HomeMy Public PortalAboutTHE CHILDREN'S CLINIC SUBRECIPIENT AGREEMENT
THIS AGREEMENT (herein "Agreement"), is made and entered into this 1st day
of July, 2006, by and between the CITY OF CARSON (herein "City"), a municipal
corporation, and THE CHILDREN'S CLINIC, a California non-profit corporation
("Subrecipient" or Provider").
RECITALS
WHEREAS, the City has entered into various funding agreements with the United
States Department of Housing and Urban Development ("HUD"), which agreements
provide funds ("CDBG Funds" to the City under the Federal Housing and Community
Development Act of 1974 (42 U.S.C. Section 5301 et seq.), as amended from time to
time (the "Act"), and the regulations promulgated thereunder (24 C.F.R. Section 570 et
seq.; "Regulations"); and
WHEREAS, the Act provides that the City may grant the CDBG Funds to
nonprofit organizations for certain purposes allowed under the Act; and
WHEREAS, the Provider is a nonprofit organization which operates a program
which is eligible for a grant of CDBG funds and the City desires to assist in the operation
of the program by granting CDBG funds to the Provider to pay for all or a portion of
those costs incurred in operating the program permitted by the Act and the Regulations
on terms and conditions more particularly set forth herein; and
WHEREAS, this Agreement is not intended to, nor shall it be construed as,
creating any rights in any third parties not a party to this contract, but rather this
Agreement is intended to assist Provider in its function of providing cost effective
services to the community it serves, as described in this Agreement.
NOW, THEREFORE, the parties hereto agree as follows:
1.0 SERVICES OF PROVIDER.
1.1 Scope of Services. Provider agrees to provide to City all of the
Services specified and detailed in its application for funding and Exhibit "A", attached
hereto and incorporated herein by reference. Provider represents and warrants to City
that it is able to provide, and will use funds granted by the City to provide the services as
represented in the Provider's application for funding. City-provided funds shall be used
only for those purposes specified in such application.
1.2 Special Requirements. Additional terms and conditions of this
Agreement, if any, which are made a part hereof, are set forth in Exhibit "B" (Special
Requirements), incorporated herein by reference.
1.3 Standard of Care. Subrecipient warrants that all services will be
performed in a competent, professional, and satisfactory manner. As a material
inducement to City to enter into this Agreement, Subrecipient hereby represents and
warrants that it has the experience and skills necessary to undertake the services to be
provided herein.
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1.4 Compliance with Laws. All services rendered hereunder by
Subrecipient shall be provided in accordance with all ordinances, resolutions, statutes,
rules, and regulations of City and any federal, state or local governmental agency having
jurisdiction at the time service is rendered.
1.5 Reports. No later than ten (10) days prior to any payment date
specified in Section 2.2, within ten (10) days following the termination of this Agreement,
and at such other times as the Contract Officer shall request, Provider shall give the
Contract Officer a written report describing the services provided during the period of
time since the last report and accounting for the specific expenditures of contract funds
hereunder, if applicable. At the times and in the manner required by law, the Provider
shall provide to the City, the Department of Housing and Urban Development, the
Comptroller General of the United States, any other individual or entity, and/or their duly
authorized representatives, any and all reports and information required for compliance
with the Act and the Regulations.
1.6. Financial Reporting. Any Provider receiving of due to receive
$20,000.00 or more from the City during the Fiscal Year (July 1, 2006 through June 30,
2007) shall provide to City a financial statement prepared by a recognized accounting
firm approved by or satisfactory to City's Chief Financial Officer completed within the
most recent twelve (12) months showing the Provider's financial records to be kept in
accordance with generally accepted accounting standards. The report shall include a
general ledger balance sheet which identifies revenue sources and expenses in
sufficient detail to demonstrate contract compliance and be balanced to bank
statements. Any organization receiving or due to receive less than $20,000.00 in the
current fiscal year from the City shall provide a copy of the organization's most recent
charitable trust report to the Attorney General, or other financial information satisfactory
to the City's Chief Financial Officer. The financial information provided for in this
paragraph shall be furnished not later than January 31st of the current fiscal year.
