HomeMy WebLinkAboutSanta Clara County - Probation Department (2017) - Amendment No. 1COUNTY OF SANTA CLARA – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing agreement
)RUP(IIHFWLYHDVRI0D\ 3DJHRI
Reason(s) for Amending the Service Agreement
Amend Term of Agreement
2UVHH$WWDFKPHQWBBBBBBBBDVLQFRUSRUDWHGE\WKLVUHIHUHQFH
Amend Contract Specifics
1RWH $QHZ$JUHHPHQWVKRXOGEHFUHDWHGLIWKH6FRSHRI6HUYLFHVLVVLJQLILFDQWO\PRGLILHGRUH[SDQGHG
2UVHH$WWDFKPHQWBBBBBBBBDVLQFRUSRUDWHGE\WKLVUHIHUHQFH
Amend Maximum Financial Obligation
$0D[LPXP)LQDQFLDO2EOLJDWLRQSULRUWRWKLV$PHQGPHQW
6DPHDVRQSDJH
%$PRXQWRILQFUHDVHRUGHFUHDVH
([SODLQEHORZ
&5HYLVHG0D[LPXP)LQDQFLDO2EOLJDWLRQ
$%ZLOOHTXDO&
([SODQDWLRQRILQFUHDVHGHFUHDVH LQFOXGHQHZSD\PHQWWHUPVLIDSSOLFDEOH
2UVHH$WWDFKPHQWBBBBBBBBDVLQFRUSRUDWHGE\WKLVUHIHUHQFH
✔
Attachment A-1 amends Section V "Contract Specifics" in its entirety. Changes for this amendment are denoted in boldfaced font.
A-1
279,550
70,000
349,550
Funding is being added to expand restorative programs in East Gilroy.
A-1
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
COUNTY OF SANTA CLARA – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing agreement
)RUP(IIHFWLYHDVRI0D\ 3DJHRI
Amend Standard Provisions
2UVHH$WWDFKPHQWBBBBBBBBDVLQFRUSRUDWHGE\WKLVUHIHUHQFH
2U6HFWLRQ9,6WDQGDUG3URYLVLRQVLVUHSODFHGLQLWVHQWLUHW\E\$WWDFKPHQWBBBBBBBB
Other (please explain below)
2UVHH$WWDFKPHQWBBBBBBBBDVLQFRUSRUDWHGE\WKLVUHIHUHQFH
Contract History
7RWDOILQDQFLDOREOLJDWLRQIURPSULRUILVFDO\HDU V
)LQDQFLDOREOLJDWLRQLQFXUUHQWILVFDO\HDU
&XPXODWLYHWRWDORIDOODJUHHPHQWVZLWKWKLV&RQWUDFWRUZLWKLQ%XGJHW8QLWIRUVDPH
W\SHRIVHUYLFHV LQFOXGLQJWKLVDPHQGPHQW
Insurance
,QVXUDQFHGRHVQRWUHTXLUHFKDQJHV
,QVXUDQFH([KLELWLVUHSODFHGE\([KLELW%BBBBBBBBDWWDFKHGDQGLQFRUSRUDWHGE\WKLVUHIHUHQFH
✔
G
107,850 (FY17-FY18)
241,700 (FY19 - FY20)
349,550
✔
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭ
6HFWLRQ9 &RQWUDFW6SHFLILFV
$PHQGHGWH[W DVRIWKLVDPHQGPHQW LVGHQRWHGEHORZLQ%2/')$&('IRQW
$6HUYLFH'HVFULSWLRQDQG([SHFWHG2XWFRPH 6FRSHRI6HUYLFH
7KLV$JUHHPHQWLVEHWZHHQWKH&RXQW\RI6DQWD&ODUD3UREDWLRQ'HSDUWPHQW ³&RXQW\´RU
³3UREDWLRQ´ DQGWKH&LW\RI*LOUR\ ³&RQWUDFWRU´ DQGUHODWHVWRHVWDEOLVKLQJDSDUWQHUVKLS
EHWZHHQWKH1HLJKERUKRRG6DIHW\6HUYLFHV8QLW 168 DQGWKH6RXWK&RXQW\<RXWK7DVN
)RUFH 6&<7) WRVXSSRUWWKH\RXWKDQGIDPLOLHVZKRUHVLGHLQ(DVW*LOUR\7KLV$JUHHPHQW
HVWDEOLVKHVDFRPPLWPHQWRQEHKDOIRIERWKWKH&RXQW\DQG&RQWUDFWRUWRZRUN
FROODERUDWLYHO\WRLQFUHDVHFRPPXQLW\VDIHW\WREXLOGFRPPXQLW\FDSDFLW\DQGOHDGHUVKLS
DPRQJVWUHVLGHQWVDQGWRIRVWHUDVHQVHRIFRPPXQLW\FRKHVLRQE\SURYLGLQJDGGLWLRQDOSUR
VRFLDORSSRUWXQLWLHVIRU(DVW*LOUR\UHVLGHQWV
&RQWUDFWRU¶VUHVSRQVLELOLWLHVVKDOOLQFOXGHWKHIROORZLQJ
'HYHORSDQGVXVWDLQDFRUHJURXSRI*LOUR\UHVLGHQWDGYLVRU\OHDGHUVZKRZLOOEH
LQWHJUDWHGLQWRWKHDGYLVRU\VWUXFWXUHRIWKH6RXWK&RXQW\<RXWK7DVN)RUFHWKURXJKWKH
6&<7)7HFKQLFDO7HDPDQGVXEFRPPLWWHHSDUWLFLSDWLRQ&RQWUDFWRUVKDOOHQVXUHWKHVH
UHVLGHQWDGYLVRUVDUHSURYLGHGWKHRSSRUWXQLW\WRSDUWLFLSDWHLQ6&<7)PHHWLQJVDGYLVH
RQZD\VWRLPSURYHSURJUDPPLQJDQGDVVLVWLQUHVLGHQWRXWUHDFKIRU6&<7)VSRQVRUHG
HYHQWV
'HYHORSDUHVLGHQWOHDGHUVKLSJURXSLQ(DVW*LOUR\7KLVUHVLGHQWOHDGHUVKLSJURXSVKDOO
ZRUNWRZDUGVLGHQWLI\LQJSULRULWL]LQJDQGLPSOHPHQWLQJDWOHDVWWZRFRPPXQLW\DFWLRQ
SURMHFWVSHU\HDUZLWKLQWKHWHUPRIWKLV$JUHHPHQW,QDQHIIRUWWRDYRLGGXSOLFDWLRQRI
HIIRUWVWKHFRPPXQLW\EDVHGRUJDQL]DWLRQ V DQG&RQWUDFWRUPD\FKRRVHWRSDUWQHUZLWK
WKH3XEOLF+HDOWK'HSDUWPHQW¶V³6DIHDQG3HDFHIXO6DQ<VLGUR3DUN´LQLWLDWLYH
6XSSRUWHIIRUWVWRSUHYHQWYLROHQFHLQFRPPXQLWLHVDQGRQVFKRROFDPSXVHVZKHUH
(DVW*LOUR\\RXWKDWWHQGRUUHFUHDWHVXFKDVWKHSODQQLQJDQGLPSOHPHQWDWLRQRI
UHVWRUDWLYHSUDFWLFHVDQGUHVWRUDWLYHMXVWLFHDFWLYLWLHV
3URYLGHSURVRFLDORSSRUWXQLWLHVIRU\RXWKDQGIDPLOLHVZKRUHVLGHLQ(DVW*LOUR\
([DPSOHVRISURVRFLDODFWLYLWLHVDUHOLVWHGLQWKHGHOLYHUDEOHVWDEOHEHORZ
D$OOSURJUDPPLQJIRUSURVRFLDODFWLYLWLHVDQGRURSSRUWXQLWLHVPXVWEHGHYHORSHG
FROODERUDWLYHO\WKURXJKWKHZRUNRIWKH6DQ<VLGURUHVLGHQWVDQGLQFROODERUDWLRQZLWK
PHPEHUVRIWKH6RXWK&RXQW\<RXWK7DVN)RUFH7HFKQLFDO7HDP
E&RQWUDFWRUPD\SURYLGHLQFHQWLYHVIRUFOLHQWVWRVXFFHVVIXOO\SDUWLFLSDWHLQ
SURJUDPPLQJ
$WWHQGDQGSDUWLFLSDWHLQWKH1HLJKERUKRRG6DIHW\6HUYLFHV8QLW 168 $GYLVRU\
&RPPLWWHHPHHWLQJVDQGDQQXDOUHWUHDWV
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
Ϯ
&ROODERUDWHZLWKWKH&RXQW\WRLPSOHPHQWDWDIXWXUHGDWHDVHULHVRIUHVLGHQWOHDGHUVKLS
ZRUNVKRSV
&RRUGLQDWHDQ\IRRGRUEHYHUDJHVSURYLGHGDWFRPPXQLW\HYHQWVDQGFODVVHVLI
QHFHVVDU\IXQGHGWKURXJKWKLV$JUHHPHQW
$VVLVWWKH&RXQW\LQFROOHFWLRQRIUHVLGHQWOHYHOGDWDLQFOXGLQJWKHLPSOHPHQWDWLRQRI
VXUYH\VDQGHYDOXDWLRQLQVWUXPHQWVDQGRUTXHVWLRQQDLUHVWRPHDVXUHFRPPXQLW\
FRKHVLRQSHUFHSWLRQRIVDIHW\DQGVDWLVIDFWLRQZLWKFRPPXQLW\HYHQWVJDWKHULQJV
6XEPLW4XDUWHUO\&RQWUDFW6WDWXV5HSRUWXVLQJDWHPSODWHSURYLGHGE\WKH&RXQW\
$WWDFKPHQW(
3URYLGHDVKDUHGZRUNVWDWLRQLQFOXGLQJDFRPSXWHULQWHUQHWDFFHVVSKRQHDQGVXSSOLHV
IRUD3UREDWLRQ&RPPXQLW\:RUNHU 3&: ZKRPD\EHORFDWHGRQVLWHIRUXSWRWKUHH
IRXUGD\VSHUZHHN KRXUVSZHHN 7KH3&:ZLOOZRUNLQFRRUGLQDWLRQZLWK
&RQWUDFWRUVWDIIWRLPSOHPHQWWKHVHUYLFHVGHVFULEHGLQWKLV$JUHHPHQW
,IUHTXHVWHGE\WKH&RXQW\&RQWUDFWRUVKDOOFROODERUDWHZLWKWKH&RXQW\WRUHQHJRWLDWH
DQDQQXDO<HDU<HDUDQG<HDU'HOLYHUDEOH6FKHGXOHDQG%XGJHW
%'HOLYHUDEOHV0LOHVWRQHVDQG7LPHOLQHIRU3HUIRUPDQFH
&RQWUDFWRUZLOOPDLQWDLQDZULWWHQDQGHOHFWURQLFLQGLYLGXDOL]HGILOHRQHDFKFOLHQW
GRFXPHQWFOLHQW¶VSURJUHVVZLWKLQDVVLJQHGVHUYLFHSURJUDPDQGQRWLI\3UREDWLRQ
6WDIIRIFOLHQW¶VSURJUHVVDQGRUSUREOHPVHQFRXQWHUHGZLWKLQDVVLJQHG
VHUYLFHSURJUDPUHIHUHQFH$WWDFKPHQW%³168(QUROOPHQW)RUP´
&RQWUDFWRUPXVWZRUNZLWKWKH&RXQW\¶VHYDOXDWLRQVWDIIDQGFRQVXOWDQWVWRFROOHFW
GDWDDVUHTXLUHGE\WKH&RXQW\
D&RQWUDFWRUPXVWDVVLVWLQVXSSRUWLQJDQGLPSOHPHQWLQJWKHJRDOVRIWKH&RXQW\
LQFOXGLQJWKHRXWFRPHPHDVXUHVDVGHWHUPLQHGE\WKH&RXQW\¶VHYDOXDWLRQ
FRQVXOWDQWV
&RQWUDFWRUPXVWSURYLGH&RXQW\ZLWKD4XDUWHUO\1DUUDWLYH5HSRUW$WWDFKPHQW(
³4XDUWHUO\1DUUDWLYH5HSRUW´2QFHWKH4XDUWHUO\1DUUDWLYH5HSRUWIRUPDWLV
DSSURYHGE\WKH&RXQW\&RQWUDFWRUPXVWVXEPLWLWTXDUWHUO\WRWKH&RXQW\IRU
FRQWHQWVDSSURYDO
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϯ
'HOLYHUDEOHVDQGPLOHVWRQHVDUHVXEMHFWWRFKDQJHDVPXWXDOO\DJUHHGXSRQE\
&RQWUDFWRUDQG&RXQW\7KHGHOLYHUDEOHVDQGPLOHVWRQHVUHODWHGWRVFRSHLWHPVDUH
DVIROORZV
<HDU )< 'HOLYHUDEOHV
'HOLYHUDEOH'HVFULSWLRQ6XSSRUW
'RFXPHQWDWLRQ
5HTXLUHGIRU
5HLPEXUVHPHQW
$QWLFLSDWHG
&RPSOHWLRQ
'DWH
)UHTXH
QF\
D 3URJUDP
6XSSOLHVIRU
SURVRFLDO
DFWLYLWLHVKHOGDW
6DQ<VLGURSDUN
7KHSXUSRVHRIWKHUHVLGHQWDGYLVRU\JURXSLV
WRSDUWLFLSDWHLQ6&<7)7HFKQLFDO7HDP
PHHWLQJVDGYLVHRQZD\VWRLPSURYH
SURJUDPPLQJDQGDVVLVWLQUHVLGHQWRXWUHDFK
IRU6&<7)VSRQVRUHGHYHQWVDQGFRQWLQXH
WKHIRXQGDWLRQDOZRUNRIWKH6DIHDQG
3HDFHIXO6DQ<VLGURLQLWLDWLYHGHYHORSHGE\
