Attachment 1
Page 1 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
REVENUE AGREEMENT FOR
THE SENIOR TRANSPORATION PILOT PROGRAM
This Revenue Agreement (“Agreement”) is entered into by and between the City of
Cupertino, City of Saratoga, Town of Los Gatos, City of Campbell, City of Monte Sereno
("West Valley Cities") and County of Santa Clara (“Fiscal Agent”). The purpose of this
Agreement is to delineate the roles and responsibilities of the Parties to this Agreement.
I. TERM
The term of this Agreement is from July 1, 2017 through June 30, 2018.
II. DESCRIPTION OF SERVICES
Obligated funds in this Agreement total $166,000 to support the Saratoga Area
Senior Coordinating Council (“SASCC”) and the West Valley Community
Services of Santa Clara County, Inc. (“WVCS”) to initiate the Senior
Transportation Pilot Program (“STPP”) through FY2017-18. SASCC and WVCS
will work together as the "Operators" of STPP.
Copies of fully-executed agreements between Fiscal Agent and the Operators
are attached to this Agreement as Exhibit A and are incorporated by this
reference.
In addition to this Agreement, Fiscal Agent intends to enter into a separate
revenue agreement with the Santa Clara Valley Transportation Authority (VTA)
which will provide funding to Fiscal Agent for STPP in the amount of $84,000.
III. WEST VALLEY CITIES OBLIGATIONS
The West Valley Cities will provide funding in the following amounts to the Fiscal
Agent to help support the Senior Transportation Pilot Program through the fiscal
year ending June 30, 2018:
A. City of Cupertino $22,000
B. City of Saratoga $19,000
C. Town of Los Gatos $17,000
D. City of Campbell $16,000
E. City of Monte Sereno $8,000
Payment shall not exceed the amount specified above. West Valley Cities shall
make a good-faith effort to provide all funds by August 30, 2017.
For Fiscal Agent’s internal accounting use only: The revenue from this
Agreement will be deposited in Cost Center 4799 and GLA 4600100.
Page 2 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
IV. FISCAL AGENT
Fiscal Agent will fund $84,000 in FY2017-18 to help support the Senior
Transportation Pilot Program.
Fiscal Agent will monitor and maintain all programmatic aspects of the services
supported under this Agreement.
Fiscal Agent will work with West Valley Cities to provide any information or data
required for reports.
Fiscal Agent is responsible for developing and monitoring contracts related to the
Senior Transportation Pilot Program.
V. AGREEMENT ADMINISTRATION/COMMUNICATION
Under this Agreement, the Fiscal Agent shall monitor and evaluate the Operators’
performance. All requests and communications about this Agreement or STPP
shall be made to:
Jorge Montes
Office of Contracts Management
Santa Clara County Social Services Agency
333 W Julian St
San Jose, CA 95110
(408) 755-7746
Jorge.Montes@ssa.sccgov.org
Under this Agreement, the Agency Contacts for the West Valley Cities are listed
below.
Entity Agency
Contact Address Phone Email
City of
Cupertino
David
Stillman
10300 Torre Ave.,
Cupertino, CA
95014
408-
777-
3343
DavidS@cupertino.org
City of
Saratoga
Crystal
Bothelio
13777 Fruitvale
Avenue, Saratoga
CA 95070
(408)
868-
1269
cbothelio@saratoga.ca.us
Town of
Los Gatos
Ying
Smith
41 miles Ave, Los
Gatos, CA 95030
408-
399-
3550
ysmith@losgatosca.gov
City of
Campbell
Tina
Wong-
Erling
1 W. Campbell
Ave. C33,
Campbell, CA
95008
(408)
866-
2147
tinaw@cityofcampbell.co
m
Page 3 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
City of
Monte
Sereno
Terry
Blount
18041 Saratoga-
Los Gatos Road,
Monte Sereno,
CA 95030
(408)
354-
7635
terry@cityofmontesereno.
org
VI. RETENTION OF RECORDS
The Fiscal Agent shall safely maintain all financial data, supporting documents,
and all other records relating to performance and billing under this Agreement for
the period required by state and federal law. The minimum retention period shall
be no less than four (4) years after the end of the term of this Agreement.
VII. RIGHT TO AUDIT
The Fiscal Agent shall permit all data and records relating to performance,
procedures, and billing to the West Valley Cities under this Agreement or STPP
to be inspected and/or audited, at any reasonable time, by the authorized
representative of the (1) West Valley Cities, or (2) any appropriate state or
federal auditing agency.
The right of each entity to inspect and/or audit under this Agreement is
independent of any right of any other entity.
VIII. AUDIT COMPLIANCE
The Fiscal Agent shall accept responsibility for receiving, replying to, and/or
complying with any audit exception by appropriate state and federal audit
agencies that directly relate to the services to be performed under this
Agreement. A draft of any reply shall be reviewed and approved for release by
the West Valley Cities before release to the relevant entity. A copy of the final
reply shall be submitted to the West Valley Cities.
IX. AUDIT LIABILITY
The Fiscal Agent shall pay the West Valley Cities the amount, if any, of the West
Valley Cities’ liability that results from the Fiscal Agent’s failure to perform the
services or comply with the conditions required by this Agreement and identified
by any audit exception. This is an express obligation which is additional to any
and all obligations imposed upon Fiscal Agent pursuant to Section VIII.
X. CONFIDENTIALITY
The Parties will maintain the confidentiality of all records generated during the term
of this Agreement to the extent required by all applicable local, state, and federal
laws and regulations.
XI. AMENDMENTS
Any amendment to this Agreement must be in writing, must be clearly marked as
an "Amendment," and signed by all Parties to this Agreement.
Page 4 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
XII. INDEMNIFICATION
In lieu of and notwithstanding the pro rata risk allocation which might otherwise
be imposed between the parties pursuant to Government Code Section 895.6,
the Parties agree that all losses or liabilities incurred by a Party shall not be
shared pro rata but instead the parties agree that pursuant to Government Code
Section 895.4, each of the Parties hereto shall fully indemnify and hold each of
the other Parties, their officers, board members, employees and agents,
harmless from any claim, expense or cost, damage or liability imposed for injury
(as defined by Government Code Section 810.8) occurring by reason of the
negligent acts or omissions or willful misconduct of the indemnifying party, its
officers, employees or agents, under or in connection with or arising out of any
performance of obligations required by this Agreement or other applicable laws
relating to this Agreement delegated to such party under this Agreement. No
party, nor any officer, board member, employee or agent thereof shall be
responsible for any damage or liability occurring by reason of the negligent acts
or omissions or willful misconduct of the other parties hereto, their officer, board
members, employees or agents, under or in connection with or arising out of any
performance of obligations required by this Agreement or other applicable laws
relating to this Agreement delegated to such other parties under this Agreement.
XIII. WAIVER
No delay or failure to require performance of any provision of this Agreement
shall constitute a waiver of that provision as to that or any other instance. Any
waiver granted by a party must be in writing and shall apply to the specific
instance expressly stated.
XIV. SEVERABILITY
If any provision of this Agreement is found by a court of competent jurisdiction to
be void, invalid or unenforceable, the same will either be reformed to comply with
applicable law or stricken if not so conformable, so as not to affect the validity or
enforceability of this Agreement.
XV. ENTIRE AGREEMENT
This document represents the entire Agreement between the Parties. All prior
negotiations and written and/or oral agreements between the Parties with respect
to the subject matter of the agreement are merged into this Agreement.
XVI. GOVERNING LAW, VENUE
This Agreement has been executed and delivered in, and shall be construed and
enforced in accordance with, the laws of the State of California. Proper venue for
legal action regarding this Agreement shall be in the County of Santa Clara.
XVII. ASSIGNMENT
No assignment of this Agreement or of the rights and obligations hereunder shall
be valid without the prior written consent of the other party.
Page 5 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
XVIII. CONTRACT EXECUTION
Unless otherwise prohibited by law or County policy, the Parties agree that an
Electronic Copy of a Signed Contract, or an Electronically Signed Contract, has
the same force and legal effect as a contract executed with an original ink
signature. The term “Electronic Copy of a Signed Contract” refers to a
transmission by facsimile, electronic mail, or other electronic means of a copy of
an original signed contract in a portable document format. The term
“Electronically Signed Contract” means a contract that is executed by applying an
electronic signature using technology approved by the County.
XIX. COUNTERPARTS
This Agreement may be executed in separate counterparts, any one of which
need not contain signatures of more than one party, but all of which taken
together will constitute one and the same Agreement.
IN WITNESS THEREOF, the Parties, intending to be legally bound, have executed this
Agreement as of the date of the last signature.
FISCAL AGENT
Date:__________ ________________________________
Jenti Vandertuig, Director
Santa Clara County, Procurement Department
Date:__________ ________________________________
Robert Menicocci, Director
Santa Clara County, Social Services Agency
Date:__________ ________________________________
Julia Wyman, Chief Financial Officer
Santa Clara County, Social Services Agency
APPROVED AS TO FORM AND LEGALITY
Date:__________ ________________________________
Cheryl Stevens, County Counsel
Santa Clara County
Page 6 of 6
REVENUE AGREEMENT FOR THE SENIOR TRANSPORATION PILOT PROGRAM
CITY OF CUPERTINO
Date:__________ Signature:________________________
Printed Name:____________________
Title:____________________________
CITY OF SARATOGA
Date:__________ Signature:________________________
Printed Name:____________________
Title:____________________________
TOWN OF LOS GATOS
Date:__________ Signature:________________________
Printed Name:____________________
Title:____________________________
CITY OF CAMPBELL
Date:__________ Signature:________________________
Printed Name:____________________
Title:____________________________
CITY OF MONTE SERENO
Date:__________ Signature:________________________
Printed Name:____________________
Title:____________________________
EXHIBIT A
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 1 of 13
SECTION I: GENERAL INFORMATION
Contractor Name:
(As Displayed In SAP)
Purchase Order Number:
Agency/Department Name: Department
Number:
Brief Description of Services:
Maximum Financial Obligation
The maximum amount payable to this Contractor
under this agreement shall not exceed:
Term of Agreement
Start Date: End Date:
Note: When left blank, start date will be the date executed by Authorized
County Representative
For County Use Only
Account
Assignment
Plant
Number
General
Ledger
(Expense
Code)
Cost
Center
(Dept
Code)
Amount WBS
(Capital Project Code)
Internal
Order
(“PCA” code
–optional)
Line 1
Line 2
Line 3
Line 4
Line 5
Saratoga Area Senior Coordinating Council
Social Services Agency / OCM 0501
Contractor will provide on-demand transportation services to seniors.
$ 125,000.00
07/01/2017 06/30/2018
0501 5255500 4799 42000
0501 5255500 4799 83000
H
H
Select
Select
Select
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Req # 40025283
4400007295
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 2 of 13
SECTION II: PARTIES TO AGREEMENT
Legal notices and invoices pertaining to this Agreement shall be sent to the appropriate contact person
listed below, except as otherwise specifically provided for herein. Notices shall be in writing and served
either by personal delivery or sent by certified or registered mail, postage prepaid, addressed as follows.
Notice shall be deemed effective on the date that the notice is personally delivered or, if mailed, three (3)
days after deposit in the mail. Either party may designate a different person and/or address for the receipt
of notices by sending written notice to the other party, which shall not require an amendment to this
Agreement.
Contractor
Contractor Name
(As Displayed In SAP):
Contact Person:
Street Address *:
City *: State: Zip:
Telephone number *:
Email Address *:
SCC Vendor Number:
(As Assigned in SAP)
* To be completed for Independent Contractors Only – DO NOT COMPLETE FOR DEPENDENT CONTRACTORS
County of Santa Clara
Agency/Department:
Program Manager/
Contract Monitor Name:
Street Address:
City: State: Zip:
Telephone Number:
Fiscal Contact
(Accounts Payable Contact):
Contract Preparer:
Saratoga Area Senior Coordinating Council
Lisa Oakley / Tylor Taylor
19655 Allendale Ave.
Saratoga CA 95070
(408) 219-7231 / (408) 868-1263
lisa@sascc.org / tylortaylor@sascc.org
1031558
Social Services Agency / Office of Contracts Management
Jonathan Leung
333 West Julian Street, 5th Floor
San Jose CA 95110
(408) 975-4886
Celia Wu
Jonathan Leung
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ313
SECTIONIII:CONTRACT AUTHORIZATION
ǡ
ǡ
Ǥǡ
ȋ Ȍ
Ǥ ǡ
ǯ Ǥ
ȋ ǡȌ Ǥ
ǡ ǡ
Ǥ
SIGNATURES
ContractisnotvaliduntilsignedbyContractorandCounty’sAuthorizedRepresentative.
Ȁ
ǣǣ
Ȁ
ǣǣ
ǣǣ
ǣǣ
(ProcurementDepartment;President,BoardofSupervisors;orDelegatedAuthority)
ǣǣ
(SignaturerequiredwhentheStandardProvisionslanguage(SectionVI)
isrevised,orforITServicespursuanttoBoardPolicy5.3.5.2(4),orforBoardapproved
contracts,orforcontractswithBoarddelegatedauthoritytoagencies/departments.)
ǣ ǡ
ǯ
Ǥ
ǣǣ
(SignaturerequiredwhenBoardapprovedcontractbyadelegationofauthority)
ǣǣ
(SignaturerequiredwhenBoardapprovedcontract)
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
6/28/2017
6/28/2017
6/30/2017 6/29/2017
6/30/2017
7/19/2017
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ413
SECTIONIV:DETERMINATIONOFRELATIONSHIPSTATUS
Ȁ Ǥ ǯ
ǡ ǯǡ
ǯ
Ǥ
ǣ ǡ
ǡǫ
ǫIftheanswertoanyofthesequestionsisYES,selectYESfromthedropdown.
ǣ ǫ
ǣ
ǫ
Ȁǣ
ǡǤǤ ǡǡ ǫ
ǣ
ȄanswerYESǤ
ȄanswerNOǤ
ǣ
ǡȋǦȌǡ ǫ
ǣ ǡ
ǡǡ ǡ DzdzǤȋ
ǤȌ
Enterbelowthebusinesslicensenumberandthecity/entitywhereissued.
BusLic.# Issuedby:
ǣȀǫ
ǡDzdzǤ
Ǥ
ǣ
ǫ ǡ Ǥ
ͷDzdzǡ IndependentContractorǤ
ͷDzdzǡ DependentContractor,
ȀǤǤ
ǣǯ Ȅ ǦͶǡ
ǡ ǦͶǡ ǤǤ
Ǥ
Ǥ
Ǥ
ǯ Ǥ
ǡ Ǥ
Contractor’sInitials:Dept.FiscalOfficer’s Signature:
No
No
No
No
No
No
No
No
No
✔
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 5 of 13
SECTION V: CONTRACT SPECIFICS
A.SERVICE DESCRIPTION AND EXPECTED OUTCOME (SCOPE OF SERVICE)
Or See Attachment: incorporated by this reference.
B.DELIVERABLES, MILESTONES, & TIMELINE FOR PERFORMANCE
Or See Attachment: incorporated by this reference.
A
A✔
✔
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ613
C. PERFORMANCESTANDARDS
ǣ Ǥ
D. PAYMENTSCHEDULE
ǣ
ͶͲ
IscontractoraCommunityBasedOrganization(CBO)?
