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Washington County ~ IG214001 ~ Washington County Community Human Services Program Contract Agreement - City Of Tigard - OLCC Minor Decoy Missions DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 Contract# 20-1318 WASHINGTON COUNTY COMMUNITY HUMAN SERVICES PROGRAM CONTRACT AGENCY AGREEMENT This AGREEMENT made and entered into by and between WASHINGTON COUNTY, a political subdivision of the State of Oregon (hereinafter"County") and City of Tigard (hereinafter "Contractor'), for the period commencing upon execution or July 1,2020 -whichever date is later, to and including June 30,2021 WITNESSETH: WHEREAS, County has established Early Learning and Youth Development programs pursuant to ORS Chapter 417.400 to 417.490 and a Community Mental Health Program pursuant to ORS Chapter 430 to serve Washington County residents; and WHEREAS, County desires to contract with the Contractor for provision of a portion of the Early Learning and/or Youth Development program and/or Community Mental Health Program for the period of this agreement; and WHEREAS, Contractor has or can obtain a Letter of Approval or License from the State of Oregon; and WHEREAS, County and Contractor are agreeable to the terms and conditions hereinafter set forth governing the provision of specified child, youth, and family services; and NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, County and Contractor agree to the following: Section 1-Purpose: 1. This contract and attachments sets forth the responsibilities and clarifies the relationship between County and Contractor and the terms of payment by County. 2. Contractor agrees it has received a full and complete copy of the County Contract Agency General Conditions ("General Conditions"), which document is incorporated into this Contract Agency Agreement by this reference. 3. This Contract Agency Agreement, including each attachment referenced below, the General Conditions, the County Statement of Conditions, all matters and laws incorporated by reference herein, any written amendments made according to the General Conditions shall be referred to as the "AGREEMENT" and constitute the entire agreement between Contractor and County. Section 2- Consideration: 1. Contractor shall perform the services described Attachment A. 2. County shall pay contractor in the manner described in Attachment B. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 1 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 Section 3-Documents Incorporated: The following documents are incorporated into this contract: ® County Contract Agency General Conditions 0 County Statement of Conditions Section 4-Additional Documents Incorporated: 1. The following Attachments are incorporated into and made a part of this contract: Attachment C - Modifications to Standard Contract Terms and Conditions 0 Attachment D - Modifications to Standard Insurance Requirements Attachment E - Intergovernmental Agreement between Washington County and OHA for the Financing of Community Addictions and Mental Health Services Attachment F - Intergovernmental Agreement between Washington County and OHA to fund SE 37 (Flexible Funding) ®❑ Attachment G - Current Risk Accepting Entity Participation Agreement between Washington County and Health Share of Oregon Attachment H - Current Health Plan Services Contract, Coordinated Care Organization Contract between OHA and Health Share of Oregon Jul Attachment I - Business Associate Agreement Other (refer to additional attachment if necessary): Attachment J-Requirements for Agreements Funded with Federal Funds Attachment K-OHA Agreement for Substance Abuse Prevention and Treatment Services 2. In the event there is a conflict between the documents comprising this contract, the following order of precedence shall apply: the terms and conditions in the body of this contract; Standard Contract Terms and Conditions as modified by Attachments A and B, Attachment C, Attachment D, Attachment E, Attachment F, Attachment G, Attachment H, Attachment I, the solicitation, and Contractor's response. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 2 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 IN WITNESS WHEREOF, the parties hereto have caused this AGREEMENT to be executed by these officers thereunto duly authorized. ............................................................................................................. CONTRACTOR DATA AND SIGNATURE Contractor Federal Tax ID# 93-0503940 DUNS (Data Universal Numbering System) # 949670459 State Tax ID# Citizenship: Nonresident alien 171 Yes 0 No Business Designation (check one): 11 Sole Proprietorship 0 Partnership El Corporation 11 Limited Liability Partnership El Non-Profit Corporation Federal tax ID numbers or Social Security numbers are required pursuant to ORS 305.385 and will be used for the administration of state, federal and local laws. Payment information will be reported to the Internal Revenue Service under the name and Federal tax ID number or, if none, the Social Security number provided above. I have read this agreement including the attachments. I understand the agreement, agree to be bound by its terms and certify that I am authorized to execute this agreement on beh If of contractor. C S?22 Sign ture Titl K4 $ Ze)20 Name ( ease print) Date ................................................................................................................ ................................................................................................................ EDOCUSignedby: WASHINGTON COUNTY SIGNATURE �` o'-. 8/7/2020 1 16:54 PDT 801C62C2808C4E1... Authorized Signature Date of Execution Ruth Osuna Deputy County Administrator Printed Signatory Name Title ................................................................................................................ 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 3 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 Contract representatives with regard to this AGREEMENT are: COUNTY: CONTRACTOR: Bernardino De La Torre Lisa Shaw Name Name Sr.Program Coordinator Business Manager Title Title Washington County City of Tigard Agency Agency 155 N First Ave.,MS 96 13125 SW Hall Blvd.,Suite A Address Address Hillsboro,OR 97124 Tigard,OR 97223-8144 City, State, Zip Code City, State, Zip Code 503-846-4547 (503)718-2554 Telephone Telephone Please note remittance address if different from above: 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 4 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 COUNTY CONTRACT AGENCY GENERAL CONDITIONS 1. Subcontracts and Assignment. Contractor shall not enter into any subcontracts for any of the work required by this contract, or assign or transfer any of its interest in this contract, without the prior written notice to County. County shall have 10 working days to object. The provisions of this contract shall be binding upon and shall inure to the benefit of the parties hereto, and their respective successors and assigns, if any. 2. Third Party Beneficiaries. County and Contractor are the only parties to this contract and are the only parties entitled to enforce its terms. Nothing in this contract gives, is intended to give, or shall be construed to give or provide any benefit or right, whether directly, indirectly, or otherwise, to third persons unless such third persons are individually identified by name herein and expressly described as intended beneficiaries of the terms of this contract. 3. Written Notice. Any notice of change, termination, or other communication having a material effect on this contract shall be upon the County Contract Administrator and the Contractor Contact Person and served in one of the following manners: a) In-person delivery; or b) deposited in the U.S. Mail under certified or registered handling, postage prepaid. Except as provided in this contract, it is agreed that fifteen calendar days shall constitute reasonable notice for the exercise of any right in the event that applicable law specifically requires such notice. 4. Governing LawNenue/Attorney Fees. This contract shall be governed by and construed in accordance with the laws of the State of Oregon without regard to principles of conflicts of law. Any claim, action, suit or proceeding (collectively, "Claim") between County and Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within the Circuit Court of Washington County for the State of Oregon; provided, however, if a Claim is brought in a federal forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the District of Oregon. CONTRACTOR, BY EXECUTION OF THIS CONTRACT, HEREBY CONSENTS TO THE IN PERSONAM JURISDICTION OF SAID COURTS. Each party shall be responsible for its own costs and attorney fees for any claim, action suit or proceeding, including any appeal. 5. Remedies Cumulative. All rights and remedies of County and Contractor shall be cumulative and may be exercised successively or concurrently. The foregoing is without limitation to or waiver of any other rights or remedies of County according to law. 6. Severability/Waiver. County and Contractor agree that, if any term or provision of this contract is declared by a court of competent jurisdiction to be illegal or in conflict with any law, the validity of the remaining terms and provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the contract did not contain the particular term or provision held to be invalid. The failure of either party to enforce any provision of this contract shall not constitute a waiver by that party of that or any other provision of this contract. 7. Public Contracting Statutes. 7.1 ORS 279B.220 through 2798.235 and 279C.500 through 279C.870, as applicable, are incorporated herein by reference. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 5 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 7.2 The Contractor agrees to: a. Make payment promptly, as due, to all persons supplying, to Contractor, labor or material for the performance of the work provided for in this contract; b. Pay all contributions or amounts due the Industrial Accident Fund incurred in the performance of the contract: C. Not permit any lien or claim to be filed or prosecuted against the County on account of any labor or material furnished pursuant to this contract; and d. Pay to the Department of Revenue all sums withheld from employees pursuant to ORS 316.167. 