HomeMy WebLinkAbout2021-012106 NACCHO CWDRKittitas County
Review Form
Grants & Contract Agreement
Contract/G rant I nformation
Recommendation for Board of Health Review on
verification the contracting Agency is not suspended/Disbarred:
Today's Date
LtlL6/202L PA Camas Request #:h3 rqt
Fund/Department
116-Public Health Agenda Date:
Contract /Grant Agency: National Association of County and City Health Officials (NACCHO)
Period Begin Date: 11l05/2O2O Period End Date: 06/30/2022
Total Grant/contract Amount: NTE sg2,gg7.42total contract amount
G rant/Contract N u m ber:
o This contract is a passthrough with Central Washington Disability Resources (CWDR)through
National Association of County and City Health Officials (NACCHO) to perform emergency
preparedness planning activities for individuals with disabilities.
o Amendment adds 532,351.97 to contracted amount for a total of 582,997 .42, and
extends the end date ofthe contractto O6/3O/2022.
Contract/G ra nt Sum mary
Department Hea Director Datenature
Kittitas County Prosecutor, Auditor, and Board of Health Review and comment:
APPR ED AS TO ORM
v'L l
I
Signature of s Office
L,
Sign of ditor's Office Date
E Agency is not suspended/disbarred I Not Checked (reason)
Grant/Contract Review Page L
Total Amount NTE 582,997.42 State Funds S Federal Funds NTE $82,997.42
Percentage County Funds Matching Funds S CFDA# 93.42L
ln-Kind S
Explain
ls Equipment being purchased?Who owns equipment?
New Personnel being hired?Contact HR hiring - reporting requirements
Future impacts or liability to Kittitas County:
Financial lnformation
Budget lnformation
Budget Amendment Needed?Yes I attach budget form No E why not
New Division Created?
Revenue Code 116.611.8L.333.93.421 (Assessment)
Pass Through lnformation
Agency to Pass Through Central Washington Disability Resources
Amount to Pass Through $82,992.+Z rutr Expense Code: LI6.61,t.8L5.4:-22
Sub-Contract Approved Date
Prosecutor Review
Has the Prosecutor reviewed this agreement?Yes Zl-No
County Departments lm acted
BOCC A I Needed?
Assignment of Tra lnformation
Auditor Facilities Maintenance
lnformation Services Human Resource
Prosecutor Treasurer
Yes !No fl
Staff Member Presenting:
Auditor's Office
Human Resource
Prosecutor's Office v -ft?:1.t .l-- '-tr4 H",*vu,
Who Signed the grant application
Reviewer Date
Grant/Contract Review Page 2
Modifi cation I to Contrac t #202 I -0 t2106
Modifi cation of Agreement
This Modification of Agreement ('Modification") is entered into, effective as of the date of thelater signature indicated below, by and between the National Association of County and City
fI-eflth offtcials (hereinafter referred to as "NAcCHo"), with its principal place ofiusiness at1201 0) Eye Street Nw 4th Fl., Washington, DC zooos, ani the'foliowing Contractor,hereinafter referred to as .oContractor:',
Kittitas County 9l-6001349
Contractor Federal Tax ID Number
507 N Nanum St. Suite 102
Address
wA98926 (s09)962-7sts
City, State and,Zip Phone
WHEREAS, the parties entered into Contract # 202l-012106 on the 27th of February, z02l('Agreement") and,
WIIEREAS, the general purposes of the Agreement are unchanged; and
WHEREAS, both parties wish to make modifications to the Agreement, as described below;
THEREFORE, for the mutual consideration described in the Agreement, the parties agree to themodifications below through the signatures of the person(s) wto have the authority ti uina tn.parties to the changes in the Modification:
l ' Tern-of Agregmen-t: Article I, section 2 of the Agreement is rhodified and shall continuein effect until June 30th, 2022, unless earlier teininated in accordance with the termsherein. NACcHo ard Contractor.agree that the term of the Agreement may be extendedto complete the projeot to June 30th,2022, provided that NACCHO receives an extensionof the programmatic activities of the related cDC GRANT # 6 NU3goT000306-02-10,
CFDA # 93.421and subject to CDC's acceptance and approval for NACCHO to continuework with contractor, applicable guidance and federal'rules and regulations. traCCUO
has.-been approved through 'oExpanded Authority" to temporarily continue the programwhile waiting fol the extension approval. Bot[ parties igree, NACCHO will not beobligated to continue the program or to make uny puy*"nts for work without CDC,s
extension approval to continue the program. nxpiration of the term or termination of thisAgreement shall not extinguish any rigtrts or obligations of the parties that have accruedprior thereto. The term of this Agreement may be extended by mutual agreement of theparties.
