HomeMy WebLinkAboutPort Townsend School District West Coast Beach Clean-up, YCCTPP - 050426 SUBRECIPIENT AGREEMENT
BETWEEN
JEFFERSON COUNTY
AND
Port Townsend School District
This Subrecipient Agreement(Agreement) Between Jefferson County and Port Townsend
School District is made and entered into by Jefferson County(County) and Port Townsend
School District(Subrecipient) for completion of Project title: West Coast Beach Clean-up
(Project)pursuant to Youth Cannabis and Commercial Tobacco Prevention Program, Jefferson
County Public Health contract number N-25-064 KPHD2483 and its A-1 (Agency Contract).
Funds awarded for this Project have been provided to by the County by the Washington State
Youth Cannabis and Commercial Tobacco Prevention Program(YCCTPP) and are state funds
that focus on cannabis and commercial tobacco activities.
IT IS AGREED UPON BY THE PARTIES AS FOLLOWS:
A. TERM OF THIS AGREEMENT
The term of this Agreement is from April 1, 2026 through June 30, 2026.
B. TERMINATION -
(1) Should a party default in providing Project services under this Agreement or materially
breach any of its provisions, the other party may terminate this Agreement upon ten(10)
days written notice. A party shall have the right and opportunity to cure any such material
breach within the ten(10) day period.
(2) The County may terminate this Agreement upon immediate notice to Subrecipient in the
event that the funding for the project ceases or is reduced in amount. Subrecipient will be
reimbursed for services expended up to the date of termination.
(3) In the event of default,the Subrecipient must return any disbursed funds associated with
this Project within thirty-days(30) of notice of termination by County.
C. PROFESSIONAL SERVICES BY SUBRECIPIENT
In completion of Project all Project services provided by Subrecipient shall include:
(1) All Work, if any, Required by the Agency Contract. All work required by the Agency
Contract, if any, a true and correct copy of which is attached as APPENDIX B.
(2) Financial and Program Management: Subrecipient will maintain an
administrative/organizational structure that clearly defines responsibilities; systems and
personnel to maintain accounting records that accurately reflect all program revenues and
expenditures;prepare monthly statements of activity; maintain appropriate client service
records and progress reports; and track key program performance indicators.
(3) Perform All Subrecipient Obligations. In addition to the above, Subrecipient shall fulfill all
of Subrecipient Obligations listed below.
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D. SUBRECIPIENT'S OBLIGATIONS
Subrecipient shall fulfill the following obligations:
(1) Subrecipient shall fulfill all the requirements of the Agency Contract.
(2Y22/2%ubrecipient shall comply with all state and federal requirements regarding the
confidentiality of participant records.
(3) Subrecipient shall have written policies regarding sexual harassment and non-
discrimination(said policies must guarantee human/civil rights);regarding a person's
right to privacy,regarding safeguarding personal information and abuse of participants;
regarding agency medication procedure;regarding respectful staff-to-participant
4/22 interactions(i.e.: including a person's right to be treated with dignity and respect free of
abuse).
(4) Subrecipient shall have a grievance policy that:
• Negotiates conflicts and advises participants of grievance procedures;
• Is explained to participants;
• Prohibits retaliation for using the grievance process;
• Includes a non-retaliation statement;
• Assures that advocates are available and encourages participants to bring advocates to
help negotiate;
• Includes a mediation process that promotes the use of someone who is unaffected by
the outcome if conflicts remain unresolved; and,
• Includes a process for tracking and reporting grievances.
(5) Subrecipient,shall comply with all applicable federal,state and local regulations.
(6) Subrecipient shall comply with all the policies of the Jefferson County department
managing this Agreement.
(7) Subrecipient shall track and analyze incident reports for potential trends and patterns.
(8) Subrecipient shall provide the following:
(a) Equal Access: Subrecipient will assures equal access to persons who do not speak or
have a limited ability to speak,read,or write English well enough to understand and
communicate effectively.
(b) Qualified Staff: Subrecipient will provide adequate, qualified staff with skills and
experience in evaluation,training, supervision, counseling and support of adults with
developmental disabilities who are earning wages,per the attached Statement of
Work. Subrecipient will assure that all direct service staff are trained,and that
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training is documented. Subrecipient will provide the County with information
regarding staff qualifications upon request
E. DEBARMENT
By signing this Agreement,and Appendix A, Subrecipient certifies that it is not presently
debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded in any
Washington State or Federal department or agency from participating in transactions(debarred).
