HomeMy WebLinkAboutC2017-620 - 5/16/2017 - Approved SIGNATURE DOCUMENT FOR
DEPARTMENT OF STATE HEALTH SERVICES
CONTRACT No. 537-18-0147-00001
UNDER THE
PUBLIC HEALTH EMERGENCY PREPAREDNESS (PHEP) COOPERATIVE
AGREEMENT 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 Level 3 chemical laboratory surge capacity activities (the "Contract").
II. LEGAL AUTHORITY
This Contract is authorized by and in compliance with the provisions of Texas
Government Code Chapter 791 or 771, as applicable.
II. DURATION
The Contract is effective on July 1, 2017 and terminates on June 30, 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.
III. BUDGET
The total amount of this Contract will not exceed Two HUNDRED ONE THOUSAND ONE
HUNDRED TWENTY-THREE DOLLARS ($201,123.00). All expenditures under the
Contract will be in accordance with ATTACHMENT B,BUDGET.
IV. 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 W. 49TH Street, MC 1990
Austin Texas 78756
Attention: Deserie Burrell
Deserie.burrell@dshs.state.tx.us
C2017-620
5/16/17
Ord. 031141
;ystem Agency Contract No.537-18-0147-00001
Tx Dept of State Health Services Page 1 of 3
SrIANNFn
Grantee
Corpus Christi-Nueces County Public Health District(City)
1702 Horne Road
Corpus Christi, Texas 78416
Attention: Margie Rose
margier@cctexas.com
V. 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 Horne Road
Corpus Christi, Texas 78416
Attention: Margie Rose
margier@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.
VI. ADDITIONAL GRANT INFORMATION
Federal Award Identification Number(FAIN): To Be Determined
Federal Award Date: July 1, 2017
Name of Federal Awarding Agency: Centers for Disease Control and Prevention
CFDA Name and Number: Federal, 93.074
Awarding Official Contact Information: To Be Determined
DUNS: 069457786
In accordance with 2 CFR 200.331(A), if any of the above information is not available at
time of contract execution, then it will be provided to the Grantee by a Technical
Guidance Letter.
SIGNATURE PAGE FOLLOWS
System Agency Contract No.537-18-0147-00001
Page 2 of 3
v.02.01.2016
SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT No.537-18-0147-00001
DEPARTMENT OF STATE HEALTH SERVICES CORPUS CHRISTI-NUECES COUNTY
PUBLIC HEALTH DISTRICT(CITY)
DocuSigned by. e—DocuSigned by:
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David Gruber Name: Annette Rodriguez
Associate Commissioner Title: Director of Public Health
Date of execution: 4/19/2017 5:17:06 PM CD of execution: 4/18/2017 11:20:47 AM CDT
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT No. 537-18-0147-
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 ,,
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REBECCA HUERTA
CITY SECRETARY
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DocuSign Envelope ID C344C4B8-26E6-4DF8-ABEO-D5ADF793B58B
SIGNATURE PAGE FOR SYSTEM AGENCY CONTRACT No.537-18-0147-00001
DEPARTMENT OF STATE HEALTH SERVICES CORPUS CHRISTI-NUECES COUNTY
PUBLIC HEALTH DISTRICT(CITY)
David Gruber Name:
Associate Commissioner Title:
Date of execution: Date of execution:
THE FOLLOWING ATTACHMENTS TO SYSTEM AGENCY CONTRACT No. 537-18-0147-
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
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ATTACHMENT A
STATEMENT OF WORK
L GRANTEE RESPONSIBILITIES
Grantee will:
A. Perform activities in support of the Public Health Emergency Preparedness Cooperative
Agreement and the Office of the Assistant Secretary for Preparedness and Response
(OASPR)from the Centers for Disease Control and Prevention(CDC).Activities include but
are not limited to: continuing Level 3 chemical laboratory surge capacity activities;
complying with new Laboratory Readiness Network (LRN) requirements for biological
laboratories; coordinating with cross-cutting public health preparedness partners, and
analyzing real-time clinical specimens. CDC's five-year Public Health Emergency
Preparedness(PHEP)—Hospital Preparedness Program(HPP)Cooperative Agreement seeks
to align PHEP and HPP programs and advance public health and healthcare preparedness and
ensure jurisdictions are capable of providing a standard battery of tests for high priority
biological threats and emerging infectious diseases.
