HomeMy WebLinkAboutC2017-234 - 8/8/2017 - Approved DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591 EBB4D887
SIGNATURE DOCUMENT FOR
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No.537-18-0077-00001
UNDER THE
IMMUNIZATION/LOCALS GRANT PROGRAM
I. PURPOSE
The Department of State Health Services ("System Agency"), a pass-through entity, and Corpus
Christi-Nueces County Public Health District (City) ("Grantee") (each a "Party" and collectively
the"Parties")enter into the following grant contract to provide funding for immunization services
(the"Contract").
II. LEGAL AUTHORITY
This Contract is authorized by and in compliance with 42 USC 247b;42 USC 243;42 USC
300aa-3,300aa-25,and 300aa-26;42 USC 1396s;Chapter 791 of the Texas Government Code,
and Chapters 81, 161 and 1001 of the Texas Health and Safety Code.
III. DURATION
The Contract is effective on September 1, 2017 and terminates on August 31, 2018, unless
renewed or terminated pursuant to the terms and conditions of the Contract. The System Agency,
at its own discretion,may extend this Contract subject to terms and conditions mutually agreeable
to both Parties.
IV. BUDGET
The total amount of this Contract will not exceed Two HUNDRED FORTY-ONE THOUSAND SIX
HUNDRED THIRTY-SEVEN DOLLARS ($241,637.00). The System Agency will act as a pass-
through entity for up to ONE HUNDRED SEVEN THOUSAND FIVE HUNDRED TWELVE DOLLARS
($107,512.00). The remainder, ONE HUNDRED THIRTY-FOUR THOUSAND ONE HUNDRED
TWENTY-FIVE DOLLARS ($134,125.00), will be provided from state funds. All expenditures
under the Contract will be in accordance with ATTACHMENT B,BUDGET.
V. CONTRACT REPRESENTATIVES
The following will act as the Representative authorized to administer activities under this
Contract on behalf of their respective Party.
System Agency
Department of State Health Services
1100 West 49th Street
Austin,Texas 78756
Attention: Tray Kirkpatrick
tray.kirkpatric k@dshs.state.tx.us
2017-234 System Agency Contract No.537-18-0077-00001
8/08/17 Page 1 of 3
Ord. 031207
TX Dept of State Health Services
INDEXED
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591EBB4D887
Grantee
Corpus Christi-Nueces County Public Health District(City)
1702 Home Road
Corpus Christi,Texas 78416
Attention:Annette Rodriguez
annetter@cctexas.com
VI. LEGAL NOTICES
Any legal notice required under this Contract shall be deemed delivered when deposited by the
System Agency either in the United States mail, postage paid, certified, return receipt requested; or
with a common carrier,overnight,signature required,to the appropriate address below:
System Agency
Department of State Health Services
Attention: Lisa Hernandez
1100 W.49th Street,MC 1911
Austin,TX 78756
Grantee
Corpus Christi-Nueces County Public Health District(City)
1702 Home Road
Corpus Christi,Texas 78416
Attention:Annette Rodriguez
annetter@cctexas.com
Notice given by Grantee will be deemed effective when received by the System Agency. Either
Party may change its address for notice by written notice to the other Party.
VII. ADDITIONAL GRANT INFORMATION
Federal Award Identification Number(FAIN): H23IP000773
Federal Award Date: 9/08/2016
Name of Federal Awarding Agency: Centers for Disease Control and Prevention
CFDA Name and Number:Immunization and Vaccines for Children Program 93.268
Awarding Official Contact Information: SeQuoyah Hill, Office: (770) 488-8350; email:
kwj3na,cdc.gov
DUNS: 069457786
SIGNATURE PAGE FOLLOWS
System Agency Contract No.537-18-0077-00001
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SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT No.537-18-0077-00001
DEPARTMENT OF STATE HEALTH SERVICES GRANTEE
CDoeuSigned by: '1 DocuSigned by:
4fC9D92742CE414..
lnsusuaouuion io...
Name: Janna Zumbrun Name: Annette Rodriguez
Title: Associate Commissioner Title: Health Director
Disease Control and Prevention Date of execution: 8/14/2017 I 10:07 AM CDT
8/15/2017 I 8:50 AM CDT
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT No. 537-18=0077-00001
ARE HEREBY INCORPORATED BY REFERENCE:
ATTACHMENT A- STATEMENT OF WORK
ATTACHMENT B - BUDGET
ATTACHMENT C - UNIFORM TERMS AND CONDITIONS
ATTACHMENT D- SUPPLEMENTAL&SPECIAL CONDITIONS
ATTACHMENT E - FEDERAL ASSURANCES AND CERTIFICATIONS
ATTACHMENT F- FFATA
•
System Agency Contract No.537-18-0077-00001
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SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT No.537-18-0077-00001
DEPARTMENT OF STATE HEALTH SERVICES GRANTEE
-IL 9(r--(Li-FtlCik,L
Name: Janna Zumbrun Name: Annette Rodriguez
Title: Associate Commissioner Title: Health Di rector
Disease Control and Prevention Date of execution:
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT No. 537-18-0077-00001
ARE HEREBY INCORPORATED BY REFERENCE:
. ej ,
ATTACHMENT A- STATEMENT OF WORK
ATTACHMENT B- BUDGET RETCITYCCA HUERTA
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ATTACHMENT C - UNIFORM TERMS AND CONDITIONS
ATTACHMENT D- SUPPLEMENTAL&SPECIAL CONDITIONS
ATTACHMENT E- FEDERAL ASSURANCES AND CERTIFICATIONS
ATTACHMENT F- FFATA
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System Agency Contract No.537-18-0077-00001
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ATTACHMENT A
STATEMENT OF WORK
L GRANTEE RESPONSIBILITIES
Grantee will:
A. Implement and operate an immunization program for children, adolescents, and adults, with
special emphasis on accelerating interventions to improve the immunization coverage of
children three (3) years of age or younger (birth to 35 months of age). Contractor shall
incorporate traditional and non-traditional systematic approaches designed to eliminate barriers,
expand immunization capacity, and establish uniform operating policies,as described herein.
B. Be enrolled as a provider in the Texas Vaccines for Children (TVFC) and the Adult Safety
(ASN) Programs by the effective date of this Program Attachment. This includes a signed
Deputization Addendum Form (E6-102) and adherence to the TVFC Operations Manual and
associated TVFC policy guidelines provided by the DSHS Immunization Unit (located at
http://www.dshs.state.tx.us/immunize/tvfc/tvfc manual.shtm).
C. Comply with written policies and procedures provided by DSHS in managing vaccines supplied
through the ASN and TVFC Programs,including guidelines for proper storage,handling,and
safeguarding of vaccines in the event of natural disaster. Contractor shall comply with all
requirements laid out in the final,approved Work Plan(Exhibit A).
1. Contractor will use the current vaccine management system as described in the
TVFC Operations Manual.
2. Contractor will notify ASN and TVFC providers of changes to vaccine storage and
handling, vaccine management reporting, and present updates and training to
providers, as requested by DSHS.
• 3. Contractor will plan and implement community-based activities and collaborations
to accomplish the required tasks as specified in the final, approved Work Plan
(Exhibit A).
D. Report all notifiable conditions as specified in Texas Administrative Code(TAC)Title 25,Part
I §§ 97.1-97.6 and §§ 97.101-97.102, and as otherwise required by law.
E. Report all vaccine adverse event occurrences in accordance with the 1986 National Childhood
Vaccine Injury Act(NCVIA)42 U.S.C. § 300aa-25 (located at http://vaers.hhs.gov/or 1-800-
822-7967).
F. Inform and educate the public about vaccines and vaccine-preventable diseases,as described in
the DSHS Immunization Contractors Guide for Local Health Departments
(located at http://www.dshs.state.tx.us/immunize/docs/contractor/E11-
13 985_FY2018_ContractorsGuide.pdf).
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ATTACHMENT A
STATEMENT OF WORK
G. Conduct outreach and collaborative activities with American Indian tribes located within the
boundaries of the contractor's jurisdiction.
H. Work to promote a health care workforce within the Local Health Department's(LHDs)service
area (including Contractor's staff) that is knowledgeable about vaccines, vaccine safety,
vaccine-preventable diseases, and delivery of immunization services.
I. Not deny vaccinations to recipients because they do not reside within Contractor's jurisdiction or
because of an inability to pay an administration fee.
J. Comply with all applicable federal and state regulations and statutes,including but not limited
to:
1. Human Resources Code §42.043,VTCA;
2. Education Code §§38.001-38.002,VTCA;
3. Health and Safety Code §§12.032, 81.023, and 161.001-161.009, VTCA;
4. TAC Title 25, Chapter 97;
5. TAC Title 25, Chapter 96;
6. TAC Title 25, Chapter 100;
7. 42 USC §§247b and 300 aa-25;
8. Omnibus Budget Reconciliation Act of 1993, 26 USC §4980B.
K. Comply with current applicable state and federal standards,policies and guidelines,including
but not limited to DSHS's Standards for Public Health Clinic Services,revised August 31,2004
(located at http://www.dshs.state.tx.us/qmb/default.shtm#public).
L. Be responsible for identification and case management of all surface antigen(HBsAg)-positive
pregnant women.Contractor shall ensure timely newborn post exposure prophylaxis(PEP)with
hepatitis B vaccine and hepatitis B immune globin(HBIG),timely completion of doses two and
three of hepatitis B vaccine, and timely completion of post-vaccination serologic testing
(PVST).
M. Be responsible for conducting outreach regarding vaccinations for children (19 through 35
months of age in the Contractor's jurisdiction)included on the list distributed to Contractor by
the ImmTrac Group at DSHS. Lists are distributed through ImmTrac at the start of each
quarterly reporting period(September 01,2017;December 01,2017;March 01,2018;and June
01, 2018).
N. Be responsible for conducting outreach to 17-year-olds included on the lists distributed to the
Contractor by the ImmTrac Group at DSHS to explain the lifetime registry and obtain their
consent to remain in ImmTrac as an adult.Lists are distributed on October 1,2017;December 1,
2017; February 1, 2018;April 1, 2018;June 1, 2018; and August 1, 2018.
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ATTACHMENT A
STATEMENT OF WORK
0. Be responsible for conducting outreach to new ImmTrac providers who have logged into
ImmTrac within 30 days of registering. Lists of these providers are distributed at the beginning
of each month.