Subrecipient agrees to include the above requirement in any and all subcontracts into which it
enters,and also agrees that it will not employ debarred individuals. Subrecipient must
immediately notify the County if,during the term of this Agreement, Subrecipient becomes
debarred. The County may immediately terminate this Agreement by providing Subrecipient
written notice,if Subrecipient becomes debarred during the term of this Agreement.
F. FEDERAL FUNDING ACCOUNTABILITY&TRANSPARENCY ACT(FFATA)
(1) This Agreement is supported by federal funds that require compliance with the Federal
Funding Accountability and Transparency Act(FFATA or the Transparency Act).The
purpose of the Transparency Act is to make information available online so the public can
see how federal funds are spent.
(2) To comply with the act and be eligible to enter into this Agreement, Subrecipient must
have a Data Universal Numbering System(DUNS®)number. A DUNS®number
provides a method to verify data about your organization. If Subrecipient does not already
have one,a DUNS®number is available free of charge by contacting Dun and Bradstreet
at-www.dnb.com.
(3) Information about Subrecipient and this Agreement will be made available on
www.uscontractorregistration:con , as required by P.L. 109-282. The Federal Funding
Accountability and Transparency Act Data Collection Form, is considered part of this
Agreement and must be completed and returned along with this Agreement.
G. FUNDING WITHDRAWN,REDUCED OR LIMITED
If the County determines in its sole discretion that the funds it relied upon to establish this
Agreement have been withdrawn,reduced or limited,or if additional or modified conditions are
placed on such funding after the effective date of this Agreement but prior to the normal,
completion of this Agreement,then the County, at its sole discretion,may: (1)Terminate this
agreement; (2)Renegotiate this Agreement under the revised funding conditions;or,(3) Suspend
Subrecipient's performance under this Agreement upon five(5)business days' advance notice to
Subrecipient,if the County determines that there is a reasonably likelihood that the funding
insufficiency may be resolved in time.to allow Subrecipient's performance to resume prior to the
normal completion date of this Agreement.
H. REIMBURSEMENTS
(1) Total reimbursements for fiscal year July 1,2025.—June 30,2026 to Subrecipient by the
County under this Agreement shall not exceed$2,300,including any allowable expenses
for the services provided under this Agreement without express written amendment signed
by both parties to this Agreement.
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(2) For said services rendered under this Agreement,the County shall reimburse Subrecipient
pursuant to this Agreement and the Agency Contract.
(3) Work performed between April 1,2026 and June 30,2026 and the execution of this
Agreement that is consistent with the provisions of this Agreement is hereby ratified.
(4) Subrecipient will receive Project balance upon execution of this agreement and will
provide monthly to the County a detailed description of Project's progress,including
accounting of all.expenditures made during the month in which Subrecipient is reporting
(template provided).
OVERPAYMENTS OR ERRONEOUS PAYMENTS TO SUBRECIPIENT
If overpayments or erroneous payments have been made to Subrecipient under this Agreement,
the County will provide notice to Subrecipient and Subrecipient shall refund the full amount of
the overpayment within thirty(30)calendar days of the notice. If Subrecipient fails to make
timely refund,the County may charge Subrecipient one percent(1%)per month on the amount
due,until paid in full.
I. RECORDS AND DOCUMENTS REVIEW
(1) Subrecipient must maintain books,records, documents,magnetic media,receipts,invoices
or other evidence relating to this Agreement and the performance of the services rendered,
along with accounting procedures and practices,all of which sufficiently and properly
reflect all direct and indirect costs of any nature expended in the performance of this
Agreement.At no additional cost,these records,including materials generated under this
Agreement,are subject at all reasonable times to inspection,review,or audit by the
Agency,the Office of the State Auditor,and state and federal officials so authorized by
law,rule,regulation,or agreement[See 42 USC 1396a(a)(27)(B);42 USC
1396a(a)(37)(B);42 USC 1396a(a)(42(A);42 CFR 431,Subpart Q; and 42 CFR 447.202].