WKHSXEOLFKHDOWKGHSDUWPHQW
5HVLGHQW$GYLVRU\*URXSVKDOOPDLQWDLQD
GHILQLWLRQRIPHPEHUVKLSWKHLUYLVLRQ
PLVVLRQDQGJRDOV
5HVLGHQW
$GYLVRU\JURXS
PHHWLQJVLJQLQ
VKHHWV
$QQXDO
F &RPPXQLW\
RXWUHDFKDQG
FRQQHFWLRQRI
FOLHQWVWR
VHUYLFHV
&RPPXQLW\2XWUHDFK:RUNHUVKDOOSURYLGH
\RXWKIDPLOLHVLQWKH(DVW*LOUR\6DQ<VLGUR
3DUNDUHDZLWKWKHRSSRUWXQLW\WRMRLQWKH
JUDVVURRWVUHVLGHQWOHGFRPPLWWHHDFWLYLWLHV
6DQ<VLGUR1XHYD9LGD JHWFRQQHFWHGWR
VHUYLFHVDQGSDUWLFLSDWHLQQHZSURJUDPVWR
EHRIIHUHGDW6DQ<VLGUR3DUN7KH
&RPPXQLW\2XWUHDFK:RUNHUVKDOODOVR
DVVLVWLQRXWUHDFKEXLOGLQJUHODWLRQVKLSZLWK
SDUNDWWHQGHHVHYHQWSODQQLQJDQGVHWXS
WDVNVIRUFRPPXQLW\HYHQWVDVQHHGHG
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
$QQXDO
G &0$3 5HFRUGLQJWKHYDULRXVDFWLYLWLHVWDNLQJSODFH
DWWKH6DQ<VLGUR&RPPXQLW\&HQWHUWREH
LQFRUSRUDWHGZLWKLQDFRPSOHWHGYLGHRRIWKH
UHVLGHQWOHDGHUVKLSJURXSGRFXPHQWLQJWKHLU
IRUPDWLRQDQGFROODERUDWLYHZRUN9LGHR
IRRWDJHFDSWXUHGLQWKHUHPDLQLQJZHHNVRI
)<ZLOOEHDGGHGWRIXWXUHVKRUW
GRFXPHQWDU\YLGHRVLQIXWXUHFRQWUDFW\HDUV
DVDQRQJRLQJSURMHFW
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
$QQXDO
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϰ
H 5HVWRUDWLYH
-XVWLFH
6XSSRUWWKH5HVWRUDWLYH-XVWLFH7UDLQLQJWR
EHKHOGLQSDUWQHUVKLSZLWKWKH*LOUR\
8QLILHG6FKRRO'LVWULFWWKHODVWWZRZHHNVRI
-XQH
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
$QQXDO
D ,QGLUHFW&RVWV ,QGLUHFWFRVWVDVQHHGHG 9DULHV 9DULHV
E 2SHUDWLQJ
([SHQVH
2SHUDWLQJH[SHQVHVDVQHHGHG 9DULHV 9DULHV
<HDU )< 'HOLYHUDEOHV
'HOLYHUDEOH'HVFULSWLRQ6XSSRUW
'RFXPHQWDWLRQ
5HTXLUHGIRU
5HLPEXUVHPHQW
$QWLFLSDWHG
&RPSOHWLRQ
'DWH
)UHTXH
QF\
D (VWDEOLVKDQG
PDLQWDLQD
UHVLGHQW
DGYLVRU\JURXS
IRFXVHGLQ(DVW
*LOUR\
6XEWRWDO
7KHSXUSRVHRIWKHUHVLGHQWDGYLVRU\JURXSLV
WRSDUWLFLSDWHLQ6&<7)7HFKQLFDO7HDP
PHHWLQJVDGYLVHRQZD\VWRLPSURYH
SURJUDPPLQJDQGDVVLVWLQUHVLGHQWRXWUHDFK
IRU6&<7)VSRQVRUHGHYHQWVDQGFRQWLQXH
WKHIRXQGDWLRQDOZRUNRIWKH6DIHDQG
3HDFHIXO6DQ<VLGURLQLWLDWLYHGHYHORSHGE\
WKH3XEOLF+HDOWK'HSDUWPHQW
5HVLGHQW$GYLVRU\*URXSVKDOOPDLQWDLQD
GHILQLWLRQRIPHPEHUVKLSWKHLUYLVLRQ
PLVVLRQDQGJRDOV
5HVLGHQW
$GYLVRU\JURXS
PHHWLQJVLJQLQ
VKHHWV
0RQWKO\
E 6XEPLVVLRQRI
$QQXDO
&RPPXQLW\
$FWLRQ3ODQ
&RQWUDFWRUVKDOODVVLVWWKH(DVW*LOUR\
5HVLGHQW/HDGHUVKLSJURXSLQHVWDEOLVKLQJD
&RPPXQLW\$FWLRQ3ODQ6SHFLILFJRDOVDQG
REMHFWLYHVWKDWDUHLGHQWLILHGE\(DVW*LOUR\
UHVLGHQWOHDGHUVGHILQHGLQWKLVDFWLRQSODQ
VKDOOEHIXQGHGWKURXJKWKLV$JUHHPHQW
&RQWUDFWRUVKDOOHQVXUHWKLVDFWLRQSODQLVLQ
DOLJQPHQWZLWKWKHUHVLGHQWOHDGHUVKLSJURXS
HVWDEOLVKHGLQ(DVW*LOUR\168ZLOOSURYLGH
6&<7)ZLWKWKH&RPPXQLW\$FWLRQ3ODQ
WHPSODWH
&RPPXQLW\
$FWLRQ3ODQ
$QQXDO
D(VWDEOLVKDQG
PDLQWDLQWKH
6&<7)(DVW
*LOUR\
7KH(DVW*LOUR\6&<7)VXEFRPPLWWHH168
,PSOHPHQWDWLRQ7HDPVKRXOGFRQVLVWRI168
VWDII6&<7)SDUWQHUV DWOHDVW&%2V DQG
$JHQGDPHHWLQJ
QRWHVVLJQLQ
VKHHW
/DVW
PHHWLQJWR
EHKHOGE\
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϱ
6XEFRPPLWWHH
ZKLFKDOVR
VHUYHVDVWKH
168
,PSOHPHQWDWLRQ
7HDP7KLV
VXEFRPPLWWHH
WHDPVKDOOPHHW
PRQWKO\
&LW\RI*LOUR\VWDIIDQG(DVW*LOUR\
UHVLGHQW
E 'HYHORSDQG
VXEPLWWKH(DVW
*LOUR\6&<7)
7HFKQLFDO7HDP
VXEFRPPLWWHH
168
,PSOHPHQWDWLRQ
7HDP
&KDUWHU:RUN
3ODQ
7KHSXUSRVHRIWKLVVXEFRPPLWWHH
&KDUWHU:RUN3ODQLVWRDOLJQWKHZRUNRIWKH
VXEFRPPLWWHHPHPEHUVZLWKWKHFRPPXQLW\
DFWLRQJRDOVRIWKHUHVLGHQWOHDGHUVKLSJURXS
HVWDEOLVKHGLQ(DVW*LOUR\
(DVW*LOUR\
6&<7)
7HFKQLFDO7HDP
VXEFRPPLWWHH
168
,PSOHPHQWDWLRQ
7HDP
&KDUWHU$FWLRQ
3ODQ
LQLWLDO
&KDUWHU
:RUN3ODQ
$QQXDO
D 3URYLGHSUR
VRFLDODQGRU
JURXSFODVVHV
UHODWHGWR
HGXFDWLRQDO
KHDOWKDQG
ZHOOQHVVVDIHW\
DQGJDQJ
SUHYHQWLRQ
UHODWHG
FODVVHVZRUNVKR
SV
SUHVHQWDWLRQVWR
(DVW*LOUR\
UHVLGHQWV
*URXSFODVVHVZRUNVKRSVDQGSUHVHQWDWLRQV
VKDOOEHORFDWHGLQ(DVW*LOUR\6DQ<VLGUR
&RPP&HQWHU
$*LOUR\UHVLGHQWVKDOOEHJLYHQSULRULW\
RYHUQRQ*LOUR\UHVLGHQWSULYDWH
EXVLQHVVHV WRWHDFKDKHDOWKDQGRU
HGXFDWLRQDOFODVVRUZRUNVKRS,QFHQWLYHVIRU
UHVLGHQWVWRWHDFKZRUNVKRSVDUHDOORZDEOH
5HVLGHQWOHGZRUNVKRSVRUSURVRFLDO
DFWLYLWLHVVKRXOGEHSODQQHGIRUDQGLQFOXGHG
LQDPRQWKO\FDOHQGDUDQGGLVWULEXWHGZLGHO\
WRUHVLGHQWVRI(DVW*LOUR\$OO
FODVVHVZRUNVKRSVVKRXOGEHDJHDSSURSULDWH
DQGGHVLJQHGWREHRSHQWRDQGEHQHILWDQ\
UHVLGHQWZKROLYHVLQWKH(DVW*LOUR\
&RPPXQLW\,I³5HVLGHQW/HDGHUV´DUHQRW
DYDLODEOHWRWHDFKDSDUWLFXODUFODVV
&RQWUDFWRUVKDOOKDYHWKHGLVFUHWLRQWR
VXEFRQWUDFWZLWKQRQUHVLGHQWVWHDFKHUVZLWK
ZULWWHQDJUHHPHQWIURPWKH&RXQW\
0RQWKO\*URXS
&ODVVHV
(QUROOPHQWVLJQ
LQVKHHWVDQG
&RVW6XPPDU\
5HSRUW
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϲ
E ,QGLYLGXDOSUR
VRFLDODFWLYLWLHV
IRUDWULVN\RXWK
LGHQWLILHGE\WKH
1683UREDWLRQ
&RPPXQLW\
:RUNHU
&ROODERUDWHZLWKWKH1683UREDWLRQ
&RPPXQLW\:RUNHU 3&: LQLGHQWLI\LQJ
DQGHQUROOLQJDWULVN\RXWKDWWHQGLQJVFKRROV
VHUYLQJ(DVW*LOUR\UHVLGHQWVLQSURVRFLDO
DFWLYLWLHV3ULRULW\ZLOOEHJLYHQWR\RXWK
LGHQWLILHGLQ0XOWL6\VWHP0HHWLQJV 067V
RUUHODWHGVFKRROGLVFLSOLQDU\PHHWLQJV
VHUYLQJ3RVLWLYH%HKDYLRU,QWHUYHQWLRQ
6XSSRUWV 3%,6 WLHUDQGWLHU\RXWK 3UR
VRFLDODFWLYLWLHVIRUDWULVN\RXWKVKDOOEH
GHWHUPLQHGRQDQLQGLYLGXDOEDVLVEDVHGRQ
WKHQHHGVDQGLQWHUHVWVRIWKH\RXWK
SDUWLFLSDQW
168(QUROOPHQW
)RUP
$WWDFKPHQW%
0RQWKO\
D&RPPXQLW\
&DOHQGDU
'HYHORSDQG6XEPLW0RQWKO\&RPPXQLW\
(YHQW&ODVVHV&DOHQGDUE\WKHWKGD\RI
HDFKPRQWKIRUWKHXSFRPLQJPRQWK
&RPPXQLW\
&DOHQGDU
0RQWKO\
E 0RQWKO\
FRPPXQLW\
PHHWLQJZLWKD
FRUHJURXSRI
UHVLGHQWOHDGHUV
\RXWKDQGRU
DGXOWV RI(DVW
*LOUR\
&RQWUDFWRUVKDOOFRRUGLQDWHDWOHDVWRQH
PRQWKO\FRPPXQLW\PHHWLQJZLWKDFRUH
JURXSRIUHVLGHQWOHDGHUV \RXWKDQGRU
DGXOWV RI(DVW*LOUR\
$JHQGDPHHWLQJ
QRWHVVLJQLQ
VKHHW
0RQWKO\
F &RPPXQLW\
RXWUHDFKDQG
FRQQHFWLRQRI
FOLHQWVWR
VHUYLFHV
&RPPXQLW\2XWUHDFK:RUNHUVKDOOSURYLGH
\RXWKIDPLOLHVLQWKH(DVW*LOUR\6DQ<VLGUR
3DUNDUHDZLWKWKHRSSRUWXQLW\WRMRLQWKH
JUDVVURRWVUHVLGHQWOHGFRPPLWWHHDFWLYLWLHV
6DQ<VLGUR1XHYD9LGD JHWFRQQHFWHGWR
VHUYLFHVDQGSDUWLFLSDWHLQQHZSURJUDPVWR
EHRIIHUHGDW6DQ<VLGUR3DUN7KH
&RPPXQLW\2XWUHDFK:RUNHUVKDOODOVR
DVVLVWLQRXWUHDFKEXLOGLQJUHODWLRQVKLSZLWK
SDUNDWWHQGHHVHYHQWSODQQLQJDQGVHWXS
WDVNVIRUFRPPXQLW\HYHQWVDVQHHGHG
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
0RQWKO\
G &0$3 3URGXFWLRQRIPHGLDPDWHULDOVUHJDUGLQJWKH
ZRUNRIWKHUHVLGHQWOHDGHUVKLSJURXS 9LGHR
DQGPXVLFFODVVHVDUHLQFRUSRUDWHGZLWKD
FRPSOHWHGYLGHRRIWKHUHVLGHQWOHDGHUVKLS
JURXSGRFXPHQWLQJWKHLUIRUPDWLRQDQG
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϳ
FROODERUDWLYHZRUN6KRUWYLGHRVZLOOEH
FRPSOHWHGRIWKHLUVSRQVRUHGHYHQWVDQG
GRFXPHQWLQJQHZFODVVHV&0$36WDIIZLOO
DWWHQGELZHHNO\UHVLGHQWPHHWLQJV
H 5HVWRUDWLYH
-XVWLFH
6XSSRUWWKHWUDLQLQJDQGLPSOHPHQWDWLRQRI
UHVWRUDWLYHMXVWLFHUHVWRUDWLYHSUDFWLFHVLQ
VFKRROVDQGRWKHUVHWWLQJVWKDWVXSSRUW(DVW
*LOUR\UHVLGHQWV
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
4XDUWHUO
\
D ,QGLUHFW&RVWV ,QGLUHFWFRVWVDVQHHGHG 9DULHV 9DULHV
E 2SHUDWLQJ
([SHQVH
2SHUDWLQJH[SHQVHVDVQHHGHG 9DULHV 9DULHV
