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HomeMy WebLinkAboutWashington State Depatment of Health - Consolidated Amendment No. 4' 5'(3jd�RSON COUNTY PUBLIC HEALTH 6---L-3 (� � O IC )015 0177 CONSOLIDATED CONTRACT 1 CONTRACT NUMBER: C17112 AMENDMENT NUMBER: 4 PURPOSE OF CHANGE: To amend this contract between the DEPARTMENT OF HEALTH hereinafter referred to as "DOH", and JEFFERSON COUNTY PUBLIC HEALTH hereinafter referred to as "LHJ ", pursuant to the Modifications /Waivers clause, and to make necessary changes within the scope of this contract and any subsequent amendments thereto. IT IS MUTUALLY AGREED: That the contract is hereby amended as follows: 1. Exhibit A Statements of Work, attached and incorporated by this reference, are amended as follows: ® Adds Statements of Work for the following programs: • Emergency Preparedness & Response - Effective July 1, 2015 • OSS LMP Implementation - Effective July 1, 2015 • Recreational Shellfish Activities - Effective July 1, 2015 ® Amends Statements of Work for the following programs: Maternal & Child Health Block Grant - Effective January 1, 2015 ❑ Deletes Statements of Work for the following programs: 2. Exhibit B -4 Allocations, attached and incorporated by this reference, amends and replaces Exhibit B -3 Allocations as follows: ® Increase of $168,191 for a revised maximum consideration of $709,002. ❑ Decrease of _ for a revised maximum consideration of ❑ No change in the maximum consideration of _ Exhibit B Allocations are attached only for informational purposes. 3. Exhibit C -4 Schedule of Federal Awards, attached and incorporated by this reference, amends and replaces Exhibit C -3. Unless designated otherwise herein, the effective date of this amendment is the date of execution. ALL OTHER TERMS AND CONDITIONS of the original contract and any subsequent amendments remain in full force and effect. IN WITNESS WHEREOF, the undersigned has affixed his /her signature in execution thereof. JEFFERSON COUNTY PUBLIC HEALTH .1 Date Appro ied as�o form ot}ly� Jefferson Co. Prosecutor' ffice David Alvarez, Chief Ci DPA Page 1 of 14 STATE OF WASHINGTON DEPARTMENT OF HEALTH Frank Webley 'Date Contract Specialist APPROVED AS TO FORM ONLY Assistant Attorney General w a N 0 � '^ w N O o -h 0 x w N 0 A 0 a w s z c cr C) N A dddd 0000 z = z = rorororo S R R R 0 � 0 OQ aQ � QQ m � Rm Rm zzzz @ 3 3 B 0 0 0 0 S S S S m` m ro io x0 m � w � a w_ S arn i - O � w c `G N N In W �D Vl W N O r+ !n N O y y � ta�rnvz, A�tCC Orx O � turf y 0 d z n a m z d rt rt z A d Y O � M y^ C N N ° O M U 0 x ro ova O O M .. w 0 a w z v WE N A n 0 N pi w � � � K R 'T ^ S ova N O J a m z 0 z A a0 o 10 9 m ° m o a CTi C R n n A r � 'Y .'T R R in ro y '9 ro G w B w .n p o w c'o ❑ � 'x o V M G _ O y N VJ N �y N O O y � 'A `M ° x N N ° S N FFi 6 S ' ° F N N fD ❑❑0 N ti N CRaD � M � � F n n r F 0 n r w d ac �R a u° S R d G., -°G o• w a y c o � S N a w N � B •e rn ° a n ❑ d 0 ° v El N <� b c aroi � m w N ° �T N 5 w nzeo w a °x F1 °a F3 _ CC I v O n o n am A fD (p y R � v a N�� o• c o N N N 'Ot O R A R✓ �+ as A A A � EL o d 0 0 o � u° g o 0 o n 0 N pi w � � � K R 'T ^ S ova N O J a m z 0 z A a0 o 10 9 m ° m o a CTi C R n n ° R .'T R M G _ O y N VJ N �y N O O y � 'A `M ° x N N ° S N G d aq ❑❑0 N ti N CRaD � M � � F n n r F 0 n r w S _ ❑® A S S R d G., a y c o a w � B •e rn ° a n 0 El N b c aroi � m w ° N 5 n 0 N pi w � � � K R 'T ^ S ova N O J a m z 0 z A �m o�'rno vdo C o �y m ^ m c R7 °,T o g o � 3 m b QQ N O U� J •-. p G G 2� 7 m� a.0 d� u,y 6s a �❑ � � w -�o � ado O c: co 6 . 