(2) Subrecipient must retain such records for a period of six(6)years after the date of final
payment under this Agreement.
(3) If any litigation,claim or audit is started before the expiration of the six(6)year period,the
records must be retained until all litigation, claims,or audit findings involving the records
have been resolved.
J. RIGHTS OF STATE AND FEDERAL GOVERNMENTS
In accordance with 45 C.F.R. 95.617,all appropriate state and federal agencies, including but
not limited to the Centers for Medicare and Medicaid Services(CMS),will have a royalty-free,
nonexclusive, and irrevocable license to reproduce,publish,translate,or otherwise use,and to
authorize others to use for Federal Government purposes: (i) software,modifications,and
documentation designed,developed or installed with Federal Financial Participation(FFP)
under 45 CFR Part 95, subpart F; (ii)the Custom Software and modifications of the Custom
Software, and associated Documentation designed,developed, or installed with FFP under this
Agreement; (iii)the copyright in any work developed under this Agreement; and(iv)any rights
of copyright to which Subrecipient purchases ownership under this Agreement.
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K. COMPLIANCE WITH SUBRECIPIENT REQUIREMENTS FROM GRANT
(1) General. In accordance with 2 CFR 200.501 and 45 CFR 75.501, Subrecipient shall:
(a) Maintain records that identify, in its accounts, all federal awards received and
expended and the federal programs under which they were received,by Catalog
of Federal Domestic Assistance(CFDA)title and number,award number and
year, name of the federal agency, and name of the pass-through entity;
(b) Maintain internal controls that provide reasonable assurance that Subrecipient is
managing federal awards in compliance with laws,regulations, and provisions of
contracts or grant agreements that could have a material effect on each of its
federal programs;
(c) Prepare appropriate fmancial statements,including a schedule of expenditures of
federal awards;
(d) Incorporate OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501 audit
requirements into all agreements between Subrecipient and its subcontractors who
are subrecipients;
(e) Comply with any future amendments to OMB Super Circular 2 CFR 200.501 and
45 CFR 75.501 and any successor or replacement Circular or regulation;
(f) Comply with the applicable requirements of OMB Super Circular 2 CFR 200.501
and 45 CFR 75.50land any future amendments to OMB Super Circular 2 CFR
200.501 and 45 CFR 75.501,and any successor or replacement Circular or
regulation; and,
(g) Comply with the Omnibus Crime Control and Safe Streets Act of 1968,Title VI
of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973;
Title II of the Americans with Disabilities Act of 1990, Title IX of the Education
Amendments of 1972, The Age Discrimination Act of 1975,and The Department
of Justice Non-Discrimination Regulations, 28 C.F.R. Part 42, Subparts C.D.E.
and G,and 28 C.F.R. Part 35 and 39. (Go to littp://ojp.gov/about/offices/ocr.htm
for additional information and access to the aforementioned Federal laws and
regulations.)
(2) Single Audit Act Compliance. If Subrecipient expends$750,000 or more in federal
awards from any and/or all sources in any fiscal year, Subrecipient will procure and pay
for a single audit or a program-specific audit for that fiscal year.Upon completion of
each audit, Subrecipient will:
(a) Submit to the Authority contact person the data collection form and reporting
package specified in OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501,
reports required by the program-specific audit guide(if applicable), and a copy of
any management letters issued by the auditor;
(b) Follow-up and develop corrective action for all audit findings; in accordance with
OMB Super Circular 2 CFR 200.501 and 45 CFR 75.501,prepare a"Summary
Schedule of Prior Audit Findings."
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(3) Overpayments. If it is determined by the Agency or the County,or during the course of a
required audit,that Subrecipient has been paid unallowable costs under this or any -
Program Agreement, Subrecipient will refund the full amount to the Agency as provided
in Section I. OVERPAYMENTS OR ERRONEOUS PAYMENTS TO SUBRECIPIENT.
L. RISK ASSESSMENT AND MONITORING FOR COMPLIANCE BY THE
COUNTY.
(1) Subrecipient shall immediately report to the County any failure to perform under this
Agreement.