<HDU )< 'HOLYHUDEOHV
'HOLYHUDEOH'HVFULSWLRQ6XSSRUW
'RFXPHQWDWLRQ
5HTXLUHGIRU
5HLPEXUVHPHQW
$QWLFLSDWHG
&RPSOHWLRQ
'DWH
)UHTXH
QF\
D (VWDEOLVKDQG
PDLQWDLQD
UHVLGHQW
DGYLVRU\JURXS
IRFXVHGLQ(DVW
*LOUR\
6XEWRWDO
7KHSXUSRVHRIWKHUHVLGHQWDGYLVRU\JURXS
WRDLPWRSDUWLFLSDWHLQ6&<7)7HFKQLFDO
7HDPPHHWLQJVDGYLVHRQZD\VWRLPSURYH
SURJUDPPLQJDQGDVVLVWLQUHVLGHQWRXWUHDFK
IRU6&<7)VSRQVRUHGHYHQWVDQGFRQWLQXH
WKHIRXQGDWLRQDOZRUNRIWKH6DIHDQG
3HDFHIXO6DQ<VLGURLQLWLDWLYHGHYHORSHGE\
WKHSXEOLFKHDOWKGHSDUWPHQW
5HVLGHQW$GYLVRU\*URXSVKDOOPDLQWDLQD
GHILQLWLRQRIPHPEHUVKLSWKHLUYLVLRQ
PLVVLRQDQGJRDOV
5HVLGHQW
$GYLVRU\JURXS
PHHWLQJVLJQLQ
VKHHWV
0RQWKO\
E 6XEPLVVLRQRI
$QQXDO
&RPPXQLW\
$FWLRQ3ODQ
&RQWUDFWRUVKDOODVVLVWWKH(DVW*LOUR\
5HVLGHQW/HDGHUVKLSJURXSLQHVWDEOLVKLQJD
&RPPXQLW\$FWLRQ3ODQ6SHFLILFJRDOVDQG
REMHFWLYHVWKDWDUHLGHQWLILHGE\(DVW*LOUR\
UHVLGHQWOHDGHUVGHILQHGLQWKLVDFWLRQSODQ
VKDOOEHIXQGHGWKURXJKWKLV$JUHHPHQW
&RQWUDFWRUVKDOOHQVXUHWKLVDFWLRQSODQLVLQ
DOLJQPHQWZLWKWKHUHVLGHQWOHDGHUVKLSJURXS
HVWDEOLVKHGLQ(DVW*LOUR\168ZLOOSURYLGH
6&<7)ZLWKWKH&RPPXQLW\$FWLRQ3ODQ
WHPSODWH
&RPPXQLW\
$FWLRQ3ODQ
$QQXDO
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϴ
D(VWDEOLVKDQG
PDLQWDLQWKH
6&<7)(DVW
*LOUR\
6XEFRPPLWWHH
ZKLFKDOVR
VHUYHVDVWKH
168
,PSOHPHQWDWLRQ
7HDP7KLV
VXEFRPPLWWHHW
HDPVKDOOPHHW
PRQWKO\
7KH(DVW*LOUR\6&<7)VXEFRPPLWWHH168
,PSOHPHQWDWLRQ7HDPVKRXOGFRQVLVWRI168
VWDII6&<7)SDUWQHUV DWOHDVW&%2V DQG
&LW\RI*LOUR\VWDIIDQG(DVW*LOUR\
UHVLGHQW
$JHQGDPHHWLQJ
QRWHVVLJQLQ
VKHHW
/DVW
PHHWLQJWR
EHKHOGE\
0RQWKO\
D 3URYLGHSUR
VRFLDODQGRU
JURXSFODVVHV
UHODWHGWR
HGXFDWLRQDO
KHDOWKDQG
ZHOOQHVVVDIHW\
DQGJDQJ
SUHYHQWLRQ
UHODWHG
FODVVHVZRUNVKR
SV
SUHVHQWDWLRQVWR
(DVW*LOUR\
UHVLGHQW
*URXSFODVVHVZRUNVKRSVDQGSUHVHQWDWLRQV
VKDOOEHORFDWHGLQ(DVW*LOUR\6DQ<VLGUR
&RPP&HQWHU
$*LOUR\UHVLGHQWVKDOOEHJLYHQSULRULW\
RYHUQRQ*LOUR\UHVLGHQWSULYDWH
EXVLQHVVHV WRWHDFKDKHDOWKDQGRU
HGXFDWLRQDOFODVVRUZRUNVKRS,QFHQWLYHVIRU
UHVLGHQWVWRWHDFKZRUNVKRSVDUHDOORZDEOH
5HVLGHQWOHGZRUNVKRSVRUSURVRFLDO
DFWLYLWLHVVKRXOGEHSODQQHGIRUDQGLQFOXGHG
LQDPRQWKO\FDOHQGDUDQGGLVWULEXWHGZLGHO\
WRUHVLGHQWVRI(DVW*LOUR\$OO
FODVVHVZRUNVKRSVVKRXOGEHDJHDSSURSULDWH
DQGGHVLJQHGWREHRSHQWRDQGEHQHILWDQ\
UHVLGHQWZKROLYHVLQWKH(DVW*LOUR\
&RPPXQLW\,I³5HVLGHQW/HDGHUV´DUHQRW
DYDLODEOHWRWHDFKDSDUWLFXODUFODVV
&RQWUDFWRUVKDOOKDYHWKHGLVFUHWLRQWR
VXEFRQWUDFWZLWKQRQUHVLGHQWVWHDFKHUVZLWK
ZULWWHQDJUHHPHQWIURPWKH&RXQW\
6HUYLFH'HOLYHU\*RDO 8QGXSOLFDWHG
3DUWLFLSDQWVSHU\HDU
0RQWKO\*URXS
&ODVVHV
(QUROOPHQWVLJQ
LQVKHHWVDQG
&RVW6XPPDU\
5HSRUW
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϵ
E ,QGLYLGXDOSUR
VRFLDODFWLYLWLHV
IRUDWULVN\RXWK
LGHQWLILHGE\WKH
1683UREDWLRQ
&RPPXQLW\
:RUNHU
&ROODERUDWHZLWKWKH1683UREDWLRQ
&RPPXQLW\:RUNHU 3&: LQLGHQWLI\LQJ
DQGHQUROOLQJDWULVN\RXWKDWWHQGLQJVFKRROV
VHUYLQJ(DVW*LOUR\UHVLGHQWVLQSURVRFLDO
DFWLYLWLHV3ULRULW\ZLOOEHJLYHQWR\RXWK
LGHQWLILHGLQ0XOWL6\VWHP0HHWLQJV 067V
RUUHODWHGVFKRROGLVFLSOLQDU\PHHWLQJV
VHUYLQJ3RVLWLYH%HKDYLRU,QWHUYHQWLRQ
6XSSRUWV 3%,6 WLHUDQGWLHU\RXWK
3URVRFLDODFWLYLWLHVIRUDWULVN\RXWKVKDOOEH
GHWHUPLQHGRQDQLQGLYLGXDOEDVLVEDVHGRQ
WKHQHHGVDQGLQWHUHVWVRIWKH\RXWK
SDUWLFLSDQW
6HUYLFH'HOLYHU\*RDO 8QGXSOLFDWHG
<RXWK
168(QUROOPHQW
)RUP
$WWDFKPHQW%
0RQWKO\
D&RPPXQLW\
&DOHQGDU
'HYHORSDQG6XEPLW0RQWKO\&RPPXQLW\
(YHQW&ODVVHV&DOHQGDUE\WKHWKGD\RI
HDFKPRQWKIRUWKHXSFRPLQJPRQWK
&RPPXQLW\
&DOHQGDU
0RQWKO\
E 0RQWKO\
FRPPXQLW\
PHHWLQJZLWKD
FRUHJURXSRI
UHVLGHQWOHDGHUV
\RXWKDQGRU
DGXOWV RI(DVW
*LOUR\
&RQWUDFWRUVKDOOFRRUGLQDWHDWOHDVWRQH
PRQWKO\FRPPXQLW\PHHWLQJZLWKDFRUH
JURXSRIUHVLGHQWOHDGHUV \RXWKDQGRU
DGXOWV RI(DVW*LOUR\
$JHQGDPHHWLQJ
QRWHVVLJQLQ
VKHHW
0RQWKO\
F&0$3 3URGXFWLRQRIPHGLDPDWHULDOVUHJDUGLQJWKH
ZRUNRIWKHUHVLGHQWOHDGHUVKLSJURXS 9LGHR
DQGPXVLFFODVVHVDUHLQFRUSRUDWHGZLWKD
FRPSOHWHGYLGHRRIWKHUHVLGHQWOHDGHUVKLS
JURXSGRFXPHQWLQJWKHLUIRUPDWLRQDQG
FROODERUDWLYHZRUN6KRUWYLGHRVZLOOEH
FRPSOHWHGRIWKHLUVSRQVRUHGHYHQWVDQG
GRFXPHQWLQJQHZFODVVHV&0$36WDIIZLOO
DWWHQGELZHHNO\UHVLGHQWPHHWLQJV
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
0RQWKO\
G5HVWRUDWLYH
-XVWLFH
6XSSRUWWKHWUDLQLQJDQGLPSOHPHQWDWLRQRI
UHVWRUDWLYHMXVWLFHUHVWRUDWLYHSUDFWLFHVLQ
VFKRROVDQGRWKHUVHWWLQJVWKDWVXSSRUW(DVW
*LOUR\UHVLGHQWVE\GHYHORSLQJDQG
&RPSUHKHQVLYH
5HVWRUDWLYH
-XVWLFH3UDFWLFHV
4XDUWHUO
\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϬ
PDLQWDLQLQJDQHWZRUNRI5HVWRUDWLYH-XVWLFH
3UDFWLWLRQHUV
3URJUDP
3URSRVDO
<HDU )< 'HOLYHUDEOHV
'HOLYHUDEOH'HVFULSWLRQ6XSSRUW
'RFXPHQWDWLRQ
5HTXLUHGIRU
5HLPEXUVHPHQ
W
$QWLFLSDWH
G
&RPSOHWLR
Q'DWH
)UHTXHQF\
D (VWDEOLVKDQG
PDLQWDLQD
UHVLGHQWDGYLVRU\
JURXSIRFXVHGLQ
(DVW*LOUR\
6XEWRWDO
7KHSXUSRVHRIWKHUHVLGHQWDGYLVRU\JURXS
WRDLPWRSDUWLFLSDWHLQ6&<7)7HFKQLFDO
7HDPPHHWLQJVDGYLVHRQZD\VWRLPSURYH
SURJUDPPLQJDQGDVVLVWLQUHVLGHQW
RXWUHDFKIRU6&<7)VSRQVRUHGHYHQWVDQG
FRQWLQXHWKHIRXQGDWLRQDOZRUNRIWKH6DIH
DQG3HDFHIXO6DQ<VLGURLQLWLDWLYH
GHYHORSHGE\WKHSXEOLFKHDOWKGHSDUWPHQW
5HVLGHQW$GYLVRU\*URXSVKDOOPDLQWDLQD
GHILQLWLRQRIPHPEHUVKLSWKHLUYLVLRQ
PLVVLRQDQGJRDOV
5HVLGHQW
$GYLVRU\JURXS
PHHWLQJVLJQLQ
VKHHWV
0RQWKO\
E 6XEPLVVLRQRI
$QQXDO
&RPPXQLW\
$FWLRQ3ODQ
&RQWUDFWRUVKDOODVVLVWWKH(DVW*LOUR\
5HVLGHQW/HDGHUVKLSJURXSLQHVWDEOLVKLQJ
D&RPPXQLW\$FWLRQ3ODQ6SHFLILFJRDOV
DQGREMHFWLYHVWKDWDUHLGHQWLILHGE\(DVW
*LOUR\UHVLGHQWOHDGHUVGHILQHGLQWKLV
DFWLRQSODQVKDOOEHIXQGHGWKURXJKWKLV
$JUHHPHQW&RQWUDFWRUVKDOOHQVXUHWKLV
DFWLRQSODQLVLQDOLJQPHQWZLWKWKH
UHVLGHQWOHDGHUVKLSJURXSHVWDEOLVKHGLQ
(DVW*LOUR\168ZLOOSURYLGH6&<7)
ZLWKWKH&RPPXQLW\$FWLRQ3ODQWHPSODWH
&RPPXQLW\
$FWLRQ3ODQ
$QQXDO
D(VWDEOLVKDQG
PDLQWDLQWKH
6&<7)(DVW
*LOUR\
6XEFRPPLWWHH
ZKLFKDOVRVHUYHV
DVWKH168
,PSOHPHQWDWLRQ
7KH(DVW*LOUR\6&<7)
VXEFRPPLWWHH168,PSOHPHQWDWLRQ7HDP
VKRXOGFRQVLVWRI168VWDII6&<7)
SDUWQHUV DWOHDVW&%2V DQG&LW\RI
*LOUR\VWDIIDQG(DVW*LOUR\UHVLGHQW
$JHQGD
PHHWLQJQRWHV
VLJQLQVKHHW
/DVW
PHHWLQJWR
EHKHOGE\
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϭ
7HDP7KLV
VXEFRPPLWWHHWHD
PVKDOOPHHW
PRQWKO\
E 'HYHORSDQG
VXEPLWWKH(DVW
*LOUR\6&<7)
7HFKQLFDO7HDP
VXEFRPPLWWHH16
8,PSOHPHQWDWLRQ
7HDP
&KDUWHU:RUN
3ODQ
7KHSXUSRVHRIWKLVVXEFRPPLWWHH&KDUWHU
:RUN3ODQLVWRDOLJQWKHZRUNRIWKH
VXEFRPPLWWHHPHPEHUVZLWKWKH
FRPPXQLW\DFWLRQJRDOVRIWKHUHVLGHQW
OHDGHUVKLSJURXSHVWDEOLVKHGLQ(DVW
*LOUR\
(DVW*LOUR\
6&<7)
7HFKQLFDO7HDP
VXEFRPPLWWHH
168
,PSOHPHQWDWLRQ
7HDP
&KDUWHU$FWLRQ
3ODQ
LQLWLDO
&KDUWHU
:RUN3ODQ
$QQXDO
D 3URYLGHSUR
VRFLDODQGRU
JURXSFODVVHV
UHODWHGWR
HGXFDWLRQDO
KHDOWKDQG
ZHOOQHVVVDIHW\
DQGJDQJ
SUHYHQWLRQUHODWHG
FODVVHVZRUNVKRS
VSUHVHQWDWLRQVWR
(DVW*LOUR\
UHVLGHQWV
*URXSFODVVHVZRUNVKRSVDQG
SUHVHQWDWLRQVVKDOOEHORFDWHGLQ(DVW
*LOUR\6DQ<VLGUR&RPP&HQWHU
$*LOUR\UHVLGHQWVKDOOEHJLYHQSULRULW\
RYHUQRQ*LOUR\UHVLGHQWSULYDWH
