2015-320-E DSS - Charles House Association to provide adult day services to OC DSS clients $25,000

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DocuSign Envelope ID:27BE0809-07F1-4358-A397-1F35DD236252 Contract 468-2009 Charles House Association Contract# 68-2009 Fiscal Year Begins_Julyl,2015 Ends June 30, 2016_ This contract is hereby entered into by and between the Orange County Department of Social Services (the "County") and Charles House Association (the "Contractor") (referred to collectively as the "Parties"). The Contractor's federal tax identification number or Social Securijy Number is 1. Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Terms and Conditions(Attachment A) (3) The Scope of Work, description of services,and rate(Attachment B) (4) Federal Certification Regarding Drug-Free Workplace&Certification Regarding Nondiscrimination(Attachment C) (5) Conflict of Interest(Attachment D) (6) No Overdue Taxes(Attachment E) (7) HIPAA Business Associate Addendum(Attachment 1) (8) Certification of Transportation(Attachment J) (9) IRS Federal Tax Exempt Letter or 501(c)(3)(Attachment K) (10) State Certification (Attachment M) (11)Outcomes and Reporting(Attachment N) (12)Contract Determination Questionnaire These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence Amon g Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Paragraph 1, above, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on July 1, 2015 and shall terminate on June 30,2016. This contract must be twelve months or less. 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work, and shall meet the requirements set forth in Attachment N, Outcomes and Reporting. 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed$25,000. This amount consists of$25,000 in Federal (CFDA 4 }, State and County funds, $0 (source of other funds if applicable). [X] a. There are no matching requirements from the Contractor. [ ] b. The Contractor's matching requirement is$ , which shall consist of: [ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed $25,000. 6. Reversion of Funds: Any unexpended grant funds shall revert to the County Department of Social Services upon termination of this contract. Contract-General(06115) Page I of 5