(2) Along with every request for reimbursement under this Agreement, Subrecipient shall
submit a Monitoring Certification using the form attached as Appendix A for purposes of
the County performing the risk assessment of Subrecipient and compliance monitoring of
this Agreement that is required of the County by the Agency.
M. GENERAL TERMS AND CONDITIONS
(1) Subrecipient's relation to the County shall at all times be that of independent
Subrecipient. Any and all employees of Subrecipient, or other persons engaged in the
performance of any work or service required of Subrecipient under this Agreement, shall
be considered employees of Subrecipient only, and any claims that may arise on behalf of
or against said employees shall be the sole obligation and responsibility of Subrecipient.
(2) Subrecipient shall not subcontract or assign any of the services covered by this
Agreement without the express written consent of the County. Subcontracting and
assignment does not include printing or other customary reimbursable expenses that may
be provided in an Agreement.
(3) Subrecipient,by signature to this Agreement, certifies that Subrecipient is not presently
debarred, suspended,proposed for debarment, declared ineligible,or voluntarily excluded
from participating in this Agreement,or any Agreement by any Federal department or
agency. Subrecipient also agrees to include the above requirement to all subcontracts into
which it enters.
(4) Subrecipient shall obtain and keep in force during the terms of this Agreement, or as
otherwise required,the following insurance with companies or through sources approved
by the State Insurance Commissioner pursuant to Chapter 48:05 RCW:
(a) Worker's compensation and employer's liability insurance. Subrecipient will
participate in the Worker's Compensation and Employer's Liability Insurance
Program as may be required by the State of Washington;
(b) Commercial Automobile Liability or Business Use Insurance providing bodily
injury and property damage liability coverage for all owned and non-owned
vehicles assigned to or usedin the performance of the work for a combined single
limit of not less than$1,000,000 each occurrence with the County named as an
additional insured in connection with Subrecipient's performance of this
Agreement.
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(c) General Commercial Liability Insurance in an amount not less than a single limit
of two million dollars($2,000,000.00)per occurrence and an aggregate of not less
than two (2)times the occurrence amount($2,000,000.00 minimum)for bodily
injury, including death and property damage,unless a greater amount is specified
in the Agency Contract specifications. The insurance coverage shall contain no
limitations on the scope of the protection provided and include the following
minimum coverage:
(i) Broad Form Property Damage,with no employee exclusion.
(ii) Personal Injury Liability, including extended bodily injury.
(iii) Broad Form Contractual/Commercial Liability-including completed
operations.
(iv)' Premises - Operations Liability(M&C).
(v) Independent Contractors and Subrecipients.
(vi) Blanket Contractual Liability.
(5) All employees or subcontractors of Subrecipient who are required to be professionally
certified by the State in the performance of services under this Agreement shall maintain
professional liability insurance/error and omissions liability insurance in the amount of
not less than one million dollars ($1,000,000). In no case shall such professional liability
to third parties be limited in any way.
(6) It shall be the responsibility of Subrecipient to ensure that any and all persons engaged in
the performance of any work or service required of Subrecipient under this Agreement,
shall comply with the same insurance requirements that Subrecipient is required to meet.
(7) Failure on the part of Subrecipient to maintain the insurance as required shall constitute a
material breach of contract upon which the County may, after giving five working days'
notice to Subrecipient to correct the breach, immediately terminate this Agreement or, at
its discretion,procure or renew such insurance and pay any and all premiums in
connection therewith, with any sums so expended to be repaid to the County on demand,
or at the sole discretion of the County, offset against funds due Subrecipient from the
County.
(8) All cost for insurance shall be considered incidental to and included in the unit contract
prices and no additional payment will be made.
(9) Excepting the Workers Compensation insurance and any professional liability insurance
secured by Subrecipient,the County will be named on all certificates of insurance as an
additional insured. Subrecipient shall furnish the County with verification of insurance
and endorsements required by this Agreement. The County reserves the right to require
complete, certified copies of all required insurance policies at any time.