P. Be responsible for conducting outreach to existing ImmTrac providers that have not logged in
into ImmTrac in the last 90 days. Lists are distributed on September 1, 2017; November 1,
2017; January 1, 2018; March 1, 2018; May 1,2018; and July 1,2018.
Q. Receive written approval from DSHS before varying from applicable policies, procedures,
protocols, and/or work plans, and must update and disseminate its implementation
documentation to its staff involved in activities under this contract within forty-eight(48)hours
of making approved changes.
R. Review monthly contract funding expenditures and salary savings from any contract-paid staff
vacancies and revise spending plan to ensure that all funds will be properly expended under this
contract before the end of the contract term on August 31, 2018.
S. Send at least one representative to Immunization Unit mandatory meetings held in Austin,
including the 1)Immunization Unit local health department held in the fall of every year and the
2) TVFC Annual Training held in January/February of every year. Additional mandatory
meetings may be required during the contract term.
T. Submit out of state travel requests to the Immunization Unit for approval when utilizing contract
funds or program income.
U. Agree DSHS reserves the right,where allowed by legal authority,to redirect funds in the event
of financial shortfalls. DSHS will monitor Contractor's expenditures on a monthly basis. If
expenditures are below what is projected in Contractor's total Program Attachment amount,
Contractor's budget may be subject to a decrease for the remainder of the Contract term.
Vacant positions existing after ninety(90)days may result in a decrease in funds.
V. The following performance measure(s)will be used,in part,to assess Contractor's effectiveness
in providing the services described in this Program Attachment, without waiving the
enforceability of any of the terms of the Contract.
AA. Investigate and document, in accordance with DSHS Emerging and Acute Infectious
1. Disease Investigation Guidelines(located at
2. http://www.dshs.state.tx.us/idcu/investigation/conditions/) and NBS Data Entry
Guidelines, at least 90% of confirmed or probable reportable vaccine-preventable
disease cases within thirty(30)days of initial report to public health.
BB. Complete 100%of the follow-up activities,designated by DSHS,for TVFC provider quality
assurance site visits assigned by DSHS.
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ATTACHMENT A
STATEMENT OF WORK
CC. Ship overstocked vaccines and vaccines approaching expiration to alternate providers for
immediate use when instructed to do so by the DSHS Health Service Region (HSR)
Immunization Program Manager to avoid vaccine waste. Contractor is responsible for
covering the cost to ship overstocked vaccines and vaccines approaching expiration.
DD. Contact and provide case management to 100% of the number of hepatitis B surface
antigen-positive pregnant women identified.
EE. Contact 3% or 250 children (whichever is more) per each Full Time Equivalent (FTE)
contract employee position,who are not up-to-date on their immunizations according to the
ImmTrac-generated client list provided to the contractor by DSHS at the beginning of each
reporting period.
FF. Perform outreach and education activities targeting adolescents 14 to 18 years of age and
their parents via health-care providers,health-care clinics,hospitals,and any other health-
care facility providing health care to adolescents 14 to 18 years of age to satisfy Texas
Health and Safety Code Chapter 161, Subsection A, Section 161.0095 requirements.
Outreach and education activities must focus on the immunization registry and the option
for an individual who is 18 years of age or older to consent to having their immunization
records stored within the immunization registry. Additional outreach and educational
activities may focus on high schools, colleges, and universities.
GG. Participate in at least one collaborative meeting concerning tribal health issues,concerns,or
needs with American Indian tribal members during the contract term if American Indian
tribes are in their jurisdiction.
HH. Report outreach done,and collaborative efforts made,with the American Indian tribes in the
contractor's jurisdiction.
II. Review 100% of monthly biological reports, vaccine orders (when applicable), and
temperature recording forms for accuracy to ensure the vaccine supply is appropriately
maintained and within established maximum stock levels. Review and approval for
vaccines orders(when applicable)must be documented in the Electronic Vaccine Inventory
(EVI) system.
JJ. Complete 100%of child-care facility and Head Start center assessments,in accordance with
the Immunization Population Assessment Manual, as assigned by the DSHS Immunization
Unit.
KK. Complete 100% of public and private school assessments, retrospective surveys, and
validation surveys,in accordance with the Immunization Population Assessment Manual,as
assigned by DSHS.
LL. Report number of doses administered to underinsured children monthly, as directed by
DSHS.
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ATTACHMENT A
STATEMENT OF WORK
MM. Report the number of unduplicated underinsured clients served, as directed by DSHS.
W. Utilize the Assessment, Feedback, Incentives, and eXchange (AFIX) on-line tool and
methodology to assess immunization practices and coverage rates for all sub-contracted entities
and non-local health department clinics. Immunization provider coverage rates will be
generated using the Comprehensive Clinic Assessment Software Application (CoCASA), as
specified by DSHS.
X. Utilize the Centers for Disease Control and Prevention(CDC)Provider Education,Assessment,
and Reporting (PEAR) system and directly enter data into PEAR to document TVFC
compliance site-visits for all sub-contracted entities and non-local health department clinics.
The Contractor shall submit the final assessment results in the PEAR system within twenty-four
(24)hours of conducting the visit.
Y. Utilize the CDC PEAR system and directly enter data into PEAR to document TVFC
unannounced storage and handling visits conducted at TVFC provider offices. The Contractor
shall submit the final unannounced storage and handling visit results in the PEAR system within
twenty-four(24)hours of conducting the visit.
Z. Required to complete and submit Immunization Inter-Local Agreement(ILA)Quarterly Report
form, utilizing the format provided by the DSHS Immunization Unit and available at
http://www.dshs.state.tx.us/immunize/providers.shtm,by the report due date.
Report Type Reporting Period Report Due Date
Programmatic 09/1/2017 to 11/30/2017 12/29/2017
Programmatic 12/1/2017 to 02/28/2018 4/01/2018
Programmatic 03/1/2018 to 05/30/2018 7/01/2018
Programmatic 06/1/2018 to 08/31/2018 10/01/2018
Contractors LHD ILA Quarterly Reports should be submitted electronically to
dshsimmunizationcontracts@dshs.state.tx.us according to the time frames stated above.
IL PERFORMANCE MEASURES
The System Agency will monitor the Grantee's performance of the requirements in Attachment
A and compliance with the Contract's terms and conditions.
III. INVOICE AND PAYMENT
A. Grantee will request monthly payments using the State of Texas Purchase Voucher
(Form B-13) at http://www.dshs.texas.gov/grants/forms.shtm. Voucher and any
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ATTACHMENT A
STATEMENT OF WORK
supporting documentation will be mailed or submitted by fax or electronic mail to the
address/number below.
Department of State Health Services
Claims Processing Unit, MC 1940
1100 West 49th Street
P.O. Box 149347
Austin,TX 78714-9347
FAX: (512)458-7442
EMAIL: invoices@dshs.state.tx.us
B. Grantee will be paid on a cost reimbursement basis and in accordance with the Budget in
Attachment B of this Contract.
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ATTACHMENT B
BUDGET SUMMARY
Organization Name: Corpus Christi-Nueces County PHD Program ID: IMM/LOCALS
Contract Number: 537-18-0077-00001
Budget Categories
Budget Categories DSHS Funds Cash In Kind Category Total
Requested Match Match
Contribution
Personnel $145,693.00 $145,693.00
Fringe Benefits $60,200.00 $60,200.00
•
$8,337.00 $8,337.00
Travel
Equipment $0.00 $0.00
Supplies $11,105.00 $11,105.00
Contractual $8,280.00 $8,280.00
Other $8,022.00 $8,022.00
Total Direct Costs $241,637.00 $241,637.00
Indirect Costs $0.00 $0.00
Totals $241,637.00 $0.00 $241,637.00
System Agency Contract No.537-18-0077-00001
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HHSC Uniform Terms and Conditions Version 2.14
Published and Effective: March 1,2017
Responsible Office:Chief Counsel
of
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Health and Human Services Commission
HHSC Uniform Terms and Conditions - Grant
Version 2.14
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TABLE OF CONTENTS
ARTICLE I.DEFINITIONS AND INTERPRETIVE PROVISIONS 4
1.01 Definitions 4
1.02 Interpretive Provisions 5
ARTICLE II Payment Methods and Restrictions 6
2.01 Payment Methods 6
2.02 Final Billing Submission 6
2.03 Financial Status Reports (FSRs) 7
2.04 Debt to State and Corporate Status 7
2.05 Application of Payment Due 7
2.06 Use of Funds 7
2.07 Use for Match Prohibited 7
2.08 Program Income 7
2.09 Nonsupplanting 8
ARTICLE III. STATE AND FEDERAL FUNDING 8
3.01 Funding 8
3.02 No debt Against the State 8
3.03 Debt to State 8
3.04 Recapture of Funds 8
ARTICLE IV Allowable Costs and Audit Requirements 9
4.01 Allowable Costs. 9
4.02 Independent Single or Program-Specific Audit 10
4.03 Submission of Audit 10
Article V AFFIRMATIONS,ASSURANCES AND CERTIFICATIONS 10
5.01 General Affirmations 10
5.02 Federal Assurances 10
5.03 Federal Certifications 10
ARTICLE VI OWNERSHIP AND INTELLECTUAL PROPERTY 11
6.01 Ownership 11
6.02 Intellectual Property 11
ARTICLE VII RECORDS,AUDIT,AND DISCLOSURE 11
7.01 Books and Records 11
7.02 Access to records,books, and documents 11
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7.03 Response/compliance with audit or inspection findings 12
7.04 SAO Audit 12
7.05 Confidentiality 12
7.06 Public Information Act 12
ARTICLE VIII CONTRACT MANAGEMENT AND EARLY TERMINATION 12
8.01 Contract Management 12
8.02 Termination for Convenience 13
8.03 Termination for Cause 13
8.04 Equitable Settlement 13
ARTICLE IX MISCELLANEOUS PROVISIONS 13
9.01 Amendment 13
9.02 Insurance 13
9.03 Legal Obligations 14
9.04 Permitting and Licensure 14
• 9.05 Indemnity 14
9.06 Assignments 15
9.07 Relationship of the Parties 15
9.08 Technical Guidance Letters 15
9.09 Governing Law and Venue 16
9.11 Survivability 16
9.12 Force Majeure 16
9.13 No Waiver of Provisions 16
9.14 Publicity 16
9.15 Prohibition on Non-compete Restrictions 17
9.16 No Waiver of Sovereign Immunity 17
9.17 Entire Contract and Modification 17
9.18 Counterparts 17
9.19 ' Proper Authority 17
9.20 Employment Verification 17
9.21 Civil Rights 17
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ARTICLE I.DEFINITIONS AND INTERPRETIVE PROVISIONS
1.01 Definitions
As used in this Contract, unless the context clearly indicates otherwise, the following terms and
conditions have the meanings assigned below:
"Amendment" means a written agreement, signed by the parties hereto, which documents
changes to the Contract other than those permitted by Work Orders or Technical Guidance
Letters, as herein defined.
