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HomeMy WebLinkAboutCOM 0521.063 2002-2004 ~tY OIy Harry Kim r Alan k. Parker - ~ F_~eaeive on Aging . t•~ O~~M~+ County o~ Hawaii OFFICF. OF AGING I lilo Lagoon CcnVC I III nupunl Slrccl. Suilc 342, I lilo_ I laeai'i 96720-4262 Phunc (808)961-8600 • rllx (X08)961-8603 = I lunama Plucc. 7i-g706 6uakini I lighway, Suitc 106. 6eilua-FunaJ I,nvHi'i 96740-17i I ~ I'honc (8081 32 7-3 597 • Fae (8081 327-3199 ~^j ~ ~ c- ~J G] DATE: August 23, 2004 TO: James Y. Arakaki Council Chair and Council Members VIA: Deanna Sako, Controller ~;ta,,•~;~~ FROM: Alan Parker, Executive on AgirFg RE: NOTIFICATION OF GRANT AWARD Compliance with Ordinance No. 04-74, Section 7(1) 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): PY04-SCSEP-H-HCOA Amount of Grant: $284,236.00 Amount of County Match: $ 87,792.00 County Revenue Account Numbers: #3301.20 County Expenditure Account Numbers: #010-481-5481.01 to 5481.02 & 5484.02 to 5484.03 Grant Period (Commence. & Completion): July 1, 2004 to June 30, 2005 Purpose of Grant To provide the subsidized part-time employment opportunities to individuals fifty-five years of age or older. Is final report required by grantor? ©Yes ~ No Notification attached: ©Yes ~ No cc: Parks & Recreation CZI~ / Comm. No. J r ~O ?.3f. To: +zef. Uate UG ~ 1 Anne ll~~raf'i('ounlr~.~'~ln eynnl opporlumip prnndrr'and emplnp¢r in Jmu agency on aging Agreement Number: PY04-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) July 1 2ooa between the (agency) Department of Labor and Industrial Relations State of Hawaii (the "STATE"), by its Director HI 96813 (the "DIRECTOR"), whose address is 830 Punchbowl Street, Room 321, Honolulu, and Hawaii Count Office of A in (the "PROVIDER"), a (government entity/corporation partnership/sole proprietorship/other business form) count overnmental enttt whose business address and taxpayer identification number are: 101 Aupuni Street, Suite 342, Hilo, Hawaii 96720 Federal IDIE: 99-6000567 State IDIl: 30016002 RECITALS A. This Agreement is for a purchase of heath 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 speci5c 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; ? thls 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 qua]iSed to participate in the federal program, and (3) has the price of the provided health and human services dictated by federal law; EXEMPT TIANSACTIONS Page 1 Foam AG3-Exam{4199) ? 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 prychologists 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 OfScer 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: (I) (identify state sources) , or (2) (identify federal sources) Public Law 108-199 , or both, in the following amounts: State: S Federal: S 284 , 236.00 D. Pursuant to (legal authority for Agreement) chancery 103-F and 26-20. H$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(a%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 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 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 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) July 1 2004 , to (date) _ June 30 2005 .unless this Agreement is sooner terminated. 3. Compensation. The PROVIDER shall be compensated ? in a total amount for all required services not to exceed Two Hundred Eighty Four Thousand Two Hundred Thirty Six _ DOLLARS 284.246_(10 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 EXEMPT TRANSACTIONS Page 3 Form 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. 4. Reportine 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 2005 No amendment to the PROVIDER'S Final Project Report shall be considered after (date) September 30 2005 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 Genera] 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 pari of this Agreement. In the event of a conflict between the Genera] 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 5rst 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 Room 309 Honolulu HI 96813 Notice t0 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, II230A, Honolulu, HI A notice shall be deemed to have been received 96813 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(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 By ~ ~suv ~nnt Name Nelson B. Befitel Title Director Date C la`'la~ RECOMMEND APPROVAL: PROVIDE~`if'~~~-^~vt~' By ,.t.~~CZ-,~ , Print Name D1~ ~TSu Alan R. Parker Executive on Aging Title t`'tQ^Q9t^0 ~Ireelo~ JUN 21 2004 Date ~i~ 2 iiii~ APPROVED AS TO FORM: Cu eputy Atto ey General APPROVED AS TO FORM AND LEGA("L~I]~T/"~Y":~~, DEPUTY PORATION COUNSEL COUNTY OF HAWAII Date ~'1,~: 1:U~'-; EXEMPT TRANSACTIONS Page $ Form AG3-Exem(4/99)