B. Perform activities in the following counties (hereinafter referred to as the "service area"):
San Patricio County,Nueces County,Aransas County,Jim Wells County,Kleberg County,
Victoria County, Bee County, Calhoun County, Goliad County, Jackson County, Live Oak
County, and Refugio County.
C. Comply with new biological laboratory requirements in accordance with the revised CDC
policy for LRN-B Reference Level Laboratories.Laboratories must attain and maintain LRN-
B Member Standard Level as detailed in the LRN Checklist of Laboratory Requirements.
Minimum standards are required for testing capabilities,administrative activities,emerging
infectious disease preparedness, and instrumentation and equipment.
D. Provide matching funds for each fiscal year of this Contract not less than ten percent(10%)
of the allocation amount for each fiscal year. Cash match is defined as an expenditure of
cash by the Grantee on allowable costs of this Contract that are borne by the Grantee.In-kind
match is defined as the dollar value of non-cash contributions by a third party given in goods,
commodities, or services that are used in activities that benefit this Contract's project and
that are contributed by non-federal third parties without charge to the Grantee. The criteria
for match must:
1. Be an allowable cost under the applicable federal cost principle;
2. Be necessary and reasonable for the efficient accomplishment of project or program
objectives;
3. Be verifiable within the Grantee's (or subcontractor's) records;
4. Be documented,including methods and sources,in the approved budget(applies only
to cost reimbursement Contracts);
5. Not be included as contributions toward any other federally-assisted project or
program(match can count only once per fiscal year);
6. Not be paid by the Federal Government under another award, except where
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT A
STATEMENT OF WORK
authorized by Federal statute to be used for cost sharing or match;
7. Conform to other provisions of governing circulars/statutes/regulations as applicable
for the Contract;
8. Be adequately documented;
9. Must follow procedures for generally accepted accounting practices as well as meet
audit requirements; and
10. Value the in-kind contributions reported and must be supported by documentation
reflecting the use of goods and/or services during the Contract term.
Grantee must match funds awarded for this Contract by costs or third party contributions that
are not paid by the Federal Government under another award, except where authorized by
Federal statute to be used for cost sharing or matching. The non-federal contributions
(match) may be provided directly or through donations from public or private entities and
may be in cash or in-kind donations,fairly evaluated,including plant,equipment,or services.
The costs that the Grantee incurs in fulfilling the matching or cost-sharing requirement are
subject to the same requirements,including the cost principles,that are applicable to the use
of Federal funds,including prior approval requirements and other rules for allowable costs as
described in 45 CFR 74.23 and 92.24.
E. Notify System Agency in advance of Grantee's plans to participate in or conduct local
exercises, in a format specified by System Agency. Grantee will participate in statewide
exercises planned by System Agency as needed to assess the capacity of Grantee to respond
to bioterrorism, other outbreaks of infectious disease, and other public health threats and
emergencies. Grantee will prepare after-action reports, documenting and correcting any
identified gaps or weaknesses in preparedness plans identified during exercise, in a form
specified by System Agency.
F. Cooperate with System Agency to coordinate all planning,training and exercises performed
under this Contract with the Governor's Division of Emergency Management of the State of
Texas, or other points of contact at the discretion of the division, to ensure consistency and
coordination of requirements at the local level and eliminate duplication of effort between the
various domestic preparedness funding sources in the state.
G. In the event of a public health emergency involving a portion of the state, Grantee will
mobilize and dispatch staff or equipment purchased with funds from the previous PHEP
cooperative agreement and that are not performing critical duties in the jurisdiction served to
the affected area of the state upon receipt of a written request from System Agency.
H. Develop, implement and maintain a timekeeping system for accurately documenting staff
time and salary expenditures for all staff funded through this Contract,including partial full-
time employees and temporary staff.
I. Maintain a confirmatory bioterrorism testing laboratory with a staff trained and proficient
in CDC's LRN biothreat protocols.