"Attachment" means documents, terms, conditions, or additional information physically added
to this Contract following the Signature Document or included by reference, as if physically,
within the body of this Contract.
"Contract"means the Signature Document, these Uniform Terms and Conditions, along with any
Attachments, and any Amendments, or Technical Guidance Letters that may be issued by the
System Agency,to be incorporated by reference herein for all purposes if issued.
"Deliverable" means the work product(s) required to be submitted to the System Agency
including all reports and project documentation.
"Effective Date" means the date agreed to by the Parties as the date on which the Contract takes
effect.
"System Agency"means HHSC or any of the agencies of the State of Texas that are overseen by
HHSC under authority granted under State law and the officers, employees, and designees of
those agencies. These agencies include: the Department of Aging and Disability Services, the
Department of Family and Protective Services, and the Department of State Health Services.
"Federal Fiscal Year" means the period beginning October 1 and ending September 30 each
year, which is the annual accounting period for the United States government.
"GAAP"means Generally Accepted Accounting Principles.
"GASB"means the Governmental Accounting Standards Board.
"Grantee"means the Party receiving funds under this Contract, if any. May also be referred to as
"Contractor" in certain attachments.
"Health and Human Services Commission" or "HHSC" means the administrative agency
established under Chapter 531,Texas Government Code or its designee.
"HUB" means Historically Underutilized Business, as defined by Chapter 2161 of the Texas
Government Code.
"Intellectual Property" means inventions and business processes, whether or not patentable;
works of authorship; trade secrets; trademarks; service marks; industrial designs; and creations
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that are subject to potential legal protection incorporated in any Deliverable and first created or
developed by Grantee, Grantee's contractor or a subcontractor in performing the Project.
"Mentor Protégé" means the Comptroller of Public Accounts' leadership program found at:
http://www.window.state.tx.us/procurement/prog/hub/mentorprotege/.
"Parties"means the System Agency and Grantee, collectively.
"Party"means either the System Agency or Grantee, individually.
"Program" means the statutorily authorized activities of the System Agency under which this
Contract has been awarded.
"Project"means specific activities of the Grantee that are supported by funds provided under this
Contract.
"Public Information Act"or"PIA"means Chapter 552 of the Texas Government Code.
"Statement of Work" means the description of activities performed in completing the Project, as
specified in the Contract and as may be amended.
"Signature Document" means the document executed by both Parties that specifically sets forth
all of the documents that constitute the Contract.
"Solicitation or "RFA" means the document issued by the System Agency under which
applications for Program funds were requested, which is incorporated herein by reference for all
purposes in its entirety, including all Amendments and Attachments.
"Solicitation Response" or "Application" means Grantee's full and complete response to the
Solicitation, which is incorporated herein by reference for all purposes in its entirety, including
any Attachments and addenda.
"State Fiscal Year" means the period beginning September 1 and ending August 31 each year,
which is the annual accounting period for the State of Texas.
"State of Texas Textravel" means Texas Administrative Code, Title 34, Part 1, Chapter 5,
Subchapter C, Section 5.22,relative to travel reimbursements under this Contract, if any.
"Technical Guidance Letter" or "TGL" means an instruction, clarification, or interpretation of
the requirements of the Contract, issued by the System Agency to the Grantee.
1.02 Interpretive Provisions
a. The meanings of defined terms are equally applicable to the singular and plural forms of the
defined terms.
b. The words "hereof," "herein," "hereunder," and similar words refer to this Contract as a
whole and not to any particular provision, section, Attachment, or schedule of this Contract
unless otherwise specified.
c. The term "including" is not limiting and means "including without limitation" and, unless
otherwise expressly provided in this Contract, (i) references to contracts (including this
Contract) and other contractual instruments shall be deemed to include all subsequent
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Amendments and other modifications thereto, but only to the extent that such Amendments
and other modifications are not prohibited by the terms of this Contract, and(ii)references to
any statute or regulation are to be construed as including all statutory and regulatory
provisions consolidating, amending, replacing, supplementing, or interpreting the statute or
regulation.
d. Any references to "sections," "appendices," or "attachments" are references to sections,
appendices, or attachments of the Contract.
e. Any references to agreements, contracts, statutes, or administrative rules or regulations in the
Contract are references to these documents as amended, modified, or supplemented from
time to time during the term of the Contract.
f. The captions and headings of this Contract are for convenience of reference only and do not
affect the interpretation of this Contract.
g. All Attachments within this Contract, including those incorporated by reference, and any
Amendments are considered part of the terms of this Contract.
h. This Contract may use several different limitations, regulations, or policies to regulate the
same or similar matters. All such limitations, regulations, and policies are cumulative and
each will be performed in accordance with its terms.
i. Unless otherwise expressly provided, reference to any action of the System Agency or by the
System Agency by way of consent, approval, or waiver will be deemed modified by the
phrase"in its sole discretion."
j. Time is of the essence in this Contract.
ARTICLE II PAYMENT METHODS AND RESTRICTIONS
2.01 Payment Methods
Except as otherwise provided by the provisions of the Contract, the payment method will be one
or more of the following:
a. cost reimbursement. This payment method is based on an approved budget and submission
of a request for reimbursement of expenses Grantee has incurred at the time of the request;
b. unit rate/fee-for-service. This payment method is based on a fixed price or a specified rate(s)
or fee(s) for delivery of a specified unit(s) of service and acceptable submission of all
required documentation, forms and/or reports; or
c. advance payment. This payment method is based on disbursal of the minimum necessary
funds to carry out the Program or Project where the Grantee has implemented appropriate
safeguards. This payment method will only be utilized in accordance with governing law
and at the sole discretion of the System Agency.
Grantees shall bill the System Agency in accordance with the Contract. Unless otherwise
specified in the Contract, Grantee shall submit requests for reimbursement or payment monthly.
by the last business day of the month following the month in which expenses were incurred or
services provided. Grantee shall maintain all documentation that substantiates invoices and make
the documentation available to the System Agency upon request.
2.02 Final Billing Submission
Unless otherwise provided by the System Agency, Grantee shall submit a reimbursement or
payment request as a final close-out invoice not later than forty-five (45) calendar days following
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the end of the term of the Contract. Reimbursement or payment requests received in the System
Agency's offices more than forty-five (45) calendar days following the termination of the
Contract may not be paid.
2.03 Financial Status Reports (FSRs)
Except as otherwise provided in these General Provisions or in the terms of any Program
Attachment(s) that is incorporated into the Contract, for contracts with categorical budgets,
Grantee shall submit quarterly FSRs to Accounts Payable by the last business day of the month
following the end of each quarter of the Program Attachment term for System Agency review
and financial assessment. Grantee shall submit the final FSR no later than forty-five (45)
calendar days following the end of the applicable term.
2.04 Debt to State and Corporate Status
Pursuant to Tex. Gov. Code § 403.055, the Department will not approve and the State
Comptroller will not issue payment to Grantee if Grantee is indebted to the State for any reason,
including a tax delinquency. Grantee, if a corporation, certifies by execution of this Contract that
it is current and will remain current in its payment of franchise taxes to the State of Texas or that
it is exempt from payment of franchise taxes under Texas law (Tex. Tax Code §§ 171.001 et
seq.). If tax payments become delinquent during the Contract term, all or part of the payments
under this Contract may be withheld until Grantee's delinquent tax is paid in full.
2.05 Application of Payment Due
Grantee agrees that any payments due under this Contract will be applied towards any debt of
Grantee, including but not limited to delinquent taxes and child support that is owed to the State
of Texas.
2.06 Use of Funds
Grantee shall expend funds provided under this Contract only for the provision of approved
services and for reasonable and allowable expenses directly related to those services.
2.07 Use for Match Prohibited
Grantee shall not use funds provided under this Contract for matching purposes in securing other
funding without the written approval of the System Agency.
2.08 Program Income
Income directly generated from funds provided under this Contract or earned only as a result of
such funds is Program Income. Unless otherwise required under the Program, Grantee shall use
the addition alternative, as provided in UGMS § _.25(g)(2), for the use of Project income to
further the Program,and Grantee shall spend the Program Income on the Project. Grantee shall
identify and report this income in accordance with the Contract, applicable law, and any
programmatic guidance. Grantee shall expend Program Income during the Contract term and
may not carry Program Income forward to any succeeding term. Grantee shall refund program
income to the System Agency if the Program Income is not expended in the term in which it is
earned. The System Agency may base future funding levels, in part, upon Grantee's proficiency
in identifying, billing, collecting, and reporting Program Income, and in using it for the purposes
and under the conditions specified in this Contract.
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2.09 Nonsupplanting
Grantee shall not use funds from this Contract to replace or substitute for existing funding from
other but shall use funds from this Contract to supplement existing state or local funds currently
available. Grantee shall make a good faith effort to maintain its current level of support.
Grantee may be required to submit documentation substantiating that a reduction in state or local
funding, if any, resulted for reasons other than receipt or expected receipt of funding under this
Contract.
ARTICLE III. STATE AND FEDERAL FUNDING
3.01 Funding
This Contract.is contingent upon the availability of sufficient and adequate funds. If funds
become unavailable through lack of appropriations, budget cuts, transfer of funds between
programs or agencies, amendment of the Texas General Appropriations Act, agency
consolidation, or any other disruptions of current funding for this Contract, the System Agency
may restrict, reduce,'or terminate funding under this Contract. This Contract is also subject to
.immediate cancellation or termination, without penalty to the System Agency, if sufficient and
adequate funds are not available. Grantee will have no right of action against the System Agency
if the System Agency cannot perform its obligations under this Contract as a result of lack of
funding for any activities or functions contained within the scope of this Contract. In the event of
cancellation or termination under this Section, the System Agency will not be required to give.
notice and will not be liable for any damages or losses caused or associated with such
termination or cancellation.
3.02 No debt Against the State
The Contract will not be construed as creating any debt by or on behalf of the State of Texas.
