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Consent Agenda
Juvenile Services
Jefferson County
Board of County Commissioners
Agenda Request
From:
Board of County Commissioners
Philip Morley, County Administ tor
Barbara Carr, J
To:
Date:
Subject:
Statement of Issue:
This contract reflects the federal funds received via the Juvenile Accountability
Block Grant which is used locally as a support for the Proctor House program.
Analysis:
None.
Alternatives:
None.
FIscal Impact:
This funding is included In my 2012 department budget.
Recommendation:
That the Board execute the three original County Program Agreements attached.
Reviewed by:
Philip Morley, County Administrator
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~~ DSHS CONTRACT NUMBER:
CONTRACT AMENDMENT 0663-98276
JABG FFY10 Amendment No. 0663-98276-06
This Contract Amendment is between the State of Washington Deparbnent of Program Contract Number
Social and Health Services (DSHS) and the Contractor identified below. Contractor Contract Number
CONTRACTOR NAME CONTRACTOR doing business ss (DBA)
Jefferson County
CONTRACTOR ADDRESS WASHINGTON UNIFORM DSHS INDEX NUMBER
BUSINESS IDENTIFIER (UBQ
PO Box 1220
615 Sheridan St 161-001-169 1223
Port Townsend. WA 98368
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS
Barbara Carr (360\ 385-9190 Ext (360\ 385-9191 bcarr@co.iefferson.wa.us
DSHS ADMINISTRATION DSHS DMSION DSHS CONTRACT CODE
Juvenile Rehabilitation Division of Operations Support 5002CS-63
Services
DSHS CONTACT NAME AND TITILE DSHS CONTACT ADDRESS
Randy Sparks P.O. Box 45720
Capital Facilities Budget Administrator
Olvrnoia. WA 98504-5720
DSHS CONTACT TELEPHONE ?r~ TONTACT FAX DSHS CONTACT E-MAIL ADDRESS
13601 902-8099 Ext: 360 902-8108 sparkraillldshs.wa.aov
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBERS
Yes 16.523 .
. AMENDMENT START DATE. . C9NTRACT eND DATE' -::: .
71112011 " .... 6/3012012 . . ,
PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT'OFINCREASE O~OEY~EASE TOTAL MAXIMUM CONTRACT AMOUNT" .
$51,200.00 $10.325.00 '". . $61,525.00
......... , ...
REASON FOR AMENDMENT; . '. '.
CHANGE OR CORRECT OTHER: Sa: PAGE TWO '. .' .... '.' .
ATTACHMENTS. When the box below is marked with an X. the following Exhibits are attached and are incorporated Into
this Contract Amendment by reference:
o Additional Exhibits ISoeclM:
TlliS Contract Amendment including all Exhibits ~lldcther docurru:lntsjdcorpQtilit~by reference;tiontains all of the teiths.
and conditlons<1Qreed upon by the parties as ch8l11/6sto the origIilal CQntract.N.oother understandings or . .
representations, ~ral or otherwise. regarding the subject matter of thiS::con~ct Amendment shall be. deemed to exist or
bind the parties; All ()ther terms and conditions. ~fthe original Contra!;t remainlh .full force and effect. The parties signIng
below warrant that they have read and understand thl!! Contract'Amendmenl,and have authoritY to enter into this Contract
An$ndmenl . . . ... '.. ..., .
CONTRACTOR SIGNATURE PRINTED NAME AND TITILE DATE SIGNED
DSHS SIGNATURE PRINTED NAME AND TITILE DATE SIGNED
Del Hontanosas
Grants & Contracts Manaaer
OSHS Central Contract Services
6024PF Contract Amendmenl (3-31-OS)
Approved as w form only:
IJ \ . 'Z)'b'Oil
Jefferson Co. Prosecutor's
Pege1
....{' ..'..- ..
This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
This Contract between the State of Washington Department of Social and Health Services (DSHS) and the
Contractor is hereby amended as follows:
The purpose of this amendment is to award the Federal Fiscal Year (FFY) 2010 JABG Grant,
1. In Exhibit A - Statement of Work, #4, Contract Project Dates, is amended as follows:
The project start date is July 1, 2011, with an estimated duration of 12 months, ending on June 30, 2012.
For this new grant period, the maximum consideration shall onlv be $10,325 with a match amount of
$1,147 for a total of $11,472.
No unspent funds from the previous grant period of July 1, 2011 through June 30, 2012 may be carried
forward.
2. In Section #6. Acknowledgement of Assistance, delete "Award No. 2009-50589-WA-JB" and replace with
"Award No. 2010-JB-FX-0087",
3. The Contractor shall submit an updated Budget to the JRA Program Administrator identified on page one
of this Agreement prior to their first billing.
4. The following JABG reports must be completed and submitted to JRA by the designated timelines below,
JRA may withhold payments for failure to submit the required JABG reports by the designated timelines.
1) Quarterly Progress Report: Due by the 10th of the month following the end of each calendar year
quarter (April 10th, July 10th, October 10th, January 10th). A report must be submitted even if no activity
occurred during that period.
2) Annual Population Report: Due by April 15, 2012.
All other terms and conditions of this Contract remain in full force and effect.
DSHS Central Contract Services
6024PF Contract Amendment (3-31-ll6)
Page 2