(10) All insurance shall be obtained from an insurance company authorized to do business in
the State of Washington. Subrecipient shall submit a verification of insurance as outlined
herein within 14 days of the execution of this Agreement to the County. All insurance
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policies obtained by Subrecipient shall be primary to any equivalent or applicable
policies held by the County.All insurance policies obtained by Subrecipient shall include
a waiver of subrogation rights. Any self-insured retention, deductible or risk retention
maintained, or participated in,by the County coverage for third-party liability claims
provided to the county, shall be excess and shall be non-contributory to the insurance
policies provided by Subrecipient in order to comply with the insurance requirements of
this Subcontract. All policies provided by Subrecipient in order to comply with the
insurance requirements of this Subcontract must be endorsed to show this primary
coverage.
(11) The County will pay no progress payments under this Agreement until Subrecipient has
fully complied with this section. This remedy is not exclusive; and the County may take
such other action as is available to them under other provisions of this Agreement, or
otherwise in law.
(12) Nothing in the foregoing insurance requirements shall prevent the County, at its option,
from additionally requesting that Subrecipient deliver to the County an executed bond as
security for the faithful performance of this Agreement and for payment of all obligations
of Subrecipient.
(13) It is understood and agreed that this Agreement is entered into in the State of
Washington. This Agreement shall be governed by and construed in accordance with the
laws of the United States,the State of Washington and the County of Jefferson,as if
applied to transactions entered into and to be performed wholly within Jefferson County,
Washington between Jefferson County residents. No party shall argue or assert that any
state law other than Washington law applies to the governance or construction of this
Agreement.
(14) Should either party bring any legal action, each party in such action shall bear the cost of
its own attorney's fees and court costs.The venue for any legal action shall be solely in
the appropriate state court in Jefferson County,Washington, subject to the venue
provisions for actions against counties in RCW 36.01.050.
(15) Subrecipient shall comply with the WA State Department of Labor and Industries
Minimum Wage Act, Chapter 49.46 RCW, acknowledging persons with disabilities
participating in job assessments are not considered employees.
(16) Subrecipient shall indemnify and hold the County, and its officers, officials, employees,
agents and volunteers(and their marital communities)harmless from and shall process
and defend at its own expense,including all costs, attorney fees and expenses relating
thereto,all claims,demands,or suits at law or equity arising in whole or in part,directly or
indirectly,from Subrecipient's negligence or breach of any of its obligations under this
Agreement;provided that nothing herein shall require a Subrecipient to indemnify the
County and its officers, officials, employees,agents and volunteers(and their marital
communities) against and hold them harmless from claims, demands or suits based solely
upon the conduct of the County,its officers, officials, employees, agents and volunteers
(and their marital communities),and provided further that if the claims or suits are caused
by or result from the concurrent negligence of:
(a) Subrecipient's agents or employees;and,
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(b) The County,its officers, officials,employees,agents and volunteers(and their
marital communities),this indemnity provision with respect to: (i) claims or suits
based upon such negligence,or(ii)the costs to the County of defending such claims
and suits,etc.,shall be valid and enforceable only to the extent of Subrecipient's
negligence or the negligence of Subrecipient's agents or employees.
(c) Subrecipient specifically assumes potential liability for actions brought against the
County by Subrecipient's employees,including all other persons engaged in the
performance of any work or service required of Subrecipient under this Agreement
and,solely for the purpose of this indemnification and defense, Subrecipient
specifically waives any immunity under the state industrial insurance law,Title 51
RCW. Subrecipient recognizes that this waiver was specifically entered into
pursuant to provisions of RCW 4.24.115 and was subject of mutual negotiation.
(d) The provisions of this section shall survive the expiration or termination of this
Agreement.
(17) Subrecipient shall not discriminate against any person presenting themselves for services
based on race,religion, color, sex, age,or national origin.
(18) No portion of this Agreement may be assigned or subcontracted to any other individual,
firm,or entity without the express and prior written approval of County.If the County
agrees in writing that all or a portion of this Agreement may be subcontracted to a third-
party,then any contract or agreement between Subrecipient and a third-party Subrecipient
must contain all provisions of this Agreement and the third-party subcontractor must agree
to be bound by all terms and obligations found in this Agreement.
(19) This Agreement memorializes the entire agreement of the parties. No representation or
promise not expressly contained in this Agreement has been made. The parties are not
entering into this Agreement based on any inducement,promise or representation,
expressed or implied,which is not expressly contained in this Agreement. This
Agreement supersedes all prior or simultaneous representations, discussions,
negotiations, and agreements,whether written or oral, within the scope of this
Agreement.
