Loading...
HomeMy WebLinkAboutSanta Clara County - Probation Department - 2017 AgreementDocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 '.; COUNTY OF SANTA CLARA �j � �'�� � SERVICE AGREEMENT SECTION I GENERAL INFORMATION Contractor Name: End Date: 06/30/2020 (As Displayed In SAP) City of Gilroy Purchase Order Number: 4400007226 Agency /Department. Name: Probation Department Department 0246 Account Number: Ledger Support youth and families who reside in East Gilroy by providing after school and /or Amount pro - social activities, establishing resident leaders /a resident advisory group, coordinating Brief Description of Services: I community events, and implementing community action projects. 4) I REQ# 40024980 Maximum ,Fi- nandal Obligation The maximum amount payable to this Contractor under this agreement shall not exceed: $ 279,550.00 I Term of Agreement Start Date: 6/9/2017 End Date: 06/30/2020 Note: When left blank, start date will be the date executed by Authorized County Representative For County Use Only 1 General Cost Internal I Account Plant Ledger I Center Amount WBS j Order Assignment Number (Expense (Dept I (Capital Project Code) ( "PCA" code � Code) Code) I — optional) Line 1 H 0246 5255500 3704 I $22,000.00 j I 1 j 103033 Line ne 2 H 0246 5255500 1 3704 $85,850.00 j 103033 Line 3 H 0246 5255500 i 3704 $85,850.00 103033 I Line 4 H ' 0246 5255500 3704 $85,850.00 103033 1 r � i 5 Select iLine Revision Date - February2016 Page 1 of 13 DocuSign Envelope ID: 34969004-C7B1-4CB0-B5D0-EF67AF1E5C40 COUNTY OF SANTA CLARA a SERVICE AGREEMENT SECTION 11: PARTIES TO AGREEMENT Legal notices'and invoices pertaining to this Agreement shall be sent to the appropriate contact person listed below, except as otherwise specifically provided for herein. Notices shall be in writing and served . either by personal delivery or sent by certified or registered mail, postage prepaid, addressed as follows. Notice shall.be deemed effective on the date that the notice is personally delivered or, if mailed, three (3) days after deposit pinthemail. Either party may designate a-different person. and /or address for the receipt of notices by Sending written notice to the Other party, which shall not require an amendment to this Agreement Contractor Contractor Name City of Gilroy (As Displayed In SAP): Contact Person: Gabriel Gonzalez Street Address 7351 Rosanna Street City Gilroy State: I CA Zip: 95020 Telephone number (408) 846-0202 Email Address Gabe.Gonzalez@cityofgilroy.org .SCC Vendor Number: 1002322 (As Assigned in SAP) To be completed for Independent Contractors On - DO NOT COMPLETE FOR DEPENDENT CONTRACTORS County of Santa Clara Agency/Department: I Probation Department Program Manager/ Contract Monitor Name: Charmayne Moran Street Address: 840 Guadalupe Parkway City: I San Jose [State: CA i Zip: 95110 Telephone Number: (408) 278-6227 Fiscal Contact (Accounts Payable Contact): Lydia Ho Contract Preparer: Sashwat Singh Revision Date - February 2016 Page 2 of 13 DocuSign Envelope ID: 34969004- C761- 4C60- B5D0- EF67AF1E5C40 COUNTY OF SANTA CLARA SERVICE AGREEMENT SECTION III: CONTRACT AUTHORIZATION It is agreed between. County and Contractor that Contractor will, for the compensation described in this Agreement,. perform the work described in Section V in accordance with all terms and conditions of this Agreement including all exhibits and attachments. In addition, County and Contractor assert that the tax , withholding status and benefit documentation (Section IV) accurately reflect the anticipated working relationship between County and Contractor. Further, Independent Contractors shall comply with the County's insurance and indemnification requirements. Contractor certifies that any applicable insurance waiver information (Section VII, B) is true and correct. This Agreement may be executed in one or more counterparts, each of which will be considered an original, but all of which together- will constitute one and the same instrument. SIGNATURES Contract is not valid until signed by Contractor and County's Authorized Representative. I j County Agency /Department Date: 6/7/2017 Manager: l�°� 6/7/2017 I AFSt753BFDS0E455... County Agency /Department Fiscal �°ocusrobr. Officer: Date: seoazseesewaze... 000asigma by: Contractor: Date: 6/7/2017 e..- TILYLSa PoLse �t C Date: County Authorized Representative: 6/9/2017 30ME46F83MB... I (Procurement Department,• President, Board of Supervisors; or Delegated Authority) County Counsel: Date: i (Signature required when the Standard Provisions language (Section VI) is revised, or for IT Services pursuant to Board Policy 5.3.5.2 (4), or for Board approved contracts, or for contracts with Board delegated authority to agencies /departments.) Please note: Attachments or exhibits that include additional terms and conditions, conflict with the County's standard provisions or require risk assessment must be approved by County Counsel. Office of the County Executive: Date: (Signature required when Board approved contract by a delegation of authority) rAttest Clerk of the Board: I I Date; (Signature required when Board approved contract) I I Revision Date - February 2016 Page 3 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 7 COUNTY OF SANTA CLARA .� �? ,`. SERVICE AGREEMENT S'ECTI.ON IV: DETERMINATION OF RELATIONSHIP STATUS Dependent /Independent status is an important relationship distinction. It determines the contractor's eligibility for Medicare and Social Security, Public Employees' Retirement System benefits; and other benefits and affects. how the contractor files tax returns and the contractor's responsibility for various federal and state taxes. i Questionnaire to be Completed by Contracting Department to Determine Relationship Status of Contractor Supervision: Will the County have the right to tell the contractor how to do the work, when to arrive or leave work, or when to take breaks? Do you have other employees performing similar work with a similar degree of No supervision? If the answer to any of these questions is YES, select YES from the dropdown. Training: Will the County instruct the contractor on how to do the job or pay for external training? No Incomplete Work: Will the Contractor be able to resign or terminate the contract without being held either No financially or legally liable for unfinished work? Place of Work /Tools: Will the County provide the Contactor with a place to work at a County location and No tools to do the job, i.e. computers, telephones, etc? Length of Relationship: When the Contractor is hired to complete ongoing departmental duties or functions— answer YES. When the contractor is hired to complete a specific project that was not the No regular tasks performed by County employees before— answer NO. Other Customers: Does the County prevent the Contractor from performing similar services for other I No customers, either due to the amount of work (full -time), or by contractual provision? Designation as Business Entity: If the Contractor has a business license or business certificate, or is a corporation, nonprofit organization, or school district, select "No" from the dropdown. (This does not No pertain to professional licenses or certificates such as a license fora physician or architect.) Enter below the business license number and the city /entity where issued. Bus Lic. # Issued by: Payment Schedule: Will payments be made either as an hourly wage or as weekly /monthly salary? If payment is by commission or based on project milestones or deliverables, answer "NO" to this question. Be sure this answer matches the contract payment schedule in Section V. No Support Services: Will County employees or other independent contractors provide assistance to this No Contractor? Assistance is defined as clerical, technical or professional support. I Ifatleast 5 of the above questions were answered "NO,,. Contractor is an Independent Contractor. If 5 or more of the above questions were answered "YES" Contractor is a Dependent Contractor, where the relationship resembles that of employer /employee. Tax withholding is required and benefits are provided. Complete and attach the following forms: Employee's Withholding Allowance Certificate— Federal Form W -4, El Withholding, Form DE -4, Determining PERS Eligibility and PERS Member Action Request. Visit www.ceo for more information regarding Dependent Contractors. 'County insurance requirements dodo not apply to Dependent Contractors. Contractor understands and agrees that the tax withholding and benefit status checked above is correct. Any changes to the contractor's tax withholding and benefit status require a new contract. Contractor is responsible for any penalties and liabilities assessed by any taxing authority, based on a change of tax withholding and benefit status. Contractor's Initials: r Dept Fiscal Officer's Signature: �8aD0II5B800FD698... Revision Date - February 2016 Page 4 of 13 DocuSign Envelope ID: 34969004- C761- 4CB0- B5D0- EF67AF1E5C40 COUNTY OF SANTA CLARA `.r ` SERVICE AGREEMENT Revision Date - February 2016 Page 5 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1 E5C40 a COUNTY OF SANTA CLARA SERVICE AGREEMENT C. PERFORMANCE STANDARDS _ I I — ff I i i See Attachment: j incorporatedby this reference. PAYMENT SCHEDULE rDr Is contractor a Community Based Organization (CBO)? Notes: All reimbursements for travel shall comply with the current County Travel Policy r Yes ICI No I r I ■ Dependent contractors are not permitted to work in excess of 40 hours per week 1 i i i I I � Or ✓ See Attachment A incorporated by this reference. Revision Date - February 2016 Page 6 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 COUNTY OF SANTA CLARA ., '�`:4f ��s SERVICE AGREEMENT SECTION VI STANDARD PROVISIONS Changes to the terms and conditions in this section require approval of County Counsel A. ENTIRE AGREEMENT This Agreement and its Appendices (if any) constitutes the final, complete and exclusive statement of the terms of the agreement between the parties. It incorporates and supersedes all the agreements, covenants and understandings between the parties concerning the subject matter hereof, and all such agreements, covenants and understandings have been merged into this Agreement No prior or contemporaneous agreement or understanding, verbal or otherwise, of the parties or their agents shall be valid or enforceable unless embodied in this Agreement B. AMENDMENTS This agreement may only be amended by a written instrument signed by the Parties. C. CONFLICTS OF INTEREST Contractor shall comply, and require its subcontractors to comply, with all applicable (i) requirements governing avoidance of impermissible client conflicts; and (ii) federal, state and local conflict of interest laws and regulations including, without limitation, California Government Code section 1090 et seq., the California Political Reform Act (California Government Code section 87100 et seq.) and the regulations of the Fair Political Practices Commission concerning disclosure and disqualification (2 California Code of Regulations section 18700 et seq.). Failure to do so constitutes a material breach of this Agreement and is grounds for immediate termination of this Agreement by the County. In accepting this Agreement, Contractor covenants that it presently has no interest, and will not acquire any interes ;.direct or indirect, financial or otherwise, which would conflict in any manner or degree with the performance of this Agreement I Contractor further covenants that, in the performance of this Agreement, it will not employ any contractor or person having such an interest Contractor, including but not limited to contractor's employees and subcontractors; may be subject to the disclosure and disqualification provisions of the California Political Reform Act of 1974 (the "Act"), that (1) requires such persons to disclose economic interests that may foreseeably be materially affected by the work performed under this Agreement, and (2) prohibits such persons from making or participating in making decisions that will foreseeably financially affect such interests. If the disclosure provisions of the Political Reform Act are applicable to any individual providing service under this Agreement, Contractor shall, upon execution of this Agreement, provide the County with the names, description of individual I duties to be performed, and email addresses of all individuals, including but not limited to Contractor's employees, agents and subcontractors, that could be substantively involved in "making a governmental decision" or "serving in a staff capacity and in that capacity participating in making governmental decisions or performing duties that would be performed by an individual in a designated position," (2 CCR 18701(a)(2)), as part of Contractor's service to the County under this Agreement Contractor shall immediately notify the County of the names and email addresses of any additional individuals later assigned to provide such service to the County under this Agreement in such a capacity. Contractor shall immediately notify the iCounty of the names of individuals working in such a capacity who, during the course of the Agreement, end their service to the County. If the disclosure provisions of the Political Reform Act are applicable to