Yes____
No____
ǣ Ǥ
✔A
✔
✔A
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 713
SECTIONVI:STANDARDPROVISIONS
A.ENTIREAGREEMENT
ȋȌ ǡ
Ǥ ǡ
ǡ ǡ
Ǥ ǡǡ
Ǥ
B.AMENDMENTS
Ǥ
C.CONFLICTSOFINTEREST
ǡ ǡ ȋȌ
ǢȋȌǡ ǡ
ǡ
ͳͲͻͲǤǤǡ ȋ
ͺͳͲͲǤǤȌ
ȋʹ ͳͺͲͲǤǤȌǤ
Ǥ
ǡ ǡ ǡ
ǡ ǡ Ǥ
ǡ ǡ
Ǥ ǡ ǯ ǡ
ͳͻͶȋDz dzȌǡȋͳȌ
ǡȋʹȌ
Ǥ
ǡ ǡ ǡǡ
ǡǡ ǯǡ
ǡ Dz dzDz
ǡdzȋʹͳͺͲͳȋȌȋʹȌȌǡ ǯ Ǥ
Ǥ
ǡ ǡ
Ǥ
ǡ
ȋȌ
ǡǡ ͵Ͳ
ǡͳǡ͵Ͳ Ǥ
D.GOVERNINGLAW,VENUE
ǡ ǡ
Ǥ Ǥ
E.ASSIGNMENT
Ǥ
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 813
F.ASSIGNMENTOFCLAYTONACT,CARTWRIGHTACTCLAIMS
ǡǡ Ͷ
ȋͳͷǤǤǤ ǤͳͷȌ ȋʹȋ ͳͲͲȌʹ
Ȍǡ ǡǡ
Ǥ
G.WAIVER
Ǥ
Ǥ
H.NONǦDISCRIMINATION
Ǧ
ǡǡ ǯ
Ǥ
ǣ ͳͻͶǢ ͳͻͻͲǢ
ͳͻ͵ȋ ͷͲ͵ͷͲͶȌǢ ȋ
ͳʹͻͲͲǤȌǢ
ͳͳͲͳͳͳͲʹǤ ǡǡ
ǡ ǡ ǡǡ ǡǡȀǡǡ
ǡ ǡ ǡ ǡǡ
ǡ ǡǡǡǡǡǡ
Ǥ
ǡ ǡ ǡǡ ǡǡȀǡǡǡ ǡ
ǡ ǡǡǤ
ȂȂ
Ǧ
ȋȌ
ǡ Ǥ
I.TERMINATION
ǡ ǡ Ǥ
Ǥǡ
ǡ Ǥ Ǥ
ǡ ǡ
Ǥ
ȂȂ
ȋȌ
ǡ Ǥ
J.BUDGETCONTINGENCY
Ǥ ǡ
Ǥ
K.COUNTYNOǦSMOKINGPOLICY
ǡ ǡ ǯǦ ǡ
͵ǤͶȋȌǡ ǣȋͳȌ
✔
✔
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 913
Ǧ ǡȋʹȌ͵Ͳ
Ǧ ǡȋ͵Ȍ
Ǥ
L.FOODANDBEVERAGESTANDARDS
ǡȀ
ǦǤ
ǡǤDzdz ȋͳȌǡǡ
ǡ ǢȋʹȌ Ǣȋ͵Ȍ
ǢȋͶȌͲǤͷǤ
ǡ ȋͳȌ ǢȋʹȌǡ Ǣȋ͵Ȍ
ǡ ǢȋͶȌȀ
Ǥǡǡ
ǤǦ ǡ ǣȋͳȌ͵ͷΨ
ǡ ǢȋʹȌͳͲΨ
Ǣȋ͵ȌǢȋͶȌ͵ͷΨ ǡ
ǢȋͷȌ͵ͲǤ
ǡǯ ȋͳȌ
ǢȋʹȌ ǡ Ǣȋ͵Ȍ
ǡǡ ȋͳΨȌǢȋͶȌǦȋe.g.ǡǡ
ǡȌͳ͵Ͳ ͺ ǢȋͷȌͳͲͲΨ ȋ
ͺ ȌǢȋȌǦ ȋ ȀȌ
ͶͲ ͺ ǤǦǤ
M.CONTRACTINGPRINCIPLES
̈́ͳͲͲǡͲͲͲ
Ȁ ǡ
Ǥ ǡ ǣȋͳȌ ǡ
ǡǢȋʹȌ ǡ Ǣȋ͵Ȍ
ǢȋͶȌ
ǯǡ ǡ ǡ ǡ
ǡ ǡ
Ǥ
N.CALIFORNIAPUBLICRECORDSACT
ȋDzdzȌǤ
ǯ ǡ
ǡ
Dz ǡdz Ǥ
ǡ Ǥ
ǡ
ǡ
Ǥ
ǡ Ǥ
ǡ ǡ
ȋ ǡ ǡǡǯȌ
ǡ ȋ Ȍǡ Ǥ
O.THIRDPARTYBENEFICIARIES
ǡǡ
Ǥ
P.INTELLECTUALPROPERTYRIGHTSǣ
ǣǡǤ ǡ
Dzdz
Ǥ ǡ
ǡ ǡǡ
ǡǡ
ǯǡ Ǥ
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1013
ȋ
Ȍ Dzǡdz
ȋͳǤǤǤ ͳͲͳȌǡǤ
ǡǡ Ǥ
Q.INTELLECTUALPROPERTYINDEMNITY
ǡǡ
ǡ ǡȀ
Ǥ ǡ ǡ
ȋ ǡ ǡǡǯȌ
Ȁ
Ǥ
Ǥ
R.OWNERSHIPRIGHTSTOMATERIALS/RESTRICTIONSONUSE
ǡ ǡ
ǡ ǡǡ ǡǡǡ ǡ
ǡ ȋ DzdzȌǡ
Ǥ ǡ
ǡǡ
Ǥ Ǧ
ǡǡǤ
ǡ
ǡ ǡ
Ǥ
ȋȌ Dz
ǡdz ȋͳǤǤǤǡ ͳͲͳȌǡǤ
ǡǡ Ǥ
ǡǡ
Ǥ
Ǥ
S.COUNTYDATA
Dzdz Ǥ ǡ
Ǥ Ǥ
ǡǯ ǡ
Ǥ
ǡ
ǡ
Ǣ
Ǥ
ǡ Ȁ
ǡ ǡ
ǯ Ǣ ǡ
ǡǡ Ǥ Ȁ
ǡ
ǡ ͳͻͺǤʹͻͳͻͺǤͺʹ ǯ
ȋ ȌǤ ǯ
Ǥ
T.WAGETHEFTPREVENTION
ȋͳȌ ǣ ǡ
ǡ ǡǡ Ǥ ǡ
ǡ ǡǡ
Ǥ
ȋʹȌ
ǡ ǡǣ ǡDzǡ ǡdz
Ǥ ǣ
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1113
ǡ ǡ ǡ
Ǥ
ȋ͵Ȍ
Ȁ ǣ
ǡ
ǡǡ
Ȅ
Ȅ
ȋȌ
Ǥ
ȋȌ Ȅ
Ȅ
ǡǡǤ
ȋͶȌ
ǣǡ
ǡ ǡ
ǡ ǡ ǡ
ǡ Ǧ
ȋȌǡͳͷǡ ǡ
ǡ ǡǤ
ǡ ǡǡ Ǧ
ǡ ǡͷǡ ǡǤ
ǡ ǡǤ
ȋͷȌǯǣ
ǡ ǡ
ǡ ǡ ǡ
Ǥ
ȋȌ ǣ Ǥ
Ȁ
ȀǤ
ȋȌ ǣ
ǣ ȄǢͲǢǡͳͳ
Ǣ
±ǡͻͷͳͳͲǤ
ǡ ǡ Ǥ
U.PAYMENTTERM[NOTAPPLICABLETOCOMMUNITYBASEDORGANIZATIONS–describepaymenttermsforCBO’sinSectionV.PAYMENT
SCHEDULE]
Ǥ ǡ ʹǤʹͷΨͳͲͶͷǡ
ͳͲ ǡͶͷǡ
ʹǤʹͷΨ Ǥ
Ǥ
ʹǤʹͷΨͳͲͶͷȋ͵ͷ Ȍ
ʹǤͲͲΨͳͷͶͷȋ͵Ͳ Ȍ
ͳǤͷΨʹͲͶͷȋʹͷ Ȍ
ͳǤ͵͵ΨʹͷͶͷȋʹͲ Ȍ
ͳǤͲͲΨ͵ͲͶͷȋͳͷ Ȍ
ͶͷȋȌ
Note:DzͶͷȋȌdzǡ Ǥ
ǡ ǡ
ǦǦ
Ǥ Ǥ
V.CONTRACTEXECUTION
ǡ ǡ
ǡ Ǥ
Dz dz ǡ ǡ
✔
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1213
SECTIONVII:INSURANCE/INDEMNIFICATION
ǯ
Ǥ .
Ǥ
ǣ
Ǥ
WorkersCompensation:
ǫ
DzdzǡǡǯȀ̵Ǥ
OwnedAutoInsurance:
ǡ
ǫ
Dzdzǡ Ǥ
HiredAutoInsurance:
ǡ
ǫ
Dzdzǡ Ǥ
ǤDz dz
Ǥ
W.LIVINGWAGE(IfApplicable)
ǡ ǡ
ǡ
͵ȋDz͵dzȌ ͷǤͷǤͷǤͷȋDz dzȌǡ
ǡ ̈́ͳͲͲǡͲͲͲȋDz dzȌǡ ͵
͵ Ǥ
ǡǡ
ǡ ǡǡǡǡ ǡǡ
ǡ ǡ Ǥ Ȁ ǡ
ǡ ǡ ǡǡǣ
ȋȌǡǡ Ǥ
ȋȌ Ȁ
Ǥ
ȋ Ȍ͵ Ǥ
̵ ̵
͵ Ǥ ǡ
Ǥ ǡ ͵
ǡ ͵
Ǥ
✔
B-2 Standard Service Contracts Above $100,000
Yes
Yes
Yes
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1313
NonǦownedAutoInsurance:
Ǧ ǡ
ǦǦ ǫ
Dzdzǡ ǦǤ
When“NO”ischecked,thisdeclarationwillserveasawaiverforthespecifiedtypeofinsurance.
SECTIONVIII:FEDERAL/STATEREQUIREDPROVISIONS
ȋ Ǧ ǡ
ȋȌǡ ǡ Ȍ
A.FederalRequiredLanguageAttached
Ǥ
ExhibitName:
B.StateRequiredLanguageAttached
Ǥ
ExhibitName:
TheExhibitsnamedaboveareattachedandincorporatedbythisreference.
SECTIONIX:ADDITIONALATTACHED EXHIBIT(S)
Ǥ ǣ
ͳȌ ǯ ǡ
ǡ
ʹȌ ȄǤ
ǡ Ǥ
ExhibitName(s)
TheExhibitsnamedaboveareattachedandincorporatedbythisreference.
Yes
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 1 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Attachment A: Scope of Service
A. Service Description and Expected Outcome
1. PURPOSE
The purpose of this Agreement is to provide professional, demand-responsive
transport for seniors residing within certain areas of Santa Clara County. This
program shall be called “Senior Transportation Pilot Program” (“STPP”).
The estimated number of rides Contractor will provide under this Agreement will be
2,324. This estimation shall not be legally binding in any way.
2. COOPERATION WITH OTHER ORGANIZATIONS
STPP is jointly operated by Saratoga Area Senior Coordinating Council and West
Valley Community Services. Saratoga Area Senior Coordinating Council and West
Valley Community Services shall cooperate with one another in the operation of
STPP to avoid duplication of services and promote efficiency.
However, Saratoga Area Senior Coordinating Council and West Valley Community
Services may operate two separate STPP facilities.
3. NON-EXCLUSIVE AGREEMENT
This Agreement is non-exclusive. County may in its sole discretion select, contract
with, and assign additional contractor(s) to perform any portion of the services
herein.
4. CONFIDENTIALITY
All information gathered by Contractor about passengers or potential passengers
within the scope of STPP shall remain confidential (“STPP Information”). Contractor
shall not, without County’s written consent, use or disclose STPP information other
than in the performance of its obligations under this Agreement. Contractor shall be
responsible for establishing and maintaining an information security program that is
designed to ensure the security and confidentiality of STPP Information, protect
against any anticipated threats or hazards to the security or integrity of STPP
Information, protect against unauthorized access to or use of STPP Information that
could result in substantial harm or inconvenience to County or any end users; and
ensure the proper disposal of STPP Information upon termination of this Agreement.
Contractor shall take appropriate action to address any incident of unauthorized
access to STPP Information, including addressing and/or remedying the issue that
resulted in such unauthorized access, notifying County as soon as possible of any
incident of unauthorized access to STPP Information, or any other breach in
Contractor’s security that materially affects County or end users; and be responsible
for ensuring compliance by its officers, employees, agents, and subcontractors with
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 2 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
the confidentiality provisions hereof. Should confidential and/or legally protected
STPP Information be divulged to unauthorized third parties, Contractor shall comply
with all applicable Federal and State laws and regulations, including but not limited
to California Civil Code Sections 1798.29 and 1798.82 at Contractor’s sole expense
(if applicable). Contractor shall not charge the County for any expenses associated
with Contractor’s compliance with the obligations set forth in this Section 4.
B. Deliverables, Milestones, & Timeline for Performance
5. SERVICE AREA
“Service Area” shall be defined to mean all of the following:
a) The city limits of Cupertino, Campbell, Saratoga, Monte Sereno, and Los Gatos;
b) Sunnyvale CalTrain Station, located at 121 W Evelyn Ave., Sunnyvale, CA;
c) Santa Clara Valley Medical Center, located at 751 S Bascom Ave., San Jose, CA
95128;
d) O’Connor Hospital, located at 2105 Forest Ave., San Jose, CA 95128;
e) El Camino Hospital Mountain View, located at 2500 Grant Road, Mountain View,
CA 94040;
f) Good Samaritan Hospital, located at 2425 Samaritan Drive, San Jose, CA
95124;
g) Kaiser Permanente - Santa Clara, located at 710 Lawrence Expressway, Santa
Clara, CA 95051;
h) O'Connor Hospital, located at 2105 Forest Avenue San Jose, CA 95128;
i) Santa Clara Valley Medical Center, located at 751 S. Bascom Avenue
San Jose, CA 95128;
If an Eligible Passenger requests a ride from Contractor and (1) both the pickup and
destination locations are within the Service Area, (2) the scheduled pickup time is
within the Transportation Hours of Service, (3) the request was made within the
Scheduling Window, (4) the Eligible Passenger has not been disqualified, and (5)
the Eligible Passenger has paid all appropriate fees, then Contractor shall make best
efforts provide that requested ride to the Eligible Passenger.
If Contractor is required to make best efforts to provide a requested ride to Eligible
Passenger and fails to provide the requested ride for any reason, Contractor shall
provide documentation to County reflecting the name of the Eligible Passenger, the
date of request, the requested date of travel, and the reason why Contractor failed to
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 3 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
provide the requested ride to the Eligible Passenger, with specific detail. This
documentation shall be provided to County at the same time as the invoice for the
calendar month.
6. PASSENGERS’ MANDATORY CONSENTS AND WAIVERS
Contractor shall require that all passengers first sign a consent which allows
Contractor to provide Passenger Information to County for the purposes of program
oversight. “Passenger Information” shall be defined as follows:
a) Income verification.
b) Customer Feedback Forms.
c) Trip information, including pickup and destination information.
d) All other information Contractor has gathered about the passenger within scope
of STPP.
Contractor shall also require that all passengers sign a waiver before receiving any
rides which shall be substantially the same as follows:
“I hereby acknowledge that the Senior Transportation Pilot Program is a service
provided by West Valley Community Services and Saratoga Area Senior
Coordinating Council, and funded by Santa Clara County. I hereby waive the right to
make any claims against Santa Clara County, West Valley Community Services, or
Saratoga Area Senior Coordinating Council, or their officials, employees, and
volunteers for any injuries, damages, charges or expenses, including attorney’s fees
which might be sustained as a result of my participation in this program. I also
acknowledge that West Valley Community Services and Saratoga Area Senior
Coordinating Council reserve the right to refuse transportation service.”
7. DRIVER WAIVER
Contractor shall require that each driver shall sign a waiver which shall be
substantially the same as follows:
“I hereby acknowledge that the Senior Transportation Pilot Program is a service
provided by West Valley Community Services and Saratoga Area Senior
Coordinating Council, and funded by Santa Clara County. I hereby waive the right to
make any claims against Santa Clara County, West Valley Community Services,
Saratoga Area Senior Coordinating Council, or their officials, employees, and
volunteers for any injuries, damages, charges or expenses, including attorney’s fees
which might be sustained as a result of my participation in this program.”
8. ELIGIBLE PASSENGERS
An “Eligible Passenger” is defined as:
a) 55 years old or older;
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 4 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
b) If Contractor is West Valley Community Services, must be a resident of
Cupertino or Campbell;
c) If Contractor is Saratoga Area Senior Coordinating Council, must be a resident of
Monte Sereno, Los Gatos, or Saratoga; and
d) Ambulatory, which shall include a person using a walker or cane;
e) Without a medical emergency at the time of the ride;
Contractor shall not transport any person that is not an Eligible Passenger or an
Eligible Passenger’s personal care attendant. No matter which organization a person
calls upon initial contact (whether Saratoga Area Senior Coordinating Council or
West Valley Community Services), they will be put into the system and their first ride
will be set up. They will then be given the appropriate contact number based on their
residency for future rides.
9. HOURS OF SERVICE
Telephone Hours of Service are defined as 8:00 am – 12:00 pm and 1:00 pm - 4:30
pm, Monday through Friday, excluding New Year’s Day, Cesar Chavez Day, Martin
Luther King Jr. Day, President’s Day, Veteran’s Day, Memorial Day, Independence
Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, the day before
Christmas Day, Christmas Day, and New Year’s Eve.
Transportation Hours of Service are defined as 8:00 am - 12:00 pm and 1:00 pm -
4:00 pm, Monday through Friday, excluding New Year’s Day, Cesar Chavez Day,
Martin Luther King Jr. Day, President’s Day, Veteran’s Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, the
day before Christmas Day, Christmas Day, and New Year’s Eve.
10. TELEPHONE CALL CENTER
Contractor is required to provide trip reservation and “Where Is My Ride” services to
all Eligible Passengers via telephone. Contractor shall ensure that its call center can
accept trip reservations and answer “Where is My Ride” calls during the Telephone
Hours of Service.
11. CUSTOMER FEEDBACK FORMS
Contractor must develop Customer Feedback Forms which reflect passengers’
satisfaction with Contractor’s service and any problems that passengers had.
Customer Feedback Forms shall contain, at a minimum, the substance of the
Sample Customer Feedback Form in this Agreement.
Contractor must inform all telephone callers interested in receiving a ride that
Customer Feedback Forms are available, whether or not they have called Contractor
previously. Contractor must provide Customer Feedback Forms to all persons that
request them and must receive, store, and organize all Customer Feedback Forms
submitted. Contractor must submit all received Customer Feedback Forms in a
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 5 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
particular calendar month to County at the same time it submits an invoice for that
calendar month.
Contractor shall not have any more than 10 valid, verified complaints per 3,000
passengers. A verified complaint is one that violates established policies or
procedures by the preponderance of the evidence.
12. PASSENGER DISQUALIFICATION
Contractor may disqualify Eligible Passengers for the following conduct while in
Contractor’s vehicle:
a) Interfere with the driver or operation of the vehicle.
b) Throw any object from the vehicle.
c) Extend a hand, arm, foot, leg or other portion of the body through any window
opening of the vehicle.
d) Place a foot on any seat of a vehicle.
e) Commit any act or engage in behavior that could, with reasonable foreseeability,
cause harm or injury to any person or property.
f) Eat, drink, or possess an open food or drink container unless necessitated by a
medical condition.
g) Consume an alcoholic beverage or possess an open container of alcoholic
beverage.
h) Discard litter within the vehicle.
i) Take an unfolded baby stroller or utility cart in a vehicle, unless the driver
determines space is available.
j) Transport any animal on in a vehicle unless: (a) the animal is a guide, service or
signal animal (or a service animal in training) that has been specially trained to
assist persons with disabilities and is on a leash; or (b) the animal is in a
completely enclosed and secured cage or carrying case which is small enough to
fit on the passenger's lap and the animal does not otherwise endanger or annoy
other person.
k) Transport any package, bundle, object, or baggage whose contents, size, bulk,
shape or nature may be dangerous, or interfere with the safe operation of the
vehicle.
l) Urinate or defecate in a vehicle, unless the incident is a direct result of disability,
age, or medical condition.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 6 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
m) Smoke, vape or use an e-cigarette, or carry a lit cigar, pipe or cigarette of any
type.