103 Debt to State
If a payment law prohibits the Texas Comptroller of Public Accounts from making a payment,
the Grantee acknowledges the System Agency's payments under the Contract will be applied
toward eliminating the debt or delinquency. This requirement specifically applies to any debt or
delinquency,regardless of when it arises.
3.04 Recapture of Funds
The System Agency may withhold all or part of any payments to Grantee to offset overpayments
made to the Grantee. Overpayments as used in this Section include payments (i) made by the
System Agency that exceed the maximum allowable rates; (ii)that are not allowed under applicable
laws, rules, or regulations; or (iii) that are otherwise inconsistent with this Contract, including any
unapproved expenditures. Grantee understands and agrees that it will be liable to the System
Agency for any costs disallowed pursuant to financial and compliance audit(s) of funds received
under this Contract. Grantee further. understands and agrees that reimbursement of such
disallowed costs will be paid by Grantee from funds which were not provided or otherwise made
available to Grantee under this Contract.
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ARTICLE IV ALLOWABLE COSTS AND AUDIT REQUIREMENTS
4.01 Allowable Costs.
System Agency will reimburse the allowable costs incurred in performing the Project that are
sufficiently documented. Grantee must have incurred a cost prior to claiming reimbursement and
within the applicable term to be eligible for reimbursement under this Contract. The System
Agency will determine whether costs submitted by Grantee are allowable and eligible for
reimbursement. If the System Agency has paid funds to Grantee for unallowable or ineligible
costs,the System Agency will notify Grantee in writing, and Grantee shall return the funds to the
System Agency within thirty (30) calendar days of the date of this written notice. The System
Agency may withhold all or part of any payments to Grantee to offset reimbursement for any
unallowable or ineligible expenditure that Grantee has not refunded to the System Agency, or if
financial status report(s) required under the Financial Status Reports section are not submitted by
the due date(s). The System Agency may take repayment (recoup) from funds available under
this .Contract in amounts necessary to fulfill Grantee's repayment obligations. Applicable cost
principles, audit requirements, and administrative requirements include-
Applicable Entity Applicable Cost Audit Administrative
Principles Requirements Requirements
State, Local and 2 CFR,Part 225 2 CFR Part 200, 2 CFR Part 200 and
Tribal Governments Subpart F and UGMS
UGMS
Educational 2 CFR, Part 220 2 CFR Part 200, 2 CFR Part 200 and
Institutions Subpart F and UGMS
UGMS
Non-Profit 2 CFR,Part 230 2 CFR Part 200, 2 CFR Part 200 and
Organizations Subpart F. and UGMS
UGMS
For-profit 48 CFR Part 31, 2 CFR Part 200, 2 CFR Part 200 and
Organization other Contract Cost Subpart F and UGMS
than a hospital and an Principles UGMS
organization named in Procedures, or
OMB Circular A-122 uniform cost
(2 CFR Part, 230) as accounting
not subject to that standards that
circular. comply with cost
principles
acceptable to the
federal or state
awarding agency
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OMB Circulars will be applied with the modifications prescribed by UGMS with effect given to
whichever provision imposes the more stringent requirement in the event of a conflict.
4.02 Independent Single or Program-Specific Audit
If Grantee,within Grantee's fiscal year, expends a total amount of at least SEVEN HUNDRED
FIFTY THOUSAND DOLLARS ($750,000) in federal funds awarded, Grantee shall have a
single audit or program-specific audit in accordance with 2 CFR 200. The $750,000 federal
threshold amount includes federal funds passed through by way of state agency awards.If
Grantee, within Grantee's fiscal year, expends.a total amount of at least$750,000 in state funds
awarded, Grantee must have a single audit or program-specific audit in accordance with UGMS,
State of Texas Single Audit Circular. The audit must be conducted by an independent certified
public accountant and in accordance with 2 CFR_200, Government Auditing Standards, and
UGMS. For-profit Grantees whose expenditures meet or exceed the federal or state expenditure
thresholds stated above shall followthe guidelines in 2 CFR 200 or UGMS, as applicable, for
their program-specific audits. HHSC Single Audit Services will notify Grantee to complete the
Single Audit Determination Form. If Grantee fails to complete the Single Audit Determination
Form within thirty.(30) calendar days after notification by HHSC Single Audit Services to do so,
Grantee shall be subject to the System Agency sanctions and remedies for non-compliance with
this Contract. Each Grantee that is required to obtain a single audit must competitively re-
• procure single audit services once every six years. Grantee shall procure audit services in •
compliance with this section, state procurement procedures, as well as with the provisions of
UGMS.
4.03 Submission of Audit
Due the earlier of 30 days after receipt of the independent certified public accountant's report or
nine months after the end of the fiscal year, Grantee shall submit electronically, one copy of the
Single Auditor Program-Specific Audit to the System Agency as directed in this Contract and
another copy to: single_audit_report@hhsc.state.tx.us
ARTICLE V AFFIRMATIONS,ASSURANCES AND CERTIFICATIONS
5.01 General Affirmations
Grantee certifies that, to the extent General Affirmations are incorporated into the Contract under
the Signature Document, the General Affirmations have been reviewed and that Grantee is in
compliance with each of the requirements reflected therein.
5.02 Federal Assurances
Grantee further certifies that, to the extent Federal Assurances are incorporated into the Contract
under the Signature Document, the.Federal Assurances have been reviewed and that Grantee is
in compliance with each of the requirements reflected therein.
5.03 Federal Certifications
Grantee further certifies, to the extent Federal Certifications are incorporated into the Contract
under the Signature Document, that the Federal Certifications have been reviewed, and that
Grantee is in compliance with each of the requirements reflected therein. In addition, Grantee
certifies that it is in compliance with all applicable federal laws, rules, or regulations, as they
may pertain to this Contract.
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ARTICLE VI OWNERSHIP AND INTELLECTUAL PROPERTY
6.01 Ownership
The System Agency will own, and Grantee hereby assigns to the System Agency, all right, title,
and interest in all Deliverables.
6.02 Intellectual Property
a. The System Agency and Grantee will retain ownership, all rights, title, and interest in and to,
their respective pre-existing Intellectual Property. A license to either Party's pre-existing
Intellectual Property must be agreed to under this or another contract.
b. Grantee grants to the System Agency and the State of Texas a royalty-free, paid up,
worldwide,perpetual,non-exclusive, non-transferable license to use any Intellectual Property
invented or created by Grantee, Grantee's contractor, or a subcontractor in the performance of
the Project. Grantee will require its contractors to grant such a license under its contracts.
ARTICLE VII RECORDS,AUDIT,AND DISCLOSURE
7.01 Books and Records
Grantee will keep and maintain under GAAP o"r GASB, as applicable, full, true, and complete
records necessary to fully disclose to the System Agency, the Texas State Auditor's Office, the
United States Government, and their authorized representatives sufficient information to
determine compliance with the terms and conditions of this Contract and all state and federal
rules, regulations, and statutes. Unless otherwise specified in this Contract, Grantee will
maintain legible copies of this Contract and all related documents for a minimum of seven (7)
years after the termination of the contract period or seven (7) years after the completion of any
litigation or dispute involving the Contract,whichever is later.
7.02 Access to records,books, and documents
In addition to any right of access arising by operation of law, Grantee and any of Grantee's
affiliate or subsidiary organizations, or Subcontractors will permit the System Agency or any of
its duly authorized representatives, as well as duly authorized federal, state or local authorities,
unrestricted access to and the right to examine any site where business is conducted or Services
are performed, and all records, whichincludes but is not limited to financial, client and patient
records, books, papers or documents related to this Contract. If the Contract includes federal
funds, federal agencies that will have a right of access to records as described in this section
include: the federal agency providing the funds, the Comptroller General of the United States,
the General Accounting Office, the Office of the Inspector General, and any of theirauthorized
representatives. In addition, agencies of the State of Texas that will have a right of access to
records as described in this section include: the System Agency, HHSC, HHSC's contracted
examiners, the State Auditor's Office, the Texas Attorney General's Office, and any successor
agencies. Each of these entities may be a duly authorized authority. If deemed necessary by the
System Agency or any duly authorized authority, for the purpose of investigation or hearing,
Grantee will produce original documents related to this Contract. The System Agency and any
duly authorized authority will have the right to audit billings both before and after payment, and
all documentation that substantiates the billings. Grantee will include this provision concerning
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the right of access to, and examination of, sites and information related to this Contract in any
Subcontract it awards.
7.03 Response/compliance with audit or inspection findings
a. Grantee must act to ensure its and its Subcontractor's compliance with all corrections
necessary to address any finding of noncompliance with any law, regulation, audit
requirement, or generally accepted accounting principle, or any other deficiency identified in
any audit, review, or inspection of the Contract and the goods or services provided
hereunder. Any such correction will be at Grantee or its Subcontractor's sole expense.
Whether Grantee's action corrects the noncompliance will be solely the decision of the
System Agency.
b. As part of the Services, Grantee must provide to HHSC upon request a copy of those portions
of Grantee's and its Subcontractors' internal audit reports relating to the Services and
Deliverables provided to the State under the Contract.
7.04 SAO Audit
Grantee understands that acceptance of funds directly under the Contract or indirectly through a
Subcontract under the Contract acts as acceptance of the authority of the State Auditor's Office
(SAO), or any successor agency, to conduct an audit or investigation in connection with those
funds. Under the direction of the legislative audit committee, an entity that is the subject of an
audit or investigation by the SAO must provide the SAO with access to any information the SAO
considers relevant to the investigation or audit. Grantee agrees to cooperate fully with the SAO
or its successor in the conduct of the audit or investigation, including providing all records
requested. Grantee will ensure that this clause concerning the authority to audit funds received
indirectly by Subcontractors through Grantee and the requirement to cooperate is included in any
Subcontract it awards.
7.05 Confidentiality
Any specific confidentiality agreement between the Parties takes precedent over the terms of this
section. To the extent permitted by law, Grantee agrees to keep all information confidential, in
whatever form produced, prepared, observed, or received by Grantee. The provisions of this
section remain in full force and effect following termination or cessation of the services
performed under this Contract.
7.06 Public Information Act
Information related to the performance of this Contract may be subject to the PIA and will be
withheld from public disclosure or released only in accordance therewith. Grantee must make all
information not otherwise excepted from disclosure under the. PIA available in portable
document file (".pdf') format or any other format agreed between the Parties.