8. Independent Contractor. 8.1 Contractor shall perform the work required by this contract as an "Independent Contractor." Although County reserves the right to determine the delivery schedule for the work to be performed and to evaluate the quality of the completed performance, the County cannot and will not control the means or manner of the Contractor's performance. The Contractor shall comply promptly with any requests by County relating to the emphasis or relative emphasis to be placed on various aspects of the work or to such other matters pertaining to the work under this contract. Contractor is responsible for determining the appropriate means and manner of performing the work. 8.2 Contractor represents and warrants that Contractor is not an employee of the County, is not currently employed by the Federal Government, meets the specific independent Contractor standards of ORS 670.600, and is not an "officer', "employee", or"agent"of the County, as those terms are used in ORS 30.260 et. seq. 8.3 Contractor shall be responsible for all federal or state taxes applicable to any compensation or payments paid to Contractor under this contract. Contractor is not eligible for any federal Social Security, unemployment insurance, or workers' compensation benefits from compensation or payments paid to Contractor under this contract. 8.4 Contractor agrees to immediately provide County notice of any claim made against Contractor by any third party. Contractor also agrees not to assign to any third party, without County's written consent, any obligation of Contractor to indemnify County for any actions under this contract. 9. Environmentally Preferred Products/Material Safety Data Sheets. Whenever possible, the Contractor should use environmentally preferable products which present a lesser impact to the public health and the environment than competing products. Contractor agrees, upon execution of this contract, to submit a copy of the relevant material safety data sheet(s)for any chemical substance the Contractor will bring on to the County's premises and use as part of the work described in this contract. 10. Nondiscrimination. No person shall be denied or subjected to discrimination in receipt of the benefits of any services or activities made possible by or resulting from this contract on the grounds of race, color, religion, gender, sexual orientation, national origin, disability, age, or marital status. Any violation of this provision shall be considered a material defect and shall be grounds for cancellation, termination or suspension in whole or in part by the County. 2020 WASHINGTON COUNTY HEATH &HUMAN SERVICES: CYF AGENCY AGREEMENT 6 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 11. Termination. 11.1 This contract may be terminated under the following conditions: a. By mutual consent of both parties. b. Contractor may terminate this contract upon a material default of County; however, Contractor must provide written notice to the County Contract Administrator and provide County with thirty days to cure the default. c. County may at any time terminate, the whole or any part of,this contract for default if Contractor fails to perform any of the provisions of this contract, or so fails to pursue the work as to endanger performance of this contract in accordance with its terms, and after receipt of written notice from the County, fails to correct such failures within seven calendar days or such other period as the County may authorize or require. 11.2 Upon receiving a notice of termination issued by County, Contractor shall immediately cease all activities under this contract, unless expressly directed otherwise by County in the notice of termination. 11.3 In the event the Board of Commissioners of Washington County reduces, changes, eliminates, or otherwise modifies the funding for this contract, or if funding from federal, state, or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services, then County may terminate this contract, in whole or in part, effective upon delivery of written notice to the Contractor, or at such later date as may be established by the County, and Contractor agrees to abide by any such decision. 11.4 In addition to its other rights to terminate, County may terminate this Agreement, in whole or in part, for convenience upon thirty days' prior notice to Contractor . During this thirty-day period, Contractor shall wind down and cease its services as quickly and efficiently as possible, without performing unnecessary services or activities and by minimizing negative effects on County from such winding down and cessation of services. 11.5 The rights and remedies of the County provided in this section, are not exclusive and are in addition to any other rights and remedies provided by law or under this contract. 11.6 If this Agreement is terminated under subsections 11.3 or 11.4, County shall be liable only for payment in accordance with the terms of this contract for services satisfactorily rendered prior to the effective date of termination. 11.7 Upon termination, Contractor shall deliver to County all contract documents, information, works-in-progress, and other property that are or would be deliverables had the contract been completed. 12. Time is of the essence. Time is of the essence in Contractor's performance of each and every obligation and duty under this contract. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 7 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 13. Force Majeure. Neither County nor Contractor shall be held responsible for delay or default caused by fire, riot, acts of God, or war where such cause was beyond, respectively, County's or Contractor's reasonable control. Contractor shall make all reasonable efforts to remove or eliminate such a cause of delay or default and shall, upon the cessation of the cause, diligently pursue performance of its obligations under this contract. 14. Compliance with Applicable Law. Contractor and its subcontractor(s) shall comply with all federal, state, and local laws and ordinances applicable to the work performed under this contract including, but not limited to the following, as applicable: Title VI of the Civil Rights Act of 1964, Section V of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990 (Pub L No. 101-336), ORS 659A.142 and all regulations and administrative rules established pursuant to those laws; and all other applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. 15. Contractor Certification Regarding Debarment,Suspension, Proposed Debarment and other Responsibility Matters. The Contractor certifies to the best of its knowledge and belief that neither it nor any of its principals: 15.1 Are presently debarred, suspended, proposed for debarment, or declared ineligible from submitting bids or proposals by any federal, state or local entity, department or agency; 15.2 Have within a three-year period preceding this offer, been convicted or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performance of a public(Federal, state or local) contract or subcontract; violation of Federal or state antitrust statues relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statement, tax evasion, or receiving stolen property; 15.3 Are presently indicted for, or otherwise criminally or civilly charged by a governmental entity with, commission of any of the offenses enumerated in paragraph 15.2 of this certification; 15.4 Have within a three-year period preceding this offer, had one or more contracts terminated for default by any Federal, state or local public agency. 15.5 Are on the list titled "Specially Designated Nationals and Blocked Persons" maintained by the Office of Foreign Assets Control of the United States Department of the Treasury and currently found at: http://www.treas.gov/offices/enforcement/ofac/sdn/tl 1 sdn.pdf 16. Oregon Registration. If Contractor is not domiciled in or registered to do business in the State of Oregon, Contractor shall promptly provide to the Oregon Department of Revenue and the Secretary of State Corporation Division all information required by those agencies relative to this contract. 17. Use of County Facilities. Contractor and its employees or agents shall have the right to use only those facilities of County that are necessary to perform the services under this contract and shall have no right of access to any facility of the County without prior approval of County management. County shall have no responsibility for the loss, theft, mysterious disappearance of or damage to equipment,tools, materials, supplies, and other personal property of Contractor or its employees, subcontractors or agents which may be stored on County premises. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 8 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 18. Publicity. Contractor shall not use in its external advertising, marketing programs or other promotional efforts, any data, pictures, or other representations of the County except on prior specific written authorization from County management. 19. Counterparts. This contract may be executed in several counterparts, each of which shall be an original, all of which shall constitute one and the same instrument. 20. Warranties. Contractor represents and warrants to County that: (a) Contractor has the power and authority to enter into and perform the contract, (b)the contract, when executed and delivered, shall be a valid and binding obligation of Contractor enforceable in accordance with its terms, and (c) Contractor's performance under the contract shall be in a good and workmanlike manner and in accordance with the professional standards. 21. Records. Contractor shall maintain all fiscal records relating to this contract in accordance with generally accepted accounting principles. In addition, Contractor shall maintain any other records pertinent to this contract in such a manner as to clearly document Contractor's performance hereunder. Contractor acknowledges and agrees that County and its duly authorized representatives shall have access to such fiscal records and all other books, documents, papers, plans, and writings of the Contractor that are pertinent to this contract for the purpose of making audits, examinations, excerpts, copies and transcriptions. In addition, Contractor shall permit authorized representatives of the County to perform site reviews for all Services Delivered by Contractor. All such fiscal records, books, documents, papers, plans, and writing shall be retained by Contractor and kept accessible for a minimum of three years, except as required longer by law, following final payment and termination of this contract, or until the conclusion of any audit, controversy, or litigation arising out of or related to this contract, whichever date is later. All subcontracts shall also comply with these provisions. If OMB Circular A-133 is applicable to this Agreement, then Contractor shall supply County with Contractor's DUNS Number. 