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HomeMy WebLinkAboutAgreements/Contracts - Juvenile (002)GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: Juvenile Court & Youth Services DATE: 06/28/2024 REQUEST SUBMITTED BY. Suhail Palacios CONTACT PERSON ATTENDING ROUNDTABLE: SUIIaII Palacios CONFIDENTIAL INFORMATION: E]YES ®NO PHONE: 509-754-5690 Ext. 4430 Ap j i '111 11 ii I I a Eizam U111111 - ®Agreement / Contract EIAP Vouchers -- OAppointment / Reappointment L 11ARPA Related 7 Bids / RFPs / Quotes Award 7Bid Opening Scheduled El Boards/ Committees El Budget ElComputer Related El County Code 7 Emergency Purchase 1:1 Employee Rel. OFacilities Related ❑ Financial 7 Funds 7 Hearing El Invoices / Purchase Orders F Grants ® Fed/State/County ❑Leases EIMOA / MOU 7 Minutes E Ordinances El Out of State Travel 7 Petty Cash 7 Policies 1:1 Proclamations El Request for Purchase 7 Resolution 1:1 Recommendation El Professional Serv/Consultant 0 Support Letter E]Sur plus Req. ❑Tax Levies ❑Thank You's ElTax Title Property 7WSLCB I am requesting your permission to electronically DocuSign the Amendment Number A contract number: S24-31219-064 with the Department of Commerce, Office of Crime Victims Advocacy specifically for the Crime Victim Service Center (CVSC) Comprehensive Service Grant, The term of this contract is from July 1st, 2024, to June 30th, 2025. If necessary, was this document reviewed by accounting? ❑ YES FwR NO If necessary, was this document reviewed by legal? 7m YES 0 NO DATE OF ACTION: APPROVE: DENIED ABSTAIN D1: z D2: D3: DEFERRED OR CONTINUED TO: 4/8/24 "IV f e &w"" 0" avaowwdO 4, "wa/ GRANT COUNTY JUVF-k-NIL R COURT & YOUTH SERVIC E-S, P.O. Box 818-1303 Abel Road,, Ephrata, WN 98-923 phone (509) 754-56901 eFax 1-509- 754-5797 August 23, 2024 Board of Grant County Commissioners PO Box 37 Ephrata, WA 98823 RE: Signature for Amendment Number A, Grant Number: S24-31219-064 Dear Board of County Commissioners: Please see attached amendment contract for review and approval. Contractor: WA State Department of Commerce, Office of Crime Victims Advocacy (OCVA) for Specific Crime Type Crime Victim Service Center (CVSC) Comprehensive Service Grant Term of Contract: July 11, 2024 to June 30th,, 2025. Purpose: To obligate Year 2 funding. I am requesting permission to Docu-Sign electronically with the contractor. Thank you for considering my request. Suhail Palacios, Juvenile Court Administrator Grant County Juvenile Court & Youth Services "It ea em Maizoa �do% w~waeo 4 w&&, A"W" d"9e �" "arme, at- led "Wd "d am, pod&6I fo WA State Department of Commerce, Office of Crime Victims Advocacy Specific Crime Type Crime Victim Service Center CVSC Amendment Number A Grant:S24-31219-064 ATTEST: Approved as to form: Rebekah "KA61o"pr, WSBA #53257 Civil Deputy Prosecuting Attorney Date: ?'/Z TIZ3; t 10 Danny E. "4tone, Vice -Chair p Ice" Y t Rob Jones, Member Docusign Envelope ID: 3BE8BDE1-El 12-4BBE-9984-73A2460D411D Deoartment of C+I't Amendment Grant Number: S24-31219-064 Amendment Number: A Washington State Department of Commerce Community Services Division Office of Crime Victims Advocacy SFY 2024-2025 Specific Crime Type Crime Victim Service Center (CVSC) Comprehensive Services Grant 1. Grantee 2. Grantee Doing Business As (optional) GRANT, COUNTY OF Grant County Juvenile Court PO BOX 37 EPHRATA WA 98823-0037 3. Grantee Representative 4. COMMERCE Representative Suhail Palacios Jenna Osterman Juvenile Court Administrator Program Coordinator spalacios@grantcountywa.gov (360) 725-2884 (5D9) 754-5694 Ext 4330 jenna.osterman@commerce.wa.gov 5. Original Grant Amount 6. Amendment Amount 7. New Grant Amount (and any previous amendments) $125,000.00 $212,614.00 $87,614.00 8. Amendment Funding Source 9. Amend. Effective Date 10. End Date Federal: ❑ State: ® 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 # SWV0002426-08 132001884 ZL6W M26 K8 KR5 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: sv"� Cin y t ue in- riderson, Assistant Director Signa ure Suhail Palacios 9/6/2024 1 4:24 PM PDT Date Name Juvenile Court Administrator APPROVED AS TO FORM ONLY BY ASSISTANT ATTORNEY GENERAL Title APPROVAL ON FILE 9/6/2024 1 3:54 PM PDT Date This Grant is amended as follows: Docusign Envelope ID: 3BE8BDE1 -El 12-4BBE-9984-73A246OD41 1 D Special Terms and Conditions 1. COMPENSATION COMMERCE shall pay an amount not to exceed $212,614.00 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:Hofm.wa.gov/sites/default/files/public/resources/travel/colormar).pdf ATTACHMENT B Budget Budget CVSC Total Salaries $119,422.43 $119,422.43 Benefits $42M57.60 $42)057.60 Goods and Services $51,133.97 $51 , 133.97 Non -Match Total $212,614.00 $212,614.00 ALL OTHER TERMS AND CONDITIONS OF THIS GRANT REMAIN IN FULL FORCE AND EFFECT. 2 Docusign Envelope ID: 3BE8BDE1 -E 1 12-4BBE-9984-73A246OD41 1 D DocuSign Contract Review and Routing Form Office of Crime Victims Advocacy V, d b'' h Jenny Osterman Grant Manager Proofed documents 8/8/2024 112:18 PM PDT Section Matched approved Obligation Summary Nicky Gleason Manager Memo and Allocation Spreadsheet 8/12/2024 19:55 AM PDT Reviewed entry and coding in CMS Correct template from IntraCOM has (Assista nt) been used Trisha Smith Managing OR 8/14/2024 110:05 PM PDT Director Documentation has been included with reason for exception Reviewed by: Title: I verify that I have: Date: Grant Checked that Grantee has completed all Manager required certifications and/or forms Updated 5/25/2022 DocuSign Certificate Of Completion Envelope Id: 3BE813DE1 El 124BBE998473A2460D411 D Status: Completed Subject: OCVA - CVSC Amendment A S24-31219-064 Division: Community Services and Housing Program: OCVA ContractNumber: S24-31219-064 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: 198.239.10.186 Record Tracking Status: Original Holder: Lupe Mendoza Location: DocuSign 8/8/2024 9:19:39 AM Iupe.mendoza@commerce.wa.gov Security Appliance Status: Connected Pool: StateLocal Storage Appliance Status: Connected Pool: Washington State Department of Commerce Location: DocuSign Signer Events ;Signature Timestamp Jenna Osterman Completed Sent: 8/8/2024 9:26:25 AM jenna.osterman@commerce.wa.gov Viewed: 8/8/2024 12:18:24 PM Security Level: Email, Account Authentication Signed: 8/8/2024 12:18:29 PM (None), Login with SSO Using IP Address: 198.239.10.249 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 Suhail Palacios spalacios@grantcountywa.gov Juvenile Court Administrator Grant County Juvenile Court and Youth Services Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Completed Sent: 8/8/2024 12:18:31 PM Viewed: 8/12/2024 9:55:44 AM Using IP Address: 198.239.106.174 Signed: 8/12/2024 9:55:58 AM Completed Sent: 8/12/2024 9:56:01 AM Viewed: 8/14/2024 10:05:14 PM Using IP Address: 198.239.106.129 Signed: 8/14/2024 10:05:25 PM Es DocuSigned by: Sent: 8/14/2024 10:05:27 PM tVU, PdA,66S Viewed: 8/21 /2024 3:33:04 PM s73A1FE,,,B1418... Signed: 9/6/2024 3:54:09 PM Signature Adoption: Pre -selected Style Using IP Address: 216.215.12.54 Sig her Events Si nature g , .: Timestamp Accepted: 8/21/2024 3:33:03 PM D: 53864e7e-342f-46c9-a 12c-1 fed66c57dOb 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; 44r Za1L 6AHCM618494EF... Signature Adoption: Pre -selected Style Using IP Address: 198.239.10.240 Sent: 9/6/2024 3:54:11 PM Viewed: 9/6/2024 4:22:17 PM Signed: 9/6/2024 4:24:26 PM In Person Si ner. Events g Si nature 9 Timestam p Editor DeliverEvents - Y v Status Timestam p Agent Delive Events ry Status`: f _ Timestam . p,. Intermedia Delive Events rJ/ Status Times amp,.-. Certified Delive Events ry Status :� Timestam _ p Carbon Copy Events 1Status� Timestamps Witness Events -:Signature Timestamps Notary Events Signature Timestamp.� Envelope Summary Events Status` Timestamps Envelope Sent Certified Delivered Signing Complete Completed Hashed/Encrypted Security Checked Security Checked Security Checked 8/8/2024 9:26:25 AM 9/6/2024 4:22:17 PM 9/6/2024 4:24:26 PM 9/6/2024 4:24:26 PM Payment Events Status Timestamps,:-:-. Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 8/11/2020 4:44:12 PM Parties agreed to: Suhail Palacios ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Washington State Department of Commerce (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to `I agree to use electronic records and signatures' before clicking 'CONTINUE' within the DocuSign system. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.15 per -page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Washington State Department of Commerce: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: docusign@commerce.wa.gov To advise Washington State Department of Commerce of your new email address To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at docusigngeommerce.wa.gov and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address. If you created a DocuSign account, you may -update it with your new email address through your account preferences. To request paper copies from Washington State Department of Commerce To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to docusign@comi-nerce.wa.gov and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any. To withdraw your consent with Washington State Department of Commerce To inform us that you no longer wish to receive fixture notices and disclosures in electronic format you may: i. decline to sign a document from within your signing session, and on the subsequent page, select the check -box indicating you wish to withdraw your consent, or you may; ii. send us an email to docusign@commerce.wa.gov and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.. Required hardware and software The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: htt-ps:Hsu-p-port.docusign.com/guide.s/sianer-guide- s.laning-system-requirements. Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check -box next to 'I agree to use electronic records and signatures' before clicking 'CONTRUE' within the DocuSign system. By selecting the check -box next to 'I agree to use electronic records and signatures', you confirm that.* You can access and read this Electronic Record and Signature Disclosure; and You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and. Disclosure to a location where you can print it, for future reference and access; and Until or unless you notify Washington State Department of Commerce as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by Washington State Department of Commerce during the course of your relationship with Washington State Department of Commerce.