(20) Subrecipient is responsible for meeting all terms and conditions of this Agreement
including standards of service, quality of materials and workmanship,costs, and
schedules. Failure of a subcontractor to perform is no defense to a breach of this
Agreement. Subrecipient assumes responsibility for and all liability for the actions and
quality of services performed by any subcontractor. Every subcontractor must agree in
writing to follow every term of this Agreement. Subrecipient must provide every
subcontractor's written agreement to follow every term of this Agreement before the
subcontractor can perform any services under this Agreement. The head of the County
department primarily responsible for overseeing Subrecipient's performance under this
Agreement or that department head's designee must approve any proposed subcontractors
in writing. Any dispute arising between Subrecipient and any subcontractors or between
any subcontractors must be resolved without involvement of any kind on the part of the
County and without detrimental impact on the delivery of contracted goods or services.
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(21) While performing services,the use of illegal drugs,alcohol, or controlled substances on
the County property or premises is strictly prohibited. Subrecipient's employees shall not
perform services while under the influence of drugs or alcohol,and if discovered,may be
reported to the appropriate law enforcement agency.
(22) The use of tobacco of any kind on property or premises of the County shall comply with
County policies.
(23) Any form of harassment,discrimination, or improper fraternization with any County
employee or a participant is strictly prohibited.
(24) No consent by either party to, or waiver of,a breach by either party,whether express or
implied, shall constitute a consent to,waiver of,or excuse of any other,different, or
subsequent breach by either party. No term or provision of this Agreement will be
considered waived by either party, and no breach excused by either party,unless such
waiver or consent is in writing signed on behalf of the party against whom the waiver is
asserted. Failure of a party to declare any breach or default immediately upon the
occurrence thereof,or delay in taking any action in connection with, shall not waive such
breach or default.
(25) The terms of this Agreement are not severable. If any provision of this Agreement or the
application of this Agreement to any person or circumstance shall be invalid, illegal,or
unenforceable to any extent,the remainder of this Agreement and the application this
Agreement shall not be enforceable.
(26) This Agreement shall be binding upon and inure to the benefit of the parties' successors
in interest,heirs and assigns.
(27) The parties do not intend, and nothing in this Agreement shall be construed to mean,that
any provision in this Agreement is for the benefit of any person or entity who is not a
ply-
(28) This Agreement may be executed in one or more counterparts, each of which shall be
deemed an original, and all of which counterparts together shall constitute the same
instrument which may be sufficiently evidenced by one counterpart. Execution of this
Agreement at different times and places by the parties shall not affect the validity of this
Agreement, so long as all the parties execute a counterpart of this Agreement.
(29) The parties agree that facsimile and electronic signatures shall have the same force and
effect as original signatures.
(30) The parties agree that this Agreement has been negotiated at arms-length, with the
assistance and advice of competent,independent legal counsel.
(31) Notwithstanding any provisions of this Agreement to the contrary,to the extent any
record, including any electronic, audio,paper or other media,is required to be kept or
indexed as a public record in accordance with the Washington Public Records Act,
Chapter 42.56 RCW(as may be amended), Subrecipient agrees to maintain all records
constituting public records and to produce or assist the County in producing such records,
within the time frames and parameters set forth in state law. Subrecipient also agrees that
upon receipt of any written public record request, Subrecipient shall, within two business
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days,notify the County by providing a copy of the request per the notice provisions of
this Agreement.