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT A
STATEMENT OF WORK
J. Train other Grantee laboratory staff in setting up and performing all diagnostic and reference
testing for select biological agents;
K. Provide test samples from identified service area for biothreat agents and toxins. Once
biological agent is identified,Grantee will be prepared to test for other infectious agents and
for other public health threats and emergencies;
L. Test food samples for select biological agents using conventional and advanced
bacteriological techniques and CDC-LRN protocols;
M. Monitor and evaluate biothreat incidents, outbreaks of infectious disease and other public
health threats and emergencies;
N. Communicate with all other laboratories within the designated service area;
O. Maintain extensive collaboration with local law enforcement,hazardous material and other
emergency responders.In addition,Grantee will prepare Standard Operating Procedures and
Standard Operating Guidelines(SOPS/SOG5)covering interaction with these agencies in the
event of an emergency or incident;
P. Maintain extensive collaboration with all hospitals located in the identified service area to
plan for response activities for biological threats. LRN service regions can be found here:
http://www.dshs.texas.gov/lab/eprLRN.shtm
Q. Review and approve all current preparedness SOPs/SOGs (copy of the titled, dated, and
initialed/signed review sheet) for use by the respective laboratories with quarterly reports;
R. Utilize System Agency's provided Public Health Laboratory Information Management
System (PHLIMS), or a LIMS that has been configured to be compatible with the CDC
Results Messenger(RM) reporting system, or CDC RM for reporting biothreat testing and
results. This reporting will include sample and laboratory data as well as the final report;
S. Prepare/provide current information during an incident about status on individual
samples, sample load/overload, personnel, reagent, equipment, and facilities;
T. Provide to System Agency a LRN surge capability plan within a timeline designated by
System Agency that details how the LRN laboratory will manage a surge in sample capacity.
The plan should include:work hours,instruments and equipment,personnel and staffing,and
identify essential lab service that must be maintained during an outbreak or emergency event.
U. Present laboratory-oriented training to hospitals and reference laboratories in the identified
service area on the LRN sentinel protocols to include packaging and shipping of both
biological and chemical samples according to published CDC protocols;
V. Maintain a system for safe specimen transport from local laboratories;
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT A
STATEMENT OF WORK
W. Explore the capabilities and needs of sentinel laboratories;
X. Inform System Agency of their plans, via e-mail or telephone, to meet updated LRN-B
program requirements for Standard reference level laboratories as outlined in the Funding
Opportunity Announcement FOA;
Y. Provide programmatic reports as directed by System Agency in a format specified by
System Agency. Grantee will provide System Agency other reports, including financial
reports, and any other reports that System Agency determines necessary to accomplish the
objectives of this contract and to monitor compliance;
Z. Submit an end-of-year performance report in a format specified by System Agency within an
established timeframe designated by System Agency;
AA. Report as requested by System Agency to satisfy information-sharing Requirements
set forth in Texas Government Code,Sections 421.071 and 421.072(b)and(c),as amended.
Grantee shall immediately notify System Agency in writing if Grantee is legally prohibited
from providing any reports required under this Contract.
BB. In the event of a local, state, or federal emergency the Grantee has the authority to
utilize approximately five percent(5%)of the Grantee's staff's time supporting this Contract
for response efforts. System Agency will reimburse Grantee up to five percent of this
Contract funded by CDC for personnel costs responding to an emergency event.Grantee will
maintain records to document the time spent on response efforts for auditing purposes.
Allowable activities also include participation of drills and exercises in the pre-event time
period. Grantee will notify the Assigned Contract Manager in writing when this provision is
implemented.
CC. For the purposes of this Contract, the Grantee may not use funds for fundraising
activities, lobbying, research, construction, major renovations and reimbursement of pre-
award costs, clinical care, purchase of vehicles of any kind, funding an award to another
party or provider who is ineligible, backfilling costs for staff or the purchase of incentive
items.
DD. Comply with all applicable federal and state laws,rules,and regulations including,but not
limited to, the following:
1. Public Law 107-188, Public Health Security and Bioterrorism Preparedness and
Response Act of 2002;
2. Public Law 113-05, Pandemic and All-Hazards Preparedness Reauthorization Act; and
3. Texas Health and Safety Code Chapter 81.
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT A
STATEMENT OF WORK
EE. Comply with the following documents and resources,which are incorporated by reference
and made a part of this Contract:
1. System Agency and CDC Public Health Emergency Preparedness Cooperative
Agreement;
2. Public Health Preparedness Capabilities: National Standards for State and Local
Planning, March 2011:
http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf;
3. Presidential Policy Directive 8/PPD-8, March 30, 2011:
http://www.hlswatch.com/wp-content/uploads/2011/04/PPD-8-Preparedness.pdf;
4. Homeland Security Exercise and Evaluation Plan(HSEEP)Documents:
https://www.preptoolkit.org/web/hseep-resources
5. Ready or Not? Have a Plan; Surviving Disaster: How Texans Prepare(videos):
http://www.texasprepares.org/survivingdisaster.htm;
6. Preparedness Program Guidance(s) as provided by System Agency and CDC; and
7. FY2017 Office of the Assistant Secretary for Preparedness and Response
(OASPR) Hospital Preparedness Program—CFDA Number 93.074
http://www.phe.gov/preparedness/planning/hpp/pages/default.aspx.