22. Work Product. All work products of the Contractor which result from this contract("the work products"), except material previously and mutually identified as confidential or proprietary, shall be provided to County upon request and shall be considered the exclusive property of the County. In addition, if any of the work products contain intellectual property of the Contractor that is or could be protected by federal copyright, patent, or trademark laws, or state trade secret laws, Contractor hereby grants County a perpetual, royalty-free, fully paid-up, nonexclusive and irrevocable license to copy, reproduce, perform, dispose of, use and re-use, in whole or in part, and to authorize others to do so. Such work products include, but are not limited to: databases, templates, file formats, scripts, links, procedures, materials, training manuals and other training materials, specially created key commands, and any other information, designs, plans, or works provided or delivered to the County or produced by Contractor under this contract. 23. County Policies. During the performance of this contract, Contractor shall follow County's Affirmative Action Program which is to promote the objectives of the Equal Opportunity Commission's guidelines as set forth in the Equal Opportunity Act of 1972, Oregon State Laws, legal mandates, and Presidential Executive Order 11246 entitled Equal Employment Opportunity as amended by Executive Order 11375 and as supplemented in Department of Labor Regulation 41 CFR part 60. Contractor shall also follow the County Workplace Discrimination, Harassment and Retaliation Prevention Policy, Workplace Violence Prevention Policy, Smoke Free Campus Policy and Personal Information Protection Policy. All subcontracts shall also comply with these provisions. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 9 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 24. Indemnification and Hold Harmless. Contractor shall defend, indemnify and hold harmless the County, its agents, officers, elected officials and employees from and against all claims, demands and judgments (including attorney fees) made or recovered against them including, but not limited to, damages to real or tangible property or for bodily injury or death to any person, arising out of, or in connection with this contract, to the extent such damage, injury or death is caused or sustained in connection with the negligent performance or willful misconduct of Contractor, or its employee, agents or subcontractors. The County agrees to promptly notify Contractor in writing of any such claim or demand to indemnify and agrees to cooperate with Contractor in a reasonable manner to facilitate the defense of such claim. 25. Insurance. Contractor shall provide insurance coverage and limits as described below. All insurance carried by Contractor must be primary to and non-contributory with any insurance, including any self-insurance or retentions carried by the County. A waiver of subrogation in favor of the County shall be required on General Liability, Workers Compensation and Automobile Liability coverage. 25.1 Workers' Compensation Insurance. Contractor shall comply with ORS 656.017, which requires subject employers to provide Oregon workers' compensation coverage for all their subject workers. No Workers' Compensation Insurance has been or will be obtained by the County for Contractor or Contractor's employees and subcontractors. Contractor shall provide and maintain workers' compensation coverage for its employees, officers, agents or partners as required by applicable workers' compensation laws including employers' liability with limits not less than $500,000/$500,000/$500,000. 25.2 Commercial General Liability Insurance. Contractor shall at all times carry a Commercial General Liability insurance policy for at least $1,000,000 combined single limit per occurrence and at least $2,000,000 in the aggregate per project, for Bodily Injury, Property Damage, and Personal Injury. This insurance shall include contractual liability coverage for the indemnity provided under this contract. 25.3 Automobile Liability Insurance. Contractor shall at all times carry Automobile Liability Insurance in the amount of$1,000,000 combined single limit per accident for Bodily Injury and Property Damage for Contractor's vehicles, whether owned, hired, or non-owned, which includes coverage for Washington County, its agents, officers, elected officials and employees. 25.4 Professional Liability/Errors and Omissions Insurance. Contractor shall at all times carry a Professional Liability/Errors and Omissions type insurance policy with limits of not less than $1,000,000 each occurrence (or each claim if coverage is afforded on a claims made basis) and $3,000,000 in the annual aggregate. If this policy is a "claims made" type policy, the policy type and company shall be approved by Washington County prior to commencement of the Work. 25.5 Extended Reporting Coverage("Tail Coverage"). For Professional Liability/Errors & Omissions Insurance written on a "claims made" basis and for any other required liability insurance provided on a "claims made" basis, Contractor shall provide "tail" coverage at the completion of the contract for a duration of thirty-six (36) months or continuous "claims made" liability coverage provided for thirty-six (36) months following contract completion. Continuous "claims made" coverage will be acceptable in lieu of"tail" coverage provided the retroactive date of the coverage is on or before the effective date of this contract. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 10 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 25.6 Maximum Deductible/Retention. Any deductible or retention must be disclosed on the certificate of insurance and no deductible or retention may exceed $25,000 without the prior written consent of the County. Contractor is responsible to pay any amounts within the deductible or retention amount. 25.7 Additional Insureds. The State of Oregon, Washington County, their agents, officers, elected officials and employees must be named as additional insureds with respect to Contractor's services to be provided under this Contract. Health Share of Oregon, its agents, officers and employees shall be named as additional insureds if any funding for this contract comes from Health Share of Oregon. All liability insurance policies, with the exception of professional and/or workers compensation policies, must be endorsed to show this additional coverage. 25.8 Insurance Certificates. Contractor shall deliver to the County, prior to the commencement of the work, a certificate of insurance evidencing all policies required by this contract including additional insured provisions afforded by the policy. This requirement can be satisfied by providing a copy of the coverage form and/or the endorsement(s). Further, it is an affirmative obligation upon the Contractor to advise the Contract Administrator within two business days of any substantive change of any insurance policy or endorsement set out herein, and failure to do so shall be construed to be a breach of this contract. 25.9 Subcontractor Insurance. Contractor shall require and verify that all of its subcontractors of any tier provide insurance coverage and limits identical to the insurance required of the Contractor under this contract, unless this requirement is expressly modified or waived by the County. 26. Survival. The terms, conditions, representations, and all warranties contained in this contract shall survive the termination or expiration of this contract. 27. Amendment. This contract may only be amended by a written amendment signed by authorized agents of both parties. 28. Protecting the Federal Government's Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment. The Federal Government suspends or debars Contractors to protect the Federal Government's interests. The Contractor shall not enter into any subcontract in excess of$25,000 with a Contractor that is debarred, suspended, or proposed for debarment unless there is a compelling reason to do so. The Contractor shall require each proposed first-tier subcontractor, whose subcontract will exceed $25,000 to disclose to the Contractor, in writing, whether as of the time of award of the subcontract, the subcontractor, or its principals, is or is not debarred, suspended, or proposed for debarment by the Federal Government. A corporate officer or a designee of the Contractor shall notify the Contract Administrator, in writing, before entering into a subcontract with a party that is debarred, suspended or proposed for debarment. 29. Security of Information 29.1 The County is required to notify its customers if any electronically stored information or written document that contains personal information has been subject to a security breach. Any Contractor of the County who becomes aware of any potential breach of a document or electronic file containing personal information of client of the County will immediately notify the Contract Administrator, who will work with the County Public Information Officer to notify the affected persons. A breach occurs when any unauthorized individual or 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 11 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 entity gains access to personal information or when unintended disclosure of personal information is made, for example loss or theft of a electronic device containing personal information, loss or theft of a paper document containing personal information, unauthorized access to a network containing personal information, or a document containing personal information being sent to the wrong address. 