HomeMy WebLinkAboutCOM 0027.000 2002-2004 Mtv,or M~
Harry Kim ~,c~ William Takaba
Mn}~nr Director
Nancy E. Crawford
•~•q, • Deputy Director
County of Hawaii
Finance Department
25 Aupuni Street, Room I18 • Hilo, Hawaii 96720
(SOA)961-A234 • Fax (808)961-8248 ,
i~'
December 2, 2002
Honorable James Arakaki, Chairperson and
Members of the County Council -
Hawai'i County Council
25 Aupuni Street _
Hilo, Hawaii 96720
Re: Operating Budget
The U.S. Department of Justice, through the State of Hawaii Department of Human Services,
Office of Youth Services, has authorized a $103,550 Title V Juvenile Delinquency Prevention
Program Grant to the Office of the Prosecuting Attorney. The funds will be used to create or
expand prevention program(s) that address juvenile delinquency risk factors identified in the
Hawaii County comprehensive strategic plan for juvenile justice. The grant is based on the
premise that preventing delinquent behavior is more cost-effective in reducing juvenile crime than
rehabilitation of adjudicated youth.
Enclosed is a resolution to authorize the Mayor to enter into an agreement with the State of Hawaii
Department of Human Services, Office of Youth Services.
Also enclosed is a bill for an ordinance amending the Operating Budget by appropriating this
$103,550 Title V Juvenile Delinquency Prevention Program Grant.
If there are any questions, please do not hesitate to call the Office of the Prosecuting Attorney.
William Taka a
Director of Finance
AP OVE
- ~ ' `
Harry Kim"
Mayor Comm. No.
Enc. File No.
/Ze5- /S-G3 I3(Il lI
cc: Prosecutors Ref. To:
ReF. Date DEC n r) ~~Z
Form # B-;;2
7!18191
CEPARTMENT OF FINANCE
REQUEST FOR COUNCIL ACTION
DEPARTMENT: PROSECU(INGATTORNEY DA-f~E: 11t26/U2
S"(AFF CONTACT: NANCY/ JUDY PHONE: 961-0466
A REQUEST:
INCREASE REVENUE IN THE AMOUNT OF $103,550.00 AND ESTABLISH ACCOUNTS FOR THE
DISBURSEMENT OF TITLE V GRANT FIJNDS FOR JUVENILE DELINQUENCY PREVENTION
PROGRAM,
(AKA: TITLE V}
B. BACKGROUND AND JUSTIFICATION (USE ADDITIONAL SHEETS AS NEEDED):
We have received additional funds from a new grant that will be used For expenses and pass-tYiru Funds for a
supplement to our JAIBG funds. (Copy attached)
Please distribute the funds as follows'
010-271-5271.??-104 Travel & Training $4,580.00
-106 Printing 1,000.00
-112 Mileage 500.00
-115 Misc. Contract Services 96,470.00
-227 Supplies 1,000.00
Total $1D3,550A0
_ ~ .
- ~>x~ DATE: 11/26/02.
~Depaitmc:ut Head
GRANT SUMMARY
(Supplement to B-52, Request for Council Action)
Type of Grant Appropriation being requested: (New or an additional appropriation)
i
® New (for this fiscal year period). OR ~ Additional appropriation (to an existing grant);
Is a draft agreement attached? Has the original grant notification been transmitted to
®Yes ~ No Council? ~ Yes ~ No
Name of Grant Program: Title V Juvenile Delinquency Prevention Program
Grantor: State Office of Youth Services
County Grantee Department or Agency: Office of the Prosecuting Attorney
County Grantee Contact Person: Nancy Kelly Phone Number: 934-33]5
Amount of Grant: $103,550
Grant Period (Commencement & Completion): 1/1/03 - 9/30/04
Purpose of Grant: To create or expand prevention program(s) that address juvenile delinquency risk
factors identified in the Hawaii County comprehensive strategic plan for juvenile justice.
County Match required?: ®Yes ~ No
If yes, Matching Amount? $51,775 Budgeted in account#
In-kind? Explain: In-kind match will be provided by the Prosecutor's Office and the
sub-grantee agency.
Explanation: In-kind match is determined by the value of goods and services utilized to
support the project. This includes staff time, equipment, supplies and use of
building & equipment.
County's personnel requirements: Amount of new position(s)?
Qty: 0 Permanent ~ Temporary: Duration:
Full-time: ~ Part-time: Time Element:
Qty:O Contractual: ~ Explain:
Explanation: The project will be supervised by existing personnel. No new positions will be necessary.
Additional Comments about Grant: 93% of funds for this project will be subgranted out to another
agency or organization to provide direct service to juveniles. The grant is based on the premise that
preventing delinquent behavior is more cost-effective in reducing juvenile crime than rehabilitation of
adjudicated youth.
B-52 GraN Summary Form
BENJAMIN J. CAYETANO 0_~4 .JfC BERT Y. MATSUOKA
GOVERNOR 4 .sea ~ EXECUTIVE DIRECTOR
•f v~~i//~ . 5
t G~
a~ `phone: (808)587-5700
P
s~.;~s,es~ Fax: (808) 587-5734
Email: oys@pixi.com
STATE OF HAWAII
DEPARTMENT OF HUMAN SERVICES
OFFICE OF YOUTH SERVICES
820 Mililani Street, Suite 817
Honolulu, Hawaii 96813
October 29, 2002
The Honorable Jay T. Kimura, Prosecutor
Office ofthe Prosecuting Attorney
County of Hawaii
34 Rainbow Drive
Hilo, Hawaii 96720
Dear Mr. Kimura:
Enclosed find two (2) sets of Agreement for Health and Human Services: Transactions Exempt
From Chapter 103F, HRS between the Office of Youth Services and the County of Hawaii,
Office of the Prosecuting Attorney identified as #DHS-03-OYS-1489. Please sign (in black ink)
and initial both sets of the Agreement and return them to this office. In addition sign and
complete the following:
• Attachment "3", Certifications Regarding Lobbying; Debarment, Suspension and
Other Resonsibility Matters; and Drug Free Workplace Requirements
If you have not done so already, please submit the following with the signed Agreements for
contract execution:
• Budget and required justification/details
• Outcome, Performance Targets and Milestones
The Agreement must be signed, dated, and returned to our office by November 15, 2002 or
execution of this Agreement will be delayed.
Please contact Debra Shiraishi-Pratt at (808) 587-5721 should you have any questions regazding
the Agreement.
Sincerely, CQ~
F'V
~ rj
' ti~
a a o4' _
Bert Y. Mat ka a~oy' ~a ~
Executive Director ~ ~ '~6,
Enclosure OCR
lb '
DHS- 03 -OYS- 1489
STATE OF HAWAII
AGREEMENT FOR- HEALTH AND HUMAN SERVICES:
TRANSACTIONS EXEMPT FROM CHAPTER 103F, HRS
'T'his Agreement, executed on the respective dates of the signatures of the
parties shown hereafter, is effective as of (date) JANOARY 1 2003 ,
between the (agency) Department of Human Services, Office of Youth Services
State of Hawaii (the "STATE"), by its. Executive Director
(the "DIRECTOR"), whose address is 820 Mililani Street, Suite 817, Honal ul u, Haeai'i 96873
and County of Hawaii, Office of the Prosecuting Attorney
(the "PROVIDER"), a (government entity/wrporation/partnership/sole proprietorship/other
business form) government entity
whose business address and taxpayer identification number are: 34 rainbow Drive,
Hilo, Hawaii 96720
RECITALS
A. This Agreement is for a purchase of health and human services that is exempt
from the requirements of Chapter 103F, HRS, because:
? this Agreement is between or among government agencies as provided
in Section 103F-101(a)(2), HRS;
? this Agreement is to award grants or subsidies of state funds
appropriated by the legislature to a specific organization as provided
in Section 103F-101(a)(1), HRS, and Section 3-141-503(a)(2), HAR,
or to award subawards and subgrants to specific organizations directed
by the funding source as provided in Section 3-141-503(a)(1);
? this Agreement is wholly or partly funded from federal sources that
conflict with the procedures and requirements established by Chapter
103F, HRS, and its implementing regulations;
? this Agreement is wholly or partly funded from federal sources that (1)
identifies a target class of beneficiaries, (2) defines the requiremenu
for a provider to be qualified to participate in the federal program, and
(3) has the price of the provided health and human services dictated
by federal law;
EXEMPT TRANSACTIONS ,
Page 1 Foam AG3•Exem(4/99)
? this Agreement is for an affiliation agreement with hospitals and other
health care providers required for University of Hawaii clinical
programs;
? this Agreement is for the services of psychiatrist, or psychologists in
criminal or civil proceedings as required by a court order or by the
rules of the court;
? this Agreement is for a transaction covered by a written exemption
from the Chief Procurement Officer for the STATE dated
g, The STATE is in need of the health and human services described in this
Agreement -and its exhibits (the "Required Services"). The PROVIDER is agreeable to
providing the Required Services.
C. Money has been appropriated for the purchase of the Required Services by:
(I) (identify state sources) Act 177 Item F- 5 2002, SLH , or
(2) (identify federal sources) Juvenile Justice and Delinquency Act of 1974 , 07 both,
as amended, PL 93-4 5; IISC 5601 et. seq; Title O, CFDA #16.548
in the following amounts:
State: $ -o-
Federal: $ 103,550.00
D. Pursuant to (legal authority for Agreement) section 346-63 alts ,
the STATE is authorized to enter into this Agreement.
E. The undersigned representative of the PROVIDER represents, and the
STATE relies upon such representation, that he or she has authority to sign this Agreement
by virtue of (check any or all that apply):
? corporate resolutions of the PROVIDER or other authorizing
documents such as partnership resolutions;
? corporate by-laws of the PROVIDER, or other similaz operating
documents of the PROVIDER, such as a partnership agreement, or an
limited liability company operating agreement;
EXEMPT TRANSACTIONS
Page 2 Form AG3-Exom(4/99)
? the PROVIDER is a sole proprietor and as such does not require any
authorizing documents to sign this Agreement;
f~ the PROVIDER is a government entity, and the undersigned
representative of the PROVIDER is duly-authorized to execute
contracts on behalf such government entity;
? other evidence of signing authority:
F'. The PROVIDER has produced, and the STATE has inspected, a certificate
of insurance in the amount of N/A DOLLARS
for bodily injury and property damage liability arising in connection with
the PROVIDER'S performance under this Agreement.
The PROVIDER has produced, and the STATE has inspected, a tax clearance
certificate with approval from the State of Hawaii, Department of Taxation, dated
N/A
NOW, THEREFORE, in consideration of the promises contained in this Agreement,
the STATE and the PROVIDER agree as follows:
1. Scope of Services. The PROVIDER shall, in a proper and satisfactory manner
as determined by the STATE, provide the Required Services as set forth in Exhibit "A" to
this Agreement, which is attached, and made a part of this Agreement.
2. Term of Agreement. The PROVIDER shall provide the Required Services
from (date) January 1 2003 ,to (date) Seytember 30
2004 ,unless this Agreement is sooner terminated.