Contractor shall send documentation to County describing the circumstances of all
Eligible Passengers disqualified under this Section 12 in a particular calendar month
at the same time as the invoice for that calendar month.
13. DIRECT ROUTE
Contractor’s drivers must take the most time-efficient route while transporting
Eligible Passengers and shall not take detours or unscheduled stops, except in the
case of an emergency.
14. VEHICLE DISQUALIFICATION
County may, during normally scheduled monitoring visits, or, as a follow-up to a
client complaint, inspect any vehicles used by Contractor to transport clients. If, in
the opinion of County, a vehicle does not meet County safety standards, it may be
“red tagged.” A vehicle that has been “red tagged” shall be immediately removed
from service. A “red tagged” vehicle may not be released for service until such time
as the problems associated with it have been rectified by Contractor and verified by
County. A vehicle may be “red tagged” by County if any of the following occurs:
a) The vehicle violates any Vehicle Code requirements;
b) Tires: Flat, worn, embedded objects, bald;
c) Passenger door interlock inoperative;
d) Headlights out;
e) Taillights out;
f) Turn signals out or inoperative;
g) Horn not working;
h) Windshield wipers not working;
i) Engine smoking excessively;
j) Brake lining too thin;
k) Fluid leaks;
l) Coolant leaks;
m) Exhaust system leaking or damaged;
n) Steering with excessive play;
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 7 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
o) Loose or missing lug nuts;
p) Any noncompliance with Federal Motor Vehicle Safety Standards and other
governing agency safety, vehicle operations regulations; or
q) Any other safety or maintenance item which may endanger the safety of
passengers.
15. DRIVER DISQUALIFICATION
a) County may require that any driver be removed from transporting clients for
excessive complaints, rudeness, or other inappropriate behavior or appearance
pursuant to the requirements of this Agreement. County has a Zero Tolerance
Policy with regard to misconduct or inappropriate contact between vehicle
operators and passengers, and if an allegation of this nature is received,
Contractor shall remove the driver from service immediately pending resolution of
the allegation to County’s satisfaction.
b) Any driver receiving three or more valid customer complaints within a rolling 30-
day period shall be removed from service.
c) County will notify Contractor, in writing, if any driver is removed from service
under this Section 15 in a particular calendar month at the same time as the
invoice for that particular calendar month.
16. BACKGROUND CHECKS
a) Contractor shall perform fingerprint-based criminal background checks (e.g., Live
Scan) and name-based criminal background checks on all of Contractor’s drivers
before they begin transporting passengers. It shall include all of the following:
1. A multistate and multijurisdictional criminal records locator or other similar
commercial nationwide database with validation.
2. A search of the United States Department of Justice National Sex
Offender Public Web site.
b) Contractor shall not contract with, employ, or retain a driver if he or she meets
any of the following criteria:
1. Is currently registered on the United States Department of Justice National
Sex Offender Public Web site.
2. Has been convicted of any of the following offenses:
i. A violent felony, as defined in Section 667.5 of the Penal Code.
ii. A violation of Section 11413, 11418, 11418.5, or 11419 of the
Penal Code.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 8 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
3. Has any Two-Point Count California Vehicle Code Violations or has an
outstanding failure-to-appear or failure-to-pay violation.
c) Contractor shall not contract with, employ, or retain a driver if he or she has been
convicted of any of the following offenses.
1. Misdemeanor assault or battery.
2. A domestic violence offense.
3. Driving under the influence of alcohol or drugs.
4. A felony violation of Section 18540 of the Elections Code, or of Section 67,
68, 85, 86, 92, 93, 137, 138, 165, 518, 530, or 18500 or, subdivision (a) of
Section 484 of, subdivision (a) of Section 487 of, or subdivision (b) of
Section 25540 of, the Penal Code.
d) Paragraphs (b) and (c) shall apply regarding a conviction of any offense
committed in another jurisdiction that includes all of the elements of any of the
offenses described or defined in those paragraphs.
e) Nothing in this Section 16 shall be interpreted to prevent Contractor from
imposing additional standards.
f) Contractor shall enroll all drivers in the California Department of Motor Vehicle’s
(DMV) Employer Pull Notice (EPN) Program before allowing them to transport
any passengers.
g) Contractor shall send all background check documentation required under this
Section 16 to County, for all of Contractor’s new active drivers in a particular
calendar month to County at the same time as the invoice for that particular
calendar month.
17. INCIDENTS
Contractor shall notify County by telephone immediately, as is feasible, and provide
written notification within 24 hours of any of the following incidents:
a) Collisions between a vehicle in use by Contractor and another vehicle, person or
object;
b) Passenger accidents, including falls to passengers who are entering, occupying
or exiting the vehicle;
c) Passenger complaints of injury or other circumstances likely to result in the filing
of claims against the Contractor or County;
d) Any passenger, driver or service complaint that arises from an accident or health-
threatening incident;
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 9 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
e) Inappropriate behavior on-board the vehicle;
f) Disturbances, assaults, fainting, sickness, deaths, or similar; and
g) Vandalism to the vehicle while transporting a passenger.
Contractor will ensure proper follow up on any accidents or incidents, where
appropriate, to ensure that any unresolved safety hazards or liability issues are
addressed. Copies of reports prepared for any of the above must be sent to County.
If loss of service occurs or a major incident occurs that will likely receive media
coverage, Contractor shall notify County immediately.
18. FARE POLICY AND COLLECTION
Contractor’s drivers may not accept any payment from passengers. Contractor will
not be reimbursed or credited in any way for fares it was required to collect but failed
to collect. Contractor shall, through policy and policy enforcement, ensure that
drivers do not request or receive gratuities.
19. EMERGENCY OPERATION INCLUDING EARTHQUAKE AND CIVIL UNREST
In the event of any natural disaster such as, earthquakes, floods, or other acts of
God or civil disturbances make it impossible or impracticable for Contractor to
continue service, Contractor may suspend its service.
20. DRIVER CODE OF CONDUCT
a) Drivers must not have any weapons in their possession or their vehicles.
b) Smoking is prohibited.
c) Drivers must conduct themselves in a professional and courteous manner
towards passengers.
d) Inappropriate behavior between passengers or between passenger and driver is
prohibited. Allegations of sexual misconduct, lewd behavior, or sexual
harassment made by any client must be reported to County staff immediately.
Should the Contractor receive notification from other than County that a driver or
an employee of Contractor is allegedly involved in a criminal activity including,
but not limited to, sexual misconduct, lewd behavior, or sexual harassment, the
Contractor shall notify County immediately as well as local police.
21. TRIP MANIFEST
Contractor shall create a Trip Manifest for all rides or its electronic equivalent. These
records shall have all of the following:
a) Signed and dated by Contractor.
b) Scheduled pickup time and drop-off time.
c) Scheduled pickup location and drop-off location.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 10 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
d) Actual pickup time and drop-off time.
e) Actual pickup location and drop-off location.
f) Number of passengers transported during ride.
g) Whether a no-show or cancellation occurred.
h) Any unscheduled trips or stops that occurred and why.
These records must be stored and organized by Contractor.
22. SCHEDULING WINDOW
The “Scheduling Window” shall be defined as 36 hours prior to a requested ride and
up to 5 weeks ahead of the requested ride.
23. VEHICLE CLEANING
All vehicles used by Contractor for STPP services must be kept clean.
24. EXCEPTIONS LOG
An exceptions log will be required which will provide a daily record of any instances
of mechanical breakdown, road calls, or air conditioning or heater malfunction on
vehicles which were in operation under this Agreement.
The exceptions log for a particular calendar month shall be provided to County at the
same time as the invoice for that same calendar month. Contractor may use a form
similar to the Sample Incident Report attached to this Agreement.
25. SIX-MONTH VEHICLE INSPECTIONS
No vehicle will be allowed to carry passengers unless the driver has determined that
the vehicle is in good working order.
Contractor shall collect Six-Month Vehicle Inspection Forms from their drivers every
six months, which shall be substantially similar to the Sample Six-Month Vehicle
Inspection Form in this Agreement. Contractor shall store and organize these Six-
Month Vehicle Inspection Forms.
26. CONTINGENCY
This Agreement shall only effective valid upon (1) the execution of a similar
agreement between County and another contractor for STPP, and (2) the receipt by
County of the following funding for this STPP from the following entities:
a) $84,000 from Valley Transportation Authority (VTA),
b) $22,000 from City of Cupertino,
c) $19,000 from City of Saratoga,
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 11 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
d) $17,000 from Town of Los Gatos,
e) $16,000 from City of Campbell, and
f) $8,000 from City of Monte Sereno.
County shall notify Contractor when these conditions have been satisfied and this
Agreement will be effective.
27. CURB-TO-CURB SERVICE
“Curb-to-Curb Service” means a type of transit service where, on both the origin and
destination ends of the trip, the driver gets out of the vehicle and assists the
passenger between the vehicle and a sidewalk or other waiting area no more than
15 feet from the vehicle.
Contractor shall provide Curb-to-Curb Service to passengers.
28. ROAD CALLS
In the event of a vehicle failure while in service, Contractor shall deploy a vehicle
immediately upon notification to replace the failed vehicle to ensure continuity of
service.
29. TRIP PURPOSE
If Contractor is aware that the purpose of a proposed ride is one of the following,
Contractor shall decline the ride:
a) Medical emergency; or
b) Joyriding (i.e., a ride for the purpose of travelling or a ride with no destination
purpose).
30. CANCELLATION NOTICE
Clients must cancel at least 24 hours prior to the pick-up time of their scheduled ride
in order to avoid being charged $5 for a No-Show, with the exception of the first No-
Show. Cancellations received during non-business hours and weekends must be
processed promptly the next business day to avoid dispatching to cancelled pick-
ups.
Under no circumstances will Contractor cancel a scheduled trip unless a State of
Emergency has been called by the authorities, a passenger has been disqualified
pursuant to Section 12, or the ride is declined pursuant to Section 29.
Contractor shall send documentation to County describing the circumstances of all
of its cancellations of scheduled trips under this Section 30 in a particular calendar
month at the same time as the invoice for that calendar month.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 12 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
31. NO PASSENGER STRANDED POLICY
At the time of the ride reservation the scheduler/dispatcher will confirm the need for
a round trip and schedule accordingly. In the event a driver does not respond to the
scheduled trip and a call is received from the passenger, immediate use of backup
systems will ensure the trip is provided.
32. VEHICLE STANDARDS
a) All vehicles in use by Contractor shall meet all applicable standards of the
California Vehicle Code. Certain equipment must be present and fully functional
as OEM (original equipment manufacture), as specified in this Section 32. All
vehicles in use by Contractor must be maintained to these standards at all times.
b) Body Condition
1. No significant body damage, frame damage, tears or rust holes in the
vehicle body and/or loose pieces hanging from the vehicle body are
permitted. Front and rear fenders, bumpers, hood, trunk, and trim shall be
securely fixed and shall be in correct alignment to the vehicle as OEM.
Body damage shall include any un-repaired dents, distortions,
depressions, bulges, tears, holes, or disfigurements.
2. The exterior of the vehicle shall be maintained in a substantially clean
condition and shall be substantially free of unsightly dirt, tar, oil, and rust.
3. The vehicle paint shall not be significantly mismatched, faded, blistered,
cracked, chipped, peeled, or scratched.
c) Climate Control
1. The air conditioning/heating units shall be functional at all times.
2. The air discharged from the air conditioner interior vent system shall be
continuously cool.
3. All air conditioning temperature controls and functions shall operate as
originally designed and manufactured with no knobs or components
broken or missing.
4. Systems shall operate on all OEM speeds with no excessive noise.
d) Hubcaps or Wheel covers
1. Hubcaps shall be on all wheels for which hubcaps are standard
equipment.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 13 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
e) Interior Condition
1. Passenger compartment, driver compartment, and trunk or luggage area
shall be clean and free of foreign matter, offensive odors, and litter.
2. Seat upholstery shall be clean. Interior walls, carpet and/or flooring, and
ceiling shall be kept reasonably clean. No significant rips or tears are
permitted. All repairs shall be done to provide a reasonable match with the
existing interior.
3. Door handles and doors shall be intact, clean, and operational. Each door
shall be capable of being unlocked and opened from the interior of the
vehicle.
4. Dashboards shall be maintained in a manner that is clean and free of
loose articles. Dashboards shall be free of significant cracks, holes, and
tears.
f) Lights and Lenses
1. Interior lights shall be operational.
2. Light lenses must be OEM, intact and contain no holes or large cracks.
g) Cell phone
Vehicles shall be equipped with a cellular phone in working order.
h) Seat Belts
Vehicle restraint system shall be maintained to OEM specifications and shall be
in good working order.
i) Windows
1. Front and rear windshield per California Vehicle Code § 26710.
2. Safety glass shall be in all windows.
3. Windows shall be operational as originally designed.
4. No window tinting on windshield or front side windows per California
Vehicle Code § 26708. Any tinting applied to the rear side or rear windows
must be light enough to allow any passengers to be viewed from the
outside.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 14 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
j) Foot Pedal Pads
OEM rubber pads on all foot controls. Pads shall not be worn or deteriorated to
the point that metal is showing.
k) Vehicle Age
A vehicle may not be older than fifteen (15) model years measured from the
current calendar year (example: during calendar year 2000, the vehicle must be
model year 1985 or later). Vehicles older than fifteen (15) model years shall not
be eligible to operate as a vehicle under any condition.
33. NO SHOW POLICY
a) A No-Show is defined as:
1. When a client fails to appear for a scheduled trip within 10 minutes after
the scheduled pick-up time (Driver must immediately notify dispatch of the
No-Show); or,
2. When a client cancellation is received less than 24 hours prior to the
scheduled pick up time.
b) Notification and Management of Client No-Shows:
1. Dispatcher attempts notification of client via telephone and informs driver
of status.
2. Client is charged one No-Show and will receive a telephone call from the
Contractor after the first No-Show.
3. Client will receive a written letter explaining termination policy after second
No-Show.
4. Three No-Shows in a 30-day period may result in client disqualification, in
the discretion of Contractor.
c) Each client’s No-Shows will be tracked monthly and recorded in client file.
34. DRIVER TRAINING
All of Contractor’s drivers must take and pass the Community Transportation
Association’s Passenger Service and Safety (PASS) Training Program before
transporting any passengers.
Additionally, all of Contractor’s drivers must be instructed on the requirements of this
Agreement before transporting passengers.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 15 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
35. LOST-AND-FOUND
Policies for handling of lost-and-found personal effects shall be as follows:
a) Drivers shall check their vehicles after each trip for items left on board. If lost
items are found, the driver is to contact their dispatch and inform them of the lost
item. At the end of the shift, the driver will fill out a lost-and-found report and turn
in the lost item to the dispatcher.
b) Dispatcher will receive the item along with the lost-and-found report from the
driver and contact the passengers from that day’s schedule to determine if item
belongs to them.
c) All lost and found items with a value of greater than $10 must be secured at the
Contractor’s facility for a period of not less than 90 days.
d) Disposal of unclaimed items other than cash after the 90 days will be reported to
County with copies of the lost-and-found reports.
36. ADMINISTRATIVE CAPACITY
Contractor shall maintain sufficient administrative capacity to professionally carry out
the services described in this Agreement. In addition to the requirements described
elsewhere in this Agreement, this sufficient administrative capacity shall include:
a) Processing client applications in a timely manner
b) Handling telephone requests and inquiries so as to maximize customer service,
giving timely, accurate and courteous service.
c) Carrying out trip reservation activities in a manner which will maximize efficiency.
d) Receive, approve and process requests for service. Review and refine daily trip
itineraries. Assess distances and routing to ensure efficient travel patterns.
Initiate client call backs regarding any trip discrepancies and or schedule
changes.
37. BACKUP SYSTEMS
Contractor shall use best efforts to provide a sufficient number of vehicles and
drivers to deliver services and meet the requirements of the STPP. This number will
be determined by the scheduling of trips and the capacity of the vehicles proposed
for this service. Determination of the number of vehicles required to provide these
services is the responsibility of Contractor.
Contractor shall use best efforts to maintain substitute or backup staff, drivers, and
vehicles to support daily services and scheduled trips. Backup systems will be in
place to handle road assistance calls from drivers, to relieve drivers if they become
sick, to relieve drivers for family emergencies, and relieve drivers who are deemed
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 16 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
inappropriate or unsafe by either Contractor or County. Backup systems will be in
place to support the dispatcher and/or the travel coordinator in their absence.
38. DRIVER DRESS AND APPEARANCE STANDARD
a) Appropriate attire that conveys a professional image will be worn by all drivers
when operating a vehicle in service. Clothing must remain in good repair, and not
appear damaged or worn out.
b) Drivers will be required to adhere to reasonable grooming and appearance
standards.
39. DRIVER TOOLS
Contractor’s drivers shall have all tools and equipment necessary to perform all the
duties of a driver. Driver equipment will include, but not be limited to, a smartphone,
clipboards, and at least one pen.
40. ON-TIME PERFORMANCE
a) Contractor shall arrive at pickup location for 95% of scheduled trips before
scheduled pickup time.
b) Scheduled pickup time shall be determined by Contractor at the time the ride is
initially scheduled with passenger and communicated to passenger at that time.
c) Contractor shall arrive at destination location for 95% of scheduled trips within 10
minutes before or 10 minutes after scheduled drop-off time.
d) Scheduled destination drop-off time shall be determined by Contractor at the time
the ride is initially scheduled with passenger and communicated to passenger at
that time.