IL PERFORMANCE MEASURES
A. System Agency will monitor the Grantee's compliance with the requirements in this Contract
and failure to meet these requirements may result in withholding a portion of the current
PHEP base awards.
B. Grantee must demonstrate adherence to reporting deadlines and the capability to receive,
stage, store, distribute and dispense materiel during a public health emergency. The initial
reporting requirement schedule for the requirements are subject to change as System Agency
and CDC may modify requirements and due dates. System Agency will send a requirements
schedule within thirty(30) days of the contract start date.
IILINVOICE AND PAYMENT
A. Grantee will request monthly payment using the Excel version of the State of Texas Purchase
Voucher(Form B-13)and Support Document including any acceptable additional supporting
documentation for reimbursement of the required services/deliverables. Additionally, the
Grantee will submit the Excel version of the Financial Status Report(FSR-269A). Vouchers,
supporting documentation and Financial Status Reports should be mailed or e-mailed to the
addresses below.
Claims Processing Unit, MC 1940
Texas Department of State Health Services
1100 West 49th Street
PO Box 149347
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT A
STATEMENT OF WORK
Austin, TX 78714-9347
B-13: invoices@dshs.state.tx.us and php.vouchersupport@dshs.state.tx.us
Support Document: invoices@dshs.state.tx.us and php.vouchersupport@dshs.state.tx.us
B-13A: invoices@dshs.state.tx.us and php.vouchersupport@dshs.state.tx.us
FSR: invoices@dshs.state.tx.us and php.vouchersupport@dshs.state.tx.us and
F SRGrants@dshs.state.tx.us
B. Grantee will be reimbursed on a monthly basis and in accordance with the Budget in
Attachment B of this Contract.
C. System Agency reserves the right,where allowed by legal authority,to redirect funds in the
event of financial shortfalls. System Agency will monitor Grantee's expenditures on a
quarterly basis. If expenditures are below that projected in Grantee's total Contract amount,
Grantee's budget may be subject to a decrease for the remainder of the Term of the Contract.
Vacant positions existing after ninety days may result in a decrease in funds.
D. Grantee may request a one-time working capital advance not to exceed 12% of the total
amount of the Contract funded by System Agency. All advances must be expended by the
end of the contract term. Advances not expended by the end of the contract term must be
refunded to System Agency.
Grantee will repay all or part of advance funds at any time during the Contract's term.
However, if the advance has not been repaid prior to the last three months of the Contract
term, the Grantee must deduct at least one-third of the remaining advance from each of
the last three months' reimbursement requests. If the advance is not repaid prior to the
last three months of the Contract term, System Agency will reduce the reimbursement
request by one-third of the remaining balance of the advance.
System Agency Contract No. 537-18-0147-00001
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ATTACHMENT B
BUDGET
Budget Categories FY18 Budget Summary
Personnel $96,660.00
Fringe Benefits $39,940.00
Travel $14,096.00
Equipment $0.00
Supplies $19,567.00
Contractual $0.00
Other $50,973.00
Sum of Direct Costs $221,236.00
Indirect Costs $0.00
Sum of Total Direct Costs and Indirect Costs $221,236.00
Less Match (Cash or In-Kind) $20,113.00
TOTAL $201,123.00
HHSC Uniform Terms and Conditions Version 2.13
Published and Effective:July 15, 2016
Responsible Office: Chief Counsel
11* TEXAS
Health and Human
Services Commission
Health and Human Services Commission
HHSC Uniform Terms and Conditions - Grant
Version 2.13
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 11
5.01 General Affirmations 11
5.02 Federal Assurances 11
5.03 Federal Certifications 11
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 12
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7.03 Response/compliance with audit or inspection findings 12
7.04 SAO Audit 12
7.05 Confidentiality 13
7.06 Public Information Act 13
ARTICLE VIII CONTRACT MANAGEMENT AND EARLY TERMINATION 13
8.01 Contract Management 13
8.02 Termination for Convenience 13
8.03 Termination for Cause 13
8.04 Equitable Settlement 14
ARTICLE IX MISCELLANEOUS PROVISIONS 14
9.01 Amendment 14
9.02 Insurance 14
9.03 Legal Obligations 14
9.04 Permitting and Licensure 14
9.05 Indemnity 15
9.06 Assignments 15
9.07 Relationship of the Parties 15
9.08 Technical Guidance Letters 16
9.09 Governing Law and Venue 16
9.11 Survivability 16
9.12 Force Majeure 17
9.13 No Waiver of Provisions 17
9.14 Publicity 17
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 18
9.20 Employment Verification 18
9.21 Civil Rights 18
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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 a work product prepared, developed, or procured by Grantee as part of the
Services under the Contract for the use or benefit of the System Agency or the State of Texas.