EXVLQHVVHV WRWHDFKDKHDOWKDQGRU
HGXFDWLRQDOFODVVRUZRUNVKRS,QFHQWLYHV
IRUUHVLGHQWVWRWHDFKZRUNVKRSVDUH
DOORZDEOH
5HVLGHQWOHGZRUNVKRSVRUSURVRFLDO
DFWLYLWLHVVKRXOGEHSODQQHGIRUDQG
LQFOXGHGLQDPRQWKO\FDOHQGDUDQG
GLVWULEXWHGZLGHO\WRUHVLGHQWVRI(DVW
*LOUR\$OOFODVVHVZRUNVKRSVVKRXOGEH
DJHDSSURSULDWHDQGGHVLJQHGWREHRSHQWR
DQGEHQHILWDQ\UHVLGHQWZKROLYHVLQWKH
(DVW*LOUR\&RPPXQLW\,I³5HVLGHQW
/HDGHUV´DUHQRWDYDLODEOHWRWHDFKD
SDUWLFXODUFODVV&RQWUDFWRUVKDOOKDYHWKH
GLVFUHWLRQWRVXEFRQWUDFWZLWKQRQ
UHVLGHQWVWHDFKHUVZLWKZULWWHQDJUHHPHQW
IURPWKH&RXQW\
6HUYLFH'HOLYHU\*RDO 8QGXSOLFDWHG
3DUWLFLSDQWVSHU\HDU
0RQWKO\*URXS
&ODVVHV
(QUROOPHQWVLJQ
LQVKHHWVDQG
&RVW6XPPDU\
5HSRUW
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϮ
E ,QGLYLGXDOSUR
VRFLDODFWLYLWLHV
IRUDWULVN\RXWK
LGHQWLILHGE\WKH
1683UREDWLRQ
&RPPXQLW\
:RUNHU
&ROODERUDWHZLWKWKH1683UREDWLRQ
&RPPXQLW\:RUNHU 3&: LQLGHQWLI\LQJ
DQGHQUROOLQJDWULVN\RXWKDWWHQGLQJ
VFKRROVVHUYLQJ(DVW*LOUR\UHVLGHQWVLQ
SURVRFLDODFWLYLWLHV3ULRULW\ZLOOEHJLYHQ
WR\RXWKLGHQWLILHGLQ0XOWL6\VWHP
0HHWLQJV 067V RUUHODWHGVFKRRO
GLVFLSOLQDU\PHHWLQJVVHUYLQJ3RVLWLYH
%HKDYLRU,QWHUYHQWLRQ 6XSSRUWV 3%,6
WLHUDQGWLHU\RXWK
3URVRFLDODFWLYLWLHVIRUDWULVN\RXWKVKDOO
EHGHWHUPLQHGRQDQLQGLYLGXDOEDVLVEDVHG
RQWKHQHHGVDQGLQWHUHVWVRIWKH\RXWK
SDUWLFLSDQW
6HUYLFH'HOLYHU\*RDO 8QGXSOLFDWHG
<RXWK
168
(QUROOPHQW
)RUP
$WWDFKPHQW%
0RQWKO\
D&RPPXQLW\
&DOHQGDU
'HYHORSDQG6XEPLW0RQWKO\&RPPXQLW\
(YHQW&ODVVHV&DOHQGDUE\WKHWKGD\RI
HDFKPRQWKIRUWKHXSFRPLQJPRQWK
&RPPXQLW\
&DOHQGDU
0RQWKO\
E 0RQWKO\
FRPPXQLW\
PHHWLQJZLWKD
FRUHJURXSRI
UHVLGHQWOHDGHUV
\RXWKDQGRU
DGXOWV RI(DVW
*LOUR\
&RQWUDFWRUVKDOOFRRUGLQDWHDWOHDVWRQH
PRQWKO\FRPPXQLW\PHHWLQJZLWKDFRUH
JURXSRIUHVLGHQWOHDGHUV \RXWKDQGRU
DGXOWV RI(DVW*LOUR\
$JHQGD
PHHWLQJQRWHV
VLJQLQVKHHW
0RQWKO\
F&0$3 3URGXFWLRQRIPHGLDPDWHULDOVUHJDUGLQJ
WKHZRUNRIWKHUHVLGHQWOHDGHUVKLSJURXS
9LGHRDQGPXVLFFODVVHVDUHLQFRUSRUDWHG
ZLWKDFRPSOHWHGYLGHRRIWKHUHVLGHQW
OHDGHUVKLSJURXSGRFXPHQWLQJWKHLU
IRUPDWLRQDQGFROODERUDWLYHZRUN6KRUW
YLGHRVZLOOEHFRPSOHWHGRIWKHLU
VSRQVRUHGHYHQWVDQGGRFXPHQWLQJQHZ
FODVVHV&0$36WDIIZLOODWWHQGELZHHNO\
UHVLGHQWPHHWLQJV
4XDUWHUO\168
5HSRUW
$WWDFKPHQW(
0RQWKO\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϯ
G5HVWRUDWLYH
-XVWLFH
6XSSRUWWKHWUDLQLQJDQGLPSOHPHQWDWLRQRI
UHVWRUDWLYHMXVWLFHUHVWRUDWLYHSUDFWLFHVLQ
VFKRROVDQGRWKHUVHWWLQJVWKDWVXSSRUW(DVW
*LOUR\UHVLGHQWVE\PDLQWDLQLQJDQHWZRUN
RI5HVWRUDWLYH-XVWLFH3UDFWLWLRQHUV
8SGDWHG
&RPSUHKHQVLYH
5HVWRUDWLYH
-XVWLFH3UDFWLFHV
3URJUDP
3URSRVDO
4XDUWHUO\
&3HUIRUPDQFH6WDQGDUGV
3ULRUWREHJLQQLQJVHUYLFHVDOO&RQWUDFWRUSHUVRQQHOZRUNLQJGLUHFWO\ZLWKFOLHQWVPXVW
REWDLQDWWKHH[SHQVHRI&RQWUDFWRURU&RQWUDFWRU¶VSHUVRQQHOD'HSDUWPHQWRI-XVWLFH
EDFNJURXQGFOHDUDQFH /LYH6FDQ ,IWKHUHVXOWVRIWKHEDFNJURXQGFKHFNDUH
XQIDYRUDEOHWKH&RXQW\ZLOOQRWLI\&RQWUDFWRUWRDUUDQJHIRUUHSODFHPHQWSHUVRQQHO,I
UHSODFHPHQWSHUVRQQHOFDQQRWEHIRXQG&RXQW\ZLOOWHUPLQDWHWKH$JUHHPHQW&RQWUDFWRU
ZLOOQHHGWRFRPSOHWHWKHIROORZLQJVWHSVWRREWDLQDEDFNJURXQGFOHDUDQFH
D&RQWDFWWKH3UREDWLRQ'HSDUWPHQW/LYH6FDQOLDLVRQDW WRREWDLQD
EDFNJURXQGFOHDUDQFHDSSOLFDWLRQ
E&RQWDFWWKH&RXQW\RI6DQWD&ODUD2IILFHRIWKH6KHULIIWRPDNHD/LYH6FDQ
DSSRLQWPHQW7KH2IILFHRIWKH6KHULIIFDQEHFRQWDFWHGE\SKRQH RU
YLDWKHLUZHEVLWHKWWS ZZZVFFJRYRUJSRUWDOVLWHVKHULII
F&RXQW\ZLOOFRQWDFW&RQWUDFWRURQFHWKHUHVXOWVRIWKHEDFNJURXQGFOHDUDQFHKDYH
EHHQUHFHLYHG
G&RQWUDFWRULVUHTXLUHGWRQRWLI\WKH3UREDWLRQ'HSDUWPHQW¶V/LYH6FDQOLDLVRQZKHQ
WKHHPSOR\PHQWRUOLFHQVLQJUHODWLRQVKLSRIDQ\LQGLYLGXDOZKRVHQDPHZDV
VXEPLWWHGIRU/LYH6FDQEDFNJURXQGFOHDUDQFHKDVFRQFOXGHG
L&RQWUDFWRUPXVWSURYLGHWKH3UREDWLRQ'HSDUWPHQWZLWKDOLVWRIHPSOR\HHV
ZKRZLOOEHSHUIRUPLQJVHUYLFHVXQGHUWKLVFRQWUDFWDQGLQFOXGHWKHIROORZLQJ
LQIRUPDWLRQE\-XO\WKRIHDFKQHZ)LVFDO<HDU )<
(PSOR\HH¶VQDPH
7KHHPSOR\HH¶VSRVLWLRQWLWOHDQGUROHZLWKLQWKHSURJUDP DQG
7KH3UREDWLRQSURJUDPVHUYLFHDQGFRQWUDFWSXUFKDVHRUGHUQXPEHUWKDW
WKHHPSOR\HHLVZRUNLQJXQGHU
=HUR7ROHUDQFH3ROLF\ =73 IRUVH[XDOPLVFRQGXFW
D&RQWUDFWRUVKDOOFRPSO\ZLWKWKH3UREDWLRQ'HSDUWPHQW¶V=73UHODWHGWR
SUHYHQWLQJGHWHFWLQJPRQLWRULQJLQYHVWLJDWLQJDQGHUDGLFDWLQJVH[XDODEXVH
VH[XDODVVDXOWUDSHRIUHVLGHQWVRUVH[XDOPLVFRQGXFWWRZDUGDQ\UHVLGHQWV
KRXVHGLQDQ\RILWVIDFLOLWLHVRUFRQWUDFWHGYHQXHV6H[XDODEXVHDQGVH[XDO
KDUDVVPHQWDUHSURKLELWHGE\VWDWHDQGIHGHUDOODZ
E,IDQ\RI&RQWUDFWRU¶VHPSOR\HHVDJHQWVUHSUHVHQWDWLYHVDQGRUPHPEHUVRILWV
%RDUGRI'LUHFWRUVLQFOXGLQJYROXQWHHUVZLOOKDYHFRQWDFWZLWKUHVLGHQWVZLWKLQ
WKHLQVWLWXWLRQDOIDFLOLWLHVWKH\VKDOODWWHQGDQGVXFFHVVIXOO\FRPSOHWHDQ\DQGDOO
VWDIIWUDLQLQJ V UHODWHGWR3ULVRQ5DSH(OLPLQDWLRQ$FW 35($ DVUHTXLUHGE\
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϰ
WKH3UREDWLRQ'HSDUWPHQW$GGLWLRQDOO\&RQWUDFWRUPXVWDELGHE\WKH
IROORZLQJ
L&RQWUDFWRUVKDOOEHUHVSRQVLEOHIRUH[SHQVHVLQFXUUHGLQFOXGLQJVDODU\
EHQHILWVDQGRUWUDQVSRUWDWLRQLQFRQQHFWLRQZLWKWKHDWWHQGDQFHRI
PDQGDWRU\35($WUDLQLQJ V E\LWVHPSOR\HHVDJHQWVUHSUHVHQWDWLYHV
DQGRUPHPEHUVRILWV%RDUGRI'LUHFWRUVLQFOXGLQJYROXQWHHUVKRZHYHU
WKH&RXQW\VKDOOSURYLGHWKHWUDLQLQJ V DWQRFRVWWR&RQWUDFWRU
LL7KH&RXQW\ZLOOSURYLGHDGRFXPHQWWLWOHG³'HSDUWPHQW35($3ROLF\
$FNQRZOHGJH6WDWHPHQW´WR&RQWUDFWRU¶VHPSOR\HHVDJHQWV
UHSUHVHQWDWLYHVDQGRUPHPEHUVRILWV%RDUGRI'LUHFWRUVLQFOXGLQJ
YROXQWHHUVZKRKDYHFRQWDFWZLWKUHVLGHQWVZLWKLQWKHLQVWLWXWLRQDO
IDFLOLWLHV(YHU\RQHZKRUHFHLYHVWKHGRFXPHQWVKDOOVLJQWKH
DFNQRZOHGJHPHQWIRUPZKLFKZLOOEHUHWDLQHGE\WKH3UREDWLRQ
'HSDUWPHQW
&RQWUDFWRUDJUHHVWRSURYLGHODQJXDJHWUDQVODWLRQVHUYLFHVIRUFOLHQWVDQGRUWKHLUIDPLOLHV
ZKRPD\KDYH/LPLWHG(QJOLVK3URILFLHQF\ /(3 VNLOOV&RQWUDFWRUIXUWKHUDJUHHVWR
LQIRUP/(3LQGLYLGXDOVRIWKHLUHOLJLELOLW\IRUEHQHILWVSURJUDPVDQGVHUYLFHVLQD
ODQJXDJHWKH\XQGHUVWDQG&RQWUDFWRUDJUHHVWRDVVHVVDOOSRLQWVRIFRQWDFWWHOHSKRQHLQ
SHUVRQPDLODQGHOHFWURQLFFRPPXQLFDWLRQLWVVWDIIKDVZLWK3UREDWLRQ¶V/(3FOLHQWVWR
GHWHUPLQHWKHEHVWPHWKRGRISURYLGLQJQRWLFHRIODQJXDJHDVVLVWDQFHVHUYLFHV&RQWUDFWRU
PXVWQRWRQO\WUDQVODWHRXWUHDFKPDWHULDOVEXWPXVWDOVRH[SODLQKRZ/(3LQGLYLGXDOV
PD\DFFHVVDYDLODEOHODQJXDJHDVVLVWDQFHVHUYLFHV0HWKRGV&RQWUDFWRUFDQXVHWRLQIRUP
/(3LQGLYLGXDOVDERXWODQJXDJHDVVLVWDQFHVHUYLFHVPD\LQFOXGHWUDQVODWLQJRXWUHDFK
PDWHULDOVLQWRRWKHUODQJXDJHVXSGDWLQJQRQ(QJOLVKFRQWHQWLQNH\ODQJXDJHVRQWKH
PDLQSDJHRILWVSURJUDP
VZHEVLWHDQGSURYLGLQJSXEOLFVHUYLFHPHVVDJHVLQQRQ
(QJOLVKPHGLDGHVFULELQJLWVSURJUDPV$GGLWLRQDOPHWKRGVRISURYLGLQJQRWLFHLQFOXGH
WKHXVHRIIRUPVEURFKXUHVDQGRUODQJXDJHDFFHVVSRVWHUVSODFHGLQFRQVSLFXRXV
ORFDWLRQVGHVFULELQJLQPXOWLSOHODQJXDJHVWKHDYDLODELOLW\RIODQJXDJHDVVLVWDQFH
VHUYLFHVWKHXVHRI³,6SHDN´ODQJXDJHLGHQWLILFDWLRQFDUGVDQGE\LQFOXGLQJLQVWUXFWLRQV
LQQRQ(QJOLVKODQJXDJHVRQWHOHSKRQHPHQXV6DPSOHRIWKH,6SHDNFDUGLVDYDLODEOH
DWWKLVZHEVLWHDQG&RQWUDFWRUPD\FUHDWHWKHLURZQYHUVLRQ
KWWS ZZZMXVWLFHJRYFUWOHSUHVRXUFHV2KLR/DQJ,'FDUGSGI