2.0 COMPENSATION.
2.1 Contract Sum. The City shall pay to the Provider on a
reimbursable basis for its services a sum not to exceed SIX THOUSAND FIVE
HUNDRED FIFTY-FIVE DOLLARS AND NO CENTS ($6,555.00) ("Contract Sum"), in
accordance with the Budget attached hereto in Exhibit "C", which shall constitute full
and complete reimbursement for the implementation of this Agreement for the entire
award year. The Provider shall submit to the City monthly statements on reimbursable
expenditures pursuant to the attached Budget along with pertinent supporting
documentation. The City shall promptly review the monthly expenditure statements and,
upon approval, reimburse the Provider its authorized operating costs.
2.2 Payroll Records. In cases where the contract sum will reimburse
payroll expenses as part of operations, the Provider will establish a system of
maintaining accurate payroll records which will track daily hours charged to the project
by the Provider's respective employees, as set forth in OMB Circular A-122 Attachment
B.6
2.3 Draw Downs. Failure by provider to request reimbursement or
encumbrance of at least 25% of the total grant by the end of each fiscal year quarter
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(September 30, December 30, March 31, and June 30) shall result in the immediate
forfeiture of 25% of the total grant, unless this requirement is waived by the Contract
Officer.
2.4 Default. In the event Provider is in default under the terms of this
Agreement, City shall have no obligation to continue compensating Provider for any
work performed after the date of default.
2.5 Completion of Work. City reserves the right to withhold 10% of
the contract amount on a completed Program until a Certificate of Completion is issued
by City.
3.0 COORDINATION OF THE WORK.
3.1 Representative of Provider. The following principals of Provider
are hereby designated as being the principals and representatives of Provider
authorized to act on its behalf with respect to the work specified herein and make all
decisions in connection therewith:
Dr. Elisa Nicholas, Executive Director
Shannon Cisch, Director of Development
Diane Nichols, Development Associate
3.2 Contract Officer. The Contract Officer shall be such person as
may be designated by the City Manager of City.
3.3 Prohibition Against Subcontracting or Assignment. Provider shall
not contract with any other entity to perform in whole or in part the services required
hereunder without the express written approval of the City. Neither this agreement nor
any interest herein may be assigned or transferred, voluntarily or by operation of law,
without the prior written approval of the City.
3.4 Independent Contractor. Neither the City nor any of its employees
shall have any control over the manner, mode, or means by which Provider, its agents or
employees, perform the services required herein, except as otherwise set forth herein.
Provider shall perform all services as required herein as an independent contractor of
City, and shall remain at all times as to City a wholly independent contractor with only
such obligations as are consistent with that role. Provider shall not at any time or in any
manner represent that it or any of its agents or employees are agents or employees of
City.
4.0 INSURANCE AND INDEMNIFICATION.
4.1 Insurance. The Provider shall procure and maintain, at its cost,
and submit concurrently with its execution of its agreement, public liability and property
damage insurance against claims for injuries against persons or damages to property
resulting from Provider's acts or omissions arising out of or related to Provider's
performance under this Agreement. Provider shall also carry Workers' Compensation
Insurance in accordance with State Workers' Compensation laws. Such insurance shall
be kept in effect during the term of this Agreement and shall not be cancelable nor
materially changed without thirty (30) days prior written notice to City, and shall be
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issued by an insurer rated "A" or better in the most recent edition of Best's Insurance
Guide. A certificate evidencing the foregoing and naming the City as an additional
insured shall be delivered to and approved by the City prior to commencement of the
services hereunder. The procuring of such insurance shall not be construed as a
limitation of Provider's obligation to indemnify the City, its officers, or employees. The
amount of insurance required hereunder shall be as required by the Contract Officer, but
shall not be less than One Million Dollars ($1,000,000).
4.2. Indemnification. The Provider shall defend, indemnify and hold
harmless the City, its officers and employees, from and against any and all actions,
suits, proceedings, claims, demands, losses, costs, and expenses, including legal costs
and attorneys' fees, for injury to or death of person(s), for damage to property (including
property owned by the City) arising out of or related to Contractor's performance under
this Agreement, except for such loss as may be caused by City's own negligence or that
of its officers or employees.
5.0 DISCRIMINATION, TERMINATION, AND ENFORCEMENT.
5.1 Covenant Against Discrimination. Provider covenants that, by and
for itself, its heirs, executors, assigns, and all persons claiming under or through them
that there shall be no discrimination against or segregation of any person or group of
persons on account of race, religious creed, color, national origin, ancestry, physical
disability, mental disability, medical condition, pregnancy, marital status, age, sexual
orientation, or any other basis pertaining to a Protected Characteristic under applicable
federal, state, or local law.