3. Compensation. The PROVIDER shall be compensated
O ONE i~tROtIDal1am~oEn1t,HO~Sa~llDrFC~~ ed services not to exceed
N0N0RF.n FTFTy ANn N0/100 DOLLARS 103.550.00
including taxes, at the time and in the manner set forth in Exhibit "B"
to this Agreement, which is attached, and made a part of this
Agreement.
? based upon referrals to the PROVIDER from fire STATE, payment
EXEMPT TRANSACTIONS
Page 3 Fonn AG3-Exem(4/99)
for each such referral shall be made according to Exhibit "B" to this
Agreement, which is attached, and made a part of this Agreement.
The STATE shall provide a minimum of referrals to
the PROVIDER.
q. Reportin~Requirements. In addition to whatever other reports may be
required elsewhere in this Agreement, the PROVIDER shall also submit a Final Project
Report, by (date October 30 2004 No amendment to the
PROVIDER's Final Project Report shall be considered after (date) November 30
2004
5. Standards of Conduct Declaration. The Standards of Conduct Declaration of
the PROVIDER is attached as Exhibit "C", and is made a part of this Agreement.
Other Terms and Conditions. The General Conditions for Health and Human
Services Contracts (the "General Conditions") are attached as Exhibit "D," and are made a
part of this Agreement. If applicable, any Special Conditions are attached as Exhibit "E,"
and are made a part of this Agreement. In the event of a conflict between the General
Conditions and the Special Conditions, the Special Conditions shall control.
7. Notices. Any notice, communication, or information required to be given by
any party to this Agreement shall be made in writing ,and shall be (a) delivered personally,
or (b) sent by United States first class mail, postage prepaid. Notice required to be given
to the DIRECTOR shall be sent to the DIRECTOR's office in Honolulu, Hawav. Notice
to the Agency Procurement Officer shall be sent to:
Department of Human Services, P.0. Box 339,
Honolulu a~--~~'~ ~~sn9 _ Notice to the
PROVIDER shall be sent to the PROVIDER at the PROVIDER'S address as indicated in
this Agreement. Notice to the STATE'S Chief Procurement Officer shall be sent to. _
1151 Punchbowl Street, #230-A,
Honolulu, Hawai' i 96813 A notice shall be deemed to have been received
three (3) days after mailing or at the time of actual receipt, whichever is earlier. The
PROVIDER is responsible for notifying the STATE in writing of any change of address.
EXEMPT TRANSACTIONS
Page 4 Form AG3-Exem(q/99)
IN VIEW OF THE ABOVE, the parties execute this Agreement by their signatures,
on the dates below, to be effective as of the date 5rst above written.
STATE
By
Print Name
'I'jtle Office of Youth Services
Department of Human Serv ces
Date
PROVIDER
B ~ ~
Y ? ~
Print Name JAY T. KIMURA
Title PRQSECUTING ATTORNEY
Date 10/31/02
APPROVED AS TO FORM:
Deputy Attorney General
EXEMPT TRANSACTIONS
Page 5 Form AG3-Exem(4/99)
r
IN VIEW OF THE ABOVE, the parties execute this Agreement by ffieir signatures,
on the dates below, to be effective as of the date first above written.
STATE
By
Print Name
Title Office of Youth Services
Department of Human Serv ces
Date
PROVIDER
By ~
Print Name JAY T. KIMURA
Title PROSECUTING ATTORNEY
Date 10/31/02
APPROVED AS TO FORM:
Deputy Attorney General
EXEMPT TRANSACTIONS
Page 5 Form AG3-Exem(4/99)
THIS PORK IS DELETED
AND INOPERATIVE
PROViDER~S .aCKNOwLEDG,rfENT
Scace of )
SS.
County of )
On this day of , befo me personally
appeared , to me personally kno ,who being by me
duly sworn, did say that helshe is the of
,the PROVIDER named in the fore ia; instrument, and chat
helshe is authorized to sip said inttrument on behalf of the ROVIDER. as provided is
Recital E of the foregoin; Agreement, and aclmowle es that he/she esecuted said
instrument as the free act and deed of the PROVIDE
~ tary PubliF
y .commission ezPires:
a ~ ~~~ONS FOfO AG~~mI ~ Y41
. Pais 6
CERTIFICATION OF EXEMPTION FROM CIViL SERVICE
1. By Heads of State Departments or Agencies Pursuant to Delegation of the Director
of Human Resources Development`
Pursuant to the delegation of the authority by the Director of Human Resources
Development, I certify that the services provided under this Agreement, and the person(s)
providing the services under this Agreement are exempt from the civil service, pursuant to
Hawaii Revised Statutes §76-16.
(signature) (date)
Bert Y. Matsuoka
Print Name
Executive Director
Print Title Office of Youth Services '
Department of Auman Services
2. By the Director of Human Resources Development, State of Hawaii=
I certify that the services provided under this Agreement, and the person(s) providing
the services under this Agreement are exempt from the civil service, pursuant to Hawaii
Revised Statutes §76-16(__).
(signature) (date)
Print Name
Print Title, if designee of Director
of Human Resources Development
tThis part o[the form may be used by all department heads and othea to whom the Dvector of
Human Resources Devebpment hat delegated authority to certify Hawaii Revised Statutes sectron 76-16
civd service exoeptitma. 'ILe specific paragraph(s) of section 76-16 upon which an exemption is bard
should be noted in the contract frle. NOTLM1 Authority to certify exceptions under Hawari Revised Statutes
sections 76-16(2) and 76-16(3) has not been delegated; only the Dvector of Human Resources
Development may certify sedioas 76.16(2) and 76-16(3) .exceptions.
zI'hb part of the form may be used oafy by the Director of Human Resources Davelopmeat or the
Director's desigoea See NOTL? at footnote 1.
EXEMPT TRANSACTIONS
Page 7 Form AG3-F,tem(s,yyl
SCOPE OF SERVICES
The PROVIDER shall, in a proper and satisfactory manner, as detennined by the STATE
pursuant to the Title V Incentive Grant for Local Delinquency Prevention Program (Title V)
of the Juvenile Justice and Delinquency Prevention Act of 1974, as amended, Public Law 93-
415, 42 U.S.C. 5601, et. seq., Catalog of Federal Domestic Assistance No. 16.548, Federal
Grant No. 02-JP-FX-001 develop and implement ajuvenile delinquency prevention
program(s) in Hawaii County. The PROVIDER shall select asub-contractor and support the
development of, and provide monitoring of, the juvenile delinquency program(s) to address
the risk factors that have been identified as priorities for this community (Family
Management, Family Conflict, and Early and Persistent Anti-Social Behavior) to achieve
outcomes in the area of family strengthening and pro-social skills for youth.
I. Program Activities
The PROVIDER shall:
A. Implement a juvenile delinquency prevention program(s) in Hawaii County
through asub-contractor who shall provide direct services and activities to at-risk
youth and families in one or more of the program azeas recommended in the
County's comprehensive strategic plan as summarized in the Youth Builders
Executive Summary attached hereto as Attachment 4 and made a part hereof.
Additionally the PROVIDER shall:
1. Coordinate the solicitation of proposals for the sub-contract(s) in accordance
with the State and County procurement guidelines.
2. Conduct a competitive review process and select a proposal(s) for funding.
3. Execute asub-contract agreement(s) with the selected agency(ies).
4. Conduct regular program and fiscal monitoring of the sub-contract
agency(ies) to ensure that the services address the priority risk factors, and are
delivered in a manner that assures quality, safety of participants and staff, and
timely coordination.
5. Assure that the staff and resources of the sub-contracted agency(ies) is
appropriately allocated in relation to the program's goals, objectives,
outcomes, performance targets and milestones.
B. Establish and convene a Prevention Policy Board (PPB) as required by the federal
grant with the purpose to assure input from all segments of the community in the
implementation of the community's juvenile delinquency prevention plan.. The
PROVIDER shall document the roles and responsibilities of the PPB and staff the
PPB. The PPB shall be comprised of not less than 15 members representing a
balance of public agencies, private non-profit organizations, business and
industry, and private citizens, and youth. The membership of the PPB shall
reflect the racial, ethnic and cultural composition of the community.
C. Provide a match of not less than 50 percent of the amount of the funds awarded.
This match shall be provided in cash or project-related costs allowable under
Exhibit "A"
Page 1
federal guidelines or through the valuation of in-kind services. The PROVIDER
shall submit Match Reports to the STATE in appropriate format and within
deadlines specified by the STATE.
D. Attend and participate in meetings concerning statewide coordination of the Title V
program as initiated by the STATE.
E. Provide any other service or assistance mutually agreed upon by both parties.
II. Outcomes
To incorporate an outcomes framework for service delivery, the PROVIDER shall:
A. Establish performance targets and milestones that address the above outcomes and
submit performance targets and milestones on Outcomes Forms 3-1, 3-2, and 3-3,
included in Attachment 2 to the STATE prior to the Agreement execution date.
B. Track and report its progress in meeting the established performance targets and
milestones and meet with the STATE to review the results of progress and make
necessary modifications and corrections.
C. Evaluate its progress in meeting the established outcomes, performance targets
and milestones. The PROVIDER shall use this self-evaluation to improve and
strengthen the services and to refine the outcomes, performance targets and
milestones.
III. Administrative Requirements
The PROVIDER shall:
A. Submit Quarterly Program Reports, Expenditure Reports, and Match Reports no
later than thirty (30) days after the end of a quarter. Quarterly reports are due:
Apri130, 2003 January 30, 2004
July 30, 2003 Apri130, 2004
October 30, 2003 July 30, 2004
Quarterly program reports shall include Outcomes Forms 3-1, 3-2, 3-3, 3-4, 3-5,
3-6, 3-7, 3-8, 3-9, 3-10, and 3-11 attached hereto as Attachment 2 and made a part
hereof. The PROVIDER shall use appropriate computer hardware and Word 97,
Access 97, and Excel 97 to record, monitor, and report data as printed reports and,
as may be required, on 3.5 HD diskettes.
Quarterly expenditure and match shall be reported on required STATE forms.
Exhibit "A"
Page 2
B. Submit final Program, Expenditure, and Match Reports, including Outcomes
Form 3-9, no later than thirty (30) days after the end of the Agreement period, or
October 30, 2004.
C. Furnish any additional reports or information that the STATE shall require or
request within 10 working days of notification.
D. Meet with representatives of the STATE to discuss the progress of work required
hereunder.
E. Certify by signing and require sub-contractors to sign the U.S. Department of
Justice, Certifications Regarding.Lobbying; Debarment, Suspension and Other
Responsibility Matters; and Drug-Free Workplace Requirements attached hereto
as Attachment 3 and made a part hereof.
IV. Quality Assurance and Evaluation Specifications
This Agreement shall be programmatically and fiscally monitored by the STATE
in accordance with requirements set forth by Chapter 103F, Hawaii Revised
Statutes. The STATE shall:
A. Review program services and reports, including but not limited to, outcomes plan,
performance targets and consumer milestones, quarterly reports and other
documents submitted to the STATE, and issues applicable to the services
provided.