29.2 No County Contractor will print a person's full Social Security Number(SSN) on any document that will be sent through the mail, without a written request from the person whose SSN will be printed on the document, except as required by law. The Contractor will use only the last 4 digits of a SSN on all documents unless there is a compelling business reason to use the entire SSN. If a document contains a full SSN, the Contractor will take steps to protect the document from unauthorized disclosure. Contractors will not provide copies of a document containing a full SSN to anyone other than the person whose SSN is listed on the document, except as allowed by State or Federal law. The Contractor may provide a copy of a document to a third party with the SSN redacted if the document is otherwise allowed to be released. No Contractor will publicly post or display a document containing a full SSN. 29.3 Any County Contractor that collects personal information must develop, implement and maintain reasonable safeguards to protect the security and confidentiality of the information. Employees of the Contractor with access to personal information must take reasonable steps to prevent a breach of the information. Reasonable steps include locking file cabinets, monitoring who has access to areas containing personal information, locking computer workstations if leaving the area, and maintaining physical control over files, computer workstations, thumb drives, cds or other media which contains personal information. Contractors must also ensure the proper disposal of documents or other media which contains personal information. Contracting with a document shredding company will be considered proper disposal of paper documents. The Contractor will be responsible for properly disposing of or erasing electronically stored personal information on hard drives, CDs, thumb drives or other devices under their control. 30. Performance Standards. Unless the Contractor is providing architectural, engineering, photogrammetric mapping, transportation planning or land surveying services or related services, as defined in ORS 279C.100, the Contractor must meet the highest standards prevalent in the industry or business most closely involved in providing the goods or services. 31. Remedies. The consequences of the Contractor's failure to perform the scope of work or to meet the performance standards established by this contract may include, but are not limited to: a. Reducing or withholding payment; b. Requiring the Contractor to perform, at the Contractor's expense, additional work necessary to perform the identified scope of work or meet the established performance standards; and c. Declaring a default, terminating the contract and seeking damages and other relief available under the terms of the contract or other applicable law. 32. Whole Contract. THIS CONTRACT CONSTITUTES THE COMPLETE AND EXCLUSIVE STATEMENT OF THE CONTRACT BETWEEN THE PARTIES RELEVANT TO THE PURPOSE DESCRIBED HEREIN AND SUPERSEDES ALL PRIOR AGREEMENTS OR PROPOSALS, ORAL OR WRITTEN, AND ALL OTHER COMMUNICATION BETWEEN THE PARTIES RELATING TO THE SUBJECT MATTER OF THIS CONTRACT. 2020 WASHINGTON COUNTY HEATH&HUMAN SERVICES: CYF AGENCY AGREEMENT 12 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 WASHINGTON COUNTY OREGON Date: 06/30/2020 Retroactive Contract Approval Form Per Purchasing Rule 10-190, Retroactive Approvals: Before the Board of the County Administrator or designee may consider retroactive approval of a contract,the Department must submit to the Board of County Administrator or designee a copy of the contract to be reviewed and a written request for contract retroactive approval consideration containing: (a) An explanation of why the contract was not submitted to the Board or the County Administrator or designee before performance began; This writer was recently hired to perform the duties of the Program Coordinator position left vacant since January 2020. This writer was informed on 06/15/20,the Minor Decoy Operations contract with Tigard Police Department ends 06/30/20. (b) A description of the steps being taken to prevent similar occurrences in the future; and This writer is now pro-actively maintaining a schedule of contract deadlines and aware of primary points of contact at Tigard Police Department for contract processing and approval of forms. (c)A proposed date for the retroactive approval of the contract. Contract start date: 07/01/2020 Note: Upload this form into the Contract folder in the ECATS contract record. 1of1 2019 WASHINGTON COUNTY RETROACTIVE CONTRACT APPROVAL FORM DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 City of Tigard Police Department Minor Decoy Operations July 1, 2020 ATTACHMENT A All services will be provided in a safe, professional, culturally competent, gender- sensitive and language appropriate manner. Goal Minors will have reduced opportunities to illegally obtain alcohol in Tigard. Objectives: ■ Increase law enforcement's minor decoy operations ■ Decrease sales of alcohol or marijuana to minors in the Tigard community. ■ Help educate community members of the criminal and civil consequences of unlawful alcohol activities Outcomes: ■ A minimum of 4 minor decoy operations will be conducted by June 30, 2021 ■ Each completed operation will be followed by a press release from the Department to the local media publicizing the results. All press releases will cite Washington County as a partner. ■ Materials provided by the Washington County Prevention Coordinator and other prevention messages will be distributed community contacts via the City's social media, Police Department's website, or newsletter at least 2 times during the contract period. Reporting The Department will submit the following data on each invoice and provide copies of any related press releases issued during the reporting period. For Minor Decoy operations: 1) Number of establishments visited, 2) Number of sales/no sales, 3) Name of establishments that sold, 4) which operations OLCC was involved in and 5) Number of Citations issued. Reports should be submitted to CYF invoices(a)co.washington.or.us and cc'd to bernardino delatorre(aD_co.washington.or.us. DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 City of Tigard Police Department Minor Decoy Operations July 1, 2020 ATTACHMENT B From July 1 , 2020 through June 30, 2021, Washington County will reimburse Contractor (City of Tigard) for true and verifiable expenses up to $8,000 for the satisfactory delivery of services defined in the Request for Proposals, Contractor's proposal, and described in Attachment A of this contract. The following process shall be followed in the allocation of contract dollars: Contractor may submit an invoice to request reimbursement for true and verifiable expenses incurred in following each Minor Decoy operation. The final invoice will be submitted by July 15, 2021. At the time Contractor submits final monitoring and fiscal reports, Contractor shall reimburse County any funds advanced which were not expended. Performance, outcome and fiscal monitoring reports are due from Contractor within one month following each Minor Decoy operations as defined in the above Reporting section. Following demonstration of satisfactory utilization, performance, and outcomes, County will continue to reimburse invoices. Agency progress towards contracted utilization, performance, and outcomes will be reviewed quarterly. Delay in receipt of complete monitoring reports or monthly reimbursement invoices will result in a delay in the disbursement of contract funds. All contract payments are subject to the availability of funds and will be paid subsequent to County receipt of payments from the Oregon Health Authority's Public Health Division. Amount: $8,000 A&D 706015-7060601 CFDA #93.959 Block Grants for Prevention and Treatment of Substance Abuse B&W Tax 706015-7061101 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 ATTACHMENT D-MODIFICATIONS TO STANDARD INSURANCE REQUIREMENTS This attachment identifies modifications to the standard insurance requirements set forth in the contract between Washington County and City of Tigard The insurance requirements are modified as follows: 1. COMMERCIAL GENERAL LIABILITY INSURANCE. If commercial general liability insurance is required,the policy shall name the State of Oregon,its officers,employees and agents, Washington County,its agents,officers,elected officials and employees,as an ADDITIONAL INSURED by separate endorsement.This insurance shall include contractual liability coverage for the indemnity provided under this contract. Not required. COMMERCIAL GENERAL LIABILITY INSURANCE with limits of not less than: $500,000/$1,000,000 $2,000,000/$4,000,000 Other: $ each occurrence/aggregate for Bodily Injury and Property Damage. D ADDITIONAL INSURED ENDORSEMENT not required. 2.AUTOMOBILE LIABILITY INSURANCE. The policy will include coverage protecting Washington County during the term of this contract. Not required. AUTOMOBILE LIABILITY INSURANCE with a combined single limit, or the equivalent of not less than: No requirement in excess of that provided for under state law. $2,000,000 ❑❑ Other: $ each accident for Bodily Injury and Property Damage. 3. PROFESSIONAL LIABILITY INSURANCE 0 Not required. PROFESSIONAL LIABILITY INSURANCE with a combined single limit, or the equivalent, of not less than: 0 $1,000,000/$3,000,000 $2,000,000/$4,000,000 Other: $ each occurrence/aggregate to cover damages caused by error, omission or negligent acts related to the professional services to be provided under this contract. 