C. Performance Standards
41. PERFORMANCE MONITORING
County staff will monitor Contractor’s performance, compliance with insurance
requirements and with Federal, State, local, and Agreement requirements, and will
gauge the quality of service on a systematic and continuing basis. Such monitoring
may include inspection of documents or files; interviews and conversations with
Contractor's managers, drivers, reservations staff; review of call center statistical
reports; analysis of complaints; road checks; passenger surveys; and the inspection
of facilities, equipment, and vehicles.
County will monitor factors such as, pickup and drop-off procedures, passenger
disagreements and issues, receive reports from the Contractor’s field monitors, and
monitor excessive no-shows and late cancellations by specific passengers.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 17 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Irrespective of the County’s monitoring program, Contractor shall implement its own
quality assurance program. Such program shall include, but not be limited to, regular
supervisory field observations, trip manifest and dispatch log reviews, complaint
mitigation, vehicle/equipment inspections, and records audits.
42. QUARTERLY REPORTS
Contractor shall provide quarterly reports to County on October 15, 2017 (covering
July 1, 2017 through September 30, 2017), January 15, 2018 (covering October 1,
2017 through December 31, 2017), April 15, 2018 (covering January 1, 2018
through March 31, 2018), and July 15, 2018 (covering April 1, 2018 through June 30,
2018). These quarterly reports shall contain the following information:
a) Quarterly and annual ridership targets, provided prospectively.
b) Residents served by jurisdiction, including unique customers and total rides
provided.
c) Subsidies provided by jurisdiction.
d) Number of subsidized riders and un-subsidized riders.
e) Cost per ride to the customer and to the program.
f) Location for pickup and drop-off by zip code.
g) Day, date, and time of rides.
h) Ride distance.
i) Customer service metrics, including requests made, requests filled, scheduled
rides that are missed, etc.
D. Payment Schedule
43. STANDARD RIDE COST
The definition of “Standard Ride Cost” for a passenger shall be
j) $9.00 for a ride up to four miles;
k) $13.00 for a ride over four and up to eight miles, and;
l) $18.00 for a ride over eight miles.
A ride shall be one-way only, from a single point of origin to a single point of
destination.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 18 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
The first no show will not be charged. Any No Show after the first, Contractor shall
charge the individual a flat fee of $5 per No Show. Any cancellations with less than
24 hours advance notice, Contractor may charge the individual a flat fee of $5 per
cancellation.
The fees listed in this Section 43 are the only type of fees that Contractor may
charge a passenger. Booking fees, application fees, and similar fees are prohibited.
A passenger’s personal care attendant or service animal may ride free of charge.
44. DISCOUNTS
The following discounts shall be granted to individuals who meet eligibility
requirements and Contractor has verified a passenger’s income.
Low income – Standard Ride Cost shall be discounted by 50%.
Very low income – Standard Ride Cost shall be discounted by 75%.
Extremely low income – Standard Ride Cost shall be discounted by 90%.
Table A: 2016 HUD definitions:
Persons
in Family
Extremely
Low
Income
Very Low
Income Low Income
1 $23,450 $39,100 $55,500
2 $26,800 $44,650 $63,400
3 $30,150 $50,250 $71,350
4 $33,500 $55,800 $79,250
5 $36,200 $60,300 $85,600
6 $38,900 $64,750 $91,950
7 $41,550 $69,200 $98,300
8 $44,250 $73,700 $104,650
Questions about how to calculate income, how to calculate the number of people in
a family, and similar questions, shall be resolved by applying current HUD laws and
regulations, when not in conflict with this Agreement. Contractor shall not be
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 19 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
required to gather income verification information beyond what is described in this
Section 44.
Contractor shall verify income by requiring passengers requesting a discount to
submit a form (“Income Verification Form”) substantially similar to Form FL-150,
“Income and Expense Declaration” produced by the Judicial Council of California,
omitting Items 4, 10, 11, 13, 14, 15, 16, 17, 18, 19, and 20 and other clearly non-
relevant parts of Form FL-150 related to litigation. The Income Verification Form
shall be signed by the passenger under the penalty of perjury, using wording
identical to the wording used by Form FL-150.
The Income Verification Form shall be accompanied by all other documentation
required by Form FL-150, including pay stubs for the prior two months, proof of any
other income. However, Contractor may choose whether or not to require an
individual’s most recent Federal tax return.
Contractor shall use due diligence in verifying income. Contractor shall not prioritize
or discriminate against passengers based on discount eligibility.
Contractor shall organize and store this income verification documentation.
45. COST-REIMBURSEMENT
a) Contractor will be reimbursed by County for its actual, reasonable, necessary,
and allowable costs incurred up to the maximum compensation, for the
performance of services as specified in this Agreement. These costs will also be
in accordance with current cost principles and with all other requirements of this
Agreement:
1. For Non-Profit Agencies, OMB Circular A-122.
2. For Local Governments, OMB Circular A-87.
3. For Public and Nonprofit Institutions of Higher Education, OMB Circular A-
121.
4. For Profit Making Organization, 41 CFR Part 1.
b) If this contract ends or is terminated for any reason, Contractor shall return all
remaining goods and services (including software and similar) purchased by
Contractor pursuant to this Section 45, unless (1) this requirement is waived by
County, in writing, or (2) meeting this requirement is impossible. Contractor may
not sell any goods or services reimbursed pursuant to this Section 45, unless
County had given advance, written consent.
Contractor shall have appropriate organization and recordkeeping to meet the
requirement of this Section 45(b).
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 20 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
c) If Contractor provides any tasks, deliverables, goods, services, or other work,
other than as specified in this Agreement, the same will be deemed to be a
gratuitous effort on the part of the Contractor, and the Contractor will have no
claim whatsoever against County.
d) Contractor must participate in a closeout period at the end of the County funding
period. During the closeout period all funds awarded to Contractor must be
reconciled to the costs incurred and to the remaining cash, if any. A closeout
packet will be provided to Contractor by County at the end of the funding period
and is due within forty-five (45) days thereafter. This provision survives the
termination of this Agreement.
46. ADJUSTMENT TO BUDGET
A budget adjustment can be made by the County without a formal contract
amendment as long as the adjustment does not increase the maximum financial
obligation specified under the subsection titled “Maximum Financial Obligation”
located in Section I: General Information, and doesn’t have a negative impact on the
Contractor’s ability to meet the obligations of this Agreement.
Contractor may request a budget revision by submitting the County’s Budget
Revision Request form to the County’s designated contract/program monitor. The
Budget Revision Request must include a statement explaining the impact that the
budget revision, if approved, would have on the program/service delivery. Upon
approval of the Contractor’s Budget Revision Request, County will forward an
approved copy of the Budget Revision Request form to the Contractor
47. INVOICES
All invoices must be signed and must explicitly certify that the signer has provided
documentation to County for all of the following for the calendar month of the
invoice:
a) Why Contractor failed to provide any Eligible Passenger a ride, if Contractor was
required to use best efforts to provide the ride pursuant to Section 5;
b) Copies of all Customer Feedback Forms from all persons, pursuant to Section
11;
c) Any Eligible Passengers that have been disqualified during the calendar month,
and the specific conduct that caused the disqualification, pursuant to Section 12;
d) Exceptions log, pursuant to Section 24;
e) Incidents, pursuant to Section 17;
f) Driver disqualification, pursuant to Section 15;
g) Contractor’s cancellation of a scheduled trip, pursuant to Section 30;
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 21 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
h) Background check documentation of all new active drivers, pursuant to Section
16; and
i) Roster of all active drivers in use by Contractor. This requirement may be
satisfied by Contractor providing timely updates as to when active drivers are
added and dropped.
Invoices must contain all of the following data:
a) Number of Rides broken out by
1. Distance category,
2. Income-level discount,
b) Number of No-shows and cancellations.
c) All payments received from passengers.
An invoice for services provided in a particular month must be submitted to County
prior to 5:00 pm on the fifteenth calendar day of the next month.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 22 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
SAMPLE SIX-MONTH VEHICLE INSPECTION FORM
Vehicle #:____________________ Date:________
Driver’s Name:
Mileage: Time of Inspection am/pm
Driver: Please take your time and inspect this vehicle thoroughly. Safety is
OUR priority. Thank you.
Items to Check Problem? Repaired? Item OK
(Please
initial)
Tire(s) Pressure
Engine Oil Level
Transmission Oil
Level
Coolant Level
Brake Fluid Level
Emergency Brake
Head Light
Turn Signals
Brake Lights
Back-up Lights
Door Locks
Mirrors
Safety Belts
Heater/A.C.
Cell Phone/radio
First Aid Kit
Transportation Log
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 23 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
SAMPLE VEHICLE MAINTENANCE FORM
Date: Maintenance Facility:
Vehicle Type/Year License Plate Number
Vehicle Indentification Number Mileage
Vehicle Capacity: #Passengers:
Inspection Item Satisfactory
Yes No N/A
1. Tires, pressure, tread wear ☐ ☐
2. Headlights – functional (high/low) and clean ☐ ☐
3. Turn Signals – functional ☐ ☐
4. Horn – functional ☐ ☐
5. Tail/Parking lights – functional and clean ☐ ☐
6. Brakes – functional, brake pedal not low ☐ ☐
7. Lift or ramp functional ☐ ☐ ☐
8. Windshield/Wipers/Fluid – functional, clear, full ☐ ☐
9. Mirrors – clean, position, clear ☐ ☐
10. Exhaust System – no leaking ☐ ☐
11. Oil/Antifreeze – full ☐ ☐
12. Hoses – good condition ☐ ☐
13. Safety Equipment – good condition
-Fire Extinguisher ☐ ☐
-Flashlight ☐ ☐
-First Aid Kit ☐ ☐
-Jumper Cables ☐ ☐ ☐
-Flares/Triangles ☐ ☐
-Cellular Phone ☐ ☐
-Securements/tie downs (bungees for walkers) ☐ ☐ ☐
14. Accident Pack – in place, current
-Registration Card ☐ ☐
-Insurance Card ☐ ☐
-Accident & Incident Report Forms ☐ ☐
-Emergency Procedure Plan ☐ ☐
Recommended Corrective Actions:
Corrective Action Follow-up:
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 24 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
SAMPLE CUSTOMER FEEDBACK FORM
Client’s Name_________Client I.D.# ______________
Address: _________________
City: _________________Zip Code: _______
Phone:
What is the complaint?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Date Report Taken:______Time Report Taken:_______
By Phone________By Mail________In Person________By Fax_________By Other________
Report Taken By:_________________
What is the Action Plan?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What was the Resolution?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Date Client was notified: ____________Was Client Satisfied?___Yes____No
How was client notified? Phone Mail In Person Fax Other
Staff’s Signature: _Date
Staff’s Signature: _______________Date
Sent to Santa Clara County__________________________Date:___________
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Page 25 of 25
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
SAMPLE INCIDENT REPORT FORM
Date of Incident: Time of Incident: _____________________________________
Name of Driver_____________________________________Vehicle I.D. No.___________________________
Location of Incident: _________________________________________________________________________
Nature of Incident: ___________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Client Name: _________________________________________________________ Client I.D.#_________
Client Address: ________________________________________________________ City:_____________
Zip Code:_____________________________
Phone: Home
What action was taken? __________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Does client wish further action?_________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Report By_____________________________________Title:
Date of Report_____________________________________
Submit report to Santa Clara County within 24 hours of incident.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Resource Table
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Agency Name:Saratoga Area Senior Coordinating Council (SASCC)
Contract Period: July 1, 2017 - June 30, 2018
Project Name:Senior Transportation Pilot Project
A B C D
Source of Funds FY17-18 Amount
% of Total
Funding Commitment Code
Social Services Agency (SSA)* 125,000$ 100%1
Other Funding Sources:
0%
0%
0%
0%
0%
0%
Total Funding Resources**125,000$ 100%
Commitment Code
1
2
3
4
5
* The SSA line in FY 17-18 Amount, Column "B" should equal the Grand Total of
Column "B" in the Budget Detail.
** The Total Funding Resources in Column "B" should equal the Grand Total of
Column "D" in the Budget Detail.
Firm Commitment-Already have an agreement or letter confirming
funding
Anticipated Renewal of Existing Funding-Continuation of current
year funding
Anticipated Resource-Projection of previous fees or donations
Application Pending-Application has been submitted, no
confirmation at this time
Pre-Application-Not yet submitted and expect funding
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Santa Clara County
Social Services Agency
FY 2017-20178 Attachment A: BUDGET
Staffing Salary
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Agency Name:Saratoga Area Senior Coordinating Council (SASCC)
Contract Period: July 1, 2017 - June 30, 2018
Project Name:Senior Transportation Pilot Project
A B C D E
Staff Name and Job Title Annual Salary
% of Time Allocated
to this Contract Number of Months
Salary Allocated to this
Contract *
TBH, Coordinator $ 41,600.00 100%12 $ 41,600
TBH, Driver $ 11,700.00 100%10 $ 11,700
TBH, Driver $ 11,700.00 100%10 $ 11,700
$ -
$ -
$ -
$ -
$ -
Total $ 65,000
*Total Salary Allocated to this Contract should equal the Salaries line in Contract Amount, Column "B"
of the Budget Detail.
If there are any staffing changes during the contract term, contractor must submit to the County a revised
"Staffing Salary". If the staffing change impacts any budget line items, Contractor must also submit to the County
a revised budget request form. (Refer to Scope of Service: Adjustment to Budget)
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Budget Detail
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Agency Name:Saratoga Area Senior Coordinating Council (SASCC)
Contract Period: July 1, 2017- June 30, 2018
Project Name:Senior Transportation Pilot Project
A B C D
Personnel Costs Contract Amount Other Funding Total
Salaries 65,000$ 65,000$
Payroll Taxes 9,750$ 9,750$
Employee Benefits 2,000$ 2,000$
-$
-$
Subtotal Personnel Costs 76,750$ -$ 76,750$
Operating Expenses**
Audit Fees -$
Communication Expense -$
Contract Services -$
Equipment 3,500$ 3,500$
Insurance 12,500$ 12,500$
Office Supplies 1,000$ 1,000$
Professional Services -$
Rent -$
Travel 5,000$ 5,000$
Utilities -$
Training & Conference 2,000$ 2,000$
Program Overhead -$
Marketing 2,000$ 2,000$
Other(Specify)
Software 3,500$ 3,500$
Subtotal Operating Expenses 29,500$ -$ 29,500$
Indirect Costs *** (maximum 15% of budget or federally approved indirect rate)
Administrative Overhead 18,750$ -$ 18,750$
Subtotal Indirect Costs 18,750$ -$ 18,750$
Grand Total****125,000$ -$ 125,000$
*Direct Costs are those costs for activities or services that benefit “specific projects” and are usually charged
directly to projects on an item-by item basis.
**These expense accounts are examples only. Vendors are not required to use these.
***Indirect Costs are costs incurred for a common or joint purpose benefiting more than one cost objective
and are not readily identified with a particular grant, contract, project function or activity. Enter only total amount under
the Administrative Overhead
****The Grand Total for Column "D" should equal Total Funding Resources of Column "B" in the Resource Table.
If there are any budget changes in certain line item expenses during the course of FY, contractor must submit to the
County a budget revision request form. (See Scope of Service: Adjustment to Budget)
Direct Costs *
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Budget Narrative
Service Agreement
between the County of Santa Clara and Saratoga Area Senior Coordinating Council - FY2018
Agency Name:Saratoga Area Senior Coordinating Council (SASCC)
Contract Period:July 1, 2017- June 30, 2018
Project Name:Senior Transportation Pilot Project
Personnel Costs Narrative
Salaries Salary for 1 FTE Program Coordinator and 2 - .5 FTE drivers
Payroll Taxes
The cost of mandated FICA, Medicare, State Unemployment and Worker's
Comp taxes computed at 15% of Salaries
Employee Benefits The cost of providing health insurance for the Coordinator
Audit Fees
Communication Expense
Contract Services
Equipment
The cost of a computer for this program; auto accessories for cell phone use in
the car
Insurance The cost of general liability insurance specifically for this program
Office Supplies
The cost of consumable supplies. Paper, files, pens, etc and other materials for
this program
Professional Services
Rent
Travel
Reimbursment for business use of a personal vehicle at $.535/mile based on
778 miles/month
Utilities
Training & Conference
The cost of Paratransit Training and training from agencies already providing
this service elsewhere in the county.
Program Overhead
Marketing The cost of purchasing advertising, publicity materials, and printed give aways
Software The cost of Simpli software for tracking information in this program
Administrative Overhead
The cost of providing Human Resources, Bookkeeping and Accounting, IT and
overall supervsion of this program by the Executive Director.
Operating Expenses
Indirect Costs
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
EXHIBIT B-2 (revised)
Rev. 9/2016 1
INSURANCE REQUIREMENTS FOR
STANDARD CONTRACTS ABOVE $100,000
Indemnity
The Contractor shall indemnify, defend, and hold harmless the County of Santa Clara (hereinafter
"County"), its officers, agents and employees from any claim, liability, loss, injury or damage
arising out of, or in connection with, performance of this Agreement by Contractor and/or its agents,
employees or sub-contractors, excepting only loss, injury or damage caused by the sole negligence
or willful misconduct of personnel employed by the County. It is the intent of the parties to this
Agreement to provide the broadest possible coverage for the County. The Contractor shall
reimburse the County for all costs, attorneys' fees, expenses and liabilities incurred with respect
to any litigation in which the Contractor contests its obligation to indemnify, defend and/or hold
harmless the County under this Agreement and does not prevail in that contest.
Insurance
Without limiting the Contractor's indemnification of the County, the Contractor shall provide and
maintain at its own expense, during the term of this Agreement, or as may be further required
herein, the following insurance coverages and provisions:
A. Evidence of Coverage
Prior to commencement of this Agreement, the Contractor shall provide a Certificate of
Insurance certifying that coverage as required herein has been obtained. Individual
endorsements executed by the insurance carrier shall accompany the certificate. In addition,
a certified copy of the policy or policies shall be provided by the Contractor upon request.