any individual providing service under this Agreement, Contractor shall ensure that all such individuals identified pursuant to this section understand that they are subject to the Act and shall conform to all requirements of the Act and other laws and regulations listed in subsection (A) including, as required, filing of Statements of Economic Interests within 30 days of commencing service pursuant to this Agreement, annually by April 1, and within 30 days of their termination of service pursuant to this Agreement D. GOVERNING LAW, VENUE This Agreement has been executed and delivered in, and shall be construed and enforced in accordance with, the laws of the State of California. Proper venue for legal action regarding this Agreement shall be in the County of Santa Clara. E. ASSIGNMENT No assignment of this Agreement or of the rights and obligations hereunder shall be valid without the prior written consent of the other party. Revision Date - February 2016 Page 7 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 a COUNTY OF SANTA CLARA SERVICE AGREEMENT F. ASSIGNMENT OF CLAYTON ACT, CARTWRIGHT ACT CLAIMS Contractor assigns to the County all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the Contractor for sale to the County pursuant to this Agreement. G. WAIVER No delay or failure to require performance of any provision of this Agreement shall constitute a waiver of that provision as to that or any other instance. Any waiver granted by a party shall be in writing and shall apply to the specific instance expressly stated. H. NON- DISCRIMINATION ✓ Standard Non - Discrimination Language Contractor shall comply with all applicable Federal, State, and local laws and regulations including Santa Clara County's policies concerning nondiscrimination and equal opportunity in contracting. Such laws include but are not limited to the following: Title VII of the Civil Rights Act of 1964 as amended; Americans with Disabilities Act of 1990; The Rehabilitation Act of 1973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code sections 12900 et seq.); and California Labor Code sections 110.1 and 1102. Contractor shall not discriminate against any subcontractor, employee, or applicant for employment because of age, race, color, national origin, ancestry, religion, sex /gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital status in the recruitment; selection for training including apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or other forms of compensation. Nor shall Contractor discriminate in provision of services provided under this contract because of age, race, color, national origin, ancestry, religion, sex /gender, sexual orientation, mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital status. - OR - Alternate Non - Discrimination Language. Attached As Exhibit , incorporated by this reference. (Requires County Counsel Approval) I. TERMINATION ✓ Standard Termination Language I The County may, by written notice to Contractor, terminate all or part of this Agreement at any time for the convenience of the County. The notice shall specify the effective date and the scope of the termination. In the event of termination, Contractor shall deliver to County all documents prepared pursuant to the Agreement, whether complete or incomplete. Contractor may retain a copy for its records. Upon receipt of the documents, Contractor shall be compensated based on the completion of services provided, as solely and reasonably determined by County. -OR- A! Tarenm�finn i �nmaon A1+�r1�nA Ac Fvl�ii�it *oa L... N,; . �F�. �. (Requires County Counsel Approval) J. BUDGET CONTINGENCY This Agreement is contingent upon the appropriation of sufficient funding by the County for the services covered by this Agreement. If funding is reduced or deleted by the County for the services covered bythis Agreement, the -County has the option to either terminate this Agreement with no liability occurring to the County or to offer an amendment to this Agreement indicating the reduced amount. K. COUNTY NO- SMOKING POLICY Contractor and its employees, agents and subcontractors, shall comply with the County's No- Smoking Policy, as set forth in the Board of Supervisors Policy Manual section 3.47 (as amended from time to time), which prohibits smoking_(1) at the Revision Date - February 2016 Page 8 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1f5C40 a COUNTY OF SANTA CLARA SERVICE AGREEMENT Santa Clara Valley Medical Center Campus and all County-owned and operated health facilities, (2) within 30 feet surrounding County-owned buildings and leased buildings where the County is the sole occupant, and (3) in all County vehicles. L. FOOD AND BEVERAGE STANDARDS Except in the event of an emergency or medical necessity, the following nutritional standards shall apply to any foods and /or beverages purchased by Contractor with County funds for County- sponsored meetings or events. If food is to be provided, healthier food options shall be offered. "Healthier food options' include (1) fruits, vegetables, whole grains, and low fat and low calorie foods; (2) minimally processed foods without added sugar and with low sodium; (3) foods prepared using healthy cooking techniques; and (4) foods with less than 0.5 grams of trans fat per serving. Whenever possible, Contractor shall (1) offer seasonal and local produce; (2) serve fruit instead of sugary, high calorie desserts; (3) attempt to accommodate special, dietary and cultural needs; and (4) post nutritional information and /or a list of ingredients for items served. If meals are to be provided, a vegetarian option shall be provided, and the Contractor should consider providing a vegan option. If pre - packaged snack foods are provided, the items shall contain: (1) no more than 35% of calories from fat, unless the snack food items consist solely of nuts or seeds; (2) no more than 10% of calories from saturated fat, (3) zero trans fat, (4) no more than 35% of total weight from sugar and caloric sweeteners, except for fruits and vegetables with no added sweeteners or fats; and (5) no more than 360 mg of sodium per serving. If beverages are to be provided, beverages that meet the County's nutritional criteria are (1) water with no caloric j sweeteners; (2) unsweetened coffee or tea, provided that sugar and sugar substitutes may be provided as condiments; (3) unsweetened, unflavored, reduced fat (either nonfat or 1% low fat) dairy milk, (4) plant - derived milk (e.g., soy milk, rice milk, and almond milk) with no more than 130 calories per 8 ounce serving, (5) 100% fruit or vegetable juice (limited to a maximum of 8 ounces per container); and (6) other low - calorie beverages (including tea and /or diet soda) that do not exceed 40 calories per 8 ounce serving. Sugar- sweetened beverages shall not be provided. _ M. CONTRACTING PRINCIPLES All entities that contract with the County to provide services where the contract value is $100,000 or more per budget unit per fiscal year and /or as otherwise directed by the Board, shall be fiscally responsible entities and shall treat their employees fairly. To ensure compliance with these contracting principles, all contractors shall: (1) comply with all applicable federal, state and local rules, regulations and laws; (2) maintain financial records, and make those records available upon request, (3) provide to the County copies of any financial audits that have been completed during the term of the contract; (4) upon the County's request, provide the County reasonable access, through representatives of the Contractor, to facilities, financial and employee records that are related to the purpose of the contract, except where prohibited by federal or state laws; I( regulations or rules._ N. CALIFORNIA PUBLIC RECORDS ACT The County'is a public agency subject to the disclosure requirements of the California Public Records Act ( "CPRA "). If Contractor's proprietary information is contained in documents or information submitted to County, and Contractor claims that such information falls within one or more CPRA exemptions, Contractor must clearly mark such information "CONFIDENTIAL AND PROPRIETARY," and identify the specific lines containing the information. In the event of a request for such information, the County will make best efforts to provide notice to Contractor prior to such disclosure. If Contractor contends that any documents are exempt from the CPRA and wishes to prevent disclosure, it is required to obtain a protective order, injunctive relief or other appropriate remedy from a court of law in Santa Clara County before the County is required to respond to the CPRA request. If Contractor fails to obtain such remedy within the time the County is required to respond to the CPRA request, County may disclose the requested information. i Contractor further agrees that it shall defend, indemnify and hold County harmless against any claim, action or litigation (including but not limited to all judgments, costs, fees, and attorney's fees) that may result from denial by County of a CPRA request for information arising from any representation, or any action (or inaction), by the Contractor. 0. THIRD PARTY BENEFICIARIES This agreement does not, and is not intended to, confer any rights or remedies upon any person or entity other than the parties. P. INTELLECTUAL PROPERTY RIGHTS: Ownership: County shall own all right, title and interest in and to the Deliverables. For purposes of this Agreement, the term "Deliverables" shall mean any documentation and deliverables created by Contractor during the performance of services that i are identified in'this Agreement. Contractor hereby assigns to the County all rights, title and interest in and to any and all r intellectual property whether or not patentable or registrable under patent, copyright, trademark or similar statutes, made or conceived or reduced to practice or learned by Contractor, either alone or jointly with others, during the period of Contractor's agreement with the County or result from the use of premises leased, owned or contracted for by the County. _.. — — Revision Date - February 2016 Page 9 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 COUNTY OF SANTA CLARA a SERVICE AGREEMENT Contractor acknowledges that all original works of authorship which are made by Contractor (either solely or jointly with others) within the scope of this Agreement and which are protectable by copyright are "works made for hire," as that term is defined in the United States Copyright Act (17 U.S.C. Section 101), and shall belong solely to County. Contractor agrees that the County will be the copyright owner in all copyrightable works of every kind and description created or delivered by Contractor. either solelv or iointiv with others. in connection with anv agreement with the Countv. Q. INTELLECTUAL PROPERTY INDEMNITY Contractor represents and warrants for the benefit of the County and its users that, to its knowledge, as of the effective date of this Agreement, Contractor is the exclusive owner of all rights, title and interest in the Deliverables and /or services provided pursuant to this Agreement Contractor shall defend, indemnify and hold the County harmless against any claim, action or litigation (including but not limited to all judgments, costs, fees, and reasonable attorney's fees) by third party alleging the Deliverables and /or services provided pursuant to this Agreement infringe upon any intellectual property rights of third parties. This indemnity and duty to defend is in addition to and does not supersede the requirements stated in VII of this agreement R. OWNERSHIP RIGHTS TO MATERIALS / RESTRICTIONS ON USE All materials obtained, developed or prepared by Contractor in the course of performing services hereunder, including but not limited to videotapes, audio recordings, still photographs, ads or brochures, and the derivative works, patent, copyright, trademark, trade secret or other proprietary rights associated therewith (collectively "Deliverables'), shall be the sole and exclusive property of the County. To the extent Contractor owns or claims ownership rights to said Deliverables, Contractor hereby expressly assigns all said rights, title, and interest in and to the Deliverables to the County pursuant to the terms and conditions of this Agreement and at no additional cost The County has the exclusive royalty-free irrevocable right to duplicate, publish or otherwise use for any purpose, all materials prepared under this Agreement If Contractor wishes to use the materials prepared hereunder for any purpose including but not limited to promotional, educational or commercial purposes, the Contractor shall obtain prior written authorization from the County, which consent may be withheld by the County in its sole discretion. Contractor acknowledges that all original works of authorship which are made by Contractor (solely or jointly with others) within the scope of this Agreement and which are protectable by copyright are "works made for hire," as that term is defined in the United States Copyright Act (17 U.S.C, Section 101), and shall belong solely to County. Contractor agrees that the County will be the copyright owner in all copyrightable works of every kind and description created or developed by Contractor, solely