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000vSign Envelope ID: n1Ce00001185-4roA~^CrB-8C1rurr0013r <br /> ATTACHMENT B <br /> SCOPE OF WORK <br /> Orange County Department of Social Services <br /> Federal Tax Id. or SSN <br /> Contract# <br /> A. CONTRACTOR INFORMATION <br /> 1. Contractor Agency Name: Charles House Association <br /> 2. /foifferon/from Contract Administrator thformation in General Contract: <br /> Address <br /> __ <br /> Telephone Number: _ Fax Number: Email: <br /> 3. Name of Program (s):. Adult Day Care <br /> 4. Status: ( ) Public ( }{ ) Private, Not for Profit ( ) Private, For Profit <br /> 5. Contractor's Financial Reporting Year July l, 2O|6 through June 30, 2017 <br /> B. Explanation of Services to be provided and to whom (include SIS Service Code): The <br /> Contractor will provide Adult Day Services(SIS Code 030)to clients of the Orange Countv <br /> Department of Social Services. These services will be provided in accordance with provisions sct <br /> forth in Volume IV of the Adult and Family Services Manual, Chapter lI-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 /> I. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) <br /> Minjmum daily rate: $33.07/day per client <br /> 2.Negotiated County Rate. <br /> D. Number of units to be provided: <br /> E. Details of Billing process and Time Frames; The County will reimburse the Contractor for <br /> services described in this contract up to the budgetary limits of the contract allotment. The <br /> County will reimburse the Contra kxu1xrutco{$]3.U7/davOo,uppcovcdserviceuprovided. For <br /> reimbursement.the Contractor must submjt 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 monthi ' u"ourcceivtpfacoun~|etc and uoorecU 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 /> contributions are contained in Family Services Manual, Volume VI, Chapter III. If a client <br /> Contract-Scope of Work(06/04) Page lofl <br />