This verification of coverage shall be sent to the requesting County department, unless
otherwise directed. The Contractor shall not receive a Notice to Proceed with the work
under the Agreement until it has obtained all insurance required and such insurance has been
approved by the County. This approval of insurance shall neither relieve nor decrease the
liability of the Contractor.
B. Qualifying Insurers
All coverages, except surety, shall be issued by companies which hold a current policy
holder's alphabetic and financial size category rating of not less than A- V, according to the
current Best's Key Rating Guide or a company of equal financial stability that is approved
by the County's Insurance Manager.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
EXHIBIT B-2 (revised)
Rev. 9/2016 2
C. Notice of Cancellation
All coverage as required herein shall not be canceled or changed so as to no longer meet
the specified County insurance requirements without 30 days' prior written notice of such
cancellation or change being delivered to the County of Santa Clara or their designated
agent.
D. Insurance Required
1. Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. Each occurrence - $1,000,000
b. General aggregate - $2,000,000
c. Products/Completed Operations aggregate - $2,000,000
d. Personal Injury - $1,000,000
2. General liability coverage shall include:
a. Premises and Operations
b. Products/Completed
c. Personal Injury liability
d. Severability of interest
3. General liability coverage shall include the following endorsement, a copy of which
shall be provided to the County:
Additional Insured Endorsement, which shall read:
“County of Santa Clara, and members of the Board of Supervisors of
the County of Santa Clara, and the officers, agents, and employees of
the County of Santa Clara, individually and collectively, as additional
insureds.”
Insurance afforded by the additional insured endorsement shall apply as primary
insurance, and other insurance maintained by the County of Santa Clara, its
officers, agents, and employees shall be excess only and not contributing with
insurance provided under this policy. Public Entities may also be added to the
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
EXHIBIT B-2 (revised)
Rev. 9/2016 3
additional insured endorsement as applicable and the contractor shall be notified by
the contracting department of these requirements.
4. Automobile Liability Insurance
For bodily injury (including death) and property damage which provides total limits
of not less than one million dollars ($1,000,000) combined single limit per
occurrence applicable to all owned, non-owned and hired vehicles.
4a. Aircraft/Watercraft Liability Insurance (Required if Contractor or any of its agents
or subcontractors will operate aircraft or watercraft in the scope of the Agreement)
For bodily injury (including death) and property damage which provides total limits
of not less than one million dollars ($1,000,000) combined single limit per
occurrence applicable to all owned, non-owned and hired aircraft/watercraft.
5. Workers' Compensation and Employer's Liability Insurance
a. Statutory California Workers' Compensation coverage including broad form
all-states coverage.
b. Employer's Liability coverage for not less than one million dollars
($1,000,000) per occurrence.
E. Special Provisions
The following provisions shall apply to this Agreement:
1. The foregoing requirements as to the types and limits of insurance coverage to be
maintained by the Contractor and any approval of said insurance by the County or
its insurance consultant(s) are not intended to and shall not in any manner limit or
qualify the liabilities and obligations otherwise assumed by the Contractor pursuant
to this Agreement, including but not limited to the provisions concerning
indemnification.
2. The County acknowledges that some insurance requirements contained in this
Agreement may be fulfilled by self-insurance on the part of the Contractor.
However, this shall not in any way limit liabilities assumed by the Contractor under
this Agreement. Any self-insurance shall be approved in writing by the County
upon satisfactory evidence of financial capacity. Contractors obligation hereunder
may be satisfied in whole or in part by adequately funded self-insurance programs
or self-insurance retentions.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
EXHIBIT B-2 (revised)
Rev. 9/2016 4
3. Should any of the work under this Agreement be sublet, the Contractor shall require
each of its subcontractors of any tier to carry the aforementioned coverages, or
Contractor may insure subcontractors under its own policies.
4. The County reserves the right to withhold payments to the Contractor in the event
of material noncompliance with the insurance requirements outlined above.
F. Fidelity Bonds (Required only if contractor will be receiving advanced funds or payments)
Before receiving compensation under this Agreement, Contractor will furnish
County with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Agreement, or authorized to sign or
countersign checks, are covered by a BLANKET FIDELITY BOND in an amount
of AT LEAST fifteen percent (15%) of the maximum financial obligation of the
County cited herein. If such bond is canceled or reduced, Contractor will notify
County immediately, and County may withhold further payment to Contractor until
proper coverage has been obtained. Failure to give such notice may be cause for
termination of this Agreement, at the option of County.
DocuSign Envelope ID: 740ADF21-B615-4F91-AC1E-000DB8406FAC
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 1 of 13
SECTION I: GENERAL INFORMATION
Contractor Name:
(As Displayed In SAP)
Purchase Order Number:
Agency/Department Name: Department
Number:
Brief Description of Services:
Maximum Financial Obligation
The maximum amount payable to this Contractor
under this agreement shall not exceed:
Term of Agreement
Start Date: End Date:
Note: When left blank, start date will be the date executed by Authorized
County Representative
For County Use Only
Account
Assignment
Plant
Number
General
Ledger
(Expense
Code)
Cost
Center
(Dept
Code)
Amount WBS
(Capital Project Code)
Internal
Order
(“PCA” code
–optional)
Line 1
Line 2
Line 3
Line 4
Line 5
West Valley Community Services of Santa Clara County, Inc.
Social Services Agency / OCM 0501
Contractor will provide on-demand transportation services to seniors.
$ 125,000.00
07/01/2017 06/30/2018
0501 5255500 4799 42000
0501 5255500 4799 83000
H
H
Select
Select
Select
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Req # 0040025285
4400007296
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 2 of 13
SECTION II: PARTIES TO AGREEMENT
Legal notices and invoices pertaining to this Agreement shall be sent to the appropriate contact person
listed below, except as otherwise specifically provided for herein. Notices shall be in writing and served
either by personal delivery or sent by certified or registered mail, postage prepaid, addressed as follows.
Notice shall be deemed effective on the date that the notice is personally delivered or, if mailed, three (3)
days after deposit in the mail. Either party may designate a different person and/or address for the receipt
of notices by sending written notice to the other party, which shall not require an amendment to this
Agreement.
Contractor
Contractor Name
(As Displayed In SAP):
Contact Person:
Street Address *:
City *: State: Zip:
Telephone number *:
Email Address *:
SCC Vendor Number:
(As Assigned in SAP)
* To be completed for Independent Contractors Only – DO NOT COMPLETE FOR DEPENDENT CONTRACTORS
County of Santa Clara
Agency/Department:
Program Manager/
Contract Monitor Name:
Street Address:
City: State: Zip:
Telephone Number:
Fiscal Contact
(Accounts Payable Contact):
Contract Preparer:
West Valley Community Services of Santa Clara County, Inc.
Josh Selo
10104 Vista Drive
Cupertino CA 95014
(408) 956-6113
joshs@wvcommunityservices.org
1002862
Social Services Agency / Office of Contracts Management
Jonathan Leung
333 West Julian Street, 5th Floor
San Jose CA 95110
(408) 975-4886
Celia Wu
Jonathan Leung
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ313
SECTIONIII:CONTRACT AUTHORIZATION
ǡ
ǡ
Ǥǡ
ȋ Ȍ
Ǥ ǡ
ǯ Ǥ
ȋ ǡȌ Ǥ
ǡ ǡ
Ǥ
SIGNATURES
ContractisnotvaliduntilsignedbyContractorandCounty’sAuthorizedRepresentative.
Ȁ
ǣǣ
Ȁ
ǣǣ
ǣǣ
ǣǣ
(ProcurementDepartment;President,BoardofSupervisors;orDelegatedAuthority)
ǣǣ
(SignaturerequiredwhentheStandardProvisionslanguage(SectionVI)
isrevised,orforITServicespursuanttoBoardPolicy5.3.5.2(4),orforBoardapproved
contracts,orforcontractswithBoarddelegatedauthoritytoagencies/departments.)
ǣ ǡ
ǯ
Ǥ
ǣǣ
(SignaturerequiredwhenBoardapprovedcontractbyadelegationofauthority)
ǣǣ
(SignaturerequiredwhenBoardapprovedcontract)
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
6/28/2017
6/28/2017
6/28/2017
6/29/2017
7/21/2017
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ413
SECTIONIV:DETERMINATIONOFRELATIONSHIPSTATUS
Ȁ Ǥ ǯ
ǡ ǯǡ
ǯ
Ǥ
ǣ ǡ
ǡǫ
ǫIftheanswertoanyofthesequestionsisYES,selectYESfromthedropdown.
ǣ ǫ
ǣ
ǫ
Ȁǣ
ǡǤǤ ǡǡ ǫ
ǣ
ȄanswerYESǤ
ȄanswerNOǤ
ǣ
ǡȋǦȌǡ ǫ
ǣ ǡ
ǡǡ ǡ DzdzǤȋ
ǤȌ
Enterbelowthebusinesslicensenumberandthecity/entitywhereissued.
BusLic.# Issuedby:
ǣȀǫ
ǡDzdzǤ
Ǥ
ǣ
ǫ ǡ Ǥ
ͷDzdzǡ IndependentContractorǤ
ͷDzdzǡ DependentContractor,
ȀǤǤ
ǣǯ Ȅ ǦͶǡ
ǡ ǦͶǡ ǤǤ
Ǥ
Ǥ
Ǥ
ǯ Ǥ
ǡ Ǥ
Contractor’sInitials:Dept.FiscalOfficer’s Signature:
No
No
No
No
No
No
No
No
No
✔
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Revision Date - 201 Page 5 of 13
SECTION V: CONTRACT SPECIFICS
A.SERVICE DESCRIPTION AND EXPECTED OUTCOME (SCOPE OF SERVICE)
Or See Attachment: incorporated by this reference.
B.DELIVERABLES, MILESTONES, & TIMELINE FOR PERFORMANCE
Or See Attachment: incorporated by this reference.
A
A✔
✔
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ613
C. PERFORMANCESTANDARDS
ǣ Ǥ
D. PAYMENTSCHEDULE
ǣ
ͶͲ
IscontractoraCommunityBasedOrganization(CBO)?
Yes____
No____
ǣ Ǥ
✔A
✔
✔A
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 713
SECTIONVI:STANDARDPROVISIONS
A.ENTIREAGREEMENT
ȋȌ ǡ
Ǥ ǡ
ǡ ǡ
Ǥ ǡǡ
Ǥ
B.AMENDMENTS
Ǥ
C.CONFLICTSOFINTEREST
ǡ ǡ ȋȌ
ǢȋȌǡ ǡ
ǡ
ͳͲͻͲǤǤǡ ȋ
ͺͳͲͲǤǤȌ
ȋʹ ͳͺͲͲǤǤȌǤ
Ǥ
ǡ ǡ ǡ
ǡ ǡ Ǥ
ǡ ǡ
Ǥ ǡ ǯ ǡ
ͳͻͶȋDz dzȌǡȋͳȌ
ǡȋʹȌ
Ǥ
ǡ ǡ ǡǡ
ǡǡ ǯǡ
ǡ Dz dzDz
ǡdzȋʹͳͺͲͳȋȌȋʹȌȌǡ ǯ Ǥ
Ǥ
ǡ ǡ
Ǥ
ǡ
ȋȌ
ǡǡ ͵Ͳ
ǡͳǡ͵Ͳ Ǥ
D.GOVERNINGLAW,VENUE
ǡ ǡ
Ǥ Ǥ
E.ASSIGNMENT
Ǥ
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 813
F.ASSIGNMENTOFCLAYTONACT,CARTWRIGHTACTCLAIMS
ǡǡ Ͷ
ȋͳͷǤǤǤ ǤͳͷȌ ȋʹȋ ͳͲͲȌʹ
Ȍǡ ǡǡ
Ǥ
G.WAIVER
Ǥ
Ǥ
H.NONǦDISCRIMINATION
Ǧ
ǡǡ ǯ
Ǥ
ǣ ͳͻͶǢ ͳͻͻͲǢ
ͳͻ͵ȋ ͷͲ͵ͷͲͶȌǢ ȋ
ͳʹͻͲͲǤȌǢ
ͳͳͲͳͳͳͲʹǤ ǡǡ
ǡ ǡ ǡǡ ǡǡȀǡǡ
ǡ ǡ ǡ ǡǡ
ǡ ǡǡǡǡǡǡ
Ǥ
ǡ ǡ ǡǡ ǡǡȀǡǡǡ ǡ
ǡ ǡǡǤ
ȂȂ
Ǧ
ȋȌ
ǡ Ǥ
I.TERMINATION
ǡ ǡ Ǥ
Ǥǡ
ǡ Ǥ Ǥ
ǡ ǡ
Ǥ
ȂȂ
ȋȌ
ǡ Ǥ
J.BUDGETCONTINGENCY
Ǥ ǡ
Ǥ
K.COUNTYNOǦSMOKINGPOLICY
ǡ ǡ ǯǦ ǡ
͵ǤͶȋȌǡ ǣȋͳȌ
✔
✔
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 913
Ǧ ǡȋʹȌ͵Ͳ
Ǧ ǡȋ͵Ȍ
Ǥ
L.FOODANDBEVERAGESTANDARDS
ǡȀ
ǦǤ
ǡǤDzdz ȋͳȌǡǡ
ǡ ǢȋʹȌ Ǣȋ͵Ȍ
ǢȋͶȌͲǤͷǤ
ǡ ȋͳȌ ǢȋʹȌǡ Ǣȋ͵Ȍ
ǡ ǢȋͶȌȀ
Ǥǡǡ
ǤǦ ǡ ǣȋͳȌ͵ͷΨ
ǡ ǢȋʹȌͳͲΨ
Ǣȋ͵ȌǢȋͶȌ͵ͷΨ ǡ
ǢȋͷȌ͵ͲǤ
ǡǯ ȋͳȌ
ǢȋʹȌ ǡ Ǣȋ͵Ȍ
ǡǡ ȋͳΨȌǢȋͶȌǦȋe.g.ǡǡ
ǡȌͳ͵Ͳ ͺ ǢȋͷȌͳͲͲΨ ȋ
ͺ ȌǢȋȌǦ ȋ ȀȌ
ͶͲ ͺ ǤǦǤ
M.CONTRACTINGPRINCIPLES
̈́ͳͲͲǡͲͲͲ
Ȁ ǡ
Ǥ ǡ ǣȋͳȌ ǡ
ǡǢȋʹȌ ǡ Ǣȋ͵Ȍ
ǢȋͶȌ
ǯǡ ǡ ǡ ǡ
ǡ ǡ
Ǥ
N.CALIFORNIAPUBLICRECORDSACT
ȋDzdzȌǤ
ǯ ǡ
ǡ
Dz ǡdz Ǥ
ǡ Ǥ
ǡ
ǡ
Ǥ
ǡ Ǥ
ǡ ǡ
ȋ ǡ ǡǡǯȌ
ǡ ȋ Ȍǡ Ǥ
O.THIRDPARTYBENEFICIARIES
ǡǡ
Ǥ
P.INTELLECTUALPROPERTYRIGHTSǣ
ǣǡǤ ǡ
Dzdz
Ǥ ǡ
ǡ ǡǡ
ǡǡ
ǯǡ Ǥ
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1013
ȋ
Ȍ Dzǡdz
ȋͳǤǤǤ ͳͲͳȌǡǤ
ǡǡ Ǥ
Q.INTELLECTUALPROPERTYINDEMNITY
ǡǡ
ǡ ǡȀ
Ǥ ǡ ǡ
ȋ ǡ ǡǡǯȌ
Ȁ
Ǥ
Ǥ
R.OWNERSHIPRIGHTSTOMATERIALS/RESTRICTIONSONUSE
ǡ ǡ
ǡ ǡǡ ǡǡǡ ǡ
ǡ ȋ DzdzȌǡ
Ǥ ǡ
ǡǡ
Ǥ Ǧ
ǡǡǤ
ǡ
ǡ ǡ
Ǥ
ȋȌ Dz
ǡdz ȋͳǤǤǤǡ ͳͲͳȌǡǤ
ǡǡ Ǥ
ǡǡ
Ǥ
Ǥ
S.COUNTYDATA
Dzdz Ǥ ǡ
Ǥ Ǥ
ǡǯ ǡ
Ǥ
ǡ
ǡ
Ǣ
Ǥ
ǡ Ȁ
ǡ ǡ
ǯ Ǣ ǡ
ǡǡ Ǥ Ȁ
ǡ
ǡ ͳͻͺǤʹͻͳͻͺǤͺʹ ǯ
ȋ ȌǤ ǯ
Ǥ
T.WAGETHEFTPREVENTION
ȋͳȌ ǣ ǡ
ǡ ǡǡ Ǥ ǡ
ǡ ǡǡ
Ǥ
ȋʹȌ
ǡ ǡǣ ǡDzǡ ǡdz
Ǥ ǣ
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1113
ǡ ǡ ǡ
Ǥ
ȋ͵Ȍ
Ȁ ǣ
ǡ
ǡǡ
Ȅ
Ȅ
ȋȌ
Ǥ
ȋȌ Ȅ
Ȅ
ǡǡǤ
ȋͶȌ
ǣǡ
ǡ ǡ
ǡ ǡ ǡ
ǡ Ǧ
ȋȌǡͳͷǡ ǡ
ǡ ǡǤ
ǡ ǡǡ Ǧ
ǡ ǡͷǡ ǡǤ
ǡ ǡǤ
ȋͷȌǯǣ
ǡ ǡ
ǡ ǡ ǡ
Ǥ
ȋȌ ǣ Ǥ
Ȁ
ȀǤ
ȋȌ ǣ
ǣ ȄǢͲǢǡͳͳ
Ǣ
±ǡͻͷͳͳͲǤ
ǡ ǡ Ǥ
U.PAYMENTTERM[NOTAPPLICABLETOCOMMUNITYBASEDORGANIZATIONS–describepaymenttermsforCBO’sinSectionV.PAYMENT
SCHEDULE]
Ǥ ǡ ʹǤʹͷΨͳͲͶͷǡ
ͳͲ ǡͶͷǡ
ʹǤʹͷΨ Ǥ
Ǥ
ʹǤʹͷΨͳͲͶͷȋ͵ͷ Ȍ
ʹǤͲͲΨͳͷͶͷȋ͵Ͳ Ȍ
ͳǤͷΨʹͲͶͷȋʹͷ Ȍ
ͳǤ͵͵ΨʹͷͶͷȋʹͲ Ȍ
ͳǤͲͲΨ͵ͲͶͷȋͳͷ Ȍ
ͶͷȋȌ
Note:DzͶͷȋȌdzǡ Ǥ
ǡ ǡ
ǦǦ
Ǥ Ǥ
V.CONTRACTEXECUTION
ǡ ǡ
ǡ Ǥ
Dz dz ǡ ǡ
✔
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1213
SECTIONVII:INSURANCE/INDEMNIFICATION
ǯ
Ǥ .