or jointly with others, in connection with any agreement with the County. If requested to, and at no further expense to the County, Contractor will execute in writing any acknowledgments or assignments of copyright ownership of such copyrightable works as may be appropriate for preservation of the worldwide ownership in the County and its nominees of such copyrights. This section shall apply to the extent not otherwise provided under this agreement. _ S. COUNTY DATA "County Data" shall mean data and information received by Contractor from County. As between Contractor and County, all County Data shall remain the property of the County. Contractor shall not acquire any ownership interest in the County Data. Contractor shall not, without County's written permission consent, use or disclose the County Data other than in the performance of its obligations under this Agreement Contractor shall be responsible for establishing and maintaining an information security program that is designed to ensure the security and confidentiality of County Data, protect against any anticipated threats or hazards to the security or integrity of County Data, protect against unauthorized access to or use of County Data that could result in substantial harm or inconvenience to County or any end users; and ensure the proper disposal of County data upon termination of this Agreement Contractor shall take appropriate action to address any incident of unauthorized access to County Data, including addressing and /or remedying the issue that resulted in such unauthorized access, notifying County as soon as possible of any incident of unauthorized access to County Data, or any other breach in Contractor's security that materially affects County or end users; and be responsible for ensuring compliance by its officers, employees, agents, and subcontractors with the confidentiality provisions hereof. Should confidential and /or legally . protected County Data be divulged to unauthorized third parties, Contractor shall comply with all applicable federal and state laws and regulations, including but not limited to California Civil Code Sections 1798.29 and 1798.82 at Contractor's sole expense (if applicable). Contractor shall not charge the County for any expenses associated with Contractor's compliance with the obligations set forth in this secti_on._ T. WAGE THEFT PREVENTION —� (1) Compliance with Wage and Hour Laws: Contractor, and any subcontractor it employs to complete work under this i Agreement, must comply with all applicable federal, state, and local wage and hour laws. Applicable laws may include, but are I not limited to, the Federal Fair Labor Standards Act, the California Labor Code, and any local Minimum Wage Ordinance or Living Wage Ordinance. � I (2) Final Judgments. Decisions. and Orders: For purposes of this Section, a "final judgment, decision, or order" refers to one for which all appeals have been exhausted. Relevant investigatory government agencies include: the federal Department of Revision Date - February 2016 Page 10 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 f „.. COUNTY OF SANTA CLARA SERVICE AGREEMENT Labor, the California Division of Labor Standards Enforcement, a local enforcement agency, or any other government entity tasked with the investigation and enforcement of wage and hour laws. (3) Prior Judgments against Contractor and /or its Subcontractors: BY SIGNING THIS AGREEMENT, CONTRACTOR AFFIRMS THAT IT HAS DISCLOSED ANY FINAL JUDGMENTS, DECISIONS, OR ORDERS FROM A COURT OR INVESTIGATORY GOVERNMENT AGENCY FINDING —IN THE FIVE YEARS PRIOR TO EXECUTING THIS AGREEMENT —THAT CONTRACTOR OR ITS SUBCONTRACTOR(S) HAS VIOLATED ANY APPLICABLE WAGE AND HOUR LAWS. CONTRACTOR FURTHER AFFIRMS THAT IT OR ITS SUBCONTRACTOR(S) HAS SATISFIED AND COMPLIED WITH —OR HAS REACHED AGREEMENT WITH THE COUNTY REGARDING THE MANNER IN WHICH IT WILL SATISFY —ANY SUCH JUDGMENTS, DECISIONS, OR ORDERS. (4) judgments During Term of Contract: If at any time during the term of this Agreement, a court or investigatory government agency issues a final judgment, decision, or order finding that Contractor or any subcontractor it employs to perform work under this Agreement has violated any applicable wage and hour law, or Contractor learns of such a judgment, decision, or order that was not previously disclosed, Contractor must inform'the Office of the County Executive -Office of Countywide Contracting Management (OCCM), no more than 15 days after the judgment, decision, or order becomes final or of learning of the final judgment, decision, or order. Contractor and its subcontractors shall promptly satisfy and comply with any such judgment, decision, or order, and shall provide the Office of the County Executive -OCCM with documentary evidence of compliance with the final judgment, decision, or order within 5 days of satisfying the final judgment, decision, or order. The County reserves the right to require Contractor to enter into an agreement with the County regarding the manner in which any such final judgment, decision, or order will be satisfied. (5) Coun 's Right to Withhold Payment: Where Contractor or any subcontractor it employs to perform work under this Agreement has been found in violation of any applicable wage and hour law by a final judgment, decision, or order of a court or government agency, the County reserves the right to withhold payment to Contractor until such judgment, decision, or order has been satisfied in full. (6) Material Breach: Failure to comply with any part of this Section constitutes a material breach of this Agreement. Such breach may serve as a basis for termination of this Agreement and /or any other remedies available under this Agreement and /or law. (7) Notice to County Related to Wage Theft Prevention: Notice provided to the Office of the County Executive as required under this Section shall be addressed to: Office of the County Executive —OCCM; 70 West Hedding Street, East Wing, 11th Floor; San Jose, CA 95110. The Notice provisions of this Section are separate from any other notice provisions in this _Agreement and, accordingly, only notice provided to the above address satisfies the notice requirements in this Section. U. PAYMENT TERM [NOT APPLICABLE TO COMMUNITY BASED ORGANIZATIONS— describe payment terms for CBO's in Section V. PAYMENT SCHEDULE] The parties agree that the payment term shall be the term selected below and payment shall be due in accordance with the selected payment term. For example, if Contractor selects 2.25% 10 Net 45 as the payment term, payment shall be due 10 days from the date the County approves the invoice, instead of 45 days, and the County shall take a discount of 2.25% of the total amount of the invoice. Payment is deemed to have been made on the date the County mails the warrantor initiates the electronic fund transfer. - - _ 2.25% 10 Net 45 (provides 35 days of cash acceleration) [� 2.00% 15 Net 45 (provides 30 days of cash acceleration) ------ - - - - -- - ------- - - - - -- - - - -- - - - - -- ­----------- j� ; 1.75% 20 Net 45 (provides 25 days of cash acceleration) 1.33% 25 Net 45 (provides 20 days of cash acceleration) ----------- J 1.00% 30 Net 45 (provides 15 days of cash acceleration) 1 ✓J Net 45 (full payment) _. -.. - -- - -- Note: Payment term will default to "Net 45 (full payment) ", if no other term was selected. Notwithstanding the option selected above, the parties agree that at any time during the contract term, either party may initiate an early payment discount on an invoice -by- invoice basis utilizing the Dynamic Discounting functionality of the Ariba Network. Contractor must have a registered account on the Ariba Network to utilize this functionality. V. CONTRACT EXECUTION Unless otherwise prohibited by law or County policy, the parties agree that an electronic copy of a signed contract, or an electronically signed contract, has the same force and legal effect as a contract executed with an original ink signature. The term "electronic copy of a signed contract" refers to a transmission by facsimile, electronic mail, or other electronic means of j Revision Date - February 2016 Page 11 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CBO- B5DO- EF67AF1E5C40 aCOUNTY OF SANTA CLARA SERVICE AGREEMENT a copy of an original signed contract in a portable document format. The term "electronically signed contract" means a contract that is executed by applying an electronic signature using technology approved by the County. W. LIVING WAGE (If Applicable) Unless otherwise exempted or prohibited by law or County policy, where applicable, Contractors that contract with the County to provide Direct Services developed pursuant to a formal Request for Proposals process, as defined in County of Santa Clara Ordinance Code Division B36 ( "Division B36 ") and Board Policy section 5.5.5.5 ( "Living Wage Policy"), and their subcontractors, where the contract value is $100,000 or more ( "Direct Services Contract "), must comply with Division B36 and the Living Wage Policy and compensate their employees in accordance with Division B36 and the Living Wage Policy. Compliance and compensation for purposes of this provision includes, but is not limited to, components relating to fair compensation, earned sick leave, paid jury duty, fair workweek, worker retention, fair chance hiring, targeted hiring, local hiring, protection from retaliation, and labor peace. If Contractor and /or a subcontractor violates this provision, the Board of Supervisors or its designee may, at its sole discretion, take responsive actions including, but not limited to, the following: (a) Suspend, modify, or terminate the Direct Services Contract. (b) . Require the Contractor and /or Subcontractor to comply with an appropriate remediation plan developed by the County. (c) Waive all or part of Division B36 or the Living Wage Policy. This provision shall not be construed to limit an employee's rights to bring any legal action for violation of the employee's rights under Division B36 or any other applicable law. Further, this provision does not confer any rights upon any person or entity other than the Board of Supervisors or its designee to bring any action seeking the cancellation or suspension of a County contract. By entering into this contract, Contractor certifies that it is currently complying with Division B36 and the Living Wage Policy with respect to applicable contracts, and warrants that it will continue to comply with Division B36 and with respect to applicable contracts. SECTION VII: INSURANCE / INDEMNIFICATION comply Independent Contractors shall 1 Y with the County's insurance and indemnification requirements. as p p indicated below. These requirements do not apply to Dependent Contractors. A. TYPE OF INSURANCE LANGUAGE The following standard insurance and indemnification language is attached and incorporated into this agreement: B -2 Standard Service Contracts Above $100,000 Modification or Waiver Attached if Appropriate B. DETERMINATION OF INSURANCE REQUIREMENTS AND WAIVER DECLARATION - - - -- Workers Compensation: Yes Does the contractor have employees? If "YES ", then, WORKER'S COMPENSATION /EMPLOYER'S LIABILITY INSURANCE IS REQUIRED. - - -------------------------- - - - - -- -' -------------- ... - - - - - -- -- ._.._.. - -- - Owned Auto Insurance: NO Will the contractor use any owned autos in the provision of direct services, such as transporting clients in autos or operating autos in performance of the work itself? If "YES ", then INSURANCE FOR OWNED AUTOS IS REQUIRED. Hired Auto Insurance: No Will the contractor use any hired autos in the provision of direct services, such as transporting clients in autos or operating autos in performance of the work itselfl If "YES, then INSURANCE FOR HIRED AUTOS IS REQUIRED. Revision Date - February 2016 Page 12 of 13 DocuSign Envelope ID: 34969004-C7B1-4CB0-B5D0-EF67AF1E5C40 COUNTY OF SANTA CLARA a SERVICE AGREEMENT ---------------------------- -------------------- - ----- -- ------- -- - -------------- - ----- - ----------- - ------ - ----- - - -------- ------- - ----------- ------------- Non-owned Auto Insurance: No Will the contractor be using any non-owned autos in the provision of direct services, such as transporting clients in non-owned autos or operating non-owned autos in performance of the work itself? If "YES" then, INSURANCE FOR NON-OWNED AUTOS IS REQUIRED. - - - -- -- - - - - -- ------- - ----- -------- - ------------- ------------ ....... ------ When "NO" is checked, this declaration will serve as a waiver for the specified type of insurance. SECTION VIII: FEDERAL/STATE R PROVISIONS -- - - - -EQUIRED, (Examples, include Drug-free Workplace Activity, Health Insurance Portability and Accountability Act JHIP Business Associate Language, etc) A. Federal Required Language Attached Only add special language if services included in the contract require language different from or in addition to that in Section VI. Exhibit Name: B. State Required Language Attached Only add special language if services included in the contract require language different from or in addition to that in Section VI. Exhibit Name: The Exhibits named above are attached and incorporated by this reference. SECTION IX: ADDITIONAL ATTACHED EXHIBIT(S) Attachments and exhibits .that conflict with County standard provisions or require risk assessment must be approved by County Counsel-. Examples ofattachments that require County Counsel approval are: 1) Contractor's terms and conditions that are different. than, or add to the standard provisions language, 2) gei n ua Any changes to the lan Section VI—Standard Provisions. --g � Exceptions to County Counsel review include attachments that further explain the Contract Specifics as outlined in Section V, and insurance exhibits. Exhibit Name(s) The Exhibits named above are attached and incorporated by this reference. Revision Date - February 2016 Page 13 of 13 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY 17 -FY20 Section V: Contract Specifics A. Service Description and Expected Outcome (Scope of Service) This Agreement is between the County of Santa Clara, on behalf of the Probation Department ( "County" or "Probation ") and the City of Gilroy ( "Contractor ") and relates to establishing a partnership between the Neighborhood Safety /Services Unit (NSU) and the South County Youth Task Force ( SCYTF), to support the youth and families who reside in East Gilroy. This Agreement establishes a commitment on behalf of both the County and Contractor to work collaboratively to increase community safety, build community capacity and leadership amongst residents, and to foster a sense of community cohesion by providing additional pro- social opportunities for East Gilroy residents. Contractor responsibilities shall include the following: 1. Contractor shall develop and sustain a core group of Gilroy resident advisory leaders who will be integrated into the advisory structure of the South County Youth Task Force through the SCYTF Technical Team and subcommittee participation. Contractor shall ensure these resident advisors are provided the opportunity to participate in SCYTF meetings, advise on ways to improve programming and assist in resident outreach for SCYTF sponsored events. 