2020 WASHINGTON COUNTY HEALTH&HUMAN SERVICES: ATTACHMENT D DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 4. OTHER COVERAGE REQUIRED POLLUTION LIABILITY INSURANCE with limits of not less than$ each occurrence(or each claim if coverage is afforded on a claims made basis)and$ in the annual aggregate to cover damages due to Bodily Injury,Property Damage and Environmental Damage resulting from sudden accidental or gradual pollution and related cleanup costs. ® EMPLOYEE DISHONESTY AND MONEY AND SECURITIES INSURANCE with a limit of not less than$ to cover Theft,Disappearance and Destruction of cash or negotiable securities in the care,custody or control of the contractor for County or on behalf of County clients. CYBER LIABILITY INSURANCE with limits of not less than$ per claim to cover data losses caused by cyber attacks,viruses, other threats,paper transactions,crisis services and lawsuits that result from data breaches or your failure to protect sensitive information. PHYSICAL ABUSE AND MOLESTATION INSURANCE with limits of not less than $ to cover actual or threatened physical abuse,mental injury, sexual molestation,or negligent employment, supervision,investigation,reporting to proper authorities or retention of any person for whom the Contractor is responsible for,including but not limited to Contractor and Contractor's employees and volunteers. Coverage can be provided by a separate policy or as an endorsement to the general or professional liability policies. PRODUCTS COMPLETED OPERATIONS HAZARD ADDITIONAL INSURED ENDORSEMENT naming Washington County,its agents,officers, elected officials and employees with respect to liability for Bodily Injury and Property Damage. OTHER(Describe coverage and limits.Refer to additional attachment if necessary): A copy of the policy or Certificate of Insurance and endorsements,where required, acceptable to the COUNTY for each policy required above shall be filed with the COUNTY prior to the effective date of this contract. The Contractor shall advise the Contract Administrator within two business days of any substantive change to any insurance policy or endorsement. 2020 WASHINGTON COUNTY HEALTH&HUMAN SERVICES: ATTACHMENT D DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 ATTACHMENT J Required for all Agreements that are funded in whole or in part by Federal Grant Funds (including Federal Funds provided by State Agencies) Catalog of Federal Domestic Assistance (CFDA) number(s) of federal funds to be paid through this Agreement: F93.959 Contractor or Sub-Recipient Determination -Washington County determines that: ❑ Recipient is a sub-recipient; OR 0 Recipient is a contractor AUDIT CLAUSES Recipient shall comply with the following applicable provisions below. Audits/Costs A. Recipients receiving federal funds in excess of$750,000 from all sources in the Recipient's fiscal year are subject to audit conducted in accordance with the provisions of 2 CFR part 200, subpart F. Subrecipient, if subject to this requirement shall at Recipient's own expense submit to County a copy of, or electronic link to, its annual audit subject to this requirement covering the funds expended under this Agreement and shall submit or cause to be submitted to County the annual audit of any subrecipients(s), contractor(s), or subcontractor(s) of Subrecipient responsible for the financial management of funds received under this Agreement. B. Audit costs for audits not required in accordance with 2 CFR part 200, subpart F are unallowable. If Subrecipient did not expend$750,000 or more in Federal funds in its fiscal year, but contracted with a certified public accountant to perform and audit, costs for performance of that audit shall not be charged to the grant. C. Subrecipient shall save, protect and hold harmless County from the cost of any audits or special investigations performed by the Federal awarding agency or any federal agency with respect to the funds expended under this Agreement. Subrecipient acknowledges and agrees that any audit costs incurred by Subrecipient as a result of allegations of fraud, waste or abuse are ineligible for reimbursement under this or any other agreement between Subrecipient and the County. Maintenance of Financial Records Recipient must maintain auditable financial records per generally accepted accounting principles and in accordance with OAR 309-013-0075 through 0220 and in sufficient detail to permit County or the State to verify how any payments received under this Agreement were expended. DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment J Access to Records Recipient agrees to permit a program reviewer or an auditor of the Federal, State, or County government or their agents to have access to records and financial statements as may be necessary. Access to records by the County or State may be with notice or without notice. Any refunds to or disallowances by the Federal Government, the State, or the County resulting from audits shall be the sole responsibility of Recipient for payment to the Federal Government, the State, or the County. Cost Principles The parties agree to comply with any applicable cost principles established for determining the allowable costs incurred as set forth in 2 CFR 200 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards), OR circulars superseded by 2 CFR 200 (OMB Circular A-87 (State and Local Governments), OMB Circular A-122 (Nonprofit Organizations), OMB Circular A-21 (Institutions of Higher Learning), 45 CFR Part 74 (Appendix E Hospitals), FAR 48 Subpart 31.2 (For profit Organizations). The parties further agree to comply with, as applicable, the administrative standards for grants set forth in 2 CFR 200 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards). Financial Reports Recipients determined to be sub-recipients of Federal funds who receive Federal awards during the current contract year from County shall provide County with a Financial Report prepared in accordance with generally accepted accounting principles upon which an independent certified public accountant has expressed an opinion. Such report shall account for funds received during the County's fiscal year, July 1 through June 30, or any part of the County's fiscal year occurring during the term of this Agreement. The report must be submitted within six months of the Recipient's fiscal year end. If the Recipient is unable to meet the deadline, they may request, in writing, an extension of up to three months. Failure to provide County with the annual Financial Report may result in withholding of payments due to the Recipient or termination of this agreement. If the Recipient has a different fiscal year from the County, then the report shall account for funds received during the Recipient's fiscal year. Expenditure Records Recipient shall document the expenditure of all funds paid to Recipient under this Agreement. Unless applicable federal law requires Recipient to utilize a different accounting system, Recipient shall create and maintain all expenditure records in accordance with generally accepted accounting principles and in sufficient detail to permit County to verify how the funds paid to Recipient under this contract were expended. 2020 Attachment J (no CFDA) 2 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment J Clauses required in non-Federal entity's contracts Source: 2 CFR Part 200,Appendix II Recipient shall comply with all applicable provisions below. (A) Administrative, contractual, or legal remedies are addressed in County Contract Agency General Conditions (Sections 4, 5, 7, 8, 11, 13, 24, 25, and 31) as well as other applicable provisions in the Agreement and Attachments (B) Termination provisions are addressed in County Contract Agency General Conditions (Section 11) as well as other applicable provisions in the Agreement and Attachments (C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of"federally assisted construction contract" in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp.,p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." (D) Davis-Bacon Act, as amended(40 U.S.C. 3141-3148). If required by the federal funding source and if this Agreement is a prime construction contract in excess of $2,000, Recipient shall comply with the Davis-Bacon Act(40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5 "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction"). If this section applies, Recipient must pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, Recipient must pay wages not less than once a week. If applicable, the County will place a copy of the current prevailing wage determination issued by the Department of Labor in the solicitation. The decision to award a Contract is conditioned upon the acceptance of the wage determination. If applicable, the County will place a copy of the current prevailing wage determination issued by the Department of Labor in the solicitation. If applicable, Recipient must accept the wage determination. If applicable, County will report all suspected or reported violations by Recipient to the Federal awarding agency. If applicable, Recipient must comply with the Copeland"Anti-Kickback"Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each Recipient is prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the 2020 Attachment J(no CFDA) 3 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment J compensation to which he or she is otherwise entitled. If applicable, County will report all suspected or reported violations by Recipient to the Federal awarding agency. (E) Contract Work Hours and Safety Standards Act(40 U.S.C. 3701-3708). If the amount of this contract exceeds $100,000 and involves the employment of mechanics or laborers Recipient shall comply with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, if applicable, Recipient shall compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. (F) Rights to Inventions Made Under a Contract or Agreement. If the funding for this Contract meets the definition of"funding agreement"under 37 CFR 401.2(a) and Contract is a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under this Agreement, Recipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the federal awarding agency. (G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act(33 U.S.C. 1251-1387). If the amount of this contract exceeds $150,000 Recipient shall comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act(42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended(33 U.S.C. 1251-1387). Violations shall be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency(EPA). (H) Debarment and Suspension (Executive Orders 12549 and 12689). Addressed in County Contract Agency General Conditions (Sections 15 and 28) as well as other applicable provisions in the Agreement and Attachments. 2020 Attachment J (no CFDA) 4 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment J (I) 2 CFR Section 200.322 Procurement of recovered materials. Contractor must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded$10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. (J) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352) By signing this Agreement, the Recipient certifies, to the best of the Recipient's knowledge and belief that: 1. No federal appropriated funds have been paid or will be paid,by or on behalf of Recipient, to any person for influencing or attempting to influence an officer or employee of an 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. 