"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 Assistive and Rehabilitative 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.
"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
Grantee Uniform Terms and Conditions
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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" 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" 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.
3.03 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 the 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. For-profit Grantees whose expenditures meet or exceed
the federal or state expenditure thresholds stated above shall follow the guidelines in 2 CFR 200
or UGMS, as applicable, for their program-specific audits. The HHSC Office of Inspector
General (OIG) will notify Grantee to complete the Single Audit Status Registration Form. If
Grantee fails to complete the Single Audit Status Form within thirty (30) calendar days after
notification by OIG to do so, Grantee shall be subject to the System Agency sanctions and
remedies for non-compliance with this Contract. The audit must be conducted by an independent
certified public accountant and in accordance with applicable OMB Circulars, Government
Auditing Standards, and UGMS. 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
Within thirty (30) calendar days of receipt of the audit reports required by the Independent
Single or Program-Specific Audit section, Grantee shall submit one copy to the System Agency
as directed in this Contract. The Grantee will also submit a copy of the Independent Single or
Program-Specific Audit to the OIG, at the following address:
Health and Human Services Commission
Office of Inspector General
Compliance/Audit, Mail Code 1326
P.O. Box 85200
Austin, Texas 78708-5200
Electronic submission to OIG should be addressed as follows:
Dani.fielding@n,hhsc.state.tx.us
If Grantee fails to submit the audit report as required by the Independent Single or Program-
Specific Audit section within thirty (30) calendar days of receipt by Grantee of an audit report,
Grantee shall be subject to the System Agency sanctions and remedies for non-compliance with
this Contract.
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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.
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 or 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.
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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, which includes 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 their authorized
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
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.
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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;
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
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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 financially 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
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.
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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
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
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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
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.
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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
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.
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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. §§168 1-1 68 8);
6. Food and Nutrition Act of 2008 (7 U.S.C. §2011 et seq.); and
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://www.hhsc.state.tx.us/about hhsc/civil-rights/brochures-posters.shtml
Grantee Uniform Terms and Conditions
Page 18 of 19
v.06.03.16
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
TTY Toll Free: (877) 432-7232
Fax: (512) 438-5885.
Grantee Uniform Terms and Conditions
Page 19 of 19
v.06.03.16
ATTACHMENT D
SUPPLEMENTAL AND SPECIAL CONDITIONS
SUPPLEMENTAL CONDITIONS
THE FOLLOWING SUPPLEMENTAL CONDITIONS APPLY TO THIS
CONTRACT AND MODIFY THE HHS UNIFORM TERMS AND CONDITIONS:
A. Uniform Terms and Conditions, Records, Audit and Disclosure, ARTICLE VII, Section
7.02, is revised to include the following:
In addition to the site visits authorized by this Article of the Uniform Terms and Conditions,
Grantee will allow DSHS to conduct on-site quality assurance reviews of Grantee. Grantee
will comply with all DSHS documentation requests and on-site visits. Grantee will make
available for review all documents related to the Contract, upon request by the DSHS
Program staff.
B. The following sections of these Uniform Terms and Conditions will not apply to interagency
or interlocal contracts:
i. Debt to State and Corporate Status, Section 2.04;
ii. Application of Payment Due, Section 2.05;
iii. Insurance, Section 9.02; and
iv. Indemnity, Section 9.05.