B. Review, amend, and approve budget and budget revisions, if the STATE deems
appropriate. Review invoices and expenditure reports.
C. Review major program service areas, such as staff qualification; organization and
effectiveness; outcomes planning, implementation, and evaluation; collaboration
efforts; file maintenance and record keeping; facility accessibility, suitability, and
safety; transportation and other liability issues; and consumer satisfaction.
D. Conduct periodic site visits, both scheduled and unscheduled.
Exhibit "A"
Page 3
COMPENSATION AND PAYMENT SCHEDULE
In full consideration for the services satisfactorily performed by the PROVIDER under
this Agreement, the STATE agrees, subject to the receipt of federal funds under the
Juvenile Justice and Delinquency Prevention Act of 1974, as amended, Public Law 93-
415, U.S.C. 5601, et. seq., Title V -Incentive Grants for Local Delinquency Prevention,
Catalog of Federal Domestic Assistance No. 16.548, Federal Grant No. 02-JP-FX-0015
and, subject to allotments to be made by the Director of Finance, State of Hawaii,
pursuant to Chapter 37, Hawaii Revised Statutes, to pay the PROVIDER a total sum of
money not to exceed ONE HUNDRED THREE THOUSAND FIVE HUNDRED
FIFTY AND NO/100 dollars ($103,550.00) for the Agreement period.
1. Method of Payment. Payments shall be paid in accordance with and subject to the
following:
a. Payments shall be made in monthly installments upon the monthly submission by
the PROVIDER of invoices in triplicate for the services provided in accordance
with Exhibit A, "Scope of Services," and in accordance with the costs identified
in the Fiscal and Budget Information Attachment attached hereto as Attachment 1
and made a part hereof. The first payment shall be an advance installment of
FIVE THOUSAND AND NO/100 dollars $5( ,000). The STATE shall withhold
a final payment of approximately one-twenty first (1/21) of the total
compensation until receipt of the final invoice and acceptance of the final written
Program, Expenditure, and Match reports.
b. The monthly installments after the initial installment made in advance shall be
determined by the STATE on a cost reimbursable basis. After the First payment,
the monthly invoices shall be based on expenditures actually incurred for the
performance of the services required under this Agreement. Invoices, together
with such supporting documents and progress reports of the performance of
services that the STATE may require to be submitted by the PROVIDER, shall be
reviewed by the STATE and shall be subject to the STATE's preliminary
determination of appropriateness and allowability of the reported expenditures.
The STATE's preliminary determination of appropriateness and allowability of
the reported expenditures shall be subject to later verification and subsequent
audit.
a If an amount of reported expenditures is preliminarily determined by the STATE
to be inappropriate and unallowable, the STATE may deduct an equivalent
amount from the next payable installment and may withhold payment if reported
expenditures are not part of the State-approved budget until later resolution of the
discrepancy by audit or other means. If, after payment of the last monthly
installment prior to final payment in final settlement, investigation and
examination reveal additional expenditures that are determined by the STATE to
be inappropriate and unallowable, the STATE may require that an equivalent
Exhibit "B"
Page 1
amount of moneys to be refunded by the PROVIDER notwithstanding the
STATE's preliminary determination of appropriateness and allowability. An
amount of moneys to be refunded by the PROVIDER may be offset against the
amount of moneys withheld by the STATE in determining the amount of the final
payment to be made to the PROVIDER in final settlement of this Agreement.
Final settlement shall include submission and acceptance of all reports and other
materials to be submitted by the PROVIDER to the STATE, resolution of all
discrepancies in performance of services, and completion of all other outstanding
matters under this Agreement.
2. Cost Principles. Payments shall be made in accordance with the State of Hawaii
Procurement Office, Chapter 103 F, HRS -Cost Principles, Purchase of Health and
Human Services, the Office of Management and Budget (OMB) Circular A-87, Cost
Principles for State and Local Units of Government, and the Office of Justice
Program's Financial Guide.
3. Budget Revisions. The PROVIDER shall request in writing to the STATE for prior
approval for any of the following:
Revisions between budget categories (i.e., "A" Personnel Costs and "B" Other
current expenses}.
Additions of new budget line items (i.e, Supplies, Telephone, Utilities, etc) not
previously budgeted.
Revisions of any budget line items that require a STATE detailed justification
farm.
As requested by the STATE.
4. Utilization Review. A review of the utilization of the service shall be conducted
quarterly. In the event the actual services provided or costs do not meet specified
levels at the time of the review date, the balance of the Agreement amount for the
remaining portion may be reduced in accordance with the utilization.
Provider's Initials:
5. Purchase and Use of Equipment. The authorized purchase and use of equipment
must be in accordance with the most current Office of Justice Program's Financial
Guide.
6. Reporting Penalty. Should PROVIDER fail to file the written Program,
Expenditure, and Match reports with STATE on or before the required date, STATE
is authorized to withhold funds owed to PROVIDER until such time as the reports are
acceptable and placed on file with STATE.
7. Final Payment. The PROVIDER will be paid the lesser of actual costs reported on
the final expenditure report or the contract amount for the budget period. The
Exhibit "B"
Page 2
amount of moneys to be refunded by the PROVIDER notwithstanding the
STATE's preliminary determination of appropriateness and allowability. An
amount of moneys to be refunded by the PROVIDER may be offset against the
amount of moneys withheld by the STATE in determining the amount of the final
payment to be made to the PROVIDER in final settlement of this Agreement.
Final settlement shall include submission and acceptance of all reports and other
materials to be submitted by the PROVIDER to the STATE, resolution of all
discrepancies in performance of services, and completion of all other outstanding
matters under this Agreement.
2. Cost Principles. Payments shall be made in accordance with the State of Hawaii
Procurement Office, Chapter 103 F, HRS -Cost Principles, Purchase of Health and
Human Services, the Office of Management and Budget (OMB) Circular A-87, Cost
Principles for State and Local Units of Government, and the Office of Justice
Program's Financial Guide.
3. Budget Revisions. The PROVIDER shall request in writing to the STATE far prior
approval for any of the following:
Revisions between budget categories (i.e., "A" Personnel Costs and "B" Other
current expenses).
Additions ofnew budget line items (i.e., Supplies, Telephone, Utilities, etc) not
previously budgeted.
Revisions of any budget line items that require a STATE detailed justification
form.
As requested by the STATE.
4. Utilization Review, A review of the utilization of the service shall be conducted
quarterly. In the event the actual services provided or costs do not meet specified
levels at the time of the review date, the balance of the Agreement amount for the
remaining portion maybe reduced in accordance with the utilization.
Provider's Initials:
5. Purchase and Use of Equipment. The authorized purchase and use of equipment
must be in accordance with the most current Office of Justice Program's Financial
Guide.
6. Reporting Penalty. Should PROVIDER fail to file the written Program,
Expenditure, and Match reports with STATE on or before the required date, STATE
is audtorzed to withhold funds owed to PROVIDER until such time as the reports aze
acceptable and placed on file with STATE.
7. Final Payment. The PROVIDER will be paid the lesser of actual costs reported on
the final expenditure report or the contract amount for the budget period. The
Exbibit "B"
Page 2
STATE will allow expenditures exceeding a budgeted line item as long as the total
amount for that budget category is not exceeded by five percent (5%}.
The final payment invoice for Grant No. 2002-JP-FX-0015 must be received by the
STATE no later than October 30, 2004 to ensure that payment is made within the
federal fund grant. Non-compliance with this requirement may result in lapsing of
federal funds. Tf federal funds lapse, the STATE shall not be obligated to make
payment to the PROVIDER. Non-payment to the PROVIDER shall not constitute a
breach of this Agreement.
Provider's Initials:
8. Payments in accordance with Chapter 40, HRS. All payments shall be made in
accordance with and subject to Chapter 40, Hawaii Revised Statutes.
Exhibit "B"
Page 3
STATE will allow expenditures exceeding a budgeted line item as long as the total
amount for that budget category is not exceeded by five percent (5%).
The final payment invoice for Grant No. 2002-JP-FX-0015 must be received by the
STATE no later than October 30, 2004 to ensure that payment is made within the
federal fund gant. Non-compliance with this requirement may result in lapsing of
federal funds. If federal funds lapse, the STATE shall not be obligated to make
payment to the PROVIDER. Non-payment to the PROVIDER shall not constitute a
breach of this Agreement.
ti-
Provider's Initials:
8. Payments in accordance with Chapter 40, HRS. All payments shall be made in
accordance with and subject to Chapter 40, Hawaii Revised Statutes.
Exhibit "B"
Page 3
THIS FORM IS DELETED
AND INOPERATIOE
ST.-\,~D,aRDS OF CO;~DCCT DECL.~RATION ~
For the purposes of this declaration:
-~.gency' means and includes the States the legislature and its committees, all xecutice
departments, boards, commissions, committees, bureaus, offices, the C;niversi of Elawaii.
and all independent commissions and other establishments of the state ,o ernment but
excluding the couru.
Controlling interest" means an interest in a business or other u dertaking which is
sufficient in fact to control, whether the interest is greater or less th fifty per cent (~0°c).
"Employee" means any nominated, appointed, or elected offic or employee of the State,
including members of boards, commissions, and committees, d employees under contract
to the State or of the constitutional convention, but exclu g legislators, delegates to the
constitutional convention, justices, and judges.
On behalf of N/s ROVIDER the undersigned does
declare as follows:
1. PROVIDER (is1 (is notl a legisl r or an employee or a business in which a
legislator or an employee has a controlling ' terest'
Z. PROVIDER has not been assist or represented by a legislator or employee for a
fee or other compensation to obtain t Agreement and will not be assisted or represented
by a legislator or employee fora a or other compensation in'the performance of the
Agreement, if the legislator ore ployee had been involved in the development or award
of the Agreement
3. PROVIDER has n been assisted or represented for a fee or other compensation
in the award of this meat by as Agenry employee or, in the case of the Legislature,
by a legislator.
4. PROVIDE has not been represented or assisted personally on maturs related to
the Agreement a person who has been an employee of the Agenry within the preceding
two (2) years who participated while in state office or employment on the matter with
which the meat is direetfy concerned.
5. OVIDER hat not been represented or assisted on matters related to this
Afire eat, for a fee or other consideration by an individual who, within the past twelve
(1 months, has been as Agenry employee. or is the case of the Legislature, a legislator.
Page 1
THIS FORK IS DELETID
APiD INOPEBATIVE
6. PROVIDER has not been represented or assisted in the award of this Agre eat
for a fee or other consideration by an individual who, a) within the past twelve (12) oaths.
ser~~ed as an Agenry employee or in the case of the Legislature, a legislat ,and b)
participated while an employee or legislator o? matters related to this Agree ent.
