HomeMy WebLinkAbout2018/01/08 - Briefing Packet MASON COUNTY COMMISSIONER BRIEFING INFORMATION FOR WEEK OF
January 8, 2018
In the spirit of public information and inclusion, the attached is a draft of
information for Commissioner consideration and discussion at the above briefing.
This information is subject to change, additions and/or deletion and is not all
inclusive of what will be presented to the Commissioners.
We have changed the packet format so that it is an interactive document. Please
click on the agenda item which then takes you to the cover sheet of that section in
the document. To get back to the agenda, hit your "home" key on the keyboard.
Please see draft briefing agenda for schedule.
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1854
BOARD OF MASON COUNTY COMMISSIONERS
DRAFT BRIEFING MEETING AGENDA
411 North Fifth Street, Shelton WA 98584
Week of January 8, 2018
Monday, January 8, 2018
Commission Chambers
9:00 A.M. Planning Advisory Commission Interview
9:15 A.M. Community Services — Dave Windom
10:15 A.M. BREAK
10:30 A.M. Public Works — Jerry Hauth
Utilities &Waste Management
11:30 A.M. Hood Canal and Pioneer School Districts — Superintendents
Shawn Batstone & Martin Brewer
Commissioner Discussion — as needed
BREAK— NOON
2:00 P.M. Public Defense — Peter Jones
2:15 P.M. Support Services — Frank Pinter
Commissioner Discussion — as needed
Tuesday, January 9, 2018
Commission Chambers
10:00 A.M. Planning Advisory Commission Interview
Briefing Agendas are subject to change,please contact the Commissioners'office for the most recent version.
Last printed 01/04/18 at 2:14 PM
If special accommodations are needed,contact the Commissioners'office at ext.419,Shelton#360-427-9670;Belfair
#275-4467,Elma#482-5269.
Members:
Cmmr. Dist. Contact - Paula Reeves EXT 286
3 Aaron Cleveland
2 Jason Bailey
1 Deborah Soper
3 Marilyn Vogler
VACANT
1 James Thomas
VACANT
Applicants:
2 Jamie Bariekman
2 Brian Smith
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Casey A. Bingham
DEPARTMENT: Public Health EXT: 562
BRIEFING DATE: 1/8/18
PREVIOUS BRIEFING DATES:
If this is a follow-up briefing, please provide only new information
ITEM: Consolidated Contract # C17118
Background:
This Consolidated Contracts CLH18253 will provide funding in years 2018-2020.
This contract supersedes Contract C17118 which covered years 2015-2017. This
initial contract is a boiler plate for amendments that will come from DOH.
Programs Included:
1. Maternal & Child Health Block Grant 50,771.00
2. Onsite Sewage Management 174,304.00
3. Drinking Water Group A Program 26,000.00
4. Drinking Water Group B Program 2,500.00
5. Emergency Preparedness 19,917.00
6. Immunizations 71944.00
7. Prescription drug Overdose Prevention 33,400.00
8. Recreational Shellfish 7,500.00
9. Onsite Septic Implementation 60,000.00
These are all Current and budgeted Programs in the 2018 budget.
Recommended Action:
Move to approve Contract C17118 between State of Washington Department of
Health and Mason County.
RECOMMENDED OR REQUESTED ACTION:
Move C17118 2018-2020 Consolidated Contract to the Action Agenda for
1/16/2018.
Briefing Summary 1/2/2018
DOH CONTRACT#: CLH18253
Table of Contents
1. Purpose ....................................................................................................................................3
2. Statements of Work.................................................................................................................3
3. Exhibits....................................................................................................................................3
4. Definitions ...............................................................................................................................3
5. Funding and Billing.................................................................................................................4
6. Contract Management..............................................................................................................5
7. Access to Records....................................................................................................................5
8. All Writings Contained Herein................................................................................................5
9. Assignment..............................................................................................................................5
10. Assurances...............................................................................................................................5
11. Confidential Information.........................................................................................................6
12. Ethics .......................................................................................................................................6
13. Debarment Certification ..........................................................................................................6
14. Disputes ...................................................................................................................................6
15. Equipment Purchases...............................................................................................................6
16. Governing Law and Venue......................................................................................................7
17. Independent Capacity ..............................................................................................................7
18. Insurance..................................................................................................................................7
19. Licensing, Accreditation and Registration ..............................................................................7
20. Maintenance of Records..........................................................................................................7
21. Modifications and Waivers......................................................................................................7
22. No Third-Party Rights Created................................................................................................7
23. Nondiscrimination ...................................................................................................................7
24. Order of Precedence ................................................................................................................8
25. Ownership of Material/Rights in Data.....................................................................................8
26. Publications..............................................................................................................................8
27. Responsibility for Actions.......................................................................................................8
28. Loss or Reduction of Funding .................................................................................................8
29. Severability..............................................................................................................................8
30. Subcontracts.............................................................................................................................8
31. Subrecipient.............................................................................................................................9
32. Survivability ............................................................................................................................9
33. Term.........................................................................................................................................9
34. Termination for Convenience..................................................................................................9
35. Termination for Default...........................................................................................................9
36. Termination Procedure ............................................................................................................9
Standard Federal Certifications and Assurances........................................................................l l
Federal Assurances-Non-Construction Programs....................................................................16
2018-2020 Consolidated Contract Page 2 of 17
DOH CONTRACT#: CLH18253
CONSOLIDATED CONTRACT
between
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
(Referred to as"DOH")
and
MASON COUNTY PUBLIC HEALTH
(Referred to as"LHJ")
for
THE DELIVERY OF PUBLIC HEALTH SERVICES
FOR THE PERIOD OF
January 1,2018 through December 31,2020
1. Purpose
This Contract is entered into in accordance with RCW 43.70.520,RCW 43.70.580,the general statutory powers of the
Secretary of the Department of Health(DOH),including at RCW 43.70.040,the general statutory powers of local health
jurisdictions(LHJs),including at RCW 70.05.060,RCW 70.08.020,and RCW 70.46.060,and the authority for joint or
cooperative action provided for under chapter 39.34 RCW. The purpose of this Contract is to define the parties'joint
and cooperative relationship. The contract and all statements of work adopted under its provisions are intended to
implement applicable objectives under the Public Health Improvement Plan and to facilitate the delivery of public health
services to the people in Washington State. This Contract is the result of cooperative planning efforts between the LHJ
and DOH.
2. Statements of Work
The individual program activities, requirements, and outcomes/deliverables to be achieved by the parties under this
Contract are described in Exhibit A, Statements of Work. Each statement of work shall comply with the performance-
based criteria under RCW 43.70.580(2)(b).
The LHJ shall furnish the necessary personnel,equipment,material and/or services and otherwise do all things necessary
for or incidental to the performance of the work as set forth in Exhibit A, Statements of Work.
3. Exhibits
This Contract incorporates by reference the following Exhibits:
• Exhibit A- Statements of Work
• Exhibit B-Allocations
• Exhibit C- Schedule of Federal Awards
4. Definitions
As used throughout this Contract and unless amended for a particular Statement of Work,the following terms shall have
the meanings set forth below:
"Budget, Accounting, and Reporting System (BARS)": The system designed by the State Auditor's office for
collecting,consolidating,and reporting financial budgeting and accounting information from all local governmental
units.
"Client": An agency, firm, organization, individual or other entity applying for or receiving services provided by
the LHJ under this Contract.
"Catalog of Federal Domestic Assistance(CFDA)": The unique identifying code assigned to a federal assistance
program which identifies the awarding agency.
"Confidential Information": Information protected from disclosure under federal or state law.
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DOH CONTRACT#: CLH18253
"Contract Coordinator": Each party's designated contact for all notices required or permitted under this Contract.
"Contracting Officer": The DOH Contracts and Procurement Office Director and his/her delegates within that
office authorized to execute this agreement on behalf of DOH.
"Contractor": An entity that provides goods or services to DOH and others. A contractor normally operates its
business in a competitive environment, provides its goods and/or services to many different purchasers during
normal business hours,and is not subject to the compliance requirements of the federal program.
"Equipment": When used in this Contract is defined as an article of non-expendable,tangible property other than
land, buildings, or fixtures which is used in operations and having a useful life of more than one year and an
acquisition cost of$5,000 or more or as otherwise provided in the Exhibit A, Statements of Work.
"Federal Assistance": Assistance provided by a federal agency in the form of grants, contracts, loans, loan
guarantees, property, cooperative agreements, interest subsidies, insurance, or direct appropriations, but does not
include direct federal cash assistance to individuals.
"Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act)": A federal act to make
information available online so the public can see how federal funds are spent.
"Fixed Assets": Fixed assets are property and/or equipment obtained through donation,gift,purchase,capital lease,
or construction with a service life of more than one year.
"Program Contact": Each party's designated contact for those purposes identified in the Exhibit A, Statements of
Work.
"Subcontractor": Any individual or group contracted with the LHJ to perform all or part of the services included
in this Contract. This term will also apply to situations where an LHJ's subcontractor contracts with another
individual or group to perform all or part of the services included in its agreement with the LHJ.
"Subrecipient" or"Subgrantee": A non-federal entity that receives a subaward of federal grant money or goods
directly or indirectly from DOH and makes decisions regarding who can receive what federal assistance; has its
performance measured against the objectives contained in the DOH agreement with the federal government;makes
decisions on how to operate the program to accomplish the program goals;has the obligation to comply with federal
subrecipient requirements; and/or use federal funds to carry out a program for the public purpose specified in the
authorizing statute.
5. Funding and Billing
A. DOH shall pay the LHJ for services as set forth in the Exhibit A,Statements of Work,not to exceed funding amounts
as detailed in the Contract Allocations,Exhibit B,for those services provided herein.
The LHJ will advise the Program Contact identified in the applicable Statement of Work in writing 90 calendar
days prior to the end of the funded period, or as soon as practicable thereafter, if the LHJ anticipates not using all
Contract funding.
B. If the Exhibit A, Statement of Work, is supported by federal funds that require compliance with FFATA (the
Transparency Act),the corresponding checkbox on the statement of work will be checked.
C. Total consideration for this Contract is38$ 2,336,or as amended.
The LHJ will submit accurate and timely billings which,for clarity and consistency,will be prepared using the form
provided and following the instructions located on the DOH website,www.doh.wa.gov.
DOH will authorize payment only upon satisfactory completion and acceptance of deliverables and for allowable
costs as outlined in the statement of work and/or budget.
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DOH CONTRACT#: CLH18253
D. The LHJ will submit a BARS A financial report by April 15 for the prior calendar year.
6. Contract Management
Unless otherwise specified in the Contract,the following individuals are the contacts("Contract Coordinators")for all
notices required or permitted under this Contract:
LHJ Contract Coordinator: DOH Contract Coordinator:
Name: Lydia Buchheit Name: Brenda Henrikson
Title: Contracts Specialist
Mailing Address: Mailing Address:
415 N. 6 h Street Bldg 8, Shelton WA 98584 PO Box 47905,Olympia WA 98504-7905
Physical Address: Ph sical Address:
Same as above 101 Israel Rd. SE,Tumwater WA 98501-5570
Phone: 360-427-9670 Fax: 360-427-7787 Phone: 360-236-3933 Fag: 360-236-2401
Email Address: Email Address:
lydiab@co.mason.wa.us brenda.henrikson@doh.wa.gov
A party may change its Contract Coordinator or its Program Contact by providing written notice to the other party.
DOH Program Contacts can be found in the Exhibit A, Statements of Work, and on the DOH website at
www.doh.wa.gov.
7. Access to Records
To the extent authorized by applicable federal and state law, the parties shall provide access to records relevant to this
Contract to each other, the Joint Legislative Audit and Review Committee, the State Auditor, and authorized federal
officials,at no additional cost. Inspections shall occur at reasonable times and upon reasonable notice.
8. All Writings Contained Herein
This Contract contains all the terms and conditions agreed upon by the parties. No other understandings,oral or otherwise,
regarding the subject matter of this Contract shall be deemed to exist or to bind any of the parties hereto. The individuals
signing this Contract certify by their signatures that they are authorized to sign this Contract on behalf of their respective
entity.
9. Assignment
Except for subcontracting as authorized in this Contract,the LHJ shall not assign or delegate, in whole or in part,this
Contract or any of its rights, duties, obligations, or responsibilities, without the prior written consent of DOH's
Contracting Officer,which consent shall not be unreasonably withheld.
10. Assurances
The parties agree that all activity pursuant to this Contract shall be in accordance with all applicable current federal,
state and local laws,rules,and regulations.
The LHJ acknowledges its agreement to comply with federal certifications and assurances by signing and returning the
following:
1. Standard Federal Certifications and Assurances
2. Federal Assurances for Non-Construction Programs
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DOH CONTRACT#: CLH18253
11. Confidential Information
The parties agree to comply with all state and federal statutes and regulations relating to Confidential Information. DOH
and LHJ will limit access to the Confidential Information to the fewest number of people necessary to complete the
work. Everyone having access to Confidential Information covered by this Contract must agree to protect the
confidentiality of the information.
Either party to this Contract may designate certain Confidential Information as "Confidential Information/Notice
Requested"The designation shall be made by clearly stamping,watermarking,or otherwise marking each page of the
Confidential Information. If a third party requestor seeks information that has been marked "Confidential
Information/Notice Requested," notice shall be given to the marking party prior to release of the information. Such
notice shall be provided to the program contact no less than five (5) business days prior to the date of disclosure, to
allow the party objecting to disclosure to seek a protective order from the proper tribunal.
DOH and LHJ agree to establish, document and maintain security practices and safeguards consistent with state and
federal laws, regulations, standards, and guidelines to prevent unauthorized access, use, or disclosure of Confidential
Information in any form. In accordance with federal and state contracting requirements,DOH may monitor, audit, or
investigate LHJ management of Confidential Information relating to this Contract. Working together, the LHJ and
DOH may use any and all tools available to track Contract related Confidential Information.
If one of the parties becomes aware of an actual or suspected breach of confidentiality,that party will promptly notify
the Contract Coordinator for the other party of the facts. The parties will work within their respective organizations to
take any steps necessary to determine the scope of the breach and to restore reasonable security to the Confidential
Information. Both parties agree to mitigate any known harmful effects of a breach in confidentiality,including notifying
affected individuals to the extent required by law. The parties will also reasonably cooperate with law enforcement as
appropriate.
12. Ethics
Both parties and their officers shall comply with all ethics laws applicable to their activities under this Contract,
including Chapters 42.23 and 42.52 RCW. If a violation occurs and is not cured within a reasonable time after notice,
the other party shall have the right to terminate this Contract. This section is expressly subject to the Disputes section
of this Contract.
13. Debarment Certification
The LHJ,by signing this Contract,certifies that the LHJ is not presently debarred,suspended,proposed for debarment,
declared ineligible, or voluntarily excluded from participating in this Contract by any federal department or agency.
The LHJ also agrees to include the above requirement in all subcontracts into which it enters. The LHJ will notify DOH
of any such events that may occur during the term of the Contract.
14. Disputes
Except as otherwise provided in this contract, when a dispute arises between the parties and it cannot be resolved by
direct negotiation,the parties agree to participate in good faith in non-binding mediation. The mediator shall be chosen
by agreement of the parties. If the parties cannot agree on a mediator,the parties shall use a mediation service located
in Washington State that selects a qualified mediator for the parties. Each party shall bear its own costs for mediation
and each party shall contribute equally to the mediator's fee,if any. The parties agree that mediation shall precede any
action in a judicial tribunal.
Nothing in this contract shall be construed to limit the parties' choice of a mutually acceptable alternate dispute
resolution method in addition to the dispute resolution procedure outlined above.
15. Equipment Purchases
Equipment purchased by the LHJ for use by the LHJ or its subcontractors during the term of this Contract using federal
funds,in whole or in part,shall be the property of the LHJ. The use,management and disposal of the equipment must
comply with federal requirements. These requirements are found in the Office of Management and Budget's(OMB's)
2018-2020 Consolidated Contract Page 6 of 17
1 1
DOH CONTRACT#: CLH18253
Uniform Guidance,Title 2 Code of Federal Regulations Part 200(2 CFR 200)-Uniform Administrative Requirements,
Cost Principles, and Audit Requirements for Federal Awards, or are included in the federal funding agency's
regulations.
16. Governing Law and Venue
The laws of the state of Washington govern this Contract. In the event of a lawsuit by the LHJ against DOH arising
under this Contract, venue shall be proper only in Thurston County, Washington. In the event of a lawsuit by DOH
against the LHJ arising under this Contract, venue shall be proper only in the county in which the LHJ is located or in
either of the two nearest judicial districts within the meaning of RCW 36.01.050.
17. Independent Capacity
The employees or agents of each party who are engaged in the performance of this Contract shall continue to be
employees or agents of that party and shall not be considered for any purpose to be employees or agents of the other
party.
18. Insurance
The LHJ certifies that it is self-insured, is a member of a risk pool, or maintains insurance coverage as required by this
Contract. Each party shall pay for losses for which it is found liable. The LHJ agrees to require all subcontractors to
maintain insurance in types and with limits as may be determined by the LHJ and/or its risk manager,unless the LHJ and
DOH agree otherwise.
19. Licensing,Accreditation and Registration
The LIU shall comply with all applicable local,state,and federal licensing,accreditation and registration requirements
and standards,necessary for the performance of this Contract.
20. Maintenance of Records
Each party to this Contract shall maintain books,records, documents and other evidence that sufficiently and properly
reflect all direct and indirect costs expended by it. All books, records, documents, and other material relevant to this
Contract will be retained for six(6)years after expiration.If any litigation,claim or audit is started before the expiration
of the six-year period, the records shall be retained until all litigation, claims, or audit findings involving the records
have been resolved.
Each party will use reasonable security procedures and protections to assure that records and documents provided by
the other party are not erroneously disclosed to third parties. Both parties agree to continue protecting records until
such time as the information is destroyed in accordance with applicable state and federal records retention laws.
21. Modifications and Waivers
This Contract,or any term or condition,may be modified only by a written amendment signed by the DOH Contracting
Officer and the authorized representative for the LHJ. Either party may propose an amendment.
Failure or delay on the part of either party to exercise any right, power,privilege or remedy provided under this Contract
shall not constitute a waiver.No provision of this Contract may be waived by either party except in a writing signed by the
DOH Contracting Officer or the authorized representative of the LET
22. No Third-Party Rights Created
This Contract, or any program hereunder, is entered into solely for the benefit of the two parties thereto and shall not
be construed as giving rise to any right,remedy or expectancy of any kind or nature on the part of any third party.
23. Nondiscrimination
During the performance of this Contract,the LHJ and DOH shall comply with all federal and state nondiscrimination laws,
regulations and policies. In the event of the LHJ's noncompliance or refusal to comply with any nondiscrimination law,
regulation or policy,this Contract may be rescinded,canceled or terminated in whole or in part,and the LHJ may be declared
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DOH CONTRACT#: CLH18253
ineligible for further contracts with DOH. The LHJ shall, however, be given a reasonable time in which to cure this
noncompliance. Any dispute may be resolved in accordance with the"Disputes"procedure set forth herein.
24. Order of Precedence
In the event of an inconsistency in the terms of this Contract,or between its terms and any applicable statute or rule,the
inconsistency shall be resolved by giving precedence in the following order:
• Applicable state and federal statutes,and local laws,rules and regulations.
• Terms and conditions of this Contract.
• Statements of Work.
• Any other provisions of this Contract,including other materials incorporated by reference.
25. Ownership of Material/Rights in Data
Records and other documents relevant to this Contract, in any medium, furnished by one party to this Contract to the
other party, will remain the property of the furnishing party, unless otherwise agreed. Data which is delivered under
the Contract shall be transferred to DOH with a nonexclusive, royalty-free, perpetual, irrevocable license to publish,
translate, reproduce, modify, deliver, perform, dispose of, and to authorize others to do so; provided that such license
shall be limited to the extent which the LHJ has a right to grant such a license. The LHJ shall exert all reasonable effort
to advise DOH, at the time of delivery of data furnished under this Contract, of all known or potential invasions of
privacy contained therein and of any portion of such document which was not produced in the performance of this
Contract. DOH shall receive prompt written notice of each notice or claim or copyright infringement received by the
LHJ with respect to any data delivered under this Contract. DOH shall have the right to modify or remove any restrictive
markings placed upon the data by the LHJ,provided that if DOH modifies or removes such markings without the LHJ's
approval, it assumes all liability for doing so.
26. Publications
Any program reports, articles, and publications that result from information gathered through use of state and federal
funds must acknowledge receiving support from DOH and/or the appropriate federal agencies. Correspondingly, such
documents resulting from information gathered through use of local funds must acknowledge receipt of such local
support.
27. Responsibility for Actions
Each party to this Contract shall be solely responsible for the acts and omissions of its own officers, employees, and
agents in the performance of this Contract. Neither party to this Contract will be responsible for the acts and omissions
of entities or individuals not party to this Contract. DOH and the LHJ shall cooperate in the defense of tort lawsuits,
when possible.
28. Loss or Reduction of Funding
In the event funding from state,federal,or other sources is withdrawn,reduced,or limited in any way after the effective
date of this contract and prior to normal completion,DOH may elect to suspend or terminate the contract, in whole or
in part, under the "Termination for Convenience" clause with a ten (10) business day notice to LHJ, to the extent
possible, subject to renegotiation at DOH's discretion under those new funding limitations and conditions.
29. Severability
If any term or condition of this Contract is held invalid,such invalidity shall not affect the validity of the other terms or
conditions of this Contract,provided,however,that the remaining terms and conditions can still fairly be given effect.
30. Subcontracts
The LHJ may subcontract any or all of the services or other obligations specified in this Contract. The LHJ will require
the subcontractor to comply with all the applicable terms and conditions of this Contract,including all terms,conditions,
certifications and assurances. The LHJ agrees it is responsible for assuring adequate performance on the part of the
subcontractor.
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DOH CONTRACT#: CLH18253
The parties agree that all subcontractors must be responsible for any liabilities created by their actions or omissions. In
the event DOH,LHJ,and subcontractor are found by a jury or trier of fact to be jointly and severally liable for personal
injury damages arising from any act or omission,then each entity shall be responsible for its proportionate share.
31. Subrecipient
For those activities designated as "subrecipient" on Exhibit A, Statements of Work, the LHJ must comply with
applicable federal requirements, including but not limited to OMB's Uniform Guidance at 2 CFR 200, Subparts D
(Administrative Requirements), E (Cost Principles) and F (Audit Requirements), and program specific federal
regulations. If the LHJ expends $500,000 or more in federal awards from all sources, it is responsible for obtaining
appropriate audits. If the LHJ expends$750,000 or more in federal grants or awards from all sources, it is responsible
for obtaining the required single audit.
32. Survivability
The terms and conditions contained in this Contract, which by their sense and context are intended to survive the
expiration of the Contract,shall survive. Surviving terms include,but are not limited to:Access to Records,Confidential
Information, Disputes, Responsibility for Actions, Maintenance of Records, Ownership of Material/Rights in Data,
Subcontracts,Termination for Convenience,Termination for Default,and Termination Procedure.
33. Term
This Contract will be in effect following execution by the parties from January 1, 2018 through December 31, 2020,
unless terminated earlier as provided herein.
34. Termination for Convenience
Except as otherwise provided in this Contract, either party may terminate or suspend this Contract, or any program
hereunder,for convenience by providing at least thirty(3 0)days' advance written notice to the other party.
If DOH elects to suspend the Contract,in whole or in part,LHJ shall stop work as of the effective date of DOH's written
notice of suspension. During suspension,each Party will reasonably notify the other of any conditions that may affect
resumption of performance. Upon DOH's written notice to resume performance, LHJ shall resume work unless the
LHJ provides notice to DOH that services cannot be resumed. If LHJ cannot resume performance, the Contract or
affected Exhibit A, Statement of Work, will be deemed terminated upon the date the LHJ received notice to suspend
performance.
35. Termination for Default
(a) In the event of a default by either party under this Contract,the nondefaulting party may give written notice to the
defaulting party that it intends to terminate this Contract,or any program hereunder,if the default is not cured within
thirty(3 0)days of the date of the notice,or such longer period of time as may be reasonable under the circumstances.
If the default is not cured within that time,the nondefaulting party may then notify the defaulting party in writing
that this Contract is terminated. In the event of such termination,the nondefaulting party shall have all rights and
remedies available to it under general law.
(b) A disputed termination for default is expressly subject to the Disputes section of this Contract.
36. Termination Procedure
Upon termination DOH may require the LHJ to deliver to DOH any non-LHJ-owned equipment,data,or other property
specifically produced or acquired for the performance of such part of this Contract as has been terminated.
DOH shall pay to the LHJ the agreed upon price, if separately stated, for completed work and services accepted by
DOH. In addition DOH shall pay the amount determined by DOH's Contracting Officer for(a) completed work and
services for which no separate price is stated, (b)partially completed work and services,(c)other property or services
which are accepted by DOH, and (d)the protection and preservation of the property. Disagreement by the LHJ with
the determination of DOH's Contracting Officer that relates to the obligations or amounts due to the LHJ shall be
considered a dispute within the meaning of the"Disputes"clause of this Contract.
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DOH may withhold from any amounts due the LHJ for such completed work or services such sum as DOH's Contracting
Officer reasonably determines to be necessary to protect DOH against potential loss or liability.
The rights and remedies of DOH provided in this section shall not be exclusive and are in addition to any other rights
and remedies provided by law or under this Contract.
After receipt of a written notice of termination,the LHJ shall:
• Stop work under the Contract on the date and to the extent specified in the notice;
• Place no further orders or subcontracts for materials,services,or facilities,except as necessary to complete such
portion of the work not terminated;
• Assign to DOH,to the extent reasonably directed by DOH's Contracting Officer and to the extent that the LHJ
has the legal right to do so, all of the right, title, and interest of the LHJ under the orders and subcontracts in
which case DOH has the right, at its reasonable discretion,to settle or pay any or all claims arising out of the
termination of such orders and subcontracts.
• Settle all outstanding liabilities and all claims arising out of orders or subcontracts, with the approval or
ratification of DOH's Contracting Officer to the extent he/she may reasonably require, which approval or
ratification shall be final for all the purposes of this clause;
• Transfer title to DOH and deliver,as reasonably directed by DOH's Contracting Officer,any property which, if
the Contract had been completed,would have been required to be furnished to DOH;
• Complete performance of such part of the work not terminated by DOH's Contracting Officer;and,
• Take such action as may be necessary,or as DOH's Contracting Officer may reasonably direct,for the protection
and preservation of the property related to this Contract which is in the possession of the LHJ, or its
subcontractors,and in which DOH has or may acquire an interest.
IN WITNESS WHEREOF,the parties have executed this Contract.
MASON COUNTY PUBLIC HEALTH STATE OF WASHINGTON
DEPARTMENT OF HEALTH
Signature Signature
Title: Title:
Print Name: Print Name:
Date: Date:
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Standard Federal Certifications and Assurances
Following are the Assurances,Certifications,and Special Conditions that apply to all federally-funded(in whole or in part)
agreements administered by the Washington State Department of Health.
CERTIFICATIONS
1. CERTIFICATION REGARDING DEBARMENT AND SUSPENSION
The undersigned (authorized official signing for the contracting organization) certifies to the best of his or her
knowledge and belief,that the contractor,defined as the primary participant in accordance with 45 CFR Part 76, and
its principals:
A. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from
covered transactions by any Federal Department or agency;
Have not within a 3-year period preceding this contract been convicted of or had a civil judgment rendered against
them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records,making false statements,or receiving stolen property;
B. Are not presently indicted or otherwise criminally or civilly charged by a governmental entity(Federal, State,or
local)with commission of any of the offenses enumerated in paragraph(b)of this certification;and
C. Have not within a 3-year period preceding this contract had one or more public transactions (Federal, State, or
local)terminated for cause or default.
Should the contractor not be able to provide this certification, an explanation as to why should be placed after the
assurances page in the contract.
The contractor agrees by signing this contract that it will include,without modification,the clause titled Certification
Regarding Debarment, Suspension, In eligibility, and Voluntary Exclusion--Lower Tier Covered Transactions in all
lower tier covered transactions(i.e.,transactions with sub-grantees and/or contractors)and in all solicitations for lower
tier covered transactions in accordance with 45 CFR Part 76.
2. CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
The undersigned(authorized official signing for the contracting organization)certifies that the contractor will, or will
continue to,provide a drug-free workplace in accordance with 45 CFR Part 76 by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession
or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be
taken against employees for violation of such prohibition;
B. Establishing an ongoing drug-free awareness program to inform employees about:
1) The Dangers of drug abuse in the workplace;
2) The contractor's policy of maintaining a drug-free workplace;
3) Any available drug counseling,rehabilitation,and employee assistance programs; and
4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;
C. Making it a requirement that each employee to be engaged in the performance of the contract be given a copy of
the statement required by paragraph 1)above;
2018-2020 Consolidated Contract Page 11 of 17
DOH CONTRACT#: CLH18253
D. Notifying the employee in the statement required by paragraph 1), above, that, as a condition of employment
under the contract,the employee will:
1) Abide by the terms of the statement;and
2) Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring
in the workplace no later than five calendar days after such conviction;
E. Notifying the agency in writing within ten calendar days after receiving notice under paragraph D. 2) from an
employee or otherwise receiving actual notice of such,conviction. Employers of convicted employees must
provide notice, including position title,to every contract officer or other designee on whose contract activity the
convicted employee was working,unless the Federal agency has designated a central point for the receipt of such
notices.Notice shall include the identification number(s)of each affected grant;
F. Taking one of the following actions, within 30 calendar days of receiving notice under paragraph D. 2) with
respect to any employee who is so convicted:
1) Taking appropriate personnel action against such an employee,up to and including termination,consistent
with the requirements of the Rehabilitation Act of 1973,as amended; or
2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program
approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate
agency;
G. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs
(A),(B),(C),(D),(E),and(F).
For purposes of paragraph(E)regarding agency notification of criminal drug convictions,DOH has designated
the following central point for receipt of such notices:
Compliance and Internal Control Officer
Office of Grants Management
WA State Department of Health
PO Box 47905
Olympia,WA 98504-7905
3. CERTIFICATION REGARDING LOBBYING
Title 31, United States Code, Section 1352, entitled "Limitation on use of appropriated funds to influence certain
Federal contracting and financial transactions," generally prohibits recipients of Federal grants and cooperative
agreements from using Federal(appropriated)funds for lobbying the Executive or Legislative Branches of the Federal
Government in connection with a SPECIFIC grant or cooperative agreement. Section 1352 also requires that each
person who requests or receives a Federal grant or cooperative agreement must disclose lobbying undertaken with
non-Federal(nonappropriated)funds.These requirements apply to grants and cooperative agreements EXCEEDING
$100,000 in total costs(45 CFR Part 93).
The undersigned (authorized official signing for the contracting organization) certifies, to the best of his or her
knowledge and belief,that:
A. No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person
for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer
or employee of Congress, or an 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, continuation, renewal, amendment, or modification of any Federal
contract,grant,loan,or cooperative agreement.
B. If any funds other than Federally appropriated funds have been paid or will be paid to any person for influencing
or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee
of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"Disclosure of Lobbying
2018-2020 Consolidated Contract Page 12 of 17
DOH CONTRACT#: CLH18253
Activities," in accordance with its instructions. (If needed, Standard Form-LLL, "Disclosure of Lobbying
Activities," its instructions,and continuation sheet are included at the end of this application form.)
C. The undersigned shall require that the language of this certification be included in the award documents for all
subcontracts at all tiers(including subcontracts, subcontracts, and contracts under grants, loans and cooperative
agreements)and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed
by Section 1352,U.S. Code.Any person who fails to file the required certification shall be subject to a civil penalty
of not less than$10,000 and not more than$100,000 for each such failure.
4. CERTIFICATION REGARDING PROGRAM FRAUD CIVIIL REMEDIES ACT(PFCRA)
The undersigned(authorized official signing for the contracting organization)certifies that the statements herein are
true,complete,and accurate to the best of his or her knowledge, and that he or she is aware that any false,fictitious,
or fraudulent statements or claims may subject him or her to criminal, civil, or administrative penalties. The
undersigned agrees that the contracting organization will comply with the Public Health Service terms and conditions
of award if a contract is awarded.
5. CERTIFICATION REGARDING ENVIRONMENTAL TOBACCO SMOKE
Public Law 103-227, also known as the Pro-Children Act of 1994 (Act),requires that smoking not be permitted in
any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or regularly for
the provision of health,day care,early childhood development services,education or library services to children under
the age of 18,if the services are funded by Federal programs either directly or through State or local governments,by
Federal grant,contract,loan,or loan guarantee.The law also applies to children's services that are provided in indoor
facilities that are constructed, operated,or maintained with such Federal funds. The law does not apply to children's
services provided in private residence, portions of facilities used for inpatient drug or alcohol treatment, service
providers whose sole source of applicable Federal funds is Medicare or Medicaid, or facilities where WIC coupons
are redeemed.
Failure to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to
$1,000 for each violation and/or the imposition of an administrative compliance order on the responsible entity.
By signing the certification, the undersigned certifies that the contracting organization will comply with the
requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision
of services for children as defined by the Act.
The contracting organization agrees that it will require that the language of this certification be included in any
subcontracts which contain provisions for children's services and that all subrecipients shall certify accordingly.
The Public Health Services strongly encourages all recipients to provide a smoke-free workplace and promote the
non-use of tobacco products.This is consistent with the PHS mission to protect and advance the physical and mental
health of the American people.
6. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS-INSTRUCTIONS FOR CERTIFICATION
By signing and submitting this proposal,the prospective contractor is providing the certification set out below.
A. The inability of a person to provide the certification required below will not necessarily result in denial of
participation in this covered transaction.The prospective contractor shall submit an explanation of why it cannot
provide the certification set out below.The certification or explanation will be considered in connection with the
department or agency's determination whether to enter into this transaction.However, failure of the prospective
contractor to furnish a certification or an explanation shall disqualify such person from participation in this
transaction.
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DOH CONTRACT#: CLH18253
B. The certification in this clause is a material representation of fact upon which reliance was placed when the
department or agency determined to enter into this transaction. If it is later determined that the prospective
contractor knowingly rendered an erroneous certification, in addition to other remedies available to the Federal
Government,the department or agency may terminate this transaction for cause of default.
C. The prospective contractor shall provide immediate written notice to the department or agency to whom this
contract is submitted if at any time the prospective contractor learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
D. The terms covered transaction,debarred,suspended,ineligible,lower tier covered transaction,participant,person,
primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the
meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549.You
may contact the person to whom this contract is submitted for assistance in obtaining a copy of those regulations.
E. The prospective contractor agrees by submitting this contract that, should the proposed covered transaction be
entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,
suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless
authorized by DOH.
F. The prospective contractor further agrees by submitting this contract that it will include the clause titled
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -- Lower Tier Covered
Transaction,provided by HHS,without modification,in all lower tier covered transactions and in all solicitations
for lower tier covered transactions.
G. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction,unless it knows that the certification is erroneous.A participant may decide the method and frequency
by which it determines the eligibility of its principals. Each participant may, but is not required to, check the
Nonprocurement List(of excluded parties).
H. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to
render in good faith the certification required by this clause. The knowledge and information of a participant is
not required to exceed that which is normally possessed by a prudent person in the ordinary course of business
dealings.
I. Except for transactions authorized under paragraph 6.of these instructions,if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or
voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal
Government,DOH may terminate this transaction for cause or default.
7. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS-PRIMARY COVERED TRANSACTIONS
A. The prospective contractor certifies to the best of its knowledge and belief,that it and its principals:
1) Are not presently debarred, suspended,proposed for debarment,declared ineligible,or voluntarily excluded
from covered transactions by any Federal department or agency;
2) Have not within a three-year period preceding this contract been convicted of or had a civil judgment rendered
against them for commission of fraud or a criminal offense in connection with obtaining,attempting to obtain,
or performing a public(Federal,State or local)transaction or contract under a public transaction;violation of
Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records,making false statements,or receiving stolen property;
3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal,
State or local)with commission of any of the offenses enumerated in paragraph 1.B.of this certification;and
4) Have not within a three-year period preceding this contract had one or more public transactions (Federal,
State or local)terminated for cause or default.
2018-2020 Consolidated Contract Page 14 of 17
DOH CONTRACT#: CLH
By signing the certification, the undersigned certifies that the contracting organization will comply with the
requirements of the Act and will not allow smoking within any portion of any indoor facility used for the provision
of services for children as defined by the Act.
The contracting organization agrees that it will require that the language of this certification be included in any
subcontracts which contain provisions for children's services and that all subrecipients shall certify accordingly.
The Public Health Services strongly encourages all recipients to provide a smoke-free workplace and promote the
non-use of tobacco products.This is consistent with the PHS mission to protect and advance the physical and mental
health of the American people.
6. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS INSTRUCTIONS FOR CERTIFICATION
By signing and submitting this proposal,the prospective contractor is providing the certification set out below.
A. The inability of a person to provide the certification required below will not necessarily result in denial of
participation in this covered transaction.The prospective contractor shall submit an explanation of why it cannot
provide the certification set out below. The certification or explanation will be considered in connection with
the department or agency's determination whether to enter into this transaction. However, failure of the
prospective contractor to furnish a certification or an explanation shall disqualify such person from participation
in this transaction.
B. The certification in this clause is a material representation of fact upon which reliance was placed when the
department or agency determined to enter into this transaction. If it is later determined that the prospective
contractor knowingly rendered an erroneous certification, in addition to other remedies available to the Federal
Government,the department or agency may terminate this transaction for cause of default.
C. The prospective contractor shall provide immediate written notice to the department or agency to whom this
contract is submitted if at any time the prospective contractor learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
D. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant,
person,primary covered transaction,principal,proposal, and voluntarily excluded,as used in this clause,have
the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549.
You may contact the person to whom this contract is submitted for assistance in obtaining a copy of those
regulations.
E. The prospective contractor agrees by submitting this contract that, should the proposed covered transaction be
entered into,it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,
suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless
authorized by DOH.
F. The prospective contractor further agrees by submitting this contract that it will include the clause titled
Certification Regarding Debarment, Suspension,Ineligibility and Voluntary Exclusion--Lower Tier Covered
Transaction, provided by HHS, without modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
G. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant may decide the method and
frequency by which it determines the eligibility of its principals. Each participant may, but is not required to,
check the Nonprocurement List(of excluded parties).
H. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order
to render in good faith the certification required by this clause.The knowledge and information of a participant
is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business
dealings.
2018-2020 Consolidated Contract Page 15 of 18
DOH CONTRACT#: CLH
I. Except for transactions authorized under paragraph 6. of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible,or voluntarily excluded from participation in this transaction,in addition to other remedies available
to the Federal Government,DOH may terminate this transaction for cause or default.
7. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY
MATTERS-PRIMARY COVERED TRANSACTIONS
A. The prospective contractor certifies to the best of its knowledge and belief,that it and its principals:
1) Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded
from covered transactions by any Federal department or agency;
2) Have not within a three-year period preceding this contract been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain,or performing a public(Federal, State or local)transaction or contract under a public
transaction;violation of Federal or State antitrust statutes or commission of embezzlement,theft, forgery,
bribery,falsification or destruction of records,making false statements,or receiving stolen property;
3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal,
State or local)with commission of any of the offenses enumerated in paragraph 1.B. of this certification;
and
4) Have not within a three-year period preceding this contract had one or more public transactions(Federal,
State or local)terminated for cause or default.
B. Where the prospective contractor is unable to certify to any of the statements in this certification, such
prospective contractor shall attach an explanation to this contract.
AUTHORIZED SIGNATURE REQUIRED
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
PLEASE PRINT OR TYPE NAME:
ORGANIZATION NAME:(if applicable) DATE
2018-2020 Consolidated Contract Page 16 of 18
DOH CONTRACT#: CLH
Federal Assurances—Non-Construction Programs
Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time
for reviewing instructions, searching existing data sources,gathering and maintaining the data needed,and completing and
reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project(0348-0040),Washington,DC 20503
PLEASE DO NOT RETURN YOUR COMPLETED,FORM TO THE OFFICE OF MANAGEMENT AND
BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.
Note: Certain of these assurances may not be applicable to your project or program.If you have questions,please contact
the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional
assurances.If such is the case,you will be notified.
As the duly authorized representative of the contractor,I certify that the contractor:
1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability
(including funds sufficient to pay the non-Federal share of project cost)to ensure proper planning, management, and
completion of the project described in this application.
2. Will give the awarding agency,the Comptroller General of the United States,and if appropriate,the State,through any
authorized representative, access to and the right to examine all records, books, papers, or documents related to the
award; and will establish a proper accounting system in accordance with generally accepted accounting standards or
agency directives.
3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the
appearance of personal or organizational conflict of interest,or personal gain.
4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency.
5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. ❑❑4728-4763) relating to prescribed
standards for merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of
OPM's Standards for a Merit System of Personnel Administration(5 C.F.R. 900, Subpart F).
6. Will comply with all Federal statutes relating to nondiscrimination.These include but are not limited to: (a)Title VI of
the Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race,color or national origin;
(b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. ❑❑1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C.
❑794),which prohibits discrimination on the basis of handicaps; (d)the Age Discrimination Act of 1975,as amended
(42 U.S.C. ❑❑ 6101-6107),which prohibits discrimination on the basis of age;(e)the Drug Abuse Office and Treatment
Act of 1972(P.L.92-255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended,
relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) ❑❑ 523 and 527 of the Public Health
Service Act of 1912(42 U.S.C. ❑❑ 290 dd-3 and 290 ee 3),as amended,relating to confidentiality of alcohol and drug
abuse patient records;(h)Title VIII of the Civil Rights Act of 1968(42 U.S.C. ❑ 3601 et seq.),as amended,relating to
nondiscrimination in the sale,rental or financing of housing; (i)any other nondiscrimination provisions in the specific
statute(s) under which application for Federal assistance is being made; and 0) the requirements of any other
nondiscrimination statute(s)which may apply to the application.
7. Will comply, or has already complied,with the requirements of Titles II and III of the uniform Relocation Assistance
and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of
persons displaced or whose property is acquired as a result of Federal or federally assisted programs.These requirements
apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases.
2018-2020 Consolidated Contract Page 17 of 18
DOH CONTRACT#: CLH
8. Will comply,as applicable,with the provisions of the Hatch Act(5 U.S.C. ❑❑1501-1508 and 7324-7328)which limit
the political activities of employees whose principal employment activities are funded in whole or in part with Federal
funds.
9. Will comply, as applicable,with the provisions of the Davis-Bacon Act(40 U.S.C. ❑0276a to 276a-7),the Copeland
Act(40 U.S.C. ❑276c and 18 U.S.C. ❑❑874)and the Contract Work Hours and Safety Standards Act(40 U.S.C. ❑❑
327-333),regarding labor standards for federally assisted construction subagreements.
10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster
Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the
program and to purchase flood insurance if the total cost of insurable construction and acquisition is$10,000 or more.
11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of
environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and
Executive Order(EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of
project consistency with the approved State management program developed under the Coastal Zone Management Act
of 1972(16 U.S.C. ❑❑1451 et seq.);(f)conformity of Federal actions to State(Clear Air)Implementation Plans under
Section 176(c)of the Clear Air Act of 1955,as amended(42 U.S.C. ❑El 7401 et seq.);(g)protection of underground
sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h)protection
of endangered species under the Endangered Species Act of 1973,as amended,(P.L.93-205).
12. Will comply with the Wild and Scenic Rivers Act of 1968(16 U.S.C. ❑❑1721 et seq.)related to protecting components
or potential components of the national wild and scenic rivers system.
13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of
1966, as amended (16 U.S.C. 0470), EO 11593 (identification and protection of historic properties), and the
Archaeological and Historic Preservation Act of 1974(16 U.S.C. ❑0469a-1 et seq.).
14. Will comply with P.L.93-348 regarding the protection of human subjects involved in research,development,and related
activities supported by this award of assistance.
15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. ❑❑2131 et seq.)
pertaining to the care,handling,and treatment of warm blooded animals held for research,teaching, or other activities
supported by this award of assistance.
16. Will comply with the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. ❑114801 et seq.)which prohibits the use
of lead-based paint in construction or rehabilitation of residence structures.
17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act
Amendments of 1996 and OMB Supercircular 2 CFR 200, Subpart F.
18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies
governing this program.
AUTHORIZED SIGNATURE REQUIRED
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL TITLE
PLEASE PRINT OR TYPE NAME
ORGANIZATION NAME(if applicable) DATE
2018-2020 Consolidated Contract Page 18 of 18
MASON COUNTY PUBLIC HEALTH
2018-2020 CONSOLIDATED CONTRACT#CLH18253
EXHIBIT A- STATEMENTS OF WORK
TABLE OF CONTENTS
DOH Program Name or Title: Maternal &Child Health Block Grant-Effective January 1,2018.....................................................................................................2
DOH Program Name or Title: NEP SSI Onsite Sewage Management-Effective January 1, 2018 ...................................................................................................6
DOH Program Name or Title: Office of Drinking Water Group A Program -Effective January 1,2018........................................................................................25
DOH Program Name or Title: Office of Drinking Water Group B Program-Effective January 1,2018........................................................................................29
DOH Program Name or Title: Office of Emergency Preparedness &Response-Effective January 1, 2018..................................................................................31
DOH Program Name or Title: Office of Immunization&Child Profile-Effective January 1, 2018...............................................................................................36
DOH Program Name or Title: OSS LMP Implementation-Effective January 1, 2018 ...................................................................................................................42
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Supplement-Effective January 1, 2018...........................................................45
DOH Program Name or Title: Recreational Shellfish Activities-Effective January 1,2018 ..........................................................................................................47
Exhibit A, Statements of Work Page 1 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Maternal&Child Health Block Grant- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through September 30,2018 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑OtherD Research&Development
Statement of Work Purpose: The purpose of this statement of work is to support local interventions that impact the target population of the Maternal and Child Health Block
Grant.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY18 MCHBG LHJ CONTRACTS 93.994 333.93.99 78120281 01/01/18 09/30/18 0 50,771 50,771
TOTALS 0 50,771 50,771
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
Maternal and Child Health Block Grant(MCHBG)Administration
la Participate in calls,at a minimum of every Designated LHJ staff will participate September 30,2018 Reimbursement for
quarter,with DOH contract manager.Dates in contract management calls. actual costs,not to
and time for calls are mutually agreed upon exceed total funding
between DOH and LHJ consideration. Action
lb Report actual expenditures for October 1, Submit actual expenditures using the May 26,2018 Plan and Progress
2017 through March 31,2018 MCHBG Budget Workbook to DOH Reports must only
contract manager reflect activities paid
lc Develop 2018-2019 MCHBG Budget Submit MCHBG Budget Workbook September 5,2018 for with funds provided
Workbook for October 1,2018 through to DOH contract manager in this statement of
September 30,2019 using DOH provided work for the specified
template. funding period.
See Program Specific
Requirements and
Exhibit A,Statements of Work Page 2 of 48 Contract Number CLH18253
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
Special Billing
Requirements.
MCHBG Assessment and Evaluation
2a Participate in project evaluation activities Documentation using report template September 30,2018 Reimbursement for
developed and coordinated by DOH,as provided by DOH actual costs,not to
requested. exceed total funding
2b Report program level strategy measure data Documentation using report template January 15,2018 consideration.
(CSHCN,UDS,ACEs). provided by DOH April 15,2018
July 15,2018 See Program Specific
Requirements and
Special Billing
Requirements.
MCHBG Implementation
3a Develop 2018-2019 MCHBG Action Plan Submit MCHBG Action Plan to Draft August 17,2018 Reimbursement for
for October 1,2018 through September 30, DOH contract manager Final September 5,2018 actual costs,not to
2019 using DOH-provided template. exceed total funding
3b Report activities and outcomes of 2017-2018 Submit Action Plan monthly reports Monthly,on or before consideration.Action
MCHBG Action Plan using DOH-provided to DOH contract manager the 151i of the following Plan and Progress
template. month Reports must only
reflect activities paid
for with funds provided
in this statement of
work for the specified
funding period.
See Program Specific
Requirements and
Special Billing
Requirements.
Children with Special Health Care Needs(CSHCN)
4a Complete Child Health Intake Form(CHIF) Submit CHIF data into Secure File January 15,2018 Reimbursement for
using the CHIF Automated System on all 7 Transport(SFT)website: April 15,2018 actual costs,not to
infants and children served by the CSHCN https://sft.wa.gov July 15,2018 exceed total funding
Program as referenced in CSHCN Program consideration.Action
Manual. Plan and Progress
Exhibit A,Statements of Work Page 3 of 48 Contract Number CLH18253
Task Task/Activity/Description "May Support PHAB Deliverables/Outcomes Due Date/Time Frame Payment Information
Number Standards/Measures and/or Amount
Reports must only
Ensure client data is collected on all children reflect activities paid
served by CSHCN contractors,including for with funds provided
neurodevelopmental centers,regional in this statement of
maxillofacial coordinators,and the DOH work for the specified
Newborn Screening Program. funding period.
4b Administer requested DOH Diagnostic and Submit completed Health Services 30 days after forms are
Treatment funds for infants and children per Authorization forms and Central completed. See Program Specific
CSHCN Program Manual when funds are Treatment Fund requests directly to Requirements and
used. the CSHCN Program as needed. Special Billing
4c Participate in the CSHCN Regional System Submit Action Plan monthly reports Monthly,on or before Requirements.
and quarterly meetings as described in the including number of regional the 151 of the following
CSHCN Program Manual. meetings attended to the DOH month
contract manager.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hqp://www.phaboard.or
ZLW-content/uploads/PHAB-Standards-and-Measures-Version-I.O.pdf
Program Specific Req uirements/Narrative
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending_gov by DOH as required by P.L. 109-282.
Program Manual,Handbook,Policy References
Children with Special Health Care Needs Manual-http://www.doh.wa.gov/Portals/l/Documents/Pubs/970-209-CSHCN-Manual.pdf
Health Services Authorization(HSA)Form
http://www.doh.wa.pov/Portals/1/Documents/Pubs/910-002-ApprovedHSA.docx
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc)
1. At least 30%of federal Title V funds must be used for preventive and primary care services for children and at least 30%must be used services for children with
special health care needs. [Social Security Law,Sec.505(a)(3)].
Exhibit A, Statements of Work Page 4 of 48 Contract Number CLH18253
2. Funds may not be used for:
a. Inpatient services,other than inpatient services for children with special health care needs or high risk pregnant women and infants,and other patient services approved by
Health Resources and Services Administration(HRSA).
b. Cash payments to intended recipients of health services.
c. The purchase or improvement of land,the purchase,construction,or permanent improvement of any building or other facility,or the purchase of major medical
equipment.
d. Meeting other federal matching funds requirements.
e. Providing funds for research or training to any entity other than a public or nonprofit private entity.
f. payment for any services furnished by a provider or entity who has been excluded under Title XVIII(Medicare),Title XIX(Medicaid),or Title XX(social services block
grant).[Social Security Law,Sec 504(b)].
3. If any charges are imposed for the provision of health services using Title V(MCH Block Grant)funds,such charges will be pursuant to a public schedule of charges;will not
be imposed with respect to services provided to low income mothers or children;and will be adjusted to reflect the income,resources,and family size of the individual
provided the services. [Social Security Law,Sec. 505(1)(D)].
Monitoring Visits(frequency,type)
Telephone calls with contract manager at least one every quarter,and annual site visit.
Special Billing Requirements
Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable A19-lA invoice voucher. Payment to completely expend the"Total Consideration"
for a specific funding period will not be processed until all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of each month
following the month in which the expenditures were incurred and must be based on actual allowable program costs. Billing for services on a monthly fraction of the"Total
Consideration"will not be accepted or approved.
DOH Program Contact
Mary Dussol
Community Consultant
Office of Family and Community Health Improvement
Washington State Department of Health
Street Address:310 Israel Rd SE,Tumwater,WA 98501
Mailing Address:PO Box 47848,Olympia,WA 98504
Telephone: 360-236-3781 /Fax:360-236-3646
Email: mary.dussol(a)doh.wa.gov
Exhibit A,Statements of Work Page 5 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-20207
DOH Program Name or Title: NEP SSI Onsite Sewage Management- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through March 31,2019 ❑ state ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is for Mason County Public Health(MCPH)to protect public health by minimizing the public's effects of
onsite septic systems(OSS)on surface water,assure effective treatment and disposal of sewage on a long-term basis,minimize potential for public exposure to sewage,uphold
and comply with design,installation,and management requirements for OSS to accommodate effective treatment and disposal of sewage on a long term basis,and enhance
protection of environmentally sensitive areas within the Oakland Bay and Hammersley Inlet shellfish growing areas.Mason County Public Health(MCPH)will employ
previously successful tools used by the health department such as following up on unsatisfactory service events and complaints,creating as-builts to complete records,completing
parcel surveys,offering monitary operation and maintenance(O&M)incentives,notifying OSS owners of an overdue O&M status and educating the public about O&M and water
quality.MCPH will identify and correct non-point source pollution sources by conducting a monitoring program for optical brighteners.MCPH will also prioritize for the
emergency closure growing area of Hammersley Inlet to implement OSS regulation and increase O&M compliance.MCPH will develop,enhance,and review risk-based protocols
to support the work. Mason County Public Health(MCPH)will work with the Washington Department of Health(DOH)to develop and implement a risk based on-site sewage
system evaluation program within the Hammersley Inlet area. The program will employ previously successful tools used by the health department such as file review,parcel
evaluations,sampling(fecal coliform and optical brightener),dye studies,notifying homeowners of overdue O&M evaluations,offering O&M incentives,and educating the public
about O&M and water quality. Mason County Public Health will focus primarily on the Hammersley Inlet shoreline and upland area.Outreach and education activities will also
occur in the Oakland Bay watershed including Uncle John's Creek which feeds Oakland Bay's Chapman Cove.
NOTE:This statement of work(SOW)carries forward incomplete tasks and unspent funds from the 2015-2017 consolidated contract SOW.Total spending between the
two SOWs may not exceed the total award amount of$202,407.There are multiple funding sources for this award.See Special Instructions for spending requirements
from each funding source.
NOTE 2:Dates that precede January 1,2018 are for reference only.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
NEP 5-6 ONSITE SEWAGE MANAGEMENT 66.123 333.66.12 261Al2A5 01/01/18 03/31/19 0 74,426 74,426
PS SSI 1-5 OSS TASK 4 66.123 333.66.12 261KI209 01/01/18 1 03/31/19 0 99,878 99,878
TOTALS 0 174,304 174,304
Exhibit A,Statements of Work Page 6 of 48 Contract Number CLH 18253
GOALS&MEASURABLE OBJECTIVES
This simply summarizes key deliverables and measures called out in the tasks below. This table is a component of the FEATS report.
Description(e.g.,"shellfish beds reopened") Units Targets
(e.g."acres") ("number")
Complete Task 0.3 Evaluation Plan Evaluation Plan 1
Complete Task 1.1 Project Factsheet Project Factsheet 1
Change the status of 19 parcel closures from.Closed to Open in the growing area of Hammersley Inlet Parcel Open 19
Growing Area
QAPP QAPP 1
Optical Brightener Policy&Procedure Plan 1
Risk Based On-Site Sewage System Evaluation Policy&Procedure Plan 1
Updated OSS Dye Testing Policy&Procedure Plan 1
Fecal coliform monitoring plan Plan 1
Number of Hammersley Inlet fecal coliform samples collected Samples 600
Number of Hammersley Inlet Optical Brighteners(OB)pads analyzed by Mason County Public Health OB pads analyzed(MCPH) 600
CP
Number of Hammersley Inlet Optical Brighteners(OB)pads analyzed by Ozark Underground Laboratory OB pads analyzed(OUL) 60
OUL
Number of sanitary surveys conducted in Hammersley Inlet Sanitary Surveys Up to 10 200
Investigative fecal coliform monitoring Samples Up to 30
Risk based list of parcels for field evaluation in Hammersley Inlet List 1
Risk based list of parcels requiring OSS dye studies. List 1
Number of dye tests conducted in Hammersley Inlet Dye Tests 100%of parcels identified
to be dye tested
Number or percentage of OSS failures found that have been fixed OSS Failures repaired or in repair 100%
process
Number of OSS Rebates distributed Rebates 100
Oakland Bay Day EDDM for DOH approval Mailer 1
Number of Oakland Bay Day Mailers went in 2018 EDDMs sent Up to 12,000
Number of Oakland Bay Day Mailers went in 2019 EDDMs sent Up to 12,000
Oakland Bay overdue O&M educational mailings Mailings Up to 80
Mailer for community meeting for DOH approval Mailer 1
Final Project Report Report 1
Exhibit A,Statements of Work Page 7 of 48 Contract Number CLH18253
Task *May Support PHAB Payment
Task/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information
Number and/or Amount
NEP ONSITE SEWAGE MANAGEMENT ROUNDS 5-6—CFDA 66.123
THESE FUNDS MUST BE SPENT FIRST.
Costs for activities charged to this grant will not exceed$74,426. All A19-1A invoice vouchers for these expenditures will be billed to NEP 5-6 ONSITE SEWAGE
MANAGEMENT(Master Index Code 261Al2A5). FEATS,MBE/WBE,and any other reporting for activities conducted under Cooperative Agreement#OOJ88801 and will
reference this agreement number. See Special Instructions for applicable federal Terms and Conditions for this agreement.
NEP SHELLFISH STRATEGIC INITIATIVE ONSITE SEWAGE MANAGEMENT—CFDA 66.123
THESE FUNDS CAN ONLY BE SPENT AFTER ALL NEP OSS ROUNDS 5-6 FUNDS ARE SPENT.
Costs for activities charged to this grant will not exceed$99,878. All A19-IA invoice vouchers for these expenditures will be billed to PS SSI 1-5 TASK 4(Master Index Code
261K1204).FEATS,MBE/WBE,and any other reporting for activities conducted under Cooperative Agreement#OOJ18001 and will reference this agreement number. See
Special Instructions for applicable federal Terms and Conditions for this agreement.
TASK 0. PROJECT DEVELOPMENT
This task must be completed before initiating any other work under this subaward.Work completed prior to the completion of Task 0 will be ineligible for reimbursement under
this subaward.
0.1 Project Spatial Data and Climate Change Project Spatial Data and September 15,2017 Reimbursement
Assessment Climate Assessment up to$0 based
In the tasks below subrecipients will create a on actual costs.
detailed project outline and timeline to describe This was included as
project expectations and outcomes.The detailed informational only for contract
project plan will also identify how the negotiations,not intended to
objectives of the project will be evaluated, stay in contract.
including quantifiable performance measures
and targets.DOH will review project to see if
actions may have climate change intersections.
If there is a strong climate change
interconnections,DOH will work with the
subrecipient on how the project may be
developed to be climate resilient. DOH will
work with the subrecipient on the plan and
establish mutual expectations.
Subrecipients should provide relevant spatial
data for their project,and this should be
identified in the detailed project plan.
Subrecipients should consult with technical staff
and spatial analysts where appropriate to
determine the spatial data,associated metadata,
and data storage location that are relevant for
Exhibit A, Statements of Work Page 8 of 48 Contract Number CLH18253
the project.All subrecipients should submit
project coordinates(latitude,longitude)in
decimal dejuees.
0.2 Quality Assurance Project Plan(QAPP) QAPP Within 60 days of award
Development
Subrecipient will submit a Quality Assurance MCPH will work with Kitsap
Project Plan(QAPP)or QAPP waiver using Public Health District,Hood
Environmental Protection Agency's(EPA's) Canal Coordinating Council,
National Estuary Program(NEP)guidance for Island County Public Health,
QAPPs.If a QAPP is required,subrecipients and Department of Ecology
will work with the Washington State (ECY)to develop an approved
Department of Ecology's QA Officer to develop QAPP•
and approve the QAPP.Work related to
collecting environmental data may not begin
until the QAPP or waivers are completed and
approved.See EPA Programmatic Condition#5
in this agreement for more information.
0.3 Evaluation Plan Complete a short one-page Within 30 days of award
document.Use it to plan the
process your program will use
to gather information or collect
data. Following the project,it
will be used to assist in
describing what the outcome
results tell you about the impact
and success of your program
activities.
TASK 1.PROJECT MANAGEMENT AND REPORTING
This task describes the data collection and reporting requirements associated with this subaward.Maintenance of project records,submittal of payment vouchers,fiscal forms,
and progress reports;compliance with applicable procurement,contracting and interlocal agreement requirements;application for,receipt of,and compliance with all required
permits,licenses,easements,or property rights necessary for the project and submittal of required performance items. Carry out project in accordance with any completion
dates outlined in the agreement.Refer to and comply with all underlying federal terms and conditions.
1.1 Project Factsheet Project Fact Sheet August 30,2017 Reimbursement
Create a project factsheet(using included up to$4,603
template)and submit it in MS Word with the based on actual
first quarterly progress report. costs.
1.2 Bi-monthly(ConCon invoices are due every 60 Bi-monthly invoice and project Due annually:
days)Invoicing and Progress Summary summaries.
The subrecipient will email bi-monthly progress June 15
summary and invoicing related to project tasks FEATS will serve as project August 15
and deliverables to the contract manager.The summary for performance October I (FEATS)
summary period is synced to inform the Grant periods that fall on or near December 15
Program's EPA reporting schedule;therefore it FEATS due dates.See FEATS March 15 (FEATS)
is critical that the Project Sponsor submit these schedule in Task 1.2.1.
summaries to the Grant Program according to
Exhibit A,Statements of Work Page 9 of 48 Contract Number CLH18253
the following schedule.Progress Summaries Annual Performance Periods
shall include,at a minimum:
• A description of the work completed in the First Period:
last performance period,including total January 1 —February
spending by the project sponsor and any
partners and any completed deliverables. Second Period:
• The status and completion date for the March—April(FEATS)
project activities and near-term
deliverables. Third Period:
• Description of any problem or May—June 30
circumstances affecting the completion
date,scope of work,or costs. Fourth Period:
• Evidence that all the reporting requirements July 1—August
have been satisfactorily completed(see
below). Fifth Period:
September—October(FEATS)
Sixth Period:
November—December
1.2.1 Financial and Ecosystem Accounting Tracking Semi-annual FEATS reports April 1
System(FEATS) October 1
Complete semi-annual FEATS progress reports, FEATS will serve as project
as well as a final FEATS report.The final summary for performance And upon contract completion
FEATS report,reflecting the final project periods that fall on or near
billing,will be provided during project closeout, FEATS due dates.See FEATS
after the end of the grant,and will describe the schedule in Task 1.2.1.
entire project,highlighting project outcomes
and discussing lessons learned.See EPA
Pro aromatic Condition#1.
1.2.2 Puget Sound Partnership Required Near-Term 1. Implementation Status 1: March 31-April 28,2017
Actions(NTA)Reporting November 1-30,2017
NTA owners are required to report on the May 1-31,2018
following: Upon project/NTA
• Implementation status of their actions on a completion or
semiannual basis November 2018
• Financial status of their actions on an annual
basis 2. Financial Status 2.: June 30-August 15,2017
June 29-August 13,2018
Upon project/NTA
completion or August 2019
1.2.3 Women/Minority-Owned Business MBE/WBE Reporting October 15 annually
(MBE/WBE)Reports
MBE/WBE reporting is required annually.This And upon project completion
federal reporting is required for assistance
agreements where there are funds budgeted for
procuring construction equipment,services and
Exhibit A,Statements of Work Page 10 of 48 Contract Number CLH18253
supplies,including funds budgeted for direct
procurement by the recipient or procurement
under subawards or loans in the"Other"
category that exceed the threshold amount of
$150,000,including amendments and/or
modifications.
1.3 Final Project Report Final Report and updated Fact Upon project completion
A final report will be written by the project Sheet
owners that describes the methods,results,
lessons learned and recommendations for future
work. The final report will evaluate the success
of achieving the performance measures
identified in the detailed project plan.Included
with the final project report will be an updated
Project Fact Sheet see 1.1 .
TASK 2. POLICY DEVELOPMENT AND REVIEW
MCPH will develop a policy and procedure that will be used in the implementation of a sampling plan to include the analysis of optical brighteners.In addition,MCPH will
develops and implements a risk based analysis of all OSS along the shoreline of Hammersley Inlet to assure the systems are functioning properly and not impacting surface
water.Policies and procedures,using existing practices in Mason and other counties,will be developed.
2.1 OB Policy&Procedure a)QAPP or QAPP addendum a-b)Within 60 days of award Reimbursement
MCPH will evaluate,develop,and complete a up to$0 based
policy and procedure for OB sampling,analysis, b)Policy and procedure for OB on actual costs.
and regulatory implication.MCPH will provide sampling reviewed by DOH
a copy to DOH for review and approval.
2.2 Risk Based OSS Evaluation Procedure Development of a risk based Final procedure to DOH by
MCPH,in cooperation with DOH,will develop OSS evaluation procedure September 30,2017
a risk based OSS evaluation procedure.The reviewed by DOH.
procedure will assess the risk of individual OSS
and the potential for impact to surface water.
The procedure will assign high,medium,and
low tiers with the intent of implementing field-
based OSS evaluations and dye studies based on
the assigned tier.
2.3 OSS Dye Study Protocol&Procedure a)Evaluation of the current a-b)Final procedure to DOH by
Reevaluation OSS dye study protocols and October 31,2017
MCPH,in cooperation with DOH,will evaluate procedures,in cooperation with
the county's current OSS dye study protocols DOH
and procedures.Protocols will be updated,as
necessary,based on current conditions and b)Update current OSS dye
evaluation techniques. study protocols and procedures
Exhibit A, Statements of Work Page 11 of 48 Contract Number CLH18253
TASK 3. SHORELINE MONITORING AND"HOT SPOT"IDENTIFICATION
Hammersley Inlet is a shallow,narrow tidal channel connecting Oakland Bay with the main body of southern Puget Sound.The inlet is approximately 6.5 miles in length and
0.13 mile wide.The entire watershed is approximately 36.5 square miles,most of which is along the southern shoreline. There are approximately 175 small creeks,drainages,
culverts,and seeps exist along the shorelines of the Inlet. This study will target a minimum of 50 drainages with historically elevated bacteria levels or located near significant
upland development.
MCPH will use the policies and procedures developed in Task 2 to conduct a pilot project to monitor for optical brighteners(OB)and fecal coliform(FC). Optical brighteners
are fluorescent dyes found in most laundry detergents. Since adsorption is critical in the performance of on-site sewage systems(OSS),the presence of OB in surface water may
indicate ineffective OSS treatment. Monitoring for OB will help differentiate the source of elevated fecal coliform bacteria levels currently and previously identified in upland
drainages.
MCPH will work with DOH to develop the sampling plan. General direction of the sampling will include drainage and discharge analysis during both the"wet"and"dry"
seasons of the study period. The period of October through April will be considered the"wet"season while May through September will be considered the"dry"season. OB
cotton pads will be installed at each site during portions of the evaluation period. Sites will be evaluated for a four week period during both"wet"and"dry"seasons. During
these evaluation periods,cotton pads will be replaced each week. Flow measurements and FC samples will be collected when the cotton pads are replaced. Additional FC and
OB sampling may be used to investigate and segment drainages with positive OB detections or elevated FC concentrations. Sampling and analysis activities will be performed
according the plans and policies developed for the study.
MCPH will analyze OB pads under a long wavelength ultraviolet(365 nm)light in-house and verify the results of approximately 10%of the samples at Ozark Underground
Laborator t. Fecal coliform samples will be analyzed at a certified laboratory outside Mason County. All results will be provided to DOH.
3.1 OB&Fecal Coliform Sampling a)OB and FC monitoring plan May 31,2019 Reimbursement
MCPH will conduct fresh water monitoring at a approved by DOH up to$41,806
minimum of 50 drainages to Hammersley Inlet based on actual
to identify the presence of optical brighteners b)Number and results of OB costs.
(OB). Sampling at each drainage will occur one cotton sample pads(up to 600)
time during the predefined"wet"and"dry" analyzed by MCPH
seasons.All OB pads will be analyzed in-house
according to developed and approved c) Number and results of OB
procedures.Ten percent of the pads will be cotton sample pads analyzed by
analyzed by Ozark Underground Laboratory for Ozark Underground Laboratory
QA/QC.Simultaneously,the selected drainages (up to 60 for QA/QC)
will be monitored for fecal coliform bacteria.
Fecal coliform samples will be analyzed by a d)Number and results of fecal
certified laboratory.MCPH will develop a coliform monitoring samples.
sampling plan in cooperation with DOH. (Up to 600 samples collected
by MCPH)
e)Number of drainages
evaluated along the shorelines
of Hammersley Inlet. (A
minimum of 50 drainages
evaluated.
Exhibit A, Statements of Work Page 12 of 48 Contract Number CLH18253
TASK 4: RISK BASED EVALUATION OF ON-SITE SEWAGE SYSTEMS(OSS)
According to a 2016 shoreline survey completed by DOH,there are approximately 350 developed parcels along the Hammersley inlet shorelines using OSS for wastewater
treatment and dispersal. Land use is a mix of residential,timber,and agricultural lands with residential development along the fresh and marine water shorelines.Ninety-eight
percent of these sites were single family use sites with 60%considered to be full time residential sites. Fifty-eight percent of the OSS used gravity distribution for dispersal of
effluent and 43%of the systems were greater than 30 years old.To identify impacts from OSS into shellfish growing areas MCPH will complete an OSS risk based evaluation
along Hammersley Inlet.
4.1 OSS Record Search a) In-house record search a) Ongoing.
Reimbursement
MCPH will complete an OSS record search for and data evaluation for a
00
all systems along the Hammersley Inlet minimum of 350 First record search due up to$
shoreline. A risk based analysis will be shoreline parcels October 31,2017. based onn actual
costs.
completed using the data collected and
summarized to prioritize field based analysis. b) Development of a risk b) September 30,2018
This will be a working document that will be based list of parcels for
continually revised and updated field evaluation
4.2 OSS Field Evaluations a)Number of field parcel a) Field evaluation of 100
MCPH will complete"wet"season field surveys.Conduct a minimum of parcels by April 2018
evaluations using the procedures identified in the 200 field parcel surveys in the
OSS field evaluation portion of the performance work area.
plan outline in Task 2.
b)Development of a risk based b) Field evaluation of 100
list of parcels requiring OSS parcels by April 2019
dye studies.
c)Summarize number and c) See Task 1.
results Deliverables/Outcomes
and other progress indicators
utilizing DOH Pollution
Identification and Correction
Implementation Reporting form
quarterly. Attach reports to
each FEATS report. The final
quarterly report will have the
cumulative total for the entire
ro.ectperiod.