SPECIAL CONDITIONS
SECTION 1.01 NOTICE OF CONTRACT ACTION
Grantee shall notify their assigned contract manager 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 1.02 NOTICE OF BANKRUPTCY
Grantee shall notify in writing its assigned contract manager of its plan to seek bankruptcy
protection within five days of such action by Grantee.
v. 11.15.2016 Page 1
ATTACHMENT D
SUPPLEMENTAL AND SPECIAL CONDITIONS
SECTION 1.03 NOTICE OF CRIMINAL ACTIVITY AND DISCIPLINARY ACTIONS
a. Grantee shall immediately report in writing to their contract manager when Grantee
has knowledge or any reason to believe that they or any person with ownership or
controlling interest in the organization/business, or their agent, employee, contractor or
volunteer that is providing services under this Contract has:
1. Engaged in any activity that could constitute a criminal offense equal to or greater
than a Class A misdemeanor or grounds for disciplinary action by a state or federal
regulatory authority; or
2. 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 the System
Agency.
SECTION 1.04 GRANTEE'S NOTIFICATION OF CHANGE OF CONTACT PERSON OR KEY
PERSONNEL
The Grantee shall notify in writing their contract manager assigned within ten days of any
change to the Grantee's Contact Person or Key Personnel.
SECTION 1.05 DISASTER SERVICES
In the event of a local, state, or federal emergency, including natural, man- made, criminal,
terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal
disaster by the appropriate federal official, Grantee may be called upon to assist the System
Agency in providing the following services:
a. Community evacuation;
b. Health and medical assistance;
c. Assessment of health and medical needs;
d. Health surveillance;
e. Medical care personnel;
f. Health and medical equipment and supplies;
g. Patient evacuation;
h. In-hospital care and hospital facility status;
i. Food, drug and medical device safety;
j. Worker health and safety;
k. Mental health and substance abuse;
1. Public health information;
m. Vector control and veterinary services; and
n. Victim identification and mortuary services.
v. 11.15.2016 Page 2
ATTACHMENT D
SUPPLEMENTAL AND SPECIAL CONDITIONS
SECTION 1.06 INTERIM EXTENSION AMENDMENT
a. Prior to or on the expiration date of this Contract, the Parties agree that this Contract
can be extended as provided under this Section.
b. The System Agency shall provide written notice of interim extension amendment to
the Grantee under one of the following circumstances:
1. Continue provision of services in response to a disaster declared by the governor; or
2. To ensure that services are provided to clients without interruption.
c. The System Agency will provide written notice of the interim extension amendment
that specifies the reason for it and period of time for the extension.
d. Grantee will provide and invoice for services in the same manner that is stated in the
Contract.
e. An interim extension under Section (b)(1) above shall extend the term of the contract
not longer than 30 days after governor's disaster declaration is declared unless the
Parties agree to a shorter period of time.
f. An interim extension under Section (b)(2) above shall be a one-time extension for
a period of time determined by the System Agency.
Remainder of page is left blank.
v. 11.15.2016 Page 3
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 Dale Atchley, County Auditor
District (County) Dale.atchley@nuecesco.com
361-888-0556
Primary Address of Contractor: FFATA Contact#2 Name, Email and Phone Number:
1702 Horne Road Blandina Costley, accountant
Corpus Christi , TX 78416 Blandinac@cctexas.com
361-826-7252
ZIP Code: 9-digits Required www.usps.com DUNS Number: 9-digits Required www.sam.gov
78416-1902 - 78495C25
State of Texas Comptroller Vendor Identification Number (VIN) 14 Digits
746000585016
Printed Name of Authorized Representative Signature of Authorized Representative
DocuSigned by:
Annette Rodriguez AAA¢.€
\-703fAnA9F2814F3
Title of Authorized Representative Date
Director of Public Health
4/18/2017 1 11:20:47 AM CDT
- 1 -
Department of State Health Services Form 4734-June 2013
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 n 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? ❑ Yes x❑ 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 x❑ 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? ❑ Yes n No
If your answer is"Yes"to this question,where can this information be accessed?
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
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.
7.