&XOWXUDO&RPSHWHQF\ &XOWXUDO'LYHUVLW\DQG,QFOXVLRQ
6HUYLFHVPXVWEHSURYLGHGLQDFXOWXUDOO\UHVSRQVLEOHPDQQHUWRWKHHQWLUHWDUJHW
SRSXODWLRQGHPRQVWUDWLQJIDLUDQGHTXLWDEOHSUDFWLFHVIRUSDUWLFLSDQWVRIGLYHUVH
LGHQWLWLHVLQFOXGLQJJHQGHUDJHUHOLJLRQUDFHHWKQLFLW\VH[XDORULHQWDWLRQJHQGHU
LGHQWLW\DQGGLVDELOLW\
,WLVWKHSROLF\RIWKH&RXQW\RI6DQWD&ODUD3UREDWLRQ'HSDUWPHQWWRPDLQWDLQDQG
SURPRWHDQRUJDQL]DWLRQWKDWSURYLGHVKLJKHVWTXDOLW\RIVHUYLFHVWRFOLHQWV
UHJDUGOHVVRIDFWXDORUSHUFHLYHGVH[XDORULHQWDWLRQJHQGHULGHQWLW\RUJHQGHU
H[SUHVVLRQ
/HVELDQ*D\%LVH[XDODQG7UDQVJHQGHU /*%7 FOLHQWVXQGHUWKHVXSHUYLVLRQRI
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϱ
WKH3UREDWLRQ'HSDUWPHQWVKDOOUHFHLYHIDLUDQGHTXLWDEOHWUHDWPHQWZLWKRXWIHDURI
QHJDWLYHELDVRUGLVFULPLQDWLRQDQGLQDSURIHVVLRQDODQGFRQILGHQWLDOPDQQHUEDVHG
RQSULQFLSOHVRIVRXQGSURIHVVLRQDOSUDFWLFH
&RXQW\ZLOOHYDOXDWHDQGGRFXPHQW&RQWUDFWRU¶VSHUIRUPDQFHLQDFFRUGDQFHZLWK&RXQW\
SROLF\&RQWUDFWRUHYDOXDWLRQPD\FRQVLVWRIEXWQRWEHOLPLWHGWRWKHIROORZLQJ
HYDOXDWLRQIRUPV
D&RQWUDFWRU3HUIRUPDQFH(YDOXDWLRQUHSRUW
E2QVLWHUHYLHZ DQGRU
F&RQWUDFWRUVHOIHYDOXDWLRQ
&RQWUDFWRUZLOOSHUIRUPWKHDJUHHGVHUYLFHVLQDFRPSHWHQWDQGH[SHGLHQWPDQQHUDQG
PXVWLPPHGLDWHO\LQIRUPWKH&RXQW\VKRXOGSUREOHPVDULVHWKDWSURKLELW&RQWUDFWRUIURP
SHUIRUPLQJWKHVHUYLFHVLQVXFKDPDQQHU
&RQWUDFWRUVKDOOPDLQWDLQZULWWHQGRFXPHQWDWLRQSURMHFWLQIRUPDWLRQDQGUHFRUGV
UHOHYDQWWRWKHVHUYLFHVSURYLGHG&RQWUDFWRUPXVWPDNHWKLVLQIRUPDWLRQDYDLODEOHIRU
UHYLHZE\&RXQW\XSRQUHDVRQDEOHQRWLFH
&RQWUDFWRUPXVWUHSRUWDOOPDMRUDQGRUPHGLDVHQVLWLYHLQFLGHQWVWRWKH3UREDWLRQ
'HSDUWPHQWFRQWUDFWPRQLWRU0DMRURUVHQVLWLYHLQFLGHQWVLQFOXGHEXWDUHQRW
OLPLWHGWR VHULRXVLQMXU\RUGHDWKUHODWHGWRWKHVHUYLFHVSURYLGHGXQGHUWKH
FRQWUDFW VHULRXVLQMXU\RUGHDWKRIDQ\SHUVRQLQWKH&RQWUDFWRU¶VFDUH VHULRXV
LQMXU\RUGHDWKRIDQ\SHUVRQRQSURSHUW\RZQHGOHDVHGRURSHUDWHGE\WKH
&RQWUDFWRULQFOXGLQJEXWQRWOLPLWHGWRIDFLOLWLHVSDUNVVLGHZDONVURDGVDQG
SDUNV VHULRXVGDPDJHWRWKHSURSHUW\RIDQRWKHUUHODWHGWRWKHVHUYLFHVSURYLGHGE\
WKH&RQWUDFWRUXQGHUWKLV$JUHHPHQW FULPLQDOFRQGXFWLQYROYLQJ&RQWUDFWRU
SHUVRQQHO DQ\HYHQWWKDWKDVDVLJQLILFDQWSRVVLELOLW\RIUHVXOWLQJLQDFODLPRU
ODZVXLWDJDLQVWWKH&RXQW\ DQ\HYHQWWKDWKDVDVLJQLILFDQWSRVVLELOLW\RIUHVXOWLQJLQ
DFODLPRUODZVXLWDJDLQVWWKH&RQWUDFWRUWKDWLVUHODWHGWRWKLV$JUHHPHQW DQGDQ\
HYHQWWKDWKDVDSRVVLELOLW\RIUHFHLYLQJSXEOLFRUPHGLDDWWHQWLRQ
7KH&RQWUDFWRUVKDOOUHSRUWDQ\VXFKLQFLGHQWVDVVRRQDVSRVVLEOHEXWQRODWHUWKDQ
WZHQW\IRXU KRXUVIURPZKHQWKHLQFLGHQWRFFXUUHG7KH&RQWUDFWRUPXVW
LQFOXGHWKHIROORZLQJLQIRUPDWLRQLQDOOLQFLGHQWUHSRUWV QDPHDQGFRQWDFW
LQIRUPDWLRQRIWKHVXEPLWWLQJLQGLYLGXDO QDPHDQGHPDLODGGUHVVRIWKHEHVW
FRQWDFWIRULPPHGLDWHDFFHVVWRD&RQWUDFWRUVWDIIPHPEHUZKRFDQDQVZHU
TXHVWLRQVUHJDUGLQJWKHLQFLGHQW DQLQGLFDWLRQRIZKHWKHUSUHVVFRYHUDJHLVOLNHO\
DQLQFLGHQWGHVFULSWLRQLQFOXGLQJGDWHWLPHDQGORFDWLRQRIWKHLQFLGHQW WKHQDPHV
DQGMREWLWOHVRI&RQWUDFWRUSHUVRQQHOLQYROYHGLQWKHLQFLGHQW DQGDGHVFULSWLRQRI
DQ\DFWLRQWDNHQLQUHVSRQVHWRWKHLQFLGHQW
'3D\PHQW6FKHGXOH
0D[LPXPFRPSHQVDWLRQSDLGWR&RQWUDFWRUXQGHUWKLV$JUHHPHQWPXVWQRWH[FHHG
LQ)<LQ)<LQ)< DQGLQ)<
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϲ
D3UREDWLRQZLOOQRWSD\PLOHDJHRUWUDYHOH[SHQVHV LQFOXGLQJORGJLQJDQGPHDO
H[SHQVHV IRU&RQWUDFWRU
&RQWUDFWRUZLOOLQYRLFH&RXQW\EDVHGRQXQLWVRIVHUYLFHSURYLGHGWKHSUHYLRXVPRQWK
5DWHVSHUXQLWRIVHUYLFHZLOOEHFKDUJHGDWWKHUDWHVKRZQRQ$WWDFKPHQW&
³%XGJHW´KHUHWRDWWDFKHGDQGLQFRUSRUDWHGE\WKLVUHIHUHQFH
D3UREDWLRQ0DQDJHPHQWDQG&RQWUDFWRUPD\DVQHHGHGDQGXSRQPXWXDODJUHHPHQWLQ
ZULWLQJPRGLI\EXGJHWOLQHLWHPPD[LPXPVDQGRUELOODEOHUDWHVQRWHGLQ
$WWDFKPHQW&³%XGJHW´WRUHIOHFWWKHVHUYLFHGHOLYHU\QHHGVRIWKH'HSDUWPHQW
ZLWKRXWH[FHHGLQJWKHPD[LPXPILQDQFLDOREOLJDWLRQRIWKLVDJUHHPHQW
,I&RQWUDFWRUSURYLGHVDQ\WDVNVGHOLYHUDEOHJRRGVVHUYLFHVRURWKHUZRUNRWKHUWKDQDV
VSHFLILHGLQWKLV$JUHHPHQWWKHVDPHZLOOEHGHHPHGWREHDJUDWXLWRXVHIIRUWRQWKHSDUW
RIWKH&RQWUDFWRUDQGWKH&RQWUDFWRUZLOOKDYHQRFODLPZKDWVRHYHUDJDLQVW&RXQW\
&RQWUDFWRUVKDOOVXEPLWDKDUGFRS\LQYRLFHIRUFRPSOHWHGGHOLYHUDEOHVRQDTXDUWHUO\
EDVLVDVDSSURSULDWH,QYRLFHZLOOLQFOXGHWKH&RQWUDFWRU¶VQDPHDQGDGGUHVV LQYRLFH
QXPEHU FRQWUDFWQXPEHU GDWHDQGGHVFULSWLRQRIVHUYLFHV WRWDOLQYRLFHDPRXQW \HDUWR
GDWHH[SHQGLWXUHVDQGUHPDLQLQJFRQWUDFWEDODQFH UHIHUWR$WWDFKPHQW'³4XDUWHUO\
,QYRLFH´
D7KHLQYRLFHFRYHULQJVHUYLFHVUHQGHUHGLQWKHILQDOSHULRGRIVHUYLFHLQHDFK
DSSOLFDEOH)<WKLVDJUHHPHQWLVLQHIIHFW IRXUWKTXDUWHURUWKHPRQWKRI-XO\DV
DSSURSULDWH VKDOOEHVXEPLWWHGQRODWHUWKDQ-XO\VW RUQH[WEXVLQHVVGD\ZKHQ
-XO\IDOOVRXWVLGHRIQRUPDO&RXQW\EXVLQHVVKRXUV
$OOSD\PHQWVDUHFRQWLQJHQWXSRQ&RQWUDFWRUSURYLGLQJWKHDJUHHGXSRQVHUYLFHV
DFFRUGLQJWRWKHVFRSHRIVHUYLFHVFRQWUDFWUHTXLUHPHQWVGHOLYHUDEOHVDQGSHUIRUPDQFH
VWDQGDUGV
,IWKHLQYRLFHDQGVXSSRUWLQJGRFXPHQWDWLRQDUHLQSURSHUIRUPDSSURSULDWHO\SD\DEOH
XQGHUWKLV$JUHHPHQWDQGKDYHEHHQUHYLHZHGDQGDSSURYHGE\WKHDSSURSULDWH
3UREDWLRQVWDII&RXQW\VKDOOPDNHSD\PHQWWR&RQWUDFWRUZLWKLQIRUW\ILYH GD\VQHW
DIWHUUHFHLSWRILQYRLFH
,QGLUHFW&RVWV±7RWDOPXVWQRWH[FHHG2,000IRUWKHWHUPRIWKHDJUHHPHQW
1,000IRU)<DQG1,000IRU)<ZKLFKZLOOQRWH[FHHGRIWKH
PD[LPXPEXGJHWIRUHDFKRIWKHWZR)<V7KHUHDUHQRLQGLUHFWFRVWVIRU)< DQG
)<,QGLUHFWFRVWVLQFOXGHWRWKHIROORZLQJ GLUHFWVDODULHVDQGZDJHVHLWKHULQFOXGLQJ
RUH[FOXGLQJEHQHILWVDQGDFWXDOWRWDOGLUHFWSURMHFWFRVWVH[FOXGLQJHTXLSPHQW3OHDVH
VHH$WWDFKPHQW)IRUPRUHGHWDLOV7KHVHLWHPVDUHFRQWLQJHQWXSRQWKH&RQWUDFWRU
SURYLGLQJWKHVHUYLFHVDFFRUGLQJWRWKHVFRSHRIVHUYLFHVFRQWUDFWUHTXLUHPHQWV
GHOLYHUDEOHVDQGSHUIRUPDQFHVWDQGDUGV
D ,QGLUHFW&RVWVPXVWLQFOXGHEDFNXSGRFXPHQWDWLRQWRVXSSRUWDQGYHULI\WKHLQYRLFH
DPRXQWV
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
$WWDFKPHQW$
&RQWUDFW6SHFLILFV6HFWLRQ9
&LW\RI*LOUR\6&<7) 168 ±)<)<
ϭϳ
E3ULRUWRVXEPLWWDOFRVWUHLPEXUVHPHQWFODLPVPXVWEHFHUWLILHGDQGVLJQHGE\D
UHVSRQVLEOHRIILFHURI&RQWUDFWRUZLWKDXWKRULW\WRFHUWLI\WKDWWKHLQIRUPDWLRQ
VXEPLWWHGE\&RQWUDFWRULVDFFXUDWHDQG&RQWUDFWRULVHQWLWOHGWRSD\PHQWXQGHUWKH
WHUPVRIWKH$JUHHPHQW&RXQW\PD\UHO\RQVDLGFHUWLILFDWLRQLQPDNLQJSD\PHQW
EXWWKLVSD\PHQWZLOOQRWFRQVWLWXWHDZDLYHURIDQ\RI&RXQW\¶VOHJDOULJKWVRU
REMHFWLRQV
F&RXQW\ZLOOQRWEHUHTXLUHGWRPDNHSD\PHQWLIWKHDPRXQWLQYRLFHGLVQRWLQ
DFFRUGDQFHZLWKWKHSURYLVLRQVRIWKLV$JUHHPHQW$OOSD\PHQWVXQGHUWKLV
$JUHHPHQWZLOOEHPDGHGLUHFWO\WR&RQWUDFWRUDVDFRUSRUDWHHQWLW\8QGHUQR
FLUFXPVWDQFHVZLOO&RXQW\EHUHTXLUHGWRPDNHSD\PHQWVLQDQ\DPRXQWSXUVXDQWWR
WKLV$JUHHPHQWWRDQ\RWKHUSDUWLHVLQFOXGLQJ&RQWUDFWRU¶VLQGLYLGXDOHPSOR\HHV
FUHGLWRUVDQG&RQWUDFWRU¶V6XEFRQWUDFWRU
G&RXQW\LVQRWREOLJDWHGWRUHLPEXUVH&RQWUDFWRUIRUDQ\H[SHQGLWXUHQRWUHSRUWHGWR
&RXQW\ZLWKLQVL[W\ FDOHQGDUGD\VDIWHUWKHHQGRIWKHODVWPRQWKRIWKH
$JUHHPHQWWHUP
2SHUDWLQJ([SHQVH7RWDOPXVWQRWH[FHHG2,000IRUWKHWHUPRIWKHDJUHHPHQW
000IRU)<DQG1,000IRU)<ZKLFKZLOOQRWH[FHHGRIWKHPD[LPXP
EXGJHWIRUHDFKRIWKHWZR)<V7KHUHDUHQRRSHUDWLQJH[SHQVHVIRU)< DQG)<