Ǥ
ǣ
Ǥ
WorkersCompensation:
ǫ
DzdzǡǡǯȀ̵Ǥ
OwnedAutoInsurance:
ǡ
ǫ
Dzdzǡ Ǥ
HiredAutoInsurance:
ǡ
ǫ
Dzdzǡ Ǥ
ǤDz dz
Ǥ
W.LIVINGWAGE(IfApplicable)
ǡ ǡ
ǡ
͵ȋDz͵dzȌ ͷǤͷǤͷǤͷȋDz dzȌǡ
ǡ ̈́ͳͲͲǡͲͲͲȋDz dzȌǡ ͵
͵ Ǥ
ǡǡ
ǡ ǡǡǡǡ ǡǡ
ǡ ǡ Ǥ Ȁ ǡ
ǡ ǡ ǡǡǣ
ȋȌǡǡ Ǥ
ȋȌ Ȁ
Ǥ
ȋ Ȍ͵ Ǥ
̵ ̵
͵ Ǥ ǡ
Ǥ ǡ ͵
ǡ ͵
Ǥ
✔
B-2 Standard Service Contracts Above $100,000
Yes
Yes
Yes
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
COUNTYOFSANTACLARA
SERVICEAGREEMENT
Ȃ ʹͲͳ 1313
NonǦownedAutoInsurance:
Ǧ ǡ
ǦǦ ǫ
Dzdzǡ ǦǤ
When“NO”ischecked,thisdeclarationwillserveasawaiverforthespecifiedtypeofinsurance.
SECTIONVIII:FEDERAL/STATEREQUIREDPROVISIONS
ȋ Ǧ ǡ
ȋȌǡ ǡ Ȍ
A.FederalRequiredLanguageAttached
Ǥ
ExhibitName:
B.StateRequiredLanguageAttached
Ǥ
ExhibitName:
TheExhibitsnamedaboveareattachedandincorporatedbythisreference.
SECTIONIX:ADDITIONALATTACHED EXHIBIT(S)
Ǥ ǣ
ͳȌ ǯ ǡ
ǡ
ʹȌ ȄǤ
ǡ Ǥ
ExhibitName(s)
TheExhibitsnamedaboveareattachedandincorporatedbythisreference.
Yes
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 1 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
Attachment A: Scope of Service
A. Service Description and Expected Outcome
1. PURPOSE
The purpose of this Agreement is to provide professional, demand-responsive
transport for seniors residing within certain areas of Santa Clara County. This
program shall be called “Senior Transportation Pilot Program” (“STPP”).
The estimated number of rides Contractor will provide under this Agreement will be
2,324. This estimation shall not be legally binding in any way.
2. COOPERATION WITH OTHER ORGANIZATIONS
STPP is jointly operated by Saratoga Area Senior Coordinating Council and West
Valley Community Services. Saratoga Area Senior Coordinating Council and West
Valley Community Services shall cooperate with one another in the operation of
STPP to avoid duplication of services and promote efficiency.
However, Saratoga Area Senior Coordinating Council and West Valley Community
Services may operate two separate STPP facilities.
3. NON-EXCLUSIVE AGREEMENT
This Agreement is non-exclusive. County may in its sole discretion select, contract
with, and assign additional contractor(s) to perform any portion of the services
herein.
4. CONFIDENTIALITY
All information gathered by Contractor about passengers or potential passengers
within the scope of STPP shall remain confidential (“STPP Information”). Contractor
shall not, without County’s written consent, use or disclose STPP information other
than in the performance of its obligations under this Agreement. Contractor shall be
responsible for establishing and maintaining an information security program that is
designed to ensure the security and confidentiality of STPP Information, protect
against any anticipated threats or hazards to the security or integrity of STPP
Information, protect against unauthorized access to or use of STPP Information that
could result in substantial harm or inconvenience to County or any end users; and
ensure the proper disposal of STPP Information upon termination of this Agreement.
Contractor shall take appropriate action to address any incident of unauthorized
access to STPP Information, including addressing and/or remedying the issue that
resulted in such unauthorized access, notifying County as soon as possible of any
incident of unauthorized access to STPP Information, or any other breach in
Contractor’s security that materially affects County or end users; and be responsible
for ensuring compliance by its officers, employees, agents, and subcontractors with
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 2 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
the confidentiality provisions hereof. Should confidential and/or legally protected
STPP Information be divulged to unauthorized third parties, Contractor shall comply
with all applicable Federal and State laws and regulations, including but not limited
to California Civil Code Sections 1798.29 and 1798.82 at Contractor’s sole expense
(if applicable). Contractor shall not charge the County for any expenses associated
with Contractor’s compliance with the obligations set forth in this Section 4.
B. Deliverables, Milestones, & Timeline for Performance
5. SERVICE AREA
“Service Area” shall be defined to mean all of the following:
a) The city limits of Cupertino, Campbell, Saratoga, Monte Sereno, and Los Gatos;
b) Sunnyvale CalTrain Station, located at 121 W Evelyn Ave., Sunnyvale, CA;
c) Santa Clara Valley Medical Center, located at 751 S Bascom Ave., San Jose, CA
95128;
d) O’Connor Hospital, located at 2105 Forest Ave., San Jose, CA 95128;
e) El Camino Hospital Mountain View, located at 2500 Grant Road, Mountain View,
CA 94040;
f) Good Samaritan Hospital, located at 2425 Samaritan Drive, San Jose, CA
95124;
g) Kaiser Permanente - Santa Clara, located at 710 Lawrence Expressway, Santa
Clara, CA 95051;
h) O'Connor Hospital, located at 2105 Forest Avenue San Jose, CA 95128;
i) Santa Clara Valley Medical Center, located at 751 S. Bascom Avenue
San Jose, CA 95128;
If an Eligible Passenger requests a ride from Contractor and (1) both the pickup and
destination locations are within the Service Area, (2) the scheduled pickup time is
within the Transportation Hours of Service, (3) the request was made within the
Scheduling Window, (4) the Eligible Passenger has not been disqualified, and (5)
the Eligible Passenger has paid all appropriate fees, then Contractor shall make best
efforts provide that requested ride to the Eligible Passenger.
If Contractor is required to make best efforts to provide a requested ride to Eligible
Passenger and fails to provide the requested ride for any reason, Contractor shall
provide documentation to County reflecting the name of the Eligible Passenger, the
date of request, the requested date of travel, and the reason why Contractor failed to
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 3 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
provide the requested ride to the Eligible Passenger, with specific detail. This
documentation shall be provided to County at the same time as the invoice for the
calendar month.
6. PASSENGERS’ MANDATORY CONSENTS AND WAIVERS
Contractor shall require that all passengers first sign a consent which allows
Contractor to provide Passenger Information to County for the purposes of program
oversight. “Passenger Information” shall be defined as follows:
a) Income verification.
b) Customer Feedback Forms.
c) Trip information, including pickup and destination information.
d) All other information Contractor has gathered about the passenger within scope
of STPP.
Contractor shall also require that all passengers sign a waiver before receiving any
rides which shall be substantially the same as follows:
“I hereby acknowledge that the Senior Transportation Pilot Program is a service
provided by West Valley Community Services and Saratoga Area Senior
Coordinating Council, and funded by Santa Clara County. I hereby waive the right to
make any claims against Santa Clara County, West Valley Community Services, or
Saratoga Area Senior Coordinating Council, or their officials, employees, and
volunteers for any injuries, damages, charges or expenses, including attorney’s fees
which might be sustained as a result of my participation in this program. I also
acknowledge that West Valley Community Services and Saratoga Area Senior
Coordinating Council reserve the right to refuse transportation service.”
7. DRIVER WAIVER
Contractor shall require that each driver shall sign a waiver which shall be
substantially the same as follows:
“I hereby acknowledge that the Senior Transportation Pilot Program is a service
provided by West Valley Community Services and Saratoga Area Senior
Coordinating Council, and funded by Santa Clara County. I hereby waive the right to
make any claims against Santa Clara County, West Valley Community Services,
Saratoga Area Senior Coordinating Council, or their officials, employees, and
volunteers for any injuries, damages, charges or expenses, including attorney’s fees
which might be sustained as a result of my participation in this program.”
8. ELIGIBLE PASSENGERS
An “Eligible Passenger” is defined as:
a) 55 years old or older;
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 4 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
b) If Contractor is West Valley Community Services, must be a resident of
Cupertino or Campbell;
c) If Contractor is Saratoga Area Senior Coordinating Council, must be a resident of
Monte Sereno, Los Gatos, or Saratoga; and
d) Ambulatory, which shall include a person using a walker or cane;
e) Without a medical emergency at the time of the ride;
Contractor shall not transport any person that is not an Eligible Passenger or an
Eligible Passenger’s personal care attendant. No matter which organization a person
calls upon initial contact (whether Saratoga Area Senior Coordinating Council or
West Valley Community Services), they will be put into the system and their first ride
will be set up. They will then be given the appropriate contact number based on their
residency for future rides.
9. HOURS OF SERVICE
Telephone Hours of Service are defined as 8:00 am – 12:00 pm and 1:00 pm - 4:30
pm, Monday through Friday, excluding New Year’s Day, Cesar Chavez Day, Martin
Luther King Jr. Day, President’s Day, Veteran’s Day, Memorial Day, Independence
Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, the day before
Christmas Day, Christmas Day, and New Year’s Eve.
Transportation Hours of Service are defined as 8:00 am - 12:00 pm and 1:00 pm -
4:00 pm, Monday through Friday, excluding New Year’s Day, Cesar Chavez Day,
Martin Luther King Jr. Day, President’s Day, Veteran’s Day, Memorial Day,
Independence Day, Labor Day, Thanksgiving Day, the day after Thanksgiving, the
day before Christmas Day, Christmas Day, and New Year’s Eve.
10. TELEPHONE CALL CENTER
Contractor is required to provide trip reservation and “Where Is My Ride” services to
all Eligible Passengers via telephone. Contractor shall ensure that its call center can
accept trip reservations and answer “Where is My Ride” calls during the Telephone
Hours of Service.
11. CUSTOMER FEEDBACK FORMS
Contractor must develop Customer Feedback Forms which reflect passengers’
satisfaction with Contractor’s service and any problems that passengers had.
Customer Feedback Forms shall contain, at a minimum, the substance of the
Sample Customer Feedback Form in this Agreement.
Contractor must inform all telephone callers interested in receiving a ride that
Customer Feedback Forms are available, whether or not they have called Contractor
previously. Contractor must provide Customer Feedback Forms to all persons that
request them and must receive, store, and organize all Customer Feedback Forms
submitted. Contractor must submit all received Customer Feedback Forms in a
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 5 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
particular calendar month to County at the same time it submits an invoice for that
calendar month.
Contractor shall not have any more than 10 valid, verified complaints per 3,000
passengers. A verified complaint is one that violates established policies or
procedures by the preponderance of the evidence.
12. PASSENGER DISQUALIFICATION
Contractor may disqualify Eligible Passengers for the following conduct while in
Contractor’s vehicle:
a) Interfere with the driver or operation of the vehicle.
b) Throw any object from the vehicle.
c) Extend a hand, arm, foot, leg or other portion of the body through any window
opening of the vehicle.
d) Place a foot on any seat of a vehicle.
e) Commit any act or engage in behavior that could, with reasonable foreseeability,
cause harm or injury to any person or property.
f) Eat, drink, or possess an open food or drink container unless necessitated by a
medical condition.
g) Consume an alcoholic beverage or possess an open container of alcoholic
beverage.
h) Discard litter within the vehicle.
i) Take an unfolded baby stroller or utility cart in a vehicle, unless the driver
determines space is available.
j) Transport any animal on in a vehicle unless: (a) the animal is a guide, service or
signal animal (or a service animal in training) that has been specially trained to
assist persons with disabilities and is on a leash; or (b) the animal is in a
completely enclosed and secured cage or carrying case which is small enough to
fit on the passenger's lap and the animal does not otherwise endanger or annoy
other person.
k) Transport any package, bundle, object, or baggage whose contents, size, bulk,
shape or nature may be dangerous, or interfere with the safe operation of the
vehicle.
l) Urinate or defecate in a vehicle, unless the incident is a direct result of disability,
age, or medical condition.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 6 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
m) Smoke, vape or use an e-cigarette, or carry a lit cigar, pipe or cigarette of any
type.
Contractor shall send documentation to County describing the circumstances of all
Eligible Passengers disqualified under this Section 12 in a particular calendar month
at the same time as the invoice for that calendar month.
13. DIRECT ROUTE
Contractor’s drivers must take the most time-efficient route while transporting
Eligible Passengers and shall not take detours or unscheduled stops, except in the
case of an emergency.
14. VEHICLE DISQUALIFICATION
County may, during normally scheduled monitoring visits, or, as a follow-up to a
client complaint, inspect any vehicles used by Contractor to transport clients. If, in
the opinion of County, a vehicle does not meet County safety standards, it may be
“red tagged.” A vehicle that has been “red tagged” shall be immediately removed
from service. A “red tagged” vehicle may not be released for service until such time
as the problems associated with it have been rectified by Contractor and verified by
County. A vehicle may be “red tagged” by County if any of the following occurs:
a) The vehicle violates any Vehicle Code requirements;
b) Tires: Flat, worn, embedded objects, bald;
c) Passenger door interlock inoperative;
d) Headlights out;
e) Taillights out;
f) Turn signals out or inoperative;
g) Horn not working;
h) Windshield wipers not working;
i) Engine smoking excessively;
j) Brake lining too thin;
k) Fluid leaks;
l) Coolant leaks;
m) Exhaust system leaking or damaged;
n) Steering with excessive play;
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 7 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
o) Loose or missing lug nuts;
p) Any noncompliance with Federal Motor Vehicle Safety Standards and other
governing agency safety, vehicle operations regulations; or
q) Any other safety or maintenance item which may endanger the safety of
passengers.
15. DRIVER DISQUALIFICATION
a) County may require that any driver be removed from transporting clients for
excessive complaints, rudeness, or other inappropriate behavior or appearance
pursuant to the requirements of this Agreement. County has a Zero Tolerance
Policy with regard to misconduct or inappropriate contact between vehicle
operators and passengers, and if an allegation of this nature is received,
Contractor shall remove the driver from service immediately pending resolution of
the allegation to County’s satisfaction.
b) Any driver receiving three or more valid customer complaints within a rolling 30-
day period shall be removed from service.
c) County will notify Contractor, in writing, if any driver is removed from service
under this Section 15 in a particular calendar month at the same time as the
invoice for that particular calendar month.
16. BACKGROUND CHECKS
a) Contractor shall perform fingerprint-based criminal background checks (e.g., Live
Scan) and name-based criminal background checks on all of Contractor’s drivers
before they begin transporting passengers. It shall include all of the following:
1. A multistate and multijurisdictional criminal records locator or other similar
commercial nationwide database with validation.
2. A search of the United States Department of Justice National Sex
Offender Public Web site.
b) Contractor shall not contract with, employ, or retain a driver if he or she meets
any of the following criteria:
1. Is currently registered on the United States Department of Justice National
Sex Offender Public Web site.
2. Has been convicted of any of the following offenses:
i. A violent felony, as defined in Section 667.5 of the Penal Code.
ii. A violation of Section 11413, 11418, 11418.5, or 11419 of the
Penal Code.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 8 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
3. Has any Two-Point Count California Vehicle Code Violations or has an
outstanding failure-to-appear or failure-to-pay violation.
c) Contractor shall not contract with, employ, or retain a driver if he or she has been
convicted of any of the following offenses.
1. Misdemeanor assault or battery.
2. A domestic violence offense.
3. Driving under the influence of alcohol or drugs.
4. A felony violation of Section 18540 of the Elections Code, or of Section 67,
68, 85, 86, 92, 93, 137, 138, 165, 518, 530, or 18500 or, subdivision (a) of
Section 484 of, subdivision (a) of Section 487 of, or subdivision (b) of
Section 25540 of, the Penal Code.
d) Paragraphs (b) and (c) shall apply regarding a conviction of any offense
committed in another jurisdiction that includes all of the elements of any of the
offenses described or defined in those paragraphs.
e) Nothing in this Section 16 shall be interpreted to prevent Contractor from
imposing additional standards.
f) Contractor shall enroll all drivers in the California Department of Motor Vehicle’s
(DMV) Employer Pull Notice (EPN) Program before allowing them to transport
any passengers.
g) Contractor shall send all background check documentation required under this
Section 16 to County, for all of Contractor’s new active drivers in a particular
calendar month to County at the same time as the invoice for that particular
calendar month.
17. INCIDENTS
Contractor shall notify County by telephone immediately, as is feasible, and provide
written notification within 24 hours of any of the following incidents:
a) Collisions between a vehicle in use by Contractor and another vehicle, person or
object;
b) Passenger accidents, including falls to passengers who are entering, occupying
or exiting the vehicle;
c) Passenger complaints of injury or other circumstances likely to result in the filing
of claims against the Contractor or County;
d) Any passenger, driver or service complaint that arises from an accident or health-
threatening incident;
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 9 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
e) Inappropriate behavior on-board the vehicle;
f) Disturbances, assaults, fainting, sickness, deaths, or similar; and
g) Vandalism to the vehicle while transporting a passenger.