5. Will comply with the Intergovernmental Personnel Act of 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
Relocation Assistance and Real Property Acquisition
standards for merit systems for programs funded under
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
Personnelwhose property is acquired as a result of Federal or
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
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
DocuSiigned by: Di rector of Public Health
LAM9)4e. t�JEL
/fl"21 iAl lAU}'JIt14J-
APPLICANT ORGANIZATION DATE SUBMITTED
'corpus Christi-Nueces County Public Health District (Col, SILU1/ 111:10:4/ AM CDT
Standard Form 424B(Rev.7-97)Back
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 District (County)
*PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE
Prefix: Mrs. *First Name: Annette Middle Name:
*Last Name: Rodriguez Suffix:
*Title: Health Di rector
*SIGNATURE: Docusigned by: *DATE: 4/18/2017 1 11:20:47 AM CDT
AMt44e rori.f,du
303DADAOF281AE3
Docu
■ SICURID
Certificate Of Completion
Envelope Id:C344C4B826E64DF8ABE0D5ADF793B58B Status:Completed
Subject:$201,123.00;CONTRACT NO.537-18-0147-00001;Corpus Christi-Nueces County PHD;CPS LRN-PHEP
Source Envelope:
Document Pages:52 Signatures:5 Envelope Originator:
Supplemental Document Pages:0 Initials:0 Josalyn Wilson
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& josalyn.wilson@hhsc.state.tx.us
Canada) IP Address: 167.137.1.15
Record Tracking
Status:Original Holder:Josalyn Wilson Location: DocuSign
2/9/2017 I 3:48 PM josalyn.wilson@hhsc.state.tx.us
Signer Events Signature Timestamp
Ayeola Williams Completed Sent:2/10/2017 111:07 AM
ayeola.williams@hhsc.state.tx.us Viewed:2/11/2017 1 3:37 PM
Staff Attorney,System Contracting Signed:2/11/2017 I 3:53 PM
HHSC Using IP Address: 160.42.85.9
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
Patty Melchior Completed Sent:2/11/2017 1 3:53 PM
Patty.Melchior@dshs.state.tx.us Viewed:2/13/2017 1 5:34 PM
Resource Director Signed:2/13/2017 1 5:34 PM
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
ID:
Annette Rodriguez DacuSipned by:
Elime44-e Sent:4/6/2017 I 9:21 AM
annetter@cctexas.com P"'t^yet Resent:4/10/2017 11:05 PM
Director of Public Health 703onoA9F2e14e3_ Viewed:4/18/2017 110:49 AM
Security Level:Email,Account Authentication Signed:4/18/2017 1 11:20 AM
(None) Using IP Address:64.201.138.67
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
Bernie Rodriguez Completed Sent:4/18/2017 I 11:20 AM
bernie.rodriguez@hhsc.state.tx.us Viewed:4/18/2017 I 1:42 PM
Procurement Manager Signed:4/18/2017 11:56 PM
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
ID:
Signer Events Signature Timestamp
David Gruber r—Ducusigned by Sent:4/18/2017 1 1:56 PM
david.gruber@dshs.texas.gov B � Viewed:4/19/2017 i 5:16 PM
Associate Commissioner for RLHS ‘`--e113A6B1CFEC4CE Signed:4/19/2017 1 5:17 PM
Texas Health and Human Services Commission
Security Level:Email,Account Authentication Using IP Address: 160.42.85.9
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
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
Deserie Burrell COPIED Sent:2/10/2017 1 11:07 AM
deserie.burrell@dshs.state.tx.us Viewed:4/20/2017 i 7:05 AM
Contract Manager
Texas Health and Human Services Commission
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
Justin Davis COPIED Sent:2/10/2017 1 11:07 AM
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
ID:
Amy Greene COPIED Sent:2/10/2017 1 11:07 AM
amy.greene@hhsc.state.tx.us Viewed:5/24/2017 1 2:11 PM
Contract Specialist V
Texas Health and Human Services Commission
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
Susana Garcia COPIED Sent:2/11/2017 1 3:53 PM
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
ID:
Carbon Copy Events Status Timestamp
William Uhlarik COPIED Sent:2/13/201715:34 PM
williamu2@cctexas.com Viewed:2/14/2017110:44 AM
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
ID:
DSHS CMU Inbox COPIED Sent:4/19/201715:17 PM
CMUContracts@dshs.texas.gov Viewed:4/20/201717:40 AM
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
ID:
Notary Events Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 4/19/201715:17 PM
Certified Delivered Security Checked 4/19/20171 5:17 PM
Signing Complete Security Checked 4/19/20171 5:17 PM
Completed Security Checked 4/19/20171 5:17 PM
Payment Events Status Timestamps