(32) All notices or other communications which any party desires or is required to give shall
be given in writing and shall be deemed to have been given if hand-delivered, sent by
facsimile, email,or mailed by depositing in the United States mail,prepaid to the party at
the address listed below or such other address as a party may designate in writing from
time to time. Notices to the County shall be sent to the following address:
(33) All notices or other communications which any party desires or is required to give shall
be given in writing and shall be deemed to have been given if hand-delivered, sent by
facsimile, email, or mailed by depositing in the United States mail,prepaid to the party at
the address listed below or such other address as a party may designate in writing from
time to time. Notices to the County shall be sent to the following address:
Jefferson County Risk Management Department -
1820 Jefferson Street
Port Townsend,WA 98368
Notices to Subrecipient shall be sent to the following address:
Name: Amy Khile
Title: Director of Finance and Business Operations
Contact Info: akhile@ptschools.org
Phone: (360) 680-5757
(SIGNATURES FOLLOW ON THE NEXT PAGE)
•
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SIGNATURE PAGE
ADOPTED THIS_ tday of 2026
BOARD OF COUNTY COMMISSIONS S SUBRECIPIENT
JEFFERSON C UNTY,WASHINGTON
By• By: .A1�2�y/fie
g •non, Chair Q
Name: Amy Khile
By: AS,l\ / OF Title: Executive Director, Business, Finance & Op
•.-YTiwirrc-y-Nollette, Commissioner 4/22/26
Date:
s
Ey: ! v
eidi Eisenhour,Commissioner
SEAL: ,,� ,,,,,,,,,
FF ER s oA ,,,,,�
.•oMMss Ds
1 : °v cn:
ATTEST: a
Ox;•
,'�As.f'{Lam(' ``,,`,
'-- i Z�
of n Gallaway, Date
Cl rk f the Board
Approved as to form only:
04-03-2026
Jere Lune; Date
D uty Prosecuting Attorney
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APPENDIX A—COMPLIANCE AND RISK MONITORING FORM
This Compliance and Risk Monitoring Form shall be submitted before the Subrecipient
Agreement can be approved with final form submitted by June 30,2026.
AGENCY CONTRACT NO: N-25-064 KPHD2483 and its A-1
DATE: April 22. 2026
NAME OF SUBRECIPIENT: Port Townsend School District
By signing below, I declare under penalty of perjury of the laws of the State of Washington and
the United States that the forgoing is true and correct. (Check the applicable boxes.)
DATE CERTIFICATION ITEM YES NO
Subrecipient is not presently debarred, suspended, proposed
for debarment, declared ineligible,or voluntarily excluded X
4/22/26
from transactions by any Federal, State, or local department
or agency
Subrecipient has not within a 3-year period preceding the
submission of this Compliance and Risk Monitoring Form
been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in X
4/22/26 connection with obtaining, attempting to obtain, or
performing a public (Federal, State, or local)transaction or
contract under a public transaction; violation of Federal or
State antitrust statutes or commission of embezzlement,
theft,forgery,bribery,falsification or destruction of
records,making false statements,or receiving stolen
property
Subrecipient is not presently indicted for or otherwise
criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of fraud or a X
4/22/26 criminal offense in connection with obtaining,attempting
to obtain, or performing a public (Federal, State, or local)
transaction or contract under a public transaction; violation
of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery,bribery, falsification or
destruction of records,making false statements, or
receiving stolen property
Subrecipient has not within a 3-year period preceding the
4/22/26 submission of this Compliance and Risk Monitoring Form X
one or more public transactions(Federal, State, or local)
terminated for cause or default
Subrecipient has provided all written reports required by
4/22/26 the Agreement as of the submission of this Compliance and X
Risk Monitoring Form(Template provided)
N-26-016(N-25-064KPHD-YCCTPP2483A-1)
Page 13 of 16
DATE CERTIFICATION ITEM YES NO
Subrecipient has provided any audit report received by it
4/22/26 from any government agency since the last certification for X
its performance related to the Agency Contract
Subrecipient certifies that all of the deliverables and other
4/22/26 work required since the last certification have been X
completed
All the work being billed for in the invoice being certified
4/22/26 by this Compliance and Risk Monitoring Form actually has X
been performed, including any timesheet or other backup
Subrecipient agrees to submit to an audit within 30 days of
4/22/26 a request from the County or the Agency X
4/22/26 Subrecipient has corrected any deficiencies identified since x
the last certification
Signed at Port Townsend WA
City State
4/7/W 4/22/26
SUBRECCIPIENT SIGNATURE DATE
Amy Khile
WRITTEN NAME OF PERSON SIGNING CERTIFICATION
APPROVE C :Y THE COUNTY:
4k _ 9 fr6,
T •PPROVAL SIGNATURE DA
igE-� TOAJ
WRITTEN NAME OF PERSON APPROVING CERTIFICATION
N-26-0I6(N-25-064KPHD-YCCTPP2483A-1)
Page 14 of 16
Appendix B
Statement of Work and Budget
Mini-grant Subrecipient Awardee:
Port Townsend School District
Title: Students for Sustainability Washington Coast Beach Clean-up
Topic: Timeline
Provide an estimated timeline for your project or event.