PROVIDER understands that the Agreement to which this document is att hed is voidable
on behalf of the STATE if this Agreement was entered into in violation f any provision of
chapter 8~1, HRS, commonly referred to as the Code of Ethics, inc ding the provisions
which are the source of the declarations above. Additionally, any e, compensation, gtft,
or profit received by any person as a result of a violation of th Code of Ethics may ''.e
recovered by the STATE.
DATED: Honolulu, Hawaii,
PROVIDER
fay
Title
'Reminder to Agenry: If "is" is ci ed. the Agenry is required, under section 8415, HRS.
to file with the State Ethia Co 'ssion, tea (10) days before the Agreement is entered
into, a written justification as why the Agreement was not required to be competitively
bid.
Exhibit "C
Page 2 ,
GENERAL CONDITIONS
1. Representations and Conditions Precedent
1.1 Agreement Subiect to the Availability of State and Federal Funds
1.1.1 State Funds. This Agreement is, at all times, subject to the
appropriation of state funds, and may be terminated without liability
to either the PROVIDER or the STATE in the event that state funds
are not appropriated or available.
1.1.2 Federal Funds. To the extent that this Agreement is funded partly or
wholly by federal funds, this Agreement is subject to the availability of
such federal funds. The portion of this Agreement that is to be funded
federally shall be deemed severable, and such federally funded portioti
may be terminated without liability to either the PROVIDER or the
STATE in the event that federal funds are not available. In any case,
this Agreement shall not be construed to obligate the STATE to
expend state funds to cover any shortfall created by the unavailability
of anticipated federal funds.
1.2 Representations of the PROVIDER. As a necessary condition to the
formation of this Agreement, the PROVIDER makes the representations
contained in this paragraph, and the STATE relies upon such representations
as a material inducement to entering into this Agreement.
1.2.1 Compliance with Laws. As of the date of this Agreement, the
PROVIDER complies with all federal, state, and county laws,
ordinances, codes, rules, and regulations, as the same maybe amended
from time to time, that in any way affect the PROVIDER'S
performance of this Agreement.
1.2.2 Licensins and Accreditation. As of the date of this Agreement, the
' PROVIDER holds all licenses and accreditations required under
applicable federal, state, and county laws, ordinances, codes and rules
to provide the Required Services under this Agreement.
1.3 Compliance with Laws. The PROVIDER shall comply with all federal, state,
and county laws, ordinances, codes, rules, and .regulations, as the same may
be amended from time to time, that in any way affect the PROVIDER'S
performance of this Agreement, including but not limited to the laws
specifically enumerated in this paragraph:
EBHIBIT "D"
GENERAL CONDITIONS
Page 1 Foam AG3-F~ISGC(a/99)
1.3.1 Smoking Policy The PROVIDER shall implement and maintain a
written smoking policy as required by Chapter 328K Hawaii Revised
Statutes, or its successor provision.
1.3.2 Drug Free Work Place. The PROVIDER shall implement and
maintain a drug free work place as required by the Drug Free
Workplace Act of 1988, or its successor.
1.3.3 Persons with Disabilities. The PROVIDER shall implement and
maintain all practices, policies, and procedures required by federal,
state, or county law, including but not limited to the Americans with
Disabilities Act (42 U.S.C. §12101, et sec and the Rehabilitation Act
(20 U.S.C. §701, et se
1.3.4 Nondiscrimination. No person performing work under this Agreement,
including any subcontractor, employee, or agent of the PROVIDER,
shall engage in any discrimination that is prohibited by any applicable
federal, state, or county law.
1.4 Insurance. The PROVIDER shall obtain, maintain, and keep in force
throughout the period of this Agreement liability insurance (the "Liability
Insurance") issued by as insurance company in a combined amount of at least
ONE MILLION AND NO/100 DOLLARS ($1,000,000.00), or such lesser
amount requested in writing by the PROVIDER and, for good cause shown,
approved by the head of the purchasing agency, which approval, if any, is
incorporated herein by reference, for bodily injury and property damage
liability arising out of each occurrence. The Liability Insurance shall provide
that it is the primary insurance for the State of Hawaii, the purchasing
agency, and their officers, employees, and agents for any liability arising out
of or resulting from occurrences connected with the PROVIDER'S
performance under this Agreement. Prior to or upon execution of this
Agreement, the PROVIDER shall obtain a certificate of insurance verifying
the existence of the necessary liability insurance coverage, including the
coverage of the State of Hawaii, and its officers, employees, and agents. If
the scheduled expiration date of the liability insurance polity is earlier than
the expiration date of the time for performance under this Agreement, the
PROVIDER, upon renewal of the policy, shall promptly cause to be provided
to the STATE an updated certificate of insurance. The certificates of
insurancx shall expressly provide that the insurance polity shall not be
cancelled unless the insurance company has first given to the STATE thirty
(30) calendar days' written notice of the intended cancellation.
EXHIBIT 'D'
GENERAL CONDITIONS
Page 2 Fam AG3-HFiSGC(a/99)
Contract No. Form g-t (Rev oago)
' OfOce of Youth Services
Outcomes Piar1
Revised 04/IJO
The FoMaiig To Be FilkO In By PmWa
Contract Number: contract Inclusive oaba: Name of Agency: Totat Funding:
federah.C~
Sbfe:
Street Adtlress Ciry, Sbte 7Jp Code
ielephonel Telephone2 Fax e.mal
Program Oirectw/Manager Telephone Fax e-ma4
Executive Director Telephone Fax
e-mail
Program Name:
Program Deudption (Basic Services Pmvitled):
CONSUMER INFORMATION: GROUP ~
Age Range Targeted Ethnlcitles:
(Behveen 5-19 '
Years): Q No Spedflc ENnlc Gmup Is Targeted.
? The Following ENnic Groups Are Targeted (Please CherJt One Or Moro):
D To
Gunder. ? Hawaiian (Full, Part) ? PueM Rican, fiispaNc ? Japanese ? NTite
? M QF Q Bob ? Rllpirro ? Portuguese ? Konen ? Bbd/
? Sartaan ? CambodWn ? Laotlan ? Amedcan IMbn
- ? Tongan ? Chinese ? Vlebumese ? Mixed (Not HawalOn)
? ONer Patific Islander ? OUror AsWn ? Onkrrown
Service Areas Check One or More
? Sble (All Islands) ? Hawall WI) Q Kawl.(Alq ? MaW (AM -
? Oahu (Ag) ? Ilawag: Kohab, Walmea ? Kaual: Kokes, Ranalel, Kllwea ? Maul: Lahalna, Wagree
? Oahu: Central ? Hawaii: Konawaona, Kailua-Kona ? Kauai: Walmea, Kdoa. Ntlhau ? Mauk Waduku, KahWW, Klhel
Q Oahu: Hmdulu ? Mawvg: Keaw, Pahw ? MeW; Kub, Wlku, Makawao
? Oahu: Leeward ? Hawai: Naalehu, Kau Keame, Fbru, Pab
Q Oahu: WlnAvard Q MauL• Laval
Maut MolWal
Risk Levels for Prima Consumer Gmu 1 (Check Box
I AHlsk (w vidence, substance abuao, and/or viminal actlNy due b geognphio, eNnic, or sa6oewrwMc fedora.
$bWa offender. ChronlWly Want, Nnaway.
II Invoked H gangs, vblence, d aWUtance abuse.
Experkndn0 serials hmity probbms:
Abused arW/a neglected.
III Any dianderlstlc o(Level 11, Wt also has basic need for food, ahelteg ducting, and/or medical treatment
Invdved N cdmhal aNviy; adludigfetl.
At risk fa out of home placement
AI rlak fir !earn mnflnemenL ,
N Any of Me Mree levels above.
RegWre Beare confinement; dak b public safety.
Fortn }7 (Rev lNNO)
N:\OYS Outmmas Fwlns\FOIm 3-t (Rev OS/00) AtYar}tmant rr~^
Contract No.
Form 3-0 (Rev 04/00)
CONSUMER INFORMATION;GROUP2
_ Age Range Targeted Ethnidties:
(Between 5- 19
Years): ? No Spedflc Ethnic Group Is Targeted.
' ? The Following Ehnic Groups Are Taryatetl (Please Check One Or More):
Ta
Gender: ? Hawaiian (Full, PaR) ~ puorto Rinn, Hispanic ? Japanese ? Whlta
? M pF ~ Both ~ Filipino ? Portuguese ? Korean
? Black
? Samoan ? Cambodian ? Laotlan
? Amednn Intlian
? Tpngan ? Chinese ~ YeNamese
? Maed (Not Hawaiian)
? ONer Padfic Islander ? ONer Asian ? Unknown
Service Areas (Check One or More):
? State (fdl Islands) ? Hawaii (All) ? Kauai (All) ? MaW (All)
? Oahu (All) ? Hawaii: Kohaia, Waimea ? Kauai: Kokee, Hanalei, Kilauea ~ Maul: Lahalna, Waihea
Q Oahu: Cenhal ? Hawaii: Konawaena, Kailua-Kona ~ Kauai: Waimea, Kdoa, Niihau ? Maui: Walluku, Kahului, Kihel
? Oahu: HondWu ? Hawaii: Keeau, Pahaa ? Maui: Kula, Haiku, Makawao
? Oahu: Leeward ? Hawaii: Naalehu, Kau Keanae, Maria, Pala
~ Oahu: yMndwaN ? Maul: Lana)
? Maul: Molokai '
Risk Levels for Prima Consumer Gmup 2 Check Box):
I At-risk for violence, substance abuse, and/or criminal acEVity due l0 geographic, ethnic, or sadceconomlc factors.
? Status offender. Chroninlly Want, runav2y.
II Involved in gangs, Nolence, w substann abuse.
Expenendng serious fatuity problems.
Abused antl/or neglected. -
III Any characteristic of Level II, but also has basic need for food, shelter, tlathing, and/or medial treatment
Involved in uiminal activity, ad)utliated.
At dsk for out of home placement - '
At risk for saws confinement
? IV Any of the three levels above.
Require severe wnfinement; risk b public safety.
Fonn 3-1 (Rev01/00) "
N:\OYS Oulcortas Forms\FOnn 3-1 (Rev OM00) ,
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page 3
Corrtratf No. Form 7~
Office of Youth Services '
QUanerhr mnes~ones 6e{?1eW
Revised 04/07!2000
To Be Used Only If Milestones Were Not Achieved
Contract Number: Noma ofApsnry: ~ For Ws awrtor~ {(Ch~•
D2'~ O2eO D3"t
For Fiscal Year
' ~ C MBeatonaa M P Qwdr Won Notlkh4raQ r
P pwrter NBe:lanu Rarlaa lab Foam Sak WaiOr ~
Lomhi or Annwl Ra
Program Name:
1. During this past_ quarter _ year, this program did not achieve the folloowing milestones at
the levels projected:
Dseoriba Cis Perbrmanee Target Cat tlxsa mwaue ova develoPstl tor: _
_ ~
ftasbxH Description of Milestone -
Numbar PMnreaera Nurteo
2. For the milestones that have actual numbers that are significantly.less than the projedad
numbers, please answer the following questions:
a) What del you assume?
b) What did you loam? .