4.3 OSS Dye Testing a) Number of OSS dye tests a) OSS dye test of 3038%
MCPH will complete dye tests of the OSS of completed. A target of parcels by April 2018
concern identified in Task 4.2 using approved 100%of OSS identified
dye testing methodologies. in the risk analysis will be OSS dye test of 100%of
dye tested. parcels April 2019
b) Number of OSS b) April 2019
deficiencies/failures
identified
Exhibit A,Statements of Work Page 13 of 48 Contract Number CLH18253
c) Summarize number and c) See Task 1.
results
Deliverables/Outcomes
and other progress
indicators utilizing DOH
Pollution Identification
and Correction
Implementation Reporting
form quarterly. Attach
reports to each FEATS
report. The final
quarterly report will have
the cumulative total for
the entire project period.
4.4 OB Positive"Hot Spot"OSS Follow up a) Completed record a) Record search and field
MCPH will follow up on positive OB and fecal searches for developed evaluations completed for
coliform results identified in Task 3 by parcels near OB postive first"wet"season by June
completing OSS record searches for those parcels drainages within 30 days 2018
in the vicinity of the implicated drainages.Risk of positive sampling
based field evaluation and dye tests shall be results.
completed according to the perfeee Flan b) Completed risk based b) Record search and field
risk-based OSS evluation procedure outlined in field evaluations of evaluations completed for
Task 2. developed parcels near second"wet"season by
OB positive drainages May 2019
within 15 days of record
search
c) Completed risk based c) OSS dye studies completd
OSS dye studies of by May 2019
developed parcels near
OB positive drainages.
d) Up to 30 investigative FC d) May 2019
samples and results.
TASK 5. STUDY EDUCATION AND OUTREACH
As a member of Mason ECO Net,MCPH will help plan and participate in Oakland Bay Day.Oakland Bay Day is hosted by Mason ECO Net to educate the community about
water quality.Mason County will have an educational booth educating attendees about OSS maintenance and regulation and water quality.MCPH will provide twelve thousand
(12,000)every door direct mailings(EDDM)to the residents and landowners in the Oakland Bay MRA to encourage attendance.
MCPH will educate the shoreline OSS owners within the Hammersley Inlet emergency closure area with an out of date O&M status about their maintenance status and ways to
move into compliance.These informational mailings will occur four(4)times throughout the project.The number of mailings will depend on the number of shoreline OSS out
of compliance at the time of the mailing.
One hundred(100)rebates will be offered first come,first served to incentivize OSS maintenance.A$200 rebate will be offered for O&M or pumping.A second$200 rebate
will be offered for the installation of risers or an effluent filter.MCPH will prioritize the rebates first to the OSS owners in the Hammersley Inlet and then to the general MRA
where appropriate.Within each priority area MCPH will offer rebates to OSS with no O&M or out-of-date O&M.
MCPH will inform all residents and landowners in the Hammersley Inlet study area,via direct mailing,of the project described in Tasks 2-3 before work starts. The mailing
will inform owners of the pending project,the importance of OSS operation and maintenance,and the time,date,and location of the scheduled community-based meeting.At
project completion,findings will be available for landowner review.
Exhibit A, Statements of Work Page 14 of 48 Contract Number CLH18253
5.1 Oakland Bay Days a) Copy of the direct mailing. a) May 30,2018 Reimbursement
MCPH will coordinate and participate in Draft mailer materials May 30,2019 up to$37,895
Oakland Bay Day 2018 and 2019 by providing will be sent to DOH staff based on actual
water quality and onsite information at an for review costs.
educational booth.
b) Number of mailings. b) June 30,2018
MCPH will send 12,000 EDDM mailings to 12,000 mailings for 2018
inform and invite residents and landowners of
the Oakland Bay MRA to Oakland Bay Day to c) Number of mailings. c) June 30,2019
help increase attendance and to track the 12,000 mailings for 2019
effectiveness of EDDM for educational events.
d) Coordinate and participate d) July 2018
in Oakland Bay Day July 2019
e) Number of Oakland Bay e) Upon project completion
Day 2018 and 2019
attendees who heard
about the event through
the mailings.MCPH will
report outcomes in
FEATS.
5.2 Oakland Bay OSS O&M Educational Mailings up to eighty(80) a)October 2017
Mailings shoreline and upland OSS
MCPH will inform all shorelines OSS owners owners within Oakland Bay b)April 2018
within the Oakland Bay Shellfish Growing Area with out of date operation and
with out of date OSS of O&M status and next maintenance compliance. c)October 2018
steps for O&M compliance and rebate d)April 2019
information.There will be four 4 mailings.
5.3 OSS Rebates a)Provide up to one hundred a)April 30,2019
Incentives will be offered to OSS owners within (100)rebates
the Oakland Bay and Hammersley shellfish
growing areas in the form of rebates.Applicants
will be required to submit their paid invoices
with the proper paperwork to receive the rebate.
A$200 rebate will be offered for either
maintenance or pumping.A second$200 rebate
will be offered to install risers and or effluent
filter.If a homeowner self-installs risers or an
effluent filter,MCPH will conduct a site visit to
inspect the construction.Each interested
household will be eligible for both rebates with
the maximum amount of$400 per household.
MCPH will-offer rebates exclusively to
Hammersley Inlet OSS owners until April 2018.
Exhibit A,Statements of Work Page 15 of 48 Contract Number CLH18253
After April 2018,the rebates offered are first
come,first served.
Within each priority area MCPH will offer
rebates to OSS with no O&M and out of date
O&M.MCPH will offer incentives to
individuals as well as targeted areas.
5.4 Hammersley Inlet Study Education&
Outreach
5.4.1 MCPH will inform all Hammersley Inlet a)Copy of the mailing. Draft a-b)September 2017
shoreline residents and landowners in the study mailer materials will be sent to
area,via direct mailing,of the project before DOH staff for review.
work starts. The mailing will inform owners of
the pending project,the importance of OSS b)Date and number of mailings
operation and maintenance,and the time,date, sent(up to 400).
and location of the scheduled community-based
meeting.At project completion,findings will be
available for landowner review.
5.4.2 MCPH will hold one community-based meeting a)Report showing agenda, a) November 2017
to inform the shoreline OSS owners,and other time,date,location and
interested parties,of the upcoming roject. estimated number of attendees.
TASK 6.BROADER IMPACTS AND COMMUNICATION
MCPH will participate in and present project outcomes at a knowledge exchange event relevant to the project topic(conference,forum,stakeholder workshop).The subrecipient
will submit high-quality project photos or video clips of the project(process,progress,etc.).MCPH will ensure anyone in the photo or video has signed a release in case photos
or videos are used for future publications.
6.1 Submit high-quality project photos or videos. a) Photos a) Upon completion of project Reimbursement
up to$0 based
Participate in and present project outcomes at a b) MCPH will create a poster b) November 2018 or on actual costs.
knowledge exchange event relevant to the displaying their results June 2019 depending on
project topic. and discussion. workshop schedule
c) Draft materials will be c) Upon completion of project
sent to DOH staff for
review.
MCPH will present and display
their poster at the South Sound
Science Symposium in
September 2019 after the close
of the grant.
Exhibit A, Statements of Work Page 16 of 48 Contract Number CLH18253
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hn://www.phaboard.orz/n-content/uploads/PHAB-Standards-and-Measures-Version-I.O.udf
BUDGET
Category Amount
Personnel/Salaries $72,734
Fringe Benefits $41,633
Travel $0
Equipment (federal definition) $0
Supplies $750
Contracts $20,500
Lab Services
Subawards $0
Name and amount ea.
Other
• Rebates $24,630
• Postage
• EDDM Mailings
Total Direct Charges $160,247
Indirect Charges $14,057
(federally approved rate
TOTAL $174,304
Program Specific Requirements/Narrative
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending_gov by DOH as required by P.L. 109-282.
Program Manual,Handbook,Policy References
Mason County's On-site Sewage System Management Plan,December 5,2007
Exhibit A,Statements of Work Page 17 of 48 Contract Number CLH18253
Special References(RCWs,WACs,etc.)
WAC 246-272A,RCW 70.118A,Puget Sound Action Agenda,Interim PIC Program Protocols
Federal funds from the Environmental Protection Agency(EPA)National Estuary Program(NEP)Account must be used to implement elements and activities of the local on-site
sewage management plans that do not conflict with and are consistent with the goals,strategies,objectives,and actions of the Puget Sound Action Agenda.
Monitoring Visits(frequency,type)
The DOH program contact may conduct at least one(1)monitoring visit during the life of this project.The type,duration,and timing of visit will be determined and scheduled in
cooperation with the subawardee.The DOH Fiscal Monitoring Unit may conduct at least one(1)fiscal monitoring visit during the life of this project.
Special Instructions
"Unexpended funds,tasks,and deliverables in this statement of work that are not completed by December 31,2017 will be reauthorized for work in 2018 in a new statement of
work under the new consolidated contract term beginning January 1,2018.Total spending between the 2015-2017 and 2018-2020 SOWS may not exceed$202,427(award total)."
Progress reports are due to DOH via email to tracy.farrellAdoh.wa.gov and me,gan.schell@doh.wa.gov on the following dates:March 1,2018, September 12018,and upon
contract completion.Minority and Women-Owned business Reporting is due to kristy.warner@doh.wa.gov and cc:frac .farrellAdoh.wa.gov and megan.schell(d),doh.wa.gov on
the following dates:October 15 annually,and upon contract completion.
All environmental data must be entered by the LHJ into EPA's Storage and Retrieval data system(STORET)at http://www.epa.gov/STORET.The semi-annual report format and
data reporting requirements will be provided by DOH and may be modified throughout the contract period via email announcement.
"Note:Deliverables and due dates after December 31,2017 are included in this statement of work for informational purposes only and will be included in a new
statement of work under the new consolidated contract term beginning January 1,2018.
Program Specific Req uirements/Narrative
The following provisions are the pass-thru requirements of all U.S.EPA-DOH subawards funded under cooperative agreement PCO1J18001-0.
Administrative Conditions
1. General Terms and Conditions-Effective March 29,2016
The subrecipient agrees to comply with the current EPA general terms and conditions available at:hMs://www.epa.gov/grants/epa-general-terms-and-conditions-effective-
march-29-2016-or-later.These terms and conditions are in addition to the assurances and certifications made as part of the award and terms,conditions or restrictions cited
below.
The EPA repository for the general terms and conditions by year can be found at: hMs://www.epa.gov/mnts/R-rant-terms-and-conditions#general
a�grant-terms-and-conditions#general
2. General Terms and Conditions-Consultant Cap-Additional Information
In addition to the General Terms and Conditions#6"Consultant Cap",as of January 1,2016,the limit is$614.48 per day$76.81 per hour.
NOTE:For future years'limits,the subrecipient may find the annual salary for Level IV of the Executive Schedule on the following Internet site: hqp://www.ppm. og v/oca.
Select"Salary and Wages",and select"Rates of Pay for the Executive Schedule".The annual salary is divided by 2087 hours to determine the maximum hourly rate,which is
then multiplied by 8 to determine the maximum daily rate.
3. General Terms and Conditions—Cybersecurity
The subrecipient agrees to comply with the current EPA general terms and conditions"Cybersecurity".
The terms and conditions can be found on the EPA Grants Terms and Conditions Website.
For STATE:hLps://www.epa.gov/zrants/state-grant-cybersecuriiy-condition
For TRIBE:bMs://www.gpa.gov/grants/tribal-grant-cybersecurity-condition
For Other Recipients:http://www2.epa.gov/sites/production/files/2015-07/documents/cybersecuritygrantconditionforotherr ecipients.pdf.
Exhibit A,Statements of Work Page 18 of 48 Contract Number CLH 18253
4. General Terms and Conditions-Indirect Costs for States and Tribal
The cost principles of 2 CFR 200 Subpart E are applicable,as appropriate,to this subaward.
In addition to the General Terms and Conditions"Indirect Cost Rate Agreements",if the subrecipient does not have a previously established indirect cost rate,it agrees to
prepare and submit its indirect cost rate proposal in accordance with 2 CFR 200 Appendix VII.
For State Agencies
The subrecipient must send its proposal to its cognizant federal agency within six(6)months after the close of the governmental unit's fiscal year.If EPA is the cognizant
federal agency,the state subrecipient must send its indirect cost rate proposal within six(6)months after the close of the governmental unit's fiscal year to:
Regular Mail
Financial Analysis and Rate Negotiation Service Center Office of Acquisition Management
U.S.Environmental Protection Agency
1200 Pennsylvania Avenue,NW,MC 3802R
Washington,DC 20460
Mail Courier(e.g.FedEx.UPS,etc.)
Financial Analysis and Rate Negotiation Service Center Office of Acquisition Management
US Environmental Protection Agency
1300 Pennsylvania Avenue,NW,6th floor
Bid and Proposal Room Number 61107
Washington,DC 20004
For Indian Tribe
If the subrecipient does not have a previously established indirect cost rate,the subrecipient must submit their indirect cost rate proposals to:
National Business Center
Indirect Cost Services
U.S.Department of the Interior
2180 Harvard Street,Suite 430
Sacramento,CA 95815-3317
The subrecipient agrees to comply with the audit requirements in accordance with 2 CFR 200 Subpart F.
5. Utilization of Small,Minority and Women's Business Enterprises(MBE/WBE)
General Compliance,40 CFR,Part 33
The subrecipient agrees to comply with the requirements of EPA's Disadvantaged Business Enterprise(DBE)Program for procurement activities under assistance agreements,
contained in 40 CFR,Part 33.
MBE/WBE Reporting,40 CFR,Part 33,Subpart E
MBE/WBE reporting is required in annual reports.Reporting is required for assistance agreements where there are funds budgeted for procuring construction,equipment,
services and supplies,including funds budgeted for direct procurement by the subrecipient or procurement under subawards or loans in the"Other"category that exceed the
threshold amount of$150,000.,including amendments and/or modifications.
Based on EPA's review of the planned budget,this award meets the conditions above and is subject to the Disadvantaged Business Enterprise(DBE)Program reporting
requirements.However,if subrecipient believes this award does not meet these conditions,the subrecipient must provide a justification and budget detail within 21 days of the
award date clearly demonstrating that,based on the planned budget,this award is not subject to the DBE reporting requirements to the Region 10 DBE Coordinator.
The subrecipient agrees to complete and submit a"MBE/WBE Utilization Under Federal Grants,Cooperative Agreements and Interagency Agreements"report(EPA Form
5700-52A)on an annual basis.All procurement actions are reportable,not just that portion which exceeds$150,000.
Exhibit A,Statements of Work Page 19 of 48 Contract Number CLH18253
When completing the annual report,subrecipients are instructed to check the box titled"annual"in section 1B of the form.For the final report,subrecipients are instructed to
check the box indicated for the"last report"of the project in section 1B of the form.Annual reports are due by October 30 of each year.Final reports are due by October 301
or 90 days after the end of the project period,whichever comes first.
The reporting requirement is based on total procurements.Subrecipients with expended and/or budgeted funds for procurement are required to report annually whether the
planned procurements take place during the reporting period or not.If no budgeted procurements take place during the reporting period,the subrecipient should check the box
in section 5B when completing the form.
The current EPA Form 5700-52A can be found at the EPA Office of Small Business Program's Home Page at b=://www.epa.jzov/osbp/dbereporting.htm.
This provision represents an approved deviation from the MBE/WBE reporting requirements as described in 40 CFR,Part 33,Section 33.502;however,the other requirements
outlined in 40 CFR Part 33 remain in effect,including the Good Faith Effort requirements as described in 40 CFR Part 33 Subpart C,and Fair Share Objectives negotiation as
described in 40 CFR Part 33 Subpart D and explained below.
Six Good Faith Efforts,40 CFR,Part 33,Subpart C
Pursuant to 40 CFR,Section 33.301,the subrecipient agrees to make the following good faith efforts whenever procuring construction,equipment,services and supplies under
an EPA financial assistance agreement,and to require that sub-subrecipients,loan subrecipients,and prime contractors also comply.Records documenting compliance with
the six good faith efforts shall be retained:
(a) Ensure DBEs are made aware of contracting opportunities to the fullest extent practicable through outreach and recruitment activities.For Indian Tribal, State and Local
and Government subrecipients,this will include placing DBEs on solicitation lists and soliciting them whenever they are potential sources.
(b) Make information on forthcoming opportunities available to DBEs and arrange time frames for contracts and establish delivery schedules,where the requirements permit,
in a way that encourages and facilitates participation by DBEs in the competitive process.This includes,whenever possible,posting solicitations forbids or proposals for
a minimum of 30 calendar days before the bid or proposal closing date.
(c) Consider in the contracting process whether firms competing for large contracts could subcontract with DBEs.For Indian Tribal,State and local Government
subrecipients,this will include dividing total requirements when economically feasible into smaller tasks or quantities to permit maximum participation by DBEs in the
competitive process.
(d) Encourage contracting with a consortium of DBEs when a contract is too large for one of these firms to handle individually.
(e) Use the services and assistance of the SBA and the Minority Business Development Agency of the Department of Commerce.
(fl If the prime contractor awards subcontracts,require the prime contractor to take the steps in paragraphs(a)through(e)of this section.
Contract Administration Provisions,40 CFR,Section 33.302
The subrecipient agrees to comply with the contract administration provisions of 40 CFR, Section 33.302.
Bidders List,40 CFR,Section 33.501(b)and(c)
Subrecipients of a Continuing Environmental Program Grant or other annual reporting grant,agree to create and maintain a bidders list. Subrecipients of an EPA financial
assistance agreement to capitalize a revolving loan fund also agree to require entities receiving identified loans to create and maintain a bidders list if the subrecipient of the
loan is subject to,or chooses to follow,competitive bidding requirements.Please see 40 CFR,Section 33.501 (b)and(c)for specific requirements and exemptions.
Fair Share Objectives,40 CFR,Part 33,Subpart D
(1) For Grant Awards$250.000 or Less
This assistance agreement is a Technical Assistance Grant(TAG);or the award amount is$250,000 or less;or the total dollar amount of all of the subrecipient's
financial assistance agreements from EPA in the current Federal fiscal year is$250,000 or less.Therefore,the subrecipient of this assistance agreement is exempt
from the fair share objective requirements of 40 CFR,Part 33,Subpart D,and is not required to negotiate fair share objectives/goals for the utilization of MBE/WBEs
in its procurements.
Exhibit A,Statements of Work Page 20 of 48 Contract Number CLH18253
(2) For Subrecivients Accepting Goals
A subrecipient must negotiate with the appropriate EPA award official,or his/her designee,fair share objectives for MBE and WBE participation in procurement
under the financial assistance agreements.
In accordance with 40 CFR, Section 33.411 some subrecipients may be exempt from the fair share objectives requirements as described in 40 CFR,Part 33,Subpart
D.Subrecipients should work with their DBE coordinator,if they think their organization may qualify for an exemption.
Accepting the Fair Share Objectives/Goals of Another Subrecipient
The dollar amount of this assistance agreement,or the total dollar amount of all of the subrecipient's financial assistance agreements in the current federal fiscal year
from EPA is$250,000,or more.The subrecipient accepts the applicable MBE/WBE fair share objectives/goals negotiated with EPA.The Region 10 fair share
objectives/goals can be found:hiip://www.epa.gov/oshp/Xdfs/rlOfairsharepoals.pdf.
By signing this financial assistance agreement,the subrecipient is accepting the fair share objectives/goals and attests to the fact that it is purchasing the same or
similar construction,supplies,services and equipment,in the same or similar relevant geographic buying market.
Negotiating Fair Share Objectives/Goals,40 CFR,Section 33.404
The subrecipient has the option to negotiate its own MBE/WBE fair share objectives/goals.If the subrecipient wishes to negotiate its own MBE/WBE fair share
objectives/goals,the subrecipient agrees to submit proposed MBE/WBE objectives/goals based on an availability analysis,or disparity study,of qualified MBEs and
WBEs in their relevant geographic buying market for construction,services,supplies and equipment.
The submission of proposed fair share goals with the supporting analysis or disparity study means that the subrecipient is not accepting the fair share
objectives/goals of another subrecipient.The subrecipient agrees to submit proposed fair share objectives/goals,together with the supporting availability analysis or
disparity study,to the Regional MBE/WBE Coordinator within 120 days of its acceptance of the financial assistance award.EPA will respond to the proposed fair
share objective/goals within 30 days of receiving the submission.If proposed fair share objective/goals are not received within the 120 day time frame,the
subrecipient may not expend its EPA funds for procurements until the proposed fair share objective/goals are submitted.
(3) For Subrecivients with Established Goals
The subrecipient must negotiate with the appropriate EPA award official,or his/her designee,fair share objectives for MBE and WBE participation in procurement
under the financial assistance agreements.
In accordance with 40 CFR,Section 33.411 some subrecipients may be exempt from the fair share objectives requirements described in 40 CFR,Part 33,Subpart D.
Subrecipients should work with their DBE coordinator,if they think their organization may qualify for an exemption.
Current Fair Share Objective/Goal
The dollar amount of this assistance agreement or the total dollar amount of all of the subrecipient's financial assistance agreements in the current federal fiscal year
from EPA is$250,000,or more.The Region 10 fair share objectives/goals can be found:hM://www.epa.gov/osbp/pdfs/rl0fairsharegoals.pdf.
Negotiating Fair Share Objectives/Goals
In accordance with 40 CFR,Part 33,Subpart D,established goals/objectives remain in effect for three fiscal years unless there are significant changes to the data
supporting the fair share objectives.The subrecipient is required to follow requirements as outlined in 40 CFR Part 33,Subpart D when renegotiating the fair share
objectives/goals.
(4) For DWSRF CWSRF and BROWNFIELDS RLF Subrecivients ONLY
Objective/Goals of Loan Subrecipients
As a subrecipient of an EPA financial assistance agreement to capitalize revolving loan funds,the subrecipient agrees to either apply its own fair share objectives
negotiated with EPA to identified loans using a substantially similar relevant geographic market,or negotiate separate fair share objectives with its identified loan
subrecipients.These separate objectives/goals must be based on demonstrable evidence of the availability of MBEs and WBEs in accordance with 40 CFR,Part 33,
Subpart D.
The subrecipient agrees that if procurements will occur over more than one year,the subrecipient may choose to apply the fair share objective in place either for the
year in which the identified loan is awarded or for the year in which the procurement action occurs.The subrecipient must specify this choice in the financial
assistance agreement,or incorporate it by reference therein.
Exhibit A, Statements of Work Page 21 of 48 Contract Number CLH 18253
(5) R10 DBE Coordinator and Where to Send Report
Andrea Bennett at(206)553-1789 or email:Bennett.Andrea(&epa.gov. The coordinator can answer any MBE/WBE reporting questions you may have.MBE/WBE
reports should be sent to the EPA Region 10,Grants and Interagency Agreements Unit, 1200 Sixth Avenue, Suite 900,OMP-173,Seattle,WA 98101 or FAX to
(206)553-4957.
Programmatic Conditions
1. Semi-Annual Performance Reports
The subrecipient shall submit performance reports every six(6)months during the life of the project.Reports are due 30 calendar days after the end of each reporting period.
Reports shall be submitted to the DOH Contract Manager and may be provided electronically.
In accordance with 2 CFR 200.328,as appropriate,the subrecipient agrees to submit performance reports that include brief information on each of the following areas:
(a) A comparison of actual accomplishments to the outputs/outcomes established in the assistance agreement work plan for the period;
(b) The reasons why established goals were not met,if appropriate;
(c) Additional pertinent information including,when appropriate,analysis and explanation of cost overruns or high unit costs.
In addition to the semi-annual performance reports,the subrecipient shall immediately notify the DOH Contract Manager of developments that have a significant impact on the
award-supported activities. As appropriate, the subrecipient agrees to inform the DOH Contract Manager as soon as problems, delays or adverse conditions become known
which will materially impair the ability to meet the outputs/outcomes specified in the assistance agreement work plan. This notification shall include a statement of the action
taken or contemplated,and any assistance needed to resolve the situation.
The subrecipient will submit performance reports through EPA's Puget Sound Financial and Ecosystem Accounting Tracking System(FEATS).Reports are due at least 30
calendar days after the end of each reporting period.Earlier,but not later due dates may be mutually agreed upon by the Contract Manager and subrecipient in the award
document.The reporting periods shall end March 31 st and September 30th of each calendar year.Reports shall be submitted to the DOH Contract Manager on the FEATS
form provided by the Contract Manager and shall be submitted by electronic mail.The subrecipient agrees to submit performance reports that include brief information on
each of the following areas:
(a) A comparison of actual accomplishments to the outputs/outcomes established in the assistance agreement work plan for the period;
(b) The reasons for slippages if established outputs/outcomes were not met;
(c) Additional pertinent information,including when appropriate,analysis and information of cost overruns or high unit costs.
2. Final Performance Report
The subrecipient shall submit a final performance report through FEATS,which is due 90 calendar days after the expiration or termination of the award.The report shall be
submitted to the DOH Contract Manager and must be provided electronically.The report shall generally contain the same information as in the periodic reports,but should
cover the entire project period.After completion of the project,the DOH Contract Manager may waive the requirement for a final performance report if the DOH Contract
Manager deems such a report is inappropriate or unnecessary.
3. Program Income-Addition
If program income is generated,the subrecipient is required to account for program income related to this project.Program income earned during the project period shall be
retained by the subrecipient and shall be added to funds committed to the project by EPA and the subrecipient,and shall be used to further eligible project objectives.
4. Recognition of EPA Funding
Reports,documents,signage,videos,or other media,developed as part of projects funded by this assistance agreement shall contain the following statement:
"This project has been funded wholly or in part by the United States Environmental Protection Agency under assistance agreement(number)to(subrecipient).The contents of
this document do not necessarily reflect the views and policies of the Environmental Protection Agency,nor does mention of trade names or commercial products constitute
endorsement or recommendation for use."
Exhibit A,Statements of Work Page 22 of 48 Contract Number CLH18253
5. Quality Assurance Requirements(2 CFR 1500.11)(if applicable)
Acceptable Quality Assurance documentation must be submitted within 30 days of the acceptance of this agreement or another date as negotiated with the DOH
Contract Manager and NEP Quality Assurance Coordinator.No work involving direct measurements or data generation,environmental modeling,compilation of data
from literature or electronic media,and data supporting the design,construction,and operation of environmental technology shall be initiated under this project until the EPA
Project Officer,in concert with the EPA Quality Assurance Manager,has approved the quality assurance document.
Instructions to Submit Quality Assurance Documents for Review
Please refer to The Department of Ecology's website at:hgp://www.ecy.wa.gov/proexams/eap/ga/docs/NEPQAPP/index.html for guidance and templates. Submit the
Acceptable Quality Assurance documentation to Tom Gries at tar1461Qecy.wa.Qov(NEP Quality Assurance Coordinator)for review with a cc:to megan.schellAdoh.wa.gov
and tract'farrell(@doh.wa.sov(DOH NEP Contract Managers).
Additional information on these requirements can be found at the EPA Office of Grants and Debarment website:http://www.epa.p-ov/ogd/grants/assurance.htm.
6. Peer Review
The results of this project may affect management decisions relating to Puget Sound.Prior to finalizing any significant technical products the Principal Investigator(PI)of this
project must solicit advice,review and feedback from a technical review or advisory group consisting of relevant subject matter specialists.A record of comments and a brief
description of how respective comments are addressed by the PI will be provided to the Project Monitor prior to releasing any final reports or products resulting from the
funded study.
7. Competency of Organizations Generating and/or Using Environmental Measurement Data
In accordance with Agency Policy Directive Number FEM-2012-02,Policy to Assure the Competency of Organizations Generating Environmental Measurement Data under
Agency-Funded Assistance Agreements,subrecipient shall maintain competency for the duration of the project period of this agreement and this will be documented during
the annual reporting process.A copy of the Policy is available online at http://www.gpa.gov/fem/lab comp.htm or a copy may also be requested by contacting the DOH
Contract Manager for this award.
Federal Assistance Agreement Funds Up To$200,000
Subrecipient agrees that if the total federal funding obligated on this award exceeds$200,000(resulting from subsequent amendments to this agreement)and will involve the
use or generation of environmental data it will(unless it has otherwise done so)demonstrate competency prior to carrying out any activities involving the generation or use of
environmental data under this agreement.
Federal Assistance Agreement Funds Exceed or Expect to Exceed$200,000
Subrecipient agrees,by entering into this agreement,that it has demonstrated competency prior to award,or alternatively,where a pre-award demonstration of competency is
not practicable.Subrecipient agrees to submit documentation and demonstrate competency prior to carrying out any activities under the award involving the generation or use
of environmental data.
Shellfish Strategic Initiative Quality Assurance Coordinator Contact:Tom Gries at tgr1461@ecy.wa.gov
8. STORET Requirement
Subrecipients are required to institute standardized reporting requirements into their work plans and include such costs in their budgets.All water quality data generated in
accordance with an EPA approved Quality Assurance Project Plan as a result of this assistance agreement,either directly or by subaward,will be required to be transmitted
into the Agency's Storage and Retrieval(STORET)data warehouse using either WQX or WQX web.Water quality data appropriate for STORET include physical,chemical,
and biological sample results for water,sediment and fish tissue.The data include toxicity data,microbiological data,and the metrics and indices generated from biological
and habitat data.The Water Quality Exchange(WQX)is the water data schema associated with the EPA, State and Tribal Exchange Network.Using the WQX schema
partners map their database structure to the WQX/STORET structure.WQX web is a web based tool to convert data into the STORET format for smaller data generators that
are not direct partners on the Exchange Network.More information about WQX,WQX web,and the STORET warehouse,including tutorials,can be found at
b=://www.epa.gov/storet/wqx/
If activities submitted as match for this federal assistance agreement involve the generation of water quality data,the resulting information must be publicly accessible(in
STORET or some other database). Subrecipients are encouraged to develop a cross walk between any non-STORET database utilized for the storage of water quality data
associated with match activities and EPA's Water Quality Exchange(WQX).
Exhibit A, Statements of Work Page 23 of 48 Contract Number CLH18253
9. Riparian Buffers
Riparian buffer restoration projects in agricultural areas shall be consistent with the interim riparian buffer recommendations provided to EPA and the Natural Resource
Conservation Service by National Marine Fisheries Service letters of January 30,2013 (stamp received date-February 4,2013)and April 9,2013 (stamp received date—
April 16,2013),or the October 28,2013 guidance.Grantees shall confirm in writing projects'consistency with the recommendations referenced above.When developing
project proposals,grantees also should consider the extent to which proposals include appropriate riparian buffers or otherwise address pollution sources on other water
courses on the properties in the project area to support water quality and salmon recovery.Deviations can only be obtained through an exception approved by EPA.In order
for EPA to evaluate a request for an exception,the grantee must submit the scientific rationale demonstrating adequacy of buffers for supporting water quality and salmon
recovery.The request must summarize tribal input on the scientific rationale or other relevant issues.The scientific rationale could be developed from sources such as site-
specific assessment data,salmon recovery plans,Total Maximum Daily Loads(TMDLs)and the state nonpoint plan.EPA will confer with the National Oceanic and
Atmospheric Administration(NOAA)and the Washington Department of Ecology and provide the opportunity for affected tribes to consult with EPA before making a final
decision on a deviation request.
10. International Travel(Including Canada)
All International Travel must be approved by the Office of International and Tribal Affairs(OITA)BEFORE travel occurs.Even a brief trip to a foreign country,for example
to attend a conference,requires OITA approval.Please contact your DOH Contract Manager as soon as possible if travel is planned out of the country,including Canada
and/or Mexico,so that they can obtain appropriate approvals from EPA Headquarters.If you have questions,please contact your DOH Contract Manager listed in this award
document.
11. Geospatial Data Standards
All geospatial data created must be consistent with Federal Geographic Data Committee(FGDC)endorsed standards.Information on these standards may be found at
www.fgdc.gov
12. ULO Stretch Goal
Subrecipients should manage their programs and subaward funding in ways that reduce the length of time that federal funds obligated and committed to subaward projects are
"unspent"federal funds,not yet drawn down through disbursements.
EPA encourages the reduction of these unliquidated obligations(ULOs)by applying the following programmatic term and condition to these assistance agreements
Assistance agreement subrecipients are to apply these"stretch"goals throughout the life of the assistance agreement and to confer with your DOH Contract Manager
whenever instances arise that make attainment of these stretch goals unlikely.
A stretch goal for utilization of funds is established.All funds should be spent by 2 years.
Stretch Goal
Funds Awarded in FY 2016
(October, 1,2016-September 30,2017)
Should all Be Drawn Down by March 2019
DOH Program Contact
Tracy Farrell,Office of Environmental Health,PO Box 47824,Olympia WA 98504-7824;360.236.3337;tracy.farrell(Uoh.wa.gov
Exhibit A,Statements of Work Page 24 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office of Drinking Water Group A Program- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Contractor (check if applicable) ❑Reimbursement
Period of Performance: January 1,2018 through December 31,2020 ® State ❑FFATA(Transparency Act) ®Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to provide funding to the LHJ for conducting sanitary surveys and providing technical assistance to small
community and non-community Group A water systems.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
Yr 20 SRF-Local Asst 15% S SS N/A 346.26.64 24139220 01/01/18 12/31/20 0 12,000 12,000
Sanitary Survey Fees(FO-SW) SS-State N/A 346.26.65 24232522 01/01/18 12/31/20 0 12,000 12,000
Yr 20 SRF-Local Asst 15% S TA N/A 346.26.66 24139220 01/01/18 12/31/20 0 2,000 2,000
TOTALS 0 26,000 26,000
Task Task/Activity/Description *May Support PHAB Deliverables/Outcomes Due Date/Time Payment Information and/or Amount
Number Standards/Measures Frame
1 Trained LHJ staff will conduct Provide Final* Sanitary Final Sanitary Upon ODW acceptance of the Final
sanitary surveys of small community Survey Reports to ODW Survey Reports Sanitary Survey Report,the LHJ shall be
and non-community Group A water Regional Office.Complete must be received by paid$400 for each sanitary survey of a non-
systems identified by the DOH Office Sanitary Survey Reports the ODW Regional community system with three or fewer
of Drinking Water(ODW)Regional shall include: Office within 30 connections.
Office. 1. Cover letter identifying calendar days of
significant deficiencies, conducting the Upon ODW acceptance of the Final
See Special Instructions for task significant findings, sanitary survey. Sanitary Survey Report,the LHJ shall be
activity. observations, paid$800 for each sanitary survey of a non-
recommendations,and community system with four or more
referrals for further connections and each community system.
ODW follow-up.
2. Completed Small Water Payment is inclusive of all associated costs
System checklist. such as travel,lodging,per diem.
Exhibit A,Statements of Work Page 25 of 48 Contract Number CLH18253
Task Task/Activity/Description -;--May Support PHAB Deliverables/Outcomes Due Date/Time Payment Information and/or Amount
Number Standards/Measures Frame
3. Updated Water Payment is authorized upon receipt and
Facilities Inventory acceptance of the Final Sanitary Survey
(WFI). Report within the 30-day deadline.
4. Photos of water system
with text identifying Late or incomplete reports may not be
features accepted for payment.
5. Any other supporting
documents.
*Final Reports reviewed
and accepted by the ODW
Regional Office.
DOH will provide a tablet and GPS The LHJ surveyor will
unit for the LHJ to gather source data record at least two(2)GPS
during a routine sanitary survey.DOH data points,for each source,
expects the LHJ to commit to using into the preloaded Excel
the tablet and GPS for a five-year template on the tablet and
period. submit that data file with the
associated sanitary survey.