Month/Date Action Item Description
April,May 2026 Planning the trip Students will plan the trip,make
reservations for lodging and transportation,
plan the meals, and recruit new students to
the club to join them on this service
project.
May 22 and 23 Beach clean-up on west coast Students will travel approximately 3 hours
beaches to the trailhead where they will hike to the
first beach and collect trash.After bringing
the first load back to the truck,they will
return to the farther beaches to bring back
another truckload of trash.
May 29 Students will conduct an evaluation All students who attended the beach clean-
of the beach clean-up up will participate in a session where they
will evaluate the successes of the trip,
create a report to save in their club records,
and offer ideas for a more successful trip
next year.
Topic: Budget
Budget Item Amount Description
U-Haul truck rental $400 Rental fee, insurance, and gas
2 school vans $500 Mileage fee and gas
N-26-016(N-25-064KPHD-YCCTPP2483A-1)
Page 15 of 16
Dumping fees $200 To dump about 800 lbs. of trash at West
Waste in Forks
Lodging $500 Rental of a house that will house 12
students and 3 chaperones
Food $600 Food for 15 people for 2 days
N-26-016(N-25-064KPHD-YCCTPP2483A-1)
Page 16 of 16
615 Sheridan Street
Port Townsend, WA 98368
deft-615on www.JeffersonCountyPublicHealth.org
5unhi Consent Agenda
Public Health
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Josh D. Peters, County Administrator
FROM: Apple Martine, Public Health Director
Denise Banker, Community Health Director
DATE: 4'1 a y % .202_0'
SUBJECT: Agenda item — Subrecipient Agreement with Port Townsend School District;
April 1, 2026 —June 30, 2026; $2,300
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH), Community Health Division, requests Board approval of the
Subrecipient Agreement with Port Townsend School District (Subrecipient) to develop and implement
coordinated tobacco, vapor and marijuana product prevention and intervention strategies; April 1, 2026 —
June 30, 2026; $2,300
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
The purpose of this agreement is for the JCPH to retain Subrecipient to develop and implement protective
factor strategies to prevent and reduce tobacco and marijuana use by youth in Jefferson County. Subrecipient
agrees to implement programs that provide protective factors for youth in Jefferson County. This agreement,
for $2,300 is to pay for direct labor, direct material, and other direct costs.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
This contract agreement is fully funded by JCPH through a regional funding received from the Washington
State Department of Health, Youth Cannabis and Commercial Tobacco Prevention Program, Jefferson County
Public Health contract number N-25-064 #2483 and its A-1 Kitsap (Agency Contract).
RECOMMENDATION:
JCPH management requests approval of the Subrecipient Agreement with Port Townsend School District to
develop and implement tobacco, vapor and marijuana product intervention strategies; April 1, 2026 — June
30, 2026; $2,300
REVIEWED BY:
01(101. Lf/3q ?L
Jos . Peters, County Administrator Date
Community Health
Developmental Disabilities Environmental Public Health
360-385-9400 360-385-9444
360-385-9401 (f) (f) 360-379-4487
Always working for a safer and healthier community
N-26-016
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Port Townsend School District Contract No: N-26-016
Contract For: West Coast Beach Clean-up, YCCTPP Term: April 1, 2026 --June 30, 2026
COUNTY DEPARTMENT: Public Health
Contact Person: Denise Banker
Contact Phone: X438
Contact email: dbanker@co.jefferson.wa.us
AMOUNT: $2,300 PROCESS: Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: $2,300 - Competitive Sealed Bid
Matching Funds Required: - Small Works Roster
Sources(s) of Matching Funds _ Vendor List Bid
Fund# ✓ RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMP CE WI 5.080 AND CHAPTER 42.23 RCW.
CERTIFIED: N/A:f April 2,2026
Glenn Gilbert Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: E N/A: G� April 2, 2026
C
Glenn Gilbert Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 4/6/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 4/3/2026.
reviewed and approved on 04-03-2026 by JBL
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1