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11-100 Agreement, Obesity Prevention Policy Development and Implementation County of Santa Clara - Non Standard Service Agreement Cover Sheet This form and the Checklist are administrative forms and are not part of the agreement SECTION 1: GENERAL INFORMATION Date: August 2. 2011 P.O. Number: (Procurement Department Use Only) Agency /Department Name: Public Health Department Department No.: 410 Brief Description of Services: For development of city food and beverage policy, increased access to fruits and vegetables, and increase of alternative comm Jte opportunities. Maximum Financial Obligation: $ 30,340 Term of Agreement: Start Date Upon Execution End Date August 31, 2012 For County Use Only — SAP Account General Cost Center Amount WBS Internal Order Assignment Ledger Linel 410 5255100 2906 $ 28,340 FY 12 Line 2 410 5255100 2906 $ 2,000 FY 13 H, I or J Expense Code Dept. Code Capital Project Code "PCA" code Optional SECTION 11: PARTIES TO AGREEMENT CONTRACTOR COUNTY of SANTA CLARA Legal notices pertaining to this agreement will be sent to the Mail Invoices to County of Santa Clara at: name, address and contact person below: Name: City of Cupertino Agency /Dept: Public Health Department Contact Person: Erin m. Cooke, Environmental Affairs Contract Monitor: Susan Stuart Coordinator Address: 10300 Torre Avenue Address: 1400 Parkmoor Ave., Suite 120B City /State /Zip: Cupertino, CA 95014 City /State /Zip: San Jose, CA 95126 Telephone: 408.777.7603 Fax: 408.777.3366 Telephone: 408.793.2721 Fax: 408.793.2731 SCC Vendor Number (SAP): 1002319 Fiscal Contact: Susan Stuart (408) 793 - 2721 Roya Rousta (408) 792 - 5108 SECTION 111: DETERMINATION OF TAX WITHHOLDING AND BENEFIT STATUS For federal tax purposes Dependent/Independent status is an important distinction. It affects how the contractor files tax returns and the contractor's responsibility for various federal and state taxes. The questionnaire also determines the contractor's eligibility for Medicare and Social Security, Public Employees' Retirement System benefits, and other benefits. Is contractor a government entity, corporation, nonprofit organization or school district? YES - This is an Independent Contractor. Proceed to Section IV NO - Complete the Questionnaire (For help with the Questionnaire, visit www.oba) Use form as a cover sheet for agreements approved outside of the Procurement Department's authority. Effective 09 /09.Page 1 County of Santa Clara - Non Standard Service Agreement Cover Sheet This form and the Checklist are administrative forms and are not part of the agreement Questionnaire to be Completed by Contracting Department to Determine Dependent or Independent Status of Contractor YES NO 1 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, mark the box YES. If NO, please explain. 2 Training: Will the County instruct the contractor on how to do the job or pay for external training? If NO, please explain. 3 Incomplete Work: Will the Contractor be able to resign or terminate the contract without being held either financially or legally liable for unfinished work? If NO, please explain. 4 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? If NO, please explain. 5 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 and explain briefly. 6 Other Customers: Does the County prevent the Contractor from performing similar services for other customers, either due to the amount of work (full - tine), or by contractual provision? If NO, please explain. 7 Designation as Business Entity: If the Contractor has a business license or business certificate, mark the box "No ". (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: 8 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. If NO, please explain. Be sure this answer matches the contract payment schedule in Section V. 9 Support Services: Will County employees or other independent contractors provide assistance to this Contractor? Assistance is defined as clerical, technical or professional support. If NO, please explain. ❑ 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 u . Contractor's Initial: Reviewed and signed off by Dept. Fiscal Officer: Use form as a cover sheet for agreements approved outside of the Procurement Department's authority. Effective 09 /09.Page 2 County of Santa Clara - Non Standard Service Agreement Cover Sheet This form and the Checklist are administrative forms and are not part of the agreement SECTION IV: VENDOR SELECTION PROCESS Contractor was selected by: CHECK ONE ❑ Informal Competitive Process (attach an executive summary in support of your recommendation) ❑ Specified by the Board of Supervisors (attach approved Board transmittal) ❑ Formal Request for Proposal / Request for Qualifications (see attached) ❑ Sole source (see attached) ® Other (see attached) SECTION V: STATEMENT OF ECONOMIC STATEMENT Is Form 700 required? ❑ Yes ® No If Form 700 is required, it must be filed with the Clerk of the Board within 30 days of the contract's effective date of . Contractor must submit Form 700 by to the Department's Contract Monitor. Department's Contract Monitor will submit the completed Form 700 with the Form 700 cover sheet to the Clerk of the Board by SECTION VI: BEVERAGE NUTRITIONAL CRITERIA Contractor shall not use County funds to purchase beverages that do not meet the County's nutritional beverage criteria. The six categories of nutritional beverages that meet these criteria are (1) water with no additives; (2) 100% fruit juices with no added sugars, artificial flavors or colors (limited to a maximum of 10 ounces per container); (3) dairy milk, non -fat, 1% and 2% only, no flavored milks; (4) plant derived (i.e., rice, almond, soy, etc.) milks (no flavored milks); (5) artificially- sweetened, calorie- reduced beverages that do not exceed 50 calories per 12 -ounce container (teas, electrolyte replacements); and (6) other non - caloric beverages, such as coffee, tea, and diet sodas. These criteria may be waived in the event of an emergency or in light of medical necessity. Use form as a cover sheet for agreements approved outside of the Procurement Department's authority. Effective 09 /09.Page 3 AGREEMENT BETWEEN THE COUNTY OF SANTA CLARA AND CITY OF CUPERTINO FOR OBESITY PREVENTION POLICY DEVELOPMENT AND IMPLEMENTATION This Agreement between the County of Santa Clara ( "County") and the City of Cupertino ( "Contractor ") for costs related to the implementation of Obesity Prevention Policy Development and Implementation. RECITALS WHEREAS, the County received grant funds from the Centers for Disease Control and Prevention to expand countywide obesity prevention efforts and focus on high- impact nutrition and physical activity intervention; resulting in policy, systems, and environmental change; and, WHEREAS, Contractor submitted a letter to accept funding for and partake in community-level change by adopting a nutrition and/or physical activity strategy(s) related to obesity prevention (selected strategies can build on the momentum of the Let's Move Cities and Towns! Initiative); and, WHEREAS, Contractor's letter of commitment have been accepted and by virtue of the parties' execution of this Agreement, the Contractor will be awarded funding under the terms of this Agreement; NOW, THEREFORE, the parties hereto agree as follows: Article 1. County's Obligations. 1.1 County will provide Contractor funding to subsidize tasks and deliverables in Scope of Work (Exhibit A) based on Line Item Budget and Budget Justification (Exhibit B). 1.2 The Parties agree that the maximum amount payable by County to Contractor under this Agreement shall not exceed $ 30,340. County does not guarantee a minimum payment to Contractor. 1.3 Payment will be made upon report and invoice from Contractor as described in Exhibit C (or earlier if all tasks are completed). Article 2. Contractor's Obligations. 2.1 Contractor shall complete tasks and deliverables as stated in Exhibit A. Agreement w/ City of Cupertino Page 1 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 2.2 Contractor shall collect evaluation data and provide the results to the County. 2.3 Contractor shall maintain records adequate to demonstrate that funding received under this Agreement is used in accordance with this Agreement. These records shall be maintained during the term of this Agreement and for a period of three (3) years from termination of this Agreement or until all claims, if any, have been resolved, whichever period is longer, or longer if otherwise required under other provisions of this Agreement. 2.4 Contractor shall permit the County and its authorized representatives to monitor Contractor's performance of this Agreement. To the extent permitted by law, such monitoring may include, but not be limited to, audits and review of records related to this Agreement. Such monitoring shall be permitted at any time during Contractor's normal business hours upon no less than 24 hours advance notice. 2.5 Contractor shall designate a project director /coordinator responsible for overseeing the performance of this Agreement, and serving as County's primary contact for the purpose of monitoring this Agreement. County must be notified in writing of any change of the project director /coordinator. Article 3. Term and Termination. 3.1 Term of this Agreement. This Agreement is effective when signed by both Contractor AND County and shall continue through August 31, 2012, unless terminated earlier in accordance with this Agreement. 3.2 Termination. 3.2.1 Termination for Cause. County may terminate this Agreement for cause upon 30 days written notice to Contractor. For purposes of this Agreement, cause includes, but is not limited to, any of the following: (a) material breach of this Agreement by Contractor, (b) violation by Contractor of any applicable laws, or (c) assignment by Contractor of this Agreement without the written consent of County. Such notice shall specify the reason for termination and shall indicate the effective date of such termination. 3.2.2 Termination for Convenience. Either party may terminate this Agreement without cause by giving the other party thirty (30) days written notice. Agreement w/ City of Cupertino Page 2 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 Article 4. Miscellaneous. 4.1 Independent Contractor. Contractor will perform all work and services described herein as an independent contractor and not as an officer, agent, servant or employee of County. None of the provisions of this Agreement is :intended to create, nor shall be deemed or construed to create, any relationship between the parties other than that of independent parties contracting with each other for purpose of effecting the provisions of this Agreement. The parties are not, and will not be construed to be in a relationship of joint venture, partnership or employer- employee. Neither party has the authority to make any statements, representations or commitments of any kind on behalf of the other party, or to use the name of the other party in any publications or advertisements, except with the written consent of the other party or as is explicitly provided herein. Contractors will be solely responsible for the acts and omissions of its offs cers, agents, employees, contractors, and subcontractors, if any. 4.2 Assignment. The parties may not assign this Agreement or the rights and obligations hereunder without the specific written consent of the other. 