ARTICLE VIII CONTRACT MANAGEMENT AND EARLY TERMINATION
8.01 Contract Management
To ensure full performance of the Contract and compliance with applicable law, the System
Agency may take actions including:
a. Suspending all or part of the Contract;
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b. Requiring the Grantee to take specific corrective actions in order to remain in compliance
with term of the Contract;
c. Recouping payments made to the Grantee found to be in error;
d. Suspending, limiting, or placing conditions on the continued performance of the Project;
e. Imposing any other remedies authorized under this Contract; and
f. Imposing any other remedies, sanctions or penalties permitted by federal or state statute, law,
regulation, or rule.
8.02 Termination for Convenience
The System Agency may terminate the Contract at any time when, in its sole discretion, the
System Agency determines that termination is in the best interests of the State of Texas. The
termination will be effective on the date specified in HHSC's notice of termination.
8.03 Termination for Cause
Except as otherwise provided by the U.S. Bankruptcy Code, or any successor law, the System
Agency may terminate the Contract, in whole or in part,upon either of the following conditions:
a. Material Breach
The System Agency will have the right to terminate the Contract in whole or in part if the
'System Agency determines, at its sole discretion, that Grantee has materially breached the
Contract or has failed to adhere to any laws, ordinances, rules,regulations or orders of any public
authority having jurisdiction and such violation prevents or substantially impairs performance of
Grantee's duties under the Contract. Grantee's misrepresentation in any aspect of Grantee's
Solicitation Response, if any or Grantee's addition to the Excluded Parties List System (EPLS)
will also constitute a material breach of the Contract.
b. Failure to Maintain Financial Viability
The System Agency may terminate the Contract if, in its sole discretion, the System Agency has
a good faith belief that Grantee no longer maintains the financial viability required to complete
the Services and Deliverables, or otherwise fully perform its responsibilities under the Contract.
8.04 Equitable Settlement
Any early termination under this Article will be subject to the equitable settlement of the
respective interests of the Parties up to the•date of termination.
ARTICLE IX MISCELLANEOUS PROVISIONS
9.01 Amendment
The Contract may only be amended by an Amendment executed by both Parties.
9.02 Insurance
Unless otherwise specified in this Contract, Grantee will acquire and maintain, for the duration of
this Contract, insurance coverage necessary to ensure proper fulfillment of this Contract and
potential liabilities thereunder with fmancially sound and reputable insurers licensed by the
Texas Department of Insurance, in the type and amount customarily carried within the industry
as determined by the System Agency. Grantee will provide evidence of insurance as required
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under this Contract, including a schedule of coverage or underwriter's schedules establishing to
the satisfaction of the System Agency the nature and extent of coverage granted by each such
policy, upon request by the System Agency. In the event that any policy is determined by the
System Agency to be deficient to comply with the terms of this Contract, Grantee will secure
such additional policies or coverage as the System Agency may reasonably request or that are
required by law or regulation. If coverage expires during the term of this Contract, Grantee must
produce renewal certificates for each type of coverage.
These and all other insurance requirements under the Contract apply to both Grantee and its
Subcontractors, if any. Grantee is responsible for ensuring its Subcontractors' compliance with all
requirements.
9.03 Legal Obligations
Grantee will comply with all applicable federal, state, and local laws, ordinances, and
regulations, including all federal and state accessibility laws relating to direct and indirect use of
information and communication technology. Grantee will be deemed to have knowledge of all
applicable laws and regulations and be deemed to understand them. In addition to any other act
or omission that may constitute a material breach of the Contract, failure to comply with this
Section may also be a material breach of the Contract.
9.04 Permitting and Licensure
At Grantee's sole expense, Grantee will procure and maintain for the duration of this Contract
any state, county, city, or federal license, authorization, insurance, waiver, permit, qualification
or certification required by statute, ordinance, law, or regulation to be held by Grantee to provide
the goods or Services required by this Contract. Grantee will be responsible for payment of all
taxes, assessments, fees, premiums, permits, and licenses required by law. Grantee agrees to be
responsible for payment of any such government obligations not paid by its contactors or
subcontractors during performance of this Contract.
9.05 Indemnity
To THE EXTENT ALLOWED BY LAW, GRANTEE WILL DEFEND, INDEMNIFY, AND HOLD
HARMLESS THE STATE OF TEXAS AND ITS OFFICERS AND EMPLOYEES, AND THE SYSTEM
AGENCY AND ITS OFFICERS AND EMPLOYEES, FROM AND AGAINST ALL CLAIMS, ACTIONS,
SUITS, DEMANDS, PROCEEDINGS, COSTS, DAMAGES, AND LIABILITIES, INCLUDING ATTORNEYS'
FEES AND COURT COSTS ARISING OUT OF,OR CONNECTED WITH,OR RESULTING FROM:
a. GRANTEE'S PERFORMANCE OF THE CONTRACT, INCLUDING ANY NEGLIGENT ACTS OR
OMISSIONS OF GRANTEE, OR ANY AGENT;EMPLOYEE, SUBCONTRACTOR, OR SUPPLIER OF
GRANTEE, OR ANY THIRD PARTY UNDER THE CONTROL OR SUPERVISION OF GRANTEE, IN
THE EXECUTION OR PERFORMANCE OF THIS CONTRACT;OR
b. ANY BREACH OR VIOLATION OF A STATUTE, ORDINANCE, GOVERNMENTAL REGULATION,
STANDARD, RULE, OR BREACH OF CONTRACT BY GRANTEE, ANY AGENT, EMPLOYEE,
SUBCONTRACTOR, OR SUPPLIER OF GRANTEE,OR ANY THIRD PARTY UNDER THE CONTROL
OR SUPERVISION OF GRANTEE,IN THE EXECUTION OR PERFORMANCE OF THIS CONTRACT;
OR
C. EMPLOYMENT OR ALLEGED EMPLOYMENT, INCLUDING CLAIMS OF DISCRIMINATION
AGAINST GRANTEE,ITS OFFICERS,OR ITS AGENTS;OR
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d. WORK UNDER THIS CONTRACT THAT INFRINGES OR MISAPPROPRIATES ANY RIGHT OF ANY
THIRD PERSON OR ENTITY BASED ON COPYRIGHT, PATENT, TRADE SECRET, OR OTHER
INTELLECTUAL PROPERTY RIGHTS.
GRANTEE WILL COORDINATE ITS DEFENSE WITH THE SYSTEM AGENCY AND ITS COUNSEL.
THIS PARAGRAPH IS NOT INTENDED TO AND WILL NOT BE CONSTRUED TO REQUIRE GRANTEE
TO INDEMNIFY OR HOLD HARMLESS THE STATE OR THE SYSTEM AGENCY FOR ANY CLAIMS OR
LIABILITIES RESULTING SOLELY FROM THE GROSS NEGLIGENCE OF THE SYSTEM AGENCY OR
ITS EMPLOYEES. THE PROVISIONS OF THIS SECTION WILL SURVIVE TERMINATION OF THIS
CONTRACT.
9.06 Assignments
Grantee may not assign all or any portion of its rights under, interests in, or duties required under
this Contract without prior written consent of the System Agency, which may be withheld or
granted at the sole discretion of the System Agency. Except where otherwise agreed in writing
by the System Agency, assignment will not release Grantee from its obligations under the
Contract.
Grantee understands and agrees the System Agency may in one or more transactions assign,
pledge, or transfer the Contract. This assignment will only be made to another State agency or a
non-state agency that is contracted to perform agency support.
9.07 Relationship of the Parties
Grantee is, and will be, an independent contractor and, subject only to the terms of this Contract,
will have the sole right to supervise, manage, operate, control, and direct performance of the
details incident to its duties under this Contract. Nothing contained in this Contract will be
deemed or construed to create a partnership or joint venture, to create relationships of an
employer-employee or principal-agent, or to otherwise create for the System Agency any
liability whatsoever with respect to the indebtedness, liabilities, and obligations of Grantee or
any other Party.
Grantee will be solely responsible for, and the System Agency will have no obligation with
respect to:
a. Payment of Grantee's employees for all Services performed; •
• b. Ensuring each of its employees, agents, or Subcontractors who provide Services or
Deliverables under the Contract are properly licensed, certified, or have proper permits to
perform any activity related to the Work;
c. Withholding of income taxes,FICA,or any other taxes or fees;
d. Industrial or workers' compensation insurance coverage;
e. Participation in any group insurance plans available to employees of the State of Texas;
f. Participation or contributions by the State to the State Employees Retirement System;
g. Accumulation of vacation leave or sick leave; or
h. Unemployment compensation coverage provided by the State.
9.08 Technical Guidance Letters
In the sole discretion of the System Agency, and in conformance with federal and state law, the
System Agency may issue instructions, clarifications, or interpretations as may be required
during Work performance in the form of a Technical Guidance Letter. A TGL must be in
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writing, and may be delivered by regular mail, electronic mail, or facsimile transmission. Any
TGL issued by the System Agency will be incorporated into the Contract by reference herein for
all purposes when it is issued.
9.09 Governing Law and Venue
This Contract and the rights and obligations of the Parties hereto will be governed by, and
construed according to, the laws of the State of Texas, exclusive of conflicts of law provisions.
Venue of any suit brought under this Contract will be in a court of competent jurisdiction in
Travis County, Texas unless otherwise elected by the System Agency. Grantee irrevocably
waives any objection, including any objection to personal jurisdiction or the laying of venue or
based on the grounds of forum non conveniens, which it may now or hereafter have to the
bringing of any action or proceeding in such jurisdiction in respect of this Contract or any
document related hereto.
9.10 Severability
If any provision contained in this Contract is held to be unenforceable by a court of law or
equity, this Contract will be construed as if such provision did not exist and the non-
enforceability of such provision will not be held to render any other provision or provisions of
this Contract unenforceable.
9.11 Survivability
Termination or expiration of this Contract or a Contract for any reason will not release either
party from any liabilities or obligations in this Contract that the parties have expressly agreed
will survive any such termination or expiration, remain to be performed, or by their nature would
be intended to be applicable following any such termination or expiration, including maintaining
confidentiality of information and records retention.
9.12 Force Majeure
Except with respect to the obligation of payments under this Contract, if either of the Parties,
after a good faith effort, is prevented from complying with any express or implied covenant of
this Contract by reason of war; terrorism; rebellion; riots; strikes; acts of God; any valid order,
rule, or regulation of governmental authority; or similar events that are beyond the control of the
affected Party (collectively referred to as a "Force Majeure"), then, while so prevented, the
affected Party's obligation to comply with such covenant will be suspended, and the affected
Party will not be liable for damages for failure to comply with such covenant. In any such event,
the Party claiming Force Majeure will promptly notify the other Party of the Force Majeure
event in writing and, if possible,such notice will set forth the extent and duration thereof
9.13 No Waiver of Provisions
Neither failure to enforce any provision of this Contract nor payment for services provided under
it constitute waiver of any provision of the Contract.