2 Trained LHJ staff will conduct Provide completed SPI Completed SPI Upon acceptance of the completed SPI
Special Purpose Investigations(SPI) Report and any supporting Reports must be Report,the LHJ shall be paid$800 for each
of small community and non- documents and photos to received by the SPI.
community Group A water systems ODW Regional Office. ODW Regional
identified by the ODW Regional Office within 2 Payment is inclusive of all associated costs
Office. working days of the such as travel,lodging,per diem.
service request.
See Special Instructions for task Payment is authorized upon receipt and
activity. acceptance of completed SPI Report within
the 2 working day deadline.
Late or incomplete reports may not be
accepted for payment.
3 Trained LHJ staff will provide direct Provide completed TA Completed TA Upon acceptance of the completed TA
technical assistance(TA)to small Report and any supporting Report must be Report,the LHJ shall be paid for each
community and non-community documents and photos to received by the technical assistance activity as follows:
Group A water systems identified by ODW Regional Office. ODW Regional a Up to 3 hours of work:$250
the ODW Regional Office. Office within 30 • 3-6 hours of work:$500
calendar days of e More than 6 hours of work:$750
See Special Instructions for task providing technical
activity. assistance.
Exhibit A,Statements of Work Page 26 of 48 Contract Number CLH18253
Task *May Support PHAB Deliverables/Outcomes Due Date/Time Payment Information and/or Amount
Number Task/Activity/Description Standards/Measures Frame y
Payment is inclusive of all associated costs
such as consulting fee,travel,lodging,per
diem.
Payment is authorized upon receipt and
acceptance of completed TA Report within
the 30-day deadline.
Late or incomplete reports may not be
acce ted for payment.
4 LHJ staff performing the activities Prior to attending the Annually LHJ shall be paid mileage,per diem,
under tasks 1,2 and 3 must have training,submit an lodging,and registration costs as approved
completed the mandatory Sanitary "Authorization for Travel on the pre-authorization form in accordance
Survey Training. (Non-Employee)"DOH with the current rates listed on the OFM
Form 710-013 to the ODW Website
See Special Instructions for task Program Contact below for bqp://www.ofin.wa.pov/resources/travel.aM
activity. approval(to ensure that
enough funds are available).
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hgp://www phaboard orgLwp-content/uploads/PHAB-Standards-and-Measures-Version-I.O.pdf
Program Specific Req uirements/Narrative
Special References(RCWs,WACs,etc)
Chapter 246-290 WAC is the set of rules that regulate Group A water systems. By this statement of work,ODW contracts with the LHJ to conduct sanitary surveys(and SPIs,and
provide technical assistance)for small community and non-community water systems with groundwater sources. ODW retains responsibility for conducting sanitary surveys(and
SPIs,and provide technical assistance)for small community and non-community water systems with surface water sources,large water systems,and systems with complex
treatment.
LHJ staff assigned to perform activities under tasks 1,2,and 3 must be trained and approved by ODW prior to performing work. See special instructions under Task 4,below.
Special Billing Requirements
The LHJ shall submit quarterly invoices within 30 days following the end of the quarter in which work was completed,noting on the invoice the quarter and year being billed for.
Payment cannot exceed a maximum accumulative fee of$24,000 for Task 1,and$2,000 for Task 2,Task 3 and Task 4 combined during the contracting period,to be paid at the
rates specified in the Payment Method/Amount section above. When invoicing for sanitary surveys bill half to BARS Revenue Code 346.26.64 and half to BARS Revenue Code
346.26.65.
When invoicing for Task 1,submit the list of WS Name,ID#,Amount Billed,Survey Date and Letter Date that you are requesting payment.
When invoicing for Task 2-3,submit the list of WS Name,ID#,TA Date and description of TA work performed,and Amount Billed.
When invoicing for Task 4,submit receipts and the signed pre-authorization form for non-employee travel to the ODW Program Contact below and a signed A19-IA Invoice
Exhibit A,Statements of Work Page 27 of 48 Contract Number CLH18253
Voucher to the DOH Grants Management,billing to BARS Revenue Code 346.26.66 under Technical Assistance(TA).
Special Instructions
Task 1
Trained LHJ staff will evaluate the water system for physical and operational deficiencies and prepare a Final Sanitary Survey Report which has been accepted by ODW.Detailed
guidance is provided in the Field Guide for Sanitary Surveys, Special Purpose Investigations and Technical Assistance(Field Guide).The sanitary survey will include an
evaluation of the following eight elements:source;treatment;distribution system;finished water storage;pumps,pump facilities and controls;monitoring,reporting and data
verification;system management and operation;and certified operator compliance. If a system is more complex than anticipated or other significant issues arise,the LHJ may
request ODW assistance.
• No more than 0 surveys of non-community systems with three or fewer connections to be completed between January 1,2018 and December 31,2018.
o No more than 30 surveys of non-community systems with four or more connections and all community systems to be completed between January 1,2018 and
December 31,2018.
The process for assignment of surveys to the LHJ,notification of the water system,and ODW follow-up with unresponsive water systems;and other roles and responsibilities of
the LHJ are described in the Field Guide.
Task 2
Trained LHJ staff will perform Special Purpose Investigations(SPIs)as assigned by ODW. SPIs are inspections to determine the cause of positive coliform samples or the cause of
other emergency conditions. SPIs may also include sanitary surveys of newly discovered Group A water systems.Additional detail about conducting SPIs is described in the Field
Guide.The ODW Regional Office must authorize in advance any SPI conducted by LHJ staff.
Task 3
Trained LHJ staff will conduct Technical assistance as assigned by ODW.Technical Assistance includes assisting water system personnel in completing work or verifying work
has been addressed as required,requested,or advised by the ODW to meet applicable drinking water regulations. Examples of technical assistance activities are described in the
Field Guide.The ODW Regional Office must authorize in advance any technical assistance provided by the LHJ to a water system.
Task 4
LHJ staff assigned to perform activities under tasks 1,2,and 3 must be trained and approved by ODW prior to performing work.LHJ staff performing the activities under tasks 1,
2 and 3 must have completed,with a passing score,the ODW Online Sanitary Survey Training and the ODW Sanitary Survey Field Training.LHJ staff performing activities under
tasks 1,2,and 3 must attend the Annual ODW Sanitary Survey Workshop,and are expected to attend the Regional ODW LHJ Drinking Water Meetings.
If required trainings,workshops or meetings are not available,not scheduled,or if the LHJ staff person is unable to attend these activities prior to conducting assigned tasks,the
LHJ staff person may,with ODW approval,substitute other training activities to be determined by ODW. Such substitute activities may include one-on-one training with ODW
staff,co-surveys with ODW staff,or other activities as arranged and pre-approved by ODW.LHJ staff may not perform the activities under tasks 1,2,and 3 without completing
the training that has been arranged and approved by ODW.
Program Manual,Handbook,Policy References
htti)://www.doh.wa.gov/Portals/l/Documents/Pubs/331-486.i)df
DOH Program Contact DOH Fiscal Contact
Denise Miles Karena McGovern
DOH Office of Drinking Water DOH Office of Drinking Water
243 Israel Rd SE 243 Israel Rd SE
Tumwater,WA 98501 Tumwater,WA 98501
Denise.Miles@doh.wa.gov Karena.McGovem@doh.wa.gov
(360)236-3028 (360)236-3094
Exhibit A, Statements of Work Page 28 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office of Drinking Water Group B Program- Local Health Jurisdiction Name: Mason County Public Health
Effective Januaa l,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
❑Federal<Select One> (check if applicable) ❑Reimbursement
Period of Performance: January 1,2018 through June 30,2018 ® State ❑FFATA(Transparency Act) ®Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to provide financial support to LHJs implementing local Group B water system programs.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
GFS-Group B(FO-SW) N/A 334.04.90 24230103 01/01/18 06/30/18 0 2,500 2,500
TOTALS 0 1 2,500 2,500
Task *May Support PHAB Memorandum of Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Agreement Number Information and/or
Amount
1 Implement a partial Group B water system An executed joint plan of Reference DOH JPR Lump sum payment
program. responsibility(JPR)with DOH #N20495 (See Special Billing
identifying responsibilities of a Requirements)
partial Group B program.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hitp://www.phaboard.orgL
W-contenVuploads/PHAB-Standards-and-Measures-Version-I.O.pdf
Proeram Specific Requirements/Narrative
Special Billing Requirements
The LHJ shall submit a$2,500 invoice before May 15,2018.
Exhibit A, Statements of Work Page 29 of 48 Contract Number CLH18253
DOH Program Contact DOH Fiscal Contact
Bonnie Waybright,P.E. Karena McGovern
Southwest Regional Manager DOH Office of Drinking Water
DOH Office of Drinking Water 243 Israel Rd SE
243 Israel Rd SE Tumwater,WA 98501
Tumwater,WA 98501 Karena.Mcgovem@doh.wa.gov
Bonnie.Waybright(a,doh.wa.gov (360)236-3094
(360)236-3025
Exhibit A,Statements of Work Page 30 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office of Emer ency Preparedness&Response- Local Health Jurisdiction Name: Mason County Public Health
Effective Januar,2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through June 30,2018 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to establish the funding and tasks for the Public Health Emergency Preparedness and Response program
for the 2017 grant period.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY17 EPR PHEP BPI LHJ FUNDING 93.069 333.93.06 18101380 01/01/18 06/30/18 0 19,917 19,917
TOTALS 1 0 19,917 19,917
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 Attend emergency preparedness events,(e.g. Submit end of year progress report. June 30,2018 Reimbursement for
trainings,meetings,conference calls,and actual costs not to
conferences)as necessary to advance LHJ exceed total funding
preparedness or complete the deliverables in this consideration amount.
statement of work.
2 Complete reporting templates as requested by Submit completed templates to June 30,2018
DOH to comply with program and federal grant DOH
requirements(e.g.performance measures,gap
analysis,mid-year and end-of-year reporting
templates,etc.
3 Use established procedures to activate a public Submit end of year progress report. June 30,2018
health emergency response plan within the
jurisdiction. Test the following: Submit the most recent Public
• How the command structure is utilized to Health Emergency Response Plan.
manage emergency response
Exhibit A,Statements of Work Page 31 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
• The relationship between the LHJ and the Submit documentation of the use
county Emergency Operations Center of the Public Health Emergency
(EOC)during a response. Response Plan during an incident
• An EOC location from which public and/or exercise. Documents
health will coordinate the Public Health should include an Incident Action
Emergency Response Plan Plan(IAP),After Action Report
• The process for notifying and mobilizing (AAR),Situation Reports(SitRep),
staff during an incident. Corrective Action Plans(CAP).
3.1)Provide training for appropriate staff who Submit agenda and sign in sheets
serve in the EOC and the Emergency Support of trainings,including attendee
Function#8(ESF#8)role on the Incident signatures and contact information,
Command System(ICS),recent Public Health conducted on Public Health
Emergency Response plans and policies Emergency Response Plan
3.2)Train appropriate public health emergency Agenda and sign in sheets of
response staff on Web EOC or applicable trainings conducted,with attendee
information management system utilized by local signatures and contact information,
emergency management in the county. or registrations if training is not
conducted by the LHJ
4 Use established decision making protocol to Submit end of year progress report. June 30,2018
support the Local Health Officer and the Public
Health Administrator in making policy level Submit documented use of the
decisions during an emergency. decision making protocol used
during an emergency to DOH
4.1 Document that Public Health,Medical and
Mortuary Response is identified in the Public Public Health,Medical and
Health Emergency Plan and is integrated with the Mortuary Response documentation
City and County Emergency Plans. showing inclusion in city and
county plans.
5 Maintain Washington Secure Electronic Submit end of year progress report. June 30,2018
Communication,Urgent Response and Exchange
System(WASECURES)program as the primary A list of registered users to include
emergency notification system within the LHJ and their title and role in the
include all critical LHJ positions as registered emergency response plan.
users.
Results of notification drill.
5.1) Conduct a notification drill using
WASECURES.
Notes: Registered users must log in quarterly at a
minimum. DOH will provide on-site technical
assistance to LHJs as needed on utilizing
Exhibit A,Statements of Work Page 32 of 48 Contract Number CLH18253
Task "May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or _
Amount
WASECURES.LHJs may choose to utilize other
notification systems in addition to WASECURES
to alert staff during incidents.
6 Use established procedures for your LHJ to request Submit end of year progress report. June 30,2018
assistance from the local EOC,neighboring LHJs,
and DOH during disasters. Submit AARs and IAPB that
• Identify how resources are coordinated with includes documentation of the
the local EOC. elements listed.
• Identify how to coordinate the logistical issues
to receive resources from DOH and other
partners. (If LHJs rely on local Emergency
Management(EM)or other partners to
coordinate logistical issues for receiving
resources,and the local EM plan documents
this fact,that documentation will suffice.
7 Use established procedures and plans to inform the Submit end of year progress report. June 30,2018
public of threats to health and safety by various
means. Include a list of the various mechanisms Submit AARs and messaging used
used by your LHJ for releasing information to the to inform the public during drills,
public during drills,exercises or incident response. exercise or incident response.
Include a summary of how
7.1)Create and maintain templates for news communication tools were used.
releases for categories of public health hazards.
Submit sample templates.
8 Participate in evaluation of response capabilities Submit end of year progress report. June 30,2018
based on a standard evaluation tool created by
DOH.
9 Use established procedures to gain and maintain Submit end of year progress report. June 30,2018
situational awareness during an incident.
Use forms and processes for collecting key data Submit an AAR which includes
elements during disasters including: how these plans and forms were
• The functionality of critical public health used to maintain situational
operations awareness during all drills,
• The functionality of critical healthcare exercises and real world incidents
facilities and the services they provide
• The functionality of critical infrastructure Submit SitReps that include the
serving public health and healthcare facilities data elements listed and a
(roads,water,sewer,power,communications) summary of how it was
• Number of disease cases disseminated.
• Number of fatalities attributed to an incident Data collection form templates.
• If key elements are collected by others,such
as local EM or Health Care Coalition(HCC),
Exhibit A,Statements of Work Page 33 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
describe how the LHJ gains access to that
information.
9.1)Create an ESF#8 situation report form based Submit ESF#8 SitReps used
on an established planning cycle to include,at a during drills,exercises or real
minimum,the data elements listed above. world incidents.
9.2)Demonstrate disseminating situation reports to Submit agenda and sign in sheets,
ESF#8 response partners including attendee signatures and
contact information,for trainings
9.3)Train staff on all procedures established to conducted on situational
maintain situational awareness during an incident. awareness.
10 Participate in one or more exercises or real world Submit end of year progress report. June 30,2018
incidents testing each of the following:
• The process for requesting and receiving Submit AAR and Improvement
mutual aid resources Plan for each
• The process for gaining and maintaining drill/exercise/incident.
situational awareness
• Development of an ESF#8 situation report,or
compilation of situational awareness
information to be included in a County
situation report
• EOC or ICS activation
• The COOP plan for the LHJ
11 Update or develop procedures to request,receive Submit end of year progress report. June 30,2018
and dispense medical countermeasures.
Submit up to date procedure to
request,receive and dispense
medical countermeasures.
12 Use established procedures and plans to manage Submit end of year progress report. June 30,2018
spontaneous health and medical volunteers during
disaster response,including roles non-vetted Submit documentation of
volunteers can perform. management of medical volunteers
during a response.
13 Implement the Continuity of Operations Plan Submit end of year progress report. June 30,2018
(COOP)plan for the local health jurisdiction.
Demonstrate the following: Submit the most current COOP
• Identification of essential services to sustain and AAR documenting COOP
LHJ mission and operations implementation demonstrating the
• Implementation of the Line of succession and elements listed.
written delegation of authority for select
critical positions in the LHJ including LHO
Exhibit A,Statements of Work Page 34 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
• Reassigning staff(scalable workforce
reduction)and temporarily discontinuing
select LHJ functions to sustain critical
services
14 Provide notification to DOH for all instances Submit end of year progress report. June 30,2018
involving a public health response by the LHJ to an
emergency utilizing emergency response plans and Submit Incident Action Plans,
structures. Situation Reports and After Action
Reports.
15 Provide LHJ situation reports to DOH during all Submit end of year progress report. June 30,2018
incidents involving an emergency response by the
LHJ. Provide Situation Reports.
16 Submit essential elements of information(EEIs) Submit end of year progress report. June 30,2018
during incident response upon request by DOH.
Provide information upon request.
17 Participate in the regional healthcare coalition and Submit end of year progress report. June 30,2018
attend coalition meetings as necessary
Provide a summary of participation
in coalition activities.
18 Provide notification to the DOH Duty Officer at Submit end of year progress report. June 30,2018
360-888-0838 or hanalert0doh.wa.gov for all
response. Documentation that notification to
DOH was provided;or statement
that no incident response occurred.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://www.phaboard.or /g_n-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Special Requirements
Federal Fundine Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending_gov by DOH as required by P.L. 109-282.
DOH Program Contact:
Jennifer Albertson,Contract and Finance Specialist
Department of Health
P O Box 47960,Olympia,WA 98504-7960
iennifer.albertson@doh.wa.gov/PHEP/HPP Deliverable Submission email address: concondeliverablesodoh.wa.gov
Exhibit A,Statements of Work Page 35 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Office of Immunization&Child Profile- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1,2018
Contract Number: CLH18253
SOW Type: Origin Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January through June 30,2018 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to define required immunization tasks,deliverables,and funding for the period January 1,2018 through
June 30,2018.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY17 VFC Ops 93.268 333.93.26 74310271 01/01/18 06/30/18 0 2,228 2,228
FFY17 317 Ops 93.268 333.93.26 74310270 01/01/18 06/30/18 0 1,423 1,423
FFY17 AFIX 93.268 333.93.26 74310272 01/01/18 06/30/18 0 4,293 4P293
TOTALS 0 7,944 7,944
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
Perform accountability activities in accordance with state and federal requirements for the Vaccines for Children(VFC)Program as outlined in the Centers for Disease Control
and Prevention(CDC)VFC Operations Guide and as directed by the state administrators of the VFC program.Accountability requirements include,but are not limited to:
provider education,provider site visits and required corrective action,quality assurance activities,VFC screening,satisfaction survey,outside provider agreements,new provider
enrollment visits,fraud and abuse reporting,monthly accountability reports,and private provider report of vaccine usage.
1 Facilitate annual renewal of the provider agreement Provider Agreements for Receipt Annually,per Annual Reimbursement for
for receipt of state supplied vaccine for all of State Supplied Vaccine received VFC Provider actual costs incurred,
healthcare providers receiving state-supplied online via the Washington Agreement Update not to exceed total
childhood vaccines Immunization Information System. Schedule funding consideration
amount.
Funds available for
this task*:
FFY17 AFIX
74310272
Exhibit A,Statements of Work Page 36 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
*See Restrictions on
Funds below
2 Enroll new providers. Conduct an enrollment site Provider Agreement for Receipt of Within ten(10)days Reimbursement for
visit to all new providers,and gather information State Supplied Vaccine with after the date of the actual costs incurred,
needed to complete Program enrollment original signature—DOH 348-002 provider enrollment not to exceed total
(NOTE: a photocopy will not be visit funding consideration
accepted) amount.
Funds available for
this task*:
FFY 17 AFIX
74310272
*See Restrictions on
Funds below
3 Use and facilitate provider use of the Washington Electronic submission of provider Based on provider Reimbursement for
Immunization Information System to place and vaccine orders via the Washington order schedules actual costs incurred,
approve provider vaccine orders. Monitor provider Immunization Information System not to exceed total
orders for appropriateness(including: accuracy of funding consideration
shipping information,order frequency,timing, amount.
quantity and type)and approve vaccine order
online after assuring the appropriateness of the Funds available for
order.
this task*:
FFY17 VFC Ops
74310271
FFY17 317 Ops
74310270
*See Restrictions on
Funds below
4 Monitor and assure electronic or paper submission a) Monthly Vaccine a) By the 25th of Reimbursement for
of vaccine accountability reports for compliance Accountability Report(DOH each month actual costs incurred,
with Provider Agreement related to vaccine 348-006 not to exceed total
management(ordering,inventory management, funding consideration
reconciliation,compliance with storage and b) Report of Vaccine Storage b) Within seven(7) amount.
handling,and reporting of all vaccine incidents and Incidents(DOH 348-154) days of the
returns). complete with reason and incident Funds available for
corrective action as needed. this task*:
Exhibit A,Statements of Work Page 37 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
c) Report all cases(or suspected c) Within seven(7) FFY17 AFIX
cases)of vaccine fraud or days of the 74310272
abuse. incident
*See Restrictions on
Funds below
5 Provide communication,technical assistance, Summary of LHJ Technical June 30,2018 Reimbursement for
consultation,and education to providers about Assistance Form(DOH 348-257) actual costs incurred,
vaccine quality assurance,accountability,program not to exceed total
participation and vaccine management. funding consideration
amount.
Funds available for
this task*:
FFY17 VFC Ops
74310271
FFY17 317 Ops
74310270
*See Restrictions on
Funds below
6 Conduct a total of two(2)VFC Compliance Site a) Enter responses from the VFC a) At the time of the Reimbursement for
Visits at the assigned provider site(s)within your Compliance Site Visit VFC Compliance actual costs incurred,
jurisdiction.DOH will assign provider site(s)via Reviewer Guide into the VFC Site Visit or not to exceed total
the VFC Site Visit Selection Tool. Provider Education, within five(5) funding consideration
Assessment,and Reporting business days of amount.
Site visits should address all requirements outlined (PEAR)online system for the site visit.
in the Provider Agreement,the CDC Vaccines for each Compliance Site Visit. Funds available for
Children Operations Guide,and messages from the Follow all corrective action this task*:
Childhood Vaccine Program. and follow-up guidance
provided by PEAR and the
Conduct VFC Compliance Site Visit Follow-Up to Childhood Vaccine Program FFY17 AFIX
assure providers resolve all follow-up actions for each incorrect response. 74310272
identified during the initial visit. Follow-up
actions may include another physical site visit or b) Attach copy of signed b) Within five(5) *See Restrictions on
verification by email,fax,or mail that follow-up Acknowledgement of Receipt days of the site Funds below
actions were completed. Documentation for each form to the Site Visit in visit
VFC Site Visit follow-up action must be uploaded PEAR.
into PEAR and/or properly notated in the Reviewer
Notes section of PEAR.
Exhibit A,Statements of Work Page 38 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
All assigned VFC Compliance Site Visits c) Attach a copy of any c) Within five(5)
including follow-up actions must be completed documents and/or emails days of receiving
by May 15,2018 for the January—June submitted by the provider to the document(s)
contract period. resolve follow-up actions to and/or email.
the site visit in PEAR.
7 NOTE: During this period of performance,no Enter the following data in the Within five(5)days Reimbursement for
new AFIX visits shall be conducted. This task Exchange tab of the AFIX Online of visit. actual costs incurred,
will focus on follow-up of AFIX visits that were Tool for follow-up visits: not to exceed total
conducted during the previous contract year. • Clinic progress on funding consideration
implementing quality amount.
Conduct AFIX follow-up visits with all provider improvement strategies.
sites that received an AFIX visit between April 1, • Follow-up coverage Funds available for
2017 and December 31,2017. Follow-up visits assessment results(from this task*:
can be conducted in-person,by telephone,or by CoCASA reports).
webinar.All AFIX follow-up visits must be FFY17 AFIX
completed six(6)months after the feedback visit. 74310272
Continue following up with provider sites until *See Restrictions on
they fully implement their selected quality Funds below
improve ent activities.
8 a) In coordination with hospitals,health care a) Enter information for each a) By the last day of Reimbursement for
providers,and health plans(if applicable),conduct case identified into the each month actual costs incurred,
activities to prevent perinatal hepatitis B infection Perinatal Hepatitis B module not to exceed total
in accordance with the Perinatal Hepatitis B of the WA Immunization funding consideration
Prevention Program Guidelines,including the Information System amount.
following:
1) identification of HBsAg-positive pregnant Funds available for
women,and pregnant women with unknown b) Annual Perinatal Hepatitis B b)June 15,2018 this task*:
HBsAg status Outreach Summary(DOH 348
2) reporting of HBsAg-positive women and their 268) FFY17 317 Ops
infants 74310270
3) Case management for infants born to HBsAg-
positive women to ensure administration of HBIG *See Restrictions on
and hepatitis B vaccine within 12 hours of birth, Funds below
the completion of the 3-dose hepatitis B vaccine
series,and post-vaccination serologic testing.
b) Provide technical assistance to birthing
hospitals to encourage administration of the
hepatitis B birth dose to all newborns within 12
hours of birth,in accordance with ACIP
recommendations.
Exhibit A,Statements of Work Page 39 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
c).Report all perinatal hepatitis B investigations,
including HBsAg-positive infants,in the Perinatal
Hepatitis B Module of the Washington State
Immunization Information System.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hU://www phaboard o�wM-content/uploads/PHAB-Standards-and-Measures-Version-1.O.pdf
Proaram Specific Reauirements/Narrative
This section is for program specific information not included elsewhere.
• All LHJ staff who conducts VFC Compliance Site Visits and AFIX visits must participate in an annual VFC and AFIX training,conducted by DOH Office of Immunization
and Child Profile(OICP)staff or their designee.
• All new LHJ site visit reviewers are required to have at least one(1)observational visit conducted by DOH OICP staff or their designee. DOH OICP staff(or designee)will
periodically conduct observational VFC/AFIX site visits with all other LHJ reviewers who conduct VFC Compliance Site Visits.
• LHJ staff who conducts VFC Compliance Site Visits must participate in at least one(1)joint(observational)VFC compliance visit with DOH staff every other year. The
observational visit will occur during a regularly scheduled site visit conducted by the LHJ reviewer. DOH will determine the Observational visit.
• Tasks in this statement of work may not be subcontracted without prior written approval from DOH OICP.
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending.gov by DOH as required by P.L. 109-282.
Program Manual,Handbook,Policy References
Office of Immunization and Child Profile References and Resources for vaccine management,VFC compliance site visits,AFIX visits,and Perinatal Hepatitis B activities can be
found at this link to our website.
VFC Operations Guide-A copy will be provided by the Office of Immunization and Child Profile. (Note:All site visit reviewers are required to have access to the most current
CDC VFC Operations Guide at every VFC compliance site visit).
Staffing Requirements
Provide notification via email to oicpcontracts(idoh.wa.eov within fifteen(15)days of any changes to staffing for those who conduct work outlined in this statement of work.
Exhibit A,Statements of Work Page 40 of 48 Contract Number CLH18253
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc.)
Allowable expenses with 317 and VFC FA Operations Funds(dated September 16,2016)document is posted on the DOH Consolidated Contract website at this link. In addition
to the funding listed in the Payment Information and/or Amount column for each task,FFY 18 317 Ops funding may be used for any activity in this statement of work conducted
between January 1,2018 and June 30,2018,per funding availability and period of performance.
These federal funds may not be used for expenses related to travel or attendance at any CDC-sponsored conference,training,or event without prior written approval from the DOH
Office of Immunization and Child Profile.
DOH Program Contact
Tawney Harper,MPA Deliverables may be sent electronically via email at oicpcontracts(c,doh.wa.gov,
Budget and Operations Manager by fax to 360-236-3590,or by mail to PO Box 47843,Olympia WA 98504-7843
Office of Immunization and Child Profile
Department of Health
PO Box 47843,Olympia WA 98504-7843
tawne .hgMer(n doh.wa.gov,360-236-3525
DOH Fiscal Contact
Vanessa Mojica,Special Projects Coordinator
Office of Immunization and Child Profile
PO Box 47843,Olympia WA 98504-7843
Vanessa.mojicana,doh.wa.gov,360-236-3802
Exhibit A,Statements of Work Page 41 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-20207
DOH Program Name or Title: OSS LMP Implementation-Effective January 1,2018 Local Health Jurisdiction Name: Mason County Public Health
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
❑Federal<Select One> (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through June 30,2019 ® State ❑FFATA(Transparency Act) ❑Fixed Price
❑Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to fund implementation of the on-site sewage system(OSS)local manamgenet plan(LMP).
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
Wastewater Management-GFS N/A 334.04.93 26701100 01/01/18 06/30/19 0 60,000 60,000
TOTALS 0 60,000 60,000
Taslc *May Support PHAB Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information
and/or Amount
1 Administration Meet reporting requirements and Report Due Date: $5,000
LHJ will participate in all grant-related meetings attend DOH-sponsored meetings July 15,2018
and conference calls sponsored by DOH. Final January 15,2019
report will be submitted including documents used June 30,2019
or produced for grant activities.
Task is ongoing throughout
the project period.
2 On-Site Education Educational Presentations Attended by greater than 10,000 Report Due Date: $25,000
2A.Mason County Public Health(MCPH)staff people. July 15,2018
will host a booth the first full weekend in October January 15,2019
for Oysterfest. June 30,2019
213.Modify and print maintenance manuals to be Task is ongoing throughout
handed out to all new system owners,hand out at the project period.
educational presentations and are available to
professional providers to give to their customers.
Exhibit A, Statements of Work Page 42 of 48 Contract Number CLH18253
Task *May Support PHAB Payment
Number
Task/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information
and/or Amount
3B.Twenty five(25)$200 rebates for pumping or
maintenance or$200 rebates for retro-fitting tanks
with risers and/or effluent filter.Each resident
would be able to qualify for two 2 rebates
3 Operation and Maintenance(O&M) Track contacts and increase in Report Due Date: $15,000
Notification to Homeowners maintenance.Progress will be July 15,2018
3A.Follow up on unsatisfactory maintenance reported on the report form. January 15,2019
reports and complaints(75 unsatisfactory reports June 30,2019
and 20 complaints per month).
Task is ongoing throughout
the project period.
4 O&M Database Management Progress will be reported on the Report Due Date: $10,000
4A.Continue truthing and creating record drawings report form. July 15,2018
January 15,2019
4B.Maintenance of the O&M database. June 30,2019
Task is ongoing throughout
the project eriod.
5 Enhance GIS On-site Sewage Data Layer Mapping data as outlined in the Report Due Date: $5,000
LHJ will continue to develop and update on-site "Marine Recovery Area(MRA) July 15,2018
sewage system(OSS)and O&M data to enhance OSS Data Reporting Requirement" January 15,2019
the Geographic Information Systems(GIS)OSS form. June 30,2019
Layer. Work will be done by GIS staff.
Task is ongoing throughout
the project period.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
http://wwwphaboard org�wp-content/uploads/PHAB-Standards-and-Measures-Version-1.O.ndf
Program Specific Requirements/Narrative
Restrictions on Funds(what funds can be used for which activities,not direct payments,etc)
These funds can NOT be used for local match to federal grants.
Special References(RCWs,WACs,etc)
WAC 246-272A and RCW 70.118A
State funds from the Aquatic Lands Enhancement Account must be used to implement elements and activities of the local on-site sewage management plans that do not conflict
with and are consistent with the goals,strategies,objectives,and actions of the Puget Sound Action Agenda.
Exhibit A,Statements of Work Page 43 of 48 Contract Number CLH18253
Definitions
Failure: A condition of an on-site sewage system or component that threatens the public health by inadequately treating sewage or by creating a potential for direct or indirect
contact between sewage and the public.Examples of failure include: (a)Sewage on the surface of the ground;(b)Sewage backing up into a structure caused by slow soil
absorption of septic tank effluent;(c)Sewage leaking from a sewage tank or collection system;(d)Cesspools or seepage pits where evidence of ground water or surface water
quality degradation exists;(e)Inadequately treated effluent contaminating ground water or surface water;or(f)Noncompliance with standards stipulated on the permit.
Maintenance and Monitoring: The actions necessary to keep the on-site sewage system components functioning as designed.Periodic or continuous checking of an on-site sewage
system,which is performed by observations and measurements,to determine if the system is functioning as intended and if system maintenance is needed.Monitoring also
includes maintaining accurate records that document monitoring activities.
Special Billing Requirements
Billing Information
1. Billings are submitted on an A19-IA form,which is provided by DOH.
2. A19-IA forms maybe submitted monthly and must be submitted bi-monthly at minimum.
Special Instructions
Semiannual progress reports,including marine recovery area(MRA)mapping data,are due to DOH via email to christie.durkinadoh.wa.gov and randal.freeb64doh.wa.gov.
Progress Report Due Dates: July 15,2018,January 15,2019,and June 30,2019
The report format will be provided by DOH and may be modified throughout the contract period via email announcement.
DOH Program Contact:Christie Durkin,Office of Environmental Health and Safety,PO Box 47824,Olympia WA 98504-7824;360-236-3396;christie.durkin@doh.wa.gov
DOH Fiscal Contact:Kristy Warner,Environmental Public Health,PO Box 47820,Olympia WA 98504-7820,360-236-3742,kristy.warner(&doh.wa. ov
Exhibit A,Statements of Work Page 44 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-20207
DOH Program Name or Title: Prescription Drug Overdose Prevention for States Local Health Jurisdiction Name: Mason County Public Health
Supplement-Effective January 1.2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
®Federal Subrecipient (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through August 31,2018 ❑ State ®FFATA(Transparency Act) ❑Fixed Price
❑ Other ❑Research&Development
Statement of Work Purpose: Mason County is among the four Washington counties with the highest opioid overdose death rates during 2010-2014. In response,under Centers
for Disease Control and Prevention(CDC)Priority Strategy 2(enhancing and empowering community-level prevention),an Opioid Overdose Prevention position will be funded.
This position will be staffed by a Public Health Nurse or other public health professional(.6 FTE)to conduct the work described below.This position will provide community and
prescriber technical assistance and education to help prevent overdoses,and to improve clinical care for patients taking opioids for chronic pain and those with opioid use disorder.
Mason County Public Health(MCPH)will 1)follow up with nonfatal overdose patients,provide training for overdose reversal,and refer nonfatal overdose patients to treatment
and other services;2)if the overdose involved a prescription opioid,follow up with the prescriber regarding the nonfatal overdose;3)when available,obtain a list of patients'
prescriptions from the Prescription Drug Monitoring Program(PDMP),and follow up with provider(s)to discuss opioid prescribing and provide education;4)on a monthly basis
provide DOH with opioid overdose reports which include the number of nonfatal overdose patients in Mason County and the number of patients served by the public health
consultant;5)perform public outreach,education and trainings to improve community awareness around opioid use and opioid overdose;and 6)attend monthly meetings with
DOH and provide updates on activities.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
FFY17 PRESCRIPTION DRUG OD-SUPP 93.136 333.93.13 77520271 01/01/18 08/31/18 0 33,400 33,400
TOTALS 0 33,400 33,400
Task *May Support PHAB Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information and/or
Amount
1. Follow up with overdose patients in Mason Provide monthly reports to DOH MCPH will submit monthly Actual cost
County to connect them to evidence based which includes number of fatal reports of ongoing activities reimbursement not
substance abuse treatment and other needed and nonfatal overdoses and January 1,2018—August 31,2018. to exceed$33,400
services. number of persons contacted. through August 31,
2018 billed no less
In the case of a suspected opioid overdose: Report technical assistance than monthly and no
Notify the person's prescribers listed in the provided(dates,location, more than quarterly
PMP and person's primary care provider,if participants-TA consultation)If
known of the overdose event.
Exhibit A,Statements of Work Page 45 of 48 Contract Number CLH18253
Task *May Support PHAB Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Due Date/Time Frame Information and/or
Amount
materials are prepared,please
Provide technical assistance,training, share.
consultation and resources regarding opioid
prescribing guidelines and opioid use At least one(1)community
disorder. forum will be held where opioid
addiction and treatment is
Provide public outreach,education,and discussed.
training to community around opioids and
opioid use disorder. Provide updates on ongoing
activities at monthly meetings
with DOH.