7KHH[SHQVHVPXVWEHWRIXUWKHUWKHSURJUDPREMHFWLYHVDQGEHFRQWLQJHQWXSRQWKH
&RQWUDFWRUSURYLGLQJWKHVHUYLFHVDFFRUGLQJWRWKHVFRSHRIVHUYLFHVFRQWUDFW
UHTXLUHPHQWVGHOLYHUDEOHVDQGSHUIRUPDQFHVWDQGDUGV2SHUDWLQJH[SHQVHVLQFOXGHEXW
DUHQRWOLPLWHGWRWKHIROORZLQJ FRQIHUHQFHVVHPLQDUVZRUNVKRSVWUDLQLQJVWUDLQLQJ
PDWHULDOVDQGRIILFHVXSSOLHV3OHDVHVHH$WWDFKPHQW)IRUPRUHGHWDLOV
D2SHUDWLQJH[SHQVHVPXVWLQFOXGHEDFNXSGRFXPHQWDWLRQWRVXSSRUWDQGYHULI\WKH
LQYRLFHDPRXQWV
E3ULRUWRVXEPLWWDOFRVWUHLPEXUVHPHQWFODLPVPXVWEHFHUWLILHGDQGVLJQHGE\D
UHVSRQVLEOHRIILFHURI&RQWUDFWRUZLWKDXWKRULW\WRFHUWLI\WKDWWKHLQIRUPDWLRQ
VXEPLWWHGE\&RQWUDFWRULVDFFXUDWHDQG&RQWUDFWRULVHQWLWOHGWRSD\PHQWXQGHUWKH
WHUPVRIWKH$JUHHPHQW&RXQW\PD\UHO\RQVDLGFHUWLILFDWLRQLQPDNLQJSD\PHQW
EXWWKLVSD\PHQWZLOOQRWFRQVWLWXWHDZDLYHURIDQ\RI&RXQW\¶VOHJDOULJKWVRU
REMHFWLRQV
F&RXQW\ZLOOQRWEHUHTXLUHGWRPDNHSD\PHQWLIWKHDPRXQWLQYRLFHGLVQRWLQ
DFFRUGDQFHZLWKWKHSURYLVLRQVRIWKLV$JUHHPHQW$OOSD\PHQWVXQGHUWKLV
$JUHHPHQWZLOOEHPDGHGLUHFWO\WR&RQWUDFWRUDVDFRUSRUDWHHQWLW\8QGHUQR
FLUFXPVWDQFHVZLOO&RXQW\EHUHTXLUHGWRPDNHSD\PHQWVLQDQ\DPRXQWSXUVXDQWWR
WKLV$JUHHPHQWWRDQ\RWKHUSDUWLHVLQFOXGLQJ&RQWUDFWRU¶VLQGLYLGXDOHPSOR\HHV
FUHGLWRUVDQG&RQWUDFWRU¶V6XEFRQWUDFWRU
G&RXQW\LVQRWREOLJDWHGWRUHLPEXUVH&RQWUDFWRUIRUDQ\H[SHQGLWXUHQRWUHSRUWHGWR
&RXQW\ZLWKLQVL[W\ FDOHQGDUGD\VDIWHUWKHHQGRIWKHODVWPRQWKRIWKH
$JUHHPHQWWHUP
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Attachment B-1
NSU Enrollment Form
City of Gilroy͕^zd& (NSU) – FY17-FY20
Neighborhood Safety/Services Unit
Juvenile Probation Department
Neighborhood Services Unit (NSU)
840 Guadalupe Parkway
San Jose, CA 95110
Charmayne Moran, Program Manager II
Email: Charmayne.Moran@pro.sccgov.org
Phone: (408) 278-6227
NSU Enrollment Form for Services
Program Information (To Be Completed by Staff):
24. Type of Program:տ Community Based ܆ School Based
25. If School based, Name of School:
_____________________________________________
26. Activity Type:܆ Leadership ܆ Academic ܆ Arts ܆ Sports
܆ Other: _____________________
Additional Sessions in 2018-2019 School Year:
30. Activity Type: ܆ Leadership ܆ Academic ܆ Arts ܆ Sports
܆ Other: _____________________
27. Date of Enrollment to Activity: __________31. Date of Enrollment to Activity: ____________
28. List Weekly Classes you participate in at School or Community
Center _____________________________________________
32. List Weekly Classes you participate in at School or Community
Center________________________________________________
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 To be Completed by or on behalf of Parent/Guardian
1. Full Name (of client enrolling in activities):
Last Name, First Name
11. Full Name of Parent/Guardian:
Last Name, First Name
2. Zip Code:
______________________________________
12. Primary Language: __________________
13. Single Parent Household?܆ Yes ܆ No
3. Phone:____________ ܆ Can we text you?14. Highest Level of Education Achieved:
܆ High School ܆ Some College
܆ Graduated College ܆ N/A/Decline to State
4. Date of Birth (MM/DD/YYYY):____/____/______15. Employment Status:܆ Full-Time ܆ Part-Time
܆ Student ܆ Other ܆ Decline to State
5. Gender:܆ Male ܆ Female ܆ Other ܆
Decline to State
16. Do you belong to a resident/neighborhood
group?܆ Yes ܆ No
17. If not, interested in becoming involved?
܆ Yes ܆ No
6. Primary Language:___________________18. How did you get to the community center?
܆ Walk ܆ Drive ܆ Bike ܆ Bus ܆ Other
19. Are you interested in Carpooling?܆ Yes ܆ No
7. Race/Ethnicity:܆ Asian ܆
Black/African American ܆ Latino/Latina ܆
Native American ܆ Pacific Islander ܆ White ܆
Other: _______________ ܆ Decline to State
20. What kind of health insurance do you have?
܆ Public (MediCal/MediCaid) ܆ Private
܆ Don’t have health insurance ܆ Decline to State
8. School:_____________________________22. What is your Annual Household Income?
9. Grade (or last grade completed):________
܆ 0 - $14,999
܆ $15,000-$34,999
܆ $35,000-$49,999
܆ $50,000-$74,999
܆ $75,000-$99,999
܆ $100,000+
܆ Don’t Know
܆ Decline to State
10. Do you have access to reliable
transportation?܆ Yes ܆ No
Information About Person Completing This Form:
30. Name: _____________________________________33. Title: _____________________________________________
31. Phone: _____________________________________34. Email: ____________________________________________
32. Signature: ___________________________________35. Today’s Date: ______________________________________
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
&zϭϳ &zϭϴ
ϭĂ
ƐƚĂďůŝƐŚĂŶĚŵĂŝŶƚĂŝŶĂƌĞƐŝĚĞŶƚĂĚǀŝƐŽƌLJŐƌŽƵƉĨŽĐƵƐĞĚŝŶ
ĂƐƚ'ŝůƌŽLJ͘ϱ͕ϬϬϬΨ ϲ͕ϬϬϬΨ
ϭď ^ƵďŵŝƐƐŝŽŶŽĨŶŶƵĂůŽŵŵƵŶŝƚLJĐƚŝŽŶWůĂŶ ͲΨ ϭϬ͕ϬϬϬΨ
ϮĂ
ƐƚĂďůŝƐŚĂŶĚŵĂŝŶƚĂŝŶƚŚĞ^zd& ĂƐƚ'ŝůƌŽLJ^ƵďĐŽŵŵŝƚƚĞĞ͕
ǁŚŝĐŚĂůƐŽƐĞƌǀĞƐĂƐƚŚĞE^h/ŵƉůĞŵĞŶƚĂƚŝŽŶdĞĂŵ͘dŚŝƐ
ƐƵďĐŽŵŵŝƚƚĞĞͬƚĞĂŵƐŚĂůůŵĞĞƚŵŽŶƚŚůLJ͘ͲΨ ϰ͕ϮϬϬΨ
Ϯď
ĞǀĞůŽƉĂŶĚƐƵďŵŝƚƚŚĞ ĂƐƚ'ŝůƌŽLJ^zd&dĞĐŚŶŝĐĂůdĞĂŵ
ƐƵďĐŽŵŵŝƚƚĞĞͬE^h/ŵƉůĞŵĞŶƚĂƚŝŽŶdĞĂŵŚĂƌƚĞƌͬtŽƌŬ
WůĂŶͲΨ ϭ͕ϬϬϬΨ
ϯĂ
WƌŽǀŝĚĞƉƌŽͲƐŽĐŝĂůĂŶĚͬŽƌŐƌŽƵƉĐůĂƐƐĞƐƌĞůĂƚĞĚƚŽ
ĞĚƵĐĂƚŝŽŶĂů͕ŚĞĂůƚŚĂŶĚǁĞůůŶĞƐƐ͕ƐĂĨĞƚLJĂŶĚŐĂŶŐƉƌĞǀĞŶƚŝŽŶ
ƌĞůĂƚĞĚĐůĂƐƐĞƐͬǁŽƌŬƐŚŽƉƐͬƉƌĞƐĞŶƚĂƚŝŽŶƐƚŽ ĂƐƚ'ŝůƌŽLJ
ƌĞƐŝĚĞŶƚƐ ͲΨ ϴ͕ϬϬϬΨ
ϯď
/ŶĚŝǀŝĚƵĂůƉƌŽͲƐŽĐŝĂůĂĐƚŝǀŝƚŝĞƐĨŽƌĂƚͲƌŝƐŬLJŽƵƚŚŝĚĞŶƚŝĨŝĞĚďLJ
ƚŚĞE^hWƌŽďĂƚŝŽŶŽŵŵƵŶŝƚLJtŽƌŬĞƌ ͲΨ ϴ͕ϬϬϬΨ
ϰĂ ŽŵŵƵŶŝƚLJĂůĞŶĚĂƌ ͲΨ ϭ͕ϮϬϬΨ
ϰď
DŽŶƚŚůLJĐŽŵŵƵŶŝƚLJŵĞĞƚŝŶŐǁŝƚŚĂĐŽƌĞŐƌŽƵƉŽĨƌĞƐŝĚĞŶƚůĞĂĚĞƌƐ
;LJŽƵƚŚĂŶĚͬŽƌĂĚƵůƚƐͿŽĨ ĂƐƚ'ŝůƌŽLJ ͲΨ ϭ͕ϮϬϬΨ
ϰĐ ŽŵŵƵŶŝƚLJŽƵƚƌĞĂĐŚĂŶĚĐŽŶŶĞĐƚŝŽŶŽĨĐůŝĞŶƚƐƚŽƐĞƌǀŝĐĞƐ ϭ͕ϵϱϬΨ ϮϬ͕ϬϬϬΨ
ϰĚ
tŽƌŬǁŝƚŚDWƚŽƉƌŽĚƵĐĞŵĞĚŝĂŵĂƚĞƌŝĂůƐŽŶƚŚĞǁŽƌŬŽĨ
ƚŚĞƌĞƐŝĚĞŶƚůĞĂĚĞƌƐŚŝƉŐƌŽƵƉϱ͕ϬϱϬΨ ϭϲ͕ϮϱϬΨ
ϰĞ
^ƵƉƉŽƌƚƚŚĞƚƌĂŝŶŝŶŐĂŶĚŝŵƉůĞŵĞŶƚĂƚŝŽŶŽĨƌĞƐƚŽƌĂƚŝǀĞ
ũƵƐƚŝĐĞͬƌĞƐƚŽƌĂƚŝǀĞƉƌĂĐƚŝĐĞƐŝŶƐĐŚŽŽůƐĂŶĚŽƚŚĞƌƐĞƚƚŝŶŐƐ
ƚŚĂƚƐƵƉƉŽƌƚ ĂƐƚ'ŝůƌŽLJƌĞƐŝĚĞŶƚƐ ϴ͕ϬϬϬΨ ϴ͕ϬϬϬΨ
ϱĂ /ŶĚŝƌĞĐƚŽƐƚƐ ϭ͕ϬϬϬΨ ϭ͕ϬϬϬΨ
ϱď KƉĞƌĂƚŝŶŐ džƉĞŶƐĞ ϭ͕ϬϬϬΨ ϭ͕ϬϬϬΨ
ϮϮ͕ϬϬϬΨ ϴϱ͕ϴϱϬΨdŽƚĂů
ĞůŝǀĞƌĂďůĞ ĞƐĐƌŝƉƚŝŽŶ
ŽƐƚ
ƚƚĂĐŚŵĞŶƚͲϭ
ƵĚŐĞƚ
ŝƚLJŽĨ'ŝůƌŽLJ͕^zd&;E^hͿͲ&zϭϳͲ&zϮϬWĂŐĞϭŽĨϮ
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
ƚƚĂĐŚŵĞŶƚͲϭ
ƵĚŐĞƚ
ŝƚLJŽĨ'ŝůƌŽLJ͕^zd&;E^hͿͲ&zϭϳͲ&zϮϬ
ƐƐŝƐƚŝŶĞƐƚĂďůŝƐŚŝŶŐĂŶĚŵĂŝŶƚĂŝŶŝŶŐĂƌĞƐŝĚĞŶƚ
ĂĚǀŝƐŽƌLJŐƌŽƵƉĨŽĐƵƐĞĚŝŶ ĂƐƚ'ŝůƌŽLJ͘
^ƵďŵŝƚŶŶƵĂůŽŵŵƵŶŝƚLJĐƚŝŽŶWůĂŶ
ƐƐŝƐƚƚŚĞĂƐƐŝŐŶĞĚE^hWtŝŶĞƐƚĂďůŝƐŚŝŶŐĂŶĚ
ŵĂŝŶƚĂŝŶŝŶŐƚŚĞ^zd& ĂƐƚ'ŝůƌŽLJ^ƵďĐŽŵŵŝƚƚĞĞ͕
ǁŚŝĐŚĂůƐŽƐĞƌǀĞƐĂƐƚŚĞE^h/ŵƉůĞŵĞŶƚĂƚŝŽŶdĞĂŵ͘
dŚŝƐƐƵďĐŽŵŵŝƚƚĞĞͬƚĞĂŵƐŚĂůůŵĞĞƚŵŽŶƚŚůLJ͘
ĞǀĞůŽƉĂŶĚƐƵďŵŝƚƚŚĞ ĂƐƚ'ŝůƌŽLJ^zd&dĞĐŚŶŝĐĂů
dĞĂŵƐƵďĐŽŵŵŝƚƚĞĞͬE^h/ŵƉůĞŵĞŶƚĂƚŝŽŶdĞĂŵ
ŚĂƌƚĞƌͬtŽƌŬƉůĂŶ
ƐƐŝƐƚŝŶƐƵƉĞƌǀŝƐŝŶŐĂŶĚĐŽŽƌĚŝŶĂƚŝŶŐŽĨƉƌŽͲƐŽĐŝĂů
ĂŶĚͬŽƌŐƌŽƵƉĐůĂƐƐĞƐƌĞůĂƚĞĚƚŽĞĚƵĐĂƚŝŽŶĂů͕ŚĞĂůƚŚ
ĂŶĚǁĞůůŶĞƐƐ͕ƐĂĨĞƚLJĂŶĚŐĂŶŐƉƌĞǀĞŶƚŝŽŶƌĞůĂƚĞĚ
ĐůĂƐƐĞƐͬǁŽƌŬƐŚŽƉƐͬƉƌĞƐĞŶƚĂƚŝŽŶƐƚŽ ĂƐƚ'ŝůƌŽLJ