9.14 Publicity
Except as provided in the paragraph below, Grantee must not use the name of, or directly or
indirectly refer to, the System Agency, the State of Texas, or any other State agency in any
media release, public announcement, or public disclosure relating to the Contract or its subject
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matter, including in any promotional or marketing materials, customer lists, or business
presentations.
Grantee may publish, at its sole expense, results of Grantee performance under the Contract with
the System Agency's prior review and approval, which the System Agency may exercise at its
sole discretion. Any publication (written, visual,.or sound) will acknowledge the support
received from the System Agency and any Federal agency, as appropriate.
9.15 Prohibition on Non-compete Restrictions
Grantee will not require any employees or Subcontractors to agree to any conditions, such as
non-compete clauses or other contractual arrangements that would limit or restrict such persons
or entities from employment or contracting with the State of Texas.
9.16 No Waiver of Sovereign Immunity
Nothing in the Contract will be construed as a waiver of sovereign immunity by the System
Agency.
9.17 Entire Contract and Modification
The Contract constitutes the entire agreement of the Parties and is intended as a complete and
exclusive statement of the promises, representations, negotiations, discussions, and other
agreements that may have been made in connection with the subject matter hereof. Any
additional or conflicting terms in any future document incorporated into the Contract will be
harmonized with this Contract to the extent possible by the System Agency.
9.18 Counterparts
This Contract may be executed in any number of counterparts, each of which will be an original,
and all such counterparts will together constitute but one and the same Contract.
9.19 Proper Authority
Each Party hereto represents and warrants that the person executing this Contract on its behalf
has full power and authority to enter into this Contract. Any Services or Work performed by
Grantee before this Contract is effective or after it ceases to be effective are performed at the sole
risk of Grantee with respect to compensation.
9.20 Employment Verification
Grantee will confirm the eligibility of all persons employed during the contract term to perform
duties within Texas and all persons, including subcontractors, assigned by the contractor to
perform work pursuant to the Contract.
9.21 Civil Rights
a. Grantee agrees to comply with state and federal anti-discrimination laws, including:
1. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et seq.);
2. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794);
3. Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et seq.);
4. Age Discrimination Act of 1975 (42 U.S.C. §§6101-6107);
5. Title IX of the Education Amendments of 1972 (20 U.S.C. §§1681-1688);
6. Food and Nutrition Act of 2008 (7 U.S.C. §2011 et seq.); and
Grantee Uniform Terms and Conditions
Page 17 of 19
v.3.1.17
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591 EBB4D887
7. The System Agency's administrative rules, as set forth in the Texas Administrative Code,
to the extent applicable to this Agreement.
Grantee agrees to comply with all amendments to the above-referenced laws, and all
requirements imposed by the regulations issued pursuant to these laws. These laws provide in
part that no persons in the United States may, on the grounds of race, color, national origin,
sex, age, disability, political beliefs, or religion, be excluded from participation in or denied
any aid, care, service or other benefits provided by Federal or State funding, or otherwise be
subjected to discrimination.
b. Grantee agrees to comply with Title VI of the Civil Rights Act of 1964, and its implementing
regulations at 45 C.F.R. Part 80 or 7 C.F.R. Part 15, prohibiting a contractor from adopting
and implementing policies and procedures that exclude or have the effect of excluding or
limiting the participation of clients in its programs, benefits, or activities on the basis of
national origin. State and federal civil rights laws require contractors to provide alternative
methods for ensuring access to services for applicants and recipients who cannot express
themselves fluently in English. Grantee agrees to take reasonable steps to provide services
and information, both orally and in writing, in appropriate languages other than English, in
order to ensure that persons with limited English proficiency are effectively informed and
can have meaningful access to programs,benefits, and activities.
c. Grantee agrees to post applicable civil rights posters in areas open to the public informing
clients of their civil rights and including contact information for the HHS Civil Rights Office.
The posters are available on the HHS website at: http://hhscx.hhsc.texas.gov/system-support-
services/civil-rights/publications
d. Grantee agrees to comply with Executive Order 13279, and its implementing regulations at
45 C.F.R. Part 87 or 7 C.F.R. Part 16. These provide in part that any organization that
participates in programs funded by direct financial assistance from the United States
Department of Agriculture or the United States Department of Health and Human Services
shall not discriminate against a program beneficiary or prospective program beneficiary on
the basis of religion or religious belief.
e. Upon request, Grantee will provide HHSC Civil Rights Office with copies of all of the
Grantee's civil rights policies and procedures.
f. Grantee must notify HHSC's Civil Rights Office of any civil rights complaints received
relating to its performance under this Agreement. This notice must be delivered no more than
ten (10) calendar days after receipt of a complaint. Notice provided pursuant to this section
must be directed to:
HHSC Civil Rights Office
701 W. 51st Street,Mail Code W206
Austin,Texas 78751
Phone Toll Free: (888)388-6332
Phone: (512)438-4313
Grantee Uniform Terms and Conditions
Page 18 of 19
v.3.1.17
DocuSign Envelope ID:19E35B26-7287-4C76-88E3-3591 EBB4D887
TTY Toll Free: (877)432-7232
Fax: (512)438-5885.
Grantee Uniform Terms and Conditions
Page 19of19
v.3.1.17
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SUPPLEMENTAL & SPECIAL CONDITIONS
SUPPLEMENTAL CONDITIONS
There are no supplemental condition for this contract that modify the HHS Uniform Terms and Conditions.
SPECIAL CONDITIONS
Section 1.01 Notice of Legal Matter or Litigation.
Grantee shall notify the contract manager assigned to this Contract of any litigation or legal matter related to or
affecting this Contract within seven calendar days of becoming aware of the litigation or legal matter.
Section 1.02 Notice of a Contract Action.
Grantee shall notify their assigned contract manager assigned to the contract if Grantee has had any contract
suspended or terminated for cause by any local,state or federal department or agency or nonprofit entity within
five days of becoming aware of the action and include the following:
a. Reason for such action;
b. Name and contact information of the local,state or federal department or agency or entity;
c. Date of the contract;
d. Date of suspension or termination; and
e. Contract or case reference number.
Section 1.03 Notice of Bankruptcy.
Grantee shall notify in writing their assigned contract manager assigned of its plan to seek bankruptcy
protection within five days of such action by Grantee.
Section 1.04 Notice of Criminal Activity and Disciplinary Actions.
a. Grantee shall immediately report in writing their contract manager when the Grantee has knowledge or
reason to believe any that they or any person with ownership or controlling interest in the
organization/business,or their agent,employee,subcontractor or volunteer that is providing services
under this Contract has engaged in any activity that:
1. Would constitute a criminal offense equal to or greater than a Class A misdemeanor;and
2. Reasonably would constitute grounds for disciplinary action by a state or federal regulatory
authority; or
3. Has been placed on community supervision,received deferred adjudication,or been
indicted for or convicted of a criminal offense relating to involvement in any financial
matter,federal or state program or felony sex crime.
b. Grantee shall not permit any person who engaged, or was alleged to have engaged,in any
activity subject to reporting under this section to perform direct client services or have direct
contact with clients,unless otherwise directed in writing by DSHS.
Section 1.05 Grantee's Notification of Change of Contact Person or Key Personnel.
Within ten days shall notify in writing the contract manager assigned to the Contract of any change enumerated
in the Grantee's Contact Person or Key Personnel.
Section 1.06 Services and Information for Persons with Limited English Proficiency.
a. Grantee shall take reasonable steps to provide services and information both orally and in writing,in
appropriate languages other than English,to ensure that persons with limited English proficiency are
effectively informed and can have meaningful access to programs,benefits and activities.
b. Grantee shall identify and document on the client records the primary language/dialect of a client who
has limited English proficiency and the need for translation or interpretation services and shall not
v. 03.10.2016 Page 1
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591EBB4D8 7ix 1 IACHIVIENT D
SUPPLEMENTAL & SPECIAL CONDITIONS
require a client to provide or pay for the services of a translator or interpreter.
c. Grantee shall make every effort to avoid use of any persons under the age of 18 or any family member
or friend of the client as an interpreter for essential communications with a client with limited English
proficiency unless the client has requested that person and using the person would not compromise the
effectiveness of services or violate the client's confidentiality and the client is advised that a free
interpreter is available.
Section 1.07 HIV/AIDS Model Workplace Guidelines.
Grantee shall implement Department's policies based on the Human Immunodeficiency Virus/Acquired
Immunodeficiency Syndrome(HIV/AIDS),AIDS Model Workplace Guidelines for Businesses at
http://www.dshs.state.tx.us/hivstd/policy/policies.shtm, State Agencies and State Grantees Policy No. 090.021.
Grantee shall also educate employees and clients concerning HIV and its related conditions,including AIDS,in
accordance with the Texas.Health&Safety Code§§ 85.112-114.
Section 1.08 Electronic and Information Resources Accessibility and Security Standards.
a. Applicability.
The following Electronic and Information Resources (EIR)requirements apply to the Contract because
the Grantee performs services that include EIR that DSHS employees are required or permitted to access
or members of the public are required or permitted to access.
This Section does not apply to incidental uses of EIR in the performance of the Agreement,unless the
Parties agree that the EIR will become property of the State of Texas or will be used by HHSC's clients
or recipients after completion of the Agreement.
Nothing in this section is intended to prescribe the use of particular designs or technologies or to prevent
the use of alternative technologies,provided they result in substantially equivalent or greater access to •
and use of a Product.
b. Definitions.
For purposes of this Section:
"Accessibility Standards"means accessibility standards and specifications for Texas agency and
institution of higher education websites and EIR set forth in 1 TAC Chapter 206 and/or Chapter 213.
"Electronic and Information Resources"means information resources,including information resources
technologies,and any equipment or interconnected system of equipment that is used in the creation,
conversion, duplication,or delivery of data or information. The term includes telephones and other
telecommunications products,information kiosks,transaction machines,Internet websites,multimedia
resources, and office equipment,including copy machines and fax machines.
"Electronic and Information Resources Accessibility Standards"means the accessibility standards for
electronic and information resources contained in 1 Texas Administrative Code Chapter 213.