2' P-ryurent of services: the updated payment schedule is as follows:
Paymenl o.f SerYic-es: Article I: Special Provisions, Clause 3 of the Agreement ismodified to amend payment by NACCHO to Contractor for services pJrformed asfollows:
Original Contract Amount
Mod I Amount
Invoice paid up to 6/30/Z0Zt
Total Contract Award Amount:
I\[EW available Contract Amount:
Updated Invoice Schedule
$50,645.45
$32,351.97
$21,102.30
$82,997.42
$61,895.l2
Invoice No.Amount Due date Deliverable
In votce I $25,322.70
(Partially
Paid
$21,102.30)
March 20,
2021
As stated in Attachment I, deliverables to
Participate in project kick-off call with
NACCHO, CDC and selected grantees on
November 19th,2020; Support or hire
disability specialist who will coordinate
project activities; Participate in disability
specialist orientation call; Participate in
monthly leaming communify meeting; and
ect
Invoice II 92t,102.25 July 15,2021 As stated in Attachment I, deliverables to
Complete first baseline assessmenfi
Participate in monthly learning community
meeting; Complete second baseline
assessment; Participate in I one-on-one
technical assistance call with NACCHO
staff/TA consultant; Develop
implementation plan based on results of
baseline assessment results; and Complete
ect
Invoice III $4,220.45 July 37,2021 As stated in Attachrnent I, deliverables for
Participate in monthly leaming community
Year 2 mvolce schedule of between 1 2021to June 3 2022
lnvoice IV $16,175.99 January 20,
2022
As stated in Attachment I, deliverables to
Participate in monthly Learning Community
meetings; Participate in I one-on-one
technical assistance call with NACCHO
staff/TA consultant, and Complete quarterly
project report (e.g.,providing updates to
2
Invoice V $16,175.98 Iune 30,2A22 As stated in Attachment 1, deliverables to
Participate in monthly Leaming Community
meetings (to end in March 2022); participate
in I one-on-one technical assistance call
with NACCHO stafflTA consultant;
Complete sustainability plan; Complete end
ofproject report to articulate challenges,
lessons learned, successes, and future needs
and final evaluation measures; and
Participate in wrap-up meeting with project
partners to share lessons leamed.
3. Scope of Work: The Scope of Work attached hereto as Attachment I to the Modification
is incorporated into the Agreement and made a part thereof,
4, All other terms and conditions of the Agreement remain unchanged.
IN WITNESS WHEREOF, the persons signing below wanant that they are duly authorized
to sign for and on behalfof, the respective parties.
AGREED AND ACCEPTED AS ABOVE:
NACCHO:CONTRACTOR:
By:erome Chester (Jan 3,2022 11:01 EST)By:
Name
Title:
Name:Jerome Ch
Title: Chief Financial Offi cer b-n*t-'Utl-cnryt*rw-
Date:Jan 3, 2022 Date: le I '+ lat
rt:vt w mirh
3
NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OF'FICIALS
MODIF'ICATION OF' AGREEMENT- ATTACHMENT I
SCOPE OF WORK
With recent CDC approval, NACCHO intends to amend the cunent contract for the Addressing
the Needs of People with Disabilities in COVID-l9 project. The scope of work and timeline oi
the project have remained the same and the conhact end date now iligns with the project end
date (June 30th,2022).
This project was originally written as a two-year work plan for the awardees to have ample time
to address COVID-I9 as well as other emergency preparedness activities among people with
disabilities.
COVID-I9 and Disability Deliverable Budget
Kittitas County Public tlealth Department
Expected
Invoice
Period
Deadline Deliverable Cost Total
fnvoice
Amount
Activities July 31,2021
Invoice 1:
November
2020 -
February
28,202t
Invoice due
March20,
202t
November
lgth,2o2o
Participate in project kick-off callwith
NACCHO, CDC and selected grantees
on November lgth,2020.
$4,220.45 $25,322.75
@artially
Paid
$21,102.30)22-Ian-21 Support or hire disability specialist who
will coordinate project activities.