4.3 Entire Agreement. This document represents the entire Agreement between the parties with respect to the subject matter hereof. All prior negotiations and written and/or oral Agreements between the parties with respect to the subject matter of this Agreement are merged into this Agreement. 4.4 Amendments. This Agreement may only be amended by an instrument signed by the parties. 4.5 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. 4.6 Parties' Representatives. Dan Peddycord, Director of Public. Health Department of County or his designee is hereby made the representative of County for all purposes under this Agreement w/ City of Cupertino Page 3 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 Agreement. The Contractor's representative, City Manager or his/her designee is hereby made the representative of Contractor for all purposes under this Agreement. 4.7 Severability. If any term, covenant, condition or provision of this Agreement, or the application thereof to any person or circumstance, shall to any extent be held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the terms, covenants, conditions and provisions of this Agreement, or the application thereof to any person or circumstance, shall remain in full force and effect and shall in no way be affected, impaired or invalidated thereby. 4.8 Governing Law. This Agreement shall be construed and its performance enforced under California law. 4.9 Venue. In the event that suit shall be brought by either Party to this Agreement, the Parties agree that venue shall be exclusively vested in the State courts of the County of Santa Clara or, if federal jurisdiction is appropriate, exclusively in the United States District Court for the Northern District of California, in San Jose, California. 4.10 Non - Discrimination. The County of Santa Clara is an equal opportunity employer. Contractor must comply with all applicable Federal, State, and local laws and regulations including Santa Clara County's equal opportunity requirements. 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 Labor Code sections 1101 and 1102. Contractor must 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 affiliation, or marital status in the recruitment, selection for training including apprenticeship, hiring, employment, utilization, promotion, layoff, rates of pay or other forms of compensation. 4.11 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 Agreement w/ City of Cupertino Page 4 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 Manual section 3.47 (as amended from time to time), which prohibits smoking: (1) at the Santa Clara Valley Medical 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. 4.12 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. 4.13 Budget Contingency. Performance and/or payment by the County pursuant to this Agreement or any contract release purchase order is contingent upon the appropriation of sufficient funds by the County for services covered by this Agreement or any contract release purchase order. If funding is reduced or deleted by the County for services covered by this Agreement or any contract release purchase order, the County may, at its option and without penalty or liability, terminate this Agreement or offer an amendment to this Agreement indicating the reduced amount. 4.14 Beverage Nutritional Criteria. Contractor shall not use County funds to purchase beverages that do not meet the County's nutritional beverage criteria. The six categories of nutritional beverages that meet these criteria are (1) water with no additives; (2) 100% fruit juices with no added sugars, artificial flavors or colors (limited to a maximum of 10 ounces per container); (3) dairy milk, non-fat, 1% and 2% only, no flavored milks; (4) plant derived (i.e., rice, almond, soy, etc.) milks (no flavored milks); (5) artificially- sweetened, calorie - reduced beverages that do not exceed 50 calories per 12 -ounce container (teas, electrolyte replacements); and (6) other non- caloric Agreement w/ City of Cupertino Page 5 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 beverages, such as coffee, tea, and diet sodas. These criteria may be waived in the event of an emergency or in light of medical necessity. 4.15 Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed to be an original, but all of which together shall constitute one and the same instrument. 4.16 Assignment of Clayton Act, Cartwright Act Claims. Contractor hereby 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. 4.17 Contracting Principals. Service contracts are subject to the Resolution of Contracting Principles adopted by the Santa Clara County Board of Supervisors on October 28, 1997 which shall be made available to the Contractor by the County. Contractor shall comply with the entire resolution including the following: 4.17.1 Contractor shall, during the term of this contract, comply with all applicable federal, state, and local rules, regulations, and laws. 4.17.2 Contractor shall maintain financial records adequate to show that County funds paid under the contract were used for purposes consistent with the terms of the contracts. These records shall be maintained during the term of this contract and for a period of three (3) years from termination of this contract or until all claims if any, have been resolved, whichever period is longer, or longer if otherwise required under other provisions of this contract. The failure of Contractor to comply with this Section or any portion thereof may be considered a material breach of this contract and may, at the option of the County, constitute grounds for the termination and/or non - renewal of the contract. Contractor