Form ae
N.'10YS Ouhvntea FanrlOUCaraa ForrtalFOrm 3@
- ~ ALtaebaeat 'a2•r
Psga 6 - 1
Conbaet No.
Form ]-8
3. What corrective actions have you already taken in this past quarter, if any, to get doser to your
milestones and pertormarice targets?
4. What corrective actions, steps, andlor approaches are planned for the next quarterl
5. Do you request a revision of your stated milestones or pen'omtance targets? ff yes, please .
submit Form 3-7.
6. As a result of the quarterly results and teaming session. with the OYS staff, what actions or
revisbns do you agree tog
Submitted by. Date:._f - . / .
For ors uw odr
Reviewed by: ~ Date:! !
Form sa ~ -
N:10YS OWmnw Foma~~snwy FamrlFOnn S8 - -
AttaeLseot. ^2"
Yage 6 - 2
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Contract No.
Form 3-0
OINOa al Youth Sarvkaa
QUBrter~y wr~nen Repp~[
Conpaq Numy,; Name of Ap~„~y;
' ~ Fo- er OuvYr Ichpk
. Oir 02"r ~09•
' Far Racy Year .
. ~ Plopnm Nrpa; ~ R~n~i~•au4.YlFina la:.
. - 1. During the past quarter. what were the ma r eocb .
towanl achieving the milestones and perfomrenoe b Iseh~menb of Your a8en~'
wntract7 rg estadlsnedrortnla
2. e~
~ S
~~sfiSi~r~m~vi BatowaNforfhu~nntrecf.'whkh components o(1heSmpa .
. are. you having dHfioWty knpb or adJevlrrp~r adYevkW7 Which component .
3. What behavior changes are you obseMrg N tiro youth bearg bn,~ b~, ihb
Program9
4, What problems does this prbgram have to deal with, M lertne of staffing, program
planrdng and adminlstret(on, outcomsa monllorinp end reporting. co
Yom Partidpetion, finances, or communkation wfih OYS9 How have 1
prebbrtx been resolved K the probbme have not been resolved, Maur
Plans for resolvtrrg tirese proWerttsp what are
5. Whet other comment, or observations do you have that wfil help OYS understarW
the Progress of this rnrdract7 '
F.ronu..o,y
N:IOYa oraeomp ForrnalFerrn >f-D
. ~ , attaChaGIIt w'1w
page 8
CaMrad No. Form s-0
Oaks dYOUIb 8arvloss
Resu~ts ~ r~arn~ng .
Mnual Report
Gonna NumOr, Mu~w gApnq':
Fnpnm Nrnl: ~ .
1. Dudng the past fiscal year, what were the major axomplislimenfs of your agency
toward achieving the milestones and performance targets established for tlda
contraG'7 What aclNPoes proved to be espedagy elfectlve7
p. Where dkl your agencya programs fell short, or were least effective in achieving the .
milestones and perfomrence tarpefs7 Why were these progrartu.not as efl'ectlva7-,~
3. In reviewing the Scope d Services~for fhb contract. whbh mmponents of the Swpe
did you auccesa/ully move towartl implementing or achieving? Which eomponMtts
did you have'difficuky knplemerNng w achievbt~ '
N.'YDYa Draeemea FamslFefm i-a ~ _ . AttacheCnt nlw _
. Yage 9 - 1
Corrtrect No. Form 3i
4. How many youth (unduplicated count) dki you work with in your program this past
1999 - 2000 contrail period? DId this target population differ from what you
expeiled7 In what ways did they dlife/)
5. What behavior changes did you observe kr the youth being served by thb pngrem? ,
- 6. What pmblems does~this program hays to deal wNh, In terms of stafing, Program .
planning and adminLstratfon, outcomes monitoring and raporgng, cvmmunicatbn,
. p~bkme been ree flohred7 1(the problems haven not been raeoNad, wheUt~ar~e your .
plans fw iesoMng these problems?
N:IOYS Orrtcerrree FormelFann 3i AttacLrent . w2a
' 'Forge -9 - 2
Conhnct No.
Form 7-a
7. What new skills, knowledge, values dkl you team through the devabpmard arM
implementation of the outcomes framework) In what ways did the outcomes
framework change the way that you traditionally devebped and implemented a
program9
H. Please describe any new curriculum model or program eetlvity that proved to be
espedalty effective.
9. Whet other comments or obaervefiona do you have fhat~wW help OYS urderaland .
your egenr.~a successes, strategbs, problems in working with the youth? '
suorrieW by: o.cc~J
trd...abr: n.~z j ~
N.10Y5 Outcomaa FormalFOrm Ya ~ ~ ~ ~ ~ ~ AYtacls~t r'2"
Page 9 - 3
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Contrail No.
a. _ Forst 3-11' . - -
~~~t~s ~~~®r~
For Which Quarter? _ 1~ _ 2id _ and _ Final
Please complete This forth and return it to the Office of Youth Services with the quarterly
program reports (Form 3-3 (Revised), Forrn 3~ (Revised), Form 3-5 (Revised), and Forth
3-73). The figures for each quarter are non-cumulative.
1st 2nd 3rd Final Total
To
Date
1. How many youths registered for your program
were a e 5-18 and attendi sctaol9
2. How many youffrs registered for your program
were a e 5 -18 and NOT attendin school?
3. How many adults individuals 19 years or
older) wen; parerds or guardians of youth
isfered for our ram?
4. How many adults served by this program were '
lice or law enforcement?
5. How many adults served by this program were
school rsonnel7
~
6. How-many individuals served"Dy this
program
were.communlly members9 Note: Adults not '
tilting into other categories should be cormted
here:
sin c a.
'Attaehseat °2"
Page 11
''s, U.S. DEPARTMENT OF JUSTICE
+ '~j OFFICE OF JUSTfCE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTiF1CATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND
OTHER RESPONSIBILITY MATTERS; AND DRUG-FREE WORKPLACE REQUIREMENTS
Appllcanta should refer to the regulations cited below to determine the certification to which they-are required to
attest. Appllcanta should also review the instructions for certification included in the regulations before completing this
form. Signature'oi this form provides for compliance with certification requirements under 28 CFR Pert 89, 'New
Restrictions on Lobbying' end 28 CFR Pert 67, 'Government-wide Debarment and Suepenalon (Nonpro-curement) and
Government-wide Requirements for Druq-Free Workplace (Grants).' The certlflcations shall be treated as a material
representation of feet upon which reliance will be placed when the Department of Juatlce determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required b1r Sector 1352, Title 31 of the U.S. Code; end public (Fedarel,Sbte, or locep transaction or contract under s
Im emented et 28 CFR Pert 89, for public Vansectbn; vblatbn of Federal or State anUtruat statutes
pl persona entedng into a or commlasbn of embezzlement, theft, forgery,
pram or cooperative agreement over St 00,000, as defined at bribery, falaHbaUOn or deatmction of records, making false
28 CFR Pert 89, tta spplkant cvrtfiies that: statements, a receiving atoNn property;
(s) No Federal spproprleted funds have been pet or will be c Are not rea
paid, by or on beftaH of the underelpned, to any person for in- P ~Y indicted for or otherwise criminally or
flusneing or attempting to inHUenee an oHker or employee of any ~h' chsrgad by a povammenbl entity (Federal, Stets, or
agency, s Member Of Congress, an aHker or employee of ~ local) wFlh a°mmisafon of any of 1M offenses enumerated in
mba Para9wpn (1)(b) of fhb csrtlHcaBOn; end
Congress, or an amployw of a Ma r of Congress In con-
nactlon with the making of any Fsdarel grant, the entering into (d) Haw not within a three-year pedbd preceding this epplka-
of any eooperetlve agreement, and the extanabn, continuation, tlon had one or more publb transecHona (Federd, State, or
renewal, ementlment, or moditlcaNon of em Federal grantor local) bnnbetsd for cause or defaulh and
cooperative agreement; -
B. where the applbant b undee ro tartly ro arty of the
(b) It sny funds otfwr than Federal appropriated funds have abtsmenb M thb certHlceUon, he or she shell attach nn
been paid or will be paid ro any person for Influencing or et- expienatlon ro thb eppllcatbn.
tempting to Influence an officer or employes of any agency, a
Member of Congress, an otiicer or employee o} Congress, or
an employes of a Member of Congress in connection with this 3. DRUG-FREE WORKPLACE
Fedeal grantor cooperetlve agreement, ins undaralpned sha11 (GRANTEES OTHER THAN INDIVIDUALS)
complete end submit Sbndar0 Form - LLL,'Dlselosure of
Lobbying Acdvltlea; in accordance with ib Instruehona; Aa required by the Druq-Free Workplace Act of 1988, end
(c) Tho underelgned shah require that the language of this ter- Nnplamanted at 28 CFR Part ti7, Subpart F, for gramaes, ea
fificatlon bo Mduded M the award documents for dl suDewarda _ defMsd at 28 CFR Part 87 SocUats 87.815 and 87.820--
etell tNre Qndudinp suDgrenb, contract under grenb end ,q- Tfy applbant certlflea that H wNl or wNl contlnue ~ro provide
rce~eplertb shaggNty udadiscbsbeseeordingly. that all sub- a drug-hea workplace by:
(a) Publishing a abtemeM notifyMg employees that Me
unbwful manufacture, dbtributlon, dbpensing, Iwssoadbn, or
2 DEBARMENT, SUSPENSK)N, AND OTHER use of a contrdled substsnce b prohibited h the grantees
RESPONSIBILITY MATTERS workplace end specHyinq ttw actlans that wNl M taken against
(DIRECT RECIPIENT ~ ~ strott prohlbitlon;
(D) EsbWbhtng an on-goMg drug-hea awareness progrem to
Aa roquired by ExecutWe Order 72549, Debarment end Inform emplayeaa sbouf-
Suepenslon, end Implemented at 28 CFR Part 87, for prospect (1) The dangers of drug abuse in the workpleee;
tiw pertbipsnb In primary covered trensactlons, as defined et (2) The grantee's
28 CFR Psrt 87, Section 87.510- PdbY of ~~InthO a drughee workplace;
A. The eppttcent certifies that H and ib principals: (3) Any aveileble dnp eounaeling, rehabfiftetton, end entpbyee
assistance Programs: and
(a) Are not presently debarred, suspended, proposed for debar- (4) Tha penattias that may Ue Imposed upon employees for
mart, declared ineligible, sentenced to a denial of Federal drug abuse violatkma occurring In the workplace;
benefit by a State or Federal court, or volunbrlly oxcluded
from covered tiansactlona by sny Federal department (e) Making tt a requirement Met each employee ro be engaged
or agettcy; - M Me performance of the grant Be given a copy of the abte-
mant required by paregreph (a);.