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
htip//www phaboard oWLW-content/uploads/PHAB-Standards-and-Measures-Version-l.0.pdf
Program Specific Rea uirements/Narrative
Special Requirements
Federal Funding Accountability and Transparency Act(FFATA)
This statement of work is supported by federal funds that require compliance with the Federal Funding Accountability and Transparency Act(FFATA or the Transparency Act).
The purpose of the Transparency Act is to make information available online so the public can see how the federal funds are spent.
To comply with this act and be eligible to perform the activities in this statement of work,the LHJ must have a Data Universal Numbering System(DUNS®)number.
Information about the LHJ and this statement of work will be made available on USASpending_gov by DOH as required by P.L. 109-282.
DOH Program Contact
Jennifer Alvisurez
Office of Community Health Systems
Washington State Department of Health
P.O.Box 47853,Olympia,WA 98504
Phone:360-236-2845 Fax:360-236-2830
jennifenalvisurez&doh.wa.gov
Exhibit A,Statements of Work Page 46 of 48 Contract Number CLH18253
Exhibit A
Statement of Work
Contract Term: 2018-2020
DOH Program Name or Title: Recreational Shellfish Activities- Local Health Jurisdiction Name: Mason County Public Health
Effective January 1.2018
Contract Number: CLH18253
SOW Type: Original Revision#(for this SOW) Funding Source Federal Compliance Type of Payment
❑Federal<Select One> (check if applicable) ®Reimbursement
Period of Performance: January 1,2018 through June 30,2019 ® State ❑FFATA(Transparency Act) ❑Fixed Price
❑ Other ❑Research&Development
Statement of Work Purpose: The purpose of this statement of work is to provide funds for shellfish harvesting safety.
Revision Purpose: N/A
Chart of Accounts Program Name or Title CFDA# BARS Master Funding Period Current Change Total
Revenue Index (LHJ Use Only) Consideration Increase(+) Consideration
Code Code Start Date End Date
Rec.Shellfish/Biotoxin N/A 334.04.93 26402600 01/01/18 06/30/19 0 7,500 7,500
TOTALS 1 0 7,500 7,500
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
1 Biotoxin Monitoring Submit report on DOH approved Email Report to DOH $7,000
• Collect samples on schedule according to format of activities for the year, by:February 15,2019
Department of Health(DOH)Biotoxin including the number and names
Monitoring Plan,coordinate deviations from the of beaches posted for (See Special
schedule with DOH,notify DOH in advance if classification. Instructions below.)
samples cannot be collected.
• Post/remove recreational shellfish warning and
/or classification signs on beaches and restock
cages as needed.
• This may also include recruiting,training,and
coordination of volunteers,and fuel
reimbursement funds for volunteer biotoxin
monitoring.
2 Outreach Submit report including the Email Report to DOH $500
• Staff educational booths at local events. number of events staffed,and by:February 15,2019
• Distribute safe shellfish harvesting information. amount of educational materials
distributed.
Exhibit A,Statements of Work Page 47 of 48 Contract Number CLH18253
Task *May Support PHAB Due Date/Time Payment
Number Task/Activity/Description Standards/Measures Deliverables/Outcomes Frame Information and/or
Amount
(See Special
Instructions below.)
*For Information Only:
Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a
Standard/Measure. More detail on these and/or other Public Health Accreditation Board(PHAB)Standards/Measures that may apply can be found at:
hM://www.phaboard org/wp-content/pploads/PHAB-Standards-and-Measures-Version-l.0.12df
Proaram Specific Reguirements/Narrative
Program Manual,Handbook,Policy References
Department of Health's Biotoxin Monitoring Plan
Special References(RCWs,WACs,etc)
Chapter 246-280 WAC
hM://www doh wa gov/CommuniVandEnviromnent/Shellfish/RecreationalShellfish
hM://www doh wa.gov/AboutUs/Proz=sandServices/EnvironmentaIPublicHealth/EnviromnentalHealthandSafM/ShellfishProgram/Biotoxins
Special Instructions
Report for work done the previous year must be submitted via email to Liz Maier by February 15,2019.
The report format will be provided by DOH and may be modified throughout the period of performance via email announcement.
DOH Program Contact:Liz Maier,Office of Environmental Health and Safety,PO Box 47824,Olympia WA 98504-7824;360.236.3308;liz.maierC&doh.wa.gov
DOH Fiscal Contact:Kristy Warner,Environmental Public Health,PO Box 47820,Olympia WA 98504-7820;360-236-3742;kristy.warner ,doh.wa.gov
Exhibit A,Statements of Work Page 48 of 48 Contract Number CLH18253
EXHIBIT 13
Mason County Public Health ALLOCATIONS Contract Number: CLH18253
Contract Term:2018-2020 Date: October 16,2017
Indirect Rate as of January 2018: 12.33%
UOII Use Only
BARS Statement of Work Chart of Accounts Funding Chart of
Federal Award Revenue Funding Period Funding Period Period Accounts
Chart of Accounts Program Title Identification# Amend# CFDA* Code** Start Date End Date Start Date End Date Amount Sub Total Total
NEP 5-6 Onsite Sewage Management OOJ88801 N/A 66.123 333.66.12 01/01/18 03/31/19 10/01/14 08/31/19 $74,426 $74,426 $74,426
PS SSI 1-5 OSS Task OIJ18001 N/A 66.123 333.66.12 01/01/18 03/31/19 07/01/17 06/30/19 $99,878 $99,878 $99,878
FFY17 EPR PHEP BPI LHJ Funding NU90TP921889-01 N/A 93.069 333.93.06 01/01/18 06/30/18 07/01/17 07/02/18 $19,917 $19,917 $19,917
FFY17 Prescription Drug OD-Supp U17CE002734 N/A 93.136 333.93.13 01/01/18 08/31/18 09/01/17 08/31/18 $33,400 $33,400 $33,400
FFY17 317 Ops 5NH231P000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $1,423 $1,423 $1,423
FFY17 AFIX 5NH23IP000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $4,293 $4,293 $4,293
FFY17 VFC Ops 5NH23IP000762-05-00 N/A 93.268 333.93.26 01/01/18 06/30/18 04/01/17 06/30/18 $2,228 $2,228 $2,228
FFY18 MCHBG LHJ Contracts NGA Not Received N/A 93.994 333.93.99 01/01/18 09/30/18 10/01/17 09/30/18 $50,771 $50,771 $50,771
GFS-Group B(FO-SW) N/A N/A 334.04.90 01/01/18 06/30/18 07/01/17 06/30/19 $2,500 $2,500 $2,500
Rec Shellfish/Biotoxin N/A N/A 334.04.93 01/01/18 06/30/19 07/01/17 06/30/19 $7,500 $7,500 $7,500
Wastewater Management-GFS N/A N/A 334.04.93 07/01/18 06/30/19 07/01/17 06/30/19 $60,000 $60,000 $60,000
YR 20 SRF-Local Asst(15%)(FS)-SS N/A N/A 346.26.64 01/01/18 12/31/20 07/01/15 12/31/20' $12,000 $12,000 $12,000
Sanitary Survey Fees(FO-SW)-SS State N/A N/A 346.26.65 01/01/18 12/31/20 07/01/17 12/31/20 $12,000 $12,000 $12,000
Yr 20 SRF-Local Asst(15%)(FS)-TA N/A N/A 346.26.66 01/01/18 12/31/20 07/01/17 12/31/20 $2,000 $2,000 $2,000
TOTAL $382,336 $382,336
Total consideration: $382,336 GRAND TOTAL $382,336
GRAND TOTAL $382,336 Total Fed $286,336
Total State $96,000
*Catalog of Federal Domestic Assistance
**Federal revenue codes begin with"333". State revenue codes begin with"334".
Page 1 of 1
Exhibit C Schedule of Federal Awards
Date: October 16,2017
MASON COUNTY HEALTH SERVICESSWV0001893-04
CONTRACT CLI-118263-Mason County Public Health
CONTRACT PERIOD 1/112018-12/3112020
DOH Total Amt Allocation Period
Chart of Accounts Program Title BARS Federal Federal Start End Contract Amt CFDA CFDA Program Title Federal Agency Name Federal Award Federal Grant Award Name
Award Date Award Date Date Identification Number
Puget Sound Action Agenda:
PS SSI 1-5 OSS TASK 4 333.66.12 08/02/16 $5,000,000 01/01/18 03/31/19 $99,878 66.123 Technical Investigations and Environmental Protection Agency 01J18001 PUGET SOUND SHELLFISH
Implementation Assistance Region 10 STRATEGIC INITIATIVE LEAD
Program
Puget Sound Action Agenda:
NEP 5.6 ONSITE SEWAGE MANAGEMENT 333.66.12 01/09/11 $2,490,000 01/01/18 03/31/19 $74,426 66.123 Technical Investigations and Environmental Protection Agency OOJ88801 PUGET SOUND RESTORATION
Implementation Assistance Region 10 PROJECT
Program
Public Health Emergency Department of Health and Human HPP AND PHEP COOPERATIVE
FFY17 EPR PHEP BP1 LHJ FUNDING 333.93.06 07/18/17 $11,062,782 01/01/16 06/30/18 $19,917 93.069 Preparedness Services Centers for Disease Control NU90TP921889-01 AGREEMENT
and Prevention
Injury Prevention and Control Department of Health and Human PRESCRIPTION DRUG OVERDOSE
FFY17 PRESCRIPTION DRUG OVERDOSE 333.93.13 03/16/16 $4,031,632 01/01/18 08/31/16 $33,400 93.136 Research and State and Services Centers for Disease Control U17CE002734 FOR STATES
Community Based Programs and Prevention
Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND
FFY17 VFC OPS 333.93.26 03/03/17 $1,201,605 01/01/18 06/30/18 $2,228 93.268 Agreements Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S
and Prevention PROGRAM
Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND
FFY17 AFIX 333.93.26 03/03/17 $1,672,289 01/01/18 06/30/18 $4,293 93.268 Agreements Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S
and Prevention PROGRAM
Immunization Cooperative Department of Health and Human IMMUNIZATION GRANT AND
FFY17 317 OPS 333.93.26 03/03/17 $575,969 01/01/18 06/30/18 $1,423 93.268 Agreements Services Centers for Disease Control 5NH231P000762-05-00 VACCINES FOR CHILDREN'S
and Prevention PROGRAM
NGA Not NGA Not Maternal and Child Health Services Department of Health and Human
FFY18 MCHBG LHJ CONTRACTS 333.93.99 Received Received 01/01/18 09/30/18 $50,771 93.994 Block Grant to the Slates Services Health Resources and NGA Not Received NGA Not Received
Services Administration
TOTAL $286,336
Page 1 of 1
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: David Windom
DEPARTMENT: Community Services EXT: 260
BRIEFING DATE: January 8, 2018
PREVIOUS BRIEFING DATES: None
If this is a follow-up briefing, please provide only new information
ITEM: Permit Assistance Center Activity Report
EXECUTIVE SUMMARY: (If applicable, please include available options and
potential solutions):
Staff has compiled an Annual Permit Assistance Center Activity Report comparing
activity, by various permit types, for the month of December 2016 and December
2017.
BUDGET IMPACTS: None
RECOMMENDED OR REQUESTED ACTION: Staff read/explain report
ATTACHMENTS: Permit Assistance Center Report
Briefing Summary 1/3/2018
MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Permit Assistance Center
Current Residential Building Permit Lag Time—35 days
December 2017 Permit Activity Report:
Permit Type Dec-16 Dec-17
Boundary Line Adjustment 5 2
Residential Building 83 89
Burn Permit 3 3
Commercial Building 16 10
Development Regulations 10 12
Disaster 0 0
Parcel Combination 3 0
Fire Protection System 5 3
Forest Practice Application 1 0
Geotechnical Report 6 2
Grading Permit 1 0
Hearing Examiner 0 1
Mason Environmental Permit 4 0
Pre-Application Conference 1 2
SEPA Review 6 5
Shoreline Permit 0 0
Shoreline Exemption 4 6
Site Pre-Inspection 8 4
Short Plats 0 0
Variance 0 0
All Permit Types 161 146
Monthly Sign In:
PAC sign-in
Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total
20161 288 357 558 550 488 5611 570 5831 496 4021 362 344 5559
20171 386 3811 507 5041 595 6261 610 5821 556 5711 441 366 6125
(Permit data retrieved via Tidemark:January 2,2018) Page 1 of 2
Residential Permits
■2016 i,K 2017
127 1261341
124 130 123
115 119 113
106"' 0210 04 09104
81 ; ; 89 8389
7
672 61 f 69
t
r=
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
YTD'17
BLD 1232 1260
• Residential Permits range in construction and may include;new SFR, MFH,additions,alterations,and/or
repairs.Commercial Permits on the other hand may include;change in tenant, new development,
additions,alterations,and/or repairs in commerce or congregative structures.
Commercial Permits
€r 2016 2017
26
2
19 1
14
15 16
13 12 12 13 12 13 12
( 10. _ 11 '11 11 10 11 x=10
8 8 7
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
YTD'17
COM 162 139
(Permit data retrieved via Tidemark:January 2,2018) Page 2 of 2
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: David Windom
DEPARTMENT: MCCS EXT: 260
BRIEFING DATE: January 8, 2017
PREVIOUS BRIEFING DATES:
If this is a follow-up briefing, please provide only new information N/A
ITEM: Exempt Well/water information
EXECUTIVE SUMMARY: (If applicable, please include available options and
potential solutions):
Community Development is finishing the policy and process components of
water/well management for the comprehensive plan. This policy work
reflects the Community Development desire to comply with the legal
requirements of Hirst while providing an assurance for builders. The outlined
policy will be posted online and briefed to staff upon commission approval.
BUDGET IMPACTS: Staff time to research, publish and then enforce local
code.
RECOMMENDED OR REQUESTED ACTION: Recommend approval to post
online and proceed as the interim policy until the legislature acts or enough
data has been compiled to allow basin wide decisions at which point policy
would need to be re-assessed.
ATTACHMENTS: attached packet.
Briefmg Summary 1/3/2018
Exempt Well/Water Information
Updated 12/17/17
On October 6, 2016, the Washington State Supreme Court issued a ruling in the case of
Whatcom County v. Western Washington Growth Management Hearings Board. The case
challenged the validity of Whatcom County's Comprehensive Plan and Development
Regulations relating to the protection of water quality and quantity under the
Growth Management Act (36.70A RCW). The Supreme Court ruled:
• It is the County's responsibility under the Growth Management Act to determine legal
availability of water for purposes of issuing land use decisions, not the Department of
Ecology.
• Development permit applications that are proposing to use a private well water supply
(in a basin that is closed or partially closed to surface water withdrawals by the
Department of Ecology) must demonstrate that groundwater withdrawal will not impair
a senior water right, including instream flows established in Chapter 173-501 WAC.
The Growth Management Act (GMA— RCW 36.70A) requires counties to ensure an adequate
water supply before granting a building permit or subdivision application and requires counties
to assure that water is both factually and legally available before issuing building permits.
The State of Washington uses the prior appropriation doctrine ("first in time, first in right") as
the basis for state water law. This means that a senior water right cannot be impaired by a
junior user with a later date of authorized water use. The Court decision clarified that this now-
applies to permit-exempt wells, in addition to permitted water rights.
How does Mason County Comply?
Mason County addressed compliance with state law in the update of the Comprehensive Plan
and Development Regulations. As part of this process, Title 6.68 Water Availability of the
Mason County Code was revised and requires that:
A. Prior to issuance of a building permit or other project permits,the applicant must provide
Mason County planning and development services evidence of adequate water supply as
documented by a water availability notification signed by the director, except as described in
subsection B. The water availability notification shall document a supply of potable water
adequate to serve a land use associated with a project permit in terms of quality, quantity, and
legal availability. The applicant must provide evidence of legal availability in the form of:
1. A water right permit from the Department of Ecology, or
� /1�,2. er from an approved public water purveyor with sufficient water rights, stating the
U��' ability to provide water, or
3. A project permit relying on surface water withdrawal for potable water, and proposing
(a) a remodel of an existing building or (b) replacement of a demolished or removed
building, either of which would increase the floor area by no more than 50 percent over
that of the existing building; however, such permits shall require current documentation
of water quality and quantity, as approved by the director.
Next Steps
Mason County will continue to work on the complex and not quickly resolved task imposed by
the Court. Protecting instream flows and resolving the private well restrictions is critical to
Mason County's viability. The County's next steps include:
• Determination and implementation of fair and equitable polices regarding
development, water use, applications and approvals for those who have spent a
significant amount of effort on securing what was previously determined legal water
prior to the Court's decision.
• Work together on potential changes to the state law with county and the state
legislature to resolve the issues.
• Seek sustainable funding for completion of the County's groundwater model.
• Establish private individual well mitigation approaches-and public basin wide mitigation
strategies geared to protect instream flows.
• Continue to develop on-going long-term water supply planning.
As updates become available, we will keep you informed on this website.
Quick Links
The links below provide more information about the issues involved. If you have specific
questions or want more information please contact Mason County Community Services at
http://www.co.mason.wa.us/questions.php or 360-427-9670 ext 352 or the Mason County
Health Department at(360)427-9670 ext 400
MASON COUNTY
r Q_ v COMMUNITY SERVICES
NWBuilding,Planning,Environmental Health,Community Health
415 N 6th Street, Bldg 8, Shelton WA 98584,
Shelton: (360)427-9670 ext 400 Belfair: (360)275-4467 ext 400 s• Elma: (360)482-5269 ext 400
FAX (360)427-7787
Application for Determination of Adequacy
Instructions
1. Complete Part 1. No determination can be made until Part 1 is fully completed.
2. Complete only the portion of Part 2 applying to the type of water system utilized.
3. Submit completed application, with attachments to the health department for review.
Part 1: Applicant/ Parcel Identification
Name on Applicant: Date:
Mailing Address: Phone:
Parcel Number:
Type of Water System Reason for Application
❑ Public/Community Water System (2 or more ❑ Building permit
connections) ❑ Division of land:
❑ Individual water source (one connection), #of Parcels? SPL
❑ Well ❑ Boundary line adjustment
❑ Spring/surface water ❑ Other(explain)
❑ Other(explain)
❑ Replacement(please indicate name of water
If you have more than one residence connected system below if applicable—no signature
to this well, check the Public/Community Water required)
System box.
Part 2: Water System Information
Complete the section appropriate for the type of water system being evaluated:
Public Water System
Name of Water System:
Water Facility Inventory(WFI) Number:
(write "none"for two-party)
❑ 1 am the manager of this water system. The water system has been approved for services.
There are presently connection(s) in use. This will be the connection.
❑ 1 am the manager of this system.This connection will be to upgrade or change the use of an existing
connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature
of this change:
This water system is able and willing to provide water to this (these) connection(s)without exceeding
the limits of the water system or any limits set by state and local regulation.
Signature of Water System Manager Date
JAFH Forms\Drinking Water Revised 1/25/2017
Page 1 of 2
This form may be scanned and available for public view on the Mason County Web site.
Individual Water Well Cont.
Within Mitigation Zone http://gis.co.maason.wa.us/planning No Maybe Yes
Licensed Hydrogeologist Report(attached) N/A Yes
Mitigation Plan Proposed (attached) N/A Yes
• WDOE determination N/A Pass
• County determination N/A Pass
• Third-party determination N/A Pass
Monitoring Plan required and attached N/A Yes
Water use or limitation bond attached N/A Yes
f..
ti
r 4
f
*This is not a complete list. Inclusion on this list should not be construed as a County endorsement.
HYDROGEOLOGY CONSULTANT LIST
COMPANY ADDRESS CITY PHONE
PBS Engineering and Environmental Inc. 2517 EASTLAKE AVE. E. Suite 100 Seattle, WA 206.233.9639
10700 Meridian Ave. N. Suite 402 Seattle, Wa 206.838.9900
GeoDesign Inc.
2502 Jefferson Ave. Tacoma, Wa 253.203.0095
GeoEngineers, Inc. 17425 NE Union Hill Road Suite 250 Redmond, Wa 425.861.6000
Skillings Connolly, Inc. 5016 Lacey Boulevard S.E. Lacey, Wa 360.491.3399
Aspect Consulting LLC 401 Second Ave. S. Suite 201 Seattle, Wa 206.780.7748
Robinson Noble, Inc. 2105 South C Street Tacoma, Wa 253.475.7711
HWA GeoSciences Inc. 21312 301h Dr. S.E. Suite 110 Bothell, Wa 425.774.0106
Herrera Environmental Consultants, Inc. 2200 Sixth Ave. Suite 1100 Seattle, Wa 206.441.9080
Cardno 801 Second Ave. Suite 700 Seattle, Wa 206.269.0104
January 2018—Mason County Community Services
Water Balance Component Value (AF/yr)
— - Evapotranspiration
UndM
erfIow to arine 32%
Waters
23%
I
r
i
Streamflow as r Streamflow-Runoff
Baseflow ; 36%
9% i
- - Water Balance Component Value
Source: Kennedy-Goldsborough (AF/yr)
Watershed Phase II Level 1 Precipitation 1,360,000
Assessment 2002 Evapotranspiration 430,000
StreamFlow- Runoff 490,000
Streamflow as Baseflow 120,000
Underflow to Marine Waters 320000
.0
0 •
10.55
• 8.5 72 72
.0 .0
LU 6.85
54
D 52 52
:� ,; •
47
44 5.28 45 6
,0 41
6 4.4939 36
LU
33 4 33
14• 13 4
2.64 ,;
• 1.81
•
•
11 1
• 0
OctJan Feb Mar Apr May Jun Jul Aug Sep
MONTH
Based on average occupancy per home in Mason County
Water Balance in gallons/acre
■ Evapotranspiration ■Streamflow-Runoff
■Streamflow as Baseflow ■ Underflow to Marine Waters
1
Average Annual Rainfall 65.7 inches
Well Use @ 2.57 persons per home 154.2 gallons/day
(60 gallons/person)
Recharge through septic(80%) 123.36 gallons/day
Net use per day 30.84 gallons
Net use per year 11,256 gallons
Rain per 2000 sq. feet(sq. ft" .62 gallons per 81,460 gallons
inch/ft*65.72 inches)
Remove 9% baseflow(already accounted) 7,331.4 gallons
Net capture 74,129 gallons per year
Net gain to ground water 62,873 gallons per year
Remainder for irrigation at net zero 62,873 gallons per 1/4 acre
Weeks of irrigation at 1"/week 9.31
Source: Kennedy-Goldsborough Watershed Phase II Level 1 Assessment 2002
2 https://www.usclimatedata.com/climate/shelton/washington/united-states/uswa04O3
/ M
--°�-.-� _ .—
To ensure water Is available for domestic DRAFT
use under the State's Groundwater Permit 8 y
Exemption(RCW 90.44.050)for new year- sd Mason County
round water supply,Mason County is ,� Water Mitigation Planning Map
proactively planning using best available P,
science and proven mitigation strategies, j 201 7
working with partner agencies and r
organizations,to allow development to I1
occur while protecting water quality and in- Pmtherlake Legend
stream flows. mnrk,nd,hLakr unser
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� Non-Regulated Areas
< A
arleirnan: tjO, c�a�Lott, TirfnLnkes Regulated Areas(mitigation)
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H.—1.11,
Ter Lake No Data(mitigation may be needed)
` 4- Tribal Lands
JJ Inkr r_ uagsk/ate Misap - Urban Growth Areas/Activity Centers
J Ac fa,rre
County
In compliance with RCW 90.44.050
� e N
5 >
0 1020 40 60 80
I Miles
)C}mrbrrrp Lake Lake Lir—irk C.S. I, DISCLAIMER AND LIMITATION OF LtABILrTY
l tentf b on
The data used make this map lane ba tested for accuracy,and
eve
I f y oAert m has been oo to*roan Mat thew data we i maty,
'tet Roc Intra f' *aorto and reliable.Hawavar,Mo..County makes no guarantee or
i �•'- warranty to W accuracy ae to labeling,dlrnansione,or placement or
Ffnnkz Lake _ /sloid
Y Lakrm�rl Carfish Lk, r 1? a'z JohnsC k I I Nxalbn of nY map isahxee cdnlafnatl heroh.The boundedee
1, 1 t r"-r�� � – PLlakems depicted by hese data ars approximate,and are not necessarily
i accurate to sunyMg or engineering standards,Them date are
�� 7? yf 1 u - 'e her llanl'md- esIntendede�brforma ^^purposes and should not be considered
a,,,e, ' m ee�,navigational legal and other age-specific
wee. Meedr County as not assume any legal liability or
Tr t f� re sibF RIM from the use ofMlsmap inamannorngIntended
Mesar County M no event shall Mason County be liable for direct,
tit - 1 Indirect,Incldnfel,cansaquesf 4 spacial,or tort a mages o1my kind,
inducting,but not Inded to,lox of anticipated profits or benefits
rising from ueeofor reliance onthe hformegoncontainedhem'n.The
/ L , burdm for determining fitness for usalies entirely with the user and the
C`' �� ` Pnnhnn l/rLnkr user I.ak da trrkame solely
mntsMed In onsible for understanding Ma accxacy limitation of
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Slm•Lnkr p
er t
MASON COUNTY
trerson COMMUNITY SERVICFS
(•
Ldrrmr
akrlrenrl le '..,
yAlLSnmpLake SIP mem y
t _ _ Grays _
or - dem Map Created Bye Meson Count'CommunRy Services Department
Harb
Thu oft Map Data:August 24,2017
< Thudston Map Fie:Water Miigaion Planning Map
t Canty - Map Created In:AmOIS 10.0
PUBLIC WORKS
MONDAY JANUARY 8.2018— BRIEFING ITEMS
FROM PUBLIC WORKS
(For Commissioners Meeting January 16,2018)
Items for this meeting are due to Diane Zoren on Wednesday,January 10,2018
5.0 CORRESPONDENCE AND ORGANIZATIONAL BUSINESS
(None)
8.0 APPROVAL OF ACTION ITEM
(None)
9.0 OTHER BUSINESS
(None)
10.0 PUBLIC HEARINGS AND ITEMS SET FOR A CERTAIN TIME
(None)
DISCUSSION ITEMS:
• Belfair Registered Warrant for end of 2017
• Skokomish Evacuation Route- Green Diamond property
Attendees:
Commissioners: Public Works: Other Dept.: Press: Public:
_Randy Neatherlin _Jerry Hauth List below: List below: List Below:
_Kevin Shutty _John Huestis
_Terri Drexler _Bart Stepp
Others-list below:
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Bart Stepp, Deputy Director/ Utilities and Waste Management
DEPARTMENT: Public Works 7EXT: 652
BRIEFING DATE: January 8, 2018
PREVIOUS BRIEFING DATE: November 8, 2017
ITEM: Belfair Registered Warrant for end of 2017
EXECUTIVE SUMMARY:
On November 8, 2017 Public Works Staff had a 2018 budget presentation of the Utilities, which
included a discussion for the need of additional REET 2 funding for Belfair in 2017 to keep a
positive fund balance in the Belfair Fund #413.
At that time, Public Works felt an additional $20,000 would be sufficient, which was approved
by the Board. During the last couple weeks of December Public Works realized $20,000 would
not be enough and the last week of December a registered warrant for $39,291.93 was issued
for Fund #413.
Last week Public Works requested $450,000 in sales and use tax budgeted for Fund #413 in
2018 be transferred to pay for the registered warrant and to provide sufficient funds for payroll
and expenses in January.
Cost Impact to the County
The interest on the registered warrant will be less than $100 for Belfair Fund #413. The
$450,000 in sales and use tax is part of the approved 2018 budget for Belfair. Since
$39,291.93 of that $450,000 is going towards 2017 expenses, 2018 expenses will need to be
reduced by that amount or additional REET 2 or Sales and Use tax funding may be needed
beyond what is already budgeted in 2018.
RECOMMENDED OR REQUESTED ACTION: No action needed at this time, this is only for
discussion and an update on the Belfair Fund.
Briefmg Summary
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Superintendents, Shawn Batstone and Martin Brewer - Hood Canal
and Pioneer School Districts
DEPARTMENT: EXT:
BRIEFING DATE: January 8, 2018
PREVIOUS BRIEFING DATES:
If this is a follow-up briefing, please provide only new information
ITEM: Information update regarding a February 13, 2018 bond measure to build a
cooperative high school between Hood Canal and Pioneer School Districts.
EXECUTIVE SUMMARY: (If applicable, please include available options and
potential solutions):
BUDGET IMPACTS:
RECOMMENDED OR REQUESTED ACTION:
ATTACHMENTS: Bond Information Presentation
Briefing Summary 1/2/2018
r '� .:"��" G; .t �,�:. _ i' ' ' _.. • r�d�'K '- .,:Its, ,Au _;�__
_ �Im
r
r
a ,
n �
AM
0 0
A February 13, 2018 capital bond measure °F C,
Pgr,VE H1GN�
to build a high school for the communities
Two Communities -
of Hood Canal and Pioneer school districts. -
ONE VISION
TIMELINE
• November 2016-Present
• Became aware of our cost of the Shelton High School Bond
• Began researching ways to respond to cost proposal
•
Joint School Board Meetings (HCSD/Pioneer) to consider
options
• Create a community input plan to include community survey
• Conduct community presentations
• Information gathering for cooperative high program
• Met with state and county officials, local businesses,and
community leaders to discuss program, cost, partnerships, and
land options
• Board approved Bond Resolution
• Informational meetings throughout Mason County
SURVEY RESULTS
• The decision for establishing our own
cooperative high school was based on feedback
and input from a series of community forums
and an online survey conducted in the spring
of 2017.
• Of the 833 responses collected, 72%
supported the cooperative high school option.
1
INNOVATIVE
• S.T.R.E.A.M.S.
• Science,Technology, Engineering, and Mathematics
• Add Reading (Literacy),Arts, and Service ►'`
• Career Pathways through Business Partnerships 1r
• Aquaculture and Forestry
• Project Based Learning
• Dual-credit opportunities
• job ready, apprenticeships, two-year, or four-year
COMPREHENSIVE
• Extra Curricular Athletics
• Girls (Volleyball, cross country, basketball,
wrestling,golf, softball, tennis,track,
cheerleading, drill team, and soccer)
• Boys (Football, cross country, basketball,
wrestling,golf, baseball, tennis,track,
cheerleading, drill team, and soccer)
• Co-Curricular
• Band, Drama, and Choir
SIZING IT U With a combined 408
students in grades 9- 11 , our
cooperative high school
would be a WIAA Single A
#1 South Kitsap ( I A) school, joining 64 other
2,024 students* schools in the classification.
#203 Our High School
408 students*
•
�:
#384 Oaksdale IF
27 students*
• Communities
*In grades 9-11 ONE
VISIONE
IOrtion
COOPERATIVE H OD CANALa't
• $60-70 million for construction of a high school �PIONEE
3
• 100,000 square feet — 750 students
• Hood Canal and Pioneer School Districts will each
contribute $30 million to the project
• $5- 10 million (anticipated state match)
• Working to secure location/site
• Anticipated Revenue
• Estimated annual state revenue at $5.6 million (does not
include local or federal revenue)
• Mason County Projected Growth
CONCEPTUAL DRAWINGS
. moor
-T�0
Hill-
ED 1 O - --
•
COOPERATIVE ONE
■.■
• HCSD Total Estimated Cost
• Current M&O $1.72
• Bond for current $0.79 (Expires December 2021)
• Cooperative HS 1.36 (Bond $30 million for 30 years)
• Total $3.87
• PSD Total Estimated Cost
• Current M&O $2.09
• Bond for current $1.06
• Cooperative HS 0.99 (Bond $30 million for 30 years)
• Total $4.14
• Shelton SD Total Estimated Cost
• Current M&O $4.53
• Bond for current $1.77
• New Bond $1.81
• Total $8.11
Which direction do we want to go with our money?
RENTINGOR
OWNING
(Annual payments to (Operating our own
other school districts) cooperative high school)
■ ■ ■
■ ■ ■
■
COMMENTS/QUESTIONS ?
• For more information, contact
• Superintendent Martin Brewer at
mbrewer(a)-psd402.org or
• Superintendent Shawn Batstone at
�batstonehoodcanaischool.org
• Approximate Date Ballots are Mailed: AL lot
January 26, 2018 •'
• Election Date: February 13 2018
� �-
• NE VISION
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Peter)ones
DEPARTMENT: Public Defense EXT: 280
BRIEFING DATE: 1-9-18
PREVIOUS BRIEFING DATES:
If this is a follow-up briefing, please provide only new information
ITEM:
2018 Public Defense Attorney Contracts
EXECUTIVE SUMMARY:
Renewal of existing contracts for 2018
BUDGET IMPACTS:
Budgeted-for
RECOMMENDED OR REQUESTED ACTION:
Approve renewal contracts for 2018 as follows:
Superior Court .5 FTE ($4,000/month): Taschner Law Offices, Sean Taschner
District Court .5 FTE ($3,000/month): Taschner Law Offices, Justus Kandoll
District Court .5 FTE ($3,000/month): Goldstein Law Offices PLLC
ATTACHMENTS:
Proposed Renewal Contracts
Briefing Summary 1/3/2018
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
This CONTRACT is made and entered into by and between Mason County, hereinafter referred
to as"COUNTY" and Taschner Law, PLLC, referred to as"CONTRACTOR." COUNTY and
CONTRACTOR are collectively referred to as "Parties"to this CONTRACT.
RECITALS:
WHEREAS, COUNTY has a need to procure the services of an individual to serve as a
contracted Public Defense attorney for Mason County District Court; and
WHEREAS, CONTRACTOR warrants that he is qualified, licensed and competent to render the
aforesaid services.
NOW, THEREFORE, for and in consideration of the CONTRACT made, and the payments to be
made by COUNTY, the parties agree to the following:
Special Conditions:
Responsibilities:
CONTRACTOR will be responsible for:
1. Providing high quality legal representation of indigent defendants in adult criminal matters in
Mason County District Court.
2. Knowing and complying with the standards for indigent defense as detailed in the Supreme
Court of Washington's Order 25700-A-1004.
Conclusion of CONTRACT Performance Period:
At the conclusion of this term, should the contract not be renewed, the following conditions will
apply:
A. Unless otherwise provided in "B" below, for appointments made through the end of the
contract period, additional payment shall be made to CONTRACTOR for time spent following
the end of the term at the rate of$50 per hour through the conclusion of the case, subject to a
determination of reasonableness.
B. Unless otherwise ordered by the Court, any assigned case that is in warrant status at the end
of the contract period, or any assigned case that enters warrant status after the conclusion of
the contract period, shall be reassigned to a new attorney upon the Defendant's next
appearance before the Court.
Termination by CONTRACTOR:
CONTRACTOR may terminate this CONTRACT by providing COUNTY with a written notice
thirty (30) or more days before last day services will be provided.
General Conditions
Scope of Services:
CONTRACTOR agrees to provide COUNTY the services and any materials as set forth as
identified in "Exhibit A Scope-of-Services," during the CONTRACT period. No material, labor or
facilities will be furnished by COUNTY, unless otherwise provided for in the CONTRACT.
Performance Period:
The performance period for this CONTRACT will start on Jan 1, 2018 and will end on 12/31/19
or sooner as determined by COUNTY following a thirty (30) day written notice.
1
Service Outside of Performance Period:
Services provided by CONTRACTOR prior to or after the term of this CONTRACT shall be
performed at the expense of CONTRACTOR and are not compensable under this CONTRACT
unless both parties hereto agree to such provision in writing. The term of this CONTRACT may
be extended by mutual consent of the parties; provided, however, that the CONTRACT is in
writing and signed by both parties
Compensation:
CONTRACTOR will be compensated as detailed in Exhibit B Compensation.
