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--ON-- - Consent Agenda
.~~CQ
(~fj!~1 JEFFERSON COUNTY PUBLIC HEALTH
'f1.~4t 615 Sheridan Street. Port Townsend. Washington. 98368
-"'liO www.Jeffol'8oncountypubDchealth.org
February 7, 2012
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
lRECEftVE[J)
FROM:
Jean Baldwin, Director
Board of County Commissioners
Philip Morley, County Administrator fEB 14 2012
JEfFERSON COUNTY
COMMISSIONERS
TO:
DATE:
SUBJECT:
February 20, 2012
Agenda Item - Professional Services Agreement - Olympic Educational
Service DIstrict 114; January 1, 2012 - June 30, 2013; fee for service
not to exceed $1,500
STATEMENT OF ISSUE:
Jefferson County Public Health requests Board approval of the Professional Servlces Agreement - Olympic
Educational Servlce DIstrict 114; January 1, 2012 - June 30,2013; fee for service not to exceed $1,500
ANALYSIS/STRATEGIC GOALS/PRO'S and CON'S:
This contract will provide Public Health Nurse Consultation to licensed daycare centers that are participating
In OESDs Early learning Interdisciplinary Infant Toddler Chlldcare Consultation Services program.
JCPH will provide services specIf1c to Infant and toddler health and safety concerns. JCPH will provide
servlces based on the availability and scheduling of the Public Health Nurse. Additional staff has not been
budgeted for at this time.
FIS~L IMPACT lCOU B!=.~,!:.fIT ANALYSIS:
ThIs contract Is funded by OESD on a fee for servlce basis paid at $50.00 an hour. OESD will also reimburse
for mileage.
RECOMMENDATION:
JCPH management request approval of the Professional Servlces Agreement - Olympic Educational Servlce
DIstrict 114; January 1, 2012 - June 30,2013; fee for servlce not to exceed $1,500
1-fb"h-
Date
COMMUNITY HEALTII
DEVELOPMENTAL DISABILITIES
MAIN: (360) 385-9400
FAX: (360) 385-9401
PUBLIC HEALTH
llLWA'fS WOIllllllG FGlIll SMIII! Mil
aWTHIER COMMUNITY
ENVIRONMENTAL HEALTII
WATER QUALITY
MAIN: (360) 385-9444
FAX: (360) 379-4487
,
CONlRACT FOR PROFESSIONAL SERVICES
BETWEEN
OLYMPIC EDUCATIONAL SERVICE DISTRICT 114
(hereinafter referred to as OESD 114)
105 National Avenue North
Bremerton, WA 98312
AND
Jefferson County Public Health
(hereinafter referred to as Consultant)
615 Sheridan
Port Townsend. W A 98368
The Catalog of Federal Domestic Assistance (CFDA) number for these federal funds is 93.575.
In consideration of the promises and conditions contained herein. OESD 114 and Consultant do
mutually agree as follows:
L DUTIES OF CONSULTANT
Consultant shall perform the following duties to the ""tkfaction of OESD .114's if~gnee:
A The general objective(s) of this contract shall be as follows:
To provide Public Health Nurse consultation services (based on availability),
spedfie to infant and toddler health and safety, tolieensed ehlldeare participating
in. the. Departments of Early Learning's Interdisciplinary Infant Toddler
Chlldeare Consultation Services project.
-- --- ~--~-_::
B. In order to accomplish the general objective(s) of this agreement, Consultant shall
perform the following specific duties:
1. Contact each provider to set up initial visit and re~lew ehlldren's health
issues with pJ1Widers.
2. Help provider identifynoeate important health information to distribute to
families.
3. Provide information on or refer to other services offered by the health
department
Revised 412009 Page 1 of7
4. Partner with Infant/Toddler Coordinator to ensure open communication and
that all provided services are consistent.
5. Work with providers to build their capacity to meet the needs of children in
their care.
6. Provide monthly reports as specified on attached form.
7. Attend quarterly Infant/Toddler Consultant meetings
8. Attend Interagency Coordinating Council meetings when available
C. The time schedule for completion of Consultant's duties shall be as follows:
January 1,2012 - June 30, 2013 (subject to funding availability)
D. Time is of the essence in connection with Consultant's performance of the foregoing
duties.
IL DUTIES OF OESD 114
In consideration of Consultant's satisfactory performance of the duties set forth herein, OESD 114
shall compensate and/or reimburse the expenses of Consultant as follows:
A. Consultant shall be compensated in the following amount:
Not to exceed $1,500.00 (One Thousand Five Hundred dollars)
Services reimbursed at $50.00 per hour.