5.2 Term. Unless earlier terminated in accordance with Section 6.3 of
this Agreement, this Agreement shall continue in full force and effect until completion of
the services, but not exceeding one (1) year from the date hereof.
5.3 Termination Prior to Expiration of Term. Either party may
terminate this Agreement at any time, with or without cause, upon thirty (30) days'
written notice to the other party. Upon receipt of the notice of termination the Provider
shall immediately cease all services hereunder except as may be specifically approved
by the Contract Officer. Provider shall be entitled to compensation for all services
rendered prior to receipt of the notice of termination and City shall be entitled to
reimbursement for any services that have been paid for but not rendered.
6.0 MISCELLANEOUS PROVISIONS.
6.1 Conflicts of Interest. Provider, its agents and employees shall
comply with applicable federal, state, and local laws and regulations governing conflict of
interest. Provider covenants that it presently has no interest and shall not acquire any
interest, direct or indirect, that may be affected by the services to be performed by
Provider under this Agreement, or that would conflict in any manner with the
performance of its services hereunder. Provider further covenants that, in performance
of this Agreement, no person having any such interest shall be employed by it.
Furthermore, Provider shall avoid the appearance of having any interest that would
conflict in any manner with the performance of its services pursuant to this agreement.
Provider agrees not to accept any employment or representation during the term of this
Agreement that is or may likely make Provider "financially interested" (as provided in
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California Government Code Sections 1090 and 87100) in any decision made by City on
any manner in connection with which Provider has been retained pursuant to this
Agreement.
6.2 Warranty and Representation of Non-Collusion. No official,
officer, or employee of the City has any financial interest, direct or indirect, in this
Agreement, nor shall any official, officer, or employee of the City participate in any
decision relating to this Agreement which may affect his/her financial interest or the
financial interest of any corporation, partnership, or association in which (s)he is directly
interested, or in violation of any state or municipal statute or regulation. The
determination of "financial interest" shall be consistent with State law and shall not
include interest found to be "remote" or"non interest" pursuant to California Government
Code Sections 1091 and 1091.5. Provider warrants and represents that (s)he/it has not
engaged in any act(s), omission(s), or other conduct or collusion that would result in the
payment of any money, consideration, or other thing of value to any third party including,
but not limited to, any City official, officer, or employee, as a result or consequence of
obtaining or being awarded any agreement. Provider is aware of and understands that
any such act(s), omission(s), or other conduct resulting in the payment of money,
consideration, or other thing of value will render this Agreement void and of no force and
effect.
Provider Representative Initials
6.3. Non-Waiver of Terms, Rights and Remedies. Waiver by either
party of any of the conditions of performance under this Agreement shall not be a waiver
of any other condition of performance under this Agreement. In no event shall the
making by City of any payment to Provider constitute or be construed as a waiver by City
of any breach of covenant, or any default that may then exist on the part of Provider, and
the making of any such payment by City shall in no way impair or prejudice any right or
remedy available to City with regard to such breach or default.
6.4 Attorney's Fees. In the event that either party to this Agreement
shall commence any legal action or proceeding to enforce or interpret the provisions of
this Agreement, the prevailing party in such action or proceeding shall be entitles to
recover its costs of suit, including reasonable attorney's fees. The venue for litigation
shall be Los Angeles County.
6.5 Notice. Any notice, demand, request, document, consent,
approval, or communication either party desires or is required to give to the other party
shall be in writing and either served personally or sent by prepaid, first class mail to the
address set forth below, or such other addressed as may from time to time be
designated by mail.
City: Keith Bennett
Community Development Block Grant Coordinator
City of Carson
1 Civic Plaza Drive, Suite 200
Carson, California 90745
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With a Copy to: Aleshire &Wynder, LLP
18881 Von Karman Avenue, Suite 400
Irvine, California 92612-1009
Attention: Dawn C. Honeywell, Esq.
Provider: Dr. Elisa Nicholas
Executive Director
The Children's Clinic
2801 Atlantic Avenue
Long Beach, California 90806
6.6 Exhibits. All documents referenced as exhibits in this Agreement
are hereby incorporated into this Agreement as if set forth fully herein.