(b) Havs not within s thfee-year period preceding this eppllca-
Lion been convicted of or bed s civil Judgment rendered against (d) Notifying the employee in the statement required by pere-
;ham for eommlaaien of fraud or a criminal aflense In cronnec- graph (a) that, es a condition of employment under the grant,
von with obtaining, attemptlnq ro obbin, or performing a tlw employee will-
. A1TAC'@~NT 3
' PAGE 1 OF 4
gnu ..,.w,a.oo neo, emcee n,e rnwua ~,u.o in..n
(1) Abkf• by tM terms of the staterrwrtt; end
(2) NotHy the •mpoyer In wdtlrtq of Ms or her convidbn for ¦
vblatlon o} a erlminsl dnp sfetuh oecurrinp in the workplap
no hhr than fiw celertdar days after such corrvictlon;
(e) NotHylnq the a Cheek O H then ue workplaps on fee shat an not kd•ntHled
gkwY, M wrltlrtp, within 10 calsnder deye hero.
otter repivinp notlp under subpanpreph (d)(2) from an ~tl,,, 87 ~0 d the r ulatlans
empbyea or oMerwbe replvirp stool nop~~} su~conviatkxr. b • Shb mey Ned b make one prtlecatlone Nt wdt Fed•re1 t
FJnployers of convidad employees must
pwebn title, b: Dspertrtwrd of Jwtlp, OHke d - ~ 1Np1 year. A Dopy of whkh shoukf be ktduded wrot each ep- .
Justice Proprems, ATTN: Control Dwk, 633 Indian. Avenw, Pilptlon ~ Department of Jwtlp fundlnp. Stites and Shb
N.W., Wsshkrgbn, D.C. 20531. Notloe shell kfcluds the Idsn- a~~p n10y b use OJP Form 1061/7.
tiflcation number(s) d NCfI effected Arent;
Check Q M the Stab tuu electW b oonghh CJP Fomr
(f) Taking one of the followlnp actions, wehM 30 plarWer ~1n• .
days of replvinp notlp unWr subpanpraph (d)(2), with
respect b any employee wfto h ao convicted- DRUG-FREE WORKPLACE
(1) Tiking spproprlah personnN actbn~ageinat such an - (GRANTEES WHO ARE INDIVIDUALS)
employe., up b end Mdudhp hnninatlon, oonslatent with ih• N required by the Drup•Free W
requlrertwnh of the Rohabilitetlon Add 1973, se amerWd; or imWemsnted at 28 CFR Pert 67,-Sribpart~br plra~rrtees as
(2) Requiring such empbye b pertidpate satlafadorly Ina defMed et 28 CFR Pert 67; Sectlone 67.615 end 67.620-_
drug shoes asshhnce or r•Mbllhtkm program approved for
such purpose by a Federal, 3ha, a kcal health, hw enforce- ~ A. N a corwnlorr of tM pranL 1 prt+h that I ww not enpaq•
m•rtt, or other epproprhh ag•rtty; lh the uniawlul manuf•dur•, dkdrlbutbn, dlaperniip, ppsp-
slon, or use of • controlled subetanp In eorWuetlnp any
(p) Mekinq a good hhh .!fort b oontlnw b rrrelrrhkr • druq~ actlvlty w6h tlN Arent; end
1rw workplace through knplem•nhtkxr d psraprapha (a), (b), S. R a a Mn>Inal rMUlt4p hom e
(W, (d), (e), end (t). violation Deco dnq offense
8. The prantN rosy hsert M the epee provkf•d DNOw tM w11 rrYrp during ~ carWud of any grern aetlvtry, I
stie(s) for the p•rrormanp of work done h tonnedlon with d d
o~onvlc~tlon, b: D•pert of Jwtkv~ OMkv~J ~tlce
~ w~ o~ Prowems, ATTN: Contra Desk. e1o s•vemh str«t rlw.,
Plop of P•rbrmsne. (Street addnu, dty, eounry, shh, ilp W~~10^• ~ 20631.
ecd•)
N tits duly authorized repr•s•matiw of the aPPlkant, 1 h•nby Artily that tM appllpnt w11 p^WIY whh tlN show eertlllpibrts.
1. GrantN Nam• and Address:
Hawaii County Office of the Prosecuting Attorney
34 Rainbow Dr.
HIlo, HI 96720 996000568
2. Appliceflon NumD•r arW/or Propct Name
9. Gnrth• IRSNerWor Number
JAY T. KIM(JRA, PROSECUTING ATTORNEY
!.Typed Nerne and Tith otAutladzed Repnaenhtlw
10/31/02 _
5. Sipne ~ 6. Deb
ATfAC~T 3
PA6'S 2 OF 4
(1) Abide by the bans of Me sbtemenk end
(2) Notify the employer In wrldnp of his or her conviction fors
vlolatlon of a criminal drop sbtub accurrinp in the workplace
no later than fire calendar days sksr such conviction; Chedt FI then are wo
(e) Notiryln the a Isere ~ rkplaya on 1pe Mat an not hdentkbd
p pency, in wrkinp, within 70 calendar days
eker receiving ratlce under subparagraph (d)(2) from en Sin 87 gap of Me repulationa rovidss Mat a rentee that
employee or otherwha recNvlnp ectrral notke of such convk:-tk>n. b a Stab msy Ned to make one rwrtlflcatkxt h wdt Federal
FJrtployere of convicted empbyeee must provkle notkU, including flegl year. A copy of whldi should De Indudsd wllh cant ep-
positlon title, to: Department of Justly, Okk;e of
Justice Proprems, AT1N: Control Desk, 833 Indians Avenue, plk:atlon }or Department of Justice furxiM¢ States and Slate
N.W., Weahhpton, D.C. 20531. Notlp shall ktclude Me kfen- apenciea may Ned U use CUP Form 108th.
tlflcatkxt number(s) d each akeded prank Check ~ H dw State has elected to compleb QIP Forth
(f) Takhp one of Ure fdlowinp adbns, within 30 Mender 1081/7.
days of reylvinp notks unWr sutpenpreph (d)(2), whh
reaped b any empbyw who b so convlded- DRUO-FREE WORKPLACE
(1) Tsklnp epproprlab pereamel actbn apeinat such an ~ (GRANTEES WNO ARE INDIVIDUALS)
employee, up to and Iraludhp brtnhatlon, consistent wIM the M required by the Orup-Free Workpyee Act d 1 pgg, and
requirements of the RehabiNtstkxt Act d 1873, se emended; or Implemented et 2g CFR Pert 87, Subpart F, for pnntees, es
(2) Requiring such e'mpbyee b psrtkipeb aatistedorily h a defhad at 28 CFR Part 87; Sedkxq 87.815 end 87.820-
drupabuse aaslabny or rehebpibtkxt program approved for A. As a eorMlUOrt o/ Ms pram, I prWy Mat I will rat engage
such purposes by a FeWrel, State, or local heakh, few snlory- h Me unbwhrl manufedure, distritwlkxt, dlspemi ea-
ment, or otMr appropriate agency, skxt, or use of a controlled aubstarae In yrWudinp arty
(p) Making a good faith ekort to oonthw b melnbh a dru¢ aetlvlry with tM prank and
hee workpley through knplemertlstkwt of psreprephs (a), (b),
(c), (d), (e), and (f J. B. k yrtvktW of a crimind dnrp okenee tesulthp from ¦
B. Ttw prentw may Insert h Ms viol report Me rrktyr9vk:tlon h °f any pram activity, I
space provided bNOw the wYl writlnp, wltMn 10 alerWar days
ahe(e) for tfw perfortnany d work done h eonnedknt wkh d 1M convletlor6 to: Departrrwrtt of Justly. Oflioe of Justly
tM spedfk: pnnt Programs, AT'TN: Control Desk, 810 Seventh Street fV1N.,
Play of Performance (Street sddress, dry, county, ebb, zip WaahNpton' ~ 20531.
code)
As the duly authorized representetiw of Me eppliym, I frereby yrtiry that tlu epplkant wsl compy wkA the slaw yrtlgcatbrta.
1. Grantee Neme end Addreu:
Hawaii County Office of the Prosecuting Attorney
34 Rainbow Dr.
Iii.lo, HI 96720 ~ 996000568
2. Appllptlm Number sndlar Project Name 3. Grantee IRSNertdor Number
JAY T. KIMURA, PRQSECUTING ATTORNEY
4. Typed Name and TIW of AuBadzed RepresenbtWe
10/31/02
5. Signature( 8. Dots
ATPACIr1MENT 3
PAGE 2 OF h
1.5 Notice to Clients. Provided that the term of this Agreement is at feast one
year in duration, within ONE HUNDRED AND EIGHTY (180) days after
the effective date of this Agreement, the PROVIDER shall create writte?
procedures for the orderly termination of services to any clients receiving the
Required Services under this Agreement, and for the transition to services
supplied by another provider upon termination of this Agreement, regardless
of the circumstances of such termination. These procedures shall include, at
the minimum, timely notice to such clients of the termination of this
Agreement, and appropriate counseling,
1.6 Reporting Requirements The PROVIDER shall submit a Final Project
Report to the STATE containing the information specified in Exhibit "B" to
this Agreement if applicable, or otherwise satisfactory to the STATE,
documenting the PROVIDER's overall efforts toward meeting the
requirements of this Agreement, and listing expenditures actually incurred in
the performance of this Agreement. The PROVIDER shall return any
unexpended funds to the STATE.
1.7 Conflicts of Interest. In addition to the Certification provided in Exhibit "C"
to this Agreement, the PROVIDER represents that neither the PROVIDER,
nor any employee or agent of the PROVIDER, presently has any interest, and
promises that no such interest, direct or indirect, shall be acquired, that would
or might conflict in any manner or degree with the PROVIDER's
performance under this Agreement.
1.8 Compliance with Managed Process If this Agreement was entered into
between July 20, 1998, sand July 1, 2001, and extends beyond June 30, 2001,
it is subject to a single review pursuant to the managed process developed
pursuant to .part III, section 6 of Act 230, 1998 Haw. Sess. Laws 785, 787.
Pursuant to the managed process review, this Agreement may be cancelled,
renegotiated, continued, or extended by the State.
2. Documents and Flies
2.1 Confidentiality-of Material.
2.1.1 All material given to or made available to the PROVIDER by virtue
of this Agreement that is identified as proprietary or confidential
information shall be safeguarded by the PROVIDER and shall not be
disclosed to any individual or organization without the prior written
approval of the STATE.
EXHIBIT •D•
GENERAL COND[TION3
Page 3 Farm AG3-HfiSGC(s199)
2.1.2 All information, data, or other material provided by the PROVIDER
to the STATE shall be subject to the Uniform Information Practices
Act, chapter 92F, HRS, or its successor, and any other applicable body
of law concerning information practices or confidentiality.
2.2 Ownership Rights and Copyrieht The STATE shall have complete ownership
of all material, both finished and unfinished that is developed, prepared,
assembled, or conceived by the PROVIDER pursuant to this Agreement, and
all such material shall be considered "works made for hire." All such material
shall be delivered to the STATE upon expiration or termination of this
Agreement. The STATE, in its sole discretion, shall have the exclusive right
to copyright any product, concept, or material developed, prepared,
assembled, or conceived by the PROVIDER pursuant to this Agreement.
