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Home My WebLink AboutAgreements/Contracts - New Hope DV/SAGRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT:New Hope REQUEST SUBMITTED BY: SIIZI FOCI@ CONTACT PERSON ATTENDING ROUNDTABLE: SuziFode CONFIDENTIAL INFORMATION: ❑YES *NO DATE: $/27/ZOZ4 PHONE:764.$402 MENU I ]BLUMMINI wilua WAI ®Agreement / Contract DAP Vouchers ❑Appointment / Reappointment DARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards / Committees ❑ Budget ❑Computer Related ❑County Code ❑Emergency Purchase ❑Employee Rel. ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders ❑ Grants — Fed/State/County ❑ Leases ❑ MOA / MOU El Minutes []Ordinances ❑Out of State Travel El Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution ❑Recommendation ❑Professional Serv/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB Ul= *3 US U119i V!j 19 10101 im:l k, I a= 100 W11 TIM W11 GRIJ, mialum W$ff4zMj Request permission for Suzi ,Fode to Docu-Sign Contract Amendment A for Grant # 24-31219-010 with Department of Commerce for Year 2 Crime Victims' Services. This will increase the grant by $224,999 in Year two for a total grant amount of $453,999 ending June 30, 2025. If necessary, was this document reviewed by accounting? ❑ YES ❑ NO 0 N/A If necessary, was this document reviewed by legal? 0 YES ❑ NO ❑ N/A � DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: D2: D3: DEFERRED OR CONTINUED TO: WITHDRAWN: 4/23/24 Docusign Envelope ID: BC07COA1-6F6C-4707-AOA4-F4B1EAA9E877 .a %0�r C OfM11c"We Amendment Grant Number: 24-31219-010 Amendment Number: A Washington State Department of Commerce Community Services Division Office of Crime Victims Advocacy SFY2024-2025 Crime Victim Service Center Grant 1. Grantee 2. Grantee Doing Business As (optional) GRANT, COUNTY OF New Hope PO BOX 37 EPHRATA WA 98823-0037 3. Grantee Representative 4. COMMERCE Representative SuziFode Helena Schlegel Director Program Coordinator sfode@grantcountywa.gov (360) 725-2987 (509) 764-8402 helena.schlegel@commerce.wa.gov 5. Original Grant Amount 6. Amendment Amount 7. New Grant Amount (and any previous amendments) $224,999.00 $4531999.00 $229,000.00 8. Amendment Funding Source 9. Amend. Effective Date 10. End Date Federal: F State: Z Other: M N/A: M 7/1/2024 12:00:00 AM 1 06/30/2025 1 11. Federal Funds (as applicable) Federal Agency: ALN Number: Indirect Rate (as applicable): 12. SWV # 13. UBI # 14. UEI # SWV0002426-17 132001884 ZL6WM26K8KR5 15. Amendment Purpose The purpose of this amendment is to obligate Year 2 funding. COMMERCE, defined as the Department of Commerce, and the Grantee, as defined above, acknowledge and accept the terms of this Grant as Amended and attachments and have executed this Grant Amendment on the date below to start as of the date and year referenced above. The rights and obligations of both parties to this Grant as Amended are governed by this Grant Amendment and the following other documents incorporated by reference: Grant Terms and Conditions including Attachment A — Scope of Work; Attachment B — Budget; and Grantee's Original Application for funding. A copy of this Grant Amendment shall be attached to and made a part of the original Grant between COMMERCE and the Grantee. Any reference in the original Grant to the "Grant77 shall mean the "Grant as Amended". FOR GRANTEE FOR COMMERCE Cindy Guertin -Anderson, Assistant Director Signature SuziFode Date Name Director APPROVED AS TO FORM ONLY BY ASSISTANT ATTORNEY GENERAL Title Approved APPROV41- ON FILE as to torm: Date (Printe 4 R E E V E D (Signed) 2 2024 Deputy Prosecuting Attorneysty Date: ar 11- W I Docusign Envelope ID: BC07COAl-6F6C-4707-AOA4-F4B1 EAA9E877 wioDl IIIDi='mI tmerls of kv t. of birterce