2. Contractor shall develop a resident leadership group in East Gilroy. This resident leadership group shall work towards identifying, prioritizing, and implementing at least two community action projects per year, within the term of this Agreement. In an effort to avoid duplication of efforts, the community based organization(s) and Contractor may choose to partner with the Public Health Department's "Safe and Peaceful San Ysidro Park" initiative. 3. In collaboration with the NSU, Contractor shall support efforts, such as the planning and implementation of restorative practices and restorative justice, as a means to prevent violence in East Gilroy and on school campuses where East Gilroy youth attend. 4. Contractor shall provide pro - social opportunities for youth and families who reside in East Gilroy. Examples of pro - social activities are listed in the deliverables table below. a. All programming for pro - social activities and/or opportunities must be developed collaboratively through the work of the San Ysidro residents and in collaboration with members of the South County Youth Task Force Technical Team. b. Contractor may provide incentives for clients to successfully participate in programming. 5. Contractor shall attend and participate in the Neighborhood Safety /Services Unit (NSU) Advisory Committee meetings and annual retreats. 6. Contractor shall collaborate with the County to implement, at a future date, a series of resident leadership workshops. 7. Contractor shall be responsible for coordinating any food or beverages provided at community events and classes if necessary funded through this Agreement. 8. Contractor shall assist Probation in collecting resident level data, including the implementation of survey and evaluation instruments and/or questionnaires to measure 1 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics', Section V City of Gilroy (NSU) — FYI 7-FY20 community cohesion, perception of safety, and satisfaction with community events /gatherings. 9. Contractor shall submit quarterly performance reports using a report template provided by the County. 10. Contractor shall provide a shared workstation, including a computer, internet access, phone and supplies, for a Probation Community Worker (PCW), who may be located on site for up to three - four days per week (24 -32 hours p /week). The PCW will work in coordination with Contractor staff to implement the services described in this Agreement. 11. If requested by the County, Contractor shall collaborate with the County to re- negotiate an annual Year 2, Year 3, and Year 4 Deliverable Schedule and Budget. 2 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY2O B. Deliverables. Milestones, and Timeline for Performance: Year 1 (FY17) Deliverables # Deliverable Description Support Anticipated Frequency Number Price per unit Grand Documentation Completion of total Required for Date allowable Reimbursement units per year 1a Program Supplies The purpose of the resident advisory group to aim to participate in SCYTF Resident 06/30/17 Annual 1 $5,000 $5,000 for pro - social Technical Team meetings, advise on ways to improve programming and assist Advisory group activities held at in resident outreach for SCYTF sponsored events, and continue the meeting sign in San Ysidro park foundational work of the Safe and Peaceful San Ysidro initiative, developed by sheets. the public health department. Resident Advisory Group shall maintain a definition of membership, their vision, mission, and goals. 4c Community Community Outreach Worker shall provide youth /families in the East Quarterly NSU 06/30/17 Annual 13 youth $50 p /referral; $1,950 outreach and Gilroy /San Ysidro Park area with the opportunity to join the grassroots Report (maximu $100 per client connection of resident -led committee activities (San Ysidro Nueva Vida) „get connected to (Attachment E) m of $150 connected to clients to services services, and participate in new programs to be offered at San Ysidro Park. p /youth) services; The Community Outreach Worker shall also assist in outreach, building $100.p /client relationship with park attendees, event planning and setup tasks for upon community events as needed. completion of service 4d CMAP Recording the various activities taking place at the San Ysdiro Community Quarterly NSU 06/30/17 Annual 1 $5,050 for Video $5,050 Center, to be incorporated within a completed video of the resident Report production leadership group, documenting their formation and collaborative work. Video (Attachment E) services footage captured in the remaining weeks of FY17, will be added to future short documentary videos.in future contract years as an ongoing project. 4e Restorative Justice Support the Restorative Justice Training to be held in partnership with the Quarterly NSU 06/30/17 Annual 1 $8,000 $8,000 Gilroy Unified School District the last two weeks of June, 2017. Report (Attachment E) 5a Indirect Costs Indirect costs as needed. Varies 6/30/17 Varies Varies Varies. $1,000 Sb Operating Expense Operating expenses as needed. Varies 6/30/17 Varies Varies Varies $1,000 Total $22,000 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSLD — FY17 -FY20 Year 2 (FYI 8) Deliverable # Deliverable Description Support Anticipated frequency Number of Price Grand Documentation Completion allowable per unit total Required for Date units per year Reimbursement la Establish and maintain a resident The purpose of the resident advisory group to aim to Resident Advisory 06/30/18 Monthly 12 $500 $6,000 advisory group focused in East Gilroy. participate in SCYTF Technical Team meetings, advise group meeting sign in Subtotal on ways to improve programming and assist in resident sheets. outreach for SCYTF sponsored events, and continue the foundational work of the Safe and Peaceful San Ysidro initiative, developed by the public health department. Resident Advisory Group shall maintain a definition of membership, their vision, mission, and goals. 1b Submission of Annual Community Contractor shall assist the East Gilroy Resident Community Action 10/01/2017 Annual 1 $10,000 $10,000 Action Plan Leadership group in establishing a Community Action Plan Plan. Specific goals and objectives that are identified by East Gilroy resident leaders, defined in this action plan, shall be funded through this Agreement. Contractor shall ensure this action plan is in alignment with the resident leadership group established in East Gilroy. NSU will provide SCYTF with the Community Action Plan template. 2a Establish and maintain the SCYTF The East Gilroy SCYTF subcommittee /NSU Agenda, meeting Last meeting Monthly 12 $350 $4,200 East Gilroy Subcommittee, which also Implementation Team should consist of NSU staff, notes, sign in sheet to be held ($350 x serves as the NSU Implementation SCYTF partners (at least 2 CBOs), and 1 City of Gilroy by: 06/30/18 12 = Team. This subcommittee/ team shall staff, and 1 East Gilroy resident. $4,200) meet monthly. 2b Develop and submit the East Gilroy The purpose of this subcommittee Charter /Work'Plan is East Gilroy SCYTF 10/01/17 Annual 1 $1,000 $1,000 SCYTF Technical Team to align the work of the subcommittee members with Technical Team (initial subcommittee /NSU Implementation the community action goals of the resident leadership subcommittee/ NSU Charter/ Team Charter /Work Plan group established in East Gilroy. Implementation Team Work Plan) Charter /Action Plan DocuSign Envelope ID; 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FYI 7-FY20 # Deliverable Description Support Documentation Required for Reimbursement Anticipated Completion Date Frequency Number of allowable units per year Price per unit Grand total 3a Provide pro - social Group classes, workshops, and presentations shall be located in East Monthly Group 06/30/18 Monthly 400 $20 $8,000 and /or group classes Gilroy /San Ysidro Comm. Center. Classes participan p /participant ($20 related to A Gilroy resident shall be given priority (over non - Gilroy resident, Enrollment sign is p /participan educational, health private businesses) to teach a health and /or educational class or in sheets, and t x 400 and wellness, safety workshop. Incentives for residents to teach workshops are allowable. Cost Summary participants and gang prevention Resident led workshops or pro - social activities should be planned for Report = $8,000) related and included in a monthly calendar and distributed widely to residents classes /workshops/ of East Gilroy. All classes /workshops should be age appropriate, and presentations to East designed to be open to and benefit any resident who lives in the East Gilroy residents Gilroy Community. If "Resident Leaders" are not available to teach a particular class, Contractor shall have the discretion to subcontract with non - residents teachers with written agreement from the County. 3b Individual pro - social Collaborate with the NSU Probation Community Worker (PCW) in NSU Enrollment 06/30/18 Monthly Varies/ $8,000 $8,000 activities for at -risk identifying and enrolling at -risk youth attending schools serving East Form as needed youth identified by Gilroy residents, in pro - social activities. Priority will be given to youth (Attachment B) the NSU Probation identified in Multi- System- Meetings (MSTs) or related school Community Worker disciplinary meetings serving Positive Behavior Intervention & Supports (PBIS) tier 2 and tier 3 youth; Pro - social activities for at -risk youth shall be determined on an individual basis, based on the needs and interests of the youth participant. DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AFIE5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 # Deliverable Description Support Anticipated Frequency Number Price per unit Grand total Documentation Completion of Required for Date allowable Reimbursement units per year 4a Community Calendar Develop and Submit Monthly Community Event /Classes Calendar by the Community 05/30/18 Monthly 12 $100 $1,200 15th day of each month for the upcoming month. Calendar 4b Monthly community Contractor shall coordinate at least one monthly community meeting Agenda, 06/30/18 Monthly 12 $100 $1,200 meeting with a core with a core group of resident leaders (youth and /or adults) of East meeting notes, group of resident Gilroy. sign in sheet leaders (youth and /or adults) of East Gilroy 4c Community outreach Community Outreach Worker shall provide youth /families in the East Quarterly NSU 06/30/18 Monthly Varies $50 p /referral; $20,000 and connection of Gilroy /San Ysidro Park area with the opportunity to join the grassroots Report $100 per client clients to services resident -led committee activities (San Ysidro Nueva Vida), get (Attachment E) connected to connected to services, and participate in new programs to be offered at services; San Ysidro Park. The Community Outreach Worker shall also assist in $100 p /client outreach, building relationship with park attendees, event planning and upon setup tasks for community events as needed. completion of service 4d CMAP Production of media materials regarding the work of the resident Quarterly NSU 06/30/18 Monthly Varies $5,050 for Video leadership group; Video and music classes are incorporated with a Report classes upon completed video of the resident leadership group, documenting their (Attachment E) completion