2. If any funds other than federal 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 Recipient shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying"in accordance with its instructions. 3. The Recipient shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients and subcontractors shall certify and disclose accordingly. 4. This certification is a material representation of fact upon which reliance was placed when this Agreement was made or entered into. Submission of this certification is a prerequisite for making or entering into this Agreement imposed by section 1352, Title 31 of the 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. 2020 Attachment J (no CFDA) 5 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment J 5. No part of any federal funds paid to Recipient under this Agreement shall be used, other than for normal and recognized executive legislative relationships, for publicity or propaganda purposes, for the preparation, distribution before the United States Congress or any State or local legislature itself, or designed to support or defeat any proposed or pending regulation, administrative action, or order issued by the executive branch of any State or local government. 6. No part of any federal funds paid to Recipient under this Agreement shall be used to pay the salary or expenses of any grant or contract recipient, or agent acting for such recipient, related to any activity designed to influence the enactment of legislation, appropriations, regulation, administrative action, or Executive Order proposed or pending before the United States Congress or any State government, State legislature or local legislature or legislative body, other than for normal and recognized executive-legislative relationships or participation by an agency or officer of a State, local or tribal government in policymaking and administrative processes within the executive branch of that government. 7. The prohibitions in subsections 5 and 6 of this section shall include any activity increase, or any proposed,pending, or future requirement or restriction on any legal consumer product, including its sale or marketing, including but not limited to the advocacy or promotion of gun control. 8. No part of any federal funds paid to Recipient under this Agreement may be used for any activity that promotes the legalization of any drug or other substance included in schedule I of the schedules of controlled substances established under section 202 of the Controlled Substances Act except for normal and recognized executive congressional communications. This limitation shall not apply when there is significant medical evidence of a therapeutic advantage to the use of such drug or other substance or that federally sponsored clinical trials are being conducted to determine therapeutic advantage. 2020 Attachment J (no CFDA) 6 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 19-0903 Oregon Grant Agreement Number 154960 Health Authority AMENDMENT TO STATE OF OREGON INTERGOVERNMENTAL GRANT AGREEMENT In compliance with the Americans with Disabilities Act, this document is available in alternate formats such as Braille, large print, audio recordings, Web-based communications and other electronic formats. To request an alternate format,please send an e-mail to dhs- oha.publicationrequest(&,,state.or.us or call 503-378-3486 (voice) or 503-378-3523 (TTY) to arrange for the alternative format. This is amendment number 1 to Grant Agreement Number 154960 between the State of Oregon, acting by and through its Oregon Health Authority, hereinafter referred to as "OHA" and Washington County 254 N. First Ave./ 155 N. First Ave., Suite 250, MS 6 Hillsboro, OR 97124 Attn: Sia Lindstrom, Sr.Deputy County Administrator / Adam Freer, Program Supervisor, Children,Youth, and Families Telephone: 503-846-8685/503-846-4491 Facsimile: 503-846-4545/503-846-4954 E-mail address: sia lindstrom(&co.washington.or.us; adam freer(&co.washington.or.us hereinafter referred to as "Recipient". 1. Upon approval of this amendment by the parties, and when required, the Department of Justice, this amendment shall become effective on July 1, 2019 regardless the date this amendment has been fully executed by every party. 2. The Agreement is hereby amended as follows: a. The OHA contact information on Page I is deleted and replaced with the following: Public Health Division Health Promotion & Chronic Disease Prevention Section 800 NE Oregon Street, Suite 730 Portland, OR 97232 Agreement Administrator: Amanda Cue or delegate Telephone: 971-673-1121 Facsimile: 971-673-0994 E-mail address: amanda.c.cueAstate.or.us b. Section 1. Effective Date and Duration is amended to change the Agreement expiration date from July 30, 2019 to June 30, 2021. C. Section 3. Grant Disbursement is hereby amended to increase the maximum not-to- exceed amount payable to Recipient under this Agreement by$647,500 to a new amount of$1,295,000. DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 d. As of July 1, 2019,Exhibit A, Part 1 - Program Description is amended as set forth in the Exhibit A, Part 1 Program Description, attached hereto as Attachment#1 and incorporated herein by this reference; language to be deleted or replaced is std through; new language is underlined and bold. e. As of July 1, 2019,Exhibit A, Part 2 - Payment and Financial Reporting is amended as set forth in the Exhibit A, Part 2 - Payment and Financial Reporting, attached hereto as Attachment#2 and incorporated herein by this reference; language to be deleted or replaced is stmek thfett ; new language is underlined and bold. f. Exhibit B, Standard Terms and Conditions, Section 18. "Notice" OHA address only, is amended as follows: Deleted language is stmek thr-eti and new language is underlined and bold. OHA: Office of Contracts & Procurement 250 Win4er-Street, Room 309 635 Capitol Street NE, Suite 350 Salem, OR 97301 Telephone: 503-945-5818 Facsimile: 503-378-4324 g. Exhibit E, "Information Required by 2 CFR 200.331(a)(1)"is hereby superseded and restated in its entirety, as set forth in Exhibit E, "Information Required by 2 CFR 200.331(a)(1)", attached hereto as Attachment#3 and incorporated herein by this reference as follows: language to be deleted or replaced is stmek thfo'• ; new language is underlined and bold. 3. Except as expressly amended above, all other terms and conditions of the original Agreement and any previous amendments are still in full force and effect. 154960/JFG Page 2 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 4. Recipient Data and Certification. Recipient shall provide the information set forth below. PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION Recipient Name (exactly as filed with the IRS): Washington County Street address: 155 N First Ave. City, state, zip code: Hillsboro, OR 97124 Email address: adam—freer@comashington.or.us Telephone: ( 503 ) 846-4491 Facsimile: ( 503 ) 846-4954 Is Recipient a nonresident alien, as defined in 26 USC § 7701(b)(1)? (Check one box): ❑ YES ❑ NO Business Designation: (Check one box): ❑ Professional Corporation ❑ Nonprofit Corporation ❑ Limited Partnership ❑ Limited Liability Company ❑ Limited Liability Partnership ❑ Sole Proprietorship ❑ Corporation ❑ Partnership ❑ Other Recipient Proof of Insurance, Recipient shall provide the following information upon submission of the signed Agreement Amendment. All insurance listed herein and required by Exhibit C of the original Agreement, must be in effect prior to Agreement execution. Workers' Compensation: Does Recipient have any subject workers, as defined in ORS 656.027? (Check one box): E] YES ❑ NO If YES,provide the following information: Workers' Compensation Insurance Company: self-insured Policy#: Expiration Date: 154960/JFG Page 3 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 RECIPIENT, BY EXECUTION OF THIS AMENDMENT,HEREBY ACKNOWLEDGES THAT RECIPIENT HAS READ THIS AMENDMENT, UNDERSTANDS IT,AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 5. Signatures. Washington County By: DocuSigned by: �lA �,l�i S{VOwt Sia Lindstrom AtWiffi zu&Sagftalure Printed Name Deputy county Administrator 8/11/2019 Title Date State of Oregon acting by and through its Oregon Health Authority By: Authorized Signature Printed Name Title Date Approved for Legal Sufficiency: Via e-mail by Cynthia Byrnes, AAG June 21, 2019 &July 10, 2019 Department of Justice Date OHA Program Approval Authorized Signature Printed Name Title Date 154960/JFG Page 4 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment#1: EXHIBIT A Part 1 Program Description 1. Alcohol and Drug Prevention and Education Program (ADPEP) Substanee Abuse Alcohol and Drug Prevention and Education Program (ADPEP) Sttbst,nee Abtise Pr-event and T,-o.,4, en4 glee,r,.,,rA (SAPT DT BG) funds are used to prevent alcohol, tobacco and drugs use and associated effects, across the lifespan. The ADPEP objective is to help plan, implement and evaluate strategies that prevent substance abuse, by reducing of risk factors and increasing protective factors associated with alcohol, tobacco and other drugs. (See https://www.samhsa.gov/grants/block-grants/sabg) ADPEP S^�Q programs, defined by the National Academies of Science Continuum of Care prevention categories, include promotion,universal direct, universal indirect, selective, and indicated prevention: • Promotion and universal prevention addresses the entire population with messages and programs aimed at prevention or delaying the use of alcohol, tobacco and other drugs. • Selective prevention targets are subsets of the total population that are deemed to be at risk for substance abuse by virtue of membership in a particular population segment. • Indicated prevention is designed to prevent the onset of substance abuse in individuals who do not meet criteria for addiction but who are showing elevated levels of risk and early danger signs. ADPEP S^�Q programs support implementation of the Center for Substance Abuse Prevention's (CSAP) six strategies: 1) Information Dissemination; 2) Prevention Education; 3) Alcohol, Tobacco & Other Drug (ATOD) Free Alternatives; 4) Community Based Processes; 5) Environmental/Social Policy; and 6) Problem Identification and Referral. 