6.7 Entire Agreement. This Agreement, and any other documents
incorporated herein by specific reference, represents the entire and integrated
agreement between City and Provider. This Agreement supersedes all prior oral or
written negotiations, representations, or agreements. This Agreement may not be
amended, nor any provision outreach hereof waived, except in a writing signed by the
parties that expressly refers to this Agreement.
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IN WITNESS WHEREOF, the parties have executed this Agreement on the date
first above written.
CITY OF CARSON, CALIFORNIA
Dated:
By:
Jim Dear, Mayor
ATTEST:
Helen S. Kawagoe, WIC. City Clerk
APPROVED AS TO FORM:
Aleshire &Wynder, LLP
(_7 ifte,,,-4,rtA-t(f&
City Attorney
PROVIDER:
THE CHILDREN'S CLINIC
By:
Name .isc{ Zcrcito%S'
Title: a,E0
By:
Name:
Title:
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Corporations require two NOTARIZED signatures by attaching a California All-Purpose
Acknowledgement; one from each of the following categories:
A. Chairman of Board, President or any Vice President; AND
B. Secretary, Assistant Secretary, Treasurer, Assistant Treasurer, or Chief
Financial Officer.)
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SCOPE OF SERVICES
EXHIBIT "A"
1. Provider shall utilize City's CDBG funds to provide medical services for
medically under-served children and their families residing in Carson. The
term "medically under-served" shall refer to children whose families do not
have adequate medical insurance coverage or are otherwise unable to pay
for services rendered by Provider.
2. Services rendered by provider shall consist of primary health care services
that include comprehensive and continuous care, as well as preventative
health care. Provider shall endeavor to provide such care in a manner that is
both culturally and linguistically appropriate.
3. Costs for which Provider shall be reimbursed from the CDBG funds shall be
limited to the costs of medical and administrative personnel associated with
the provision of the medical services provided in (2) above; pharmaceutical,
medical, office and other operating supplies associated with the
aforementioned medical services; space rent and utilities costs for Provider's
medical clinic; patient transportation costs, insurance and licensing fees, and
copying and printing charges.
4. The primary location for services provided in accordance with this Agreement
shall be Provider's clinic located at 2801 Atlantic Avenue, Long Beach,
California, but shall also include facilities operated by entities with which
Provider is affiliated, and other facilities to which Provider will have referred
its clients.
5. Provider anticipates providing medical services to approximately 150 to 250
Carson residents consisting of approximately 400 to 600 patient contacts.
6. Recognizing that the CDBG program exists to serve persons of
predominantly low and moderate income, Provider shall ensure that at least
fifty-one per cent (51%) of clients meet the standard of low and moderate
income as determined by the City. Provider shall verify participants' total
household income by requesting to see documentation that provides income
information for all household members, and shall keep records reflecting the
verification of such income on file and available for inspection by
representatives of City and/or HUD. Provider shall also, to the extent
practicable, obtain information on the racial, ethnic, and female-headed
household status of clients. Provider shall report the income, race, ethnicity,
and female-headed household status of clients to City in accordance with
Section 3, Program Evaluation and Review, and Section 4, Reporting
Requirements, of the attached Exhibit"B", Special Requirements.
[END OF EXHIBIT"Al
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EXHIBIT "B"
SPECIAL REQUIREMENTS
1. Compliance with Laws. All services rendered hereunder by
Subrecipient shall be provided in accordance with all ordinances, resolutions,
statutes, rules and regulations of City and any federal, state, or local governmental
agency having jurisdiction at the time service is rendered. This Agreement is subject
to and incorporates the terms of the Housing and Community Development Act of
1974, as amended; 24 Code of Federal Regulations ("C.F.R.") Chapter V, Part 570;
City's CDBG Program Guidelines; and all amendments or successor regulations or
guidelines thereto.
2. Federal Contracting Provisions. Subrecipient agrees to comply with
the following federal requirements in the performance of this Agreement:
A. Executive Order 11246, as amended by Executive Orders 11375
and 12086, and implementing regulations at 41 C.F.R. Chapter 60, which requires
that during the performance of this Agreement, Subrecipient agrees not to
discriminate against any employee or applicant for employment because of race,
religion, sex, color, or national origin. Subrecipient shall consider all applicants
without respect to their race, religion, sex, or national origin with respect to the
following without limitation: employment, upgrading, demotion, or transfer;
recruitment or recruitment advertising; layoff or termination; rates of pay or other
forms of compensation; and selection for training, including apprenticeship.