of formation and collaborative work. Short videos will be completed of service; $2,500 p/ their sponsored events and documenting new classes. CMAP Staff will completed attend biweekly resident meetings. video (up to 4); $100 per biweekly meeting (x12) $16,250 4e Restorative Justice Support the training and implementation of restorative Quarterly NSU 06/30/18 Quarterly 1 justice /restorative practices in schools and other settings that support Report East Gilroy residents. (Attachment E) $8,000 $8,000 5a Indirect Costs Indirect costs as needed. Varies 6/30/17 Varies Varies Varies $1,000 5b Operating Expense Operating expenses as needed. Varies 6/30/17 Varies Varies Varies $1,000 Total $85,850 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FYI 7-FY20 Year 3 (FYI 9) Deliverables # . Deliverable Description Support Anticipated Frequency Number of Price per unit Grand Documentation Completion allowable total Required for Date units per Reimbursement year 1a Establish and maintain The purpose of the resident advisory group to aim to Resident Advisory 06/30/19 Monthly 12 $500 $6,000 a resident advisory participate in SCYTF Technical Team meetings, advise on ways group meeting sign group focused in East to improve programming and assist in resident outreach for in sheets. Gilroy. SCYTF sponsored events, and continue the foundational work Subtotal of the Safe and Peaceful San Ysidro initiative, developed by the public health department. Resident Advisory Group shall maintain a definition of membership, their vision, mission, and goals. lb Submission of Annual Contractor shall assist the East Gilroy Resident Leadership Community Action 10/01/2018 Annual 1 $10,000 $10,000 Community Action Plan group in establishing a Community Action Plan. Specific goals Plan and objectives that are identified by East Gilroy resident leaders, defined in this action plan, shall be funded through this Agreement: Contractor shall ensure this action plan is in alignment with the resident leadership group established in East Gilroy. NSU will provide SCYTF with the Community Action Plan template. 2a Establish and maintain The East Gilroy SCYTF subcommittee /NSU Implementation Agenda, meeting Last meeting Monthly 12 $350 $4,200 the SCYTF East Gilroy Team should consist of NSU staff, SCYTF partners (at least 2 notes, sign In sheet to beheld ($350 x Subcommittee, which CBOs), and 1 City of Gilroy staff, and 1 East Gilroy resident. by: 06/30/19 12 = also serves as the NSU $4,200) Implementation Team. This subcommittee /team shall meet monthly 2b Develop and submit the The purpose of this subcommittee Charter /Work Plan is to East Gilroy SCYTF 10/01/18 Annual 1 $1,000 $1,000 East Gilroy SCYTF align the work of the subcommittee members with the Technical Team (initial Technical Team community action goals of the resident leadership group subcommittee/ NSU Charter/ subcommittee /NSU established in,East Gilroy. Implementation Work Plan) Implementation Team Team Charter/Work Plan Charter /Action Plan DocuSign Envelope ID: 34969004- C7B14CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 # Deliverable Description Support Documentation Required for Reimbursement Anticipated Completion Date Frequency Number of allowable units per year Price per unit Grand total 3a Provide pro - social Group classes; workshops, and presentations shall be located in East Monthly Group 06/30/19 Monthly 400 $20 p /participant $8;000 and /or group Gilroy /San Ysidro Comm. Center. Classes Enrollment participant ($20 classes related to A Gilroy resident shall be given priority (over non - Gilroy resident, sign in sheets, and s p /partici educational, private businesses) to teach a health and /or educational class or Cost Summary pant x health and workshop. Incentives for residents to teach workshops are allowable. Report 400 wellness, safety Resident led workshops or pro - social activities should be planned for participa and gang and included in a monthly calendar and distributed widely to nts = prevention related residents of East Gilroy. All classes /workshops should be age $8,000) classes /workshops appropriate, and designed to be open to and benefit any resident / presentations to who lives in the East Gilroy Community. If "Resident Leaders" are not East Gilroy available to teach a particular class, Contractor shall have the residents discretion to subcontract with non - residents teachers with written agreement from the County. 3b Individual pro- Collaborate with the NSU Probation Community Worker (PCW) in NSU Enrollment 06/30/19 Monthly Varies/ $8,000 $8,000 social activities for identifying and enrolling at -risk youth attending schools serving East Form (Attachment as needed at -risk youth Gilroy residents, in pro - social activities. Priority will be given to youth B) identified by the identified in Multi- System- Meetings (MSTs).or related school NSU Probation disciplinary meetings serving Positive Behavior Intervention & Community Supports (PBIS) tier 2 and tier 3 youth. Worker Pro - social activities for at -risk youth shall be determined on an Individual basis, based on the needs and interests of the youth participant. DocuSign Envelope ID; 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 q Deliverable Description Support Anticipated Frequency Number of Price per unit Grand Documentation Completion allowable total Required for Date units per Reimbursement year 4a Community Develop and Submit Monthly Community Event /Classes Calendar by Community 05/30/19 Monthly 12 $100 $1,200 Calendar_ the 151h day of each month for the upcoming month. Calendar 4b Monthly Contractor shall coordinate at least one monthly community meeting Agenda, meeting 06/30/19 Monthly 12 $100 $1,200 community with a core group of resident leaders (youth and /or adults) of East notes, sign in meeting with a Gilroy. sheet core group of resident leaders (youth and /or adults) of East Gilroy 4c Community Community Outreach Worker shall provide youth /families in the East Quarterly NSU 06/30/19 Monthly Varies $50 p /referral; $20,000 outreach and Gilroy /San Ysidro Park area with the opportunity to join the Report $100 per client connection of grassroots resident -led committee activities (San Ysidro Nueva Vida), (Attachment E) connected to clients to services get connected to services, and participate in new programs to be services; offered at San Ysidro Park. The Community Outreach Worker shall $100 p /client upon also assist in outreach, building relationship with park attendees, completion of event planning and setup tasks for community events as needed. service 4d CMAP Production of media materials regarding the work of the resident Quarterly NSU 06/30/19 Monthly Varies $5,050 for Video leadership group; Video and music classes are incorporated with a Report classes upon completed video of the resident leadership group, documenting their (Attachment E) completion of formation and collaborative work. Short videos will be completed of service; , $2500 p/ $2,50completed their sponsored events and documenting new classes. CMAP Staff video will attend biweekly resident meetings. (up to 4); $100 per biweekly meeting (x12) $16,250 4e Restorative Justice Support the training,and implementation of restorative Quarterly NSU 06/30/19 Quarterly 1 justice /restorative practices in schools and other settings that Report support East Gilroy residents. (Attachment E) $8,000 $8,000 5a Indirect Costs Indirect costs as needed. Varies 6/30/17 Varies Varies Varies $1,000 5b Operating Expense I Operating expenses as needed. Varies 6/30/17 Varies Varies Varies $1,000 Total $85;850 DocuSign Envelope ID: 34969004- C7Bl- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSin — FY17 -FY20 Year 4 (FY20) Deliverables # Deliverable Description Support Anticipated Frequency Number of Price per unit Grand total Documentation Completion allowable Required for Date units per Reimbursement year la Establish and maintain a The purpose of the resident advisory group to aim to Resident Advisory 06/30/20 Monthly 12 $500 $6,000 resident advisory group participate in SCYTF Technical Team meetings, advise group meeting sign focused in East Gilroy. on ways to improve programming and assist in resident in sheets. Subtotal outreach for SCYTF sponsored events, and continue the foundational work of the Safe and Peaceful San Ysidro initiative, developed by the public health department. Resident Advisory Group shall maintain a definition of membership, their vision, mission, and goals. lb Submission of Annual Contractor shall assist the East Gilroy Resident Community Action 10/01/19 Annual 1 $10,000 $10,000 Community Action Plan Leadership group in establishing a Community Action Plan Plan. Specific goals and objectives that are identified by East Gilroy resident leaders, defined in this action plan, shall be funded through this Agreement. Contractor shall ensure this action plan is in alignment with the resident leadership group established in East Gilroy. NSU will provide SCYTF with the Community Action Plan template. 2a Establish and maintain The East Gilroy SCYTF subcommittee /NSU Agenda, meeting Last meeting Monthly 12 $350 $4,200 the SCYTF East Gilroy Implementation Team should consist of NSU staff, notes, sign in sheet to be held ($350 x 12 = Subcommittee, which SCYTF partners (at least 2 CBOs), and 1 City of Gilroy by: 06/30/20 $4,200) also serves as the NSU staff, and 1 East Gilroy resident. Implementation Team. This subcommittee /team shall meet monthly 2b Develop and submit the The purpose of this subcommittee Charter/ Work Plan East Gilroy SCYTF 10/01/19 Annual 1 $1,000 $1,000 East Gilroy SCYTF is to align the work of the subcommittee members with Technical Team (initial Technical Team the community action goals of the resident leadership subcommittee/ NSU Charter/ subcommittee /NSU group established in East Gilroy. Implementation Work Plan) Implementation Team Team Charter /Work Plan Charter /Action Plan 10 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AFlE5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 # Deliverable Description Support Documentation Required for Reimbursement Anticipated Completion Date Frequency Number of allowable units per year Price per unit Grand total 3a Provide pro - social Group classes, workshops, and presentations shall be Monthly Group 06/30/20 Monthly 400 .$20 p /participant $8,000 and /or group classes locatediin East Gilroy /San Ysidro Comm. Center. Classes Enrollment participants ($20 related to educational, A Gilroy resident shall be given priority (over non - Gilroy sign in sheets, and p /participan health and wellness, resident, private businesses) to teach a health and /or . Cost Summary t x 400 safety and gang educational class or workshop. Incentives for residents Report participants prevention related to teach workshops are allowable. _ $8,000) classes /workshops/ Resident led workshops or pro - social activities should presentations to East be planned for and included in a monthly calendar and Gilroy residents distributed widely to residents of East Gilroy. All classes /workshops should be age appropriate, and designed to be open to and benefit any resident who lives in the East Gilroy Community. If "Resident Leaders" are not available to teach a particular class, Contractor shall have the discretion to subcontract with non - residents teachers with written agreement from the County. 3b Individual pro - social Collaborate with the NSU Probation Community Worker NSU Enrollment 06/30/20 Monthly Varies/ $8,000 $8,000 activities for at -risk (PCW) in identifying and enrolling at -risk youth Form (Attachment as needed youth identified by the attending schools serving East Gilroy residents, in pro- B) NSU Probation social activities. Priority will be given to youth identified Community Worker in Multi- System- Meetings (MSTs) or related school disciplinary meetings serving Positive Behavior Intervention & Supports (PBIS) tier 2 and tier 3 youth. Pro - social activities for at -risk youth shall,be determined on an individual basis, based on the needs and interests of the youth participant. 11 DocuSign Envelope ID: 34969004- C7B1- 4CBO- B5DO- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY2O # Deliverable Description Support Anticipated Frequency Number of Price per unit Grand total Documentation Completion allowable Required for Date units per Reimbursement year 4a Community Calendar Develop and Submit Monthly Community Event /Classes Community 05/30/20 Monthly 12 $100 $1,200 Calendar by the 151n day of each month for the Calendar upcoming month. 4b Monthly community Contractor shall coordinate at least one monthly Agenda, meeting 06/30/20 Monthly 12 $100 $1,200 meeting with a core community meeting with a core group of resident notes, sign in sheet group of resident leaders leaders (youth and /or adults) of East Gilroy. (youth and /or adults) of East Gilroy 4c Community outreach Community Outreach Worker shall provide Quarterly NSU 06/30/20 Monthly Varies $50 p /referral; $20,000 and connection of clients youth /families in the East Gilroy /San Ysidro Park area Report (Attachment $100 per client to services with the opportunity to join the grassroots resident -led E) connected to committee activities (San Ysidro Nueva Vida), get services; connected to services, and participate in new programs $100 p /client upon to be offered at San Ysidro Park. The Community completion of service Outreach Worker shall also assist in outreach, building relationships with part attendees, event planning and setup tasks for community events as needed. 