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Contract #64-2009 <br />Charles House Association <br />ATTACHMENT B <br />SCOPE OF WORK <br />Orange County Department of Social Services <br />Federal "fax [d. or SSN ~ ~' ~ <br />Contract # 68-2009 <br />A. CONTRACTOR INFORMATION <br />l . Contractor Agency Name: Charles House Association <br />2. if efferent from Contract Administrator Information in General Contract: <br />Telephone Number: <br />Fax Number: Email: <br />Name of Program (s): Adult Day Service <br />4. Status: ( )Public (X) Private, Not for Profit ( )Private, For Profit <br />5. Contractor's Financial Reporting Year July 1, 2011 through June 30, 2012 <br />B. Explanation of Services to be provided and to whom (include SIS Service Code): The <br />Contractor will provide Adult Da~Services (SIS Code 0301 to clients of the Orange County <br />Department of Social Services These services will be provided in accordance with provtstons set <br />forth in Volume IV of the Adttlt and Family Services Manual Chapter II-Adult Day Care <br />Services The Contractor is required to meet all goals and outcomes listed in Attachment N. <br />C. Rate per unit of Service (define the unit): <br />1. If Standard Fixed Rate, Maxitnutn Allowable, (See Rates for Services Chart) <br />$33 07/day <br />2. Negotiated County Rate. <br />D. Number of units to be provided: <br />E. Details of Billing process and Time Frames; The County will reimburse the Contractor for <br />services described in this contract up to the budgetary limits of the contract allotment. Tl~e <br />County will reimburse the Contractor at a rate of $33 07/day for approved services provided. For <br />reimbursement the Contractor must submit an original and two copies of an invoice by the fifth <br />of the month for the preceding month's expenditures to the designated County Administrator. <br />The Count will reimburse the Contractor monthly upon receipt of a complete and correctly filed <br />report <br />The service(s) under contract with the Contractor are services for which a client may voluntarily <br />contribute to the cost Policies regarding the solicitation and acceptance of voluntary <br />Contract-Scope of Work (06/04) Page (of 2 <br />