shall be provided reasonable notice of any intended termination or non - renewal on the ground of non - compliance with this Section, and be given the opportunity to respond and discuss the County's intended action. Agreement w/ City of Cupertino Page 6 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 Article 5. Indemnification and Insurance requirements. Before providing any services under, and throughout the term of this Agreement, Contractor shall comply with County's insurance and indemnification requirements as described in Exhibit B2B, which is attached hereto and incorporated herein by this reference. Article 6. Notice. Any notice required to be given by either Party, or which either party may wish to give, shall be in writing and served either by personal delivery or sent by certified or registered mail, postage prepaid., addressed as follows: To County: Public Health Department Attn: Susan Stuart Communicable Disease and Injury Prevention Program 1400 Parkmoor Ave., #120B San Jose, CA 95126 To Contractor: City of Cupertino Attn: Erin M. Cooke Environmental Affairs Coordinator City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 Notice shall be deemed effective on the date personally delivered or, if mailed, three (3) days after deposit in the United States mail. Agreement w/ City of Cupertino Page 7 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 Signed: PUBLIC HEALTH DEPARTMENT CITY OF CUPERTINO by /6/ U w L ik i /Wry" 1( ° ° by . ,� c��.. _ .. . L� t 1 Dan Peddycor , RN, MPA/HA Date David W. Knapp, City Z l ager Date Public Health Director City of Cupertino Approved as to Form Legality: q e/1//i . , Ah r .„„„ ri 2)1 Je Lam Date Care orade Date De I ty Cou ty Counsel City Attorney Emil arrison D Kimberly Smith p Date Deputy County Executive r City Clerk Exhibits to this Agreement: Exhibit A: Scope of Work Exhibit B: Line Item Budget and Budget Justification Exhibit C: Program Requirements Exhibit B2B: Indemnity & Insurance Requirements Agreement w/ City of Cupertino Page 8 of 8 For Development of Obesity Prevention Policy Through August 31, 2012 EXHIBIT A Santa Clara County Communities Putting Prevention to Work - Obesity Prevention Workplan for Cities Policy Development and implementation Upon Execution- August 31, 2012 JURISDICTION: City of Cupertino PHYSICAL ACTIVITY OBJECTIVES Strategy: Access Policy /Systems /Environmental: Environmental By March 2012, leverage Bicycle Friendly Community Status and participation in Let's Move Cities, Towns and Counties, to implement policy goals of the Cupertino Bicycle Master Plan through proposal of Objective PA2: integration of commute recommendations into City Municipal Code and through engaging at least 15 businesses in alternative commute opportunities and incentives through the Association of Bay Area Governments(ABAG) /Santa Clara County- supported Green Business Program. Key Activities Tracking Measures Milestones Time Frame Expand ABAG /SCC Green Green Business (GreenBiz) Updated Green Business checklist created. 4/30/12 Business checklist Checklist measures to include additional alternative commute opportunities for employers, including bike /buddy /bike ambasador (mentorship) and bike share programs. Promote City of Cupertino Promotion materials, city Go Green Grants promotion materials created. 3/31/12 Go Green Grants in order website, and newsletters. to expand alternative Materials distributed to 15 businesses and posted on 7/31/12 commute programs city website. (including bike mentorship) and supporting infrastructure (including bike racks) among Green Business Partners. Integrate alternative City Council Meeting Minutes Municipal Code draft created. 6/30/12 commute recommendations into Muncipal Code language considered by Council. 8/31/12 Municipal code Title 11:Vehicles & Traffic and Title 19: Parking Regulations Engage at least 15 new List of participating businesses Outreach conducted to businesses. 8/31/12 businesses in alternative commute programs 15 new businesses engaged in GreenBiz alternative 8/31/12 through City's newly commute programs. launched GreenBiz program (supplement to ABAG /Santa Clara County Green Business Program), building on materials and information supplied by VTA/Transit.511 and the Silicon Valley Bicycle Coalition. 1 of4 EXHIBIT A NUTRITION OBJECTIVES Strategy: Access, Point of Purchase 1Pelicyl3yatemsl ovlrot mental: Policy, Systems, Environmental By August 2012, in accordance with Let's Move pillars /goals, develop, adopt and implement a City food and beverage policy including recommended healthier food and beverages standards designed for food Objective N1: vendor /catering services at City operations and at City- hosted and external events, which is approved by the Cupertino City Council. KeitActtillues tividnosioasures . M tonss,- a s tinwrAutio Create a list of City List of locations where food is Locations list completed. 3/31/12 locations /venues where served. food is served (Note: couple with a waste audit to ensure facilities also provide compost containers /service). Summary table of policies Summary table completed. 4/30/12 Complete summary table of "model" policies from adjacent jurisdictions, including draft policy language. Draft documents prepared Parks & Recreation Commission Draft guidelines presented to Parks & Recreation 5/31/12 and presented to Parks & minutes. Commission. Recreation Commission (which oversees vendor Feedback incorporated into draft language. 6/31/12 guidelines for food & beverage services at City facilities) and feedback integrated into future draft documents for Council review. Draft policy, staff report City Council Meeting Minutes Council consideration of draft guidelines. 