2. Required Recipient Activities (each an"Activity") 2.1 Recipient shall submit to Oregon Health Authority(OHA) for approval, a Biennial Alcohol and Drug Prevention and Education Program(ADPEP) Plan ("Biennial ADPEP Plan"), for 2019-21 and 2021-23 2017 19 and 2019 '" which details the strategies to be implemented, as outlined in this Program Description and as described in annual guidance documents provided by OHA and the goals, objectives and outcomes to be achieved by implementing those strategies. (Completion Due: the 2017-19 Biennial ADPEP Plan is due June 26, 2017 under the previous grant and Service Element; and the second 2019-21 Biennial ADPEP Plan is due June 30, 2019, and the third 2021-23 Biennial ADPEP Plan is due June 1, 2021 . 154960/JFG Page 5 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 2.2 Recipient shall implement the Recipient's OHA-approved 2019-212017 19 Biennial ADPEP Plan, including but not limited to, the following types of activities: • Information Dissemination—local implementation of media campaigns; Public Service Announcements (PSA); • Prevention Education—assuring school policy supports evidence-based school curricula and parenting education and skill building; peer leadership; classroom education; • Alcohol, Tobacco & Other Drug (ATOD) Free Alternatives - youth leadership and community service projects that support policy strategies and goals; mentoring programs; • Community Based Processes - community engagement and mobilization; Building and effectively managing prevention coalitions; • Environmental/Social Policy- school policies and community or organizational rules and laws regulating alcohol, tobacco and other drugs; and • Problem Identification and Referral—sustainable referral systems to evidence- based health care systems, services and providers. (Completion Due: on an ongoing basis throughout the term of this Agreement). 2.3 Recipient shall coordinate efforts among diverse stakeholders and related programs (e.g. other alcohol and drug efforts such as prescription drug overdose, tobacco prevention, mental health and suicide prevention)in local communities. Such coordination offers a shared benefit of coordinated mobilization and leveraged resources to achieve local policy and environmental change goals and measurable improvement in health status. Recipients must determine how best to coordinate with local Tobacco Prevention and Education Program (TPEP) to include in the biennial plan detail of coordinated strategies. Per the ADPEP Program Guidance for the 2019-2021 Biennium for program requirements, Recipient shall share finalized biennial program plan with TPEP Coordinators within a shared service area to aid in greater coordination and collaboration. Reeipient shall eeer-dinate with the leeal Tebaeee Prevention and E"eation Program 2017 19 Biennial ADPEP Plan to a&anee and eeer-dinate tebaeee prevention (Completion Due: on an ongoing basis throughout the term of this Agreement). 2.4 Recipient shall participate in site visits, state trainings, meetings and evaluation activities as requested or required by OHA. (Completion Due: on an ongoing basis throughout the term of this Agreement). 154960/JFG Page 6 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 3. Reporting Requirements 3.1 Recipient shall report to OHA semi-annually to describe progress made in completing activities and achieving the goals and objectives set forth in the Recipient's OHA- approved Biennial ADPEP Plan. If Recipient completes fewer than 75% of the planned activities in its OHA-approved Biennial Local Alcohol and Other Drug Prevention Program Plan for two consecutive calendar quarters in one state fiscal year Recipient will not be eligible to receive funding under this Grant Agreement during the next state fiscal year. (Semi-Annual Progress Reports Due: on an ongoing basis throughout the term of this Agreement each six months beginning with the first report in January, 2020 2418 and as otherwise requested by OHA). 3.2 Recipient shall submit written annual Progress reports to OHA using forms and procedures provided by OHA to describe results in achieving the goals and objectives through implementing the evidence-based strategies set forth in the Recipient's OHA- approved Biennial ADPEP Plan as well as any obstacles encountered, successes and lessons learned. (Annual Progress Reports Due: July 30, 201 July 30, 2019 (for the period of July 1, 2018—June 30, 2019) and July 30, 2020 (for the period of July 1, 2019—June 30, 2020). Note: if this Agreement is extended for 2021-23 by an amendment, OHA will include an Annual Progress Report requirement for the period of July 1, 2020— June 30, 2021 in the extension amendment. 154960/JFG Page 7 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 Attachment#2: EXHIBIT A Part 2 Payment and Financial Reporting 1. Expenditure of Grant Funds. a. OHA will reimburse Recipient for allowable expenses incurred in performing Program activities as described in Exhibit A, Part 1, Program Description consistent with the OHA approved Budget* for the subject period. *Note re: Budget Adjustments: Budget adjustments of up to 10% of the cumulative grant award amount are allowable between or within Budget categories and line items. No OHA approval is required for such adjustments, but Recipient shall notify the OHA Agreement Administrator of all such changes. Budget adjustments exceeding 10% of the cumulative grant award amount between or within Budget categories and line items require the prior written approval of the OHA Agreement Administrator. b. Recipient shall prepare and submit written Expenditure Reports and Reimbursement Requests at least quarterly and no more than monthly and within 30 days of the subject period end. C. Recipient's Expenditure Reports and Reimbursement Requests shall include: • Recipient's name • Agreement number; • Agreement not-to-exceed(NTE) amount; • Budget NTE amount per Activity; • An itemized list of Program expenses to be reimbursed for the subject period such as personnel, fringe, travel, supplies, indirect, other); and • Amounts billed by Recipient for current Reimbursement Request period by Activity; and • The Cumulative amounts billed by Recipient to date per Activity,--, and d. Recipient's Expenditure Reports shall include a detailed accounting report of the itemized expenses. Supporting documentation of Program expenses must be maintained by Recipient and made available to OHA upon request. Recipient shall revise and resubmit Expenditure Reports to OHA's satisfaction. e. Recipient shall send all Expenditure Reports and Reimbursement Request, to OHA's Contract Administrator(Amanda Cue) (Ashley Thir-st p) at following email addresses, or to any other address as OHA may indicate in writing to Recipient: amanda.c.cueAstate.or.us , 154960/JFG Page 8 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 2. Travel and Other Expenses. OHA will reimburse Recipient for travel and other expenses included in the OHA- approved budget. 014A will fiet reimbor-se Reeipient for any tr-avel or-additional expenses wider this n R ee ent 154960/JFG Page 9 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:WCAEOD-D921-4821-81FA9-ECO261BE67137 Attachment#3: EXHIBIT E Information Required by 2 CFR 200.331(a)(1)* Federal Award Identification 1. Subrecipient* Name (which must match the name associated with 2. below): Washington County 2. Subrecipient's Unique Entity Identifier (i.e., DUNS number): 069389448 3. Sub-award Period of Performance Start and End Date: From: 7/1/2017 To: 6/30/2021. 4. Total Amount of Federal Funds Obligated by this Agreement: $564296.25 5. Total Amount of Federal Funds Obligated to the Subrecipient by the pass-through entity including this Agreement**: $1128592.5 6. Name of pass-through entity, and contact information for awarding official of the pass-through entity: (a) Name of pass-through entity: Oregon Health Authority (b) Contact Information for awarding official of the pass—through entity: Luci Longoria, Health Promotion Manager; 971-673-1064; luci.longoriackstate.or.us 7. Federal Award: SAPT (a) Federal Award Identification Number (FAIN): 2B08TI010043-16 and 2B08TI010043-18 (b) Federal Award Date: 10/01/2015-9/30/2019 (The money is continuous and another NOA will be received in October 2019) (c) Total Amount of Federal Award committed to the Subrecipient by the pass-through entity: $1128592.5 (d) Federal Awarding Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (e) Federal Award Project Description: Provides block grant resources for treatment services (OHA Health Services) and foundational substance abuse prevention (PHD) to address alcohol, tobacco and other drugs. (f) CFDA Number and Name: 93.959 (Substance Abuse Prevention and Treatment Block Grant) Amount: $10,289,173 (g) Indirect Cost Rate: 5% of total direct cost 154960/JFG Page 10 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 (h) Is Award Research and Development? ❑ Yes ® No 8. Federal Award: SPF-PFS (If Applicable per Item 8.(c) below) (a) Federal Award Identification Number(FAIN): 5U79SP020705-03 (b) Federal Award Date: 9/30/2016-9/29/2017 (The money is continuous and another NOA will be received in October 2017) (c) Total Amount of Federal Award committed to the Subrecipient by the pass-through entity: NA (d) Federal Awarding Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (e) Federal Award Project Description: Provides resources to complement and accelerate alcohol prevention for 18-25 year olds. (f) CFDA Number and Name: 93.243 (Oregon Strategic Prevention Framework- Partnership for Success) Amount: $2,016,000 (g) Indirect Cost Rate: 15% of personnel and fringe only (h) Is Award Research and Development? ❑ Yes ® No *For the purposes of this Exhibit F,"Subrecipient"refers to Recipient and"pass-through entity"refers to OHA. **The total amount of federal funds obligated to the Subrecipient by the pass-through entity is the total amount of federal funds obligated to the Subrecipient by the pass-through entity from 7/1/2017 to 6/30/2021. 