Loading...
HomeMy WebLinkAboutCOM 0021.062 2002-2004 ~`Y w• Ham Kim bfator Alan R. Parker Ezecutire on Aging .!•~O ~'«•N'~ County of Hawaii ' - ~ = ' ' OFFICE OF AGING Hilo Lagoon Centre. I OI Aupuni Street. Suile 342, Hilo, Hawaii 9640-126'_ Phone (808) 961-8600. Fax (808) 961-R603 - ' Hanama Place. 75-5706 Kuakini Highway. Suite 106. Kailua-Kona, Hawaii 96740-1 X51 Phone (808) 3273597 Fax (808) 3274599 ~ ~ ' DATE: January 3, 2003 TO: James Y. Arakaki Council Chair and Council Members VIA: Deanna Sako, ontroller ~G.Qr,i-A~ ~,i~. ~o FROM: Alan ar~ 1, Exe ntive on Aging RE: NOTIFICATION OF GRANT AWARD Compliance with Ordinance No. OJfi5, Section 7(1) Ol~lw Name of Grant Program: Kapuna Care Services Grantor: llept. of Health. Executive Office of Aging, County Grantee Department or Agency: I lawaii County Office of Aging Grant No. (IF KNOWN): HA-2002/03-2(A) Amount of Grant: $1,304,327.00 = (~Y02) $657.749 + (T;Y03) $646.578 Amount of County Match: $96,000.00 County Rev. & Exp. Account Numbers: #3304.06 & #010-411-54] 1.09 to 10 - $554,419.00 (HCOA) (Por 7/1/02-6/30/03) #3304.04 Xz #010-481-5483.01 to 03 - $92,159.00 (HCNP) Grant Period (Commence. & Completion): .luly 1, 2001 to June 30, 2003 Purpose of Grant: To enable Hawaii"s "Na Kupuna" to have access to affordable and quality home-and-community based services that are client- centered and family-supportive. allowing them to live with independence and dignity. Services are Adult Day Care, Attendant Care. Case Management, Chore, Homemaker/Housekeeper- Ycrsonal Care- Assisted "transportation, and Home Delivered Meals. is final report required by grantor? ©Yes No Comm. No Notification attached: Ox Yes No, becau~le No. Pnnn NGA 6/01 Ref. To: 10 2003 An Area Agency on Aging Kef. Date~AN Ei~jW BENJAMIN J. CAYETANO ~ s~;, MARILYN R. SEELY GOVERNOR ~ DIRECTOR S~ a ~m.e.m.a~ TELEPHONE NO. STATE OF HAWAII (808)586-0100 EXECUTIVE OFFICE ON AGING EAxNO. NO. 1 CAPITOL DISTRICT (9oa) sas-Ores 250 SOUTH HOTEL STREET, SUITE 406 - , HONOLULU,HAWA1196813-2831 { - I-± r __,Y June 3, 2002 ~ ~,->._PJ_. . . ~l' 7la ~ t'ui: TO: Alan Parker County Executive Hawaii County O face on Aging FROM: Mar~Se Director SUBJECT: CONTRACT NO. HA-2002/2003-2(A) Enclosed is your copy of the consummated Contract No. HA-2002/2003-2(A), Supplemental Agreement No. 1. If you have any questions, please contact Caroline Cadirao at 586-7267. Mahalo. CTC:dmh Enclosure EQUAL OPPORTUNITY EMPLOYER STATE OF HAWAII SUPPLEMENTAL AGREEMENT NO. 1 TO AGREEMENT HA-2002103-2(Al (EOA's Primary Contract This Supplemental Agreement No. 1 ,executed on the respective dates indicated below, is effective as of X May 1 2002 between the Department of Health State of Hawaii (the "STATE"), by its Director Executive Office on Aaing , (Insert title of Slate officer executing agreement) whose address is 250 South Hotel Street Suite 406 Honolulu Hawaii 96813 and Coin of Hawaii by and through its Countv Council and its_ Ma or (the "PROVIDER"), a overnment entit ' business address and taxpayer identification number are: Hawaii Countv Office of A in 101 Au uni St. Room 342 Hilo Hawaii 96720 TIN 99-6000567 RECITALS A. WHEREAS, the STATE and the PROVIDER entered into an Agreement No. HA-2002/03-2(A) (Insert agreement number or other identifying information) dated Jul 1 , 200 1 ,whereby the PROVIDER agreed to provide the goods or services described in the Agreement, and 1 WHEREAS, the parties now desire to amend the Agreement, NOW, THEREFORE, the STATE and the