Amendment Grant Number: 24-31219-010 Amendment Number: A Washington State Department of Commerce Community Services Division Office of Crime Victims Advocacy SFY2024-2025 Crime Victim Service Center Grant 1. Grantee 2. Grantee Doing Business As (optional) GRANT, COUNTY OF New Hope PO BOX 37 EPHRATA WA 98823-0037 3. Grantee Representative 4. COMMERCE Representative Suzi Fode Helena Schlegel Director Program Coordinator sfode@grantcountywa.gov (360) 725-2987 (509) 764-8402 helena.schlegel@commerce.wa.gov 5. Original Grant Amount 6. Amendment Amount 7. New Grant Amount (and any previous amendments) $2247999.00 $453,999.00 $2297000.00 8. Amendment Funding Source 9. Amend. Effective Date 10. End Date Federal: ❑ State: Z Other: ❑ N/A: ❑ 7/1 /2024 12:00:00 AM 06/30/2025 11. Federal Funds (as applicable) Federal Agency: ALN Number: Indirect Rate (as applicable): 12. SWV # 13. UBI # 14. UEI # SWV0002426-17 132001884 ZL6WM26K8KR5 15. Amendment Purpose The purpose of this amendment is to obligate Year 2 funding. COMMERCE, defined as the Department of Commerce, and the Grantee, as defined above, acknowledge and accept the terms of this Grant as Amended and attachments and have executed this Grant Amendment on the date below to start as of the date and year referenced above. 'the rights and obligations of both parties to this Grant as Amended are governed by this Grant Amendment and the following other documents incorporated by reference: Grant Terms and Conditions including Attachment A — Scope of Work; Attachment B — Budget; and Grantee's Original Application for funding. A copy of this Grant Amendment shall be attached to and made a part of the original Grant between COMMERCE and the Grantee. Any reference in the original Grant to the "Grant" shall mean the "Grant as Amended". FOR GRANTEE FOR COMMERCE DocuSigned by: DocuSigned by: sw�( Cin y ue in-. riderson, Assistant Director Signa ure Suzi Fode 8/27/2024 1 2:26 PM PDT Date Name Director APPROVED AS TO FORM ONLY BY ASSISTANT ATTORNEY GENERAL Title APPROVAL ON FILE 8/27/2024 12:08 PM PDT Date Docusign Envelope ID: BC07COA1-6F6C-4707-AOA4-F4B 1 EAA9E877 This Grant is amended as follows: Special Terms and Conditions 1. COMPENSATION COMMERCE shall pay an amount not to exceed $453,999.00 for the performance of all things necessary for or incidental to the performance of work as set forth in Attachment A - Scope of Work. Grantee's' compensation for services rendered shall be in accordance with Attachment B — Budget. Transfer of funds between line item budget categories must be approved by the Office of Crime Victims Advocacy (OCVA) program staff. A cumulative amount of these transfers exceeding ten (10) percent of the total program budget shall be subject to justification and negotiation between the Grantee and OCVA, including approval from the Grantee's signature authority and the relevant OCVA Section Manager. Payment will be on a reimbursement basis only. Travel expenses incurred or paid by Grantee shall be reimbursed at a rate not to exceed the current state rate and in accordance with the State of Washington Office of Financial Management Travel Regulations. Current travel rates may be accessed at: https://ofm.wa.gov/sites/default/files/public/resources/travel/colormap.pdf ATTACHMENT B Budget Budget CVSC Total Salaries $2681281.75 $268,281.75 Benefits $105,342.32 $1055342.32 Goods and Services $805374.93 $80)374.93 [Non - Match Total $4531999.00 $453)999.00 ALL OTHER TERMS AND CONDITIONS OF THIS GRANT REMAIN IN FULL FORCE AND EFFECT. 