$4,220.45
Week of
January
25th,2021
Participate in disability specialist
orientation call
$4,22A.45
Dates
TBD
Participate in monthly Learning
Community meetings
$4,220.45
Feb-21 first baseline assessment $4,220.45
Feb-21 Complete quarterly project report $4,220.50
Invoice 2:
March l-
June 30,
2021
lnvoice due
July 15,
202r
Dates
TBD
Participate in monthly Learning
Community meetings
94,220.45 $21,102.25
April 1,
2021
Complete second baseline assessment $4,220.45
Date TBD Participate in 1 one-on-one technical
assistance call with NACCHO stafflTA
consultant
$4,220-45
May l,
2021
Develop implementation plan based on
results of baseline assessment results
s4,22A.45
June l,
2021
Complete quarterly project report $4,220.45
4
NATIONAL ASSOCIATION OF'COUNTY AND CITY HEALTH OF'F'ICIALS
MODIF'ICATION OF' AGREEMENT_ ATT.A,CHMENT I
qQQPE OF WORK
With recent CDC approval, NACCHO intends to amend the current contract for the Addressing
the Needs of People with Disabilities in COVID-19 project. The scope of work and timeline ofthe project have remained the same and the contract end date no* ulign, with the project end
date (June 30th,2022).
This-project was originally written as a two-year work plan for the awardees to have ample timeto address COVID-I9 as well as other emergency preparedness activities among peoile with
disabilities.
l9 and Disability Deliverable BudgetcovID-
Kittitas County Public Health Department
Expected
Invoice
Period
Deadline Deliverable Cost Total
Invoice
Amount
Activities Thro 20213t
November
lgth,2020
Participate in project kick-off call with
NACCHO, CDC and selected grantees
on November lgth 2020.
$4,220.45
22-Jan-21 Support or hire disability specialist who
will coordinate activities.
$4,220.45
25th 2A2t
Week of
January
in disability specialistParticipate
orientation call
$4,220.45
Dates
TBD
Participate in monthly Learning
Com
$4,220.45
Feb-21 first baseline assessment 5
Invoice 1:
November
2020 -
February
28,2021
Invoice due
March 20,
2021
Feb-21 s4,220.50
925,322.75
(Partially
Paid
$21,102.30)
Dates
TBD
Participate in monthly Learning $4,220.45
April I,
2A2l
Complete second baseline assessment 94,220.45
Date TBD Participate in I one-on-one technical
assistance call with NACCHO stafflTA
s4,220.45
May 1,
2021
Develop implementation plan based on
results of baseline assessment results
94,220.45
Invoice 2:
March 1-
June 30,
2021
Invoice due
July 15,
2021
June l,
2021
Complete quarterly project report fi4,220.45
$21,102.25
4
Invoice 3:
July I -
July 31,
2A2t
lnvoice due
August 15,
2021
Date TBD Participate in monthly
Community meetings
Leaming 94,220.45 $4,220.45
$50,645.{5
1,2021 June 30,2022Activities
Dates
TBD
tnParticipate monthly Leaming $4,044.00
Dates
TBD
Participate in I one-on-one technical
assistance call with NACCHO stafflTA
consultant
$4,044.00
Invoice 4:
August 1-
December
31,202',1
Invoice due
January 20,
2022
Dec.2l
providing updates
plan progress)
(e.g.Complete quarterly project report
to implementation
$8,087.99
$16,175.99
January
2022-
March
Participate in monthly
Community rneetings
2022)
Learning
(to end in March
$2,022.00
Dates
TBD
I one-on-one technical
assistance catl with NACCHO stafflTA
consultant
Participate in $2,a22.98
May-22
successes, and fufure needs and final
end ofComplete toprojectreport
articulate lessonschallenges,learned,
$4,044.00
Invoice 5:
January l,
2022-
June 30,
2022
Invoice due
June 30,
2022
Jun-22
prcject paftners
leamed-
tnParticipate wfap-up withmeeting
to share lessons
$4,044.00
t 6,l75.gg
.91TOTAL BUDGET
fi92,997.42
5
FEDERAL FT'NDING ACCOLNTABILITY AND TRANSPARENCY ACT
Data Collection Form
The office of Management and Budget (oMB) has created a searchabre, no-cost-publicly accessiblewebsite that includes the following information for each new federal award and/or first tier subawards equalto or greater than $25,000. As of october l, 2}ll,recipients of federal grants and conhacts must complywith subrecipient reporting requirements under the Federal Funding Acc-ountability and Transparency Act(P,L. t09-2E2).