5m cTQ 0 m m D. 5 ~ 0 w c � .`. 7 O 6 o n N a`q' D �° � ❑ v� O N O [o � O M r] O N w A R • w �pJ. 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STATEMENT OF ISSUE: Jefferson County Public Health requests Board approval of the Consolidated Contracts A -4 between JCPH and State of Washington Department of Health; January 1, 2015 - December 31, 2017; add'I $168,191 f total of $709,002. ANALYSIS /STRATEGIC GOALS /PRO'S and COWS: This agreement with the Department of Health, a two -year agreement, comprises State and Federal funds. This amendment adds $168,191 in revenue to the existing contract. The affected programs are as follows: • $34,991 Emergency Preparedness & Response Program: the purpose of the revision is to add funding for administrative oversight and development of the program. • $36,700 Maternal & Child Health Block Grant: the purpose of this revision is to increase and extenc funding to meet implementation and continuation of MCHBG related activities. • $90,000 On -site sewage system (OSS) local management plan (LMP): the purpose of this revision i to add funding to implement OSS and LMP inspections and administrative oversight • $6,500 Recreational Shellfish Activities: the purpose of this revision is to continue funding for this program from 7/01/2015 — 06/30/2016. FISCAL IMPACT /COST BENEFIT ANALYSIS: Total consideration for this Contract Amendment is $168,191 for a total of $709,002. The Consolidated Contract is funded by the Department of Health, and comprises both Federal and State funds. RECOMMENDATION: JCPH management request approval of Consolidated Contracts, A -4; January 1, 2015 — December 31, add'I $168,191 for total of $709,002. 171�K� Date 360- 385 -9401 (f) Always working for a safer and healthier community Environmental Health Water Quality 360 -385 -9444 (f) 360- 379 -4487 �e�ucson Public Health CONTRACT WITH: 615 Sheridan Street Port Townsend, WA 98368 www.JeffersonCountyPublicHealth.org CONTRACT REVIEW FORM of Health f v SEP 0 3 2058-15 -oz -A4 CONTRACT FOR: Consolidated Contracts Amendment #4 TERM: January 1, 2015 – Dec. 31, 2017 E K (This form to stay with conLthrou review process) a' sDS 2015 community Health ON COUNTY Developmental Disabilities NG ATTORNEY 360- 385 -9400 360 -385 -9401 Ifl Always working for a safer and healthier community Environmental Health Wafer Quality 360 -385 -9444 (fi 360- 379 -4487 COUNTY DEPARTMENT: Jefferson County Public Health For More Information Contact: Julia Danskin Contact Phone #: X420 RETURN TO: Denise Banker RETURN BY: ASAP kMOUNT: Add'I $168,191 for total $709,002 PROCESS: 0 Exempt from Bid Process Revenue: Expenditure: __ latching Funds Required: ❑ Consultant Selection Process) ❑ Cooperative Purchase ❑ Competitive Sealed Bid ❑ Small Work Roster ource(s) of Matching Funds: ❑ Vendor List Bid ❑ RFP or RFQ ❑Other: Review by: Step 1: REVIEW BY RIS *10t1r4nedfor / < - Date Revie e : APPROVED FORM revision (See Comments) Comments: Step 2: REVIEW BY PRO CUTI G ATT R Review by: BLV i"L Y Date Reviewed: APPROVED AS TO FORM —one f Commen r r vision (See Comments) (This form to stay with conLthrou review process) a' sDS 2015 community Health ON COUNTY Developmental Disabilities NG ATTORNEY 360- 385 -9400 360 -385 -9401 Ifl Always working for a safer and healthier community Environmental Health Wafer Quality 360 -385 -9444 (fi 360- 379 -4487