Contractor will ensure proper follow up on any accidents or incidents, where
appropriate, to ensure that any unresolved safety hazards or liability issues are
addressed. Copies of reports prepared for any of the above must be sent to County.
If loss of service occurs or a major incident occurs that will likely receive media
coverage, Contractor shall notify County immediately.
18. FARE POLICY AND COLLECTION
Contractor’s drivers may not accept any payment from passengers. Contractor will
not be reimbursed or credited in any way for fares it was required to collect but failed
to collect. Contractor shall, through policy and policy enforcement, ensure that
drivers do not request or receive gratuities.
19. EMERGENCY OPERATION INCLUDING EARTHQUAKE AND CIVIL UNREST
In the event of any natural disaster such as, earthquakes, floods, or other acts of
God or civil disturbances make it impossible or impracticable for Contractor to
continue service, Contractor may suspend its service.
20. DRIVER CODE OF CONDUCT
a) Drivers must not have any weapons in their possession or their vehicles.
b) Smoking is prohibited.
c) Drivers must conduct themselves in a professional and courteous manner
towards passengers.
d) Inappropriate behavior between passengers or between passenger and driver is
prohibited. Allegations of sexual misconduct, lewd behavior, or sexual
harassment made by any client must be reported to County staff immediately.
Should the Contractor receive notification from other than County that a driver or
an employee of Contractor is allegedly involved in a criminal activity including,
but not limited to, sexual misconduct, lewd behavior, or sexual harassment, the
Contractor shall notify County immediately as well as local police.
21. TRIP MANIFEST
Contractor shall create a Trip Manifest for all rides or its electronic equivalent. These
records shall have all of the following:
a) Signed and dated by Contractor.
b) Scheduled pickup time and drop-off time.
c) Scheduled pickup location and drop-off location.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 10 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
d) Actual pickup time and drop-off time.
e) Actual pickup location and drop-off location.
f) Number of passengers transported during ride.
g) Whether a no-show or cancellation occurred.
h) Any unscheduled trips or stops that occurred and why.
These records must be stored and organized by Contractor.
22. SCHEDULING WINDOW
The “Scheduling Window” shall be defined as 36 hours prior to a requested ride and
up to 5 weeks ahead of the requested ride.
23. VEHICLE CLEANING
All vehicles used by Contractor for STPP services must be kept clean.
24. EXCEPTIONS LOG
An exceptions log will be required which will provide a daily record of any instances
of mechanical breakdown, road calls, or air conditioning or heater malfunction on
vehicles which were in operation under this Agreement.
The exceptions log for a particular calendar month shall be provided to County at the
same time as the invoice for that same calendar month. Contractor may use a form
similar to the Sample Incident Report attached to this Agreement.
25. SIX-MONTH VEHICLE INSPECTIONS
No vehicle will be allowed to carry passengers unless the driver has determined that
the vehicle is in good working order.
Contractor shall collect Six-Month Vehicle Inspection Forms from their drivers every
six months, which shall be substantially similar to the Sample Six-Month Vehicle
Inspection Form in this Agreement. Contractor shall store and organize these Six-
Month Vehicle Inspection Forms.
26. CONTINGENCY
This Agreement shall only effective valid upon (1) the execution of a similar
agreement between County and another contractor for STPP, and (2) the receipt by
County of the following funding for this STPP from the following entities:
a) $84,000 from Valley Transportation Authority (VTA),
b) $22,000 from City of Cupertino,
c) $19,000 from City of Saratoga,
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 11 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
d) $17,000 from Town of Los Gatos,
e) $16,000 from City of Campbell, and
f) $8,000 from City of Monte Sereno.
County shall notify Contractor when these conditions have been satisfied and this
Agreement will be effective.
27. CURB-TO-CURB SERVICE
“Curb-to-Curb Service” means a type of transit service where, on both the origin and
destination ends of the trip, the driver gets out of the vehicle and assists the
passenger between the vehicle and a sidewalk or other waiting area no more than
15 feet from the vehicle.
Contractor shall provide Curb-to-Curb Service to passengers.
28. ROAD CALLS
In the event of a vehicle failure while in service, Contractor shall deploy a vehicle
immediately upon notification to replace the failed vehicle to ensure continuity of
service.
29. TRIP PURPOSE
If Contractor is aware that the purpose of a proposed ride is one of the following,
Contractor shall decline the ride:
a) Medical emergency; or
b) Joyriding (i.e., a ride for the purpose of travelling or a ride with no destination
purpose).
30. CANCELLATION NOTICE
Clients must cancel at least 24 hours prior to the pick-up time of their scheduled ride
in order to avoid being charged $5 for a No-Show, with the exception of the first No-
Show. Cancellations received during non-business hours and weekends must be
processed promptly the next business day to avoid dispatching to cancelled pick-
ups.
Under no circumstances will Contractor cancel a scheduled trip unless a State of
Emergency has been called by the authorities, a passenger has been disqualified
pursuant to Section 12, or the ride is declined pursuant to Section 29.
Contractor shall send documentation to County describing the circumstances of all
of its cancellations of scheduled trips under this Section 30 in a particular calendar
month at the same time as the invoice for that calendar month.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 12 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
31. NO PASSENGER STRANDED POLICY
At the time of the ride reservation the scheduler/dispatcher will confirm the need for
a round trip and schedule accordingly. In the event a driver does not respond to the
scheduled trip and a call is received from the passenger, immediate use of backup
systems will ensure the trip is provided.
32. VEHICLE STANDARDS
a) All vehicles in use by Contractor shall meet all applicable standards of the
California Vehicle Code. Certain equipment must be present and fully functional
as OEM (original equipment manufacture), as specified in this Section 32. All
vehicles in use by Contractor must be maintained to these standards at all times.
b) Body Condition
1. No significant body damage, frame damage, tears or rust holes in the
vehicle body and/or loose pieces hanging from the vehicle body are
permitted. Front and rear fenders, bumpers, hood, trunk, and trim shall be
securely fixed and shall be in correct alignment to the vehicle as OEM.
Body damage shall include any un-repaired dents, distortions,
depressions, bulges, tears, holes, or disfigurements.
2. The exterior of the vehicle shall be maintained in a substantially clean
condition and shall be substantially free of unsightly dirt, tar, oil, and rust.
3. The vehicle paint shall not be significantly mismatched, faded, blistered,
cracked, chipped, peeled, or scratched.
c) Climate Control
1. The air conditioning/heating units shall be functional at all times.
2. The air discharged from the air conditioner interior vent system shall be
continuously cool.
3. All air conditioning temperature controls and functions shall operate as
originally designed and manufactured with no knobs or components
broken or missing.
4. Systems shall operate on all OEM speeds with no excessive noise.
d) Hubcaps or Wheel covers
1. Hubcaps shall be on all wheels for which hubcaps are standard
equipment.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 13 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
e) Interior Condition
1. Passenger compartment, driver compartment, and trunk or luggage area
shall be clean and free of foreign matter, offensive odors, and litter.
2. Seat upholstery shall be clean. Interior walls, carpet and/or flooring, and
ceiling shall be kept reasonably clean. No significant rips or tears are
permitted. All repairs shall be done to provide a reasonable match with the
existing interior.
3. Door handles and doors shall be intact, clean, and operational. Each door
shall be capable of being unlocked and opened from the interior of the
vehicle.
4. Dashboards shall be maintained in a manner that is clean and free of
loose articles. Dashboards shall be free of significant cracks, holes, and
tears.
f) Lights and Lenses
1. Interior lights shall be operational.
2. Light lenses must be OEM, intact and contain no holes or large cracks.
g) Cell phone
Vehicles shall be equipped with a cellular phone in working order.
h) Seat Belts
Vehicle restraint system shall be maintained to OEM specifications and shall be
in good working order.
i) Windows
1. Front and rear windshield per California Vehicle Code § 26710.
2. Safety glass shall be in all windows.
3. Windows shall be operational as originally designed.
4. No window tinting on windshield or front side windows per California
Vehicle Code § 26708. Any tinting applied to the rear side or rear windows
must be light enough to allow any passengers to be viewed from the
outside.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 14 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
j) Foot Pedal Pads
OEM rubber pads on all foot controls. Pads shall not be worn or deteriorated to
the point that metal is showing.
k) Vehicle Age
A vehicle may not be older than fifteen (15) model years measured from the
current calendar year (example: during calendar year 2000, the vehicle must be
model year 1985 or later). Vehicles older than fifteen (15) model years shall not
be eligible to operate as a vehicle under any condition.
33. NO SHOW POLICY
a) A No-Show is defined as:
1. When a client fails to appear for a scheduled trip within 10 minutes after
the scheduled pick-up time (Driver must immediately notify dispatch of the
No-Show); or,
2. When a client cancellation is received less than 24 hours prior to the
scheduled pick up time.
b) Notification and Management of Client No-Shows:
1. Dispatcher attempts notification of client via telephone and informs driver
of status.
2. Client is charged one No-Show and will receive a telephone call from the
Contractor after the first No-Show.
3. Client will receive a written letter explaining termination policy after second
No-Show.
4. Three No-Shows in a 30-day period may result in client disqualification, in
the discretion of Contractor.
c) Each client’s No-Shows will be tracked monthly and recorded in client file.
34. DRIVER TRAINING
All of Contractor’s drivers must take and pass the Community Transportation
Association’s Passenger Service and Safety (PASS) Training Program before
transporting any passengers.
Additionally, all of Contractor’s drivers must be instructed on the requirements of this
Agreement before transporting passengers.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 15 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
35. LOST-AND-FOUND
Policies for handling of lost-and-found personal effects shall be as follows:
a) Drivers shall check their vehicles after each trip for items left on board. If lost
items are found, the driver is to contact their dispatch and inform them of the lost
item. At the end of the shift, the driver will fill out a lost-and-found report and turn
in the lost item to the dispatcher.
b) Dispatcher will receive the item along with the lost-and-found report from the
driver and contact the passengers from that day’s schedule to determine if item
belongs to them.
c) All lost and found items with a value of greater than $10 must be secured at the
Contractor’s facility for a period of not less than 90 days.
d) Disposal of unclaimed items other than cash after the 90 days will be reported to
County with copies of the lost-and-found reports.
36. ADMINISTRATIVE CAPACITY
Contractor shall maintain sufficient administrative capacity to professionally carry out
the services described in this Agreement. In addition to the requirements described
elsewhere in this Agreement, this sufficient administrative capacity shall include:
a) Processing client applications in a timely manner
b) Handling telephone requests and inquiries so as to maximize customer service,
giving timely, accurate and courteous service.
c) Carrying out trip reservation activities in a manner which will maximize efficiency.
d) Receive, approve and process requests for service. Review and refine daily trip
itineraries. Assess distances and routing to ensure efficient travel patterns.
Initiate client call backs regarding any trip discrepancies and or schedule
changes.
37. BACKUP SYSTEMS
Contractor shall use best efforts to provide a sufficient number of vehicles and
drivers to deliver services and meet the requirements of the STPP. This number will
be determined by the scheduling of trips and the capacity of the vehicles proposed
for this service. Determination of the number of vehicles required to provide these
services is the responsibility of Contractor.
Contractor shall use best efforts to maintain substitute or backup staff, drivers, and
vehicles to support daily services and scheduled trips. Backup systems will be in
place to handle road assistance calls from drivers, to relieve drivers if they become
sick, to relieve drivers for family emergencies, and relieve drivers who are deemed
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 16 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
inappropriate or unsafe by either Contractor or County. Backup systems will be in
place to support the dispatcher and/or the travel coordinator in their absence.
38. DRIVER DRESS AND APPEARANCE STANDARD
a) Appropriate attire that conveys a professional image will be worn by all drivers
when operating a vehicle in service. Clothing must remain in good repair, and not
appear damaged or worn out.
b) Drivers will be required to adhere to reasonable grooming and appearance
standards.
39. DRIVER TOOLS
Contractor’s drivers shall have all tools and equipment necessary to perform all the
duties of a driver. Driver equipment will include, but not be limited to, a smartphone,
clipboards, and at least one pen.
40. ON-TIME PERFORMANCE
a) Contractor shall arrive at pickup location for 95% of scheduled trips before
scheduled pickup time.
b) Scheduled pickup time shall be determined by Contractor at the time the ride is
initially scheduled with passenger and communicated to passenger at that time.
c) Contractor shall arrive at destination location for 95% of scheduled trips within 10
minutes before or 10 minutes after scheduled drop-off time.
d) Scheduled destination drop-off time shall be determined by Contractor at the time
the ride is initially scheduled with passenger and communicated to passenger at
that time.
C. Performance Standards
41. PERFORMANCE MONITORING
County staff will monitor Contractor’s performance, compliance with insurance
requirements and with Federal, State, local, and Agreement requirements, and will
gauge the quality of service on a systematic and continuing basis. Such monitoring
may include inspection of documents or files; interviews and conversations with
Contractor's managers, drivers, reservations staff; review of call center statistical
reports; analysis of complaints; road checks; passenger surveys; and the inspection
of facilities, equipment, and vehicles.
County will monitor factors such as, pickup and drop-off procedures, passenger
disagreements and issues, receive reports from the Contractor’s field monitors, and
monitor excessive no-shows and late cancellations by specific passengers.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 17 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
Irrespective of the County’s monitoring program, Contractor shall implement its own
quality assurance program. Such program shall include, but not be limited to, regular
supervisory field observations, trip manifest and dispatch log reviews, complaint
mitigation, vehicle/equipment inspections, and records audits.
42. QUARTERLY REPORTS
Contractor shall provide quarterly reports to County on October 15, 2017 (covering
July 1, 2017 through September 30, 2017), January 15, 2018 (covering October 1,
2017 through December 31, 2017), April 15, 2018 (covering January 1, 2018
through March 31, 2018), and July 15, 2018 (covering April 1, 2018 through June 30,
2018). These quarterly reports shall contain the following information:
a) Quarterly and annual ridership targets, provided prospectively.
b) Residents served by jurisdiction, including unique customers and total rides
provided.
c) Subsidies provided by jurisdiction.
d) Number of subsidized riders and un-subsidized riders.
e) Cost per ride to the customer and to the program.
f) Location for pickup and drop-off by zip code.
g) Day, date, and time of rides.
h) Ride distance.
i) Customer service metrics, including requests made, requests filled, scheduled
rides that are missed, etc.
D. Payment Schedule
43. STANDARD RIDE COST
The definition of “Standard Ride Cost” for a passenger shall be
j) $9.00 for a ride up to four miles;
k) $13.00 for a ride over four and up to eight miles, and;
l) $18.00 for a ride over eight miles.
A ride shall be one-way only, from a single point of origin to a single point of
destination.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 18 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
The first no show will not be charged. Any No Show after the first, Contractor shall
charge the individual a flat fee of $5 per No Show. Any cancellations with less than
24 hours advance notice, Contractor may charge the individual a flat fee of $5 per
cancellation.
The fees listed in this Section 43 are the only type of fees that Contractor may
charge a passenger. Booking fees, application fees, and similar fees are prohibited.
A passenger’s personal care attendant or service animal may ride free of charge.
44. DISCOUNTS
The following discounts shall be granted to individuals who meet eligibility
requirements and Contractor has verified a passenger’s income.
Low income – Standard Ride Cost shall be discounted by 50%.
Very low income – Standard Ride Cost shall be discounted by 75%.
Extremely low income – Standard Ride Cost shall be discounted by 90%.
Table A: 2016 HUD definitions:
Persons
in Family
Extremely
Low
Income
Very Low
Income Low Income
1 $23,450 $39,100 $55,500
2 $26,800 $44,650 $63,400
3 $30,150 $50,250 $71,350
4 $33,500 $55,800 $79,250
5 $36,200 $60,300 $85,600
6 $38,900 $64,750 $91,950
7 $41,550 $69,200 $98,300
8 $44,250 $73,700 $104,650
Questions about how to calculate income, how to calculate the number of people in
a family, and similar questions, shall be resolved by applying current HUD laws and
regulations, when not in conflict with this Agreement. Contractor shall not be
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 19 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
required to gather income verification information beyond what is described in this
Section 44.
Contractor shall verify income by requiring passengers requesting a discount to
submit a form (“Income Verification Form”) substantially similar to Form FL-150,
“Income and Expense Declaration” produced by the Judicial Council of California,
omitting Items 4, 10, 11, 13, 14, 15, 16, 17, 18, 19, and 20 and other clearly non-
relevant parts of Form FL-150 related to litigation. The Income Verification Form
shall be signed by the passenger under the penalty of perjury, using wording
identical to the wording used by Form FL-150.
The Income Verification Form shall be accompanied by all other documentation
required by Form FL-150, including pay stubs for the prior two months, proof of any
other income. However, Contractor may choose whether or not to require an
individual’s most recent Federal tax return.
Contractor shall use due diligence in verifying income. Contractor shall not prioritize
or discriminate against passengers based on discount eligibility.
Contractor shall organize and store this income verification documentation.
45. COST-REIMBURSEMENT
a) Contractor will be reimbursed by County for its actual, reasonable, necessary,
and allowable costs incurred up to the maximum compensation, for the
performance of services as specified in this Agreement. These costs will also be
in accordance with current cost principles and with all other requirements of this
Agreement:
1. For Non-Profit Agencies, OMB Circular A-122.
2. For Local Governments, OMB Circular A-87.
3. For Public and Nonprofit Institutions of Higher Education, OMB Circular A-
121.
4. For Profit Making Organization, 41 CFR Part 1.
b) If this contract ends or is terminated for any reason, Contractor shall return all
remaining goods and services (including software and similar) purchased by
Contractor pursuant to this Section 45, unless (1) this requirement is waived by
County, in writing, or (2) meeting this requirement is impossible. Contractor may
not sell any goods or services reimbursed pursuant to this Section 45, unless
County had given advance, written consent.