7/31/12 and presentation prepared for Council review. Educate department Meeting minutes Education sessions completed. 8/31/12 heads, employees, and community members about new food /beverage policy. Integrate approved RFP & RFQ boiler plate RFP & RFQ boiler plate language completed. 8/31/12 language into RFP & RFQ language. documents for vendor /catering services. Include approved Extemal Partner Facility Rental External Partner Facility Rental Guide Revised 8/31/12 guidelines language in Guide online & print external partner facility rental guide. Include approved langauge Parks & Recreation "Green Parks & Recreation "Green Policies" Revised 8/31/12 in Parks & Recreation Policies" "green policies." 2 cf 4 EXHIBIT A Strategy: Access, Point of Purchase, Price Policy /Systems/Environmental: Policy By August 2012, in accordance with Let's Move pillars /goals and GreenBiz Cupertino, increase accessibility and affordability of fruits and vegetables by increasing Community Supported Agriculture (CSA) Objective N2: opportunities for employees and low to moderate income residents and through encouragement of acceptance of Cal Fresh (food stamps) Electronic Benefit Transfer (EBT) cards at a newly created Farmers' Market. Key Activities Tracking Measures Mitestones Time Frame Integrate health and Revised GreenBiz framework. GreenBiz framework revised to include health and 4/30/12 wellness goals (including wellness criteria. food and beverage standards and CalFresh EBT acceptance) into GreenBiz Cupertino framework to promote businesses that not only conserve resources but also promote health and wellness programs. Introduce at least 15 Meeting minutes and emails Outreach to 10 businesses completed. 8/31/12 businesses, including farmers markets, grocers, and food service providers, to health and wellness goals through GreenBiz outreach. Work with city processes Farmers market promotional Newly formed farmers' market considers acceptance of 5/31/12 to encourage newly formed materials. EBT. farmers' market to accept CalFresh Electronic Benefit Transfer (EBT) cards. Establish a City of CSA promotional materials. City Community Supported Agriculture distribution 6/30/12 Cupertino Employee opportunity created. Community Supported Agriculture (CSA) distribution opportunity and evaluate potential for expanding to other local public agency service providers, including but not limited to County Fire, County Sheriffs Office and County Library Services. 3 of 4 EXHIBIT A Build a partnership with CSA promotional materials. New drop -off /pick -up location for CSA at 8/31/12 CSA providers to establish public /community facility a drop -off /pick -up location at a centrally located public /community facility (e.g. City Hall or Quinlan Community Center), exploring opportunities for CalFresh /EBT acceptance and marketing CSA program through Affordable Housing and CDBG programs, and West Valley Community Services. Host Healthy Communities Healthy Communities Festival Healthy food providers promoted through Healthy 4/30/12 Festival (. e Earth Day) to promotional materials. 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UJ EXHIBIT -C Program Requirements Item Deadline ❑ Quarterly Reports October 1, 2011 (service period 7/1 — 9/30) Invoice January 1, 2012 (service period 10 /1 — 12/31/11) Narrative of April 1, 2012 (service period 1/1/12 — 3/31/12) accomplishments July 1, 2012 (service period 4/1 -6/30) August 31, 2012 (service period 7/1 -8/30) Promotional materials paid for by CPPW must include the following attribution: Made possible by funding from the Department of Health and Human Services. It is highly recommended that grantees make arrangements to attend CPPW convenings of funded cities and community organizations. Dates to be determined. EXHIBIT B -2 B (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 frcm 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 1 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: 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 :; 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 Contracting Principles October 1997 WHEREAS the County of Santa Clara purchases contract services; WHEREAS the County of Santa Clara purchases these services in the interests of meeting the needs of its residents and such services are integral to the County's mission to serve the public; WHEREAS the County of Santa Clara is concerned over the increased costs of providing health care to the uninsured through the services of the Santa Clara Valley Health and Hospital System; WHEREAS the County of Santa Clara is committed to the provision of quality services, whether provided directly by the County or by contract agencies; WHEREAS the County of Santa Clara is committed to insuring that services are provided by responsible contract agencies; WHEREAS the County of Santa Clara seeks to maximize direct resident/client services while minimizing indirect service costs and seeks to promote fiscal responsibility; WHEREAS the County of Santa Clara has an interest in encouraging, to the extent possible, an environment in which labor and employment disputes do not disrupt the continuous delivery of purchased services; WHEREAS the County of Santa Clara has a strong and ongoing interest in providing continuous services to the consumers of those services; WHEREAS the County of Santa Clara needs to know the level of pay and benefits provided by County contractors in order to intelligently consider their impact; WHEREAS this consideration should take place in the County's open and public discussion of contract awards; NOW, THEREFORE, be it resolved that effective June 1, 1998, as a condition of the renewal of any contract or the letting of any new contract any