ƌĞƐŝĚĞŶƚƐ͘KƉĞŶĂŶĚĐůŽƐĞĨŽƌƉƌŽͲƐŽĐŝĂůĐůĂƐƐĞƐĂƚ
^ĂŶzƐŝĚƌŽĂŶĚĂƐƐŝƐƚŝŶĐŽŵŵƵŶƚŝLJĞǀĞŶƚƐĂƐ
ŶĞĞĚĞĚ͘
ƐƐŝƐƚŝŶĐŽŽƌĚŝŶĂƚŝŶŐŵŽŶƚŚůLJĐŽŵŵƵŶŝƚLJŵĞĞƚŝŶŐƐ
ǁŝƚŚĂĐŽƌĞŐƌŽƵƉŽĨƌĞƐŝĚĞŶƚůĞĂĚĞƌƐ;LJŽƵƚŚĂŶĚͬŽƌ
ĂĚƵůƚƐͿŽĨ ĂƐƚ'ŝůƌŽLJ͘
ϯď /ŶĚŝǀŝĚƵĂůWƌŽͲ^ŽĐŝĂů
ĐƚŝǀŝƚŝĞƐ
sĂƌŝĞƐ /ŶĚŝǀŝĚƵĂůƉƌŽͲƐŽĐŝĂůĂĐƚŝǀŝƚŝĞƐĨŽƌĂƚͲƌŝƐŬLJŽƵƚŚ
ŝĚĞŶƚŝĨŝĞĚďLJƚŚĞE^hWƌŽďĂƚŝŽŶŽŵŵƵŶŝƚLJtŽƌŬĞƌ͘
ϴ͕ϬϬϬΨ ϴ͕ϬϬϬΨ
WƌŽͲƐŽĐŝĂůĐƚŝǀŝƚŝĞƐ sĂƌŝĞƐ
WƌŽͲƐŽĐŝĂůĂĐƚŝǀŝƚŝĞƐƚŚĂƚƉƌŽŵŽƚĞŚĞĂůƚŚ͕ǁĞůůďĞŝŶŐ͕
ĞĚƵĐĂƚŝŽŶ͕ĂŶĚĐŽŵŵƵŶƚŝLJďƵŝůĚŝŶŐ͘
&ƵŶĚƐŵƵƐƚďĞĂƉƉƌŽǀĞĚĂŶĚǀĞƚƚĞĚƚŚƌŽƵŐŚƚŚĞ^ĂŶ
zƐŝĚƌŽƌĞƐŝĚĞŶƚůĞĂĚĞƌƐŚŝƉŐƌŽƵƉ͘WƌŽͲƐŽĐŝĂůĂĐƚŝǀŝƚŝĞƐ
ŵƵƐƚďĞŝĚĞŶƚŝĨŝĞĚŝŶƚŚĞŽŵŵƵŶƚŝLJsŝŽůĞŶĐĞ
WƌĞǀĞŶƚŝŽŶWůĂŶ͘
ϮϬ͕ϬϬϬΨ ϮϬ͕ϬϬϬΨ
&ŽŽĚĨŽƌƉƌŽŐƌĂŵŵŝŶŐ &ŽŽĚƉƵƌĐŚĂƐĞƐŵƵƐƚĐŽŵƉůLJǁŝƚŚƚŚĞĐŽƵŶƚLJΖƐĨŽŽĚ
ĂŶĚďĞǀĞƌĂŐĞƉŽůŝĐLJ͘
ϯ͕ϬϬϬΨ ϯ͕ϬϬϬΨ
^ƵƉƉůŝĞƐ ^ƵƉƉůŝĞƐŵƵƐƚďĞƵƐĞĚƚŽƉƌŽŵŽƚĞ͕ŝŵƉůĞŵĞŶƚ͕Žƌ
ĞŶŚĂŶĐĞƉƌŽͲƐŽĐŝĂůƉƌŽŐƌĂŵƐĂŶĚƐĞƌǀŝĐĞƐ͘
ϳ͕ϲϬϮΨ ϳ͕ϲϬϮΨ
ϰĐ DĞĚŝĂWƌŽũĞĐƚ DW
tŽƌŬǁŝƚŚDWƚŽƉƌŽĚƵĐĞŵĞĚŝĂŵĂƚĞƌŝĂůƐŽŶƚŚĞ
ǁŽƌŬŽĨƚŚĞƌĞƐŝĚĞŶƚůĞĂĚĞƌƐŚŝƉŐƌŽƵƉ͘
ϳ͕ϬϬϬΨ ϳ͕ϬϬϬΨ
ϰĞ ZĞƐƚŽƌĂƚŝǀĞ:ƵƐƚŝĐĞ
WŝůŽƚWƌŽũĞĐƚ
ŽŵŵƵŶƚŝLJďĂƐĞĚŽƌŐĂŶŝnjĂƚŝŽŶƚŽďĞ
ƐĞůĞĐƚĞĚƚŚƌŽƵŐŚĂŶŽƉĞŶĐŽŵƉĞƚŝƚŝǀĞ
ƉƌŽĐƵƌĞŵĞŶƚƉƌŽĐĞƐƐ
^ƵƉƉŽƌƚƚŚĞƚƌĂŝŶŝŶŐĂŶĚŝŵƉůĞŵĞŶƚĂƚŝŽŶŽĨ
ƌĞƐƚŽƌĂƚŝǀĞũƵƐƚŝĐĞͬƌĞƐƚŽƌĂƚŝǀĞƉƌĂĐƚŝĐĞƐŝŶƐĐŚŽŽůƐ
ĂŶĚŽƚŚĞƌƐĞƚƚŝŶŐƐƚŚĂƚƐƵƉƉŽƌƚ ĂƐƚ'ŝůƌŽLJƌĞƐŝĚĞŶƚƐ
ďLJĚĞǀĞůŽƉŝŶŐĂŶĚŵĂŝŶƚĂŝŶŝŶŐĂŶĞƚǁŽƌŬŽĨ
ZĞƐƚŽƌĂƚŝǀĞ:ƵƐƚŝĐĞWƌĂĐƚŝƚŝŽŶĞƌƐ͘
ϱϬ͕ϬϬϬΨ ϱϬ͕ϬϬϬΨ
ϭϮϬ͕ϴϱϬΨ ϭϮϬ͕ϴϱϬΨ
&zϭϵ &zϮϬĞůŝǀĞƌĂďůĞ ĞƐĐƌŝƉƚŝŽŶ
ϰĂͲϰď
Ϯϱ͕ϮϰϴΨ Ϯϱ͕ϮϰϴΨ
dŽƚĂů
͘ϱϬ&d ZĞĐƌĞĂƚŝŽŶĂů
^ƉĞĐŝĂůŝƐƚ
ΨϮϮ͘ϬϳƉͬŚƌdžϮϬŚƌƐƉͬǁĞĞŬdžϱϮ
ǁĞĞŬƐсΨϮϮ͕ϵϱϮ
&ƌŝŶŐĞсϭϬй
ΨϮϮ͕ϵϱϮdž͘ϭϬсϮ͕Ϯϵϱ
dŽƚĂůсΨϮϮ͕ϵϱϮdžϮ͕ϮϵϱсΨϮϱ͕Ϯϰϴ
ϭĂͲϯĂ
/ƚĞŵ ZĂƚĞ
WĂŐĞϮŽĨϮ
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Attachment D-1
Quarterly Invoice
City of Gilroy͕^zd& (NSU) - FY17-FY20
BILL TO:Department of Probation REMITTANCE: City of Gilroy
County of Santa Clara
ADDRESS: 840 Guadalupe Pkwy ADDRESS: 7351 Rosanna Street
San Jose, CA 95110 Gilroy, CA 95020
Attn: Fiscal Division
PO #: Invoice #:
Date of Submission:
Start Date End Date
Contract Period:7/1/2018 6/30/2019
Invoice Period:
Final Invoice (circle one):Yes No % of Period Elapsed -11891%
Program Deliverable(s) / Written
Report for the reporting period
Submitted (circle one):Yes No
ab ef
CATEGORIES BUDGET
FUNDS
PREVIOUSLY
REQUESTED
REMAINING
CONTRACT
BALANCE
(a-d)
% of
Budget
Expended
(d/a)
1a - 3a: 0.5 FTE Recreation
Specialist 25,248.00 - 25,248.00 0%
3b: Pro-Social Activities
(identified by PCW) 8,000.00 - 8,000.00 0%
4a - 4c: Pro-Social Activities 29,402.00 - 29,402.00 0%
4d Production of Media Materials 7,000.00 - 7,000.00 0%
4e Restorative
Justice/Restorative Practices 85,000.00 - 85,000.00 0%
Totals 154,650.00 - 154,650.00 0%
I hereby certify under penalty of perjury that the amount billed above is true and correct in accordance with the contract.
Title:
Date:
Accounting Contact Person:
Phone Number:
Fax Number:
E-mail Address:
Invoice Amount: SAP DOC #
Adjustment:Input Date:
Net Payment:Name:
Explanation:Approver:
Contract Monitor: Date:
PROBATION DEPARTMENT STAFF USE ONLY
LESS PROGRAM INCOME -$
TOTAL EXPENDITURES BILLED -$
Vendor / Contractor Authorized Signature:
- -
- -
TOTAL EXPENDITURES -$
- -
- -
- -
- -
INVOICE
c d
ACTUAL CONTRACT
EXPENSES THIS PERIOD
TOTAL CONTRACT
EXPENSES TO
DATE
(b+c)
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Attachment E-1
Quarterly Narrative Report
City of Gilroy (NSU)͕^zd& – FY17-FY20
Quarterly Contract Status Report
(SCYTF - FY 2017-2018)
Page 1 of 4
PO #Date of Update
Period of Update
Section 1 – Milestone 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 associated tasks, as
identified in the contract scope of work. If tasks associated with a milestone have an assigned
target quantity, provide the current quantity completed. For example, if a task in the milestone is
to provide pro-social activities to a minimum of 300 individuals, provide the current quantity of
individuals served year-to-date,from the start date of contract to the last day of report update.
Milestone #1 Start Date 7/1/19 Target Date 6/30/20
Description Provide additional opportunities for residents (children, youth, adults, and seniors)
to engage in educational, health and safety related classes, workshops, and
presentations to be located in East Gilroy.
x Based on the plan developed by the East Gilroy SCYTF Technical Team
subcommittee and the resident/neighborhood group in East Gilroy,
Contractor shall provide pro-social activities to a minimum of 300
individuals in FY19. Provide the number of UNDUPLICATED number of
residents engaged in each workshop/class.
Q1
Q2
Q3
Q4
Milestone #2 Start Date 7/1/19 Target Date 6/30/20
Description Collaborate with the NSU Probation Community Worker (PCW) in identifying and
enrolling at-risk youth attending schools serving East Gilroy residents, in pro-social
activities. Priority will be given to youth identified 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.
x Develop menu of Pro-social activities for at-risk youth attending schools
serving East Gilroy residents.
x Collaborate with PCW to enroll 35 at-risk youth in individualized, pro-social
programming beginning June, 2017 through June, 2019.
Q1
Q2
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Quarterly Contract Status Report Page 2 of 4
Q3
Q4
Milestone # 3 Start Date 7/1/19 Target Date 6/30/20
Description Establishment of “Resident Leaders” - A Gilroy resident shall be given priority (over
non-Gilroy resident, private businesses) to teach a health and/or educational class
or workshop as described in deliverable #1. The “Resident Leader” may receive an
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
successfully execute a class of their design. 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.
x Develop Community Event/Class Schedule and identify “Resident Leaders.”
First Community Calendar due July 1st, 2019.
Q1
Q2
Q3
Q4
Milestone # 4 Start Date 7/1/19 Target Date 6/30/20
Description Contractor will maintain a resident advisory group to participate in SCYTF Technical
Team meetings, advise on ways to improve programming and assist in resident
outreach for SCYTF sponsored events.
x Establish Resident Advisory Group membership, vision, mission, and goals
by June 30, 2018.
Q1
Q2
Q3
Q4
Milestone # 5 Start Date 7/1/19 Target Date 6/30/20
Description Contractor 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 planned for and included in a monthly
calendar and distributed widely to residents of East Gilroy.
x Develop Community Event/Class Schedule and identify “Resident Leaders.”
First Community Calendar due July 1st, 2018.