Subrecipient agrees to post in conspicuous places, available to employees and
employment applicants, notices setting forth the provisions of this nondiscrimination
clause.
B. In its solicitations or advertisements for employees, Subrecipient
shall state that all qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, or national origin.
C. The restrictions against discrimination as required by Executive
Order 11063, as amended by Executive Order 12259 and implementing regulations
at 24 C.F.R. Part 107.
D. Section 3 of the Housing and Urban Development Act of 1968, as
amended, 12 U.S.C. 1701 et seq., which requires that to the greatest extent feasible,
opportunities for training and employment be given to lower income residents of the
project area and contracts for work in connection with the project be awarded to
business concerns that are located in, or owned in substantial part by, persons
residing in the project area.
E. Title VI of the Civil Rights Act of 1964, and Section 109 of the
Housing and Community Development Act of 1974, which provides that no person
shall, on the grounds of race, color, national origin, or sex, be excluded from
participation in, be denied the benefits of, or be subjected to discrimination under any
program or activity receiving federal financial assistance.
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F. Section 504 of the Rehabilitation Act of 1973 (P.L. 93-112), as
amended, and implementing regulations;
G. The Age Discrimination Act of 1975 (P.L. 94-135), as amended,
and implementing regulations;
H. The relocation requirements of Title II and the acquisition
requirements of Title III of the Uniform Relocation Assistance and Real Property
Acquisition Policies Act at 24 C.F.R. Part 42;
I. The restrictions prohibiting the use of funds for the benefit of a
religious organization or activity as set forth in 24 C.F.R. 570.200(j);
J. The labor standard requirements as set forth in 24 C.F.R. Part
570, Subpart K and HUD regulations issued to implement said requirements.
K. The Program Income requirements as set forth in 24 C.F.R.
570.504(c) and 570.503(b)(8);
L. The Subrecipient is to carry out each activity in compliance with all
Federal laws and regulations described in 24 C.F.R. 570, Subpart K, except that the
Subrecipient does not assume the City's environmental responsibilities as described
at 24 C.F.R. 570.604; nor does the Subrecipient assume the City's responsibility for
initiating the review process under the provisions of 24 C.F.R. Part 52;
M. Executive Order 11988 relating to the evaluation of flood hazards
and Executive Order 11988 relating to the prevention, control, and abatement of
water pollution;
N. The flood insurance purchase requirement of Section 102(a) of
the Flood Disaster Protection Act of 1978 (P.L. 93-234);
O. The regulations, policies, guidelines and requirements of 24 CFR
570; the "Common Rule," 24 C.F.R. Part 85 and Subpart J; OMB Circular Nos. A-
102, Revised, A-87, A-110 and A-122 as they relate to the acceptance and use of
federal funds under the federally assisted program;
P. Title VII of the Civil Rights Act of 1968 (P. L. 90-284), as
amended;
Q. The lead-based paint requirements of 24 C.F.R. Part 35 issued
pursuant to the Lead-Based Paint Poisoning Prevention Act (42 U.S.C. 4801 et
seq.);
R. Maintain property inventory system to numerically identify HUD
purchased property and document its acquisition date as set forth in OMB Circular A-
110 Attachment N Property Management Standard 6d;
S. Reversion of asset. Upon expiration of the agreement, the
subrecipient shall transfer to the City any CDBG Funds on hand at the time of
expiration and any accounts receivable attributable to the use of CDBG Funds.
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Additionally, any real property under the subrecipient's control that was acquired or
improved in whole or in part with CDBG Funds (including CDBG Funds provided to
the subrecipient in the form of a loan) in excess of$25,000 is either:
i) Used to meet one of the national objectives
in Section 570.208 (formerly Section 570.901) until five years after
expiration of the agreement, or for such longer period of time as
determined to be appropriate by the City; or
ii) Not used in accordance with paragraph
(s)(i) above, in which event the subrecipient shall pay to the City an
amount equal to the current market value of the property less any portion
of the value attributable to expenditures of non-CDBG funds for the
acquisition of, or improvement to, the property. The payment is program
income to the City. (No payment is required after the period of time
specified in paragraph (s) of this section.)