NAccHo, as a recipient of federal funding, is required to collect the information below and input thisinfonnation into the FFATA website (www.fsrs.gov).
Please complete the inforrnation requested below and submit this form to:
Ade Hutapea LL.M,, CFCM
Lead Contracts Administrator
National Association of Counfy & City Health Officials
!?01 (I) Eye Sreet NW 4th H:, Washington, DC 20005
Direct Liue: e02) 507-4272 -
Email: ahutapea@naccho.org
www.naccho.org
Please answer the foilowing questions:
l ' Is the total value ofthis conlract (including any option periods) expocted to exceed $25,000.00?
lS "o No
3. If you answered yes to euestion 1 and 2, ptease provide the following infonnation below:
Name ofEntity:
Address of Entity:
b
Congressional District of Entity Location:tq
Unique Identifier (DUNS #):'01-b'
CCR/Cage Code #;1 ApplicableNAICS
2' If you answered Yes toQuesti-on I' in the previous ta,r year, was your gross income from all sourcesgreater than or equal to $300,000? (If you answered No tL afur# i;i"u do not need to complete theremainder of this information,equ"sq.
($ "" O*,
Award Title Describing Purpose:'il
ht-,h6
\Amount of Award:A
L
l\0ortti;_
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
Data Collection Form
Funding Agency:CFDA #:
Treasury acoount symbol (TAS) as reported in FpDS
4' If you answered Yes to Questions I and 2, is 80% or more of your annual gross rnvenues from federalconhacts, subcontracts, loans, grants, subcontracts and cooperatiu"
"gr€ementsr
Q Yes ONo
5' If you answered Yes to Question 4, do you have $25,000,000 or more in annual gross revenues fromFederal contracts, subconhacts, roans, grants, sub-grants, i"a """p"r"tive agreements?
Q ver ONo
6' [f you answered Yes to -Questions 4 and 5, is information about the compensation of Subcontractorexecutives available publicly^_through periodic reports fifi-;il;; secfion l3(a) or t5(d) of rhesecurities^Exchange Act of is:+ (riu.b.c. 78m(a), 78o(d) or section 6104 of the Internal Revenuecode of 1986? If Yes, please provide copies of thi public'niinlr pio"ioi"g such information.
If no'.please provide the following information below: Names and total compen$ation of each of thefive (5) most. highly
"omp"nrut"d executives for subcontractor's preceding fiscal year. Totalcompensation includes salary and bonus, awards orstock, sioct "pii"* and stook appreciation rights,eamings for services under non-equity incentive.plans, cnange in llnrion ""tu", above'-market
"u*ing*on deferred compensation which ii not tax-qualirt"a, *Joifi".
"J*p"irution, if the aggregate value ofall such other compensation (e.g. tru*r*r*, termination_ puyrc"tl, oolue of life insurance paid onbehalf of employee, nllpisjtes oi property) for the executive ixcrca. dro,ooo. For more information,please see 17 CFR229.4,AZ@)Q).
-
Names and total compensation ofthe live highest compensated officers of the entity:
NAME COMPENSATION
1.
2.
3.
4,
5.
2
Cerfillcation
r certify' on bcholf of subcontractor/ consultent thrt the informrtion provided in rerponse to thisrnformatlon Requect ir complete lud accurate. r_further *.tiry r[.i r lave the authorlty to providethe requerted informstlon and erecute this cerrification on tetianor iuucontrecton r,sst, r certifythrt Subcontnrctor has been notilied rnd is rware thrt the lnformrtion provided in response to thisfnforrnation Requestwill be made public.
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
Data Collection Form
(
Name
Date
3
CNRITTTCATION OF' NON-DEBARMENT OR SUSPENSION
By my signature I attest that has not been debarredorsuspendedpursuant to 2 CFR 200 SUBPA (200.208) and not subcontract withparties listed on the General Services Administration's List of parties Excluded frsmFederal Procurement or Nonprocurement Programs in accordance with E.O.s 12549 and12689 "Debarment and Suspension " and 2 CFR 180
or AutHoRrzEu CERrlrnNo OprrcralStoNarunr:'fttr,a
0,
^l
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