"Product"means information resources technology that is, or is related to EIR.
"Web Site Accessibility Standards/Specifications"means standards contained in Volume 1 Tex.Admin.
Code Chapter 206(c)Accessibility Requirements.
Under Tex. Gov't Code Chapter 2054, Subchapter M,and implementing rules of the Texas Department of
v. 03.10.2016 Page 2
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591EBB4D887
iACIIMENT D •
SUPPLEMENTAL & SPECIAL CONDITIONS
Information Resources,DSHS must procure Products and services that comply with the Accessibility
Standards when those Products are available in the commercial marketplace or when those Products are
developed in response to a procurement solicitation.Accordingly, Grantee must provide electronic and
information resources and associated Product documentation and technical support that comply with the
Accessibility Standards.
c. Evaluation,Testing,and Monitoring.
1. DSHS may review,test,evaluateand monitor Grantee's.Products and services,as well as
associated documentation and technical support for compliance with the Accessibility Standards.
Review,testing, evaluation and monitoring may be conducted before and after the award of a
contract.Testing and monitoring may include user acceptance testing.
Neither the review,testing(including acceptance testing),evaluation or monitoring of any Product
or service,nor the absence of review,testing,evaluation or monitoring,will result in a waiver of the
State's right to contest the Grantee's assertion of compliance with the Accessibility Standards.
2. Grantee agrees to cooperate fully and provide DSHS and its representatives timely access to
Products, records, and other items and information needed to conduct such review, evaluation,
testing, and monitoring.
d. Representations and Warranties.
1. Grantee represents and warrants that:
•
i. As of the Effective Date of the Contract,the Products and associated documentation and
technical support comply with the Accessibility Standards as they exist at the time of entering
the Agreement,unless and to the extent the Parties otherwise expressly agree in writing;and
ii. If the Products will be in the custody of the state or a DSHS client or recipient after the Contract
expiration or termination,the Products will continue to comply with Accessibility Standards
after the expiration or termination of the Contract Term,unless DSHS or its clients or recipients,
as applicable,use the Products in a manner that renders it.noncompliant.
2. In the event Grantee becomes aware,or is notified that the Product or service and associated.
documentation and technical support do not comply with the Accessibility Standards, Grantee
represents and warrants that it will,in a timely manner and at no cost to DSHS,perform all
necessary steps to satisfy the Accessibility Standards,including remediation,replacement,and
upgrading of the Product or service,or providing a suitable substitute.
3. Grantee acknowledges and agrees that these representations and warranties are essential
inducements on which DSHS relies in awarding this Contract.
4. Grantee's representations and warranties under this subsection will survive thetermination or
expiration of the Contract and will remain in full force and effect throughout the useful life of the
Product.
e. Remedies.
1. Under Tex. Gov't Code§ 2054.465,neither the Grantee nor any other person has cause of action
against DSHS for a claim of a failure to comply with Tex.Gov't Code Chapter 2054, Subchapter M,
and rules of the Department of Information Resources.
2. In the event of a breach of Grantee's representations and warranties,Grantee will be liable for
direct,consequential,indirect,special,or liquidated damages and any other remedies to which
DSHS may be entitled under this Contract and other applicable law. This remedy is cumulative of
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DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591 EBB4D887i 1 1 ACHMENT D
SUPPLEMENTAL & SPECIAL CONDITIONS
any other remedies to which DSHS may be entitled under this Contract and other applicable law.
•
v. 03.10.2016 Page 4
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591EBB4D887
OMB Number:4040-0007 •
Expiration Date:01/31/2019
ASSURANCES -NON-CONSTRUCTION PROGRAMS
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing
instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of
information.Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions.for
reducing this burden,to the Office of Management and Budget, Paperwork Reduction Project(0348-0040),Washington, DC 20503.
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND
IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
•
NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions,please contact the
awarding agency.Further,certain Federal awarding agencies may require applicants to certify to additional assurances.
If such is the case,you will be notified.
As the duly authorized representative of the applicant, I certify that the applicant:
1. Has the legal authority to apply for Federal assistance Act of 1973,as amended(29 U.S.C.§794),which
and the institutional,managerial and financial capability prohibits discrimination on the basis of handicaps; (d)
(including funds sufficient to pay the non-Federal share the Age Discrimination Act of 1975,as amended(42 U.
of project cost)to ensure proper planning, management S.C.§§6101-6107),which prohibits discrimination on
and completion of the project described in this the basis of age;(e)the Drug Abuse Office and
application. Treatment Act of 1972(P.L.92-255),as amended,.
relating to nondiscrimination on the basis of drug
2. Will give the awarding agency,the Comptroller General abuse;(f)the Comprehensive Alcohol Abuse and
of the United States and,if appropriate,the State, Alcoholism Prevention,Treatment and Rehabilitation
through any authorized representative,access to and Act of 1970(P.L:91-616),as amended, relating to
the right to examine all records,books, papers,or nondiscrimination on the basis of alcohol abuse or
documents related to the award;and will establish a alcoholism; (g)§§523 and 527 of the Public Health -
proper accounting system in accordance with generally Service Act of 1912(42 U.S.C.§§290 dd-3 and 290
accepted accounting standards or agency directives. ee-3),as amended,relating to confidentiality of alcohol
and drug abuse patient records; (h)Title VIII of the Civil
3. Will establish safeguards to prohibit employees from Rights Act of 1968(42 U.S.C.§§3601 et seq.),as
using their positions for a purpose that constitutes or amended, relating to nondiscrimination in the sale,
presents the appearance of personal or organizational rental or financing of housing;(i)any other
conflict of interest,or personal gain. nondiscrimination provisions in the specific statute(s)
under which application for Federal assistance is being
4. Will initiate and complete the work within the applicable made;and, (j)the requirements of any other
time frame after receipt of approval of the awarding nondiscrimination statute(s)which may apply to the
agency. -
application.
5. Will comply with the Intergovernmental Personnel Act of 7. Will comply,or has already complied,with the
1970(42 U.S.C.§§4728-4763)relating to prescribed requirements of Titles II and III of the Uniform
standards for merit systems for programs funded under Relocation Assistance and Real Property Acquisition
one of the 19 statutes or regulations specified in Policies Act of 1970(P.L.91-646)which provide for
Appendixfair and equitable treatment of persons displaced or
A of OPM's Standards for a Merit System of
whose property is acquired as a result of Federal or
Personnel Administration(5 C.F.R.900,Subpart F). federally-assisted programs.These requirements
apply to all interests in real property acquired for
6. Will comply with all Federal statutes relating to
project purposes regardless of Federal participation in
nondiscrimination.These include but are not limited to: purchases.
(a)Title VI of the Civil Rights Act of 1964(P.L.88-352)
which prohibits discrimination on the basis of race,color 8. Will comply,as applicable,with provisions of the
or national origin;(b)Title IX of the Education Hatch Act(5 U.S.C.§§1501-1508 and 7324-7328)
Amendments of 1972,as amended(20 U.S.C.§§1681- which limit the political activities of employees whose
1683, and 1685-1686),which prohibits discrimination on principal employment activities are funded in whole
the basis of sex;(c)Section 504 of the Rehabilitation or in part with Federal funds.
Previous Edition Usable Standard Form 424B(Rev.7-97)
Authorized for Local Reproduction Prescribed by OMB Circular A-102
DocuSign Envelope ID: 19E35B26-72B7-4C76-88E3-3591 EBB4D887
9. Will comply,as applicable,with the provisions of the Davis- 13. Will assist the awarding agency in assuring compliance
Bacon Act(40 U.S.C.§§276a to 276a-7),the Copeland Act with Section 106 of the National Historic Preservation
(40 U.S.C.§276c and 18 U.S.C.§874),and the Contract Act of 1966,as amended (16 U.S.C. §470), EO 11593
Work Hours and Safety Standards Act(40 U.S.C.§§327- (identification and protection of historic properties),and
333), regarding labor standards for federally-assisted the Archaeological and Historic Preservation Act of
construction subagreements. 1974(16 U.S.C.§§469a-1 et seq.).
10. Will comply, if applicable,with flood insurance purchase 14. Will comply with P.L.93-348 regarding the protection of
requirements of Section 102(a)of the Flood Disaster human subjects involved in research,development,and
Protection Act of 1973(P.L.93-234)which requires related activities supported by this award of assistance.
recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of 15• Will comply with the Laboratory Animal Welfare Act of
insurable construction and acquisition is$10,000 or more. 1966(P.L.89-544,as amended, 7 U.S.C. §§2131 et
seq.)pertaining to the care, handling,and treatment of
11. Will comply with environmental standards which may be warm blooded animals held for research,teaching,or
prescribed pursuant to the following: (a)institution of other activities supported by this award of assistance.
environmental quality control measures under the National
Environmental Policy Act of 1969(P.L.91-190)and 16. Will comply with the Lead Based Paint Poisoning
Executive Order(EO) 11514; (b)notification of violating Prevention Act(42 U.S.C.§§4801 et seq.)which
facilities pursuant to EO 11738;(c)protection of wetlands prohibits the use of lead-based paint in construction or
pursuant to EO 11990; (d)evaluation of flood hazards in rehabilitation of residence structures.
floodplains in accordance with EO 11988; (e)assurance of 17. Will cause to be performed the required financial and
project consistency with the approved State management compliance audits in accordance with the Single Audit
program developed under the Coastal Zone Management Act Amendments of 1996 and OMB Circular No.A-133,
Act of 1972(16 U.S.C.§§1451 et seq.);(f)conformity of "Audits of States, Local Governments, and Non-Profit
Federal actions to State(Clean Air)Implementation Plans Organizations."
under Section 176(c)of the Clean Air Act of 1955,as
amended(42 U.S.C.§§7401 et seq.); (g)protection of 18. Will comply with all applicable requirements of all other
underground sources of drinking water under the Safe Federal laws,executive orders, regulations, and policies
Drinking Water Act of 1974,as amended(P.L. 93-523); governing this program.
and, (h)protection of endangered species under the
Endangered Species Act of 1973, as amended(P.L.93- 19. Will comply with the requirements of Section 106(g)of
205). the Trafficking Victims Protection Act(TVPA)of 2000, as
amended (22 U.S.C.7104)which prohibits grant award
12. Will comply with the Wild and Scenic Rivers Act of recipients or a sub-recipient from(1)Engaging in severe
1968(16 U.S.C.§§1271 et seq.)related to protecting forms of trafficking in persons during the period of time
components or potential components of the national that the award is in effect(2)Procuring a commercial
wild and scenic rivers system. sex act during the period of time that the award is in
effect or(3)Using forced labor in the performance of the
award or subawards under the award.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
r—ooeuSigned by: Di rector of Public Health
`4F(9n977d7r Fd1Q
APPLICANT ORGANIZATION DATE SUBMITTED
(Corpus Christi-Nueces County Public Health Ei/14/1U1/ 110:0/ AM CDT
( Standard Form 4248(Rev.7-97)Back
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591EBB4D887
CERTIFICATION REGARDING LOBBYING
Certification for Contracts,Grants,Loans,and Cooperative Agreements
The undersigned certifies,to the best of his or her knowledge and belief,that:
(1)No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any
person for influencing or attempting to influence an officer or employee of an agency,a Member of
Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with
the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the
entering into of any cooperative agreement,and the extension,continuation,renewal,amendment,or
modification of any Federal contract,grant,loan,or cooperative agreement.