T. Such other City, County, State, or Federal laws, rules and
regulations, executive orders or similar requirements which might be applicable.
U. City will use federal funds to pay Subrecipient for the services to
be performed under this Agreement. 31 U.S.C. Section 1352 prohibits any recipient of
subrecipient of federal funds from using such funds to influence or attempt to influence
an officer or employee of any federal agency, a Member of Congress or an officer or
employee of Congress, or any employee of a Member of Congress in connection with
the awarding of any federal contract, the making of any federal grant, the making of any
federal loan, the entering into of any cooperative agreement and the extension of,
continuation, renewal, amendment or modification of any federal contract, grant, loan or
cooperative agreement.
requests V. Every person who receives
loan or cooperative agreement from a federal agencor receives federal contract,requests grant,
loan
federal agency a commitment that would provide for the United States to insure or
guarantee a loan must file with that agency a written declaration and certify that he or
she has not made and will not make any prohibited expenditure. Further, any person
who requests or receives from a person referred to above, a subcontract under a federal
contract, a subgrant or contract under a federal grant, a contract or subcontract to carry
out any purpose for which a particular federal loan is made, or contract under a federal
cooperative agreement, is required to file a written declaration with the person who
received the federal contract, grant, loan or commitment to insure or guarantee a loan.
W. Subrecipient receives no program income as defined in 24 C.F.R.
Section 570.500(a).
3. Program Evaluation and Review. Subrecipient shall make
performance, financial, and all other records pertaining to this Agreement available to all
City and HUD personnel. City and HUD personnel may inspect and mnitor
Subrecipient's facilities and program operations, including the interview of Subrecipient's
staff and program participants. Subrecipient agrees to submit to City or HUD all data
necessary to complete the Annual Grantee Performance Report in accordance with HUD
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requirements and in the format and at the time designated by City or HUD Project
Directors or their designees.
4. Reporting Requirement. Subrecipient shall submit to City a monthly
statistical status report, using the form shown in Exhibit "D" (CDBG Monthly Status
Report) attached hereto, setting forth its activities for each reportable month. Such
report shall be filed with City not later than the 15th day of the month following the
reportable month. The monthly status report shall contain without limitation ethnic
group, income level, female-headed household status and any other data as may be
requested by City, of each person assisted and the result of such assistance. In addition
to the monthly statistical status report, Subrecipient shall, on or before July 15, 2007,
furnish City with a summary of Subrecipient's activities for the fiscal year commencing
July 1, 2006. Such summary shall include an annual statistical report.
5. Revenue Disclosure Requirement. Subrecipient shall make available
all books and records pertaining to each project or business activity that is funded by
CDBG funds under this Agreement for inspection and audit by HUD's representatives,
upon request, at any time during the term of this Agreement and for a period of 5 years
thereafter. All such books and records shall be maintained by Subrecipient at a location
in Los Angeles County. Failure of Subrecipient to comply with the requirements of this
section shall constitute a material breach for which City may terminate or suspend this
Agreement.
6. Suspension, Recovery of Funds.
A. In accordance with 24 C.F.R. Section 85.43, suspension r
termination may occur if Subrecipient materially fails to comply with any term of the
award.
B. If the funding source demands reimbursement for prior payments
to Subrecipient due to Subrecipient's failure to comply with any applicable term of this
Agreement, regulation or statute, Subrecipient shall reimburse City in the amount of
such disallowed payments.
C. The award may be terminated for convenience in accordance with
24 C.F.R. Section 85.44.
D. Upon expiration of this Agreement, Subrecipient shall transfer to
City any funds paid pursuant to this Agreement that are on hand at the time of expiration
and any accounts receivable attributable to the use of such funds.
[END OF EXHIBIT"B"]
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BUDGET
(SCHEDULE OF COMPENSATION)
EXHIBIT "C"
For the services rendered pursuant to this Agreement, the Subrecipient shall be
reimbursed a fee for medical services provided by the Subrecipient in the amount NOT
TO EXCEED the Contract Sum of SIX THOUSAND FIVE HUNDRED FIFTY-FIVE
DOLLARS AND NO CENTS ($6,555.00) during the term of this Agreement.