All mileage reimbursed at $0,51 per mile.
Payment shall be made within a reasonable period following termination of this
agreement and upon Consultant's compliance with the terms and conditions of this
agreement.
(Optional) Progress payments shall be made, in the following amount, upon the dates
specified and in return for the partial performance, all as set forth as follows:
Payment Number
Date
Amount
B. (Optional) In addition to the compensation provided for above, Consultant shall be
reimbursed travel expenses, supplies and/or other expenses (specifY): in an
amount not to exceed $ _not applicable.
Revised 412009 Page 2 of 7
C. All payments of compensation and expenses to Consultant shall be conditioned upon
Consultant's:
1. Submission of detailed vouchers which support the performance which has been
rendered or expenses incurred for which payment is requested. and
2. Performance to the satisfaction of Superintendent's designee: PROVIDED, that
approval shall not be unreasonably withheld.
D. Except as expressly provided herein, all expenses necessary to the Consultant's
satisfactory performance of this agreement shall be bome in full by the Consultant
E. Any date specified herein for payment(s) to Consultant shall be considered extended as
necessary to process and deliver an OESD 114 warrant for the amount(s).
DL PROHIBmON AGAINST ASSIGNMENT
Neither this contract nor any interest therein may be assigned by either party, without first obtaining
the consent of the other party.
IV. OWNERSHIP OF WORKPRODUcrS AND RESTRICflON AGAINST DISSEMINATION
All correspondence, papers, documents, reports, files, films, work products (inclusive of intellectual
concepts and properties) and all copies thereof, which are received or developed by Consultant and
Consultant's emp1oyee(s) and agent(s) in the course of performing, or as incident thereto,
Consultant's duties pursuant to this agreement shall, immediately upon receipt, preparation, or
development, become the exclusive property of OESD 114 in perpetuity for any and all purposes.
All items described above shall be provided to and left with OESD 114 upon the termination of this
agreement by OESD 114 or upon Consultant's performance, whichever shall occur first.
Consultant and Consultant's employee(s) and agent(s) shall not, without prior written approval of
OESD 114, either during the term of this agreement or at any time thereafter, directly or indirectly,
disclose or give to any state or federal government, or corporation, agency or political subdivision of
any state or federal government, or any educational agency, institution or organization, any portion of
the above described items and properties or any information acquired in the course of or as an
incident to the performance of Copsultant's duties hereunder, for any purpose or reason.
Revised 412009
Page 3 of7
v. INDEPENDENT CONTRACTOR STATUS OF CONSULTANT
Consultant and Consultanfs employee(s) and agent(s) shall perform all duties pursuant to this
agreement as an independent contractor. Superintendent shall not control or supervise the manner in
which this agreement is performed nor withhold or pay any taxes in behalf of Consultant or
Consultant's employee(s) or agent(s).
. VI. INDEMNIFICATION
Any and all claims which hereafter arise on the part of any and all persons as a direct or indirect
result of Consultant's or its employee's(') or agenfs(') performance or failure to perform duties
pursuant to this agreement, shall be the Consultant's sole obligation and the Consultant shall
inrl<m1nii)r and hold harmless the Superintendent in full for any and all such acts or failures to act on
the part of Consultant or its employee(s) or agent(s).
VII. TERMINATION
This agreement may be terminm-ed by OESD 114 or any designee thereof, at any time, with or
without reason, upon written notification thereof to the Consultant The notice shall specify the date
of termination and shall be conclusively deemed to have been delivered to and received by
Consultant as of midnight of the second day following the date of its posting in the United States
mail - addressed as first noted I:!.erein in the absence of proof of actual delivery to and receipt by
Consultant by mail or other means at an earlier date and/or time.
In the event of termination by OESD 114, Consultant shall be entitled to an equitable proration of the
total compensation provided for herein for lUlcompensated services which have been performed as of
termination and to the reimbursement of expenses incurred as of termination by solely to the extent
such expenses are reimbursable pursuant to the provisions of this Agreement
VIII. VERBAL AGREEMENT
This written Agreement constitotes the mutual agreement of Consultant and OESD 114 in whole.
No alteration or variation of the terms of this Agreement and no oral understandings or agreements
not incorporated herein, unless made in writing between the parties hereto, shall be binding.
IX. AJ.>PLICABLE LAW
This Agreement shall be governed by the laws of the State ofWasbington.
Rovised412009
Page 4 of7
X. NON-DISCRIMINATION
No person shall, on the ground of race, creed, color, national origin, mental/physical/sensory
handicap, or sex, be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any activity performed pursuant to this Agreement
XI. CONFLICT OF INTEREST
Neither the Consultant nor Consultant's employee(s) shall perform any duty pursuant to this
Agreement in which duty he/she may have participated as an employee of OESD 114.