2.3 Records Retention. The PROVIDER and any subcontractors shall maintain
the books and records that relate to the Agreement, and any cost or pricing
data for three (3) years from the date of final payment under the Agreement.
In the event that any litigation, claim, investigation, audit, or other action
involving the records retained under this provision arises, then such records
shall be retained for three (3) years from the date of final payment, or the
date of the resolution of the action, which ever occurs later. Outing the
period that records are retained under this section, the PROVIDER and any
subcontractors shall allow the STATE free and unrestricted access to such
records.
3. Relationship between Parties
3.1 Coordination of Services the STATE. The head of the purchasing agency,
(which term includes the designee of the head of the purchasing agency), shall
coordinate the services to be provided by the PROVIDER in order to
complete the performance required in the Agreement. The PROVIDER shall
maintain communications with the head of Ure purchasing agency at all stages
of the PROVIDER's work, and submit to the head of the purchasing agency
for resolution a~ questions which may arise as to the performance of this
Agreement.
3.2 Subcontracts and Assittttments. The PROVIDER may assign or subcontract
any of the PROVIDER's duties, obligations, or interests under this
Agreement, but only if (i) the PROVIDER obtains the prior written consent
of the STATE and (v) the PROVIDER's assignee or subcontractor submits
to the STATE a tax cleazance certificate from the Director of Taxation, State
of Hawaii, showing that all delinquent taxes, if any, levied or accrued under
EXBIBIT 'D'
GENERAL CONDITIONS
Page 4 F«m AG3-HHSGC(a)99)
state law against the PROVIDER'S assignee or subcontractor have been paid.
Additionally, ?o assignment by the PROVIDER of the PROVIDER'S right
to compensation under this Agreement shall be effective unless and until the
assignment is approved by the Comptroller of the State of Hawaii, as
provided in section 40-58, HRS, or its successor provision.
3.3 Chanee of name. When the PROVIDER asks to change the name in which
it holds this Agreement with the STATE, the procurement officer of the
purchasing agency (hereinafter referred to as the "Agency Procurement
Officer") shall, upon receipt of a document acceptable or satisfactory to the
Agency Procurement Officer indicating such change of name such as an
amendment to the PROVIDER'S articles of incorporation, enter into an
amendment to this Agreement with the PROVIDER to effect the change of
name. Such amendment to this Agreement changing the PROVIDER'S name
shall specifically indicate that no other. terms and conditions' of this
Agreement are thereby changed, unless the change of name amendment is
incorporated with a modification or amendment to the Agreement under
Section 4.1 of these general conditions.
3.4 Independent Contractor Status and Responsibilities. IncludinY Tax
Responsibilities.
3.4.1 In the performance of services required under this Agreement, the
PROVIDER is an "independent contractor," with the authority and
responsibility to control and direct the performance and details of the
work and services required under this Agreement; however, the
STATE shall have a general right to inspect work in progress to
determine whether, in the STATE'S opinion, the services are being
performed by the PROVIDER in compliance with this Agreement.
3.4.2 Unless otherwise provided by special condition, the STATE shall be
free to contract with other individuals and entities to provide services
similar to those performed by the Provider under this Agreement, and
the PROVIDER shall be free to contract to provide services to other
individuals or entities while under contract with the STATE.
3.4.3 The PROVIDER and the PROVIDER'S employees and agents are not
by reason of this Agreement, agents or employees of the State for any
purpose. The PROVIDER and the PROVIDER'S employees and
agents shall not be entitled to claim or receive from the State nay
vacation, sick leave, retirement, workers' compensation, unemployment
insurance, or other benefits provided to state employees. Unless
EXBIBIT 'D'
GENERAL CONDITIONS
Page 5 Fam AG3-HHSGCt~)
specifically authorized in writing by the DIRECTOR, the PROVIDER
and the PROVIDER'S employees and agents are not authorized to
speak on behalf and no statement or admission made by the
PROVIDER or the PROVIDER'S employees or agents shall be
attributed to the STATE, unless specifically adopted by the
DIRECTOR in writing.
3.4.4 The PROVIDER shall be responsible for the accuracy, completeness,
and adequacy of the PROVIDER'S performance under this
Agreement. Furthermore, the PROVIDER intentionally, voluntarily,
and knowingly assumes the sole and entire liability to the
PROVIDER'S employees and agents, and to any individual not a party
to this Agreement, for all loss, damage, or injury caused by the
PROVIDER, or the PROVIDER'S employees or agents in the course
of their employment.
3.4.5 The PROVIDER shall be responsible for payment of all applicable
federal, state, and county taxes and fees which may become due and
owing by the PROVIDER by reason of this Agreement, including but
not limited to (i) income taxes, (ii) employment related fees,
assessments, and taxes, and (iii) general excise taxes. The PROVIDER
also is responsible for obtaining all licenses, permits, and certificates
that may be required in order to perform this Agreement.
3.4.6 The PROVIDER shall obtain a general excise. tax license from the
Department of Taxation, State of Hawaii, in accordance with section
237-9, HRS, or its successor provision, and shall comply with all
requirements thereof. The PROVIDER shall obtain a tax clearance
certificate from the Director of Taxation, State of Hawaii, showing
that all delinquent taxes, if any, levied or accrued under state law
against the PROVIDER have beta paid and submit the same to the
STATE prior to commencing any performance under this Agreement.
The PROVIDER shall also be solely responsible for meeting all
requirements necessary to obtain the tax clearance certificate required
for final payment under sections 103-53 and 237-45, HRS, or their
successor provisions, and these General Conditions.
3.4.7 The PROVIDER is responsible for securing all employee-related
insurance coverage for the PROVIDER and the PROVIDER'S
employees and agents that is or may be required by law, and for
payment of all premiums, costs, and other liabilities associated with
securing the insurance coverage.
~IBIT "D"
GENERAL CONDITIONS
Page 6 Fam AG3-HHSGC(4199)
3.5 Personnel Requirements
3.5.1 The PROVIDER shall secure, at the PROVIDER'S own expense, all
personnel required to perform this Agreement, unless otherwise
provided in this Agreement.
3.5.2 The PROVIDER shall ensure that the PROVIDER'S employees or
agents are experienced and fully qualified to engage in the activities
and perform the services required under this Agreement, and that all
applicable licensing and operating requirements imposed or required
under federal, state, or county law, and all applicable accreditation and
other standards of quality generally accepted in the field of the
activities of such employees and agents ate complied with and satisfied.
4. Modification and Termination of Agreement
4.1 Modifications of Agreement.
4.1.1 In writinr. Any modification, alteration, amendment, change, or
extension of any term, provision, or condition of this Agreement
permitted by this Agreement shall be made by written amendment to
this Agreement, signed by the PROVIDER and the STATE.
4.1.2 No oral modification. No oral modification, alteration, amendment,
change, or extension of any term, provision or condition of this
Agreement shall be permitted.
4.1.3 Tax clearance. The STATE may, at its discretion, require the
PROVIDER to submit to the STATE, prior to the STATE'S approval
of any modification, alteration, amendment, change, or extension of
any term, provision, or condition of this Agreement, a tax clearance
from the Director of Taxation, State of Hawaii, showing that all
delinquent taxes, if a~+, levied or accrued under state law against the
PROVIDER have been paid.
4.2 Termination in General. This Agreement may be terminated in whole or in
part for a reduction in funds available to pay the PROVIDER, or when, in its
sole discretion, the STATE determines (i) that there has been a change in the
conditions upon which the need for the Required Services was based, (ii) that
the PROVIDER has failed to provide the Required Services adequately or
satisfactorily, or (iii) that other good catue for the whole or partial
termination of this Agreement exists. Termination under this section shall be
E7t~IBIT 'D'
GENERAL CONDITIONS
Page ~ Form AG3-HHSGC(dJ99)
made by a written notice sent to the PROVIDER ten (10) working days prior
to the termination date that includes a brief statement of the reaso? for the
termination.
4.3 Termination for Necessity or Convenience. If the STATE determines, in iu
sole discretion, that it is necessary or convenient, this Agreement may be
terminated in whole or in part at the option of the STATE upon ten (10)
working days' written notice to the PROVIDER. If the STATE elects to
terminate under this section, the PROVIDER shall be entitled to reasonable
payment as determined by the STATE for satisfactory services rendered under
this Agreement up to the time of termination. If the STATE elects to
terminate under this section, the PROVIDER shall cooperate with the
STATE to effect an orderly transition of services to clients.
4.4 Termination by Contractor. The PROVIDER may withdraw fiom this
Agreement after obtaining the written consent of the STATE. The STATE,
upon the PROVIDER's withdrawal, shall determine whether payment is due
to the PROVIDER, and the amount that is due. If the STATE elects to
terminate under this section, the PROVIDER shall cooperate with the
STATE to effect an orderly transition of services to clients.
4.5 State's Right of Offset. The STATE may offset against any monies or other
obligations the STATE owes to the PROVIDER under this Agreement, any
amounts_ owed to the State of Hawaii by the PROVIDER under this
Agreement, or any other agreement, or pursuant to any law or other
obligation owed to the State of Hawaii by the PROVIDER, including but not
limited to the payment of any taxes or levies of any hind or nature. The
STATE shall notify the PROVIDER in writing of any exercise of its right of
offset and the nature and amount of such offset. For purposes of this
paragraph, amounts owed to the State of Hawai i shall not include debts or
obligations which have been liquidated by agreement with the PROVIDER,
and that are covered by an installment payment or other settlement plan
approved by the State of Hawaii, provided, however, that the PROVIDER
shall be entitled to such exclusion only to the extent that the PROVIDER is
current, and in compliance with, and not delinquent on,. any payvtenu,
obligations, or duties owed to the State of Hawaii under such payment or
other settlement plan.
5. Indemnification
S.1 Indemnification and Defense The PROVIDER shall defend, indemnify, and
hold harmless the State of Hawaii, the contracting agency, and their officers,
E%SIBIT "D"
GENERAL CONDITIONS
page $ Eam AG3-E~iSGC<~)
employees, and agents from and against all liability; loss, damage, cost, and
expense, including all attorneys' fees, and al] claims, suits, and demands
therefor, arising out of or resulting from the acts or omissions of the
PROVIDER or the PROVIDER'S employees, officers, agents, or
subcontractors under this Agreement. The provisions of this paragraph shall
remain in full force and effect notwithstanding the expiration or early
termination of this Agreement.
5.2 Cost of Litigation. In case the STATE shall, without any fault on its part, be
made a party to any litigation commenced by or against the PROVIDER in
connection with this Agreement, the PROVIDER shall pay all cosu and
expenses incurred by or imposed on the STATE, including attorneys' fees.
6. Miscellaneous Provisions
6.1 Nondiscrimination. No person performing work under this Agreement,
including any subcontractor, employee, or agent of the PROVIDER, shall
engage in any discrimination that is prohibited by any applicable federal, state,
or county law.