Accounting and Payment for CONTRACTOR Services:
A. Payment to the CONTRACTOR for services rendered under this CONTRACT shall be as set
forth in "Exhibit B Compensation." Where Exhibit "B" requires payments by the COUNTY,
payment shall be based upon written claims supported, unless otherwise provided in Exhibit "B,"
by documentation of units of work actually performed and amounts earned, including, where
appropriate, the actual number of days worked each month, total number of hours for the
month, and the total dollar payment requested, so as to comply with municipal auditing
requirements. Acceptable invoices will be processed within 30 days of receipt.
B. Unless specifically stated in Exhibit "B" or approved in writing in advance by the official
executing this CONTRACT for COUNTY or his or her designee (hereinafter referred to as the
"Administrative Officer"). COUNTY will not reimburse the CONTRACTOR for any costs or
expenses incurred by the CONTRACTOR in the performance of this CONTRACT. Where
required, COUNTY shall, upon receipt of appropriate documentation, compensate the
CONTRACTOR, no more often than monthly, in accordance with COUNTY's customary
procedures, pursuant to the fee schedule set forth in Exhibit "B."
Taxes:
A. CONTRACTOR understands and acknowledges that COUNTY will not withhold Federal or
State income taxes. Where required by State or Federal law, the CONTRACTOR authorizes
COUNTY to withhold for any taxes other than income taxes (i.e., Medicare). All compensation
received by the CONTRACTOR will be reported to the Internal Revenue Service at the end of
the calendar year in accordance with the applicable IRS regulations. It is the responsibility of
the CONTRACTOR to make the necessary estimated tax payments throughout the year, if any,
and the CONTRACTOR is solely liable for any tax obligation arising from the CONTRACTOR's
performance of this CONTRACT. The CONTRACTOR hereby agrees to indemnify COUNTY
against any demand to pay taxes arising from the CONTRACTOR's failure to pay taxes on
compensation earned pursuant to this CONTRACT.
B. COUNTY will pay sales and use taxes imposed on goods or services acquired hereunder as
required by law. The CONTRACTOR must pay all other taxes, including, but not limited to,
Business and Occupation Tax, taxes based on the CONTRACTOR's gross or net income, or
personal property to which COUNTY does not hold title. COUNTY is exempt from Federal
Excise Tax.
Withholding Payment:
In the event the CONTRACTOR has failed to perform any obligation under this CONTRACT
within the times set forth in this CONTRACT, then COUNTY may, upon written notice, withhold
from amounts otherwise due and payable to CONTRACTOR, without penalty, until such failure
to perform is cured or otherwise adjudicated. Withholding under this clause shall not be
deemed a breach entitling CONTRACTOR to termination or damages, provided that COUNTY
promptly gives notice in writing to the CONTRACTOR of the nature of the default or failure to
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perform, and in no case more than ten (10) days after it determines to withhold amounts
otherwise due. A determination of the Administrative Officer set forth in a notice to the
CONTRACTOR of the action required and/or the amount required to cure any alleged failure to
perform shall be deemed conclusive, except to the extent that the CONTRACTOR acts within
the times and in strict accord with the provisions of the Disputes clause of this CONTRACT.
COUNTY may act in accordance with any determination of the Administrative Officer which has
become conclusive under this clause, without prejudice to any other remedy under the
CONTRACT, to take all or any of the following actions: (1) cure any failure or default, (2)to pay
any amount so required to be paid and to charge the same to the account of the
CONTRACTOR, (3) to set off any amount so paid or incurred from amounts due or to become
due the CONTRACTOR. In the event the CONTRACTOR obtains relief upon a claim under the
Disputes clause, no penalty or damages shall accrue to CONTRACTOR by reason of good faith
withholding by COUNTY under this clause.
Labor Standards:
CONTRACTOR agrees to comply with all applicable state and federal requirements, including
but not limited to those pertaining to payment of wages and working conditions, in accordance
with RCW 39.12.040, the Prevailing Wage Act; the Americans with Disabilities Act of 1990; the
Davis-Bacon Act; and the Contract Work Hours and Safety Standards Act providing for weekly
payment of prevailing wages, minimum overtime pay, and providing that no laborer or mechanic
shall be required to work in surroundings or under conditions which are unsanitary, hazardous,
or dangerous to health and safety as determined by regulations promulgated by the Federal
Secretary of Labor and/or the State of Washington.
Independent Contractor:
A. CONTRACTOR's services shall be furnished by the CONTRACTOR as an independent
contractor, and nothing herein contained shall be construed to create a relationship of
employer-employee. All payments made hereunder and all services performed shall be made
and performed pursuant to this CONTRACT by the CONTRACTOR as an independent
contractor.
B. CONTRACTOR acknowledges that the entire compensation for this CONTRACT is specified
in Exhibit B Compensation and the CONTRACTOR is not entitled to any benefits including, but
not limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance
benefits, or any other rights or privileges afforded to employees of COUNTY.
C. CONTRACTOR represents that he/she/it maintains a separate place of business, serves
clients other than COUNTY, will report all income and expense accrued under this CONTRACT
to the Internal Revenue Service, and has a tax account with the State of Washington
Department of Revenue for payment of all sales and use and Business and Occupation taxes
collected by the State of Washington.
D. CONTRACTOR will defend, indemnify and hold harmless COUNTY, its officers, agents or
employees from any loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys'fees or costs incurred by reason of claims or demands because of breach of
the provisions of this paragraph.
Assignment and Subcontracting:
The performance of all activities contemplated by this CONTRACT shall be accomplished by
CONTRACTOR. No portion of this CONTRACT may be assigned or subcontracted to any other
individual, firm or entity without the express and prior written approval of COUNTY.
No Guarantee of Employment:
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The performance of all or part of this CONTRACT by the CONTRACTOR shall not operate to
vest any employment rights whatsoever and shall not be deemed to guarantee any employment
of CONTRACTOR or any employee of CONTRACTOR or any sub-contractor or any employee
of any sub-contractor by COUNTY at the present time or in the future.
Conflict of Interest:
If at any time prior to commencement of, or during the term of this CONTRACT, CONTRACTOR
or any of its employees involved in the performance of this CONTRACT shall have or develop
an interest in the subject matter of this CONTRACT that is potentially in conflict with the
COUNTY's interest, then CONTRACTOR shall immediately notify COUNTY of the same. The
notification of COUNTY shall be made with sufficient specificity to enable COUNTY to make an
informed judgment as to whether or not COUNTY's interest may be compromised in any
manner by the existence of the conflict, actual or potential. Thereafter, COUNTY may require
CONTRACTOR to take reasonable steps to remove the conflict of interest. COUNTY may also
terminate this CONTRACT according to the provisions herein for termination.
Non-Discrimination in Employment:
COUNTY's policy is to provide equal opportunity in all terms, conditions and privileges of
employment for all qualified applicants and employees without regard to race, color, creed,
religion, national origin, sex, sexual orientation, age, marital status, disability, or veteran status.
CONTRACTOR shall comply with all laws prohibiting discrimination against any employee or
applicant for employment on the grounds of race, color, creed, religion, national origin, sex,
sexual orientation, age, marital status, disability, or veteran status, except where such
constitutes a bona fide occupational qualification.
Non-Discrimination in Client Services:
CONTRACTOR shall not discriminate on the grounds of race, color, creed, religion, national
origin, sex, age, marital status, sexual orientation, disability, or veteran status; or deny an
individual or business any service or benefits under this CONTRACT; or subject an individual or
business to segregation or separate treatment in any manner related to his/her/its receipt any
service or services or other benefits provided under this CONTRACT; or deny an individual or
business an opportunity to participate in any program provided by this CONTRACT.
Waiver of Noncompetition:
CONTRACTOR irrevocably waives any existing rights which it may have, by contract or
otherwise, to require another person or corporation to refrain from submitting a proposal to or
performing work or providing supplies to COUNTY, and CONTRACTOR further promises that it
will not in the future, directly or indirectly, induce or solicit any person or corporation to refrain
from submitting a bid or proposal to or from performing work or providing supplies to COUNTY.
Confidentiality:
CONTRACTOR, its employees, sub-contractors, and their employees shall maintain the
confidentiality of all information provided by COUNTY or acquired by CONTRACTOR in
performance of this CONTRACT, except upon the prior written consent of COUNTY or an order
entered by a court after having acquired jurisdiction over COUNTY. CONTRACTOR shall
immediately give to COUNTY notice of any judicial proceeding seeking disclosure of such
information. CONTRACTOR shall indemnify and hold harmless COUNTY, its officials, agents
or employees from all loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys' fees and costs resulting from CONTRACTOR's breach of this provision.
Right to Review:
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This CONTRACT is subject to review by any Federal, State or COUNTY auditor. COUNTY or
its designee shall have the right to review and monitor the financial and service components of
this program by whatever means are deemed expedient by the Administrative Officer or by
COUNTY's Auditor's Office. Such review may occur with or without notice and may include, but
is not limited to, on-site inspection by COUNTY agents or employees, inspection of all records
or other materials which COUNTY deems pertinent to the CONTRACT and its performance, and
any and all communications with or evaluations by service recipients under this CONTRACT.
CONTRACTOR shall preserve and maintain all financial records and records relating to the
performance of work under this CONTRACT for six (6) years after CONTRACT termination, and
shall make them available for such review, within Mason County, State of Washington, upon
request. CONTRACTOR also agrees to notify the Administrative Officer in advance of any
inspections, audits, or program review by any individual, agency, or governmental unit whose
purpose is to review the services provided within the terms of this CONTRACT. If no advance
notice is given to CONTRACTOR, then CONTRACTOR agrees to notify the Administrative
Officer as soon as it is practical.
Insurance Requirements:
At a minimum, CONTRACTOR shall provide insurance that meets or exceeds the requirements
detailed in "Exhibit C Insurance Requirements."
Insurance as a Condition of Payment:
Payments due to CONTRACTOR under this CONTRACT are expressly conditioned upon the
CONTRACTOR's strict compliance with all insurance requirements under this CONTRACT.
Payment to CONTRACTOR shall be suspended in the event of non-compliance. Upon receipt
of evidence of full compliance, payments not otherwise subject to withholding or set-off will be
released to CONTRACTOR.
Proof of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
Industrial Insurance Waiver:
With respect to the performance of this CONTRACT and as to claims against COUNTY, its
officers, agents and employees, CONTRACTOR expressly waives its immunity under Title 51 of
the Revised Code of Washington, the Industrial Insurance Act, for injuries to its employees and
agrees that the obligations to indemnify, defend and hold harmless provided in this CONTRACT
extend to any claim brought by or on behalf of any employee of CONTRACTOR. This waiver is
mutually negotiated by the parties to this CONTRACT.
CONTRACTOR Commitments, Warranties and Representations:
Any written commitment received from CONTRACTOR concerning this CONTRACT shall be
binding upon CONTRACTOR, unless otherwise specifically provided herein with reference to
this paragraph. Failure of CONTRACTOR to fulfill such a commitment shall render
CONTRACTOR liable for damages to COUNTY. A commitment includes, but is not limited to,
any representation made prior to execution of this CONTRACT, whether or not incorporated
elsewhere herein by reference, as to performance of services or equipment, prices or options
for future acquisition to remain in effect for a fixed period, or warranties.
Defense and Indemnity Contract:
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A. Indemnification by CONTRACTOR. To the fullest extent permitted by law, CONTRACTOR
agrees to indemnify, defend and hold COUNTY and its departments, elected and appointed
officials, employees, agents and volunteers, harmless from and against any and all claims,
damages, losses and expenses, including but not limited to court costs, attorney's fees and
alternative dispute resolution costs, for any personal injury, for any bodily injury, sickness,
disease or death and for any damage to or destruction of any property (including the loss of use
resulting therefrom)which 1) are caused in whole or in part by any act or omission, negligent or
otherwise, of the CONTRACTOR, its employees, agents or volunteers or CONTRACTOR's
subcontractors and their employees, agents or volunteers; or 2) are directly or indirectly arising
out of, resulting from, or in connection with performance of this CONTRACT; or 3) are based
upon CONTRACTOR's or its subcontractors' use of, presence upon or proximity to the property
of COUNTY. This indemnification obligation of CONTRACTOR shall not apply in the limited
circumstance where the claim, damage, loss or expense is caused by the sole negligence of
COUNTY. This indemnification obligation of the CONTRACTOR shall not be limited in any way
by the Washington State Industrial Insurance Act, RCW Title 51, or by application of any other
workmen's compensation act, disability benefit act or other employee benefit act, and the
CONTRACTOR hereby expressly waives any immunity afforded by such acts. The foregoing
indemnification obligations of the CONTRACTOR are a material inducement to COUNTY to
enter into this CONTRACT, are reflected in CONTRACTOR's compensation, and have been
mutually negotiated by the parties.
B. Participation by County— No Waiver. COUNTY reserves the right, but not the obligation, to
participate in the defense of any claim, damages, losses or expenses and such participation
shall not constitute a waiver of CONTRACTOR's indemnity obligations under this CONTRACT.
C. Survival of CONTRACTOR's Indemnity Obligations. CONTRACTOR agrees all
CONTRACTOR's indemnity obligations shall survive the completion, expiration or termination of
this CONTRACT.
Compliance with Applicable Laws, Rules and Regulations:
This CONTRACT shall be subject to all laws, rules, and regulations of the United States of
America, the State of Washington, political subdivisions of the State of Washington and Mason
County. CONTRACTOR also agrees to comply with applicable Federal, State, County or
municipal standards for licensing, certification and operation of facilities and programs, and
accreditation and licensing of individuals.
Administration of Contract:
COUNTY hereby appoints, and CONTRACTOR hereby accepts, the Mason County's Support
Services Director or designee, as COUNTY's representative, hereinafter referred to as the
Administrative Officer, for the purposes of administering the provisions of this CONTRACT,
including COUNTY's right to receive and act on all reports and documents, and any auditing
performed by the COUNTY related to this CONTRACT. The Administrative Officer is:
Peter Jones
Chief Public Defender
Mason County
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 280
E-mail: Peter*(cDco.mason.wa.us
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CONTRACTOR's Primary Contact's Information:
Notice:
Except as set forth elsewhere in the CONTRACT, for all purposes under this CONTRACT
except service of process, notice shall be given by CONTRACTOR to COUNTY's Administrative
Officer under this CONTRACT. Notices and other communication may be conducted via e-mail,
U.S. mail, fax, hand-delivery or other generally accepted manner including delivery services.
Modifications:
Either party may request changes in the CONTRACT. Any and all agreed modifications, to be
valid and binding upon either party, shall be in writing and signed by both of the parties.
Termination for Default:
A. If CONTRACTOR defaults by failing to perform any of the obligations of the CONTRACT or
becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency or
makes an assignment for the benefit of creditors, COUNTY may, by depositing written notice to
CONTRACTOR in the U.S. mail, terminate the CONTRACT, and at COUNTY's option, obtain
performance of the work elsewhere. If the CONTRACT is terminated for default,
CONTRACTOR shall not be entitled to receive any further payments under the CONTRACT
until all work called for has been fully performed. Any extra cost or damage to COUNTY
resulting from such default(s) shall be deducted from any money due or coming due to
CONTRACTOR. CONTRACTOR shall bear any extra expenses incurred by COUNTY in
completing the work, including all increased costs for completing the work, and all damage
sustained, or which may be sustained by COUNTY by reason of such default.
B. If a notice of termination for default has been issued and it is later determined for any reason
that CONTRACTOR was not in default, the rights and obligations of the parties shall be the
same as if the notice of termination had been issued pursuant to the Termination for Public
Convenience paragraph hereof.
Termination for Public Convenience:
COUNTY may terminate this CONTRACT in whole or in part whenever COUNTY determines, in
its sole discretion, that such termination is in the interests of COUNTY. Whenever the
CONTRACT is terminated in accordance with this paragraph, CONTRACTOR shall be entitled
to payment for actual work performed in compliance with Exhibit A Scope-of-Services and
Exhibit B Compensation. An equitable adjustment in the CONTRACT price for partially
completed items of work will be made, but such adjustment shall not include provision for loss of
anticipated profit on deleted or uncompleted work. Termination of this CONTRACT by
COUNTY at any time during the term, whether for default or convenience, shall not constitute
breach of CONTRACT by COUNTY.
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Termination for Reduced Funding:
COUNTY may terminate this CONTRACT in whole or in part should COUNTY determine, in its
sole discretion, that such termination is necessary due to a decrease in available funding
including State and/or Federal grants. Whenever the CONTRACT is terminated in accordance
with this paragraph, the CONTRACTOR shall be entitled to payment for actual work performed
in compliance with Exhibit A Scope-of-Services and Exhibit B Compensation.
Disputes:
A. Differences between the CONTRACTOR and COUNTY, arising under and by virtue of the
AGREEMENT shall be brought to the attention of COUNTY at the earliest possible time in order
that such matters may be settled or other appropriate action promptly taken. For objections that
are not made in the manner specified and within the time limits stated, the records, orders,
rulings, instructions, and decisions of the Administrative Officer shall be final and conclusive.
B The CONTRACTOR shall not be entitled to additional compensation which otherwise may be
payable, or to extension of time for (1) any act or failure to act by the Administrative Officer of
COUNTY, or(2) the happening of any event or occurrence, unless the CONTRACTOR has
given COUNTY a written Notice of Potential Claim within ten (10) days of the commencement of
the act, failure, or event giving rise to the claim, and before final payment by COUNTY. The
written Notice of Potential Claim shall set forth the reasons for which the CONTRACTOR
believes additional compensation or extension of time is due, the nature of the cost involved,
and insofar as possible, the amount of the potential claim. CONTRACTOR shall keep full and
complete daily records of the work performed, labor and material used, and all costs and
additional time claimed to be additional.
C. The CONTRACTOR shall not be entitled to claim any such additional compensation, or
extension of time, unless within thirty (30) days of the accomplishment of the portion of the work
from which the claim arose, and before final payment by COUNTY, the CONTRACTOR has
given COUNTY a detailed written statement of each element of cost or other compensation
requested and of all elements of additional time required, and copies of any supporting
documents evidencing the amount or the extension of time claimed to be due.
Arbitration:
A. Other than claims for injunctive relief brought by a party hereto (which may be brought either
in court or pursuant to this arbitration provision), and consistent with the provisions hereinabove,
any claim, dispute or controversy between the parties under, arising out of, or related to this
CONTRACT or otherwise, including issues of specific performance, shall be determined by
arbitration in Shelton, Washington, under the applicable American Arbitration Association (AAA)
rules in effect on the date hereof, as modified by this CONTRACT. There shall be one arbitrator
selected by the parties within ten (10) days of the arbitration demand, or if not, by the AAA or
any other group having similar credentials. Any issue about whether a claim is covered by this
CONTRACT shall be determined by the arbitrator. The arbitrator shall apply substantive law
and may award injunctive relief, equitable relief(including specific performance), or any other
remedy available from a judge, including expenses, costs and attorney fees to the prevailing
party and pre-award interest, but shall not have the power to award punitive damages. The
decision of the arbitrator shall be final and binding and an order confirming the award or
judgment upon the award may be entered in any court having jurisdiction. The parties agree
that the decision of the arbitrator shall be the sole and exclusive remedy between them
regarding any dispute presented or pled before the arbitrator. At the request of either party
made not later than forty-five (45) days after the arbitration demand, the parties agree to submit
the dispute to nonbinding mediation, which shall not delay the arbitration hearing date; provided,
that either party may decline to mediate and proceed with arbitration.
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B. Any arbitration proceeding commenced to enforce or interpret this CONTRACT shall be
brought within six (6) years after the initial occurrence giving rise to the claim, dispute or issue
for which arbitration is commenced, regardless of the date of discovery or whether the claim,
dispute or issue was continuing in nature. Claims, disputes or issues arising more than six (6)
years prior to a written request or demand for arbitration issued under this Agreement are not
subject to arbitration.
Venue and Choice of Law:
In the event that any litigation should arise concerning the construction or interpretation of any
of the terms of this CONTRACT, the venue of such action of litigation shall be in the courts of
the State of Washington and Mason County. Unless otherwise specified herein, this
CONTRACT shall be governed by the laws of the State of Washington.
Severability:
If any term or condition of this CONTRACT or the application thereof to any person(s) or
circumstances is held invalid, such invalidity shall not affect other terms, conditions or
applications which can be given effect without the invalid term, condition or application. To this
end, the terms and conditions of this CONTRACT are declared severable.
Waiver:
Waiver of any breach or condition of this CONTRACT shall not be deemed a waiver of any prior
or subsequent breach. No term or condition of this CONTRACT shall be held to be waived,
modified or deleted except by an instrument, in writing, signed by the parties hereto. The failure
of COUNTY to insist upon strict performance of any of the covenants of this CONTRACT, or to
exercise any option herein conferred in any one or more instances, shall not be construed to be
a waiver or relinquishment of any such, or any other covenants or contracts, but the same shall
be and remain in full force and effect.
Order of Precedence:
A. Applicable federal, state and county statutes, regulations, policies, procedures, federal Office
of Management and Budget (OMB) circulars and federal and state executive orders and
Exhibit D.
B. Exhibit C Insurance Requirements
C. Special Conditions
D. General Conditions
E. Exhibits A and B
Entire Contract:
This written CONTRACT, comprised of the writings signed or otherwise identified and attached
hereto, represents the entire CONTRACT between the parties and supersedes any prior oral
statements, discussions or understandings between the parties.
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IN WITNESS WHEREOF, COUNTY and CONTRACTOR have executed this CONTRACT as
of the date and year last written below.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
NAME(Print): Peter Jones, Chief Public Defender
Dated: Dated:
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EXHIBIT A
SCOPE OF SERVICES
CONTRACTOR's Duties:
A. CONTRACTOR agrees to provide criminal defense representation to all appointed clients in
a professional, skilled manner, consistent with the Washington State Bar Association Standards,
the Rules of Professional Conduct, Washington State Office of Public Defense Standards, RCW
10.101 et.seq., Supreme Court of Washington's Order 25700-A-1004 and as applicable, Mason
County Ordinance No. 140.08, case law, and other court rules defining the duties of counsel and
the rights of defendants in criminal cases.
B. CONTRACTOR will provide the Mason County Office of Public Defense, the Superior Court
Administrator, the Defendant, and the Board of Mason County Commissioners with a telephone
number that provides an ability to leave a voice message, i.e. voice mail system with adequate
capacity, answering service, or secretarial staff. Lack of a functional communication system is
considered a violation of the terms of this CONTRACT.
C. Upon notice of appointment, CONTRACTOR shall arrange an initial interview with the
defendant within a reasonably short time and will maintain client contact, keep the client
informed of the progress of the case and effectively provide legal advice to the client throughout
the representation.
D. The services of CONTRACTOR shall continue in each assigned case until the case has been
terminated by final judgment, including final rulings on post-trial motions (if any), restitution
hearings, the filing of notice of appeal and motion and affidavit for order of indigency, if required,
or order of dismissal, unless allowed to withdraw or otherwise be removed by order of the Court.
E. CONTRACTOR agrees to attend seven hours of training approved by the Office of Public
Defense prior to 12/31/17.
F. CONTRACTOR agrees to be available to take telephone calls from the jail on new
misdemeanor arrests on nights and weekends, but may share this duty on a mutually agreed-
upon schedule with other District Court defense attorneys.
Mason County Ordinance NO. 140-08 and RCW 10.101.050 Compliance:
A. Pursuant to Standard 4: Caseload Limits in Ordinance No. 140-08 of the Mason County
Indigent Defense Standards, adult contracts will be monitored for compliance, i.e., a one-half
contract will be 16.6 unweighted misdemeanor or gross misdemeanor appointments per month
per CONTRACTOR. Each newly assigned case shall be counted as one case except as
follows:
1. Cases which are counted as one-third of a case include: probation violations, reviews,
restitution hearings, modifications of no-contact orders, etc., that do not require a
contested hearing, including the same probation violation allegation(s) brought against a
defendant who is on probation for more than one case.
B. In the event the statistics generated in this review do not coincide with CONTRACTOR's
internal records, CONTRACTOR will provide a detailed list of new monthly appointments
including; case number, defendant's name and date of appointment.
C. Because case assignment and resolution is not a static process during a year,
CONTRACTOR and COUNTY agree that the actual number of cases at any one time that have
been assigned under this CONTRACT may total slightly more or less than the contracted
caseload. Such a temporary variance shall not result in alteration of payment owed to
CONTRACTOR by COUNTY. COUNTY shall use its best effort to effect caseload adjustments
for variances not corrected within a reasonable amount of time through natural systemic
adjustments.
Monthly Reporting:
CONTRACTOR is required to submit a monthly report to the Office of Public Defense by the fifth
(5th) day of the following month, which shall include the following information for the preceding
month:
A. The number of new case assignments under this CONTRACT.
B. The number and type of cases in his or her private practice, if any (i.e. cases handled outside
this defense contract including but not limited to retained cases of any type).
C. The number and type of other public defense contracts, if any.
D. The amount of time spent practicing law on matters other than servicing this CONTRACT, if
any.
E. Payment for services may be held if the monthly report has not been received by the
fifth (5th) of the month
Affidavit of Compliance:
CONTRACTOR shall file the required affidavit of compliance with these standards with the
Court on a quarterly basis and provide a copy to the Office of Public Defense.
Client or Third Party Complaints:
CONTRACTOR will respond to complaints regarding his or her performance under this
CONTRACT. If after efforts by CONTRACTOR to resolve any conflict, the client or third party
states he or she continues to have a complaint, the CONTRACTOR shall provide the client with
contact information for the Office of Public Defense so the client or third party may pursue the
complaint.
EXHIBIT B
COMPENSATION
Compensation:
A. Base Compensation-COUNTY shall pay a base compensation of three thousand ($3,000)
per month which includes funding from the Washington State Office of Public Defense for the
performance of all things necessary for, or incidental to, the performance of the work set out in
Exhibit A Scope of Services. Said sum is to be paid by order directing payment through the
County Auditor the last week of each month. CONTRACTOR may request a mid-month draw,
which will be paid by the County Auditor no earlier than the 15th day of each month.
B. Trial/Motion Compensation-except as provided in "D" below, in addition to the base monthly
base compensation, CONTRACTOR shall be paid $250.00 for the first day of trial and $125.00
for each one-half day of trial thereafter. CONTRACTOR shall be paid a flat fee of$150.00 in
addition to the base monthly compensation for each case on which a 3.5 and/or 3.6 motion is
argued on assigned cases. Trial preparation time and time researching and writing legal
motions are considered part of the base compensation and shall not receive additional
compensation. Payment shall be made upon receipt of a billing from CONTRACTOR,
PROVIDED, however, that the billing on each trial or motion shall be submitted to the Office of
Public Defense no later than thirty (30) days after the conclusion of the trial or motion.
C. Administrative and Other Costs-the compensation stated above includes administrative costs
associated with providing legal representation. These costs are the responsibility of
CONTRACTOR, and include, but are, not limited to, support staff, telephones, law library,
financial accounting, case management software systems, computers and software, high-speed
internet access, office space, supplies and other costs necessarily incurred in the day-to-day
management of the CONTRACT.
D. Extraordinary Compensation Policy and Procedure-in extraordinary cases requiring
exceptional amounts of time and preparation. CONTRACTOR may petition COUNTY for
permission for additional compensation. The award and amount of additional compensation is
at the discretion of the Office of Public Defense. Any application for extraordinary compensation
must be made in writing to the Office of Public Defense during the pendency of representation
or within thirty (30) days following the conclusion of the case.
E. In the event of termination of this contract, at COUNTY'S option, any currently pending cases
shall be either re-assigned or shall be the responsibility of CONTRACTOR, who shall bill
COUNTY an hourly rate of$50.00/hour for all work done on those cases following the
termination of this contract.
Requests for Payment:
A. At a minimum the invoice is to include: CONTRACTOR's name, address, phone number and
e-mail; case name; case number; detail of service provided by date and number of hours for
hourly charges or number of half or full days for Trial/Motion compensation; total number of
hours and/or trial/motion days; invoice total; and any additional applicable information.
B. Submit via e-mail or hard copy as preferred to:
Sonya Asche
Mason County Office Public Defense
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 589
saa(a),co.mason.wa.us
C. Payment will be made to CONTRACTOR within thirty (30) days of the receipt of a complete
and accurate invoice
EXHIBIT C
INSURANCE REQUIREMENTS
A. MINIMUM Insurance Requirements:
Professional liability (errors & omissions) insurance. CONTRACTOR shall maintain professional
liability insurance that covers the services to be performed in connection with this CONTRACT,
in the minimum amount of $250,000 per claim with a $500,000 aggregate. Any policy inception
date, continuity date, or retroactive date must be before the effective date of this agreement and
Consultant agrees to maintain continuous coverage through a period no less than three years
after completion of the services required by this CONTRACT.
B. Certificate of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
EXHIBIT D
SUPREME COURT OF WASHINGTON'S Order 25700-A-1004
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
This CONTRACT is made and entered into by and between Mason County, hereinafter referred
to as"COUNTY" and Taschner Law. PLLC, referred to as"CONTRACTOR." COUNTY and
CONTRACTOR are collectively referred to as "Parties"to this CONTRACT.
RECITALS:
WHEREAS, COUNTY has a need to procure the services of an individual to serve as a
contracted Public Defense attorney for Mason County Superior Court; and
WHEREAS, CONTRACTOR warrants that he is qualified, licensed and competent to render the
aforesaid services.
NOW, THEREFORE, for and in consideration of the CONTRACT made, and the payments to be
made by COUNTY, the parties agree to the following:
Special Conditions:
Responsibilities:
CONTRACTOR will be responsible for:
1. Providing high quality legal representation of indigent defendants in adult criminal matters in
Mason County Superior Court.
2. Knowing and complying with the standards for indigent defense as detailed in the Supreme
Court of Washington's Order 25700-A-1004.
Conclusion of CONTRACT Performance Period:
At the conclusion of this term, should the contract not be renewed, the following conditions will
apply:
A. Unless otherwise provided in "B" below, for appointments made through the end of the
contract period, additional payment shall be made to CONTRACTOR for time spent following
the end of the term at the rate of$50 per hour through the conclusion of the case, subject to a
determination of reasonableness.
B. Unless otherwise ordered by the Court, any assigned case that is in warrant status at the end
of the contract period, or any assigned case that enters warrant status after the conclusion of
the contract period, shall be reassigned to a new attorney upon the Defendant's next
appearance before the Court.
Termination by CONTRACTOR:
CONTRACTOR may terminate this CONTRACT by providing COUNTY with a written notice
thirty (30) or more days before last day services will be provided.
General Conditions
Scope of Services:
CONTRACTOR agrees to provide COUNTY the services and any materials as set forth as
identified in "Exhibit A Scope-of-Services," during the CONTRACT period. No material, labor or
facilities will be furnished by COUNTY, unless otherwise provided for in the CONTRACT.
Performance Period:
The performance period for this CONTRACT will start on Jan 1, 2018 and will end on 12/31/19
or sooner as determined by COUNTY following a thirty (30) day written notice.
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Service Outside of Performance Period:
Services provided by CONTRACTOR prior to or after the term of this CONTRACT shall be
performed at the expense of CONTRACTOR and are not compensable under this CONTRACT
unless both parties hereto agree to such provision in writing. The term of this CONTRACT may
be extended by mutual consent of the parties; provided, however, that the CONTRACT is in
writing and signed by both parties
Compensation:
CONTRACTOR will be compensated as detailed in Exhibit B Compensation.
Accounting and Payment for CONTRACTOR Services:
A. Payment to the CONTRACTOR for services rendered under this CONTRACT shall be as set
forth in "Exhibit B Compensation." Where Exhibit "B" requires payments by the COUNTY,
payment shall be based upon written claims supported, unless otherwise provided in Exhibit "B,"
by documentation of units of work actually performed and amounts earned, including, where
appropriate, the actual number of days worked each month, total number of hours for the
month, and the total dollar payment requested, so as to comply with municipal auditing
requirements. Acceptable invoices will be processed within 30 days of receipt.
B. Unless specifically stated in Exhibit"B" or approved in writing in advance by the official
executing this CONTRACT for COUNTY or his or her designee (hereinafter referred to as the
"Administrative Officer"). COUNTY will not reimburse the CONTRACTOR for any costs or
expenses incurred by the CONTRACTOR in the performance of this CONTRACT. Where
required, COUNTY shall, upon receipt of appropriate documentation, compensate the
CONTRACTOR, no more often than monthly, in accordance with COUNTY's customary
procedures, pursuant to the fee schedule set forth in Exhibit "B."
Taxes:
A. CONTRACTOR understands and acknowledges that COUNTY will not withhold Federal or
State income taxes. Where required by State or Federal law, the CONTRACTOR authorizes
COUNTY to withhold for any taxes other than income taxes (i.e., Medicare). All compensation
received by the CONTRACTOR will be reported to the Internal Revenue Service at the end of
the calendar year in accordance with the applicable IRS regulations. It is the responsibility of
the CONTRACTOR to make the necessary estimated tax payments throughout the year, if any,
and the CONTRACTOR is solely liable for any tax obligation arising from the CONTRACTOR's
performance of this CONTRACT. The CONTRACTOR hereby agrees to indemnify COUNTY
against any demand to pay taxes arising from the CONTRACTOR's failure to pay taxes on
compensation earned pursuant to this CONTRACT.
B. COUNTY will pay sales and use taxes imposed on goods or services acquired hereunder as
required by law. The CONTRACTOR must pay all other taxes, including, but not limited to,
Business and Occupation Tax, taxes based on the CONTRACTOR's gross or net income, or
personal property to which COUNTY does not hold title. COUNTY is exempt from Federal
Excise Tax.
Withholding Payment:
In the event the CONTRACTOR has failed to perform any obligation under this CONTRACT
within the times set forth in this CONTRACT, then COUNTY may, upon written notice, withhold
from amounts otherwise due and payable to CONTRACTOR, without penalty, until such failure
to perform is cured or otherwise adjudicated. Withholding under this clause shall not be
deemed a breach entitling CONTRACTOR to termination or damages, provided that COUNTY
promptly gives notice in writing to the CONTRACTOR of the nature of the default or failure to
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perform, and in no case more than ten (10) days after it determines to withhold amounts
otherwise due. A determination of the Administrative Officer set forth in a notice to the
CONTRACTOR of the action required and/or the amount required to cure any alleged failure to
perform shall be deemed conclusive, except to the extent that the CONTRACTOR acts within
the times and in strict accord with the provisions of the Disputes clause of this CONTRACT.
COUNTY may act in accordance with any determination of the Administrative Officer which has
become conclusive under this clause, without prejudice to any other remedy under the
CONTRACT, to take all or any of the following actions: (1) cure any failure or default, (2) to pay
any amount so required to be paid and to charge the same to the account of the
CONTRACTOR, (3) to set off any amount so paid or incurred from amounts due or to become
due the CONTRACTOR. In the event the CONTRACTOR obtains relief upon a claim under the
Disputes clause, no penalty or damages shall accrue to CONTRACTOR by reason of good faith
withholding by COUNTY under this clause.
Labor Standards:
CONTRACTOR agrees to comply with all applicable state and federal requirements, including
but not limited to those pertaining to payment of wages and working conditions, in accordance
with RCW 39.12.040, the Prevailing Wage Act; the Americans with Disabilities Act of 1990; the
Davis-Bacon Act; and the Contract Work Hours and Safety Standards Act providing for weekly
payment of prevailing wages, minimum overtime pay, and providing that no laborer or mechanic
shall be required to work in surroundings or under conditions which are unsanitary, hazardous,
or dangerous to health and safety as determined by regulations promulgated by the Federal
Secretary of Labor and/or the State of Washington.