City shall reimburse Subrecipient for expenses, documented to the satisfaction of the
City, incurred by Subrecipient in the expense categories as detailed in the "Estimated
Budget" to be attached hereto. While the dollar amounts listed for such expense
categories in said Estimated Budget shall constitute Subrecipient's best estimate for
those expense categories, City shall not reimburse Subrecipient for expenses incurred
that do not conform to the expense categories detailed in said Estimated Budget. City
shall have the right to disapprove reimbursement for specific expenditures and expense
categories as the City finds to be ineligible under CDBG guidelines. There shall be no
changes to the expense categories as outlined in said Estimated Budget unless the
same is requested in writing by Subrecipient, and approved in writing by the City.
Provided that Subrecipient is not in default hereunder, the Subrecipient shall be
reimbursed in accordance with the terms of this Agreement within thirty (30) days after
the City's receipt of an invoice from Subrecipient.
[END OF EXHIBIT"Cl
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ATTACHMENT TO EXHIBIT C
THE CHILDREN'S CLINIC
Serving Children and Their Families
Carson Budget
2006-2007
Internal Detail
Personnel Rate
Pediatrician 6.00% 52.00 S 6,490.00
RN Nurse 5.00% 35.00 3,640.00
Medical Assistant 15.00% 14.50 4,524.00
Receptionist 15.00% 12.00 3,744.00
Administrative Personnel 5.00% 21.00 2,184.00
Total personnel S 20,582.00
Payroll Taxes&Benefits 24.00% 4,940.00
Total Personnel S 25,522.00
Other Expenses
Pharmacy 0.37% 21,000.00 S 78.00
Medical Supplies 0.37% 115,000.00 426.00
Operating&Office Supplies 0.37% 83,000.00 308.00
Rent 0.37% 124,000.00 460.00
Utilities
Telephone 0.37% 38,000.00 14100
Other 0.37% 21.000.00 78.00
Transportation 0.37% 15,000.00 56.00
Insurance 0.37% 19,000.00 70.00
Licensing fees 0.37% 4,000.00
1 5.00
Copying/Printing 0.37% 98,000.00 363.00
Total Other Expenses S 1,995.00
TOTAL S 27,517.00
Total Amount Provided by the City of Carson S 6,555.00
Project Description:
The Children's Clinic Program for serving the uninsured and underinsured children and their families
from the City of Carson.
EXHIBIT D
CDBG Monthly Status Report
City of Carson Group Name:
Housing&Neighborhood Development Division Address:
Staff Contact:
Title: Contract Term:
Business 11 Contract Amount: $
Business Fax#: Current Billing: $
• Amount Remaining: $
CLIENT DATA:
Current Month:
Year--- to-Date:
1. TOTAL number of clients served*
UNDUPLICATED clients 1. TOTAL number of clients served*
la. Number of
(if available) la. Number of UNDUPLICATED clients
(if available)
2. Number of Carson residents served
2. Number of Carson residents served
3. Nunber of female heads of household 3. Number of female heads of household
served
served
4. Client Income Level Breakdown(only
one cate o a lies : 4• Client Income Level Breakdown(only
g gory Pp ) one category applies):
Extremely Low g rY a y lies)
Low Extremely Low
Moderate Low
Above Moderate Moderate
Unknown Above Moderate
TOTALS* Unknown
TOTALS*
5. Client Ethnic&Breakdown(only one
category applies): 5. Client Ethnici Breakdown(only one
Hispanic or Latino category applies):
Not Hispanic or Latino Hispanic or Latino
TOTALS* Not Hispanic or Latino
TOTALS*
6. Client Racial Breakdown one or "more
6. Client Racial Breakdown one or more categories apply):
American Indian or Alaska categories apply):
Native American Indian or Alaska
Asian Native
Black or African American Asian
Native Hawaiian or Other Black or African American --
Pacific Islander Native Hawaiian or Other --
White or Caucasian Pacific Islander
Other White or Caucasian
TOTALS Other
TOTALS --
*Note: These totals should match. If they do not,please attach a brief explanation. It should be noted that because the race
categories permit a person to be identified with more than one category if applicable,the totals for race may not necessarily
match the totals for income level,ethnicity,or number of clients served.
I hereby certify that the above billing,income level,ethnicity,and race information is true and correct to the best of our ability
and verifiable by documents on file in our administrative offices.
Signature:
Date:
Title: