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HomeMy WebLinkAboutWashington State Department of Social & Health Services, Juvenile Justice & Rehabilitaion Administration, Amendment No. 1 - 090616DSHS Central Contract Services Page 1 6024PF Contract Amendment (3-31-06) DSHS CONTRACT NUMBER: CONTRACT AMENDMENT 1563-42418 gg DI ARTS ENT OF 7OC1ALE+HEALTH WSART Consultation for County Amendment No. 01 SERVICES Juvenile Courts This Contract Amendment is between the State of Washington Department of Program Contract Number Social and Health Services (DSHS) and the Contractor identified below. Click here to enter text. Contractor Contract Number CONTRACTOR NAME CONTRACTOR doing business as (DBA) Jefferson Count CONTRACTOR ADDRESS WASHINGTON UNIFORM DSHS INDEX NUMBER BUSINESS IDENTIFIER (UBI) 1820 Jefferson St Port Townsend, WA 98368- 161-001-169 1223 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Barbara Carr 360 385-9190 360 385-9191 bcarr co.jefferson.wa.us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Rehabilitation Administration Division of Treatment and 5000CC-63 Intergovernmental Pro DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS Cory Redman 1115 Washington Street SE Pro ram Administrator Olympia, WA 98504 DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS (360)902-8079 r I cory.redman@dshs.wa.gov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBERS No AMENDMENT START DATE CONTRACT END DATE 08/22/2016 06/30/2017 PRIOR MAXIMUM CONTRACT AMOUNT AMOUNT OF INCREASE OR DECREASE TOTAL MAXIMUM CONTRACT AMOUNT $18,920.00 $-320.00 $18,600.00 REASON FOR AMENDMENT; CHANGE OR CORRECT MAXIMUM CONTRACT AMOUNT ATTACHMENTS. When the box below is marked with an X, the following Exhibits are attached and are incorporated into this Contract Amendment by reference: ❑ Additional Exhibits (specify): This Contract Amendment, including all Exhibits and other documents incorporated by reference, contains all of the terms and conditions agreed upon by the parties as changes to the original Contract. No other understandings or representations, oral or otherwise, regarding the subject matter of this Contract Amendment shall be deemed to exist or bind the parties. All other terms and conditions of the original Contract remain in full force and effect. The parties signing below warrant that they have read and understand this Contract Amendment, and have authority to enter into this Contract Amendment. CONTRACT R SIGNATURE CZ ` PRINTED NAME AND TITLE Kc �(ee� Ker CU ati wtm Co DATE SIGNED i u vL © CC— DSHS SIGNATURE PRINTED NAME AND TITLE DA E SIGNED Del Hontanosas q (l 1 t �• Grants & Contracts Manager DSHS Central Contract Services Page 1 6024PF Contract Amendment (3-31-06) This Contract between the State of Washington Department of Social and Health Services (DSHS) and the Contractor is hereby amended as follows: 1. The maximum consideration for FY17 is reduced by $320 from $9,460 to $9,140. 2. Due to an oversight error the hourly rates of $45.56 per hour for FY16 and $46.84 per hour for FY17 were incorrect and therefore changed to $40.00 per hour for FY16/17. 3. In EXHIBIT A: Statement of Work - WSART Consultation for County Juvenile Courts, Section 3. Consideration, is changed to read as follows: Total consideration payable to Contractor for satisfactory performance of the work under this Contract is up to a maximum of $18,600, including any and all expenses, and shall be based on the following: a. The maximum consideration payable for Fiscal Year 2016 is $9,460 and for Fiscal Year 2017 is $9,140. Funds not expended in Fiscal Year 2016 cannot be carried over to the following Fiscal Year. b. The Contractor shall be paid $40.00 per hour for FY16/17 for clinical consultation services and payment shall be based upon the Juvenile Rehabilitation's Juvenile Court Program Administrator receipt and approval of monthly summary report. c. The Contractor shall only be reimbursed for travel costs pre -approved in writing by the Juvenile Rehabilitation's Juvenile Court Program Administrator. All other terms and conditions of this Contract remain in full force and effect. DSHS Central Contract Services Page 2 6024PF Contract Amendment (3-31-06) Consent Agenda Regular Agenda Jefferson County Board of County Commissioners Agenda Request TO: Board of Commissioners Philip Morley, County Administrator FROM: Barbara Carr DATE: Tuesday, September 6, 2016 RE: WSART Consultant Contract 1563-43418 AMENDMENT STATEMENT OF ISSUE: Contract in the amount of $18,920.00 - Funding for 7/2015 — 6/2017 Amendment to reduce amount to $18,600.00. ANALYSIS: Shannon Burns, a Juvenile Probation Counselor in Jefferson County is currently serving as one of five statewide consultants to perform consultant duties to WSART programs. Jefferson County is reimbursed for Shannon's time pursuant to the WSART Quality Assurance requirements. FISCAL IMPACT: None. These funds reimburse for salary, benefits and travel. DEPARTMENT CONTACT: Barbara Carr, Juvenile Court Administrator RECOMMENDATION: That the Board approve the Contract and sign 3 originals. A fully executed original will be returned to the BOCC office. Approved bV, ip Morley, qou-nty A Date CONTRACT REVIEW FORM / � —I b CONTRACT WITH: DSHS - Juvenile Justice & Rehabilitation Administration CONTRACT FOR: WSART Amendment No 1— Juvenile Court TERM: 07/01/15-06/30/17 COUNTY DEPARTMENT: For More Information Contact: Contact Phone #: RETURN TO: Barbara Carr (Person in Denartment) Juvenile & Barbara Carr 385-9192 RETURN BY: AMOUNT: $18,600.00 PROCESS: Revenue: 18,600.00 Expenditure: 18,600.00 Matching Funds Required: Sources(s) of Matching Funds Exempt from Bid Process Consultant Selection Process Cooperative Purchase Competitive Sealed Bid Small Works Roster Vendor List Bid RFP or RFQ Other Sole source Step 1: REMEW BY RISIL NT Review by: -� Date Reviewed: % APPROVED FORM ❑ Returned for revision (See Comments) Comments Step 2: RMEW BY PROSECUTING ATTORNEY Review by: Date Reviewed:' zufG APPROVED AS TO FORM ❑ Returned for revision (See Comments) Comments Ph., (- . Z" Step 3: (If required) DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF ORIGINALS Step 5: SUBMIT TO BOCC FOR APPROVAL Submit originals and 9 copies of Contract, Review Form, and Agenda Bill to BOCC Office. Place "Sign Here" markers on all places the BOCC needs to sign. MUST be in BOCC Office by 5 p.m. TUESDAY for the following Monday's agenda.