6.2 Publici Any and all publicity that the PROVIDER may undertake in
connection with the Required Services, shall be subject to the limitations of
Section 3.4.3 of these General Conditions, and the requiremenu of this
section:
6.2.1 Acknowledgment of State Support. Subject to the limitations of
Section 3.4.3 of these General Conditions, the PROVIDER shall, in
all news releases, public statements, announcements, broadcasts,
posters, programs, computer postings, and other printed, published, or
electronically disseminated materials relating to the PROVIDER'S
performance under this Agreement, acknowledge the support by the
State of Hawaii and the purchasing agency through appropriations
made by the Legislature of the State of Hawaii.
6.2.2 The PROVIDER shall not refer to the STATE, or any office, agency,
or officer thereof, or any State employee, including the head of the
purchasing agenry, the chief procurement officer, the DIRECTOR, the
Agenry procurement officer, or to the services or goods, or both,
provided under this Agreement, in any of the PROVIDER'S publicity
not related to the PROVIDER'S performance under this Agreement,
including but not limited to commercial advertisements, recruiting
materials, and solicitations for charitable donations.
EXHIBIT 'D'
GENERAL CONDITIONS
Page 9 Fam AG3-HHSGC(d199)
6.3 Section Headin¢s. The section headings appearing in this Agreement have
been inserted for the purpose of convenience and ready reference. They shall
not be to define, limit or extend the scope or intent of the sections to which
they pertain.
6.4 Antitrust Claims. The STATE and the PROVIDER recognize that in actual
economic practice, overcharges resulting from antitrust violations are in fact
usually borne by the purchaser. Therefore, the PROVIDER hereby assigns
to STATE any and all claims for overcharges as to goods and materials
- purchased in connection with this Agreement, except as to overcharges which
result from violations commencing after the price is established under this
Agreement and which are not passed on to the STATE under an escalation
clause.
6.5 GoverniriY Law. The validity of this Agreement and any of its terms or
provisions, as well as the rights and duties of the parties to this Agreement,
shall be governed by the laws of the State of Hawaii. Any action at law or
in equity to enforce or interpret the provisions of this Agreement shall be
brought in a state court of competent jurisdiction in Honolulu, Hawaii.
6.6 Conflict between General Conditions and Procurement Rules. In the event
of a conflict between the General Conditions and the Procurement Rules or
a Procurement Directive, the Procurement Rules or any Procurement
Directive in effect on the date this Agreement became effective shall control
and are hereby incorporated by reference.
6.7 Entire Agreement. This Agreement sets forth all of the agreements,
conditions, understandings, promises, warranties, and representations between
the STATE and the PROVIDER relative to this Agreement This Agreement
supersedes all prior agreements, conditions, understandings, promises,
warranties, and representations, which shall have no further force or effect.
There are no agreements, conditions, understandings, promises, warranties,
or representations, oral or written, express or implied, between the STATE
and the PROVIDER other than as set forth or as referred to herein.
6.8 Severability. In the event that any provision of this Agreement is declared
invalid or unenforceable by a court, such invalidity or unenforceability shall
not affect the validity or enforceability of the remaining terms of this
Agreement
6.9 Waiver The failure of the STATE to insist upon the strict compliance with
any term, provision, or condition of this Agreement shall not constitute or be
E%HIBIT 'D'
GENERAL CONDITIONS
Pagt 10 Farm AG3-ErfrSGC(a/99)
deemed to constitute a waiver or relinquishment of the STATE's right :o
enforce the same in accordance with this Agreement. The fact that the
STATE specifically refers to one provision of the Procurement Rules or one
section of the Hawaii Revised Statutes, and does not include other provisions
or statutory sections in this Agreement shall not constitute a waiver or
relinquishment of the STATE'S rights or the PROVIDER'S obligations under
the Procurement Rules or statutes.
6.10 Execution in Counterparts. -This Agreement may be executed in several
counterparts, each of which shall be regarded as an original and all of which
shall constitute one instrument.
E%HIBIT 'D'
GENERAL CONDITIONS
Page 11 Farm AG3-HHSGC(a/99)
SPECIAL CONDITIONS
1. Deletion of Portions of Agreement. For purposes of the Agreement to which
this Exhibit E is attached, paragraph 5 of the Agreement, "Standards of Conduct
Declaration," together with Exhibit C, are deleted and the parties agree that
paragraph 5 of the Agreement and Exhibit C are not operative.
2. Deletion of General Conditions. For purposes of the Agreement to which this
Exhibit E is attached, the following General Conditions of Exhibit D are deleted
and have no operative effect as between the parties:
a. Paragraph 1.4
b. Paragraph 3.4.6
c. Paragraph 4.1.3
3. Reports. The PROVIDER shall submit to the STATE reports as the STATE may
from time to time require, such as quarterly expenditure and match reports,
progress reports on the performance of services, and information required by the
STATE for its budget program reports and its reports under the Federal Grant.
The PROVIDER shall submit reports in the appropriate formats and within the
deadlines specified by the STATE. Generally, cumulative expenditure and match
reports, and progress reports on the performance of services shall be submitted
within thirty (30) calendar days after the end of each quarter. Within thirty (30)
calendar days after the expiration of the time of performance for the contract
period or a sooner termination date, the PROVIDER shall submit to the STATE a
final expenditure and match report, together with any unexpended balance of
funds advanced by the STATE, and a final report of the services performed under
this Agreement.
4. Records Maintenance, Retention, and Access. The PROVIDER shall, in
accordance with generally acceptable accounting practices, maintain fiscal
records, supporting documents and related files, papers, and reports that
adequately reflect all direct and indirect expenditures and management and fiscal
practices related to the PROVIDER'S performance of services under this
Agreement. The STATE, the Comptroller of the State of Hawaii, the Federal
granting agency, the Comptroller General of the United States, and any of their
authorized representatives, the committees (and their staffs) of the Legislature of
the State of Hawaii, and the Legislative Auditor of the State of Hawaii shall have
the right of access to any book, document, paper, file, or other record of the
PROVIDER (and any of its subcontractors) that is related to the performance of
services under this Agreement in order to conduct an audit or other examination
or to make excerpts and transcripts for the purposes of monitoring and evaluating
the PROVIDER'S performance of services and the PROVIDER'S program,
management, and fiscal
Exhibit "E"
Page 1
practices to assure the proper and effective expenditure of funds under this
Agreement. The right of access shall not be limited to the required retention
period but shall last as long as the records are retained. The PROVIDER shall
retain all records related to the PROVIDER'S performance of services under this
Agreement for at least six (6) years after the date of submission of the
PROVIDER'S final expenditure report, except that if any litigation, claim,
negotiation, investigation, audit, or other action involving the records has been
started before the expiration of the six-year period, the PROVIDER shall retain
the records until completion of the action and resolution of all issues that rise
from it, or until the end of the regular six-year retention period, whichever occurs
later.
5. Audit Requirement. The PROVIDER, when required shall have an independent
certified public accountant conduct a financial and compliance audit in
accordance with the guidelines of the Office of Management and Budget Circular
No. A-133, Revised, Audit Requirements for State, Local Governments, and Non-
Profit Organizations.
6. Publications. The PROVIDER shall submit all reports and written publications
resulting from this Agreement for review, comment and approval prior to
publication. Reports or written products that the PROVIDER will publish using
grant funds shall be submitted to STATE for approval from the Office of Juvenile
Justice and Delinquency Prevention (OJJDP). Any report or written product
published with grant funds must prominently display the OJJDP logo on the
cover.
Any publications resulting from the Agreement (written, visual, or sound),
whether published at the PROVIDER'S or STATE'S expense shall contain the
following statements (Note: This excludes press releases, newsletters, and issue
analyses):
This project was supported by Award No. 2002-JP-FX-0015 awarded by the
Office of Juvenile Justice and Delinquency Prevention, Office of Justice
Programs to the Office of Youth Services, Department of Human Services,
State of Hawaii.
The opinions, findings, and conclusions or recommendations expressed in this
publication/program exhibition are those of the author(s) and do not
necessarily reflect the views of the Department of Justice and the Office of
Youth Services.
7. Immigration and Naturalization Service Employment Eligibility Verification
Form (I-9). All PROVIDERS shall keep on file a completed I-9 Form to verify
that personnel are eligible to work in the U.S.
Exhibit "E"
Page 2
8. Equal Employment Opportunity Plan (EEOP). PROVIDERS who receive
federal funds and who have 3% of more of minorities in their service population
and have 50 or more employees shall comply with the Equal Opportunity Plan
requirement. PROVIDERS who receive $25,000 or more must maintain an EEOP
on file. PROVIDERS who receive $500,000 or more, or $1,000,000 in an 18-
month period, shall submit the comprehensive EEOP or the Short Form to the
following address, within 60 days of this Agreement:
U. S. Department of Justice
Office of Justice Programs
Office of Civil Rights
810 Seventh Street, N.W. Room 5107
Washington, D.C. 20531
Exhibit "E"
Page 3
Fiscal and Budget Information
FY 04
(1/1/03 - 9/30/04)
1. Source of Funds
State Funds
Federal Funds $103,550.00
02-JP-FX-OOIS
(CFDA# 16.548)
Total $103,550.00
2. Required Match
Provider Funds $ 51,775.00
Total $51,775.00
3. Total Agreement and $155,325.00
Match Funding
Attachment 1
Page 1
f
CONTRACT BUDGET
Budget Period Jan. 1, 2003 -Sept. 30, 200 Organization: Hawaii County Prosecutors Office
Contract# DHS-2003-OYS-1489
Total Budget
CATEGORIES Budget for Program for Contract comments
A. PERSONNEL COST
* 1 Salaries
* 2 Payroll Taxes $ Assessments
* 3 Fringe Benefts
TOTAL PERSONNEL COST 0.00 0.00
B. OTHER CURRENT EXPENSES
1 Supplies 1,000.00
2 Postage, Freight $ Delivery
3 Telephone
4 Publication $ Pringng 1 ,000.00
5 Mileage 500.00
* s Airtare 840.00
7 Subsistence/Per Diem 700.00
8 Taxi /Bus Fare /Rent-A-Car 2'40.00
9 Lease/Rental of Space
10 Lease/Rental of Equipment
11 Lease /Rental of Motor Vehicle
12 Utilities
13 Repair $ Maintenance
14 Insu2nce
15 Independent Audit
* t6 Contractual services 96,470.00
17 Staff Training 2,800.00
* 1B Depreciation
* 19
* 20
* 21
TOTAL OTHER CURRENT EXPENSES 103,550.00 0.00
TOTAL A+B 103,550.00 0.00
For Official Use Only Budget Prepared By:
Nancy T. Kelly, 934-3315 10/15/02
c Name $ P one (Please a e
<V.~,~r~,s2~ -~ra to-aa-oZ l011~~0z
Signature of Program Reviewer Date Signa of A or¢ed iG Date
Jay T. Kimura, Prosecuting Attorney
Signature of Fiscal Reviewer Date Name and Title (Please type or print)
Attachment 1 Form OYS-205 free: 7/17/971