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Home My WebLink AboutCOM 0041.044 2008-2010 c William P. Kenoi - '111 Alan R. Parker qq Mayor 4V ';l ",%'f Executive on Aging County of Hawaii OFFICE OF AGING Aging and Disability Resource Center, 1055 Kino`ole Street, Suite 101, Hilo, Hawaii 96720 -3872 Phone (808) 961 -8600 • Fax (808) 961 -8603 • Email: hcoa @hawaiiantel.net Hanama Place, 75 -5706 Kuakini Highway, Suite 106, Kailua -Kona, Hawai`i 96740 -1751 Phone (808) 327 -3597 • Fax (808) 327 -3599 • Email: hcoakona @hawaiiantel.net DATE: November 22, 2010 TO: Jay Yoshimoto, Council Chairman and Council Members VIA: Kay Oshiro, Controller FROM Alan R. Parker, Executive on Aging RE: NOTIFICATION OF GRANT AWARD Compliance with Ordinance No. 10 -59 Name of Grant Program: Community Living Program Grantor: Executive Office on Aging, Department of Health State of Hawai`i under an Administration on Aging grant County Grantee Department or Agency: Hawai`i County Office of Aging Grant No. (IF KNOWN): HA.CLP.2010.11.N Amount of Grant: $55,848.00 Amount of County Match: -0- County Revenue & Expenditure Account Numbers: 3301.04 & 010.411.5411.09 to 10 Grant Period (Commencement & Completion): (NTP) November 10, 2010 to September 30, 2011 Purpose of Grant: To develop the infrastructure necessary to launch Hawai`i's Community Living Program to help non - Medicaid eligible individuals but at imminent risk for nursing home placement to remain at home and avoid spend -down and possibly linking them to home and community services. Is final report required by grantor? [x Yes n No 1 i • Comm. No. Notification attached: ® Yes ❑ No, because Ref. To: Ref. Date NOV 2 9 2010 . vN �r oss� Hawai 'i County is an Equal Opportunity Provider and Employer. ; LINDA LINGLE o'F " H NO EMI PENDLETON GOVERNOR OF HAWAII B6 DIRECTOR • CHIYOME L. FUKINO, M.D. Telephone DIRECTOR OF HEALTH .,'a ., a f;' `:� :.�„j;.";.. 6 ¢,• (808) 586 -0100 e i Fax STATE OF HAWAII (808) 586.0185 EXECUTIVE OFFICE ON AGING • NO, 1 .CAPITOL DISTRICT 250 SOUTH HOTEL STREET, SUITE 406 HONOLULU, HAWAII 96813 -2831 November 10, 2010 TO: Alan Parker County Executive Hawaii County Office of A g FROM: Noemi Pendleton Director Executive Office on Aging SUBJECT: NOTICE TO PROCEED HA.CLP.2010.11.N Enclosed is the fully executed contract number HA.CLP.2010.11.N. This contract serves. to support the County of Hawaii in collaboration to meet the goals and objectives of Hawaii's Community Living Program, including the option for participant- directed long term services and supports, under a federal discretionary. grant. You may proceed to carry out the fiinctions as described in Attachment-S1 of the Scope of Services. Funding for this, contract has been approved and is being encumbered. This Notice to Proceed is effective as of today's date November 10, 2010. • If you have any questions, please contact Nancy Moser, Grants Manager at 586 -7309. NM:jl Enclosure • c: ' Caroline Cadirao • • John Grant • • • • • • • F •'' yq '�'s STATE OF HAWAII y T 1 *,.<< CONTRACT FOR GOODS AND SERVICES (IN THE FOLLOWING CATEGORIES: EXEMPT; SMALL PURCHASE; �o::aes SOLE SOURCE; OR EMERGENCY) • This Contract, executed on the respective dates indicated below, is effective as of The STATE's Notice to Proceed , between Department of Health (Insert name of state department, agency, board or commission) State of Hawaii ( "STATE "), by its Director, Executive Office on Aging , (Insert title of person signing for State) (hereafter also referred to as the HEAD OF THE PURCHASING AGENCY or designee ( "HOPA ")), whose address is 250 South Hotel Street, Suite 406, Honolulu, Hawaii 96813 and County of Hawaii ( "CONTRACTOR "), a government entity (htsert corporation, partnership, joint venture, sole proprietorship. or other legal fora, of the Contractor) under the laws of the State of Hawaii , whose business address and federal and state taxpayer identification numbers are as follows: 1055 Kino'ole Street, Suite 101, Hilo, Hawaii 96720 Federal Tax I.D. #99- 6000567 State Tax I.D. #W40793866 -01 RECITALS A. The STATE is in need of the goods and services, or both, described in this Contract and its attachments. The CONTRACTOR is agreeable to providing the goods and services, or both, as the case may be. B. This Contract is for (check one box): ® (1) A procurement expenditure of public funds for goods or services, • or both, that is otherwise exempt from public bidding as set forth in section 103D -102, Hawaii Revised Statutes ( "HRS "), and chapter 3 -120, Hawaii Administrative Rules ( "HAR "); or ; or ❑ (2) A small purchase procurement of goods or services, or both, as set forth in section 103D -305, HRS, and subchapter 8, chapter 3 -122, HAR; or ❑ (3) A sole source procurement of goods or services, or both, as set forth in section 103D -306, HRS, and subchapter 9, chapter 3 -122, HAR; or ❑ (4) An emergency procurement of goods or services, or both, as set forth in section 103D -307, HRS, and