PROVIDER mutually agree to amend the Agreement as follows: (Check applicable box(es)) ? Amend the SCOPE OF SERVICES according to the terms set forth in Exhibit "A", which is attached hereto and is incorporated herein. ? Amend the TIME OF PERFORMANCE according to the terms set forth in Exhibit "C", which is attached hereto and is incorporated herein. ® Amend the COMPENSATION AND PAYMENT SCHEDULE according to the terms set forth in Exhibit "B", which is attached hereto and is incorporated herein. ? Amend the SPECIAL CONDITIONS according to the terms set forth in the Supplemental Special Conditions, which is attached hereto and incorporated herein. A tax clearance certificate from the State of Hawaii ? is ® is not required to be submitted to the STATE prior to commencing any performance under this Supplemental Agreement. A tax clearance certificate from the Internal Revenue Service ? is ®is not required to be submitted to the STATE prior to commencing any performance under this Supplemental Agreement. Unless amended herein, the Agreement shall remain in full force and effect. 2 IN VIEW OF THE ABOVE, the STATE and the PROVIDER execute this Supplemental Agreement No. 1 by their signatures below. STATE EXECUTIVE OFFICE ON AGING By Its Director PROVIDER COUNTY OF HAWAII s ~r, aunty o a aii APPROVED BY: ,,99 L1XAnJ i Hawaii County Office of Aging County Executive APPROVED AS TO FORM AND LEGALITY: Deputy Corpor ion Council County of Hawaii APPROVED A~S~TO F M: Deputy Attorney General State of Hawaii 'Evidence of Authority of the Provider's representativ a to sign this Agreem ent for the Provider must be attached. 3 STATE OF HAWAII ) SS. COUNTY OF HAWAII ) On this '`l day of "f , 2002, before me personally appeared DIXIE KAETSU, 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. (y!L%. x.16 _ ~ _ i~-2 z; ~l ~ VI GINIA M. TOLENTINO Notary Public, State of Hawaii My commission expires: 4122/2005 w~ ~O7'4R1:'~o% ttb A G;~ f~~~iq~~Of ~P~~` N • ~ O O 0 N ~ ~ O ~ ~ r ~ O N N m ~ m O d O ~ N ll W O ~h ~ y N ~ ~ M ti W } c'> N ~ V ~ ~ N W fn p I Vl ~ N I O C N ~ ~ _ I ~ c LL' ~ m c 1 0 ~ o c~i E ` y E o cn h- ~ ~ m ~ U d m~ o I~ ~ 'o ~ Y ~ m CD T~ N U) I L N ~ c0 N O c0 ~ c: N y ~ ~ ~ F a V a~ i ~ vi m E a v ~ ~ Q U o x m z~ E m `S = m w Q c ~ W o ( co U U ~ ~ c E V Q ; o Y o U Q Q U ~ U Y o I c ~ ~ o C'. ~ a - ~ ~ C_ ' U rn m 2 ~ L, Y ~ a x o I o i U_ ~ O N O ~ N U C N Ch N p ~ N Cn ~ ~ O = N ~ N ~ m o U ~p 0 U j ~ ~ ~ f`D N U C N > ~ U W ~ c!~ Y ~ ~ r ~ ~ ~ ~ ~ M ~ ~ O ~ W ~ ~ aOp 0 m Q) ~ p N N N 7 d' ~ ~Y W p(O ~ Q1 N N NjN O M O O N ~ '~t 'U ~ <t O ~ N N O O 7 lh O ~ C U U 7 C ~ ~ O r. U [D Z ~ _ ~ N N w d LL d •O Q' ~ ~ C V LL N = ~ ~ I lL C F C ~ d N o ~ ' v o ' ~ ~ ` N v~ C fl. m ~ ! •C ~t O Q ~ Z o ~ ~ ~ ~ m U -o ~ ° Q a`0i o o ¢ ~ ~ ~ w ~ ~ o c d m o 0 0 z. ~ m ~ ~ ~ o ~ N ~ O w ~ o r' ~ m ` U U a N ~ _ ~ ~ .3 o E ~ ~ Q U _ Qj ~ w (6 V1 ~ O ~ ~ ~ ~ ~ j "6 (0 C Y c a~i Q ~ c o ~ Q ~ o U W Q Y Z N m (D ~ ~ N _ O ' m m M <Y M ~ r to O V Ip ~ ~ W Op O r 00 ~ M M ~ o~ ~ ~ ' V W ~ N t~C) N O ~ N ~ 7 dam' T M N (D w 4 O ~ M M ~ ~ ~ rn m M N 7 d ~ ~ O ~ 'C ~ m N n 7 O N j N r l!7 N V V ~ 00 ~ M N CD N ~ d O ~ M ~ ~ N C ~ O U ~ N ? 7 ~ Z o ~ o m .~~,LL ON QE a o T w `6 Q Q o~ c ~ ~ ~ w H ~ a~ c N a a~ ~ ~ 7 d E Q ~ ~ ~ U 0 0 ~ ~ o U o ~ ' ~ c Q ~ rn ~ d a ~ ~ ~ m z m o O~ ~ = 00 Il ~ G N = ~ ~ 7 _ ~ 4 ~ Z ~ O ~ ~ tq ~ j y U ~ o ~ ~ U v ~ ~ 'c ~ ~ ~ U O E rn ~ ~ ~ ~ Z N ~ ~ i Q U S (6 ~ ~ ~ > (n fy/) ~ O ~ ~ C (p N o = ~ U ~ Y ' ~ Q j Y U U w I Y m Y Q Y Z