(2)If any funds other than Federal appropriated funds have been paid or will be paid to any person for
•
influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an
officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal
contract,grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard
Form-LLL,"Disclosure of Lobbying Activities,"in accordance with its instructions.
(3)The undersigned shall require that the language of this certification be included in the award documents
for all subawards at all tiers(including subcontracts,subgrants,and contracts under grants,loans,and
cooperative agreements)and that all subrecipients shall certify and disclose accordingly.This certification
is a material representation of fact upon which reliance was placed when this transaction was made or
entered into.Submission of this certification is a prerequisite for making or entering into this transaction
imposed by section 1352,title 31,U.S.Code.Any person who fails to file the required certification shall be
subject to a civil penalty of not less than$10,000 and not more than$100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance
The undersigned states,to the best of his or her knowledge and belief,that:
If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer
or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of
a Member of Congress in connection with this commitment providing for the United States to insure or
guarantee a loan,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying
Activities,"in accordance with its instructions.Submission of this statement is a prerequisite for making or
entering into this transaction imposed by section 1352,title 31,U.S.Code.Any person who fails to file the
required statement shall be subject to a civil penalty of not less than$10,000 and not more than$100,000
for each such failure.
*APPLICANT'S ORGANIZATION
corpus christi-Nueces County Public Health
*PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: *First Name: Annette Middle Name:
*Last Name: Rodriguez Suffix:
*Title: Di rector of Publ i c Health
*SIGNATURE: oocuSigned by: *DATE: 8/14/2017 1 10:07 AM CDT
1/41
4FC89821425€444
DocuSign Envelope ID: 19E35B26-7287-4C76-88E3-3591EBB4D887
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
The certifications enumerated below represent material facts upon which DSHS relies when reporting
information to the federal government required under federal law. If the Department later determines
that the Contractor knowingly rendered an erroneous certification, DSHS may pursue all available
remedies in accordance with Texas and U.S. law. Signor further agrees that it will provide immediate
written notice to DSHS if at any time Signor learns that any of the certifications provided for below were
erroneous when submitted or have since become erroneous by reason of changed circumstances. If the
Signor cannot certify all of the statements contained in this section, Signor must provide written
notice to DSHS detailing which of the below statements it cannot certify and why.
Legal Name of Contractor: FFATA Contact#1 Name, Email and Phone Number:
Corpus Christi-Nueces County Public Health Constance Sanchez, Constancep@cctexas.com,
361-826-3227
Primary Address of Contractor: FFATA Contact#2 Name, Email and Phone Number:
1702 Horne Rd, Corpus Christi , Tx Blandina Costley, BlandinaC@cctexas.com,
361-826-7252
ZIP Code:9-digits Required www.usps.com DUNS Number:9-digits Required www.sam.gov
78416-1902 - 065457786 1
State of Texas Comptroller Vendor Identification Number(VIN) 14 Digits
746)00574-1027
Printed Name of Authorized Representative Signature of Authorized Representative
1-DocuSigned by:
Annette Rodriguez AAAe,I.e Fo,tr;Tiez.
'-4FC9D92742CF414
Title of Authorized Representative Date
Director of Public Health
8/14/2017 1 10:07 AM CDT
- 1-
Department of State Health Services Form 4734—June 2013
DocuSign Envelope ID:19E35B26-72B7-4C76-88E3-3591 EBB4D887
Fiscal Federal Funding Accountability and Transparency Act
(FFATA) CERTIFICATION
As the duly authorized representative(Signor)of the Contractor, I hereby certify that
the statements made by me in this certification form are true, complete and correct to
the best of my knowledge.
Did your organization have a gross income, from all sources, of less than $300,000 in
your previous tax year?❑Yes xn No
If your answer is "Yes",skip questions "A", "B", and "C" and finish the certification.
If your answer is "No", answer questions "A" and "B".
A. Certification Regarding%of Annual Gross from Federal Awards.
Did your organization receive 80% or more of its annual gross revenue from federal
awards during the preceding fiscal year? n Yes n No
B. Certification Regarding Amount of Annual Gross from Federal Awards.
Did your organization receive $25 million or more in annual gross revenues from federal
awards in the preceding fiscal year? ❑Yes n No
If your answer is "Yes"to both question "A" and "B",you must answer question "C".
If your answer is "No" to either question "A" or "B", skip question "C" and finish the
certification.
C. Certification Regarding Public Access to Compensation Information.
Does the public have access to information about the compensation of the senior
executives in your business or organization (including parent organization, all branches,
and all affiliates worldwide) through periodic reports filed under section 13(a) or 15(d)
of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of the
Internal Revenue Code of 1986? n Yes n No
If your answer is"Yes"to this question,where can this information be accessed?
City Of Corpus Christi-City Secretary
If your answer is "No" to this question, you must provide the names and total
compensation of the top five highly compensated officers below.
Provide compensation information here:
-2-
Department of State Health Services Form 4734—June 2013
Docu ;
i SECURED
Certificate Of Completion
Envelope Id: 19E3562672B74C7688E33591 EBB4D887 Status:Completed
Subject:$241,637;537-18-0077-00001;Corpus Christi-Nueces Co Public Health Dist(City);DCP IMM LocalsCounter
Source Envelope:
Document Pages:55 Signatures:5 Envelope Originator:
Supplemental Document Pages:0 Initials:0 Cathy Hartman
Certificate Pages:3
AutoNav:Enabled Payments:0 1860 Michael Faraday Dr
Envelopeld Stamping:Enabled Reston,VA 20190
Time Zone:(UTC-06:00)Central Time(US& cathy.hartman2@hhsc.state.tx.us
Canada) IP Address: 167.137.1.16
Record Tracking
Status:Original Holder:Cathy Hartman Location:DocuSign
4/25/2017 I 2:03 PM cathy.hartman2@hhsc.state.tx.us
Signer Events Signature Timestamp
Rosalyn Lazare-Payne Completed Sent:4/25/2017 1 2:28 PM
rosalyn.lazare-payne@hhsc.state.tx.us Resent:4/26/2017 I 3:28 PM
Texas Health and Human Services Commission Viewed:4/27/2017 I 8:07 AM
Security Level:Email,Account Authentication Using IP Address: 167.137.1.13 Signed:4/27/2017 I 8:11 AM
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Joe James Completed Sent:4/27/2017 1 8:11 AM
joe.james@hhsc.state.tx.us Viewed:5/8/2017 1 10:48 AM
Texas Health and Human Services Commission Signed:518/2017 I 10:50 AM
Security Level:Email,Account Authentication Using IP Address: 167.137.1.16
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Patty Melchior Completed Sent:5/8/2017 I 10:50 AM
Patty.Melchior@dshs.state.tx.us Viewed:5/8/2017 111:12 AM
Resource Director Signed:5/8/2017 111:12 AM
Department State Health Services Using IP Address: 160.42.85.9
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Annette Rodriguez ,-DocuSignetlby Sent:5/8/2017 111:12 AM
annetter@cctexas.com AAAC4k P0414 TeZ. Resent:7/31/2017 11:36 PM
4FC9D92742CE414
Health Director Viewed:5/24/2017 I 11:43 AM
Security Level:Email,Account Authentication Signed:8/14/2017 110:07 AM
(None) Using IP Address:64.201.138.24
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Bernie Rodriguez Completed Sent:8/14/2017 1 10:07 AM
bernie.rodriguez@hhsc.state.tx.us Viewed:8/15/2017 I 8:29 AM
Procurement Manager Signed:8/15/2017 1 8:29 AM
Texas Health and Human Services Commission Using IP Address: 167.137.1.15
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signer Events Signature Timestamp
Janna Zumbrun —DocuS'gnedby Sent:8/15/2017 I 8:29 AM
Janna.Zumbrun@dshs.state.tx.us Cdr^"`a '" �^^ Viewed:8/15/2017 I 8:50 AM
Associate Commissioner for Disease Control and s-143030e5cc sn,e Signed:8/15/2017 I 8:50 AM
Prevention
Texas Health and Human Services Commission Using IP Address: 160.42.85.8
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Justin Davis COPIED Sent:4/25/2017 I 2:28 PM
justin.davis@dshs.state.tx.us
Department of State Health Services
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Amy Greene _ COPIED
Sent:4/25/2017 I 2:28 PM
amy.greene@hhsc.state.tx.us
Contract Specialist V
Texas Health and Human Services Commission
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tray Kirkpatrick COPIED Sent:4/27/2017 I 8:11 AM
tray.kirkpatrick@dshs.state.tx.us
Contract Manager
Texas Health and Human Services Commission
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Susana Garcia COPIED Sent:5/8/2017 110:50 AM
susana.garcia@dshs.state.tx.us
Unit Director
Texas Health and Human Services Commission
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Carbon Copy Events Status Timestamp
William M.Uhlarik Sent:5/8/2017 I 11:12 AM
williamU2@cctexas.com COPIED Viewed:8/15/2017 I 12:54 PM
Assistant Director of Public Health
Corpus Christi-Nueces County P.H.D.
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
DSHS CMU Inbox COPIED Sent:8/15/2017 18:50 AM
CMUContracts@dshs.texas.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 8/15/2017 1 8:50 AM
Certified Delivered Security Checked 8/15/2017 1 8:50 AM
Signing Complete Security Checked 8/15/2017 1 8:50 AM
Completed Security Checked 8/15/2017 1 8:50 AM
Payment Events Status Timestamps