subchapter 10, chapter 3 -122, HAR. C. Money is available to fund this Contract pursuant to: (1) Item F -24, Act 162, 2009 HSL 510 (Identify state sources) or (2) #90CD1207/01 (Identify federal sources) or both, in the following amounts: State $ Federal $ $55,848.00 D. Pursuant to Section 349 -3, HRS , the STATE (Legal authority to enter into this Contract) is authorized to enter into this Contract. • E. The agency's Chief Procurement Officer is Aaron S. Fujioka • who ❑ has approved this procurement or ® is not required to approve this procurement. • NOW, THEREFORE, in consideration of the promises contained in this Contract, the STATE and the CONTRACTOR agree as follows: 1. Scope of Services. The CONTRACTOR shall, in a proper and satisfactory • manner as determined by the STATE, provide all the goods or services, or both, set forth in Attachment - S1, which is made a part of this Contract. 1 HA.CLP.2010.11.N AG -002 Rev 07/24/2006 2. Compensation. The CONTRACTOR shall be compensated for goods supplied or services performed, or both, under this Contract in a total amount not to exceed FIFTY -FIVE THOUSAND EIGHT HUNDRED FORTY -EIGHT AND NO /100 DOLLARS ($ 55,848.00 ), including approved costs incurred and taxes, according to the Compensation and Payment Schedule set forth in Attachment -S2, which is made a part of this Contract. 3. Time of Performance. The services or goods required of the CONTRACTOR under this Contract shall be performed and completed in accordance with the Time of Perfomance set forth in Attachment -S3, which is made a part of this Contract. 4. Bonds. The CONTRACTOR ❑ is required to provide or ® is not required to provide: El a performance bond, ❑ a payment bond, ❑ a performance and payment bond in the amount of DOLLARS ($ ). 5. Standards of Conduct Declaration. The Standards of Conduct Declaration of the CONTRACTOR is attached to and made a part of this Contract. 6. Other Terms and Conditions. The General Conditions and any Special Conditions are attached to and made a part of this Contract. In the event of a conflict between the General Conditions and the Special Conditions, the Special Conditions shall control. 7. Liquidated Damages. Liquidated damages shall be assessed in the amount of N/A DOLLARS ($ N/A ) per day, in accordance with the terms of paragraph 9 of the General Conditions. • 8. Notices. Any written notice required to be given by any party to this Contract shall be (a) delivered personally, or (b) sent by United States first class mail, postage prepaid. Notice to the STATE shall be sent to the HOPA'S address indicated in the Contract. Notice to the • CONTRACTOR shall be sent to the CONTRACTOR'S address indicated in the Contract. 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 CONTRACTOR is responsible for notifying the STATE in writing of any change of address. IN VIEW OF TIIE ABOVE, the parties execute this Contract by their signatures, on the dates below, to be effective as of the date first above written. STATE . (Signature) (Print Name) (Print Title) (Date) CONT' ' OR CORPORATE: SEAL (if available) (Name of Contracts ) (Signature) (Print Name) (Print Title) (Date) APPRO /' 1 AS TO FORM: Deputy Attorney General Evidence of authority of the CONTRACTOR'S representative to sign this Contract for the CONTRACTOR must be attached. HA.CLP.2010.11.N 2 AG -002 Rev 07/24/2006 IN VIEW OF THE ABOVE, the parties execute this Contract by their signatures, on the dates below, to be effective as of the date first above written. • • STATE EXECUTIV OVICE ON AGING B, Print Name Noemi Pendleton Title Director Date November 10, 2010 CONTRACTOR COUNTY O AWAII By _ _ Print Name . WILLIAM P. KENOI Title MAYOR Date NOV 0 1 2 010 RECOMMEND APPROVAL: C21 v ? ' .bate Ibllbk Hawaii County • ffice of Aging County Executive APPROVED AS TO FORM AND LEG _ TY: Deputy Corpora i Counsel County of .. aii APPROVED AS TO FORM: Deputy Attorney General State of Hawaii • Page 3 HA.CLP.2010.1 1.N y P y 4 4 "' • STATE OF HAWAII CONTRACTOR'S ACKNOWLEDGMENT STATE OF itQ.IAICU‘ ) S S. COUNTY OF On this 1 day of °vt-h ► bex , c O 10 before me appeared WILLIAM P. KINOI and , tome a known, to be the person(s) described in and, who, being by me duly sworn, did say thatOshe /the} are MAYOR and of }- eivki i , the CONTRACTOR named in th for going instrument, and that he /she /they is /are authorized to sign said instrument on behalf of the CONTRACTOR, and acknowledges that he /she /they executed said instrument as the free act and deed of the CONTRACTOR. di /11414.) , 1+ 0 (Signature) Notary Stamp or Seal) NADINE H. POMROY (Print Name) Notary Public, State of Pr'JU -1 l My commission expires: 07/12/2013 The STATE's Notice to Doc. Date: Proceed # Pages: L i Notary NaimNADINE H. POMROY Circuit Doc. Description: Contract for Goods and Services HA.CLP.2010.11.N ? >;t ! ,G Y !.: , 3 '.; ` -:„ ; 7 � 1 1 77 NOV 01 2010 Notary Signature Date NOTARY CERTIFICATION 1 HA.CLP.2010.11.N AG -009 Rev 7/25/08