Independent Contractor:
A. CONTRACTOR's services shall be furnished by the CONTRACTOR as an independent
contractor, and nothing herein contained shall be construed to create a relationship of
employer-employee. All payments made hereunder and all services performed shall be made
and performed pursuant to this CONTRACT by the CONTRACTOR as an independent
contractor.
B. CONTRACTOR acknowledges that the entire compensation for this CONTRACT is specified
in Exhibit B Compensation and the CONTRACTOR is not entitled to any benefits including, but
not limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance
benefits, or any other rights or privileges afforded to employees of COUNTY.
C. CONTRACTOR represents that he/she/it maintains a separate place of business, serves
clients other than COUNTY, will report all income and expense accrued under this CONTRACT
to the Internal Revenue Service, and has a tax account with the State of Washington
Department of Revenue for payment of all sales and use and Business and Occupation taxes
collected by the State of Washington.
D. CONTRACTOR will defend, indemnify and hold harmless COUNTY, its officers, agents or
employees from any loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys' fees or costs incurred by reason of claims or demands because of breach of
the provisions of this paragraph.
Assignment and Subcontracting:
The performance of all activities contemplated by this CONTRACT shall be accomplished by
CONTRACTOR. No portion of this CONTRACT may be assigned or subcontracted to any other
individual, firm or entity without the express and prior written approval of COUNTY.
No Guarantee of Employment:
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The performance of all or part of this CONTRACT by the CONTRACTOR shall not operate to
vest any employment rights whatsoever and shall not be deemed to guarantee any employment
of CONTRACTOR or any employee of CONTRACTOR or any sub-contractor or any employee
of any sub-contractor by COUNTY at the present time or in the future.
Conflict of Interest:
If at any time prior to commencement of, or during the term of this CONTRACT, CONTRACTOR
or any of its employees involved in the performance of this CONTRACT shall have or develop
an interest in the subject matter of this CONTRACT that is potentially in conflict with the
COUNTY's interest, then CONTRACTOR shall immediately notify COUNTY of the same. The
notification of COUNTY shall be made with sufficient specificity to enable COUNTY to make an
informed judgment as to whether or not COUNTY's interest may be compromised in any
manner by the existence of the conflict, actual or potential. Thereafter, COUNTY may require
CONTRACTOR to take reasonable steps to remove the conflict of interest. COUNTY may also
terminate this CONTRACT according to the provisions herein for termination.
Non-Discrimination in Employment:
COUNTY's policy is to provide equal opportunity in all terms, conditions and privileges of
employment for all qualified applicants and employees without regard to race, color, creed,
religion, national origin, sex, sexual orientation, age, marital status, disability, or veteran status.
CONTRACTOR shall comply with all laws prohibiting discrimination against any employee or
applicant for employment on the grounds of race, color, creed, religion, national origin, sex,
sexual orientation, age, marital status, disability, or veteran status, except where such
constitutes a bona fide occupational qualification.
Non-Discrimination in Client Services:
CONTRACTOR shall not discriminate on the grounds of race, color, creed, religion, national
origin, sex, age, marital status, sexual orientation, disability, or veteran status; or deny an
individual or business any service or benefits under this CONTRACT; or subject an individual or
business to segregation or separate treatment in any manner related to his/her/its receipt any
service or services or other benefits provided under this CONTRACT; or deny an individual or
business an opportunity to participate in any program provided by this CONTRACT.
Waiver of Noncompetition:
CONTRACTOR irrevocably waives any existing rights which it may have, by contract or
otherwise, to require another person or corporation to refrain from submitting a proposal to or
performing work or providing supplies to COUNTY, and CONTRACTOR further promises that it
will not in the future, directly or indirectly, induce or solicit any person or corporation to refrain
from submitting a bid or proposal to or from performing work or providing supplies to COUNTY.
Confidentiality:
CONTRACTOR, its employees, sub-contractors, and their employees shall maintain the
confidentiality of all information provided by COUNTY or acquired by CONTRACTOR in
performance of this CONTRACT, except upon the prior written consent of COUNTY or an order
entered by a court after having acquired jurisdiction over COUNTY. CONTRACTOR shall
immediately give to COUNTY notice of any judicial proceeding seeking disclosure of such
information. CONTRACTOR shall indemnify and hold harmless COUNTY, its officials, agents
or employees from all loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys' fees and costs resulting from CONTRACTOR's breach of this provision.
Right to Review:
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This CONTRACT is subject to review by any Federal, State or COUNTY auditor. COUNTY or
its designee shall have the right to review and monitor the financial and service components of
this program by whatever means are deemed expedient by the Administrative Officer or by
COUNTY's Auditor's Office. Such review may occur with or without notice and may include, but
is not limited to, on-site inspection by COUNTY agents or employees, inspection of all records
or other materials which COUNTY deems pertinent to the CONTRACT and its performance, and
any and all communications with or evaluations by service recipients under this CONTRACT.
CONTRACTOR shall preserve and maintain all financial records and records relating to the
performance of work under this CONTRACT for six (6) years after CONTRACT termination, and
shall make them available for such review, within Mason County, State of Washington, upon
request. CONTRACTOR also agrees to notify the Administrative Officer in advance of any
inspections, audits, or program review by any individual, agency, or governmental unit whose
purpose is to review the services provided within the terms of this CONTRACT. If no advance
notice is given to CONTRACTOR, then CONTRACTOR agrees to notify the Administrative
Officer as soon as it is practical.
Insurance Requirements:
At a minimum, CONTRACTOR shall provide insurance that meets or exceeds the requirements
detailed in "Exhibit C Insurance Requirements."
Insurance as a Condition of Payment:
Payments due to CONTRACTOR under this CONTRACT are expressly conditioned upon the
CONTRACTOR's strict compliance with all insurance requirements under this CONTRACT.
Payment to CONTRACTOR shall be suspended in the event of non-compliance. Upon receipt
of evidence of full compliance, payments not otherwise subject to withholding or set-off will be
released to CONTRACTOR.
Proof of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
Industrial Insurance Waiver:
With respect to the performance of this CONTRACT and as to claims against COUNTY, its
officers, agents and employees, CONTRACTOR expressly waives its immunity under Title 51 of
the Revised Code of Washington, the Industrial Insurance Act, for injuries to its employees and
agrees that the obligations to indemnify, defend and hold harmless provided in this CONTRACT
extend to any claim brought by or on behalf of any employee of CONTRACTOR. This waiver is
mutually negotiated by the parties to this CONTRACT.
CONTRACTOR Commitments, Warranties and Representations:
Any written commitment received from CONTRACTOR concerning this CONTRACT shall be
binding upon CONTRACTOR, unless otherwise specifically provided herein with reference to
this paragraph. Failure of CONTRACTOR to fulfill such a commitment shall render
CONTRACTOR liable for damages to COUNTY. A commitment includes, but is not limited to,
any representation made prior to execution of this CONTRACT, whether or not incorporated
elsewhere herein by reference, as to performance of services or equipment, prices or options
for future acquisition to remain in effect for a fixed period, or warranties.
Defense and Indemnity Contract:
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A. Indemnification by CONTRACTOR. To the fullest extent permitted by law, CONTRACTOR
agrees to indemnify, defend and hold COUNTY and its departments, elected and appointed
officials, employees, agents and volunteers, harmless from and against any and all claims,
damages, losses and expenses, including but not limited to court costs, attorney's fees and
alternative dispute resolution costs, for any personal injury, for any bodily injury, sickness,
disease or death and for any damage to or destruction of any property (including the loss of use
resulting therefrom) which 1) are caused in whole or in part by any act or omission, negligent or
otherwise, of the CONTRACTOR, its employees, agents or volunteers or CONTRACTOR's
subcontractors and their employees, agents or volunteers; or 2) are directly or indirectly arising
out of, resulting from, or in connection with performance of this CONTRACT; or 3) are based
upon CONTRACTOR's or its subcontractors' use of, presence upon or proximity to the property
of COUNTY. This indemnification obligation of CONTRACTOR shall not apply in the limited
circumstance where the claim, damage, loss or expense is caused by the sole negligence of
COUNTY. This indemnification obligation of the CONTRACTOR shall not be limited in any way
by the Washington State Industrial Insurance Act, RCW Title 51, or by application of any other
workmen's compensation act, disability benefit act or other employee benefit act, and the
CONTRACTOR hereby expressly waives any immunity afforded by such acts. The foregoing
indemnification obligations of the CONTRACTOR are a material inducement to COUNTY to
enter into this CONTRACT, are reflected in CONTRACTOR's compensation, and have been
mutually negotiated by the parties.
B. Participation by County— No Waiver. COUNTY reserves the right, but not the obligation, to
participate in the defense of any claim, damages, losses or expenses and such participation
shall not constitute a waiver of CONTRACTOR's indemnity obligations under this CONTRACT.
C. Survival of CONTRACTOR's Indemnity Obligations. CONTRACTOR agrees all
CONTRACTOR's indemnity obligations shall survive the completion, expiration or termination of
this CONTRACT.
Compliance with Applicable Laws, Rules and Regulations:
This CONTRACT shall be subject to all laws, rules, and regulations of the United States of
America, the State of Washington, political subdivisions of the State of Washington and Mason
County. CONTRACTOR also agrees to comply with applicable Federal, State, County or
municipal standards for licensing, certification and operation of facilities and programs, and
accreditation and licensing of individuals.
Administration of Contract:
COUNTY hereby appoints, and CONTRACTOR hereby accepts, the Mason County's Support
Services Director or designee, as COUNTY's representative, hereinafter referred to as the
Administrative Officer, for the purposes of administering the provisions of this CONTRACT,
including COUNTY's right to receive and act on all reports and documents, and any auditing
performed by the COUNTY related to this CONTRACT. The Administrative Officer is:
Peter Jones
Chief Public Defender
Mason County
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 280
E-mail: peterl(a)_co.mason.wa.us
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CONTRACTOR's Primary Contact's Information:
Notice:
Except as set forth elsewhere in the CONTRACT, for all purposes under this CONTRACT
except service of process, notice shall be given by CONTRACTOR to COUNTY's Administrative
Officer under this CONTRACT. Notices and other communication may be conducted via e-mail,
U.S. mail, fax, hand-delivery or other generally accepted manner including delivery services.
Modifications:
Either party may request changes in the CONTRACT. Any and all agreed modifications, to be
valid and binding upon either party, shall be in writing and signed by both of the parties.
Termination for Default:
A. If CONTRACTOR defaults by failing to perform any of the obligations of the CONTRACT or
becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency or
makes an assignment for the benefit of creditors, COUNTY may, by depositing written notice to
CONTRACTOR in the U.S. mail, terminate the CONTRACT, and at COUNTY's option, obtain
performance of the work elsewhere. If the CONTRACT is terminated for default,
CONTRACTOR shall not be entitled to receive any further payments under the CONTRACT
until all work called for has been fully performed. Any extra cost or damage to COUNTY
resulting from such default(s) shall be deducted from any money due or coming due to
CONTRACTOR. CONTRACTOR shall bear any extra expenses incurred by COUNTY in
completing the work, including all increased costs for completing the work, and all damage
sustained, or which may be sustained by COUNTY by reason of such default.
B. If a notice of termination for default has been issued and it is later determined for any reason
that CONTRACTOR was not in default, the rights and obligations of the parties shall be the
same as if the notice of termination had been issued pursuant to the Termination for Public
Convenience paragraph hereof.
Termination for Public Convenience:
COUNTY may terminate this CONTRACT in whole or in part whenever COUNTY determines, in
its sole discretion, that such termination is in the interests of COUNTY. Whenever the
CONTRACT is terminated in accordance with this paragraph, CONTRACTOR shall be entitled
to payment for actual work performed in compliance with Exhibit A Scope-of-Services and
Exhibit B Compensation. An equitable adjustment in the CONTRACT price for partially
completed items of work will be made, but such adjustment shall not include provision for loss of
anticipated profit on deleted or uncompleted work. Termination of this CONTRACT by
COUNTY at any time during the term, whether for default or convenience, shall not constitute
breach of CONTRACT by COUNTY.
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Termination for Reduced Funding:
COUNTY may terminate this CONTRACT in whole or in part should COUNTY determine, in its
sole discretion, that such termination is necessary due to a decrease in available funding
including State and/or Federal grants. Whenever the CONTRACT is terminated in accordance
with this paragraph, the CONTRACTOR shall be entitled to payment for actual work performed
in compliance with Exhibit A Scope-of-Services and Exhibit B Compensation.
Disputes:
A. Differences between the CONTRACTOR and COUNTY, arising under and by virtue of the
AGREEMENT shall be brought to the attention of COUNTY at the earliest possible time in order
that such matters may be settled or other appropriate action promptly taken. For objections that
are not made in the manner specified and within the time limits stated, the records, orders,
rulings, instructions, and decisions of the Administrative Officer shall be final and conclusive.
B The CONTRACTOR shall not be entitled to additional compensation which otherwise may be
payable, or to extension of time for (1) any act or failure to act by the Administrative Officer of
COUNTY, or(2)the happening of any event or occurrence, unless the CONTRACTOR has
given COUNTY a written Notice of Potential Claim within ten (10) days of the commencement of
the act, failure, or event giving rise to the claim, and before final payment by COUNTY. The
written Notice of Potential Claim shall set forth the reasons for which the CONTRACTOR
believes additional compensation or extension of time is due, the nature of the cost involved,
and insofar as possible, the amount of the potential claim. CONTRACTOR shall keep full and
complete daily records of the work performed, labor and material used, and all costs and
additional time claimed to be additional.
C. The CONTRACTOR shall not be entitled to claim any such additional compensation, or
extension of time, unless within thirty (30) days of the accomplishment of the portion of the work
from which the claim arose, and before final payment by COUNTY, the CONTRACTOR has
given COUNTY a detailed written statement of each element of cost or other compensation
requested and of all elements of additional time required, and copies of any supporting
documents evidencing the amount or the extension of time claimed to be due.
Arbitration:
A. Other than claims for injunctive relief brought by a party hereto (which may be brought either
in court or pursuant to this arbitration provision), and consistent with the provisions hereinabove,
any claim, dispute or controversy between the parties under, arising out of, or related to this
CONTRACT or otherwise, including issues of specific performance, shall be determined by
arbitration in Shelton, Washington, under the applicable American Arbitration Association (AAA)
rules in effect on the date hereof, as modified by this CONTRACT. There shall be one arbitrator
selected by the parties within ten (10) days of the arbitration demand, or if not, by the AAA or
any other group having similar credentials. Any issue about whether a claim is covered by this
CONTRACT shall be determined by the arbitrator. The arbitrator shall apply substantive law
and may award injunctive relief, equitable relief(including specific performance), or any other
remedy available from a judge, including expenses, costs and attorney fees to the prevailing
party and pre-award interest, but shall not have the power to award punitive damages. The
decision of the arbitrator shall be final and binding and an order confirming the award or
judgment upon the award may be entered in any court having jurisdiction. The parties agree
that the decision of the arbitrator shall be the sole and exclusive remedy between them
regarding any dispute presented or pled before the arbitrator. At the request of either party
made not later than forty-five (45) days after the arbitration demand, the parties agree to submit
the dispute to nonbinding mediation, which shall not delay the arbitration hearing date; provided,
that either party may decline to mediate and proceed with arbitration.
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B. Any arbitration proceeding commenced to enforce or interpret this CONTRACT shall be
brought within six (6) years after the initial occurrence giving rise to the claim, dispute or issue
for which arbitration is commenced, regardless of the date of discovery or whether the claim,
dispute or issue was continuing in nature. Claims, disputes or issues arising more than six (6)
years prior to a written request or demand for arbitration issued under this Agreement are not
subject to arbitration.
Venue and Choice of Law:
In the event that any litigation should arise concerning the construction or interpretation of any
of the terms of this CONTRACT, the venue of such action of litigation shall be in the courts of
the State of Washington and Mason County. Unless otherwise specified herein, this
CONTRACT shall be governed by the laws of the State of Washington.
Severability:
If any term or condition of this CONTRACT or the application thereof to any person(s) or
circumstances is held invalid, such invalidity shall not affect other terms, conditions or
applications which can be given effect without the invalid term, condition or application. To this
end, the terms and conditions of this CONTRACT are declared severable.
Waiver:
Waiver of any breach or condition of this CONTRACT shall not be deemed a waiver of any prior
or subsequent breach. No term or condition of this CONTRACT shall be held to be waived,
modified or deleted except by an instrument, in writing, signed by the parties hereto. The failure
of COUNTY to insist upon strict performance of any of the covenants of this CONTRACT, or to
exercise any option herein conferred in any one or more instances, shall not be construed to be
a waiver or relinquishment of any such, or any other covenants or contracts, but the same shall
be and remain in full force and effect.
Order of Precedence:
A. Applicable federal, state and county statutes, regulations, policies, procedures, federal Office
of Management and Budget (OMB) circulars and federal and state executive orders and
Exhibit D.
B. Exhibit C Insurance Requirements
C. Special Conditions
D. General Conditions
E. Exhibits A and B
Entire Contract:
This written CONTRACT, comprised of the writings signed or otherwise identified and attached
hereto, represents the entire CONTRACT between the parties and supersedes any prior oral
statements, discussions or understandings between the parties.
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IN WITNESS WHEREOF, COUNTY and CONTRACTOR have executed this CONTRACT as
of the date and year last written below.
CONTRACTOR BOARD OF COUNTY COMMISSIONERS
MASON COUNTY,WASHINGTON
NAME(Print): Peter Jones, Chief Public Defender
Dated: Dated:
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MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Peter Jones
DEPARTMENT: Public Defense EXT: 280
BRIEFING DATE: 1-9-18
PREVIOUS BRIEFING DATES:
If this is a follow-up briefing, please provide only new information
ITEM:
2018 Public Defense Attorney Contracts
EXECUTIVE SUMMARY:
Renewal of existing contracts for 2018
BUDGET IMPACTS:
Budgeted-for
RECOMMENDED OR REQUESTED ACTION:
Approve renewal contracts for 2018 as follows:
Superior Court .5 FTE ($4,000/month): Taschner Law Offices, Sean Taschner
District Court .5 FTE ($3,000/month): Taschner Law Offices, Justus Kandoll
District Court .5 FTE ($3,000/month): Goldstein Law Offices PLLC
ATTACHMENTS:
Proposed Renewal Contracts
Briefing Summary 1/3/2018
EXHIBIT A
SCOPE OF SERVICES
CONTRACTOR's Duties:
A. CONTRACTOR agrees to provide criminal defense representation to all appointed clients in
a professional, skilled manner, consistent with the Washington State Bar Association Standards,
the Rules of Professional Conduct, Washington State Office of Public Defense Standards, RCW
10.101 et.seq., Supreme Court of Washington's Order 25700-A-1004 and as applicable, Mason
County Ordinance No. 140.08, case law, and other court rules defining the duties of counsel and
the rights of defendants in criminal cases.
B. CONTRACTOR will provide the Mason County Office of Public Defense, the Superior Court
Administrator, the Defendant, and the Board of Mason County Commissioners with a telephone
number that provides an ability to leave a voice message, i.e. voice mail system with adequate
capacity, answering service, or secretarial staff. Lack of a functional communication system is
considered a violation of the terms of this CONTRACT.
C. Upon notice of appointment, CONTRACTOR shall arrange an initial interview with the
defendant within a reasonably short time and will maintain client contact, keep the client
informed of the progress of the case and effectively provide legal advice to the client throughout
the representation.
D. The services of CONTRACTOR shall continue in each assigned case until the case has been
terminated by final judgment, including final rulings on post-trial motions (if any), restitution
hearings, the filing of notice of appeal and motion and affidavit for order of indigency, if required,
or order of dismissal, unless allowed to withdraw or otherwise be removed by order of the Court.
E. CONTRACTOR agrees to attend seven hours of training approved by the Office of Public
Defense prior to 12/31/17.
F. CONTRACTOR agrees to be available to take telephone calls from the jail on new
misdemeanor arrests on nights and weekends, but may share this duty on a mutually agreed-
upon schedule with other District Court defense attorneys.
Mason County Ordinance NO. 140-08 and RCW 10.101.050 Compliance:
A. Pursuant to Standard 4: Caseload Limits in Ordinance No. 140-08 of the Mason County
Indigent Defense Standards, adult contracts will be monitored for compliance, i.e., a one-half
contract will be 6 unweighted felony appointments per month per CONTRACTOR. Each newly
assigned case shall be counted as one case except as follows:
1. Cases which are counted as one-third of a case include: probation violations, reviews,
restitution hearings, modifications of no-contact orders, etc., that do not require a
contested hearing, including the same probation violation allegation(s) brought against a
defendant who is on probation for more than one case.
2. CONTRACTOR shall not be assigned more than two (2) Class-A felony cases, or two (2)
offenses that are "most serious offenses" as defined in RCW 9.94A.030(33) in the space
of a single month, regardless of case count.
3. Contractor shall not be assigned any "serious violent offense" under this contract as that
term is defined in RCW 9.94A.030(46).
B. In the event the statistics generated in this review do not coincide with CONTRACTOR's
internal records, CONTRACTOR will provide a detailed list of new monthly appointments
including; case number, defendant's name and date of appointment.
C. Because case assignment and resolution is not a static process during a year,
CONTRACTOR and COUNTY agree that the actual number of cases at any one time that have
been assigned under this CONTRACT may total slightly more or less than the contracted
caseload. Such a temporary variance shall not result in alteration of payment owed to
CONTRACTOR by COUNTY. COUNTY shall use its best effort to effect caseload adjustments
for variances not corrected within a reasonable amount of time through natural systemic
adjustments.
Monthly Reporting:
CONTRACTOR is required to submit a monthly report to the Office of Public Defense by the fifth
(5th) day of the following month, which shall include the following information for the preceding
month:
A. The number of new case assignments under this CONTRACT.
B. The number and type of cases in his or her private practice, if any (i.e. cases handled outside
this defense contract including but not limited to retained cases of any type).
C. The number and type of other public defense contracts, if any.
D. The amount of time spent practicing law on matters other than servicing this CONTRACT, if
any.
E. Payment for services may be held if the monthly report has not been received by the
fifth (5th) of the month
Affidavit of Compliance:
CONTRACTOR shall file the required affidavit of compliance with these standards with the
Court on a quarterly basis and provide a copy to the Office of Public Defense.
Client or Third Party Complaints:
CONTRACTOR will respond to complaints regarding his or her performance under this
CONTRACT. If after efforts by CONTRACTOR to resolve any conflict, the client or third party
states he or she continues to have a complaint, the CONTRACTOR shall provide the client with
contact information for the Office of Public Defense so the client or third party may pursue the
complaint.
EXHIBIT B
COMPENSATION
Compensation:
A. Base Compensation-COUNTY shall pay a base compensation of four thousand ($4,000) per
month which includes funding from the Washington State Office of Public Defense for the
performance of all things necessary for, or incidental to, the performance of the work set out in
Exhibit A Scope of Services. Said sum is to be paid by order directing payment through the
County Auditor the last week of each month. CONTRACTOR may request a mid-month draw,
which will be paid by the County Auditor no earlier than the 15th day of each month.
B. Trial/Motion Compensation-except as provided in "D" below, in addition to the base monthly
base compensation, CONTRACTOR shall be paid $250.00 for the first day of trial and $125.00
for each one-half day of trial thereafter. CONTRACTOR shall be paid a flat fee of$150.00 in
addition to the base monthly compensation for each case on which a 3.5 and/or 3.6 motion is
argued on assigned cases. Trial preparation time and time researching and writing legal
motions are considered part of the base compensation and shall not receive additional
compensation. Payment shall be made upon receipt of a billing from CONTRACTOR,
PROVIDED, however, that the billing on each trial or motion shall be submitted to the Office of
Public Defense no later than thirty (30) days after the conclusion of the trial or motion.
C. Administrative and Other Costs-the compensation stated above includes administrative costs
associated with providing legal representation. These costs are the responsibility of
CONTRACTOR, and include, but are, not limited to, support staff, telephones, law library,
financial accounting, case management software systems, computers and software, high-speed
internet access, office space, supplies and other costs necessarily incurred in the day-to-day
management of the CONTRACT.
D. Extraordinary Compensation Policy and Procedure-in extraordinary cases requiring
exceptional amounts of time and preparation. CONTRACTOR may petition COUNTY for
permission for additional compensation. The award and amount of additional compensation is
at the discretion of the Office of Public Defense. Any application for extraordinary compensation
must be made in writing to the Office of Public Defense during the pendency of representation
or within thirty (30) days following the conclusion of the case.
E. In the event of termination of this contract, at COUNTY'S option, any currently pending cases
shall be either re-assigned or shall be the responsibility of CONTRACTOR, who shall bill
COUNTY an hourly rate of$50.00/hour for all work done on those cases following the
termination of this contract.
Requests for Payment:
A. At a minimum the invoice is to include: CONTRACTOR's name, address, phone number and
e-mail; case name; case number; detail of service provided by date and number of hours for
hourly charges or number of half or full days for Trial/Motion compensation; total number of
hours and/or trial/motion days; invoice total; and any additional applicable information.
B. Submit via e-mail or hard copy as preferred to:
Sonya Asche
Mason County Office Public Defense
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 589
saa(aD-co.mason.wa.us
C. Payment will be made to CONTRACTOR within thirty (30) days of the receipt of a complete
and accurate invoice
EXHIBIT C
INSURANCE REQUIREMENTS
A. MINIMUM Insurance Requirements:
Professional liability (errors & omissions) insurance. CONTRACTOR shall maintain professional
liability insurance that covers the services to be performed in connection with this CONTRACT,
in the minimum amount of $250,000 per claim with a $500,000 aggregate. Any policy inception
date, continuity date, or retroactive date must be before the effective date of this agreement and
Consultant agrees to maintain continuous coverage through a period no less than three years
after completion of the services required by this CONTRACT.
B. Certificate of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
EXHIBIT D
SUPREME COURT OF WASHINGTON'S Order 25700-A-1004
MASON COUNTY
PROFESSIONAL SERVICES CONTRACT
This CONTRACT is made and entered into by and between Mason County, hereinafter referred
to as"COUNTY" and Ari Goldstein, Law Office of Ari Goldstein referred to as"CONTRACTOR."
COUNTY and CONTRACTOR are collectively referred to as "Parties" to this CONTRACT.
RECITALS:
WHEREAS, COUNTY has a need to procure the services of an individual to serve as a
contracted Public Defense attorney for Mason County District Court; and
WHEREAS, CONTRACTOR warrants that he is qualified, licensed and competent to render the
aforesaid services.
NOW, THEREFORE, for and in consideration of the CONTRACT made, and the payments to be
made by COUNTY, the parties agree to the following:
Special Conditions:
Responsibilities:
CONTRACTOR will be responsible for:
1. Providing high quality legal representation of indigent defendants in adult criminal matters in
Mason County District Court.
2. Knowing and complying with the standards for indigent defense as detailed in the Supreme
Court of Washington's Order 25700-A-1004.
Conclusion of CONTRACT Performance Period:
At the conclusion of this term, should the contract not be renewed, the following conditions will
apply:
A. Unless otherwise provided in "B" below, for appointments made through the end of the
contract period, additional payment shall be made to CONTRACTOR for time spent following
the end of the term at the rate of$50 per hour through the conclusion of the case, subject to a
determination of reasonableness.
B. Unless otherwise ordered by the Court, any assigned case that is in warrant status at the end
of the contract period, or any assigned case that enters warrant status after the conclusion of
the contract period, shall be reassigned to a new attorney upon the Defendant's next
appearance before the Court.
Termination by CONTRACTOR:
CONTRACTOR may terminate this CONTRACT by providing COUNTY with a written notice
thirty (30) or more days before last day services will be provided.
General Conditions
Scope of Services:
CONTRACTOR agrees to provide COUNTY the services and any materials as set forth as
identified in "Exhibit A Scope-of-Services," during the CONTRACT period. No material, labor or
facilities will be furnished by COUNTY, unless otherwise provided for in the CONTRACT.
Performance Period:
The performance period for this CONTRACT will start on 1/1/18 will end on 12/31/19 or sooner
as determined by COUNTY following a thirty (30) day written notice.
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Service Outside of Performance Period:
Services provided by CONTRACTOR prior to or after the term of this CONTRACT shall be
performed at the expense of CONTRACTOR and are not compensable under this CONTRACT
unless both parties hereto agree to such provision in writing. The term of this CONTRACT may
be extended by mutual consent of the parties; provided, however, that the CONTRACT is in
writing and signed by both parties
Compensation:
CONTRACTOR will be compensated as detailed in Exhibit B Compensation.
Accounting and Payment for CONTRACTOR Services:
A. Payment to the CONTRACTOR for services rendered under this CONTRACT shall be as set
forth in "Exhibit B Compensation." Where Exhibit "B" requires payments by the COUNTY,
payment shall be based upon written claims supported, unless otherwise provided in Exhibit "B,"
by documentation of units of work actually performed and amounts earned, including, where
appropriate, the actual number of days worked each month, total number of hours for the
month, and the total dollar payment requested, so as to comply with municipal auditing
requirements. Acceptable invoices will be processed within 30 days of receipt.
B. Unless specifically stated in Exhibit "B" or approved in writing in advance by the official
executing this CONTRACT for COUNTY or his or her designee (hereinafter referred to as the
"Administrative Officer"). COUNTY will not reimburse the CONTRACTOR for any costs or
expenses incurred by the CONTRACTOR in the performance of this CONTRACT. Where
required, COUNTY shall, upon receipt of appropriate documentation, compensate the
CONTRACTOR, no more often than monthly, in accordance with COUNTY's customary
procedures, pursuant to the fee schedule set forth in Exhibit "B."
Taxes:
A. CONTRACTOR understands and acknowledges that COUNTY will not withhold Federal or
State income taxes. Where required by State or Federal law, the CONTRACTOR authorizes
COUNTY to withhold for any taxes other than income taxes (i.e., Medicare). All compensation
received by the CONTRACTOR will be reported to the Internal Revenue Service at the end of
the calendar year in accordance with the applicable IRS regulations. It is the responsibility of
the CONTRACTOR to make the necessary estimated tax payments throughout the year, if any,
and the CONTRACTOR is solely liable for any tax obligation arising from the CONTRACTOR's
performance of this CONTRACT. The CONTRACTOR hereby agrees to indemnify COUNTY
against any demand to pay taxes arising from the CONTRACTOR's failure to pay taxes on
compensation earned pursuant to this CONTRACT.
B. COUNTY will pay sales and use taxes imposed on goods or services acquired hereunder as
required by law. The CONTRACTOR must pay all other taxes, including, but not limited to,
Business and Occupation Tax, taxes based on the CONTRACTOR's gross or net income, or
personal property to which COUNTY does not hold title. COUNTY is exempt from Federal
Excise Tax.
Withholding Payment:
In the event the CONTRACTOR has failed to perform any obligation under this CONTRACT
within the times set forth in this CONTRACT, then COUNTY may, upon written notice, withhold
from amounts otherwise due and payable to CONTRACTOR, without penalty, until such failure
to perform is cured or otherwise adjudicated. Withholding under this clause shall not be
deemed a breach entitling CONTRACTOR to termination or damages, provided that COUNTY
promptly gives notice in writing to the CONTRACTOR of the nature of the default or failure to
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perform, and in no case more than ten (10) days after it determines to withhold amounts
otherwise due. A determination of the Administrative Officer set forth in a notice to the
CONTRACTOR of the action required and/or the amount required to cure any alleged failure to
perform shall be deemed conclusive, except to the extent that the CONTRACTOR acts within
the times and in strict accord with the provisions of the Disputes clause of this CONTRACT.
COUNTY may act in accordance with any determination of the Administrative Officer which has
become conclusive under this clause, without prejudice to any other remedy under the
CONTRACT, to take all or any of the following actions: (1) cure any failure or default, (2) to pay
any amount so required to be paid and to charge the same to the account of the
CONTRACTOR, (3) to set off any amount so paid or incurred from amounts due or to become
due the CONTRACTOR. In the event the CONTRACTOR obtains relief upon a claim under the
Disputes clause, no penalty or damages shall accrue to CONTRACTOR by reason of good faith
withholding by COUNTY under this clause.
Labor Standards:
CONTRACTOR agrees to comply with all applicable state and federal requirements, including
but not limited to those pertaining to payment of wages and working conditions, in accordance
with RCW 39.12.040, the Prevailing Wage Act; the Americans with Disabilities Act of 1990; the
Davis-Bacon Act; and the Contract Work Hours and Safety Standards Act providing for weekly
payment of prevailing wages, minimum overtime pay, and providing that no laborer or mechanic
shall be required to work in surroundings or under conditions which are unsanitary, hazardous,
or dangerous to health and safety as determined by regulations promulgated by the Federal
Secretary of Labor and/or the State of Washington.
Independent Contractor:
A. CONTRACTOR's services shall be furnished by the CONTRACTOR as an independent
contractor, and nothing herein contained shall be construed to create a relationship of
employer-employee. All payments made hereunder and all services performed shall be made
and performed pursuant to this CONTRACT by the CONTRACTOR as an independent
contractor.
B. CONTRACTOR acknowledges that the entire compensation for this CONTRACT is specified
in Exhibit B Compensation and the CONTRACTOR is not entitled to any benefits including, but
not limited to: vacation pay, holiday pay, sick leave pay, medical, dental, or other insurance
benefits, or any other rights or privileges afforded to employees of COUNTY.
C. CONTRACTOR represents that he/she/it maintains a separate place of business, serves
clients other than COUNTY, will report all income and expense accrued under this CONTRACT
to the Internal Revenue Service, and has a tax account with the State of Washington
Department of Revenue for payment of all sales and use and Business and Occupation taxes
collected by the State of Washington.
D. CONTRACTOR will defend, indemnify and hold harmless COUNTY, its officers, agents or
employees from any loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys' fees or costs incurred by reason of claims or demands because of breach of
the provisions of this paragraph.
Assignment and Subcontracting:
The performance of all activities contemplated by this CONTRACT shall be accomplished by
CONTRACTOR. No portion of this CONTRACT may be assigned or subcontracted to any other
individual, firm or entity without the express and prior written approval of COUNTY.
No Guarantee of Employment:
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The performance of all or part of this CONTRACT by the CONTRACTOR shall not operate to
vest any employment rights whatsoever and shall not be deemed to guarantee any employment
of CONTRACTOR or any employee of CONTRACTOR or any sub-contractor or any employee
of any sub-contractor by COUNTY at the present time or in the future.
Conflict of Interest:
If at any time prior to commencement of, or during the term of this CONTRACT, CONTRACTOR
or any of its employees involved in the performance of this CONTRACT shall have or develop
an interest in the subject matter of this CONTRACT that is potentially in conflict with the
COUNTY's interest, then CONTRACTOR shall immediately notify COUNTY of the same. The
notification of COUNTY shall be made with sufficient specificity to enable COUNTY to make an
informed judgment as to whether or not COUNTY's interest may be compromised in any
manner by the existence of the conflict, actual or potential. Thereafter, COUNTY may require
CONTRACTOR to take reasonable steps to remove the conflict of interest. COUNTY may also
terminate this CONTRACT according to the provisions herein for termination.
Non-Discrimination in Employment:
COUNTY's policy is to provide equal opportunity in all terms, conditions and privileges of
employment for all qualified applicants and employees without regard to race, color, creed,
religion, national origin, sex, sexual orientation, age, marital status, disability, or veteran status.