2 Docusign Envelope ID: BC07COA1-6F6C-4707-AOA4-F4B1EAA9E877 A Q_Wj Wash*ngton State LA k I 'to Department of 44 4 0. DocuSign Contract Review and Routing Form Office of Crime Victims Advocacy ... ..... .... R: u lewe 'haVe. D"Me Helena Schlegel Grant Proofed documents Manager 8/7/2024 12:41 PM PDT Section Matched approved Obligation Summary Nicky Gleason Manager Memo and Allocation Spreadsheet 8/12/2024 110:23 AM PDT Reviewed entry and coding in CMS Correct template from IntraCOM has (Assistant) been used Trisha Smith Managing OR 8/14/2024 19:59 PM PDT Director Documentation has been included with reason for exception Updated 5/25/2022 DocuSign Certificate Of Envelope Id: BC07COAl 6F6C4707AOA4F4B 1 EAA9E877 Status: Completed Subject: OCVA - SFY24-25 CVSC Amendment A 24-31219-010 Division: Community Services and Housing Program: OCVA ContractNumber: 24-31219-010 DocumentType: Contract Amendment Source Envelope: Document Pages: 3 Signatures: 2 Envelope Originator: Certificate Pages: 5 Initials: 0 Lupe Mendoza AutoNav: Enabled 1011 Plum Street SE Envelopeld Stamping: Enabled MS 42525 Time Zone: (UTC-08:00) Pacific Time (US & Canada) Olympia, WA 98504-2525 lupe.mendoza@commerce.wa.gov IP Address: 198.239.10.137 Record Tracking Status: Original 8/7/2024 10:55.02 AM Security Appliance Status: Connected Storage Appliance Status: Connected Signer Events Helena Schlegel helena.schlegel@commerce.wa.gov Security Level: Email, Account Authentication (None), Login with SSO Electronic Record and Signature Disclosure: Not Offered via DocuSign Nicky Gleason nicky.gleason@commerce.wa.gov Washington State Department of Commerce Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Trisha Smith trisha.smith@commerce.wa.gov AMD WA State Dept of Commerce Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Suzi Fode sfode@grantcountywa.gov Director Grant County Security Level- Email, Account Authentication (None) Electronic Record and Signature Disclosure: Holder: Lupe Mendoza Location: DocuSign Iupe.mendoza@commerce.wa.gov Pool: StateLocal Pool: Washington State Department of Commerce Location: DocuSign Signature Timestamp Completed Sent: 8/7/2024 11:05:30 AM Viewed: 8/7/2024 2:40:47 PM Signed: 8/7/2024 2:41:00 PM Using IP Address: 147.55.149.242 Completed Sent: 8/7/2024 2:41:02 PM Viewed: 8/12/2024 10:23:09 AM Signed: 8/12/2024 10:23:16 AM Using IP Address: 198.239.106.174 Completed Sent: 8/12/2024 10:23:18 AM Viewed: 8/14/2024 9:59:20 PM Signed: 8/14/2024 9:59:43 PM Using IP Address: 198.239.106.129 oocusigned by: Sent: 8/14/2024 9:59:45 PM Sj�b Viewed: 8/15/2024 3:42:43 PM 9E23A7B2935D493. Signed: 8/27/2024 2:08:47 PM Signature Adoption: Pre -selected Style Using IP Address: 216.215.12.5 Signer Events Signature Timestarn _ p Accepted: 7/22/2021 9:54:00 AM ID: f9391 c86-5931-4a2b-9328-a83d20f3b27c Cindy Guertin -Anderson Cindy.guertin-anderson@commerce.wa.gov Assistant Director, Commerce Washington State Department of Commerce Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign DocuSigned by; 8AMC98618494EF... Signature Adoption: Pre -selected Style Using IP Address: 198.238.29.22 Sent: 8/27/2024 2:08:49 PM Viewed: 8/27/2024 2:24:29 PM Signed: 8/27/2024 2:26:14 PM In Person Sr ner Events 9 _ Si na ture J_ , _ . . = Tsmestam p Edit' rD alive Events' o rY _ Status' =, . Timestam A ant Delwe _ Events , =�� :g , �`y �� Status Tim Times Inter mediary De ivery Events Status; Timestarn Certified Delive EventsStatus ;. r`Y _� _ Timestam . p, Carbon Copy Events Status' Timestam p; , Witness Events. �� Signatures _ Times ta�m p Notary Events Signature Timestamp Envelop e S mm p u ary Events Status . Tlmestamps Envelope Sent Certified Delivered Signing Complete. Completed Hashed/Encrypted Security Checked Security Checked Security Checked 8/7/2024 11:05:30 AM 8/27/2024 2:24:29 PM 8/27/2024 2:26:14 PM 8/27/2024 2:26:14 PM Payment Events Status Timestamps Electronic Record and Signature --,-Disclosure