4d CMAP Production of media materials regarding the work of Quarterly NSU 06/30/20 Monthly Varies $5;050 for Video $16,250 the resident leadership group Report (Attachment classes upon Video and music classes are incorporated with a E) completion of completed video of the resident leadership group, service; $2,500 p/ completed documenting their formation and collaborative work. video (up to 4); Short videos will be completed of their sponsored $100 per biweekly events and documenting new classes. CMAP Staff will meeting (x12) attend biweekly resident meetings. 4e Restorative Justice Support the training and implementation of restorative Quarterly NSU 06/30/20 Quarterly 1 $8,000 $8,000 justice /restorative practices in schools and other Report (Attachment settings that support East Gilroy residents. E) 5a Indirect Costs Indirect costs as needed. Varies 6/30/17 Varies Varies Varies $1,000 5b Operating Expense Operating expenses as needed. Varies 6/30/17 Varies Varies Varies $1,000 Total $85,850 12 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 C. Performance Standards: 1. Prior to beginning services, all Contractor personnel working directly with clients must obtain, at the expense of Contractor or Contractor's personnel, a Department of Justice background clearance (Live Scan). If the results of the background check are unfavorable, the County will notify Contractor to arrange for replacement personnel. If replacement personnel cannot be found, County will terminate the Agreement. Contractor will need to complete the following steps to obtain a background clearance: a. Contact the Probation Department Live Scan liaison at (408) 468 -1633 to obtain a background clearance application. b. Contact the County of Santa Clara Office of the Sheriff to make a Live Scan appointment. The Office of the Sheriff can be contacted by phone: (800) 211- 2220 or via their website hqp: / /www.scc og v orgZportal/site /sheriff. c. County will contact Contractor once the results of the background clearance have been received. d. Contractor is required to notify the Probation Department's Live Scan liaison when the employment or licensing relationship of any individual whose name was submitted for Live Scan background clearance has concluded. 2. Prison Rape Elimination Act (PREA) a. Contractor shall comply with the Probation Department's zero - tolerance policy related to the sexual assault or rape of juveniles, or sexual misconduct toward any juveniles housed in any of its facilities or contracted venues. Sexual abuse and sexual harassment are prohibited by state and federal law. 3. Contractor agrees to provide language /translation services for clients and/or their families who may have Limited English Proficiency (LEP) skills. Contractor further agrees to inform LEP individuals of their eligibility for benefits, programs, and services in a language they understand. Contractor agrees to assess all points of contact, telephone, in- person, mail, and electronic communication its staff has with Probation's LEP clients to determine the best method of providing notice of language assistance services. Contractor must not only translate outreach materials, but must also explain how LEP individuals may access available language assistance services. Methods Contractor can use to inform LEP individuals about language assistance services may include translating outreach materials into other languages, updating non - English content in key languages on the main page of its program's website, and providing public service messages in non- English media describing its programs. Additional methods of providing notice include the use of forms, brochures, and/or language access posters placed in conspicuous locations describing in multiple languages the availability of language assistance services, the use of "I Speak" language identification cards, and by including instructions in non - English languages on telephone menus. Sample of the "I Speak" card is available at this website and Contractor may create their own version. http://www.justice.gov/crt/lep/resources/OhioLan,izlDcard.pd 13 DocuSign Envelope ID: 34969004- C761- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FY17 -FY20 4.. Cultural Competency: Services must be provided in a culturally competent manner to the entire target population regardless of gender, age, religion, race, ethnicity, sexual orientation and disability. Services must also demonstrate ability to provide Limited English Speaking proficient population with translation services. 5. Confidentiality: During the performance of this Agreement, Contractor will have access to confidential information about the client/probationer, which is protected by California and Federal privacy laws, and such information is not permitted to be disclosed, disseminated or distributed to another entity or party other than the County's Probation Department staff and staff from the Probation Department's contracted evaluation consultants, if applicable. Contractor must use all necessary care to maintain and secure confidential information at all times, including the destruction of this information when it is no longer needed and/or upon termination of this Agreement. Contractor must not discuss such information with any other party, without the express written consent of the Probation Department or with the signed consent of parent/guardian or as Contractor may be required by law to disclose. In the event that Contractor receives a subpoena, court order, or other legal document requiring release of the information, or is informed that such document is being requested, Contractor must immediately give notice to the Probation Department in order to permit the County to seek a protective order or other similar order. 6. Privacy: Contractor must comply with all state and federal laws regarding the privacy of medical information, including but not limited to the following: a. The Health Insurance Portability and Accountability Act, 45 C.F.R parts 160, 162 and 164 ( "HIPAA "); b. The Health Information Technology for Economic and Clinical Health Act ( "HITECH" Act), Pub. L. 111 -5, Div. A, Title XIII, § 130001 et seq., Div. B, Title IV, § 4001 et seq., Feb. 17, 2009, 123 Stat. 226, 467, 42 U.S.C.A. § 300ii, et seq., and 4U.S.C.A. § 17901, et seq.; c. California Welfare and Institutions Code section 5328 et seq.; and d. California Evidence Code section 1010 et seq. 7. County will evaluate and document the Contractor's performance in accordance with County policy. Contractor evaluation may consist of, but not be limited to, the following evaluation forms: a. Contractor Performance Evaluation report; b. On -site review; and/or c. Contractor self - evaluation. 8. Contractor will perform the agreed upon services in a competent and expedient manner and must immediately inform the County should problems arise that prohibit the Contractor from performing the services in such a manner.. 9. Contractor must maintain written documentation, project information, and records relevant to the services provided. Contractor must make this information available for review by the County upon reasonable notice. 14 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) —FYI 7-FY20 D. Payment Schedule: 1. Maximum compensation paid to Contractor under this Agreement must not exceed $279,550; $22,000 in FYI 7, $85,850 in FYI 8, $85,850 in FYI 9, and $85,850 in FY20. 2. Contractor will invoice County based on units of service provided the previous month. Rates per unit of service will be charged at the rate shown on Attachment C, "Budget", hereto attached and incorporated by this reference. a. Probation Management and Contractor may, as needed and upon mutual agreement in writing, modify budget line -item maximums and/or billable rates noted in Attachment C, "Budget ", to reflect the service delivery needs of the Department without exceeding the maximum financial obligation of this agreement. 3. If Contractor provides any tasks, deliverable, goods, services, or other work, other than as specified in this Agreement, the same will be deemed to be a gratuitous effort on the part of the Contractor, and the Contractor will have no claim whatsoever against County. 4. Contractor shall submit a hard copy invoice for completed deliverables on a quarterly basis, as appropriate. Invoice will include the Contractor's name and address; invoice number; contract number; date and description of services; total invoice amount; year -to- date expenditures and remaining contract balance (refer to Attachment D, "Quarterly Invoice "). 5. All payments are contingent upon Contractor providing the agreed upon services according to the scope of services, contract requirements, deliverables and performance standards: 6. If the invoice and supporting documentation are in proper form, appropriately payable under this Agreement, and have been reviewed and approved by the appropriate Probation staff, County shall make payment to Contractor within forty -five (45) days net after receipt of invoice. 7. Indirect Costs — Total must not exceed $27,955.00 for the term of the agreement: $2,200.00 for fiscal year 2017, $8,585.00 for fiscal year 2018, $8,585.00 for fiscal year 2019, and $8,585.00 for fiscal year 2020, which will not exceed 10% of the maximum budget for each fiscal year. Indirect costs include to the following: direct salaries and wages, either including or excluding benefits and actual total direct project costs, excluding equipment. Please see Attachment F for more details. These items are contingent upon the Contractor providing the services according to the scope of services, contract requirements, deliverables and performance standards. a. Indirect Costs must include backup documentation to support and verify the invoice amounts 15 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment A Contract Specifics, Section V City of Gilroy (NSU) — FYI 7-FY20 b. Prior to submittal, cost reimbursement claims must be certified and signed by a responsible officer of Contractor with authority to certify that the information submitted by Contractor is accurate and Contractor is entitled to payment under the terms of the Agreement. County may rely on said certification in making payment, but this payment will not constitute a waiver of any of County's legal rights or objections. c. County will not be required to make payment if the amount invoiced is not in accordance with the provisions of this Agreement. All payments under this Agreement will be made directly to Contractor as a corporate entity. Under no circumstances will County be required to make payments in any amount pursuant to this Agreement to any other parties, including Contractor's individual employees, creditors and subcontractors Contractor. d. County is not obligated to reimburse Contractor for any expenditure not reported to County within sixty (60) calendar days after the end of the last month of the Agreement term. 8. Operating Expense - Total must not exceed $13,977.50 for the term of the agreement: $1,100.00 for fiscal year 2017, $4,292.50 for fiscal year 2018, $4,292.50 for fiscal year 2019, and $4,292.50 for fiscal year 2020, which will not exceed 5% of the maximum budget for each fiscal year. The expenses must be to further the program objectives and be contingent upon the Contractor providing the services according to the scope of services, contract requirements, deliverables and performance standards. Operating expenses include, but are not limited to, the following: conferences, seminars, workshops, trainings, training materials, and office supplies. Please see Attachment F for more details. i. Operating expenses must include backup documentation to support and verify the invoice amounts ii. Prior to submittal, cost reimbursement claims must be certified and signed by a responsible officer of Contractor with authority to certify that the information submitted by Contractor is accurate and Contractor is entitled to payment under the terms of the Agreement. County may rely on said certification in making payment, but this payment will not constitute a waiver of any of County's legal rights or objections. iii. County will not be required to make payment if the amount invoiced is not in accordance with the provisions of this Agreement. All payments under this Agreement will be made directly to Contractor as a corporate entity. Under no circumstances will County be required to make payments in any amount pursuant to this Agreement to any other parties, including Contractor's individual employees, creditors and subcontractors Contractor. iv. County is not obligated to reimburse Contractor for any expenditure not reported to County within sixty (60) calendar days after the end of the last month of the Agreement term. Attachment B DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 NSU Enrollment Form City of Gilroy (NSU) - FY17 -FY20 Neighborhood Safety /Services Unit Juvenile Probation Department Charmayne Moran, Program Manager II Neighborhood Services Unit (NSU) Email: Charmayne.Moran @pro.sccgov.org 840 Guadalupe Parkway Phone: (408) 278 -6227 N San Jose, CA 95110 NSU Enrollment Form for Services Client /Parent Information (All Fields Are Required): This information will be kept strictly confidential. That means that no one outside the program and the organizations that sponsor it will know how you answer these questions. Your contact information will be used to give you updates about our services and in emergencies only. All other information helps us determine how to better provide services. To Be Completed by or on behalf of Youth 1. Full Name (of client enrolling in activities): Last Name, First Name Last Name, First Name 2. Zip Code: Zip Code 3. Phone: ( # # #) # # # - # # ## ® Can we text you? 4. Age: MM /DD /YYYY 5. Gender: ❑ Male ❑ Female ❑ Other ❑ Decline to State 6. Primary Language: Language 7. Race /Ethnicity: ❑ Asian ❑ Black /African American ❑ Latino /Latina ❑ Native American ❑ Pacific Islander ❑ White ❑ Other: Race /Ethnicity ❑ Decline to State 8. School: School Name 9. Grade (or last grade completed): Grade To be Completed by or on behalf of Parent/Guardian 10. Full Name (of client enrolling in activities): Last Name, First Name Last Name, First Name 11. Parent Primary Language: Language 12. Single Parent Household? ❑ Yes ❑ No 13. Did You Graduate from High School? ❑ Yes, Both Parents Did ❑ No, Neither Parent Did ❑ Yes, One Parent Did 14. Employment Status: ❑ Full -Time ❑ Part-Time ❑ Student ❑ Other ❑ Decline to State 15. Are you a Neighborhood Association member? ❑Yes ❑No 16. If not, interested in becoming a member? ❑ Yes ❑ No 17. Does the client participating in the activity have access to reliable transportation? ❑ Yes ❑ No 18. Are you interested in Carpooling? ❑ Yes ❑ No 19. What kind of health insurance do you have? ❑ Public (MediCal /MediCaid) ❑ Private ❑ Don't have health insurance 20. What is your Household Size? Household Size 21. What is your Annual Household Income? ❑ 0 - $14,999 11 $75,000 - $99,999 ❑ $15,000 - $34,999 ❑ $100,000+ ❑ $35,000 - $49,999 ❑ Don't Know ❑ $50,000 - $74,999 ❑ Decline to State 22. Parent/Guardian Signature: Program Information (To Be Completed by Staff): 23. Type of Program: ❑ Community Based ❑ School Based 24. If School based, Name of School: School 26. Activity Type: ❑ Leadership ❑ Academic ❑ Arts ❑ Sports ❑ Other: Activity Type 25. Date of enrollment: M M /DD /YYYY 27. Estimated Number of Activity Hours: # Of Activity Hours Information About Person Completing This Form: 28. Name: Last Name, First Name 31. Title: Title 29. Phone: ( # # #) # # # - # # ## 32. Email: Email 30. Signature: 33. Today's Date: MM /DD /YYYY DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 FY17 -FY20 SCYTF Budget Neighborhood Safey Unit (NSU) Attachment C Budget City of Gilroy (NSU) - FY17 -FY20 i Cost Deliverable Description FY17 FY_ 18 FY19 FY20 Establish and maintain a resident advisory group focused in la East Gilroy. $ 5,000 $ 6,000 $ 6,000 $ 6,000 lb Submission of Annual Community Action Plan $ - $ 10,000 $ 10,000 $ 10,000 Establish and maintain the SCYTF East Gilroy Subcommittee, which also serves as the NSU Implementation Team. This 2a subcommittee /team shall meet monthly. $ - $ 4,200 $ 4,200 $ 4,200 Develop and submit t a East Gilroy SCYTF Technical Team subcommittee /NSU Implementation Team Charter/Work � 2b Plan $ - $',000 $ 11000 $ 1,000 Provide pro-social an or group classes related to educational, health and wellness, safety and gang prevention / > related classes /workshops /presentations to East Gilroy 3a residents $ - $ $;000 $ /$,Q00 $ 8,000 Individual pro - social activities for at -risk youth identified by \ \ r�% 3b the NSU Probation Community Worker $ - $ $a00 ;$ 8,000 $ 8,000 4a Community Calendar $ - $ 1,2'0Q' $ 1,200 $ 1,200 Monthly community meeting with a core group of resident - leaders . �$\ 4b (youth and /or adults) of East Gilroy ,$11,200 $ 1,200 $ 1,200 j\.��\1 4c Community outreach and connection of clients to services / $ 1,95�Y $ 20,000 $ 20,000 $ 20,000 Work with CMAP to produce media materials omthe wor of �\�\ 4d the resident leadership group </\ $ 5,050 $ 16,250 $ 16,250 $ 16,250 uppo a raining an imp emen a ierno Tres ora Ive justice /restorative practices in schools`and`otRer settii g� 4e that support East Gilroy residents \\ \% $ 8,000 $ 8,000 $ 8,000 $ 8,000 5a Indirect Costs \ \ \� $ 1,000 $ 1,000 $ 1,000 $ 1,000 5b - Operating Expense \ \ \ \ \. $ 1,000 $ 1,000 $ 1,000 $ 1,000 Total /\ \ \ $ 22,000 $ 85,850 $ 85,850 $ 85,850 i DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 INVOICE BILL TO: Department of Probation County of Santa Clara ADDRESS: Attn: Fiscal Division PO #: Start Date End Date Contract Period: Invoice Period: Final Invoice (circle one): Yes No Program Deliverable(s) / Written Report for the reporting period Submitted (circle one): Yes No Attachment D Quarterly Invoice City of Gilroy (NSU) - FY17 -FY20 REMITTANCE: VENDOR NAME ADDRESS: Invoice #: Date of Submission: 1% of Period Elapsed TOTAL EXPENDITURES $ LESS PROGRAM INCOME $ TOTAL EXPENDITURES BILLED $ I hereby certify under penalty of perjury that the amount billed above is true and correct in accordance with the contract. Vendor/ Contractor Authorized Signature: Title: Date: Accounting Contact Person: Phone Number: Fax Number: E -mail Address: PROBATION DEPARTMENT STAFF USE ONLY Invoice Amount: SAP DOC # Adjustment: Input Date: Net Payment: Name: Explanation: rover: Contract Monitor: Date: a b c d e f CATEGORIES BUDGET FUNDS PREVIOUSLY REQUESTED ACTUAL CONTRACT EXPENSES THIS PERIOD TOTAL CONTRACT EXPENSES TO DATE REMAINING CONTRACT BALANCE (a -d) %of Budget Expended (d/a #DIV /0! #DIV /0! #DIV /0! #DIV /0! - #DIV /0! #DIV /0! #DIV /0! Totals - #DIV /01 TOTAL EXPENDITURES $ LESS PROGRAM INCOME $ TOTAL EXPENDITURES BILLED $ I hereby certify under penalty of perjury that the amount billed above is true and correct in accordance with the contract. Vendor/ Contractor Authorized Signature: Title: Date: Accounting Contact Person: Phone Number: Fax Number: E -mail Address: PROBATION DEPARTMENT STAFF USE ONLY Invoice Amount: SAP DOC # Adjustment: Input Date: Net Payment: Name: Explanation: rover: Contract Monitor: Date: DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment D Quarterly Invoice City of Gilroy (NSU) - FY17 -FY20 Quarter .. Units of Service Doc 1 Contractor City of Gilro , South County Youth Task Force Address PO # Date Dept. # 246 Fiscal Year 201712018 Source Documentation Expenditure Invoice Amount Doc 1 Doc 2 Doc 3 Doc 4 Doc 5 I. Deliverables is Resident Advisory Group b # of Community Events/Gatherings 0 0.0% $ 5,000.00 1a Resident Advisory Group S $ c # of Event/Gathering Attendees 0 Team $ 1 b Community Action Plan $ $ Team Charter/Work Plan $ $ 0.0% Team $ $ $ 0.0% $ 3b Pro - Social Activities identified by PCW Team Charter/Work Plan $ 0.0% $ 4a Community Calendar $ $ 3a Pro - Social and /or Group Classes $ 4b Monthly Community Meetings $ $ 0.0% $ - 3b Pro - Social Activities identified by PCW $ $ 0.0% $ 1,950.00 4d Production of Media Materials $ 5,050.00 4a Community Calendar $ $ 5,050.00 4e Training /Implementation of Restorative Justice /Restorative Practices in Schools $ 8,000.00 $ 0.0% 4b Monthly Community Meetings $ $ 1,000.00 $ 0.0% $ 1,000.00 5b Oper ting Expense 4c Community Outreach /Service Linkage $ 0.0% $ 1,000.00 Grand Total $ 22,000.00 $ 4d Production of Media Materials $ 4e Training /Implementation of Restorative Justice /Restorative Practices in Schools $ 5a Indirect Costs $ 5b Operating Expense $ Grand Total $ Performance Units of Service Doc 1 Doc 2 Doc 3 Doc 4 Doc 5 a # of Residents Enrolled into Pro - Social Activities 0 c # of Event/Gathering Attendees 0 75 is Resident Advisory Group b # of Community Events/Gatherings 0 0.0% $ 5,000.00 1 b Community Action Plan $ - $ c # of Event/Gathering Attendees 0 Team $ $ 0.0% $ Year -To -Date Information YTD Target = 0 Target Line Item Budget YTD Expended % Expended Budget Remaining Deliverables c # of Event/Gathering Attendees 0 75 is Resident Advisory Group $ 5,000.00 S 0.0% $ 5,000.00 1 b Community Action Plan $ - $ 0.0% $ - Team $ $ 0.0% $ Team Charter/Work Plan $ $ 0.0% $ 3a Pro - Social and /or Group Classes $ $ 0.0% $ 3b Pro - Social Activities identified by PCW $ $ 0.0% $ 4a Community Calendar $ $ 0.0% $ 4b Monthly Community Meetings $ $ 0.0% $ - 4c Community Outreach /Service Linkage $ 1,950.00 $ 0.0% $ 1,950.00 4d Production of Media Materials $ 5,050.00 $ 0.0% $ 5,050.00 4e Training /Implementation of Restorative Justice /Restorative Practices in Schools $ 8,000.00 $ 0.0% $ 8,000.00 5a Indirect Costs $ 1,000.00 $ 0.0% $ 1,000.00 5b Oper ting Expense $ 1,000.00 $ 0.0% $ 1,000.00 Grand Total $ 22,000.00 $ 0.0% $ 22,000.00 Performance Units of Service Target a # of Residents Enrolled into Pro - Social Activities 0 25 b # of Community Events/Gatherings 0 12 c # of Event/Gathering Attendees 0 75 FY 2016 -2017 Quarterly Invoice (SCYTF).xlsx July Expenditure Report Page 2 of 2 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment E Quarter) Contract Status Quarterly Narrative Report y City of Gilroy (NSU) - FY17 -FY20 Report (SCYTF - FY 2017 -2018) PO # Period of Update Section 1 - Milestone Update Date of Update Instructions: Provide a brief update (no more than 4 -6 sentences) on the current status of each contract milestone. The update should clarify the status of the milestone, summarizing major activities, successes and /or challenges related to the milestone and its asserdibited tasks, as identified in the contract scope of work. If tasks associated with a milestonehave an assigned target quantity, provide the current quantity completed. For example, if Ja�task in the. milestone is to-provide pro - social activities to a minimum of 75 individuals, provide the cur7en quantity of individuals served year -to -date, from the start date of contract to the 1`5st day of report up2 ate. Milestone ,# 1 Start Dated 7/1/17 Tang Date/ 6130118' Description Provide ,additional opportunities for residents'(6c 41dren; youth, adults, and seniors) Collaborate vii tlii ttie NSU- Probation Community Worker (PCW) in identifying and' - I to engage in. educational, :health and s# -rela a classes, wor' hops, and presentations to be located in East y / enrolling at risk youth attending schools serving East Gilroy=residents, in pro= social Gi activities.rigrity will be given to youth identified in Multi- System - Meetings (MSTs) or- related Positive Behavior Intervention • Based on, the plan developed ^by the East Gilroy\ SCYTF Technical Team schooVdisciplinary meetings serving. & subcommittee and the 444 dent/neigFborhood group in East Gilroy, u p its (PBIS) tier 2 and tier 3 youth. Pro - social activities for at -risk youth _shall be Contractor shall provide pro - social activities to a minimum of 75 individuals determined_/on an individual basis, based on the needs and interests of the youth. in Year 1: participant Q 1 Q2 Q3 F7��4 Q1 Milestone # 2 �\ > ��`� Start Date 7/1/17 1 Target Date 1 6/30/18 Description Collaborate vii tlii ttie NSU- Probation Community Worker (PCW) in identifying and' - I enrolling at risk youth attending schools serving East Gilroy=residents, in pro= social r activities.rigrity will be given to youth identified in Multi- System - Meetings (MSTs) or- related Positive Behavior Intervention schooVdisciplinary meetings serving. & u p its (PBIS) tier 2 and tier 3 youth. Pro - social activities for at -risk youth _shall be determined_/on an individual basis, based on the needs and interests of the youth. participant e� evelop menu of Pro- social activities for at -risk youth attending schools .serving East .Gilroy residents. • Collaborate with PCWto enroll 50 at -risk youth in individualized, pro - social programming beginning June, 2017 through June,, 2019. Q1 Q2 Q3 Q4 Page 1 of 5 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment E Quarterly Narrative Report City of Gilroy (NSU) — FY17 -FY20 Milestone # 3 -Start Date 7/1117 1 Target Date 6/30/1$ escription Establishment of "Resident Leaders" - A Gilroy resident shall be given priority (over Technical Team meetings, advise on ways to, mprove programming and assist in. non - Gilro y. resident, private businesses) to teach a health and /or educational: class resident outreach far'SCYTF spon sored; events,. o Establish R orworkshop as described in deliverable #1. The "Resident. Leader" may receive an • s denUAv[sry Group membership, vision mission, and goals by-J 30, 20177 � incentive for each class or workshop they teach. Probation and SCYTF staff will work alongside resident leaders. to develop a class schedule, curriculum if necessary, and support them in developing leadership /organizational skills to Q1 successfully execute a class of their design. All classes/workshops should be age: Q2 appropriate, and designed to be open to and benefit any resident who lives in the Q3 East Gilroy Community. If "Resident. Leaders" are not available to teach a particular Q4 class, Contractor shall have the discretion to subcontract With non- residents teachers with written agreement from the County., Develop Community Event/Class Schedule and ide tm ify ".Resident: First Community Calendar due July 1st; 2017. Q1 Q2 Q3 Q4 <\ V Milestone # 4 tart`Date 7/1117 Target Date 1 6/30/18 Description Contractor