Contractor shall have appropriate organization and recordkeeping to meet the
requirement of this Section 45(b).
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 20 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
c) If Contractor provides any tasks, deliverables, goods, services, or other work,
other than as specified in this Agreement, the same will be deemed to be a
gratuitous effort on the part of the Contractor, and the Contractor will have no
claim whatsoever against County.
d) Contractor must participate in a closeout period at the end of the County funding
period. During the closeout period all funds awarded to Contractor must be
reconciled to the costs incurred and to the remaining cash, if any. A closeout
packet will be provided to Contractor by County at the end of the funding period
and is due within forty-five (45) days thereafter. This provision survives the
termination of this Agreement.
46. ADJUSTMENT TO BUDGET
A budget adjustment can be made by the County without a formal contract
amendment as long as the adjustment does not increase the maximum financial
obligation specified under the subsection titled “Maximum Financial Obligation”
located in Section I: General Information, and doesn’t have a negative impact on the
Contractor’s ability to meet the obligations of this Agreement.
Contractor may request a budget revision by submitting the County’s Budget
Revision Request form to the County’s designated contract/program monitor. The
Budget Revision Request must include a statement explaining the impact that the
budget revision, if approved, would have on the program/service delivery. Upon
approval of the Contractor’s Budget Revision Request, County will forward an
approved copy of the Budget Revision Request form to the Contractor
47. INVOICES
All invoices must be signed and must explicitly certify that the signer has provided
documentation to County for all of the following for the calendar month of the
invoice:
a) Why Contractor failed to provide any Eligible Passenger a ride, if Contractor was
required to use best efforts to provide the ride pursuant to Section 5;
b) Copies of all Customer Feedback Forms from all persons, pursuant to Section
11;
c) Any Eligible Passengers that have been disqualified during the calendar month,
and the specific conduct that caused the disqualification, pursuant to Section 12;
d) Exceptions log, pursuant to Section 24;
e) Incidents, pursuant to Section 17;
f) Driver disqualification, pursuant to Section 15;
g) Contractor’s cancellation of a scheduled trip, pursuant to Section 30;
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 21 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
h) Background check documentation of all new active drivers, pursuant to Section
16; and
i) Roster of all active drivers in use by Contractor. This requirement may be
satisfied by Contractor providing timely updates as to when active drivers are
added and dropped.
Invoices must contain all of the following data:
a) Number of Rides broken out by
1. Distance category,
2. Income-level discount,
b) Number of No-shows and cancellations.
c) All payments received from passengers.
An invoice for services provided in a particular month must be submitted to County
prior to 5:00 pm on the fifteenth calendar day of the next month.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 22 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
SAMPLE SIX-MONTH VEHICLE INSPECTION FORM
Vehicle #:____________________ Date:________
Driver’s Name:
Mileage: Time of Inspection am/pm
Driver: Please take your time and inspect this vehicle thoroughly. Safety is
OUR priority. Thank you.
Items to Check Problem? Repaired? Item OK
(Please
initial)
Tire(s) Pressure
Engine Oil Level
Transmission Oil
Level
Coolant Level
Brake Fluid Level
Emergency Brake
Head Light
Turn Signals
Brake Lights
Back-up Lights
Door Locks
Mirrors
Safety Belts
Heater/A.C.
Cell Phone/radio
First Aid Kit
Transportation Log
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 23 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
SAMPLE VEHICLE MAINTENANCE FORM
Date: Maintenance Facility:
Vehicle Type/Year License Plate Number
Vehicle Indentification Number Mileage
Vehicle Capacity: #Passengers:
Inspection Item Satisfactory
Yes No N/A
1. Tires, pressure, tread wear ☐ ☐
2. Headlights – functional (high/low) and clean ☐ ☐
3. Turn Signals – functional ☐ ☐
4. Horn – functional ☐ ☐
5. Tail/Parking lights – functional and clean ☐ ☐
6. Brakes – functional, brake pedal not low ☐ ☐
7. Lift or ramp functional ☐ ☐ ☐
8. W indshield/Wipers/Fluid – functional, clear, full ☐ ☐
9. Mirrors – clean, position, clear ☐ ☐
10. Exhaust System – no leaking ☐ ☐
11. Oil/Antifreeze – full ☐ ☐
12. Hoses – good condition ☐ ☐
13. Safety Equipment – good condition
-Fire Extinguisher ☐ ☐
-Flashlight ☐ ☐
-First Aid Kit ☐ ☐
-Jumper Cables ☐ ☐ ☐
-Flares/Triangles ☐ ☐
-Cellular Phone ☐ ☐
-Securements/tie downs (bungees for walkers) ☐ ☐ ☐
14. Accident Pack – in place, current
-Registration Card ☐ ☐
-Insurance Card ☐ ☐
-Accident & Incident Report Forms ☐ ☐
-Emergency Procedure Plan ☐ ☐
Recommended Corrective Actions:
Corrective Action Follow-up:
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 24 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
SAMPLE CUSTOMER FEEDBACK FORM
Client’s Name_________Client I.D.# ______________
Address: _________________
City: _________________Zip Code: _______
Phone:
What is the complaint?
_____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
Date Report Taken:______Time Report Taken:_______
By Phone________By Mail________In Person________By Fax_________By Other________
Report Taken By:_________________
What is the Action Plan?
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What was the Resolution?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Date Client was notified: ____________W as Client Satisfied?___Yes____No
How was client notified? Phone Mail In Person Fax Other
Staff’s Signature: _Date
Staff’s Signature: _______________Date
Sent to Santa Clara County__________________________Date:___________
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Page 25 of 25
Service Agreement between the County of Santa Clara and West Valley Community Services of
Santa Clara County, Inc. - FY2018
SAMPLE INCIDENT REPORT FORM
Date of Incident: Time of Incident: _____________________________________
Name of Driver_____________________________________Vehicle I.D. No.___________________________
Location of Incident: _________________________________________________________________________
Nature of Incident: ___________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
Client Name: _________________________________________________________ Client I.D.#_________
Client Address: ________________________________________________________ City:_____________
Zip Code:_____________________________
Phone: Home
What action was taken? __________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Does client wish further action?_________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________ _____________________________________________________________________________________________
Report By_____________________________________Title:
Date of Report_____________________________________
Submit report to Santa Clara County within 24 hours of incident.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Resource Table
Service Agreement between
the County of Santa Clara and West Valley Community Services of Santa Clara County, Inc. - FY2018
Agency Name:West Valley Community Services of Santa Clara County, Inc.
Contract Period: July 1, 2017 - June 30, 2018
Project Name:Senior Transportation Pilot Program
A B C D
Source of Funds FY17-18 Amount
% of Total
Funding Commitment Code
Social Services Agency (SSA)* 125,000$ 100%1
Other Funding Sources:
0%
0%
0%
0%
0%
0%
Total Funding Resources**125,000$ 100%
Commitment Code
1
2
3
4
5
* The SSA line in FY 17-18 Amount, Column "B" should equal the Grand Total of
Column "B" in the Budget Detail.
** The Total Funding Resources in Column "B" should equal the Grand Total of
Column "D" in the Budget Detail.
Firm Commitment-Already have an agreement or letter confirming
funding
Anticipated Renewal of Existing Funding-Continuation of current
year funding
Anticipated Resource-Projection of previous fees or donations
Application Pending-Application has been submitted, no
confirmation at this time
Pre-Application-Not yet submitted and expect funding
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Santa Clara County
Social Services Agency
FY 2017-20178 Attachment A: BUDGET
Staffing Salary
Service Agreement between
the County of Santa Clara and West Valley Community Services of Santa Clara County, Inc. - FY2018
Agency Name:West Valley Community Services of Santa Clara County, Inc.
Contract Period: July 1, 2017 - June 30, 2018
Project Name:Senior Transportation Pilot Program
A B C D E
Staff Name and Job Title Annual Salary
% of Time Allocated
to this Contract Number of Months
Salary Allocated to this
Contract *
TBH, Coordinator $ 41,600.00 100%12 $ 41,600
TBH, Driver $ 11,700.00 100%10 $ 11,700
TBH, Driver $ 11,700.00 100%10 $ 11,700
$ -
$ -
$ -
$ -
$ -
Total $ 65,000
*Total Salary Allocated to this Contract should equal the Salaries line in Contract Amount, Column "B"
of the Budget Detail.
If there are any staffing changes during the contract term, contractor must submit to the County a revised
"Staffing Salary". If the staffing change impacts any budget line items, Contractor must also submit to the County
a revised budget request form. (Refer to Scope of Service: Adjustment to Budget)
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Budget Detail
Service Agreement between
the County of Santa Clara and West Valley Community Services of Santa Clara County, Inc. - FY2018
Agency Name:West Valley Community Services of Santa Clara County, Inc.
Contract Period: July 1, 2017- June 30, 2018
Project Name:Senior Transportation Pilot Program
A B C D
Personnel Costs Contract Amount Other Funding Total
Salaries 65,000$ 65,000$
Payroll Taxes 9,750$ 9,750$
Employee Benefits 2,000$ 2,000$
-$
-$
Subtotal Personnel Costs 76,750$ -$ 76,750$
Operating Expenses**
Audit Fees -$
Communication Expense -$
Contract Services -$
Equipment 3,500$ 3,500$
Insurance 12,500$ 12,500$
Office Supplies 1,000$ 1,000$
Professional Services -$
Rent -$
Travel 5,000$ 5,000$
Utilities -$
Training & Conference 2,000$ 2,000$
Program Overhead -$
Marketing 2,000$ 2,000$
Other(Specify)
Software 3,500$ 3,500$
Subtotal Operating Expenses 29,500$ -$ 29,500$
Indirect Costs *** (maximum 15% of budget or federally approved indirect rate)
Administrative Overhead 18,750$ -$ 18,750$
Subtotal Indirect Costs 18,750$ -$ 18,750$
Grand Total****125,000$ -$ 125,000$
*Direct Costs are those costs for activities or services that benefit “specific projects” and are usually charged
directly to projects on an item-by item basis.
**These expense accounts are examples only. Vendors are not required to use these.
***Indirect Costs are costs incurred for a common or joint purpose benefiting more than one cost objective
and are not readily identified with a particular grant, contract, project function or activity. Enter only total amount under
the Administrative Overhead
****The Grand Total for Column "D" should equal Total Funding Resources of Column "B" in the Resource Table.
If there are any budget changes in certain line item expenses during the course of FY, contractor must submit to the
County a budget revision request form. (See Scope of Service: Adjustment to Budget)
Direct Costs *
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
Santa Clara County
Social Services Agency
FY 2017-2018 Attachment A: BUDGET
Budget Narrative
Service Agreement between
the County of Santa Clara and West Valley Community Services of Santa Clara County, Inc. - FY2018
Agency Name:West Valley Community Services of Santa Clara County, Inc.
Contract Period:July 1, 2017- June 30, 2018
Project Name:Senior Transportation Pilot Program
Personnel Costs Narrative
Salaries Salary for 1 FTE Program Coordinator and 2 - .5 FTE drivers
Payroll Taxes
The cost of mandated FICA, Medicare, State Unemployment and Worker's
Comp taxes computed at 15% of Salaries
Employee Benefits The cost of providing health insurance for the Coordinator
Audit Fees
Communication Expense
Contract Services
Equipment
The cost of a computer for this program; auto accessories for cell phone use in
the car
Insurance The cost of general liability insurance specifically for this program
Office Supplies
The cost of consumable supplies. Paper, files, pens, etc and other materials for
this program
Professional Services
Rent
Travel
Reimbursment for business use of a personal vehicle at $.535/mile based on
778 miles/month
Utilities
Training & Conference
The cost of Paratransit Training and training from agencies already providing
this service elsewhere in the county.
Program Overhead
Marketing The cost of purchasing advertising, publicity materials, and printed give aways
Software The cost of Simpli software for tracking information in this program
Administrative Overhead
The cost of providing Human Resources, Bookkeeping and Accounting, IT and
overall supervsion of this program by the Executive Director.
Operating Expenses
Indirect Costs
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
EXHIBIT B-2 (revised)
Rev. 9/2016 1
INSURANCE REQUIREMENTS FOR
STANDARD CONTRACTS ABOVE $100,000
Indemnity
The Contractor shall indemnify, defend, and hold harmless the County of Santa Clara (hereinafter
"County"), its officers, agents and employees from any claim, liability, loss, injury or damage
arising out of, or in connection with, performance of this Agreement by Contractor and/or its agents,
employees or sub-contractors, excepting only loss, injury or damage caused by the sole negligence
or willful misconduct of personnel employed by the County. It is the intent of the parties to this
Agreement to provide the broadest possible coverage for the County. The Contractor shall
reimburse the County for all costs, attorneys' fees, expenses and liabilities incurred with respect
to any litigation in which the Contractor contests its obligation to indemnify, defend and/or hold
harmless the County under this Agreement and does not prevail in that contest.
Insurance
Without limiting the Contractor's indemnification of the County, the Contractor shall provide and
maintain at its own expense, during the term of this Agreement, or as may be further required
herein, the following insurance coverages and provisions:
A. Evidence of Coverage
Prior to commencement of this Agreement, the Contractor shall provide a Certificate of
Insurance certifying that coverage as required herein has been obtained. Individual
endorsements executed by the insurance carrier shall accompany the certificate. In addition,
a certified copy of the policy or policies shall be provided by the Contractor upon request.
This verification of coverage shall be sent to the requesting County department, unless
otherwise directed. The Contractor shall not receive a Notice to Proceed with the work
under the Agreement until it has obtained all insurance required and such insurance has been
approved by the County. This approval of insurance shall neither relieve nor decrease the
liability of the Contractor.
B. Qualifying Insurers
All coverages, except surety, shall be issued by companies which hold a current policy
holder's alphabetic and financial size category rating of not less than A- V, according to the
current Best's Key Rating Guide or a company of equal financial stability that is approved
by the County's Insurance Manager.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
EXHIBIT B-2 (revised)
Rev. 9/2016 2
C. Notice of Cancellation
All coverage as required herein shall not be canceled or changed so as to no longer meet
the specified County insurance requirements without 30 days' prior written notice of such
cancellation or change being delivered to the County of Santa Clara or their designated
agent.
D. Insurance Required
1. Commercial General Liability Insurance - for bodily injury (including death) and
property damage which provides limits as follows:
a. Each occurrence - $1,000,000
b. General aggregate - $2,000,000
c. Products/Completed Operations aggregate - $2,000,000
d. Personal Injury - $1,000,000
2. General liability coverage shall include:
a. Premises and Operations
b. Products/Completed
c. Personal Injury liability
d. Severability of interest
3. General liability coverage shall include the following endorsement, a copy of which
shall be provided to the County:
Additional Insured Endorsement, which shall read:
“County of Santa Clara, and members of the Board of Supervisors of
the County of Santa Clara, and the officers, agents, and employees of
the County of Santa Clara, individually and collectively, as additional
insureds.”
Insurance afforded by the additional insured endorsement shall apply as primary
insurance, and other insurance maintained by the County of Santa Clara, its
officers, agents, and employees shall be excess only and not contributing with
insurance provided under this policy. Public Entities may also be added to the
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
EXHIBIT B-2 (revised)
Rev. 9/2016 3
additional insured endorsement as applicable and the contractor shall be notified by
the contracting department of these requirements.
4. Automobile Liability Insurance
For bodily injury (including death) and property damage which provides total limits
of not less than one million dollars ($1,000,000) combined single limit per
occurrence applicable to all owned, non-owned and hired vehicles.
4a. Aircraft/Watercraft Liability Insurance (Required if Contractor or any of its agents
or subcontractors will operate aircraft or watercraft in the scope of the Agreement)
For bodily injury (including death) and property damage which provides total limits
of not less than one million dollars ($1,000,000) combined single limit per
occurrence applicable to all owned, non-owned and hired aircraft/watercraft.
5. Workers' Compensation and Employer's Liability Insurance
a. Statutory California Workers' Compensation coverage including broad form
all-states coverage.
b. Employer's Liability coverage for not less than one million dollars
($1,000,000) per occurrence.
E. Special Provisions
The following provisions shall apply to this Agreement:
1. The foregoing requirements as to the types and limits of insurance coverage to be
maintained by the Contractor and any approval of said insurance by the County or
its insurance consultant(s) are not intended to and shall not in any manner limit or
qualify the liabilities and obligations otherwise assumed by the Contractor pursuant
to this Agreement, including but not limited to the provisions concerning
indemnification.
2. The County acknowledges that some insurance requirements contained in this
Agreement may be fulfilled by self-insurance on the part of the Contractor.
However, this shall not in any way limit liabilities assumed by the Contractor under
this Agreement. Any self-insurance shall be approved in writing by the County
upon satisfactory evidence of financial capacity. Contractors obligation hereunder
may be satisfied in whole or in part by adequately funded self-insurance programs
or self-insurance retentions.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533
EXHIBIT B-2 (revised)
Rev. 9/2016 4
3. Should any of the work under this Agreement be sublet, the Contractor shall require
each of its subcontractors of any tier to carry the aforementioned coverages, or
Contractor may insure subcontractors under its own policies.
4. The County reserves the right to withhold payments to the Contractor in the event
of material noncompliance with the insurance requirements outlined above.
F. Fidelity Bonds (Required only if contractor will be receiving advanced funds or payments)
Before receiving compensation under this Agreement, Contractor will furnish
County with evidence that all officials, employees, and agents handling or having
access to funds received or disbursed under this Agreement, or authorized to sign or
countersign checks, are covered by a BLANKET FIDELITY BOND in an amount
of AT LEAST fifteen percent (15%) of the maximum financial obligation of the
County cited herein. If such bond is canceled or reduced, Contractor will notify
County immediately, and County may withhold further payment to Contractor until
proper coverage has been obtained. Failure to give such notice may be cause for
termination of this Agreement, at the option of County.
DocuSign Envelope ID: E7F32BC5-2FA1-46FA-9EDE-B36037EFD533