Q1
Q2
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Quarterly Contract Status Report Page 3 of 4
Q3
Q4
Milestone # 6 Start Date 7/1/19 Target Date 6/30/20
Description Contractor shall identify a group of resident leaders, and assist in developing,
prioritizing, and implementing at least two community action projects within the
term of this Agreement. Contractor shall work with the resident group to complete
and submit an annual community action project plan. Contractor shall assist in
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.
x Update Community Action Project Plan for Year 3 by December 31, 2018.
Q1
Q2
Q3
Q4
Milestone # 7 Start Date 7/1/19 Target Date 6/30/20
Description Submit an updated annual East Gilroy SCYTF Technical Team subcommittee action
plan. Ensure the core elements of the action plan are funded through funds
provided in this Agreement.
Q1
Q2
Q3
Q4
Milestone # 8 Start Date 7/1/19 Target Date 6/30/20
Description Through participation in the Gilroy Unified School District’s Restorative Justice
Leadership Team, support the planning, training, and implementation of restorative
justice and restorative practices in schools where East Gilroy youth attend.
During QTR 2-3 – Submit Restorative Justice Comprehensive Framework, indicating
details on the development and implementation of a Restorative Justice Practitioner
Network.
QTR 4 – Summary of training, activities, and participants should be reported.
Q1
Q2
Q3
Q4
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Quarterly Contract Status Report Page 4 of 4
Section 2 – Success Story or Testimonial
Instructions: Please write a brief story or testimonial about a family that has been positively
impacted by an NSU-funded program and/or service that occurred in each quarter. The story or
testimonial for each quarter should be approximately 250-500 words and no more than 1/3
page. If possible, include the referral source of the highlighted family.
Success Story or Testimonial
Q1
Q2
Q3
Q4
Section 3 – Year-End Summary
Instructions: Answer the following questions upon conclusion of 4th Quarter or Program Year.
Each answer should be approximately 250-500 words and no more than 1/3 page.
A) Summarize the program services provided during the contract term, how they met or did not
meet program objectives, and why.
B) Summarize the program’s strengths, challenges, and lessons learned.
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Attachment &
Indirect Cost and Operating Expenses Language
ŝƚLJŽĨ'ŝůƌŽLJ͕^zd& ;E^hͿ- FYϭϳͲ&zϮϬ
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 ƉŽƐŝƚŝŽŶƐacross 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.
ͻ ŶƐǁĞƌŝŶŐƐĞƌǀŝĐĞĨĞĞƐ͖ ͻ onfidential expenditures;
ͻ ŽŶĨĞƌĞŶĐĞƐ͕ƐĞŵŝŶĂƌƐ͕ǁŽƌŬƐŚŽƉƐ͕ĂŶĚƚƌĂŝŶŝŶŐ͖ ͻ /ŶƚĞƌŶĞƚĂĐĐĞƐƐ͖
ͻ :ĂŶŝƚŽƌŝĂůƐĞƌǀŝĐĞƐ͖ ͻ KĨĨŝĐĞƐƵƉƉůŝĞƐ͖
ͻ KĨĨŝĐĞƐƉĂĐĞ͖ ͻ WŽƐƚĂŐĞ͖
ͻ WƌŝŶƚŝŶŐ͖ ͻ dĞůĞƉŚŽŶĞͬŽŵŵƵŶŝĐĂƚŝŽŶƐ
ͻ ŶĚdƌĂŝŶŝŶŐŵĂƚĞƌŝĂůƐ͘
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
ȂʹͲͳͺͳ
SECTIONVI:STANDARDPROVISIONS
A.ENTIREAGREEMENT
ȋȌ ǡ
Ǥ ǡ
ǡ ǡ
Ǥ ǡǡ
Ǥ
B.AMENDMENTS
Ǥ
C.CONFLICTSOFINTEREST
ǡ ǡ ȋȌ
ǢȋȌǡ ǡ
ǡ
ͳͲͻͲǤǤǡ ȋ
ͺͳͲͲǤǤȌ
ȋʹ ͳͺͲͲǤǤȌǤ
Ǥ
ǡ ǡ ǡ
ǡ ǡ Ǥ
ǡ ǡ
Ǥ ǡ ǯ ǡ
ͳͻͶȋDz dzȌǡȋͳȌ
ǡȋʹȌ
Ǥ
ǡ ǡ ǡǡ
ǡǡ ǯǡ
ǡ Dz dzDz
ǡdzȋʹͳͺͲͳȋȌȋʹȌȌǡ ǯ Ǥ
Ǥ
ǡ ǡ
Ǥ
ǡ
ȋȌ
ǡǡ ͵Ͳ
ǡͳǡ͵Ͳ Ǥ
D.GOVERNINGLAW,VENUE
ǡ ǡ
Ǥ Ǥ
E.ASSIGNMENT
Ǥ
"UUBDINFOU(
4UBOEBSE1SPWJTJPOT
4FDUJPO7*
$JUZPG(JMSPZ
4$:5' /46
':':
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Revision Date – ʹͲͳͺ
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.COMPLIANCE WITH ALL LAWS, INCLUDING NONDISCRIMINATION, EQUAL OPPORTUNITY, AND WAGE THEFT
PREVENTION
ȋͳȌ Compliance with All Laws. Contractor shall comply with all applicable Federal, State, and local laws, regulations, rules,
and policies (collectively, “Laws”), including but not limited to the non-discrimination, equal opportunity, and wage and hour
Laws referenced in the paragraphs below.
ȋʹȌ Compliance with Non-Discrimination and Equal Opportunity Laws: Contractor shall comply with all applicable Laws
concerning nondiscrimination and equal opportunity in employment and contracting, including but not limited to the
following: Santa Clara County’s policies for contractors on nondiscrimination and equal opportunity; Title VII of the CivilRights
Act of 1964 as amended; Americans with Disabilities Act of 1990; the Age Discrimination in Employment Act of 1967;the
Rehabilitation Act of 1973 (Sections 503 and 504); the Equal Pay Act of 1963; California Fair Employment and HousingAct
(Gov. Code § 12900 et seq.); California Labor Code sections 1101, 1102, and 1197.5; and the Genetic Information
Nondiscrimination Act of 2008. In addition to the foregoing, Contractor shall not discriminate against any subcontractor,
employee, or applicant for employment because of age, race, color, national origin, ancestry, religion, sex, gender identity,
gender expression, sexual orientation, mental disability, physical disability, medical condition, political belief, organizational
affiliation, or marital status in the recruitment, selection for training (including but not limited to apprenticeship), hiring,
employment, assignment, promotion, layoff, rates of pay or other forms of compensation. Nor shall Contractor discriminate in
the provision of services provided under this contract because of age, race, color, national origin, ancestry, religion, sex,gender
identity, gender expression, sexual orientation, mental disability, physical disability, medical condition, politicalbeliefs,
organizational affiliations, or marital status.
ȋ͵Ȍ Compliance with Wage and Hour Laws: Contractor shall comply with all applicable wage and hour Laws, which may
include but are not limited to, the Federal Fair Labor Standards Act, the California Labor Code, and, if applicable, any local
minimum wage, prevailing wage, or living wage Laws.
ȋͶȌ Definitions: For purposes of this SubsectionH, the following definitions shall apply. A “Final Judgment” shall mean a
judgment, decision, determination, or order (a) which is issued by a court of law, an investigatory government agency
authorized by law to enforce an applicable Law, an arbiter, or arbitration panel and (b) for which all appeals have been
exhausted or the time period to appeal has expired. For pay equity Laws, relevant investigatory government agencies include
the federal Equal Employment Opportunity Commission, the California Division of Labor Standards Enforcement, and the
California Department of Fair Employment and Housing. Violation of a pay equity Law shall mean unlawful discrimination in
compensation on the basis of an individual’s sex, gender, gender identity, gender expression, sexual orientation, race, color,
ethnicity, or national origin under Title VII of the Civil Rights Act of 1964 as amended, the Equal Pay Act of 1963, CaliforniaFair
Employment and Housing Act, or California Labor Code section 1197.5, as applicable. For wage and hour Laws, relevant
investigatory government agencies include the federal Department of Labor, the California Division of Labor Standards
Enforcement, and the City of San Jose’s Office of Equality Assurance.
ȋͷȌ
ǡ ǣǡ
ȋȌ ǡ
ǡǡȋȌ
Ǥ Ȃ
Ȃ Ǥ
ʹ
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Revision Date – ʹͲͳͺ
(6) Violations of Wage and Hour Laws or Pay Equity Laws During Term of Contract: If at any time during the term of this
Agreement, Contractor receives a Final Judgment rendered against it for violation of an applicable wage and hour Law or pay
equity Law, then Contractor shall promptly satisfy and comply with any such Final Judgment. Contractor shall inform the
Office of the County Executive-Office of Countywide Contracting Management (OCCM) of any relevant Final Judgment against
it within 30 days of the Final Judgment becoming final or of learning of the Final Judgment, whichever is later. Contractor
shall also provide any documentary evidence of compliance with the Final Judgment within 5 days of satisfying the Final
Judgment. Any notice required by this paragraph shall be addressed to the Office of the County Executive-OCCM at 70 W.
Hedding Street, East Wing, 11th Floor, San José, CA 95110. Notice provisions in this paragraph are separate from any other
notice provisions in this Agreement and, accordingly, only notice provided to the Office of the County Executive-OCCM
satisfies the notice requirements in this paragraph.
(7) Access to Records Concerning Compliance with Pay Equity Laws: In addition to and notwithstanding any other
provision of this Agreement concerning access to Contractor’s records, Contractor shall permit the County and/or its
authorized representatives to audit and review records related to compliance with applicable pay equity Laws. Upon the
County’s request, Contractor shall provide the County with access to any and all facilities and records, including but not
limited to financial and employee records, that are related to the purpose of this Subsection H, except where prohibited by
federal or state laws, regulations or rules. County’s access to such records and facilities shall be permitted at any time during
Contractor’s normal business hours upon no less than 10 business days’ advance notice.
(8) Pay Equity Notification: Contractor shall (1) at least once in the first year of this Agreement and annually thereafter,
provide each of its employees working in California and each person applying to Contractor for a job in California
(collectively, “Employees and Job Applicants”) with an electronic or paper copy of all applicable pay equity Laws or (2)
throughout the term of this Agreement, continuously post an electronic copy of all applicable pay equity Laws in conspicuous
places accessible to all of Contractor’s Employees and Job Applicants.
(9) Material Breach: Failure to comply with any part of this Subsection H shall constitute a material breach of this
Agreement. In the event of such a breach, the County may, in its discretion, exercise any or all remedies available under this
Agreement and at law. County may, among other things, take any or all of the following actions:
(i) Suspend or terminate any or all parts of this Agreement.
(ii) Withhold payment to Contractor until full satisfaction of a Final Judgment concerning violation of an applicable
wage and hour Law or pay equity Law.
(iii) Offer Contractor an opportunity to cure the breach.
(10) Subcontractors: Contractor shall impose all of the requirements set forth in this Subsection H on any subcontractors
permitted to perform work under this Agreement. This includes ensuring that any subcontractor receiving a Final Judgment
for violation of an applicable Law promptly satisfies and complies with such Final Judgment.
I.TERMINATION
Standard Termination Language
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 –
Alternate Termination Language Attached As Exhibit
(Requires County Counsel Approval)
, incorporated by this reference.
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 by this 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.
͵
✔
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Revision Date – ʹͲͳͺ
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
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 l ess 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
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,
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.
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.
O.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:
Ͷ
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Revision Date – ʹͲͳͺ
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
are identified in this Agreement. Contractor hereby assigns to the County all rights, title and interest in and to any and all
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.
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 solely or jointly with others, in connection with any agreement with the County.
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 a 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 section.
ͷ
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
Revision Date – ʹͲͳͺ
T.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 selec ted 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
warrant or 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)
1.75% 20 Net 45 (provides 25 days of cash acceleration)
1.33% 25 Net 45 (provides 20 days of cash acceleration)
1.00% 30 Net 45 (provides 15 days of cash acceleration)
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.
U.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
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.
V.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
the Living Wage Policy with respect to applicable contracts.
✔
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
EXHIBIT B-2 (revised)
Rev. 9/2016 1
INSURANCE REQUIREMENTS FOR
STANDARD CONTRACTS ABOVE $100,000
Indemnity
The Contractor 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 Contractor 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 Contractor shall
reimburse the County for all costs, attorneys' fees, expenses and liabilities incurred with respect
to any litigation in which the Contractor contests its obligation to indemnify, defend and/or hold
harmless the County under this Agreement and does not prevail in that contest.
Insurance
Without limiting the Contractor's indemnification of the County, the Contractor 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 Contractor 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 Contractor upon request.
This verification of coverage shall be sent to the requesting County department, unless
otherwise directed. The Contractor 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 Contractor.
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.
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
EXHIBIT B-2 (revised)
Rev. 9/2016 2
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 of Santa Clara 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.”
Insurance afforded by the additional insured endorsement shall apply as primary
insurance, and other insurance maintained by the County of Santa Clara, 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
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
EXHIBIT B-2 (revised)
Rev. 9/2016 3
additional insured endorsement as applicable and the contractor shall be notified by
the contracting department of these requirements.
4. Automobile Liability 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 Contractor 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.
5. 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 Contractor 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 Contractor 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 Contractor.
However, this shall not in any way limit liabilities assumed by the Contractor under
this Agreement. Any self-insurance shall be approved in writing by the County
upon satisfactory evidence of financial capacity. Contractors obligation hereunder
may be satisfied in whole or in part by adequately funded self-insurance programs
or self-insurance retentions.
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE
EXHIBIT B-2 (revised)
Rev. 9/2016 4
3. Should any of the work under this Agreement be sublet, the Contractor shall require
each of its subcontractors of any tier to carry the aforementioned coverages, or
Contractor may insure subcontractors under its own policies.
4. The County reserves the right to withhold payments to the Contractor in the event
of material noncompliance with the insurance requirements outlined above.
F. Fidelity Bonds (Required only if contractor will be receiving advanced funds or payments)
Before receiving compensation under this Agreement, Contractor will furnish
County with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Agreement, or authorized to sign or
countersign checks, are covered by a BLANKET FIDELITY BOND in an amount
of AT LEAST fifteen percent (15%) of the maximum financial obligation of the
County cited herein. If such bond is canceled or reduced, Contractor will notify
County immediately, and County may withhold further payment to Contractor until
proper coverage has been obtained. Failure to give such notice may be cause for
termination of this Agreement, at the option of County.
DocuSign Envelope ID: 7E6FB488-0F18-4CED-A4EE-B3D6852DB8AE