XII. EFFECTIVE DATE - DURATION
This Agreement shall commence on the --L day of January. 2012. This Agreement shall
terminRt" at midnight on the.1!L day of June. 2013, with the sole exception of Sections IV
(Ownership of Work Products and Restriction Against Dissemination) and VI (Indemnification)
which shall continue to bind the parties, their heirs and successors.
XIII. FEDERAL BACKUP WITHHOLDING INFORMATION
The Consultant certifies to OESD 114 that the Consultant is not subject to backup withholding
under Section 3406(a)(l)(c) of the Internal Revenue Code. The Consultant agrees to notifY OESD
114 in writing if this information is not true.
XIV. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
This certification is required by the regulations implementing Executive Order 12549,
Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The
regulations were published as Part VII of the May 26,1988 Federal Rel!ister (pages 19160-
19211).
(BEFORE COMPLETING CERTIFICATION, READ ATTACHED INSTRUCTIONS
WHICH ARE AN INTEGRAL PART OF THE CERTIFICATION)
The Consultant certifies to OESD 114 that neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department oragency.
Revised 4/2009
Page 5 of7
IN WITNESS THEREOF, OESD 114 and Consultant have executed this Agreement consisting of
nine pages.
CONSULTANT
Who certifies that he/she is the person duly
qualified and anthorized to bind the
Consultant so identified to the foregoing
Agreement and under penalty of perjury,
certifies the Social Security Number or
Federal Identification Number provided is
correct.
Signed this
20_.
day of
Consultant Signature
Jefferson Countv
Business name, if different from above
Check appropriate box:
o Individual/Sole Proprietor
o Corporation
o Partnership
o Limited Liability Company
~~ Gov't Entity
Address (number, street and apt or suite #f)
615 Sheridan st.
City, state and zip code
Port Townsend, WA 98368
Taxpayer Identification Nmnber
(Social security nmnber or
Employer identification nmnber)
91-6001322
Revised 412009
EDUCATIONAL SERVICE DISTRICT 114
Walt Bigby, Superintendent
Signed this day of
20_.
ESD USE ONLY
APPROVALS:
DEPARTMENTHEAD DATE
DMSION HEAD DATE
PURCHASE ORDER NUMBER
Approved as te fonn only:
() 'Z..}rllz-
ce
Page 6 of?
.
.
CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER
RESPONSIBILITY MAITERS - PRIMARY COVERED TRANSACTIONS
By signing and submitting this contract, the contractor, defined as the primaIy participant in accordance
with 45 CPR 76 certifies to the best of his or her knowledge and belieftbat it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily
excluded from covered transaction by any Federal Department or agency;
(b) Have not within a 3-year period preceding this proposal been convicted or had a civil judgement
rendered against them for commission of fraud or a 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, bn"bery, falsification or destruction of records, making false statement, or receiving
stolen property;
(c) Are not presently or otherwise criminally or civilly charged by a governmental entity (Federal, Sate or
local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and
(d) Have not within a 3-year period preceding this application/proposal had one or more public
transactions (Federal, State or local) terminated for cause or default
The inability of a person to provide the certification required above will not necessarily result in denial of
participation in this agreement Ifnecessary, the prospective participant shall submit an explanation of
why it cannot provide the certification. OESD and the Federal agency will determine whether to enter into
this transaction. However, failure of the prospective primaIy participant to furnish a certification or an
explanation shall disqualify such person from participation in this transaction.
The prospective primary participant agrees that by submitting this proposal, it will include the clause
entitled "Certification Regarding Dl;lbarment, Suspension, Ineligibility and Voluntary Exclusion-Lower
Tier Covered Transactions," provided below without modification in all lower tier covered transactions.
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGffiILITY AND VOLUNTARY
EXCLUSION-LOWER TIER COVERED TRANSACTIONS
(TO BE SUPPLIED TO LOWER TIER PARTICIPANTS)
By signing and submitting this lower tier proposal, the prospective lower tier participant, as defined in 45
CFR, Part 76, certifies to the best of its knowledge and belief that it and its principals:
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency.
(b) Where the prospective lower tier participant is unable to certilY to any of the above, such prospective
participant shall attach an explanation to this proposal.
The prospective lower tier participant further agrees by submitting this proposal that it will include this
clause entitled ''Certification Regarding Debarment, Suspension, Ineligt'bility and Voluntary Exclusion-
Lower Tier Covered Transaction," ~out modification in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
Revised 412009
Page 7 of7