CONTRACTOR shall comply with all laws prohibiting discrimination against any employee or
applicant for employment on the grounds of race, color, creed, religion, national origin, sex,
sexual orientation, age, marital status, disability, or veteran status, except where such
constitutes a bona fide occupational qualification.
Non-Discrimination in Client Services:
CONTRACTOR shall not discriminate on the grounds of race, color, creed, religion, national
origin, sex, age, marital status, sexual orientation, disability, or veteran status; or deny an
individual or business any service or benefits under this CONTRACT; or subject an individual or
business to segregation or separate treatment in any manner related to his/her/its receipt any
service or services or other benefits provided under this CONTRACT; or deny an individual or
business an opportunity to participate in any program provided by this CONTRACT.
Waiver of Noncompetition:
CONTRACTOR irrevocably waives any existing rights which it may have, by contract or
otherwise, to require another person or corporation to refrain from submitting a proposal to or
performing work or providing supplies to COUNTY, and CONTRACTOR further promises that it
will not in the future, directly or indirectly, induce or solicit any person or corporation to refrain
from submitting a bid or proposal to or from performing work or providing supplies to COUNTY.
Confidentiality:
CONTRACTOR, its employees, sub-contractors, and their employees shall maintain the
confidentiality of all information provided by COUNTY or acquired by CONTRACTOR in
performance of this CONTRACT, except upon the prior written consent of COUNTY or an order
entered by a court after having acquired jurisdiction over COUNTY. CONTRACTOR shall
immediately give to COUNTY notice of any judicial proceeding seeking disclosure of such
information. CONTRACTOR shall indemnify and hold harmless COUNTY, its officials, agents
or employees from all loss or expense, including, but not limited to, settlements, judgments,
setoffs, attorneys' fees and costs resulting from CONTRACTOR's breach of this provision.
Right to Review:
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This CONTRACT is subject to review by any Federal, State or COUNTY auditor. COUNTY or
its designee shall have the right to review and monitor the financial and service components of
this program by whatever means are deemed expedient by the Administrative Officer or by
COUNTY's Auditor's Office. Such review may occur with or without notice and may include, but
is not limited to, on-site inspection by COUNTY agents or employees, inspection of all records
or other materials which COUNTY deems pertinent to the CONTRACT and its performance, and
any and all communications with or evaluations by service recipients under this CONTRACT.
CONTRACTOR shall preserve and maintain all financial records and records relating to the
performance of work under this CONTRACT for six (6) years after CONTRACT termination, and
shall make them available for such review, within Mason County, State of Washington, upon
request. CONTRACTOR also agrees to notify the Administrative Officer in advance of any
inspections, audits, or program review by any individual, agency, or governmental unit whose
purpose is to review the services provided within the terms of this CONTRACT. If no advance
notice is given to CONTRACTOR, then CONTRACTOR agrees to notify the Administrative
Officer as soon as it is practical.
Insurance Requirements:
At a minimum, CONTRACTOR shall provide insurance that meets or exceeds the requirements
detailed in "Exhibit C Insurance Requirements."
Insurance as a Condition of Payment:
Payments due to CONTRACTOR under this CONTRACT are expressly conditioned upon the
CONTRACTOR's strict compliance with all insurance requirements under this CONTRACT.
Payment to CONTRACTOR shall be suspended in the event of non-compliance. Upon receipt
of evidence of full compliance, payments not otherwise subject to withholding or set-off will be
released to CONTRACTOR.
Proof of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
Industrial Insurance Waiver:
With respect to the performance of this CONTRACT and as to claims against COUNTY, its
officers, agents and employees, CONTRACTOR expressly waives its immunity under Title 51 of
the Revised Code of Washington, the Industrial Insurance Act, for injuries to its employees and
agrees that the obligations to indemnify, defend and hold harmless provided in this CONTRACT
extend to any claim brought by or on behalf of any employee of CONTRACTOR. This waiver is
mutually negotiated by the parties to this CONTRACT.
CONTRACTOR Commitments, Warranties and Representations:
Any written commitment received from CONTRACTOR concerning this CONTRACT shall be
binding upon CONTRACTOR, unless otherwise specifically provided herein with reference to
this paragraph. Failure of CONTRACTOR to fulfill such a commitment shall render
CONTRACTOR liable for damages to COUNTY. A commitment includes, but is not limited to,
any representation made prior to execution of this CONTRACT, whether or not incorporated
elsewhere herein by reference, as to performance of services or equipment, prices or options
for future acquisition to remain in effect for a fixed period, or warranties.
Defense and Indemnity Contract:
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A. Indemnification by CONTRACTOR. To the fullest extent permitted by law, CONTRACTOR
agrees to indemnify, defend and hold COUNTY and its departments, elected and appointed
officials, employees, agents and volunteers, harmless from and against any and all claims,
damages, losses and expenses, including but not limited to court costs, attorney's fees and
alternative dispute resolution costs, for any personal injury, for any bodily injury, sickness,
disease or death and for any damage to or destruction of any property (including the loss of use
resulting therefrom) which 1) are caused in whole or in part by any act or omission, negligent or
otherwise, of the CONTRACTOR, its employees, agents or volunteers or CONTRACTOR's
subcontractors and their employees, agents or volunteers; or 2) are directly or indirectly arising
out of, resulting from, or in connection with performance of this CONTRACT; or 3) are based
upon CONTRACTOR's or its subcontractors' use of, presence upon or proximity to the property
of COUNTY. This indemnification obligation of CONTRACTOR shall not apply in the limited
circumstance where the claim, damage, loss or expense is caused by the sole negligence of
COUNTY. This indemnification obligation of the CONTRACTOR shall not be limited in any way
by the Washington State Industrial Insurance Act, RCW Title 51, or by application of any other
workmen's compensation act, disability benefit act or other employee benefit act, and the
CONTRACTOR hereby expressly waives any immunity afforded by such acts. The foregoing
indemnification obligations of the CONTRACTOR are a material inducement to COUNTY to
enter into this CONTRACT, are reflected in CONTRACTOR's compensation, and have been
mutually negotiated by the parties.
B. Participation by County— No Waiver. COUNTY reserves the right, but not the obligation, to
participate in the defense of any claim, damages, losses or expenses and such participation
shall not constitute a waiver of CONTRACTOR's indemnity obligations under this CONTRACT.
C. Survival of CONTRACTOR's Indemnity Obligations. CONTRACTOR agrees all
CONTRACTOR's indemnity obligations shall survive the completion, expiration or termination of
this CONTRACT.
Compliance with Applicable Laws, Rules and Regulations:
This CONTRACT shall be subject to all laws, rules, and regulations of the United States of
America, the State of Washington, political subdivisions of the State of Washington and Mason
County. CONTRACTOR also agrees to comply with applicable Federal, State, County or
municipal standards for licensing, certification and operation of facilities and programs, and
accreditation and licensing of individuals.
Administration of Contract:
COUNTY hereby appoints, and CONTRACTOR hereby accepts, the Mason County's Support
Services Director or designee, as COUNTY's representative, hereinafter referred to as the
Administrative Officer, for the purposes of administering the provisions of this CONTRACT,
including COUNTY's right to receive and act on all reports and documents, and any auditing
performed by the COUNTY related to this CONTRACT. The Administrative Officer is:
Peter Jones
Chief Public Defender
Mason County
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 280
E-mail: peteriCaD-co.mason.wa.us
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CONTRACTOR's Primary Contact's Information:
Ari Rothman Goldstein
Goldstein Law PLLC
2950 Poppy Ln SW Apt 2-302
Tumwater, WA 98512-6047
United States
Phone: (206) 486-6758
E-mail: ari@arigoldsteinlaw.com
Notice:
Except as set forth elsewhere in the CONTRACT, for all purposes under this CONTRACT
except service of process, notice shall be given by CONTRACTOR to COUNTY's Administrative
Officer under this CONTRACT. Notices and other communication may be conducted via e-mail,
U.S. mail, fax, hand-delivery or other generally accepted manner including delivery services.
Modifications:
Either party may request changes in the CONTRACT. Any and all agreed modifications, to be
valid and binding upon either party, shall be in writing and signed by both of the parties.
Termination for Default:
A. If CONTRACTOR defaults by failing to perform any of the obligations of the CONTRACT or
becomes insolvent or is declared bankrupt or commits any act of bankruptcy or insolvency or
makes an assignment for the benefit of creditors, COUNTY may, by depositing written notice to
CONTRACTOR in the U.S. mail, terminate the CONTRACT, and at COUNTY's option, obtain
performance of the work elsewhere. If the CONTRACT is terminated for default,
CONTRACTOR shall not be entitled to receive any further payments under the CONTRACT
until all work called for has been fully performed. Any extra cost or damage to COUNTY
resulting from such default(s) shall be deducted from any money due or coming due to
CONTRACTOR. CONTRACTOR shall bear any extra expenses incurred by COUNTY in
completing the work, including all increased costs for completing the work, and all damage
sustained, or which may be sustained by COUNTY by reason of such default.
B. If a notice of termination for default has been issued and it is later determined for any reason
that CONTRACTOR was not in default, the rights and obligations of the parties shall be the
same as if the notice of termination had been issued pursuant to the Termination for Public
Convenience paragraph hereof.
Termination for Public Convenience:
COUNTY may terminate this CONTRACT in whole or in part whenever COUNTY determines, in
its sole discretion, that such termination is in the interests of COUNTY. Whenever the
CONTRACT is terminated in accordance with this paragraph, CONTRACTOR shall be entitled
to payment for actual work performed in compliance with Exhibit A Scope-of-Services and
Exhibit B Compensation. An equitable adjustment in the CONTRACT price for partially
completed items of work will be made, but such adjustment shall not include provision for loss of
anticipated profit on deleted or uncompleted work. Termination of this CONTRACT by
COUNTY at any time during the term, whether for default or convenience, shall not constitute
breach of CONTRACT by COUNTY.
Termination for Reduced Funding:
COUNTY may terminate this CONTRACT in whole or in part should COUNTY determine, in its
sole discretion, that such termination is necessary due to a decrease in available funding
including State and/or Federal grants. Whenever the CONTRACT is terminated in accordance
7
with this paragraph, the CONTRACTOR shall be entitled to payment for actual work performed
in compliance with Exhibit A Scope-of-Services and Exhibit B Compensation.
Disputes:
A. Differences between the CONTRACTOR and COUNTY, arising under and by virtue of the
AGREEMENT shall be brought to the attention of COUNTY at the earliest possible time in order
that such matters may be settled or other appropriate action promptly taken. For objections that
are not made in the manner specified and within the time limits stated, the records, orders,
rulings, instructions, and decisions of the Administrative Officer shall be final and conclusive.
B The CONTRACTOR shall not be entitled to additional compensation which otherwise may be
payable, or to extension of time for(1) any act or failure to act by the Administrative Officer of
COUNTY, or(2) the happening of any event or occurrence, unless the CONTRACTOR has
given COUNTY a written Notice of Potential Claim within ten (10) days of the commencement of
the act, failure, or event giving rise to the claim, and before final payment by COUNTY. The
written Notice of Potential Claim shall set forth the reasons for which the CONTRACTOR
believes additional compensation or extension of time is due, the nature of the cost involved,
and insofar as possible, the amount of the potential claim. CONTRACTOR shall keep full and
complete daily records of the work performed, labor and material used, and all costs and
additional time claimed to be additional.
C. The CONTRACTOR shall not be entitled to claim any such additional compensation, or
extension of time, unless within thirty (30) days of the accomplishment of the portion of the work
from which the claim arose, and before final payment by COUNTY, the CONTRACTOR has
given COUNTY a detailed written statement of each element of cost or other compensation
requested and of all elements of additional time required, and copies of any supporting
documents evidencing the amount or the extension of time claimed to be due.
Arbitration:
A. Other than claims for injunctive relief brought by a party hereto (which may be brought either
in court or pursuant to this arbitration provision), and consistent with the provisions hereinabove,
any claim, dispute or controversy between the parties under, arising out of, or related to this
CONTRACT or otherwise, including issues of specific performance, shall be determined by
arbitration in Shelton, Washington, under the applicable American Arbitration Association (AAA)
rules in effect on the date hereof, as modified by this CONTRACT. There shall be one arbitrator
selected by the parties within ten (10) days of the arbitration demand, or if not, by the AAA or
any other group having similar credentials. Any issue about whether a claim is covered by this
CONTRACT shall be determined by the arbitrator. The arbitrator shall apply substantive law
and may award injunctive relief, equitable relief(including specific performance), or any other
remedy available from a judge, including expenses, costs and attorney fees to the prevailing
party and pre-award interest, but shall not have the power to award punitive damages. The
decision of the arbitrator shall be final and binding and an order confirming the award or
judgment upon the award may be entered in any court having jurisdiction. The parties agree
that the decision of the arbitrator shall be the sole and exclusive remedy between them
regarding any dispute presented or pled before the arbitrator. At the request of either party
made not later than forty-five (45) days after the arbitration demand, the parties agree to submit
the dispute to nonbinding mediation, which shall not delay the arbitration hearing date; provided,
that either party may decline to mediate and proceed with arbitration.
B. Any arbitration proceeding commenced to enforce or interpret this CONTRACT shall be
brought within six (6) years after the initial occurrence giving rise to the claim, dispute or issue
for which arbitration is commenced, regardless of the date of discovery or whether the claim,
dispute or issue was continuing in nature. Claims, disputes or issues arising more than six (6)
8
years prior to a written request or demand for arbitration issued under this Agreement are not
subject to arbitration.
Venue and Choice of Law:
In the event that any litigation should arise concerning the construction or interpretation of any
of the terms of this CONTRACT, the venue of such action of litigation shall be in the courts of
the State of Washington and Mason County. Unless otherwise specified herein, this
CONTRACT shall be governed by the laws of the State of Washington.
Severability:
If any term or condition of this CONTRACT or the application thereof to any person(s) or
circumstances is held invalid, such invalidity shall not affect other terms, conditions or
applications which can be given effect without the invalid term, condition or application. To this
end, the terms and conditions of this CONTRACT are declared severable.
Waiver:
Waiver of any breach or condition of this CONTRACT shall not be deemed a waiver of any prior
or subsequent breach. No term or condition of this CONTRACT shall be held to be waived,
modified or deleted except by an instrument, in writing, signed by the parties hereto. The failure
of COUNTY to insist upon strict performance of any of the covenants of this CONTRACT, or to
exercise any option herein conferred in any one or more instances, shall not be construed to be
a waiver or relinquishment of any such, or any other covenants or contracts, but the same shall
be and remain in full force and effect.
Order of Precedence:
A. Applicable federal, state and county statutes, regulations, policies, procedures, federal Office
of Management and Budget (OMB) circulars and federal and state executive orders and
Exhibit D.
B. Exhibit C Insurance Requirements
C. Special Conditions
D. General Conditions
E. Exhibits A and B
Entire Contract:
This written CONTRACT, comprised of the writings signed or otherwise identified and attached
hereto, represents the entire CONTRACT between the parties and supersedes any prior oral
statements, discussions or understandings between the parties.
IN WITNESS WHEREOF, COUNTY and CONTRACTOR have executed this CONTRACT as
of the date and year last written below.
Ari Goldstein BOARD OF COUNTY COMMISSIONERS
LAW OFFICE OF ARI GOLDSTEIN MASON COUNTY,WASHINGTON
Ari R. Goldstein Frank Pinter, Support Services Director
Dated: Dated:
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EXHIBIT A
SCOPE OF SERVICES
CONTRACTOR's Duties:
A. CONTRACTOR agrees to provide criminal defense representation to all appointed clients in
a professional, skilled manner, consistent with the Washington State Bar Association Standards,
the Rules of Professional Conduct, Washington State Office of Public Defense Standards, RCW
10.101 et.seq., Supreme Court of Washington's Order 25700-A-1004 and as applicable, Mason
County Ordinance No. 140.08, case law, and other court rules defining the duties of counsel and
the rights of defendants in criminal cases.
B. CONTRACTOR will provide the Mason County Office of Public Defense, the District Court
Administrator, the Defendant, and the Board of Mason County Commissioners with a telephone
number that provides an ability to leave a voice message, i.e. voice mail system with adequate
capacity, answering service, or secretarial staff. Lack of a functional communication system is
considered a violation of the terms of this CONTRACT.
C. Upon notice of appointment, CONTRACTOR shall arrange an initial interview with the
defendant within a reasonably short time and will maintain client contact, keep the client
informed of the progress of the case and effectively provide legal advice to the client throughout
the representation.
D. The services of CONTRACTOR shall continue in each assigned case until the case has been
terminated by final judgment, including final rulings on post-trial motions (if any), restitution
hearings, the filing of notice of appeal and motion and affidavit for order of indigency, if required,
or order of dismissal, unless allowed to withdraw or otherwise be removed by order of the Court.
E. CONTRACTOR agrees to attend seven hours of training approved by the Office of Public
Defense prior to 12/31/17.
F. CONTRACTOR agrees to be available to take telephone calls from the jail on new
misdemeanor arrests on nights and weekends, but may share this duty on a mutually agreed-
upon schedule with other District Court defense attorneys.
Mason County Ordinance NO. 140-08 and RCW 10.101.050 Compliance:
A. Pursuant to Standard 4: Caseload Limits in Ordinance No. 140-08 of the Mason County
Indigent Defense Standards, adult contracts will be monitored for compliance, i.e., a one-half
contract will be 16.6 unweighted misdemeanor or gross misdemeanor appointments per month
(on average) per CONTRACTOR. Each newly assigned case shall be counted as one case
except as follows:
1. Cases which are counted as one-third of a case include: probation violations, reviews,
restitution hearings, modifications of no-contact orders, etc., that do not require a contested
hearing, including the same probation violation allegation(s) brought against a defendant who is
on probation for more than one case.
B. In the event the statistics generated in this review do not coincide with CONTRACTOR's
internal records, CONTRACTOR will provide a detailed list of new monthly appointments
including; case number, defendant's name and date of appointment.
C. Because case assignment and resolution is not a static process during a year,
CONTRACTOR and COUNTY agree that the actual number of cases at any one time that have
been assigned under this CONTRACT may total slightly more or less than the contracted
caseload. Such a temporary variance shall not result in alteration of payment owed to
CONTRACTOR by COUNTY. COUNTY shall use its best effort to effect caseload adjustments
for variances not corrected within a reasonable amount of time through natural systemic
adjustments.
Monthly Reporting:
CONTRACTOR is required to submit a monthly report to the Office of Public Defense by the fifth
(5th) day of the following month, which shall include the following information for the preceding
month:
A. The number of new case assignments under this CONTRACT.
B. The number and type of cases in his or her private practice, if any (i.e. cases handled outside
this defense contract including but not limited to retained cases of any type).
C. The number and type of other public defense contracts, if any.
D. The amount of time spent practicing law on matters other than servicing this CONTRACT, if
any.
E. Payment for services may be held if the monthly report has not been received by the
fifth (5th) of the month
Affidavit of Compliance:
CONTRACTOR shall file the required affidavit of compliance with these standards with the
Court on a quarterly basis and provide a copy to the Office of Public Defense.
Client or Third Party Complaints:
CONTRACTOR will respond to complaints regarding his or her performance under this
CONTRACT. If after efforts by CONTRACTOR to resolve any conflict, the client or third party
states he or she continues to have a complaint, the CONTRACTOR shall provide the client with
contact information for the Office of Public Defense so the client or third party may pursue the
complaint.
EXHIBIT B
COMPENSATION
Compensation:
A. Base Compensation-COUNTY shall pay a base compensation of three-thousand dollars
($3,000.00) per month which includes funding from the Washington State Office of Public
Defense for the performance of all things necessary for, or incidental to, the performance of the
work set out in Exhibit A Scope of Services. Said sum is to be paid by order directing payment
through the County Auditor the last week of each month. CONTRACTOR may request a mid-
month draw, which will be paid by the County Auditor no earlier than the 15th day of each
month.
B. Trial/Motion Compensation-except as provided in "D" below, in addition to the base monthly
base compensation, CONTRACTOR shall be paid $250.00 for the first day of trial and $125.00
for each one-half day of trial thereafter. CONTRACTOR shall be paid a flat fee of$150.00 in
addition to the base monthly compensation for each case on which a 3.5 and/or 3.6 motion is
argued on assigned cases. Trial preparation time and time researching and writing legal
motions are considered part of the base compensation and shall not receive additional
compensation. Payment shall be made upon receipt of a billing from CONTRACTOR,
PROVIDED, however, that the billing on each trial or motion shall be submitted to the Office of
Public Defense no later than thirty (30) days after the conclusion of the trial or motion.
C. Administrative and Other Costs-the compensation stated above includes administrative costs
associated with providing legal representation. These costs are the responsibility of
CONTRACTOR, and include, but are, not limited to, support staff, telephones, law library,
financial accounting, case management software systems, computers and software, high-speed
internet access, office space, supplies and other costs necessarily incurred in the day-to-day
management of the CONTRACT.
D. Extraordinary Compensation Policy and Procedure-in extraordinary cases requiring
exceptional amounts of time and preparation. CONTRACTOR may petition COUNTY for
permission for additional compensation. The award and amount of additional compensation is
at the discretion of the Office of Public Defense. Any application for extraordinary compensation
must be made in writing to the Office of Public Defense during the pendency of representation
or within thirty (30) days following the conclusion of the case.
E. In the event of termination of this contract, at COUNTY'S option, any currently pending cases
shall be either re-assigned or shall be the responsibility of CONTRACTOR, who shall bill
COUNTY an hourly rate of$50.00/hour for all work done on those cases following the
termination of this contract.
Requests for Payment:
A. At a minimum the invoice is to include: CONTRACTOR's name, address, phone number and
e-mail; case name; case number; detail of service provided by date and number of hours for
hourly charges or number of half or full days for Trial/Motion compensation; total number of
hours and/or trial/motion days; invoice total; and any additional applicable information.
B. Submit via e-mail or hard copy as preferred to:
Sonya Asche
Mason County Office Public Defense
411 N. 5th Street
Shelton, WA 98584
Phone: 360-427-9670 Ext. 589
saa(@co.mason.wa.us
C. Payment will be made to CONTRACTOR within thirty (30) days of the receipt of a complete
and accurate invoice
EXHIBIT C
INSURANCE REQUIREMENTS
A. MINIMUM Insurance Requirements:
Professional liability (errors &omissions) insurance. CONTRACTOR shall maintain professional
liability insurance that covers the services to be performed in connection with this CONTRACT,
in the minimum amount of$250,000 per claim with a $500,000 aggregate. Any policy inception
date, continuity date, or retroactive date must be before the effective date of this agreement and
Consultant agrees to maintain continuous coverage through a period no less than three years
after completion of the services required by this CONTRACT.
B. Certificate of Insurance:
A Certificate of Insurance naming COUNTY as the Certificate Holder must be provided to
COUNTY within five (5) days of CONTRACT execution.
EXHIBIT D
SUPREME COURT OF WASHINGTON'S Order 25700-A-1004
Mason County Support Services Department Budget Management
411 North 5th Street Commissioner Administration
Emergency Management
Shelton, WA 98584 Facilities, Parks&Trails
360.427.9670 ext. 419 Human Resources
y
Information Services
Labor Relations
Risk Management
MASON COUNTY COMMISSIONER BRIEFING ITEMS FROM SUPPORT SERVICES
January 8, 2018
• Specific Items for Review
o Reminder that January 15 is Martin Luther King, Jr Holiday
o Process for Mason Transit Authority appointments—Diane
o Housing Authority application from Kathy Haigh —ok to appoint?—Diane
o Schedule 5th Tuesday meeting in Belfair (January 30)?Agenda items?—Diane
o Recommendation from Parks &Trails Advisory Board for fees—Frank
o Schedule public hearing on January 23, 6:30 p.m. to consider 2018-2023 Parks &Trails
Comprehensive Plan. A public workshop will be held on Wednesday,January 17 at 6 p.m. in
Commission Chambers—Frank
o Shorecrest Tax Title Property Bid - Frank
o CORE 360 training module—Dawn
o Underground tank liability insurance renewal - Dawn
• Commissioner Discussion
J:\DLZ\Briefmg Items\2018\2018-01-08.docx
14 Mason County Transit
Don Pogreba Shelton, WA 98584
Deborah Petersen Shelton, WA 98584
Wes Martin Grapeview, WA 98546
Nancy Montgomery Grapeview, WA 98546
Casey Breeze Grapeview, WA 98546
Sandy Tarzwell Shelton, WA 98584
Dan Ward Shelton, WA 98584
RESOLUTION NO. -17
RECOMMENDATION TO THE COUNTY COMMISSION BY THE
BOARD COMPOSITION REVIEW COMMITTEE RELATING TO THE COMPOSITION OF
THE MASON TRANSIT AUTHORITY BOARD.
A RESOLUTION OF THE COMMISSIONERS OF MASON COUNTY, WASHINGTON, ON
APPROVING THE COMPOSITION OF MASON TRANSIT AUTHORITY BOARD.
WHEREAS, pursuant to RCW 36.57A.055, a meeting of representatives from the component
jurisdictions within the Mason County Public Transportation Benefit Area, namely the three
County Commissioners and a City Commissioner, was set for September 26, 2017, to be held at
1:00 PM at the Transit-Community Center Conference Room, 601 West Franklin Street in
Shelton; and
WHEREAS, that Board Composition Review Committee meeting was continued until
November 8, 2017 to be held 12:30 PM at the Mason Transit Administrative Office Conference
Room located at 790 E. Johns Prairie Rd in Shelton; and
WHEREAS, notice of the continued meeting was conspicuously posted at the Transit-
Community Center Conference Room and at the Mason Transit Authority Administrative
Offices; and
WHEREAS,the November 8,2017,meeting was held and attended by all four members; and
WHEREAS, the Board Composition Review Committee has a recommendation concerning the
composition of the Mason Transit Authority Board, which recommendation is to be approved by
the Mason County Commission and Shelton City Council;
NOW THEREFORE, THE BOARD OF COMMISSIONERS OF MASON COUNTY,
WASHINGTON HEREBY RESOLVES AS FOLLOWS:
Section 1. The Mason County Public Transportation Benefit Area (Mason Transit
Authority)Board composition shall be as follows:
Three(3)Mason County Commissioners;
One(1) City of Shelton Council member;
Five (5) members who shall be elected officials selected by the Mason County
Commissioners with the goal of seeking equal voting representation among the County
commission districts.
Board members so appointed shall serve a four-year term. Vacancies through resignation or
disqualification shall be filled by the County Commission to fill the unexpired term.
Section 2. The Board composition shall also contain one (1) non-voting labor
representative as set forth in RCW 36.57A.050.
J:\RESOLUTIONS&ORDINANCES\RESOLUTIONS-ORDINANCES Word Files\2017\MTA Board
composition.docx
Section 3. The new Board composition shall be effective as of January 1,2018.
EFFECTIVE this, l day of November, 2017.
BOARD OF COUNTY COMMISSIONERS
MASON COUNTY, WASHINGTON
ATTEST:
f
WMESS WR , KEVIN S TTY, Chair
Clerk of the Board
I
rr
APPROVED AS TO FORM: TERRI DREXLER, Commissioner
'4�z A__\
TIM WHITEHEAD, Ch. DPA Y NEATHERLIN, Commissioner
J:\RESOLUTIONS&ORDINANCES\RESOLUTIONS-ORDINANCES Word Files\2017\MTA Board
composition.docx
h
MASON COUNTY
BRIEFING ITEM SUMMARY FORM
TO: BOARD OF MASON COUNTY COMMISSIONERS
FROM: Dawn Twiddy
DEPARTMENT: Human Resources EXT: 422
BRIEFING DATE: 1/8/18
PREVIOUS BRIEFING DATES:
this is a follow-up briefing,please provide only new information
ITEM: Approval to set an Agenda Action Item on the January 16, 2018 Commissioners Agenda for
the Chair to sign the AIG Storage Tank Third Party Liability TankGuard Renewal Warranty
Acknowledgement Form to bind coverage effective April 21, 2018 - April 21, 2019. This policy
provides coverage for the county's fuel storage tank systems.
BUDGET IMPACTS: This expense is budgeted for under Non Departmental and Public Works.
BACKGROUND: The County's fuel storage tank insurance policy renews on April 21, 2018. This
policy provides coverage for the county's fuel storage tank systems. Arthur J. Gallagher Risk
Management Services, Inc. is the County's assigned Broker through the Washington Counties Risk
Pool.
RECOMMENDED OR REQUESTED ACTION: Approval to set an Agenda Action Item on the
January 16th Commissioners Agenda and for the Chair to sign the AIG Storage Tank Third Party
Liability TankGuard Renewal Warranty Acknowledgement Form to bind coverage effective April 21,
2018-April 21,2019.There is no change in the policy as written for the previous year.
ATTACHMENTS: Storage Tank Third Party Liability TankGuard Renewal Warranty
Acknowledgement Form on file with Clerk of the Board.
Briefing Summary 1/3/2018
JAIGI
Storage Tank Third Party Liability
TankGuard ® Renewal Warranty
NAMED INSURED: Mason County
INSURER: Commerce and Industry Insurance Company
POLICY NUMBER: PLCO01926399
POLICY PERIOD: 4/21/18 - 04/21/19
The undersigned warrants and represents that there have been no changes to the schedule of covered tanks or
locations:
THIS RENEWAL WARRANTY DOES NOT BIND THE APPLICANT TO BUY, OR THE COMPANY TO ISSUE THE
INSURANCE, BUT IT IS AGREED THAT THIS FORM SHALL BE THE BASIS OF THE CONTRACT SHOULD A POLICY
BE ISSUED, AND IT WILL BE ATTACHED TO THE ORIGINAL APPLICATION AND MADE A PART OF THE POLICY.
THE UNDERSIGNED APPLICANT DECLARES, WARRANTS AND REPRESENTS THAT THE-STATEMENTS SET
FORTH IN THIS WARRANTY ARE TRUE AND THAT NO MATERIAL FACTS HAVE BEEN SUPPRESSED OR
MISSTATED. THE APPLICANT FURTHER DECLARES, WARRANTS AND REPRESENTS THAT IF THE
INFORMATION SUPPLIED ON THIS WARRANTY CHANGES BETWEEN THE EXECUTION DATE OF THE
WARRANTY AND THE RENEWAL POLICY EFFECTIVE DATE, THE APPLICANT WILL IMMEDIATELY NOTIFY THE
COMPANY OF SUCH CHANGES, AND THE COMPANY MAY WITHDRAW OR MODIFY ANY OUTSTANDING
QUOTATIONS AND/OR AUTHORIZATION TO BIND THE INSURANCE.
ALL WRITTEN STATEMENTS AND MATERIALS FURNISHED TO THE COMPANY IN CONJUNCTION WITH THE
MOST RECENT LONG FORM APPLICATION AS WELL AS THE RENEWAL WARRANTY SIGNED HEREUNDER ARE
INCORPORATED BY REFERENCE INTO THIS APPLICATION AND MADE A PART THEREOF.
In the event that the company issues a policy, the undersigned acting on behalf of the applicant and all
proposed insureds, acknowledges that the company, in providing coverage, will have relied upon, as
representations, the declarations and statements which are contained in or attached to or incorporated by
reference into this warranty and which are incorporated into the policy.
If the insured would like an indication for higher limits, please indicate.
LIMITS DESIRED: (each incident/aggregate)
❑ $1 million/$1 million $1 million/$ 2 million ❑ $2 million/$2 million
❑ OTHER:
DEDUCTIBLE DESIRED: (each incident)
❑ $5,000 ❑ $10,000 ❑ $25,000 [ $50,000 ❑ $100,000
For Deductibles above $50,000, please include your most current audited financial statement.
91177 (03/17)
Alu
Renewal Warranty Acknowledgement
APPLICANT: BROKER: Arthur J. Gallagher Risk Managemen
Mason Cllgwlq ry 1501 MarKeq Street, Suite 250
APPLICANT;
Tacoma, WA 98402-
(Print Name) (Street Mailing Address)
DATE; Ms . Vicki Alridge
(Contact person)
(Phone#, Fax#, Email Address)
(Signature of Broker or Agent)
247654
(License Number and State)
36-2102482
(Tax I.D.#)
Please note that if you are planning on adding either additional tanks or locations to this policy, the Company
requires that we first receive a fully completed renewal application within thirty(30) days of the policy expirations
expiration date. Please visit our website www.chamberagent.com to download to application.
NOTICE TO APPLICANTS: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY
INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF
CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR, CONCEALS, FOR THE PURPOSE OF
MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT
ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES.
91177 (03/17)
e
Core 360
Loss Control Training Modules for Mason County
Core 360 is an online safety training and resource system provided through Arthur J. Gallagher, our Risk
Pool Broker.As part of their service,they are dedicated to assisting counties reduce their liabilities by
reducing losses and minimizing the total cost of risk.
All our current employees have been loaded into the CORE software system. Human Resources, along
with Elected Officials and Department Heads will have the ability to assign their employees trainings and
track their success.
Each module has a quiz at the end of the training, if passed a certificate will be generated. Most
trainings run 10-25 minutes.
Washington Counties Risk Pool has determined all counties that have employees who drive to conduct
county business should have and be assigned the following five defensive driving training modules:
• Defensive Driving—Backing Safely, R is for Reverse
• Defensive Driving Basics—Part 1
• Defensive Driving—General Auto Risk Management
• Defensive Driving—Intersections
• Defensive Driving—Winter Weather Conditions(The spring training will follow this one.)
Human Resources worked with the Risk Pool to identify additional trainings that would be of use to the
county based on past claims. Each year the trainings need reviewed and new ones selected, if necessary.
• Family Medical Leave Act(FMLA)
• Sexual Harassment(English &Spanish)
• Smart Risk Management—Five Core Principles
• Ethics in Action
• Bloodborne Pathogens
• Slip, Trip and Fall
Washington Counties Risk Pool
Loss Control Services
CORE360
Evaluating and Minimizing
Your Total Cost of Risk
IG
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. Arthur J. Gallagher & Co.
BUSINESS WITHOUT BARRIERS"'
Online
Training
CORE360 Loss Control Portal
Your online safety training and resource system
Powered by: Safety programs are critical to reducing losses and minimizing your total cost
of risk. Arthur J. Gallagher&Co.'s CORE360 Loss Control Portal provides
Allf"MI go beyond online training to support your safety program.
C'4LLAGµ��
�asse� Key features include:
• Managers and employees gain annual access to ten training modules of your
choosing, with the opportunity to refresh your ten modules annually
• Learning Management System (LMS)software uses SCORM to track and run
reports on participants' progress and quiz results
• Automatic email function notifies employees of training assignments with a
direct system link
.• • Safety Bulletins and Weekly Best Management Practices Training Bulletins
** C 0 R E 3 6 O emailed regularly to users
Evaluating and Minimizing • Online resource tools, model workplace policies, procedures and forms
Your Total Cost of Risk available, plus Human Resources Self-Assessment tools, with the ability to add
your own customized information
Focusing on: • Easy on-boarding of unlimited users and user assignment levels
® • The CORE360 Loss Control Portal can be customized to fit your
organization's needs
• Losses Within Deductible/Retention
Online Training Modules
Keep your training fresh!Select ten replacement modules each year you
Learn more at www.ajg.com/CORE360 renew with Arthur J. Gallagher& Co.
Most training modules run 10-25 minutes with a quiz. Safety Shorts run less
than 5 minutes, with no quiz.
View a full demo of the CORE360 Loss Control Portal here.
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