agency or company contracting to deliver services for the County shall comply with the following contracting principles; County of Santa Clara Contracting Principles 1 of 17 I. Contracting Principles A. All Type I and Type II contracts, as hereinafter defined, shall include a contract provision specifying that the contractor shall comply with all applicable federal, state and local rules, regulations and laws. B. In order to assure fiscal responsibility, strength and compliance with these principles all Type I and Type II contracts shall include a contract provision specifying that the contractor shall maintain financial records, that would be adequate to show that County funds were used for purposes consistent with the terms of the service contract. C. All Type II contractors shall provide specific information in addition to that which is required of a responsible bidder. The information will be delineated in the contractor selection process document but shall, at a minimum, include the following information pertaining to the actual provision of services and /or expenditures charged to the contract: 1. Information regarding the wage level, pay range and benefits for positions and job classifications. a) The wage and benefit information for executive, managerial and supervisory positions may be presented as one aggregate figure. For example: "Executive, Managerial and Supervisory wage and benefits costs for this contract are (or in the case of a new program the projected level) $X for each year of the contract." However, in no instance would an individual be identified by employee name. b) The wage level, pay range and benefit costs for all other positions and job classifications that will be providing actual services and /or expenditures charged to the contract should specify actual distribution (or in the case of a new program the projected level) of wage rates within each pay range by the specific salary level. However, in no instance would an individual salary be identified by employee name. In the case of single position job classes the information may be aggregated with similar job classes. For example: "In Job Classification A there are five positions with a pay range of $X to $Y. With two employees paid at $X, two employees paid at $Y and one paid at $Z midpoint between $X and $Y." c) If medical insurance is provided a summary of coverage for each plan must be submitted (or in the case of a new program the projected level). In addition, the County may also request the entire plan document. County of Santa Clara Contracting Principles 2 of 17 The summary must include the total premium cost, the amount of the premium paid by the employer and employee, and any co- payments or other employee costs. If medical insurance is not provided, the County Agency /Department presenting the contract for approval shall calculate and disclose the costs of providing medical insurance to the employees of the contractor. Costs shall be determined by the County Executive based on a standard cost provided by the Santa Clara Valley Health and Hospital System. 2. Length of Service a) The length of continuous employment with the contractor by job classification (information shall not include employee names). b) In addition, the contractor may submit information detailing the relevant prior experience of employees within each job classification (information shall not include employee names). 3. The annual rate of staff turnover. 4. The number of hours of training for each position in subject matters directly related to providing services to County residents /clients. 5. The number of legal complaints issued by an enforcement agency for alleged violations of applicable federal, state or local rules, regulations or laws and the number of citations, court findings or administrative findings for violations of applicable federal, state or local rules, regulations or laws. The information must include the date, enforcement agency, the rule, law or regulation involved and any additional information the contractor may wish to submit. 6. Copies of any collective bargaining agreements or summary of personnel policies covering the employees providing services to the County. D. All Type II contracts shall include a contract provision specifying that in order to determine compliance to these principles as well as the contract, the contractor shall be required to provide the County or its agents, except where prohibited by federal or state laws, regulations or rules, reasonable access, through representatives of the contractor, to facilities, records and employees that are used in conjunction with the provision of contract services. County of Santa Clara Contracting Principles 3 of 17 E. During the term of any contract all Type II contractors shall provide to the County copies of any financial audits that have been completed. The contractor shall use County funds for County services and shall not use County funds for general employer costs that do not support or otherwise directly relate to the scope of contracted services. Consistent with the financial provisions of the contracts, this shall not preclude the realization of profits or savings. F. During the term of any contract all Type II contractors shall advise the County Department/Agency responsible for monitoring the contract of the issuance of any legal complaint by an enforcement agency, or of any enforcement proceedings by any Federal, State or Local agency for alleged violations of federal, state or local rules, regulations or laws. In addition, the specific contract may include additional provisions regarding notice to the County of specific client/patient service issue complaints. G. During the term of any contract all Type II contractors shall advise the County of the issuance of citations, court findings or administrative findings for violations of applicable federal, state or local rules, regulations or laws. H. Violations of this policy may be considered material breaches of any Type I or Type II contract, and may, at the option of the county, constitute grounds for the termination or non - renewal of any such contract, according to its terms. The contractor shall be provided reasonable notice of any intended termination or non - renewal and the opportunity to respond and discuss the County' s intended action. 11. Definitions A. For purpose of this Resolution renewal of any contract shall not include modifications or amendments that do not extend the original length of the contract. B. For purposes of this Resolution services shall not include the rental, purchase, sale, lease, lease back or lease purchase of goods. Nor shall the rental, purchase, sale, lease, lease back or lease purchase of any facility or property be included. C. For purposes of this resolution Type 1 Service contracts shall include any of the following in which the county purchases services from: 1. Sole Source 2. Construction or other work required by law to be contracted out. 3. Individuals and contractors that employ less than twenty -five (25) employees. County of Santa Clara Contracting Principles 4 of 17 4. Contract which provides for immediate needs necessary to preserve public health, safety or peace and any other emergency work which cannot be handled because staff and equipment have been allocated and the work must be done post- haste. 5. Contract necessary to provide immediate emergency repair of facilities or equipment in order to preserve or provide continuous public, inmate, patient or client services or for the safety and health of the public or employees. 6. Contract with other public agencies. 7. Contract of One Hundred Thousand Dollars ($100,000) or less (excluding contractors where the aggregate of multiple contracts for the same or similar services with the same contractor exceeds $100,000), except where a labor contract contains a specific provision that requires notice to the County labor organization, then the labor contract provision and threshold dollar amount shall be applied. 8. Contract with Professionals (such as legal, financial, engineering, architectural, management consulting services, and physician and medical consulting services) where the primary services contracted for will be provided by those professionals. 9. Contract requires work to be performed with specialized equipment (such as trucks, cranes and other similar large equipment) including those contracts when the contractor provides an operator for the equipment. 10. Contract for facility or equipment maintenance except such facility or equipment maintenance provided by County employees at the time of adoption of this resolution (i.e., FY 1998). 11. Contract is for maintenance services incidental to the purchase (or lease etc.) Of goods or equipment. 12. Contracts to provide employee benefits pursuant to provisions of County labor contracts. D. For purposes of this Resolution Type II Service Contracts include all service contracts in which the County purchases services not covered under Definitions I.B. and I.C. of this Resolution. Implementation A. The County Executive shall direct the preparation and dissemination of any administrative guidelines and directives to County Departments /Agencies as are necessary to implement this Resolution as of June 1, 1998. These directives shall include a requirement that each County Department or County of Santa Clara Contracting Principles 5 of 17 Agency advise current service contractors of the implementation of this Resolution prior to June 1, 1998. B. The County Counsel shall develop and disseminate standardized contract provisions that implement this Resolution. C. This Resolution and its requirements shall be a part of, and shall be added to, the previously adopted Board policy on Bidding and Contracting. D. The implementation and actual experience under terms of this resolution shall be reviewed by the Board Finance Committee and then the full Board beginning one year after adoption of this resolution. The Board shall affirmatively seek out and consider the input of contractors operating under these contracting principles. In addition, the County Executive shall provide quarterly reports to the Finance Committee. County of Santa Clara Contracting Principles 6 of 17 DECLARATION OF CONTRACTOR (To be completed by all Type 1 and Type II contractors) This is a Type I service contract under the Board of Supervisor's Resolution of // Contracting Principles. If this box is checked, please complete the following: L Cv -- C-27)1 /-C Type 1 Category: h.eilniA ( �h S f aL 7oyl r i✓r /, ottic Cli 4'b & d 7'_ %% /i ; Explanation: �� LCh, I �U�.,-,. �4 6° i-a Lk �L� n /�t� 7a -f' i n l ❑ This is a Type 11 contract under the Board of Supervisor's Resolution on Contracting Principles. The contractor currently has other County contracts for the same or similar services: ❑ Yes ❑ No If Yes is checked, please list and describe contracts, types and dollar amounts. 1 am authorized to complete this form on behalf of [Name of contracting entity]. I have used due diligence in obtaining this information, and this information contained herein is complete and accurate. �gr� Contractor :ture: -- Y = -' Name: I $ V✓ . b 0 Title: `/ _ / Date: • i { County of Santa Clara Contracting Principles 7 of 17 TYPE II CONTRACTOR INFORMATION PACKET This set of forms is applicable generally for contractors providing service to the County of Santa Clara. It is not intended for contractors that provide rental, purchase, sale, lease, lease back or lease purchase of goods to the County. It should be assumed that contractors are Type II providers unless they meet the exceptions as described in II. C. 1 -12 of the Resolution of Contracting Principles. County of Santa Clara Contracting Principles 8 of 17 SECTION 1 Information regarding the wages and benefits for executive, managerial and supervisory positions pertaining to services provided under the proposed contract. (Please do not provide employee names) Aggregate total wages for the above positions pertaining to services provided under the proposed contract. (Please do not provide employee names) Aggregate total medical benefit employer costs for the above positions pertaining to services provided under the proposed contract: If no medical benefits are provided, County Agency /Departments will consider and include such costs for these employees, as determined by the Santa Clara Valley health and Hospital system and set by the County Executive. Equivalent total medical benefit employer costs attributed to the above positions: County of Santa Clara Contracting Principles 9 of 17 SECTION 2 Information regarding the wages and benefits for all other positions except: executive, managerial and supervisory positions, pertaining to services provided under the proposed contract. (Please do not provide employee names) Total Number Job Class of Positions Pay Employees Pay Ranges at this level Subtotals A B C D E Total medical benefit employer costs attributed to the above positions: If no medical benefits are provided, County Agency / Department will consider and include such costs for these employees, as set by the County Executive and determined by the Santa Clara Valley Health and Hospital System. Equivalent total medical benefit costs attributed to the above positions: (Use additional sheets of Section 2 page for more job classes or more positions) County of Santa Clara Contracting Principles 10 of 17 SECTION 3 Medical cost (medical, dental, vision and life insurance premium) breakdown for employees in Sections 1 and 2; if a different benefit package is offered to management employees, please identify an describe: Medical Cost Employer Employee Self Total Cost Contribution Contribution Employee only Employee plus one dependent Employee plus multiple dependents Please check one: ❑ Administrative /Management Employees Only ❑ Line Employees Only ❑ All employees Please attach a summary of all medical (medical, dental, vision and life insurance premium) plans her for employees reported in Sections 2 and 3. The County reserves the right to have contractor provide entire plan documents. (Use additional sheets of Section 3 page for additional plans) County of Santa Clara Contracting Principles 11 of 17 SECTION 4 Please provide information for length of service of contractor staff in the area of service currently provided to the County or proposed to be provided to the County: Job Class: Length of continuous agency Prior Experience service (Optional) Employee A Employee B Employee C Employee D Employee E Employee F Employee G Employee H Job Class: Length of continuous agency Prior Experience service (Optional) Employee A Employee B Employee C Employee D Employee E Employee F Employee G Employee H Job Class: Length of continuous agency Prior Experience service (Optional) Employee A Employee B Employee C Employee D Employee E Employee F Employee G Employee H (Use additional sheets of Section 4 page for more job classes) County of Santa Clara Contracting Principles 12 of 17 SECTION 5 Please provide the annual rate of turnover of staff for prior 1 year. Immediate past 12 months / prior fiscal year / prior calendar year [Please circle one] Note: This section pertains to contractor staff in the area of service currently provided to the County or proposed to be provided to the County. (Example: if 10 positions are covered and 5 employees left their positions in the last year, the annual turnover rate is 50 %) County of Santa Clara Contracting Principles 13 of 17 SECTION 6 Training records for prior 1 year - immediate past 12 months / prior fiscal year / prior calendar year [please circle one] for contractor staff in the area of service currently provided to the County or proposed to be provided to the County: Training subject matter related to Employee classes Date Total hours contracted services County of Santa Clara Contracting Principles 14 of 17 SECTION 7 Please list legal complaints, citations, court findings, or administrative findings for violations issued by enforcement agencies for the previous five (5) years for alleged violations of applicable federal, state or local rules, regulations or laws: Rules, laws, Enforcement regulations Type Agency Date of Issue involved • County of Santa Clara Contracting Principles 15 of 17 SECTION 8 Please list and provide copies of collective bargaining agreements covering contractor staff in the area of service currently provided to the County or proposed to be provided to the County. Bargaining Units Union Term of Agreement If there are no collective bargaining agreements, please provide summaries or actual personnel policies covering contractor staff in the area of service currently provided to the County or proposed to be provided to the County. County of Santa Clara Contracting Principles 16 of 17 SECTION 9 DECLARATION THAT INFORMATION IS COMPLETE I am authorized to complete this packet of forms on behalf of [Name of contracting entity] I have used due diligence in obtaining this information, and this information contained herein is complete and accurate. Signature: Name: Title: Date: County of Santa Clara Contracting Principles 17