will establish a res§ii4ent ailvisorxgkoup to participate in SCYTF Cbntrarctor shall coordinate at least one monthly community event/gathering with a Technical Team meetings, advise on ways to, mprove programming and assist in. core-group of resident leaders (youth and /or adults) of East Gilroy. Resident led resident outreach far'SCYTF spon sored; events,. o Establish R workshops or pro - social activities should be pla_.nned for and included in a monthly • s denUAv[sry Group membership, vision mission, and goals by-J 30, 20177 � calendar and distributed. widely-to; residents of 'East Gilroy. Q2 Q3 Q1 / j% Q4 t ( Q2 Milestone # -5 Start Date 1 7/1/17 1 Target. Date 6/30/18 Description Cbntrarctor shall coordinate at least one monthly community event/gathering with a core-group of resident leaders (youth and /or adults) of East Gilroy. Resident led workshops or pro - social activities should be pla_.nned for and included in a monthly calendar and distributed. widely-to; residents of 'East Gilroy. • . Develop Community Event/Class Schedule and identify"Resident Leaders." First Community Calendar due July 1st; 201'7 Q1 Q2 j Q3 Q4 Quarterly Contract Status Report Page 2 of 5 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment E Quarterly Narrative Report City of Gilroy (NSU) — FY17 -FY20 Milestone # 6 Start-Date 1 7/1/17 1, Target Date 1.,6/30/18 Description Contractor shall identify a group, of resident, leaders, and assist in developing, /Target prioritizing, .and'. implementing at Jeast two community action projects within the Description term of this.Agreement. Contractor shall work with, theresident group to complete Q3 and submit an annual community action; project plan. Contractor shall assist:in =Q4 providing outreach and event coordination for each community action project. Depending on community action: project, the resident leaders will be empowered to present to the Gilroy Parks and Recreation Commission and to Gilroy City Council.' • Develop Community Action Project Plan for Year 1 by,/Ju a 30, 2017. Q1 Q3 Q4 Q3 Q4 Milestone # 7 Start -; e '7- -1'14 7 Date 6/30/18' 1 6/30/18 Description .a /Target Description Community Outreach Worker shalil provide youth/families n:the East Gilroy/ San: Q3 Ysidro Park area,with theopportvuii%lty to jgintthe grassraotsresiide_nt -led committee (San Ysidro Nueva Vida), get-connected tosel�llces, and participate in new =Q4 programs to be offered at San Ysidr o P�rk1 `ti . • Commune Outreach 1luorkershall make contact with a minimum, of 30` ty unduplicated youth /farnilles in the'East Gilroy /San Ysidro Park area by June 30, 2017. Q2 Q3 Q4 Milestone / #/8 Start 'Date 7/1/17 1 Target Date 1 6/30/18 Description S.ubmit-an annum East Gilroy SCYTF Technical Team subcommittee Action plan. Ensure the core elements of the action plan are funded through funds provided in this Agreement. • - *nuat "Envisioning a Drug Free Gilroy" Action Plan due June 30,; 2017. Q1 Q2 Q3 =Q4 Quarterly Contract Status Report Page 3 of 5 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment E Quarterly Narrative Report City of Gilroy (NSU) - FY17 -FY20 Mil'eston_e # 9 StartDate 7/1117 Target: !ate. -' - 6/30/18 D`escnpti- Through panic pationim the Gilroy Unllfied School District's?Restorative Jusi�ce Leatlersh�p Team, support the�plannmg ,;trairungand�implem" ent>onlof restorative. justice and.restorative practicesWm.schools where3EastG�lroy1Wa h attend :. , ;. • 'Resto "rative Justice,Leadershh'A' m Actron Plan /,roa p'd'emJurie 30, m ,.2017. ,.. _. _.-.. ,. Q1 AV AN Q2 V4& Aff Q3 Al Q4 Section 2 - Success Story or Testimonial Instructions: Please write a brief story or ,impacted by an NSU- funded program ani testimonial for each quarter should be ap page. If possible, include the referral soul M111, t a family that has been positively occurred in each quarter. The story or 500 words and no more than 1/3 kited family. Success Story- or Testimor ial�_ IL . 'W Q1 Q2 r, X Q3 Q4 Quarterly Contract Status Report Page 4 of 5 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment E Quarterly Narrative Report City of Gilroy (NSU) — FY17 -FY20 Section 3 — Year -End Summary Instructions: Answer the following questions upon conclusion of 41 Quarter or Program Year. Each answer should be approximately 250 -500 words and no more than 1/3 page. A);' Summarize the, programservices prodded durmg�the, contract term, how they met ordid +not meet,.program objectives, 'and why. - �x: 4, B) Summarize, the program's strengths, challenges .T& d+ess `searned ,, f_ et M �J Quarterly Contract Status Report Page 5 of 5 r % l �J Quarterly Contract Status Report Page 5 of 5 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 Attachment F Indirect Cost and Operating Expenses Language City of Gilroy (NSU) - FY17 -FY20 Indirect Cost Indirect costs are shared costs that cannot be directly assigned to a particular activity, but are necessary for operation of the organization and the performance of the project. The costs of operating and maintaining facilities; accounting services and administrative salaries are examples of indirect costs. Indirect cost invoices must include supporting documentation that demonstrates the cost breakdown of the items stated above and the percentage allocated across various programs; e.g. administrative salaries. Contractor will not charge /invoice for administrative staff positions across programs and contracts in the excess of 100% of their cost. Operating Expenses Allowable operating expenses are defined as necessary expenditures exclusive of personnel salaries, benefits, and equipment. The expenses must be service- related (i.e., to further the program's objectives). A. ALLOWABLE EXPENSE ITEMS —See examples of operating expenses below. Any items that are not listed below may be invoiced as an operating expense if pre- approved by the Probation Manager /other Probation official overseeing the contract. • Answering service fees; • Confidential expenditures; • Conferences, seminars, workshops, and training; • Internet access; e Janitorial services; • Office supplies; • Office space; • Postage; • Printing; • Telephone /Communications • And Training materials. DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 EXHIBIT B -2 (revised) INSURANCE REQUIREMENTS FOR STANDARD CONTRACTS ABOVE $100,000 Mutual Indemnitv The City of Gilroy (hereinafter "City ") shall indemnify, defend, and hold harmless the County of Santa Clara (hereinafter "County"), its officers, agents and employees from any claim, liability, loss, injury or damage arising out of, or in connection with, performance of this Agreement by the City and/or its agents, employees or sub - contractors, excepting only loss, injury or damage caused by the sole negligence or willful misconduct of personnel employed by the County. It is the intent of the parties to this Agreement to provide the broadest possible coverage for the County. The City shall reimburse the County for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which the City contests its obligation to indemnify, defend and/or hold harmless the County under this Agreement and does not prevail in that contest. The County shall indemnify, defend, and hold harmless the City, its officers, agents and employees from any claim, liability, loss, injury or damage arising out of, or in connection with, performance of this Agreement by the County and/or its agents, employees or sub - contractors, excepting only loss, injury or damage caused by the sole negligence or willful misconduct of personnel employed by the City. It is the intent of the parties to this Agreement to provide the broadest possible coverage for the City. The County shall reimburse the City for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which the County contests its obligation to indemnify, defend and /or hold harmless the City under this Agreement and does not prevail in that contest. Insurance Without limiting the City's indemnification of the County, the City shall provide and maintain at its own expense, during the term of this Agreement, or as may be further required herein, the following insurance coverages and provisions: A. Evidence of Coverage Prior to commencement of this Agreement, the City shall provide a Certificate of Insurance certifying that coverage as required herein has been obtained. Individual endorsements executed by the insurance carrier shall accompany the certificate. In addition, a certified copy of the policy or policies shall be provided by the City upon request. This verification of coverage shall be sent to the requesting County department, unless otherwise directed. The City shall not receive a Notice to Proceed with the work under the Agreement until it has obtained all insurance required and such insurance has been approved by the County. This approval of insurance shall neither relieve nor decrease the liability of the City. Rev. 6/2017 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 EXHIBIT B -2 (revised) B. Qualifying Insurers All coverages, except surety, shall be issued by companies which hold a current policy holder's alphabetic and financial size category rating of not less than A- V, according to the current Best's Key Rating Guide or a company of equal financial stability that is approved by the County's Insurance Manager. C. Notice of Cancellation All coverage as required herein shall not be canceled or changed so as to no longer meet the specified County insurance requirements, without 30 days' prior written notice of such cancellation or change being delivered to the County or their designated agent. D. Insurance Required 1. Commercial General Liability Insurance - for bodily injury (including death) and property damage which provides limits as follows: a. Each occurrence - $1,000,000 b. General aggregate - $2,000,000 c. Products /Completed Operations aggregate - $2,000,000 d. Personal Injury - $1,000,000 2. General liability coverage shall include: a. Premises and Operations b. Products /Completed C. Personal Injury liability d. Severability of interest 3. General liability coverage shall include the following endorsement, a copy of which shall be provided to the County: Additional Insured Endorsement, which shall read: "County of Santa Clara, and members of the Board of Supervisors of the County of Santa Clara, and the officers, agents, and employees of the County of Santa Clara, individually and collectively, as additional insureds." Rev. 6/2017 2 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 EXHIBIT B -2 (revised) Insurance afforded by the additional insured endorsement shall apply as primary insurance, and other insurance maintained by the County, its officers, agents, and employees shall be excess only and not contributing with insurance provided under this policy. Public Entities may also be added to the additional insured endorsement as applicable and the City shall be notified by the contracting department of these requirements. 4. Automobile Liabilitv Insurance For bodily injury (including death) and property damage which provides total limits of not less than one million dollars ($1,000,000) combined single limit per occurrence applicable to all owned, non -owned and hired vehicles. 4a. Aircraft/Watercraft Liability Insurance (Required if the City or any of its agents or subcontractors will operate aircraft or watercraft in the scope of the Agreement) For bodily injury (including death) and property damage which provides total limits of not less than one million dollars ($1,000,000) combined single limit per occurrence applicable to all owned, non -owned and hired aircraft/watercraft. Workers' Compensation and Employer's Liability Insurance a. Statutory California Workers' Compensation coverage including broad form all- states coverage. b. Employer's Liability coverage for not less than one million dollars ($1,000,000) per occurrence. E. Special Provisions The following provisions shall apply to this Agreement: 1. The foregoing requirements as to the types and limits of insurance coverage to be maintained by the' City and any approval of said insurance by the County or its insurance consultant(s) are not intended to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed by the City pursuant to this Agreement, including but not limited to the provisions concerning indemnification. 2. The County acknowledges that some insurance requirements contained in this Agreement may be fulfilled by self-insurance on the part of the City. However, this shall not in any way limit liabilities assumed by the City under this Agreement. Any self - insurance shall be approved in writing by the County upon satisfactory Rev. 6/2017 DocuSign Envelope ID: 34969004- C7B1- 4CB0- B5D0- EF67AF1E5C40 EXHIBIT B -2 (revised) evidence of financial capacity. The City's obligation hereunder may be satisfied in whole or in part by adequately funded self - insurance programs or self - insurance retentions. Should any of the work under this Agreement be sublet, the City shall require each of its subcontractors of any tier to carry the aforementioned coverages, or the City may insure subcontractors under its own policies. 4. The County reserves the right to withhold payments to the City in the event of material noncompliance with the insurance requirements outlined above. Rev. 6/2017 4