in a crisis, whether it be utility shut-off, rental eviction or
homelessness are assisted on a priority basis. They will be taken as a walk-in, or
scheduled that same day they call for assistance. To ensure they receive services
in a timely manner their case is handled before a non-crisis case.
7.2 Describe how the agency accommodates clients who require an
appointment outside of regular business hours.
Appointments are scheduled outside of normal business hours for clients who are
not at all able to attend an appointment during normal business hours.
7.3 Describe how agency ensures program access for persons who are
homebound.
Accommodations are made for persons who are homebound. CAP staff will visit
the client at their home to offer CAP services.
Maricopa County Human Services Department

Section III Work Statement Page 10
7.4 Describe the services in place to assist individuals when MCHSD financial
assistance service funds have been depleted.
Referrals are made to various agencies: Salvation Army, Local Churches, St.
Vincent de Paul and Pascua Yaqui Tribe for tribal members.
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.
Client information is documented by the Director and case manager after
completing an application or assisting a client with other services. Any time
spent serving the client is also documented. All information is first documented
into their physical file and then entered into the HSD online Client Data System.
7.6 Describe agency process and procedures for obtaining and retaining all
required client verification and documentation in client file.
When a client application is taken all verification and documentation is required
at first hand. Copies are made of all the documentation of verification provided
by the client. Retention of all documentation is kept in client file for six years.
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
Maricopa County Human Services Department

Section III Work Statement Page 11
solving procedures, including the provision to each client the
approval/denial/appeal for services form provided by MCHSD.
All clients are given and required to sign at the time of an application intake a
designated notice of all rights and responsibilities. It is handed to the client
before the start of the intake process. They are also given a copy of the
Grievance/problem solving procedures and approval/denial/appeal for services.
If they do not understand any part of the forms it is explained in more depth by
the Director or case manager.
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.
CAP Director and Case Manager review all applications before submitting the
final processed application to MCHSD. CAP reviews all applications for quality
assurance and that all required information is included and is correctly entered
into the HSD On-line data system. The applications are submitted within 5
working days from the date of the application intake.
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.
CAP Director and Case Manager process all clarification, corrections and data
entry errors within 3 days of notification from MCHSD. Both CAP Director and
Case Manager are responsible for responding to these requests.
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
Maricopa County Human Services Department

Section III Work Statement Page 12
kept secure. The agency shall determine which staff is authorized to sign
completed vouchers, and provide MCHSD with the list of authorized staff,
and update as needed.
After an application for services is completed and the client is determined
eligible for assistance per the fund sourced used. CAP staff will contact the land
lord or mortgage company to verify that a financial assistance voucher will be
accepted for the amount of assistance available and that this will avert the
eviction/foreclosure. If accepted by the landlord/mortgage company, a voucher
is issued by the CAP Director. The policy and procedure regarding MCHSD
financial assistance vouchers used per the MCHSD/CSD Program Policy and
Procedure Handbook. The CAP Director and Case Manager are the only persons
authorized to sign financial assistance vouchers. Vouchers are kept in a secured
locked drawer in a locked office. If there are changes to a voucher that has been
issued, including cancellation, CAP staff will notify MCHSD staff immediately.
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;
After an application is taken and a client is determined eligible for utility
assistance, CAP staff makes an immediate guarantee by telephone with the
appropriate utility company or vendor. Guarantees are noted in each client’s file.
The CAP Director ensures that the process is followed for each utility assistance
payment.
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.)
Maricopa County Human Services Department

Section III Work Statement Page 13
After an application is taken and the client is determined eligible for utility
assistance, CAP staff makes an immediate guarantee by telephone with the
appropriate utility company or vendor. Guarantees are also noted in each
client’s file. The CAP Director ensures that this process is followed.
8.6 Describe agency process or procedure for the provision of energy
conservation education to all applicants receiving utility assistance.
CAP staff provides all clients with energy education brochures or material at
application intake for any services, including utility assistance. CAP staff
reviews the brochures or material with the client. Energy education material is
available to the general public and provided to all who enter the CAP office. In
addition, CAP staff assists eligible clients in applying for or renewing their
utility discount program enrollment.
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.
CAP staff provides LIHEAP-eligible clients with an ENERGY SAVERS
brochure, providing targeted energy savings activities education to at least 50%
of all LIHEAP recipients. CAP staff reviews the material with the client, and
shares how they can request additional information on energy usage and saving
tips from other sources including the utility companies. Clients who receive this
targeted energy-saving activities education and ENERGY SAVERS brochure are
documented using Service Code EEO in the HSD online date system.
9.0 INFORMATION & REFERRAL:
Maricopa County Human Services Department

Section III Work Statement Page 14
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.
The Guadalupe CAP has strong working relationships with service organizations
in our area. To keep informed of referral sources and availability of funds, CAP
staff attends local and other meetings of service providers. CAP staff also uses
the Directory of Human services and Self-Help Support Groups. Information on
resources that can be used for Guadalupe residents are kept in a resource file that
is shared among the CAP staff and volunteers.
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.
During application intake for all services, including utility assistance, CAP staff
explores the needs for home weatherization and /or repair/replacement services
with the individual applying for services. If there is a need for these services, a
referral is made to MCHSD/CSD. MCHSD/CSD staff determines application
eligibility for weatherization and repair/replacement.
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.
All CAP clients, regardless of receipt of direct financial assistance services, are
enrolled in appropriate utility and phone discount programs available to Town of
Guadalupe residents. The discount programs include the Telephone Assistance
Program (TAP), the Southwest Gas Discount Program (LIRA), the SRP
Economy Price Plan Discount and Lifeline Phone Assistance Program. CAP
Maricopa County Human Services Department

Section III Work Statement Page 15
staff may complete these applications for the clients if they are unable to
complete them on their own. These discount applications are available to the
general public and provided to all who enter the CAP office. Assistance with the
applications is provided upon request. Those clients who return to the office for
utility assistance are assisted with renewal of discount utility or telephone
programs if needed.
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).
Clients, and any resident of Guadalupe, are assisted with completion of the
applications and forms for Kids CARE, Social Security, Supplemental Security
Income, Food Stamps, Veterans Administration, Housing programs, and other
necessary forms to apply for services. Persons seeking this type of assistance are
given appointments.
10.0 MATERIALS/SERVICES PROVIDED BY MCHSD:
10.1 Maricopa County Human Services Department/Community Services
Division Policy & 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.
Maricopa County Human Services Department

Section III Work Statement Page 16
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
Maricopa County Human Services Department

SECTION IV
COMPENSATION
Maricopa County
Human Services
Maricopa County Human Services Department

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 (10th) 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
Maricopa County Human Services Department

Section IV Compensation Page 2
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.
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.
Maricopa County Human Services Department

Section IV Compensation Page 3
ATTACHMENT A - OPERATING BUDGET for SFY14
Contract Operating Budget - MCHSD July 1, 2013 to June 30, 2014
CONTRACTOR: Town of Guadalupe
Maricopa County Human Services Department

Section IV Compensation Page 4
Service: Crisis Case Management and Financial Assistance Services
Revenue Sources
MCHSD* 20,000.00
Total Revenues 20,000.00
Budget Categories
Personnel / ERE 20,000.00
Travel/Materials & Supplies/Operating Services 0
Total Expenses 20,000.00
*Funding will be allocated internally on a monthly basis
by Maricopa County Human Services Department/Financial Services.
Based on fund availability, funds utilized may include, but are not limited to:
SSBG, TANF, LIHEAP, County Funds and CSBG
Maricopa County Human Services Department

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

Maricopa County Human Services Department

Section V Contractor Hours of Operation and Service Area Page 1
FACILITY LOCATION CHART – ATTACHMENT B
Contract Services shall be delivered only at the facilities and locations specified below and will be available during the hours of operation indicated.
NAME OF FACILITY, ADDRESS, PHONE AND FAX DAYS & HOURS OF DESCRIPTION OF THE COMMUNITY SERVICE
CONTRACT SERVICE(S) SUB
NO. WHERE SERVICE(S) WILL BE PROVIDED OPERATION AREA
Service Location(s)/Office(s) Crisis Case Management Mondays 7:30am-
Guadalupe Community Service
and Financial Assistance N/A 5:30pm
Tuesdays 7am- Area as indicated in map
Guadalupe CAP Services
5pm Attachment B-1
9241 S. Avenida del Yaqui
Wednesdays
Guadalupe, AZ 85283
7:30am-5:30pm
Phone: 480-730-3093
Thursdays 7am-
FAX: 480-505-5383
5pm
Administrative Office
Town of Guadalupe
9241 S. Avenida del Yaqui
Guadalupe, AZ 85283
Phone: 480-730-3080
FAX: 480-505-5368
Maricopa County Human Services Department

Section V Contractor Hours of Operation and Service Area Page 2
The facility(s) listed above will not be open on those holidays marked below (darken box for applicable holiday):
New Year’s Day Washington’s birthday Memorial Day Rosh Hashanah Veteran’s Day
Martin Luther King JR’s President’s Day Independence Day Yom Kippur Thanksgiving
Birthday Day
Lincoln’s birthday Good Friday Labor Day Columbus Day Christmas Day
OTHER HOLIDAYS:
Day After Thanksgiving Floating Holiday – Day Before Christmas Cesar Chavez’s
Day
(specify) (specify)
Maricopa County Human Services Department