HomeMy WebLinkAboutCOM 0021.061 2002-2004
Ham Kim Alan R. Parker
i47aYOr ~ EseadrvP on Aea{¢
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County of Hawaii
OFFICE OF AGING , ~ ` '
Hdo Lagoon Centre. 101 Aupuni Street, Sui[ 342. Hilo. Hawaii 96720-4262 - - -
Phone(808)961-8600 • Fax (608)961-8603
Hanama Place, 75-5706 Kuakini Highway. Suite I06, Railua-Kona Hawai-i 96 740-1 7 5 1
Phone (608)327-3597 Fax (808)327-3599
DATE: January 7, 2003
TO: James Y. Arakaki Council Chair and
Council Members
VIA: Deanna ko Controller GY1-Gt~~P~a
2/
FROM: Alan Park r, xecutive on Aging
RE: NOTIF[CA"LION OF GRAN"f AWAKD
Compliance with Ordinance No. (~55, Section 7(1)
oi•
Name of Grant Program: Senior Employment Program
Grantor: SOH, Dept. of Labor & Ind. Relations, Workforce Dev.
Div.
County Grantee Department or Agency: Hawaii County Office of Aging
Grant No. (IF KNOWN): PY02-SCSEP-H-HCOA
Amount of Grant: $280,730.00
Amount of County Match: $ 87,792.00
County Revenue Account Numbers: #330L20
County Expenditure Account Numbers: #010-4R1-5481.01 to 5481.02 & 5484.02, to 5484.03
Grant Period (Commence. & Completion): July I, ?002 to June 30, 2003
Purpose of Grant: Fo provide the subsidized part-time employment opportunities to
individuals fifty-five years of age or older.
Is final report required by grantor? [X~ Yes ? No
Notification attached: ~ Yes ? No- because
C e ~ ~~riLti iii crz Comm. No.
File No. ~
Ret. rj`0;~ ? Form N(iA 6/01
Ref. Date O ~oo" -.4n Area Agency on Aging
BENJAMIN J. CAYETANO s ° ~ ~~4 LEONARD AGOR
GOVERNOR e `~~r ~ pireclor
P AUOREY HIDANO
i DePUN Director
a`4 a
n.~.m„~B~ ELAINE YOUNG
AtlmmisVator
STATE OF HAWAII
DEPARTMENT OF LABOR AND INDUSTRIAL RELATIONS
WORKFORCE DEVELOPMENT DIVISION
830 Punchbowl Street, Room 329
Honolulu, Hawaii 96813 DA'I E fiECEIVED r L U
June 25, 2002 C~~ 1J.._.__~.
AC f IOId BY,-- -
DA7@ UiIE SO
FILE 5G5EP ront~art
MEMORANDUM o t d ter
TO: Alan Parker, Executive on Aging
Hawaii County Office of Aging
FROM: Elaine Yormg, Administrator f t` ` ' ~ ' ~ ~ f
Workforce Development Division' 111
SUBJECT: Agreement for Health and Human Services: Competitive Purchase of Service
Agreement Number PY02-SCSEP-H-HCOA
Attached for your appropriate action is an executed copy of the Agreement referenced above.
This Agreement is for the administration and operation of a Senior Community Service
Employment Program on the County of Hawaii for the period from July 1, 2002 to
June 30, 2003.
Please note that this Agreement is not valid, binding or enforceable until the State of Hawaii
receives a Notice of Obligation from the U.S. Department of Labor providing the State funding
authority to operate programs under Title V of the Older Americans Act for the grant period from
July 1, 2002 to June 30, 2003. When this Agreement becomes valid, binding and enforceable,
this Agreement will be effective beginning July 1, 2002.
ff there are questions or concerns, please contact Yvonne Chong at 586-9262.
Attachment
Agreement Number: PY02-SCSEP-H-HCOA
STATE OF HAWAII
AGREEMENT FOR HEALTH AND HUMAN SERVICES:
TRANSACTIONS EXEMPT FROM CHAPTER 103F, HRS
This Agreement, executed on the respective dates of the signatures of the
parties shown hereafter, is effective as of (date) .lulu 1 zoo2 ,
between the (agency) Department of Labor and nd +c ia1 Rel ar; nnc _
State of Hawaii (the "STATE"), by its Director
(the "DIRECTOR"), whose address is 830 Punchbowl Street 11321 xonoln~„_ xT 46813
and Hawaii Count Office of A in
(the "PROVIDER"), a (government entity/corporation/partnership/sole proprietorship/other
business form) a county ¢overnmental e ri r~, +
whose business address and taxpayer identification number are:
101 Aupuni Street Suite 342 Hilo Hawaii 96720 Federal IDlI: 99-6000567 .
State ID11: 30016002
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 f7om federal sources that
conflict with the procedures and requirements established by Chapter
]03F, 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 requirements
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 Focm AG3-Exem(4I99)
? 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
B. 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:
(1) (identify state sources) , or
(2) (identify federal sources) Public Law 107-116 . or both,
in the following amounts:
State: S
Federal: S 2$0,730.00
D. Pursuant to (legal authority for Agreement) chapter 103E and 26-20 xi;s.
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 similar operating
documents of the PROVIDER, such as a partnership agreement, or an
limited liability company operating agreement;
EXEMPT TRANSACTIONS
Page 2 Form AG3•Exem(4/99)
? the PROVIDER is a sole proprietor and as such does not require any
authorizing documents to sign this Agreement;
? the PROVIDER is a government entity, and the undersigned
representative of the PROVIDER is dulyauthorized to execute
contracts on behalf such government entity;
? other evidence of signing authority:
F. The PROVIDER has produced, and the STATE has inspected, a certi5cate
of insurance in the amount of DOLLARS
for bodily injury and property damage liability arising in connection with
the PROVIDER'S performance under this Agreement. N/A
G. 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 Sen~ces. 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
fiom (date July 1 2002 , to (date June 30
~nn~ .unless this Agreement is sooner terminated.
3. Compensation. The PROVIDER shall be compensated
Gs] in a total amount for all required services not to exceed
T~vo Hundred Eighty Thousand Seven Hundred Thi rtv and No/10o DOLLARS 7Hn 7'in.nn
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 the STATE, payment
Ea'EI.fPT TRANSACTIONS
Page 3 Form AG3-F,cem(a/v9)
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.
4. Reporiin~ 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) August 31 zoo3 No amendment to the
PROVIDER'S Final Project Report shall be considered after (date) September 30
2003
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.
6. 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 requited 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 Srst class mail, postage prepaid. Notice required to be given
to the DIRECTOR shall be sent to the DIRECTOR'S office in Honolulu, Hawaii. Notice
to the Agency Procurement Officer shall be sent to:
830 Punchbowl Street II309 Honolulu H1 96814 NOt1Ce t0 the
PROVIDER shall be sent to the PROVIDER at the PROV]DER's address as indicated in
this Agreement. Notice to the STATE'S Chief Procurement Officer shall be sent to 1151
Punchbowl street, IIZ3oA. Honolulu. Hl A notice shall be deemed to have been received
96 13
three (3) days after mailing or at the time of actual receipt, whichever is earlier. The
PROV]DER is responsible for notifying the STATE in writing of any change of address.
EXEMPT TRANSACTIONS
Page 4 Form AG~Ercem(4/99)
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 0
By ~
Print Name Leonard AEor
Director
Title Department of Labor and Industrial Relations
Date JUN 2 5 2001
RECu^MtAEt1D kPPROVAL PROVIDER
Exet. on Aging Print Name~g,. v=m
Date; l~~~~~Da h~
Title County of Hawaii
Date
APPROVED AS TO FORM:
~C(,LL(, T ~ ~ l~t,'
Deputy Atto 5 General
APPROVED AS TO
FO~tM A{ND LEGA~.IT~':
,~%~'(/~,v
D PUTY CORPORATION COUNSEL
COUNTY OF AWAjI
Date ~ ! ~ ~
EXEMPT TRANSACTIONS
Page 5 Form AG3-F~c~m(4/99)
PROM ER'S ACKNOWLEDGMENT
State of )
SS.
County of
On this day of , before me personally
appeared , to me personally known, who being by me
duly sworn, did say that be/she is the of
,the PROVIDER named in the foregoing instrument, and that
he/she is authorized to sign said instrument on behalf of the PROVIDER, as provided in
Recital E of the foregoing Agreement, and cknowledges that he/she executed said
instrument as the flee act and deed of the PRO DER.
Notary Publ ,
My commissi expires:
EXEMPT TRANSACTIONS
Page 6 Form AG3-Ezem(4/99)
STATE OF HAWAII )
SS.
COUNTY OF HAWAII )
On this ~l~ day of J"`^~`A- , 2002, before me
personally appeared DIXIE ttAETSU, to me personally known, who, being by me duly
sworn, did say that she is the Managing Director of the County of Hawaii, a municipal
corporation of the State of Hawaii; that the seal affixed to the foregoing instrument is
the corporate seal of said County of Hawaii; that the foregoing instrument was signed
and sealed in behalf of the County of Hawaii by authority given to said Mayor of the
County of Hawaii by Section 5-1.3(g) of the County Charter, County of Hawaii (1991),
as amended, and assigned by the Mayor to the Managing Director pursuant to
Section 6-1.3(h) of the County Charter; and said DIXIE KAETSU acknowledged said
instrument to be the free act and deed of said County of Hawaii.
v
JEAN (ERNES
Notary Public, State of Hawaii
My commission expires: 11/1/2005