Staff Report
PREPARED BY: MATT MORLEY
DIRECTOR OF PARKS AND PUBLIC WORKS
Reviewed by: Assistant Town Manager Town Attorney Finance
MEETING DATE: 09/20/16
ITEM NO: 5
COUNCIL AGENDA REPORT
DATE: SEPTEMBER 9, 2016
TO: MAYOR AND TOWN COUNCIL
FROM: LAUREL PREVETTI, TOWN MANAGER
SUBJECT: PARTNERSHIP TO IMPROVE COMMUNITY HEALTH GRANTS
A. ACCEPT A PARTNERSHIP TO IMPROVE COMMUNITY HEALTH (PICH)
GRANT FROM THE SANTA CLARA COUNTY HEALTH DEPARTMENT FOR
ADVANCEMENT OF THE SAFE ROUTES TO SCHOOLS PROGRAM IN THE
AMOUNT OF $15,000.
B. ACCEPT A PARTNERSHIP TO IMPROVE COMMUNITY HEALTH GRANT
FROM THE SANTA CLARA COUNTY HEALTH DEPARTMENT FOR
SMOKING PREVENTION OUTREACH IN THE AMOUNT OF $20,000.
C. AUTHORIZE A BUDGET ADJUSTMENT IN THE AMOUNT OF $35,000 TO
RECOGNIZE RECEIPT AND USE OF GRANT FUNDS.
D. AUTHORIZE THE TOWN MANAGER TO EXECUTE ALL GRANT
DOCUMENTS AND AGREEMENTS.
RECOMMENDATIONS:
Staff recommends that the Town Council:
1. Accept a Partnership to Improve Community Health (PICH) grant from the Santa Clara County
Health Department for advancement of the Safe Routes to Schools program in the amount of
$15,000.
2. Accept a Partnership to Improve Community Health grant from the Santa Clara County Health
Department for smoking prevention outreach in the amount of $20,000.
3. Authorize a budget adjustment in the amount of $35,000 to recognize receipt and use of grant funds.
4. Authorize the Town Manager to execute all grant documents and agreements.
BACKGROUND:
Town staff recently applied for two grants through the Santa Clara County Health Department’s PICH
grant program and was successful with both grant requests.
PAGE 2
MAYOR AND TOWN COUNCIL
SUBJECT: PARTNERSHIP TO IMPROVE COMMUNITY HEALTH GRANTS
SEPTEMBER 9, 2016
DISCUSSION:
The Parks and Public Works Department applied for a PICH grant in the amount of $15,000 to assist
with the development of a three year work plan for the Los Gatos Monte Sereno Safe Routes to School
program. The program will include a business plan developed through the involvement of participating
schools and through parent outreach. This effort will parallel the establishment of the Safe Routes
coalition as a nonprofit and help ensure viability of the organization over time and as leadership
changes. The work associated with the grant will be led by the Town and the Los Gatos Union School
District, who will act as a consultant to the Town for this project. This grant takes the form of an
amendment to the existing PICH grant received for the Town’s Bicycle and Pedestrian Master Plan and
the grant documents reflect this.
The Town Attorney applied for a PICH grant in the amount of $20,000 to assist with outreach and
communication around implementation of the Town’s new smoking ordinance. The work includes staff
time and expenses associated with signage, noticing, and other public outreach.
CONCLUSION/NEXT STEPS:
Both grants begin October 1, 2016 with reporting requirements over the following twelve month time
period. Town staff will work to implement the associated projects and provide the necessary reports to
the Santa Clara County Health Department for reimbursement.
COORDINATION:
This report has been coordinated with the Santa Clara County Health Department (Grantor) and the
Finance Department.
FISCAL IMPACT:
The receipt of these grants will relieve the Town of associated costs associated with advancing these
priorities. Approval of this action will allow for the necessary budgetary actions to receive the funds.
ENVIRONMENTAL ASSESSMENT:
This is not a project as defined under CEQA, and no further action is required.
Attachments:
1. Grant Agreement – Safe Routes to School
2. Grant Agreement – Smoking Ordinance
COUNTY OF SANTA CLARA – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing Agreement
Form Effective as of April 2014 Page 1 of 4
Purchase Order
Number: Amendment
Number:
Effective Date (Will be the date
executed by Authorized County
Representative):
Maximum Financial Obligation
(Prior to this Amendment): $ Amended Maximum Financial Obligation
(If dollar amount is changing): $
Current Agreement End Date: New Agreement End Date:
For County Use Only – SAP
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
Parties to AgreementLegal notices and invoices pertaining to this Agreement shall be sent to the appropriate contact person listed below. 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 – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing Agreement
Form Effective as of April 2014 Page 2 of 4
County of Santa Clara
Agency / Department: Department Number:
Program Manager or
Contract Monitor Name:
Street Address:
City, State, Zip:
Telephone Number:
Fiscal Contact
(Accounts Payable Contact):
Contract Preparer:
Signatures
Amendment is not valid until signed by Contractor and the County Authorized Representative. The
Agreement as amended constitutes the entire agreement of the parties concerning the subject matter
herein and supersedes all prior oral and written agreements, representations and understandings
concerning such subject matter. By signing below, signatory warrants and represents that he/she
executed this Amendment in his/her authorized capacity, that he/she has the authority to bind the entity
listed below to contractual obligations and that by his/her signature on this Amendment, the entity on
behalf of which he/she acted, executed this Amendment.
Agency/Department Manager: Date:
Agency/Department Fiscal Officer: Date:
Contractor: Date:
County Authorized Representative:
(Procurement Department, Board of Supervisors, or
Delegated Authority)
Date:
County Counsel:
(Signature required when the Standard Provisions
language (Section VI) is revised, or for IT Services
pursuant to Board Policy 5.3.5.2 (4), or for
Board approved contracts, or for contracts with Board
delegated authority to agencies/departments.)
Please note: Attachments and exhibits that include
additional terms and conditions, conflict with County
standard provisions, or require risk assessment
must be approved by County Counsel.
Date:
Office of the County Executive:
(Signature required when Board approved contract by a
Delegation of Authority)
Date:
Attest Clerk of the Board: (Signature required when Board approved contract)
Date:
COUNTY OF SANTA CLARA – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing agreement
Form Effective as of April 2014 Page 3 of 4
Reason(s) for Amending the Service Agreement
Amend Term of Agreement
Or see Exhibit ________ as incorporated by this reference
Amend Contract Specifics
Note: A new Agreement should be created if the Scope of Services is significantly modified or expanded.
Or see Exhibit ______ _______as incorporated by this reference
Amend Maximum Financial Obligation
A. Maximum Financial Obligation prior to this Amendment:
(Same as on page 1) $
B. Amount of increase or decrease:
(Explain below) $
C. Revised Maximum Financial Obligation:
(A +/- B will equal C) $
Explanation of increase / decrease (include new payment terms if applicable):
Or see Exhibit _ __ as incorporated by this reference
COUNTY OF SANTA CLARA – AMENDMENT TO SERVICE AGREEMENT
This is an amendment to an existing agreement
Form Effective as of April 2014 Page 4 of 4
Amend Standard Provisions
Or see Exhibit ________ as incorporated by this reference
Or Section VI. Standard Provisions is replaced in its entirety by Attachment________
Other (please explain below)
Or see Exhibit ________ as incorporated by this reference
Contract History
Total financial obligation from prior fiscal year(s): $
Financial obligation in current fiscal year: $
Cumulative total of all agreements with this Contractor within Budget Unit for same
type of services (including this amendment): $
Insurance
Insurance does not require changes
Insurance Exhibit is replaced by Exhibit B ________ attached and incorporated by this reference.
Exhibit C.1
PICH Budget 1 of 2 9/12/2016
A.
$ 49,091
$ 79,976 3%12 $ 2,399
$ 48,000 20%12 $ 9,600
Administrative Analyst - Responsible for administrative support and quality control activities. Acts as team lead for all outreach and community
engagement activities. Supports implementation activities throughout the duration of the funding cycle.
JOB DESCRIPTIONS:
Write a brief job description for each of the postions/titles listed above. The descriptions should correspond to the scope of work/workplan task and
goals. It is not necessary to repeat descriptions for duplicated positions except for those positions whose work differs from the others of the same
title/position. If hiring a consultant, list the purpose for hiring the consultant and the specific tasks and deliverables they will accomplish - these should
align with the scope of work/workplan task and goals.
Town Traffic Engineer - Provides content expertise for traffic infastructure and needs assessment. Acts as a team lead for all planning activities
related to automotive, bicycle and pedestrian infastructure. Supports planning and implementation activities throughout the duration of the funding
cycle.
Town Engineer- Provides content expertise for town infastructure and exisitng conditions. Acts as a team lead for all planning activities related to over
town planning process. Supports implementation activities throughout the duration of the funding cycle.
Santa Clara County United for Health - PICH (Partnership to Improve Community Health) Project
February 22, 2016 - September 29, 2017
Budget and Justification Worksheet
City Name: Town of Los Gatos, Parks & Public Works Department
Salary Amount
=(Salary x
FTE%)/Months First & Last Name
Position/Title
$ 116,209 5%
3%
BUDGET CATEGORY
SALARIES
Months Requested Annual Salary (Full
Time Basis)
Town Engineer $ 157,173
Town Traffic Engineer
February 22, 2016 - September 29, 2016
% of Full Time (FTE)
Assigned to PICH
9 $ 4,358 Jessy Pu
$ 1,799
$ 27,398
Salary Subtotal:
$ 73,100 50%9Consultant:
Los Gatos Union School Distirct - Karen Briones
September 30, 2016 - September 29, 2017
Administrative Analyst
Bobby Gonzalez
Consultant
$ 3,536 9
Administrative Analyst
Bobby Gonzalez $ 79,976 3%9
Lisa Petersen
Exhibit C.1
PICH Budget 2 of 2 9/12/2016
B.
$ 2,908.11 $ 2,908
$ 719.78 $ 720
$ 3,628
C..
$ -
D.
$ 2,281
$ 2,281
E.
$ -
$ -
F.
$ -
$ -
G.
$ -
BUDGET
TOTAL: $ 55,000
Coordinator - The coordinator will carry the workload on this project, ensuring the goals of the project, as outlined in the attached, are achieved.
Consultant- Consultant will evaluate conditions, recommend implementation, and create a Bicycle and Pedestrian Master Plan for use by the Town of
Los Gatos.
INDIRECTS MAY NOT EXCEED 10% OF SALARIES (salary subtotal from above). If indirects are claimed as an expense please indicate the basis for
the charge. For example 5% of salaries would be 5% x 131 = 7.
Indirects Subtotal:
Contracts
FRINGE BENEFITS
Travel/Meetings/Mileage Subtotal:
SUB-CONTRACTS
Supplies Subtotal:
TRAVEL/MEETINGS/MILEAGE
INDIRECTS/Administrative Overhead
Feb 22, 2016 - Sept 29, 2016: Fringe benefits (30% of
salaries)
Fringe Benefits Subtotal:
SUPPLIES
Sept 30, 2016 - Sept 29, 2017: Fringe benefits (30%) - City
Staff only
Printing and outreach materials (surveys, promotional flyers)
EQUIPMENT
For expense categories C-F, please provide a short narrative of the expense details that makes clear the expense and the purpose in general. In those cases where expenses may be
significantly different, you may enter multiple expenses for that category. For example, category E could use separate lines for local mileage, costs to travel to a meeting or conference
and the expenses related to hosting a conference or meeting, if applicable. PLEASE REFER TO THE PICH ALLOWABLE EXPENSES DOCUMENT for assistance in completing these sections.
Equipment Subtotal:
Exhibit F.1
Santa Clara County United for Health – Partnership to Improve Community Health (PICH)
City of Los Gatos, Department of Parks & Public Works: Scope of Work
Payment Schedule for City of Los Gatos, Department of Parks & Public Works
February 22, 2016 – September 29, 2017
Payment will be made according to the Budget in Exhibit C.1, attached hereto and incorporated herein by
this reference. Contractor’s invoices shall be submitted to the County, on a monthly basis, on a form
with a format approved by the County.
Total Budget $55,000
Modifications to Exhibits A.1, F.1 and/or C.1 will require County approval and signature from both parties
and may require an amendment to the Agreement.
INVOICE GUIDELINES:
1. Invoices cannot bridge two County fiscal years because the fiscal year costs must be separated for
payment and record-keeping purposes.
a. Example: The County fiscal year ends on June 30, therefore all costs prior to June 30 must
be included on invoices for the months prior to July (which starts a new fiscal year).
2. Invoices should cover only one month and the tasks that are listed on the invoice should only be
the tasks actually worked on during that month and cited in the Progress Report with a description
of the work that was completed.
Exhibit A.1
Santa Clara County United for Health – Partnerships to Improve Community Health (PICH) Grant
Town of Los Gatos
Scope of Work and Performance Standards
(February 22. 2016 – September 29, 2017)
A. Introduction
This Scope of Work is to accomplish, under the Partnerships to Improve Community Health (PICH) grant, activities
to support the focus areas of the PICH project. The Town of Los Gatos plans to participate in increasing access to
opportunities for physical activity and active transportation.
B. Reporting Requirements
1. Contractor will prepare a Monthly Progress Report on their activities/progress and submit it to:
Joanne Seavey, Health Care Program Manager II
Chronic Disease & Injury Prevention (CDIP), Santa Clara County Health Dept.
1400 Parkmoor Avenue, Suite 120B
San Jose, CA 95126
2. Contractor will also submit a Bi-Annual Report (March and September) on PHD Template to:
Joanne Seavey, Health Care Program Manager II (at address shown above)
C. Phases and Task Description
February 22, 2016 – September 29, 2016
Year 2
Objectives:
1. Promote opportunities for physical activity and active transportation through the establishment
of a Bicycle and Pedestrian Master Plan.
Anticipated Reach:
1. City Staff: 100 Public: 30,000
Task # Task Description Timeline Responsible Staff Key Deliverables
Task # 1 Bicycle and Pedestrian Master Plan
1.1 Project Kick-Off - Meeting with
city staff and key stakeholders to
clearly establish the scope of
work, schedule, and key priorities
for future work
February
2016
• PPW Director
• Traffic Engineer
• Town Engineer
• Admin. Analyst
• Consultant
1.1.a
Copies of model standards
1.2 Project Management & Quality
Control – regular meetings with
Town staff, 3-tiered QC process
February -
August 2016
• Consultant
• Traffic Engineer
• Town Engineer
• Admin. Analyst
1.2.a
Meeting minutes
1.3 Existing Conditions Assessment- February • Consultant 1.3.a
Exhibit A.1 Town of Los Gatos PICH FFY16-17
Review pertinent planning
documents, Inventory pedestrian
& bicycle network, Bicycle &
pedestrian collision analysis,
Existing Conditions Report, &
Bicycle & Pedestrian Counts
2016 • Traffic Engineer
• Town Engineer
Existing Conditions Report
1.4 Public Outreach –User & Online
Surveys, Focus Groups/Working
Groups, & Pop-Up Events (x2);
invitations to Commission
meetings, school district outreach,
SR2S meetings
February
2016
• Consultant
• Admin. Analyst
1.4.a
Public input for the Master
Plan
1.5 Needs Analysis/Recommended
Projects – Proposed Standards &
Goals, Proposed Bicycle &
Pedestrian Capital Projects,
Proposed Programs
February
2016
• Consultant
• Traffic Engineer
1.5.a
Needs Analysis Report
1.6 Implementation, Funding
Strategy, & Prioritization – Cost
Estimates for Projects &
Programs, Prioritization & Phasing
Recommendations, Funding
Sources
March 2016 • Consultant
• Town Engineer
• Traffic Engineer
• Admin. Analyst
1.6. a
Strategy for implementation,
funding and prioritization of
projects
1.7 Bicycle & Pedestrian Master Plan
– Draft B&P Master Plan, Final
B&P Master Plan
March –
September
2016
• Consultant
1.7.a
Final Bicycle & Pedestrian
Master Plan
1.8 Environmental Review – Develop
environmental documents for the
Master Plan
March –
September
2016
• Consultant
• Traffic Engineer
• Town Engineer
1.8.a
Master Plan environmental
review per CEQA
September 30, 2016 – September 29, 2017
Year 3
Objective: Create a joint agreement between the Town of Los Gatos, and four local school entities
(Los Gatos Union School District, Los-Gatos-Saratoga Union High School District, Union School
District and Hillbrook School) to develop a sustainable Los Gatos/Monte Sereno Safe Routes To
School Program in order to increase physical activity among the school population.
Anticipated Reach: Population of 15,000 individuals (students, parents, school employees)
Task 2 Develop a joint agreement between the Town of Los Gatos and the School Districts that will result in
government and school systems collaborating on a strategic plan to sustain and promote the Safe
Routes To School Program
Task #2 Task Description Timeline Responsible Staff Key Deliverables
2.1 Hold meeting with Town staff and
key school staff/coordinator to
establish the scope of the joint
systems agreement to develop a
strategic plan.
October –
Dec 2016
• PPW Director
• SRTS
Coordinator
• School Districts
2.1.a
Signed agreement to develop
strategic sustainability plan.
Exhibit A.1 Town of Los Gatos PICH FFY16-17
2.2 Hold bi-monthly meetings with
Town staff, key school
stakeholders, and other SRTS
stakeholders to develop action
steps to be included in the
strategic sustainability plan.
October
2016 –
January
2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School Districts
• Key
Stakeholders
2.2.a
Meeting minutes and plan
drafts.
2.3 Develop strategic sustainability
plan to include Safe Routes to
School (SRTS) programming goals,
stakeholders involved and action
steps to jointly sustain the
program.
October
2016 –
February
2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School
Districts
2.3.a
Strategic plan developed that
focuses on sustaining SRTS
program by the Town and the
school districts.
2.4 Implement strategic plan goals
including:
• promoting the “Where
Will Your Feet Take You?”
educational campaign to
promote SRTS
• developing
recommendations for
neighborhood
improvements
surrounding schools to
support safe routes
• institutionalizing a SRTS
curriculum in schools for
education and promotion
of active transportation
February –
September
2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School
Districts
2.4.a
Summary of goals that were
accomplished/implemented
collaboratively by all Town
and School systems involved.
Summary to include:
• Any promotion done
from educational
campaign
• List of
recommendations of
neighborhood
improvements
• Schools who will be
utilizing curriculum
2.5 Outreach to the school population
and conduct a survey with
parents/public to determine
future SRTS priorities for schools
involved: 4 Elementary, 1 Middle,
1 High School, and 1 Private
School.
February
2017 – May
2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School
Districts
2.5.a
Survey developed and
administered.
2.6 Summarize survey results on SRTS
priorities
June 2017-
July 2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School
Districts
2.6.a
Survey results compiled and
summarized
Exhibit A.1 Town of Los Gatos PICH FFY16-17
2.7 Hold planning meeting with Town
staff and key stakeholders to
develop strategic plan scope of
work and future work priorities
(based on survey results) for
2017-2018 school year.
August
2017-
September
2017
• PPW Director
• Police Dept
• SRTS
Coordinator
• School
Districts
2.7.a
Meeting minutes
D. Performance Standards
Performance is expected to adhere to the following standards in addition to evaluations completed by the PICH
Evaluation contractor:
1. Quality - Deliverables and final products will be as described in the Scope of Work and will be of high quality.
2. Timeliness - Deliverables and final products will be completed as scheduled.
3. Achievement of Project Goals – Project will achieve its’ goals as described in the Scope of Work.
4. Achievement of Project Reach – Project activities and deliverables will reach at least 75% of the projected
population numbers of this contract.
EXHIBIT B-2A (revised)
INSURANCE REQUIREMENTS FOR
STANDARD SERVICE CONTRACTS
BETWEEN $50,001 AND $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 is obligated to indemnify, defend and hold harmless the
County under this Agreement.
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.
Rev. 3/2010 1
EXHIBIT B-2A (revised)
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 - $1,000,000
c. Products/Completed Operations aggregate - $1,000,000
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
Rev. 3/2010 2
EXHIBIT B-2A (revised)
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 hundred thousand dollars ($100,000) 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 hundred thousand dollars ($100,000) 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.
Rev. 3/2010 3
EXHIBIT B-2A (revised)
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.
Rev. 3/2010 4
Attachment D
Additional County Provisions
Debarment and Suspension Certification
Contractor guarantees that it, its employees, contractors, subcontractors or agents (collectively
“Contractor”) are not suspended, debarred, excluded, or ineligible for participation in Medicare,
Medi-Cal or any other federal or state funded health care program, or from receiving Federal
funds as listed in the List of Parties Excluded from Federal Procurement or Non-procurement
Programs issued by the Federal General Services Administration. Contractor must within 30
calendar days advise the County if, during the term of this Agreement, Contractor becomes
suspended, debarred, excluded or ineligible for participation in Medicare, Medi-Cal or any other
federal or state funded health care program, as defined by 42. U.S.C. 1320a-7b(f), or from
receiving Federal funds as listed in the List of Parties Excluded from Federal Procurement or
Non-procurement Programs issued by the Federal General Services Administration. Contractor
will indemnify, defend and hold the County harmless for any loss or damage resulting from the
conviction, debarment, exclusion or ineligibility of the Contractor.
Contractor Name:
(As Displayed In SAP)
Purchase Order Number:
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION I: GENERAL INFORMATION
Town of Los Gatos
Agency/Department Name: Public Health Department
Brief Description of Services:
Department
Number:
0410
This Scope of Work is to accomplish, under the Partnerships to Improve Community Health
(PICH) grant, activities to support the focus areas of the PICH project, The Town of Los
Gatos plans to support the creation of a Tobacco Retail License Program and conduct
outreach to the community to successfully implement the environmental tobacco control
rules in public spaces throughout the town.
Maximum Financial Obligation
The maximum amount payable to this Contractor
under this agreement shall not exceed:
Start Date:
$ 20,000.00
Term of Agreement
Note: When Left blank, start date will be the date executed by Authorized
County Representative
End Date: 09/29/2017
For County Use Only
General Cost
Account Plant Ledger Center Amount
Assignment Number (Expense (Dept
Code) Code)
Line 1 H
Line 2 H
Line 3 Select
Line 4 Select
Line 5 Select
Revision Date - July 2015
WBS
(Capital Project Code)
0410 5255500 2841 $18,000 FY17
0410 5255500 2841 $2,000 FY18
Internal
Order
("PCA" code
- optional)
Page 1 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
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 Name
Contractor
(As Displayed In SAP): Town of Los Gatos
Contact Person: Robert Schultz, Town Attorney
Street Address *: Town of Los Gatos, 110 E. Main Street, Los Gatos, CA 95030
City *: Los Gatos State: CA Zip: 95030
Telephone number *: 408.354.6818
Email Address *: RSchultz@losgatosca.gov
SCC Vendor Number: 1010468
(As Assigned in SAP)
* To be completed for Independent Contractors Only — DO NOT COMPLETE FOR DEPENDENT CONTRACTORS
County of Santa Clara
Agency/Department: Public Health Department
Program Manager/
Contract Monitor Name: Joanne Seavey-Hultquist, Health Care Program Manager II
Street Address: 1400 Parkmoor Avenue, Suite 120B
City: San Jose State: CA Zip: 95126
Telephone Number: 408.793.2714
Fiscal Contact
(Accounts Payable Contact): Arleen Speidel
Contract Preparer: Bianca Jones
Revision Date - July 2015 Page 2 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION III: CONTRACT AUTHORIZATION
It is agreed between County and Contractor that Contractor will, for the compensation described in this
Agreement, perform the work described in Section V in accordance with all terms and conditions of this
Agreement including all exhibits and attachments. In addition, County and Contractor assert that the tax
withholding status and benefit documentation (Section IV) accurately reflect the anticipated working
relationship between County and Contractor. Further, Independent Contractors shall comply with the
County's insurance and indemnification requirements. Contractor certifies that any applicable insurance
waiver information (Section VII, B) is true and correct. This Agreement may be executed in one or more
counterparts, each of which will be considered an original, but all of which together will constitute one
and the same instrument.
SIGNATURES
Contract is not valid until signed by Contractor and County's Authorized Representative.
Agency/Department Manager:
Agency/Department Fiscal Officer:
Contractor:
Date:
Date:
•"—*C4A4(G .y16w1.� Date:
Le/7c,iH &-' JobSC'bitz(%
County Authorized Representative:
(Procurement Department; President, Board of Supervisors; or Delegated Authority)
County Counsel:
(Signature required when the Standard Provisions language (Section VI)
is revised, or for IT Services pursuant to Board Policy 5.3.5.2 (4), or for Board approved
contracts, or for contracts with Board delegated authority to agencies/departments.)
Please note: Attachments or exhibits that include additional terms and conditions, conflict with
the County's standard provisions or require risk assessment must be approved by County
Counsel.
Office of the County Executive:
(Signature required when Board approved contract by a delegation of authority)
Attest Clerk of the Board:
(Signature required when Board approved contract)
Revision Date - July 20i5
Date:
Date:
Date:
Date:
Page 3 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION IV: DETERMINATION OF RELATIONSHIP STATUS
Dependent/Independent status is an important relationship distinction. It determines the contractor's
eligibility for Medicare and Social Security, Public Employees' Retirement System benefits, and other
benefits and affects how the contractor files tax returns and the contractor's responsibility for various
federal and state taxes.
Questionnaire to be Completed by Contracting Department to Determine Relationship Status of Contractor
Supervision: Will the County have the right to tell the contractor how to do the work, when to arrive or leave
work, or when to take breaks? Do you have other employees performing similar work with a similar degree of
supervision? If the answer to any of these questions is YES, select YES from the dropdown.
No
Training: Will the County instruct the contractor on how to do the job or pay for external training? No
Incomplete Work: Will the Contractor be able to resign or terminate the contract without being held either
financially or legally liable for unfinished work?
Place of Work/Tools: Will the County provide the Contactor with a place to work at a County location and
tools to do the job, i.e. computers, telephones, etc?
Length of Relationship: When the Contractor is hired to complete ongoing departmental duties or
functions— answer YES. When the contractor is hired to complete a specific project that was not the
regular tasks performed by County employees before— answer NO.
Other Customers: Does the County prevent the Contractor from performing similar services for other
customers, either due to the amount of work (full-time), or by contractual provision?
Designation as Business Entity: If the Contractor has a business license or business certificate, or is a
corporation, nonprofit organization, or school district, select "No" from the dropdown. (This does not
pertain to professional licenses or certificates such as a license for a physician or architect.)
Enter below the business license number and the city/entity where issued.
Bus Lic. # Issued by:
Payment Schedule: Will payments be made either as an hourly wage or as weekly/monthly salary? If payment
is by commission or based on project milestones or deliverables, answer "NO" to this question. Be sure this
answer matches the contract payment schedule in Section V.
Support Services: Will County employees or other independent contractors provide assistance to this
Contractor? Assistance is defined as clerical, technical or professional support.
No
No
No
No
No
No
No
If at least 5 of the above questions were answered "NO", Contractor is an Independent Contractor. ✓
If 5 or more of the above questions were answered "YES", Contractor is a Dependent Contractor, where the
relationship resembles that of employer/employee. Tax withholding is required and benefits are provided.
Complete and attach the following forms: Employee's Withholding Allowance Certificate —Federal Form W-4,
State Withholding, Form DE-4, Determining PERS Eligibility and PERS Member Action Request. Visit www.oba
for more information regarding Dependent Contractors. County insurance requirements do not apply to
Dependent Contractors.
Contractor understands and agrees that the tax withholding and benefit status checked above is correct. Any changes to the
contractor's tax withholding and benefit status require a new contract. Contractor is responsible for any penalties and
liabilities assessed by any taxing authority, based on a change of tax withholding and benefit status.
Contractor's Initials:
/A4
Dept. Fiscal Officer's Signature:
Revision Date - July 2015 Page 4 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION V: CONTRACT SPECIFICS
A. SERVICE DESCRIPTION AND EXPECTED OUTCOME (SCOPE OF SERVICE)
Or ✓ See Exhibit: A incorporated by this reference.
B. DELIVERABLES, MILESTONES, & TIMELINE FOR PERFORMANCE
Or
See Exhibit : A incorporated by this reference.
Revision Date - July 2015
Page 5 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
C. PERFORMANCE STANDARDS
Or See Exhibit : A incorporated by this reference.
D. PAYMENT SCHEDULE
Notes:
• All reimbursements for travel shall comply with the current County Travel Policy
• Dependent contractors are not permitted to work in excess of 40 hours per week
Or SeeExhibits
F,C
incorporated by this reference.
Page 6 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION VI: STANDARD PROVISIONS
Changes to the terms and conditions in this section require approval of County Counsel
A. ENTIRE AGREEMENT
This Agreement and its Appendices (if any) constitutes the final, complete and exclusive statement of the terms of the
agreement between the parties. It incorporates and supersedes all the agreements, covenants and understandings between
the parties concerning the subject matter hereof, and all such agreements, covenants and understandings have been merged
into this Agreement. No prior or contemporaneous agreement or understanding, verbal or otherwise, of the parties or their
agents shall be valid or enforceable unless embodied in this Agreement.
B. AMENDMENTS
This agreement may only be amended by a written instrument signed by the Parties.
C. CONFLICTS OF INTEREST
Contractor shall comply, and require its subcontractors to comply, with all applicable (i) requirements governing avoidance
of impermissible client conflicts; and (ii) federal, state and Local conflict of interest laws and regulations including, without
limitation, California Government Code section 1090 et. seq., the California Political Reform Act (California Government Code
section 87100 et. seq.) and the regulations of the Fair Political Practices Commission concerning disclosure and
disqualification (2 California Code of Regulations section 18700 et. seq.). Failure to do so constitutes a material breach of this
Agreement and is grounds for immediate termination of this Agreement by the County.
In accepting this Agreement, Contractor covenants that it presently has no interest, and will not acquire any interest, direct or
indirect, financial or otherwise, which would conflict in any manner or degree with the performance of this Agreement.
Contractor further covenants that, in the performance of this Agreement, it will not employ any contractor or person having
such an interest. Contractor, including but not limited to contractor's employees and subcontractors, may be subject to the
disclosure and disqualification provisions of the California Political Reform Act of 1974 (the "Act"), that (1) requires such
persons to disclose economic interests that may foreseeably be materially affected by the work performed under this
Agreement, and (2) prohibits such persons from making or participating in making decisions that will foreseeably financially
affect such interests.
If the disclosure provisions of the Political Reform Act are applicable to any individual providing service under this
Agreement, Contractor shall, upon execution of this Agreement, provide the County with the names, description of individual
duties to be performed, and email addresses of all individuals, including but not limited to Contractor's employees, agents
and subcontractors, that could be substantively involved in "making a governmental decision" or "serving in a staff capacity
and in that capacity participating in making governmental decisions or performing duties that would be performed by an
individual in a designated position," (2 CCR 18701(a)(2)), as part of Contractor's service to the County under this Agreement.
Contractor shall immediately notify the County of the names and email addresses of any additional individuals later assigned
to provide such service to the County under this Agreement in such a capacity. Contractor shall immediately notify the
County of the names of individuals working in such a capacity who, during the course of the Agreement, end their service to
the County.
If the disclosure provisions of the Political Reform Act are applicable to any individual providing service under this
Agreement, Contractor shall ensure that all such individuals identified pursuant to this section understand that they are
subject to the Act and shall conform to all requirements of the Act and other laws and regulations listed in subsection (A)
including, as required, filing of Statements of Economic Interests within 30 days of commencing service pursuant to this
Agreement, annually by April 1, and within 30 days of their termination of service pursuant to this Agreement.
D. 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.
E. 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.
Revision Date - July 2015 Page 7 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
F. ASSIGNMENT OF CLAYTON ACT, CARTWRIGHT ACT CLAIMS
Contractor assigns to the County all rights, title, and interest in and to all causes of action it may have under Section 4 of the
Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division
7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the Contractor for sale to
the County pursuant to this Agreement.
G. 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 shall be in writing and shall apply to the specific instance expressly
stated.
H. NON-DISCRIMINATION
Standard Non -Discrimination Language
Contractor shall comply with all applicable Federal, State, and local laws and regulations including Santa Clara County's
policies concerning nondiscrimination and equal opportunity in contracting. Such laws include but are not limited to the
following: Title VII of the Civil Rights Act of 1964 as amended; Americans with Disabilities Act of 1990; The Rehabilitation Act
of 1973 (Sections 503 and 504); California Fair Employment and Housing Act (Government Code sections 12900 et seq.); and
California Labor Code sections 1101 and 1102. Contractor shall not discriminate against any subcontractor, employee, or
applicant for employment because of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation,
mental disability, physical disability, medical condition, political beliefs, organizational affiliations, or marital status in the
recruitment, selection for training including apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or
other forms of compensation. Nor shall Contractor discriminate in provision of services provided under this contract because
of age, race, color, national origin, ancestry, religion, sex/gender, sexual orientation, mental disability, physical disability,
medical condition, political beliefs, organizational affiliations, or marital status.
- OR -
Alternate Non -Discrimination Language Attached As Exhibit , incorporated by this reference.
(Requires County Counsel Approval)
I. TERMINATION
Standard Termination Language
The County may, by written notice to Contractor, terminate all or part of this Agreement at any time for the convenience of the County. The
notice shall specify the effective date and the scope of the termination. In the event of termination, Contractor shall deliver to County all
documents prepared pursuant to the Agreement, whether complete or incomplete. Contractor may retain a copy for its records. Upon
receipt of the documents, Contractor shall be compensated based on the completion of services provided, as solely and reasonably
determined by County.
-OR-
Alternate Termination Language Attached As Exhibit , incorporated by this reference.
(Requires County Counsel Approval)
J. BUDGET CONTINGENCY
This Agreement is contingent upon the appropriation of sufficient funding by the County for the services covered by this
Agreement. If funding is reduced or deleted by the County for the services covered by this Agreement, the County has the
option to either terminate this Agreement with no liability occurring to the County or to offer an amendment to this
Agreement indicating the reduced amount.
K. COUNTY NO -SMOKING POLICY
Contractor and its employees, agents and subcontractors, shall comply with the County's No -Smoking Policy, as set forth in the Board of
Supervisors Policy Manual section 3.47 (as amended from time to time), which prohibits smoking: (1) at the Santa Clara Valley Medical
Revision Date - July 2015 Page 8 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Center Campus and all County -owned and operated health facilities, (2) within 30 feet surrounding County -owned buildings and leased
buildings where the County is the sole occupant, and (3) in all County vehicles.
L. FOOD AND BEVERAGE STANDARDS
Except in the event of an emergency or medical necessity, the following nutritional standards shall apply to any foods and/or
beverages purchased by Contractor with County funds for County -sponsored meetings or events.
If food is to be provided, healthier food options shall be offered. "Healthier food options" include (1) fruits, vegetables, whole
grains, and low fat and low calorie foods; (2) minimally processed foods without added sugar and with low sodium; (3) foods
prepared using healthy cooking techniques; and (4) foods with less than 0.5 grams of trans fat per serving. Whenever
possible, Contractor shall (1) offer seasonal and local produce; (2) serve fruit instead of sugary, high calorie desserts; (3)
attempt to accommodate special, dietary and cultural needs; and (4) post nutritional information and/or a list of ingredients
for items served. If meals are to be provided, a vegetarian option shall be provided, and the Contractor should consider
providing a vegan option. If pre -packaged snack foods are provided, the items shall contain: (1) no more than 35% of
calories from fat, unless the snack food items consist solely of nuts or seeds; (2) no more than 10% of calories from saturated
fat; (3) zero trans fat; (4) no more than 35% of total weight from sugar and caloric sweeteners, except for fruits and
vegetables with no added sweeteners or fats; and (5) no more than 360 mg of sodium per serving.
If beverages are to be provided, beverages that meet the County's nutritional criteria are (1) water with no caloric
sweeteners; (2) unsweetened coffee or tea, provided that sugar and sugar substitutes may be provided as condiments; (3)
unsweetened, unflavored, reduced fat (either nonfat or 1% low fat) dairy milk; (4) plant -derived milk (e.g., soy milk, rice
milk, and almond milk) with no more than 130 calories per 8 ounce serving; (5) 100% fruit or vegetable juice (limited to a
maximum of 8 ounces per container); and (6) other low -calorie beverages (including tea and/or diet soda) that do not exceed
40 calories per 8 ounce serving. Sugar -sweetened beverages shall not be provided.
M. CONTRACTING PRINCIPLES
All entities that contract with the County to provide services where the contract value is $100,000 or more per budget unit
per fiscal year and/or as otherwise directed by the Board, shall be fiscally responsible entities and shall treat their employees
fairly. To ensure compliance with these contracting principles, all contractors shall: (1) comply with all applicable federal,
state and local rules, regulations and laws; (2) maintain financial records, and make those records available upon request; (3)
provide to the County copies of any financial audits that have been completed during the term of the contract; (4) upon the
County's request, provide the County reasonable access, through representatives of the Contractor, to facilities, financial and
employee records that are related to the purpose of the contract, except where prohibited by federal or state laws,
regulations or rules.
N. CALIFORNIA PUBLIC RECORDS ACT
All proposals become the property of the County, which is a public agency subject to the disclosure requirements of the
California Public Records Act ("CPRA"). If Contractor's proprietary information is contained in documents submitted to
County, and Contractor claims that such information falls within one or more CPRA exemptions, Contractor shall clearly mark
such information "CONFIDENTIAL AND PROPRIETARY," and identify the specific lines containing the information. In the
event of a request for such information, the County will make best efforts to provide notice to Contractor prior to such
disclosure. If Contractor contends that any documents are exempt from the CPRA and wishes to prevent disclosure, it is
required to obtain a protective order, injunctive relief or other appropriate remedy from a court of law in Santa Clara County
before the County responds to the CPRA request. If Contractor fails to obtain such a remedy before the County responds to
the CPRA request, County may disclose the requested information.
Contractor further agrees that is shall defend, indemnify and hold the County harmless against any claim, action or litigation
(including but not limited to all judgments, costs, fees, and attorney's fees) that may result from denial by County of a CPRA
request for information arising from any representation, or any action (or inaction), by the Contractor.
O. THIRD PARTY BENEFICIARIES
This agreement does not, and is not intended to, confer any rights or remedies upon any person or entity other than the
parties.
P. INTELLECTUAL PROPERTY RIGHTS:
Ownership: County shall own all right, title and interest in and to the Deliverables. For purposes of this Agreement, the term
"Deliverables" shall mean any documentation and deliverables created by Contractor during the performance of services that
are identified in this Agreement. Contractor hereby assigns to the County all rights, title and interest in and to any and all
intellectual property whether or not patentable or registrable under patent, copyright, trademark or similar statutes, made or
conceived or reduced to practice or learned by Contractor, either alone or jointly with others, during the period of
Contractor's agreement with the County or result from the use of premises leased, owned or contracted for by the County.
Revision Date - July 2015 Page 9 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Contractor acknowledges that all original works of authorship which are made by Contractor (either solely or jointly with
others) within the scope of this Agreement and which are protectable by copyright are "works made for hire," as that term is
defined in the United States Copyright Act (17 U.S.C. Section 101), and shall belong solely to County. Contractor agrees that
the County will be the copyright owner in all copyrightable works of every kind and description created or delivered by
Contractor, either solely or jointly with others, in connection with any agreement with the County.
Q. INTELLECTUAL PROPERTY INDEMNITY
Contractor represents and warrants for the benefit of the County and its users that, to its knowledge, as of the effective date
of this Agreement, Contractor is the exclusive owner of all rights, title and interest in the Deliverables and/or services
provided pursuant to this Agreement. Contractor shall defend, indemnify and hold the County harmless against any claim,
action or litigation (including but not limited to all judgments, costs, fees, and reasonable attorney's fees) by a third party
alleging the Deliverables and/or services provided pursuant to this Agreement infringe upon any intellectual property rights
of third parties. This indemnity and duty to defend is in addition to and does not supersede the requirements stated in VII of
this agreement.
R. OWNERSHIP RIGHTS TO MATERIALS / RESTRICTIONS ON USE
All materials obtained, developed or prepared by Contractor in the course of performing services hereunder, including but
not limited to videotapes, audio recordings, still photographs, ads or brochures, and the derivative works, patent, copyright,
trademark, trade secret or other proprietary rights associated therewith (collectively "Deliverables"), shall be the sole and
exclusive property of the County. To the extent Contractor owns or claims ownership rights to said Deliverables, Contractor
hereby expressly assigns all said rights, title, and interest in and to the Deliverables to the County pursuant to the terms and
conditions of this Agreement and at no additional cost. The County has the exclusive royalty -free irrevocable right to
duplicate, publish or otherwise use for any purpose, all materials prepared under this Agreement. If Contractor wishes to use
the materials prepared hereunder for any purpose including but not limited to promotional, educational or commercial
purposes, the Contractor shall obtain prior written authorization from the County, which consent may be withheld by the
County in its sole discretion. Contractor acknowledges that all original works of authorship which are made by Contractor
(solely or jointly with others) within the scope of this Agreement and which are protectable by copyright are "works made
for hire," as that term is defined in the United States Copyright Act (17 U.S.C., Section 101), and shall belong solely to County.
Contractor agrees that the County will be the copyright owner in all copyrightable works of every kind and description
created or developed by Contractor, solely or jointly with others, in connection with any agreement with the County. 1f
requested to, and at no further expense to the County, Contractor will execute in writing any acknowledgments or
assignments of copyright ownership of such copyrightable works as may be appropriate for preservation of the worldwide
ownership in the County and its nominees of such copyrights. This section shall apply to the extent not otherwise provided
under this agreement.
S. COUNTY DATA
"County Data" shall mean data and information received by Contractor from County. As between Contractor and County, all
County Data shall remain the property of the County. Contractor shall not acquire any ownership interest in the County Data.
Contractor shall not, without County's written permission consent, use or disclose the County Data 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 County Data, protect against any
anticipated threats or hazards to the security or integrity of County Data, protect against unauthorized access to or use of
County Data that could result in substantial harm or inconvenience to County or any end users; and ensure the proper
disposal of County data upon termination of this Agreement. Contractor shall take appropriate action to address any incident
of unauthorized access to County Data, 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 County Data, 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 the confidentiality provisions hereof. Should confidential and/or legally
protected County Data 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.
T. WAGE THEFT PREVENTION
(1) Compliance with Wage and Hour Laws: Contractor, and any subcontractor it employs to complete work under this
Agreement, must comply with all applicable federal, state, and local wage and hour laws. Applicable laws may include, but are
not limited to, the Federal Fair Labor Standards Act, the California Labor Code, and any local Minimum Wage Ordinance or
Living Wage Ordinance.
(2) Final ludgments. Decisions, and Orders: For purposes of this Section, a "final judgment, decision, or order" refers to one
for which all appeals have been exhausted. Relevant investigatory government agencies include: the federal Department of
Revision Date - July 2015 Page 10 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Labor, the California Division of Labor Standards Enforcement, a local enforcement agency, or any other government entity
tasked with the investigation and enforcement of wage and hour laws.
(3) Prior Judgments against Contractor and/or its Subcontractor: BY SIGNING THIS AGREEMENT, CONTRACTOR AFFIRMS
THAT IT HAS DISCLOSED ANY FINAL JUDGMENTS, DECISIONS, OR ORDERS FROM A COURT OR INVESTIGATORY
GOVERNMENT AGENCY FINDING —IN THE FIVE YEARS PRIOR TO EXECUTING THIS AGREEMENT —THAT CONTRACTOR OR
ITS SUBCONTRACTOR(S) HAS VIOLATED ANY APPLICABLE WAGE AND HOUR LAWS.
CONTRACTOR FURTHER AFFIRMS THAT IT OR ITS SUBCONTRACTOR(S) HAS SATISFIED AND COMPLIED WITH —OR HAS
REACHED AGREEMENT WITH THE COUNTY REGARDING THE MANNER IN WHICH IT WILL SATISFY —ANY SUCH
JUDGMENTS, DECISIONS, OR ORDERS.
(4) Judgments During Term of Contract: If at any time during the term of this Agreement, a court or investigatory government
agency issues a final judgment, decision, or order finding that Contractor or any subcontractor it employs to perform work
under this Agreement has violated any applicable wage and hour law, or Contractor learns of such a judgment, decision, or
order that was not previously disclosed, Contractor must inform the Office of the County Executive -Office of Countywide
Contracting Management (OCCM), no more than 15 days after the judgment, decision, or order becomes final or of learning of
the final judgment, decision, or order. Contractor and its subcontractors shall promptly satisfy and comply with any such
judgment, decision, or order, and shall provide the Office of the County Executive-OCCM with documentary evidence of
compliance with the final judgment, decision, or order within 5 days of satisfying the final judgment, decision, or order, The
County reserves the right to require Contractor to enter into an agreement with the County regarding the manner in which
any such final judgment, decision, or order will be satisfied.
(5) County's Right to Withhold Payment: Where Contractor or any subcontractor it employs to perform work under this
Agreement has been found in violation of any applicable wage and hour law by a final judgment, decision, or order of a court
or government agency, the County reserves the right to withhold payment to Contractor until such judgment, decision, or
order has been satisfied in full.
(6) Material Breach: Failure to comply with any part of this Section constitutes a material breach of this Agreement. Such
breach may serve as a basis for termination of this Agreement and/or any other remedies available under this Agreement
and/or law.
(7) Notice to County Related to Wage Theft Prevention: Notice provided to the Office of the County Executive as required
under this Section shall be addressed to: Office of the County Executive—OCCM; 70 West Hedding Street; East Wing, 1 lth
Floor; San Jose, CA 95110. The Notice provisions of this Section are separate from any other notice provisions in this
Agreement and, accordingly, only notice provided to the above address satisfies the notice requirements in this Section.
U. PAYMENT TERM
The parties agree that the payment term shall be the term selected below and payment shall be due in accordance with
the selected payment term. For example, if Contractor selects 2.25% 10 Net 45 as the payment term, payment shall be
due 10 days from the date the County approves the invoice, instead of 45 days, and the County shall take a discount of
2.25% of the total amount of the invoice. Payment is deemed to have been made on the date the County mails the
warrant or initiates the electronic fund transfer.
2.25% 10 Net 45 (provides 35 days of cash acceleration)
2.00% 15 Net 45 (provides 30 days of cash acceleration)
1.75% 20 Net 45 (provides 25 days of cash acceleration)
1.33% 25 Net 45 (provides 20 days of cash acceleration)
1.00% 30 Net 45 (provides 15 days of cash acceleration)
17 Net 45 (full payment)
Note: I'ay mont tot in mill default to' Net 45 (full payment) 11 no othci tern) w,)s srlet tod
Notwithstanding the option selected above, the parties agree that at any time during the contract term, either party
may initiate an early payment discount on an invoice -by -invoice basis utilizing the Dynamic Discounting functionality
of the Ariba Network. Contractor must have a registered account on the Ariba Network to utilize this functionality.
V. 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.
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W. LIVING WAGE (If Applicable)
Unless otherwise exempted or prohibited by law or County policy, where applicable, Contractors that contract with the
County to provide Direct Services developed pursuant to a formal Request for Proposals process, as defined in County of
Santa Clara Ordinance Code Division B36 ("Division B36") and Board Policy section 5.5.5.5 ("Living Wage Policy"), and their
subcontractors, where the contract value is $100,000 or more ("Direct Services Contract"), must comply with Division B36
and the Living Wage Policy and compensate their employees in accordance with Division B36 and the Living Wage Policy.
Compliance and compensation for purposes of this provision includes, but is not limited to, components relating to fair
compensation, earned sick leave, paid jury duty, fair workweek, worker retention, fair chance hiring, targeted hiring, local
hiring, protection from retaliation, and labor peace. If Contractor and/or a subcontractor violates this provision, the Board of
Supervisors or its designee may, at its sole discretion, take responsive actions including, but not limited to, the following:
(a) Suspend, modify, or terminate the Direct Services Contract.
(b) Require the Contractor and/or Subcontractor to comply with an appropriate remediation plan developed by the
County.
(c) Waive all or part of Division B36 or the Living Wage Policy.
This provision shall not be construed to limit an employee's rights to bring any legal action for violation of the employee's
rights under Division B36 or any other applicable law. Further, this provision does not confer any rights upon any person or
entity other than the Board of Supervisors or its designee to bring any action seeking the cancellation or suspension of a
County contract. By entering into this contract, Contractor certifies that it is currently complying with Division B36 and the
Living Wage Policy with respect to applicable contracts, and warrants that it will continue to comply with Division B36 and
the Living Wage Policy with respect to applicable contracts.
SECTION VII: INSURANCE / INDEMNIFICATION
Independent Contractors shall comply with the County's insurance and indemnification requirements as
indicated below. These requirements do not apply to Dependent Contractors.
A. TYPE OF INSURANCE LANGUAGE
The following standard insurance and indemnification language is attached and incorporated into this agreement:
B-2B Standard Service Contracts Between $10,001 and $50,000
Modification or Waiver Attached if Appropriate
B. DETERMINATION OF INSURANCE REQUIREMENTS AND WAIVER DECLARATION
Workers Compensation:
Does the contractor have employees?
If"YES", then, WORKER'S COMPENSATION/EMPLOYER'S LIABILITY INSURANCE IS REQUIRED.
Owned Auto Insurance:
Will the contractor use any owned autos in the provision of direct services, such as transporting clients in
autos or operating autos in performance of the work itself?
If "YES", then INSURANCE FOR OWNED AUTOS IS REQUIRED.
Hired Auto Insurance:
Will the contractor use any hired autos in the provision of direct services, such as transporting clients in
autos or operating autos in performance of the work itself?
if "YES", then INSURANCE FOR HIRED AUTOS IS REQUIRED.
Yes
No
No
Revision Date - July 2015 Page 12 of 13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Non -owned Auto Insurance:
Will the contractor be using any non -owned autos in the provision of direct services, such as transporting
clients in non -owned autos or operating non -owned autos in performance of the work itself?
If "YES" then, INSURANCE FOR NON -OWNED AUTOS IS REQUIRED.
When "NO" is checked, this declaration will serve as a waiver for the specified type of insurance.
No
SECTION VIII: FEDERAL/STATE REQUIRED PROVISIONS
(Examples include Drug -free Workplace Activity, Health Insurance Portability and Accountability Act
(HIPAA), Business Associate Language, etc)
A. Federal Required Language Attached
Only add special language if services included in the contract require language different from or in addition to that
in Section VI.
Exhibit Name: Attachment D- Debarment
B. State Required Language Attached
Only add special language if services included in the contract require language different from or in addition to that
in Section VI.
Exhibit Name:
The Exhibits named above are attached and incorporated by this reference.
SECTION IX: ADDITIONAL ATTACHED EXHIBIT(S)
Attachments and exhibits that conflict with County standard provisions or require risk assessment must
be approved by County Counsel. Examples of attachments that require County Counsel approval are:
1) Contractor's terms and conditions that are different than, or add to the standard provisions
language,
2) Any changes to the language in Section VI —Standard Provisions.
Exceptions to County Counsel review include attachments that further explain the Contract Specifics as
outlined in Section V, and insurance exhibits.
Exhibit Name(s) Attachment D- Debarment
The Exhibits named above are attached and incorporated by this reference.
Revision Date - July 2015 Page 13 of 13
Exhibit A
Scope of Work & Performance Standards
Town of Los Gatos
September 30, 2016 — September 29, 2017
A. Introduction
This Scope of Work is to support the creation of a Tobacco Retail License under the Partnerships to
Improve Community Health (PICH) grant.
B. Reporting Requirements
1. Contractor will prepare a Monthly Progress Report on their activities/progress and submit
it to:
Joanne Seavey, Health Care Program Manager II
Chronic Disease & Injury Prevention (CDIP), Santa Clara County Health Dept.
1400 Parkmoor Avenue, Suite 120E
San Jose, CA 95126
2. Contractor will also submit a Quarterly Report on PHD Template to:
Joanne Seavey, Health Care Program Manager II (at address shown above)
C. Task Description
Objectives
Task # 1
1.1
1. Conduct outreach to the community to implement successfully the
environmental tobacco control rules in public spaces throughout the Town.
2. Work to create a Tobacco Retail License program for the Town's twenty-seven
(27) tobacco retailers.
Anticipated Reach:
1. Population of Los Gatos: 29,493
2. Youth under 21: 6,755
Task Description Timeline
Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
commercial zones
Oct 2016-
April 2017
Responsible Staff
Community
Outreach
Coordinator, Town
Attorney
Key Deliverables
1.1.a
Draft notifications of
public notices
1.1.b
Signs for public spaces
indicating Town's
smoking restrictions
1 I (,c,c:
1.2
Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
restaurants/bars
1.3 Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
all recreational areas
1.4 Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
service areas/lines
1.5 Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
any facility licensed for
childcare, family day
care, health care or
community care
' Oct 2016-
April 2017
Oct 2016-
April 2017
Oct 2016-
April 2017
Oct 2016-
April 2017
Community
Outreach
Coordinator, Town
Attorney
—
Community
Outreach
Coordinator, Town
Attorney
Community
Outreach
Coordinator, Town
Attorney
Community
Outreach
Coordinator, Town
Attorney
1.2.a
Draft notifications of
public notices
1.2.b
Printed copies of public
notices
1.2.c
Sign templates for
establishments
indicating Town's
smoking restrictions
1.3.a
Draft notifications of
public notices
1.3.b
Signs for public spaces
indicating Town's
smoking restrictions
1.4.a
Draft notifications of
public notices
1.4.b
Printed copies of public
notices
1.4.c
Community outreach to
inform residents of
Town's new rules
1.5.a
Draft notifications of
public notices
1.5.b
Printed copies of public
notices
1.5.c
Outreach to care
centers to inform
caregivers of new rules
21 I' o cg €:
1.6
Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for
all hotels and motels
1.7 Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
areas
within 100 feet of all
school buildings
1.8 ; Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for all
transportation vehicles
1.9 Provide support to
establish recently
adopted new smoking
restrictions ordinance
(May 2016) for rental
multiunit housing
Oct 2016- Community
April 2017 Outreach
Coordinator, Town
Attorney
Oct 2016-
April 2017
Oct 2016-
April 2017
Oct 2016-
April 2017
Community
Outreach
Coordinator, Town
Attorney
Community
Outreach
Coordinator, Town
Attorney
Community
Outreach
Coordinator, Town
Attorney
1.6.a
Draft notifications of
public notices
1.6.b
Printed copies of public
notices
1.6.c
Outreach to property
owners to inform on
new rules
1.7.a
Draft notifications of
public notices
1.7.b
Printed copies of public
notices
1.7.c
Outreach to schools to
provide support for rule
enforcement
1.8.a
Draft notifications of
public notices
1.8.b
Printed copies of public
notices
1.9.a
Draft notifications of
public notices
1.9.b
Printed copies of public
notices
1.9.c
Outreach to property
owners and managers
Task #2 Task Description Timeline Responsible Staff
2.1 Research and draft ' Oct 2016
tobacco retailer
licensing report and
proposal
2.2 Tobacco retailer initial
outreach
2.3
2.4
Staff are invited to
present report and
proposal to Town
Council
Community
, Outreach
Coordinator, Town
Attorney
Nov 2016 I Community
Outreach
Coordinator, Town
Attorney
Nov 2016-Jan
2017
Tobacco retail licensing Jan 2017-
implementation I March 2017
outreach
Community
Outreach
Coordinator, Town
Attorney
Community
Outreach
Coordinator, Town
Attorney
Key Deliverables
2.1.a
Draft report
2.2.a
Retail survey to better
understand impact on
retailers
2.3.a
Staff are invited to
present a report and
proposal to Town
Council for review and
recommendation
2.4.a
Establish system to
implement and enforce
a Tobacco retail license
program
D. Performance Standards
Performance is expected to adhere to the following standards in addition to evaluations completed by
the PICH Evaluation contractor:
1. Quality - Deliverables and final products will be as described in the Scope of Work and will be of
high quality.
2. Timeliness - Deliverables and final products will be completed as scheduled.
3. Achievement of Project Goals — Project will achieve its' goals as described in the Scope of Work.
4. Achievement of Project Reach — Project activities and deliverables will reach at least 75% of the
projected population numbers of this contract.
Modifications to this Scope of Work will require County approval and signature from both parties and
may require an amendment to the Agreement.
4 I i' (; i7 E_;
EXHIBIT B-2B (revised)
INSURANCE REQUIREMENTS FOR
STANDARD SERVICE CONTRACTS
BETWEEN $10,001 AND $50,000
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 is obligated to indemnify, defend and hold harmless the
County under this Agreement.
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.
Rev. 3/2010 1
EXHIBIT B-2B (revised)
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 - $500,000
b. General aggregate - $500,000
c. Products/Completed Operations aggregate - $500,000
d. Personal Injury $500,000
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
Rev. 3/2010 2
EXHIBIT B-2B (revised)
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 hundred thousand dollars ($100,000) 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 hundred thousand dollars ($100,000) combined single limit per
occurrence applicable to all owned, non -owned and hired aircraft/watercraft.
5. Workers' Compensation and Employer's Liability Insurance
a. Statutory California Workers' Compensation coverage including broad form
all -states coverage.
b. Employer's Liability coverage for not less than one million dollars
($ 1 ,000,000) per occurrence.
E. Special Provisions
The following provisions shall apply to this Agreement:
"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 w,Titing 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.
Rev. 3/2010 3
EXHIBIT B-2B (revised)
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.
Rev. 3/2010 4
September 30, 2016 - September 29, 2017
Town of Los Gatos 9/30/2016 - 9/29/2017
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Attachment D
Additional County Provisions
Debarment and Suspension Certification
Contractor guarantees that it, its employees, contractors, subcontractors or agents (collectively
"Contractor") are not suspended, debarred, excluded, or ineligible for participation in Medicare,
Medi-Cal or any other federal or state funded health care program, or from receiving Federal
funds as listed in the List of Parties Excluded from Federal Procurement or Non -procurement
Programs issued by the Federal General Services Administration. Contractor must within 30
calendar days advise the County if, during the term of this Agreement, Contractor becomes
suspended, debarred, excluded or ineligible for participation in Medicare, Medi-Cal or any other
federal or state funded health care program, as defined by 42. U.S.C. 1320a-7b(f), or from
receiving Federal funds as listed in the List of Parties Excluded from Federal Procurement or
Non -procurement Programs issued by the Federal General Services Administration. Contractor
will indemnify, defend and hold the County harmless for any loss or damage resulting from the
conviction, debarment, exclusion or ineligibility of the Contractor.
Exhibit F
Santa Clara County United for Health — Partnership to Improve Community Health (PICH) FFY17
Town of Los Gatos: Scope of Work to support the creation of a Tobacco Retail License Program under
the Partnerships to Improve Community Health (PICH) grant.
Payment Schedule for Town of Los Gatos
September 30, 2016 — September 29, 2017
Payment will be made according to the Budget in Exhibit C, attached hereto and incorporated herein by
this reference. Contractor's invoices shall be submitted to the County, on a monthly basis, on a form
with a format approved by the County.
September 30, 2016 — September 29, 2017
Total Budget
$20,000
$20,000
Modifications to Exhibits A, F and/or C will require County approval and signature from both parties and
may require an amendment to the Agreement.
INVOICE GUIDELINES:
1. Invoices cannot bridge two County fiscal years because the fiscal year costs must be separated for
payment and record -keeping purposes.
a. Example: The County fiscal year ends on June 30, therefore all costs prior to June 30 must
be included on invoices for the months prior to July (which starts a new fiscal year).
2. Invoices should cover only one month and the tasks that are listed on the invoice should only be
the tasks actually worked on during that month and cited in the Progress Report with a description
of the work that was completed.
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
Non -owned Auto Insurance:
Will the contractor be using any non -owned autos in the provision of direct services, such as transporting
clients in non -owned autos or operating non -owned autos in performance of the work itself?
If "YES" then, INSURANCE FOR NON -OWNED AUTOS IS REQUIRED.
When "NO" is checked, this declaration will serve as a waiver for the specified type of insurance.
No
SECTION VIII: FEDERAL/STATE REQUIRED PROVISIONS
(Examples include Drug -free Workplace Activity, Health Insurance Portability and Accountability Act
(HIPAA), Business Associate Language, etc)
✓ A. Federal Required Language Attached
Only add special language if services included in the contract require language different from or in addition to that
in Section VI.
Exhibit Name: Attachment D- Debarment
B. State Required Language Attached
Only add special language if services included in the contract require language different from or in addition to that
in Section VI.
Exhibit Name:
The Exhibits named above are attached and incorporated by this reference.
SECTION IX: ADDITIONAL ATTACHED EXHIBIT(S)
Attachments and exhibits that conflict with County standard provisions or require risk assessment must
be approved by County Counsel. Examples of attachments that require County Counsel approval are:
1) Contractor's terms and conditions that are different than, or add to the standard provisions
language,
2) Any changes to the language in Section VI —Standard Provisions.
Exceptions to County Counsel review include attachments that further explain the Contract Specifics as
outlined in Section V, and insurance exhibits.
i Exhibit Name(s) Attachment D- Debarment
The Exhibits named above are attached and incorporated by this reference.
Revision Date - July 2015 Page 13 of 13
Contractor Name:
(As Displayed In SAP)
Purchase Order Number:
Agency/Department Name:
Brief Description of Services:
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
SECTION I: GENERAL INFORMATION
Town of Los Gatos
Public Health Department
Department
Number:
0410
This Scope of Work is to accomplish, under the Partnerships to Improve Community Health
(PICH) grant, activities to support the focus areas of the PICH project. The Town of Los
Gatos plans to support the creation of a Tobacco Retail License Program and conduct
outreach to the community to successfully implement the environmental tobacco control
rules in public spaces throughout the town.
Maximum Financial Obligation
The maximum amount payable to this Contractor
under this agreement shall not exceed: $ 20,000.00
Term of Agreement
Start Date:
Note: When left blank, start date will be the date executed by Authorized
County Representative
Account
Assignment
Line 1 H
Line 2 H
Line 3 Select
Line 4 Select
Line 5 Select
Revision Date - July 2015
End Date: 09/29/2017
For County Use Only
General Cost
Plant Ledger Center Amount
Number (Expense (Dept
Code) Code)
0410 5255500 2841
0410 5255500 2841
WBS
(Capital Project Code)
$18,000 FY17
$2,000 FY18
Internal
Order
("PCA" code
- optional)
Page 1of13
COUNTY OF SANTA CLARA
SERVICE AGREEMENT
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 Name
Contractor
(As Displayed In SAP): Town of Los Gatos
Contact Person: Robert Schultz, Town Attorney
Street Address *: Town of Los Gatos, 110 E. Main Street, Los Gatos, CA 95030
City *: Los Gatos State: CA Zip: 95030
Telephone number *: 408.354.6818
Email Address *: RSchultz@losgatosca.gov
SCC Vendor Number:
(As Assigned in SAP) 1010468
* To be completed for Independent Contractors Only - DO NOT COMPLETE FOR DEPENDENT CONTRACTORS
County of Santa Clara
Agency/Department: Public Health Department
Program Manager/
Contract Monitor Name: Joanne Seavey-Hultquist, Health Care Program Manager II
Street Address: 1400 Parkmoor Avenue, Suite 120E
City: San Jose State: CA
Telephone Number: 408.793.2714
Fiscal Contact
(Accounts Payable Contact): Arleen Speidel
Contract Preparer: Bianca Jones
Revision Date - ►uly 2015
Zip: 95126
Page 2 of 13
MEETING DATE: 05/17/16
ITEM NO: 2
COUNCIL AGENDA REPORT
DATE: MAY 11, 2016
TO: MAYOR AND TOWN COUNCIL
FROM: ROBERT SCHULTZ, TOWN ATTORNEY
SUBJECT: ADOPT AN ORDINANCE OF THE TOWN COUNCIL OF THE TOWN OF
LOS GATOS AMENDING SECTION 18.60.10 TO INCLUDE RESTRICTIONS
ON SMOKING IN COMMERCIAL ZONED AREAS AND IN MULTI -UNIT
RESIDENCES AND OTHER MISCELLANEOUS EDITS
RECOMMENDATION:
Adopt ordinance that was introduced at the Town Council meeting of May 3, 2016, amending
Section 18.60.010 to the Los Gatos Town Code related to smoking regulations.
BACKGROUND:
At its May 3, 2106 meeting, the Town Council voted 5-0 to approve amending the Town Code,
Section 18.60.010 to include restrictions on smoking in commercial zoned areas and in multi-
unit residences and other miscellaneous edits.
DISCUSSION:
Should the Council adopt the ordinance (Attachment I ), the new provisions would take effect in
thirty days. Staff will coordinate with businesses and property owners regarding the change in
the law.
ENVIRONMENTAL ASSESSMENT:
The action is not a project defined under CEQA and no further action is required.
Attachments:
1. Amended Ordinance for Town Code Section 18.60.010
PREPARED BY: ROBERT SCHULTZ
Town Attorney
Reviewed by: Assistant Town Manager Town Manager Finance
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