154960/JFG Page 11 of 11 OHA Grant Amendment(reviewed by DOJ) Updated: 11.02.17 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 DOCUMENT RETURN STATEMENT Please complete the following statement and return with the completed signature page and the Contractor Data and Certification page and/or Contractor Tax Identification Information (CTII) form, if applicable. If you have any questions or find errors in the above referenced Document, please contact the contract specialist. Document number: 154960-1 , hereinafter referred to as "Document." Sia Lindstrom Deputy County Administrator Name Title received a copy of the above referenced Document, between the State of Oregon, acting by and through the Department of Human Services, the Oregon Health Authority, and Washington County by email. Contractor's name DS On 7/29/19 8/11/2019 �1 Date l/ I signed the electronically transmitted Document without change. I am returning the completed signature page, Contractor Data and Certification page and/or Contractor Tax Identification Information (CTII) form, if applicable, with this Document Return Statement. FSDocuSigned bye�"" A �lVjS r6Ki 8/11/2019 Auth -iffiR79PO'dfure Date Please attach this completed form with your signed document(s) and return to the contract specialist via email. Document Return Statement, Rev. 10/16 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 NGYtiN Co �y� AGENDA Z WASHINGTON COUNTY BOARD OF COMMISSIONERS f Agenda Category: Consent—Health and Human Services Agenda Title: AUTHORIZE INTERGOVERNMENTAL AGREEMENT WITH OREGON HEALTH AUTHORITY FOR ALCOHOL, TOBACCO AND DRUG PREVENTION SERVICES Presented by: Marni Kuyl, Director, Department of Health and Human Services SUMMARY: This Intergovernmental Agreement between the Oregon Health Authority, Public Health Division (PHD) and Washington County grants state and federal funds to the County to implement alcohol, tobacco and drug prevention strategies in local communities. In June 2019, Washington County Health and Human Services submitted a plan for continued funding of community-based substance abuse prevention strategies during the 2019-21 biennium, This plan for the County to receive $647,500 has been accepted by the PHD and includes $197,726 in subcontracts for community organizations engaging in substance abuse prevention work, DEPARTMENT'S REQUESTED ACTION: Authorize the 2019-2021 Intergovernmental Agreement with the Oregon Health Authority, Public Health Division to receive a total of$647,500 between July 1, 2019 and June 30, 2021, to implement alcohol, tobacco and drug prevention strategies in local communities in Washington County, COUNTY ADMINISTRATOR'S RECOMMENDATION: I concur with the requested action, APPROVED WASHINGTON COUN'.Y t BOARD OF COMMISSIONERS Agenda Item No, 2•w• MINUTE ORDRI#II j.�„; .,�,f.? � Date: 06/1$/19 DATE............. ....».....SP�2 9.. DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 Administrative Use Only - Z99999 Supplier Name: Oregon Health Authority Actual Contract Number(CustomText4): 19-0903 Department: HHS - Children&Fam Contract Type: 6 Amendment Contract Sub Type: Minute Order Number: 19-182 Master Contract Number: BCC 17-0930 2019 WASHINGTON COUNTY-ARCHIVE RECEIPT DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 Qocu� � SECURE 6 Certificate Of Completion Envelope Id: DOD934C875654486AC95713E646BA8D6 Status:Completed Subject: Please DocuSign: 19-0903 Source Envelope: Document Pages: 14 Signatures:0 Envelope Originator: Certificate Pages: 1 Initials: 1 Kittie Kong AutoNav: Enabled 155 N. First Ave,Suite 270 Envelopeld Stamping: Enabled MS28 Time Zone: (UTC-08:00)Pacific Time(US&Canada) Hillsboro,OR 97124-3087 kittie_kong@co.washington.or.us IP Address:204.147.152.3 Record Tracking Status:Original Holder:Kittie Kong Location: DocuSign 9/30/2019 8:06:43 AM kittie_kong@co.washington.or.us Security Appliance Status:Connected Pool:StateLocal Storage Appliance Status:Connected Pool:Washington County Location: DocuSign Signer Events Signature Timestamp Sia Lindstrom EDSent:9/30/2019 8:09:40 AM sia_Lindstrom@co.washington.or.us Viewed:9/30/2019 5:40:49 PM Deputy County Administrator Signed:9/30/2019 5:41:59 PM Washington County,Oregon Security Level: Email,Account Authentication Signature Adoption: Pre selected Style (None),Access Code Using IP Address:204.147.152.1 Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 9/30/2019 8:09:40 AM Certified Delivered Security Checked 9/30/2019 5:40:50 PM Signing Complete Security Checked 9/30/2019 5:41:59 PM Completed Security Checked 9/30/2019 5:41:59 PM Payment Events Status Timestamps DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 For Administrative Use Only—Z99999 Supplier Name: City of Tigard Actual Contract Number(CustomText4):20-1318 Department(Location):HHS-Children&Fam Contract Type: 2 P/P Services Contract Sub Type(Custom2Code): P/P Services Minute Order Date: Minute Order Number: Master Contract Number(CustomTextl): 20-1318 Bid/RFP#(BidRFP): BPO Number(CustomlCode): Expense Contract SHIP TO(LocShipTo):HHS-Children&Fam BILL TO(LocBillTo): HHS-Children&Fam Project Number(CustomText2): Chargeable Program Number(ChargeProgram): Contract Admin(Administrator): Bernardo De_La Torre 2019 WASHINGTON COUNTY-ARCHIVE RECEIPT DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67B7 DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 07/23/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sid Friedman AU AINS NAME: Brown&Brown Northwest PHONE (503)274-6511 FAx A/C No Ext: A/C,No): CA License#0714755 E-MAIL sfriedman@bbnw.com ADDRESS: PO Box 29018 INSURER(S)AFFORDING COVERAGE NAIC# Portland OR 97296 INSURERA: SAIF Corporation INSURED INSURER B: City of Tigard INSURER C: 13125 SW Hall Blvd INSURER D: INSURER E: Tigard OR 97223 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2072342257 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ —] DAMAGE TO CLAIMS-MADE r OCCUR PREM IS Ea occurrence)l $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 PER STATUTE ETH AND EMPLOYERS'LIABILITY Y/N 3,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A OFFICER/MEMBER EXCLUDED? NIA 860903 07/01/2020 07/01/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 3,000,000 If yes,describe under 3,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Grant Funding for Minor Decoy Operations.Proof of Coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN The State of Oregon,Washington County their agents,officers,elected ACCORDANCE WITH THE POLICY PROVISIONS. employees AUTHORIZED REPRESENTATIVE 155 N First Avenue Hillsboro OR 97124 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261 BE67137 CERTIFICATE OF COVERAGE Agent This certificate is issued as a matter of information only and confers no rights upon Brown & Brown Northwest the certificate holder other than those 2701 NW Vaughn St, Ste. 340 provided in the coverage document. This Portland, OR 97210 certificate does not amend,extend or alter the coverage afforded by the coverage www.bbnw.com documents listed herein. cltycounty insurance services Named Member or Participant Companies Affording Coverage Clt of Tigard COMPANY A-CIS 1325 SW Hall Blvd COMPANY B-National Union Fire Insurance Co Tigard OR all Bl COMPANY C-RSUI Indemnity COMPANY D-Federal Insurance Company 20281 LINES OF COVERAGE This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement,term or condition of any contract or other document with respect to which the certificate may be issued or may pertain,the coverage afforded by the coverage documents listed herein is subject to all the terms,conditions and exclusions of such coverage documents. Company Certificate Effective Termination Type of Coverage Letter Number Date Date Coverage Limit General Liability General Aggregate: $30,000,000 ✓ Commercial General Liability A 20LTIG 7/1/2020 7/1/2021 Each Occurrence: $10,000,000 ✓ Public Officials Liability ✓ Employment Practices ✓ Occurrence Auto Liability General Aggregate: None ✓ Scheduled Autos A 20LTIG 7/1/2020 7/1/2021 Each Occurrence: $10,000,000 ✓ Hired Autos ✓ Non-Owned Autos Auto Physical Damage ✓ Scheduled Autos A 20APDTIG 7/1/2020 7/1/2021 ✓ Hired Autos C ✓ Non-Owned Autos ✓ Property C 20PTIG 7/1/2020 7/1/2021 Per Filed Values A ✓ Boiler and Machinery D 20BTIG 7/1/2020 7/1/2021 Per Filed Values Excess Liability ✓ Excess Crime B 20ECTIG 7/1/2020 7/1/2021 Per Loss $1,000,000 ✓ Excess Earthquake C 20EQTIG 7/1/2020 7/1/2021 Each Occurrence $5,000,000 ✓ Excess Flood C 20FTIG 7/1/2020 7/1/2021 Each Occurrence $5,000,000 Excess Cyber Liability Occurrence/Aggregate: Workers'Compensation Description: Operations of Named Member as respects Grant Funding for Minor Decoy Operations. Attached CIS Trust General and Auto Liability Coverage Agreement CIS applies. Subject to policy terms,conditions and exclusions. Certificate Holder: CANCELLATION:Should any of the coverage documents herein be cancelled before the expiration date thereof,CIS will provide 30 days written notice to the certificate holder named herein,but failure to mail such notice shall impose no obligation or liability of any The State of Oregon,Washington County, kind upon CIS,its agents or representatives,or the issuer of this certificate. their agents, officers, elected officials and employees 155 N First Avenue Hillsboro OR 97124 By: Ron Cutter Date: 7/23/2020 56693860 1 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page I of 6 DocuSign Envelope ID:AA3CAEOD-D921-4821-8FA9-ECO261BE6767 CIS TRUST GENERAL AND AUTO LIABILITY COVERAGE AGREEMENT This is an agreement between the Trust, as defined herein, and the named member identified in the General &Auto Liability Coverage Declarations as "Named Member" for"Public Entity Liability Coverage" for the applicable coverage period. Various provisions of this agreement restrict coverage. Read the entire coverage agreement carefully to determine rights, duties, and what is and what is not covered. Words or phrases that appear in bold-faced type have special meaning and are defined in Sections 1, 1013, 11 B, and 12C. 1. DEFINITIONS A. "Administration" means: (1) Giving counsel to employees with respect to the employee benefit programs; (2) Interpreting the employee benefit programs; (3) Handling records in connection with employee benefit programs; (4) Effecting enrollment, termination or cancellation of employees under the employee benefits programs; provided all such acts are authorized by the named member. B. "Airport" means any area of land or water that is intended for the landing and takeoff of aircraft, and includes its buildings and related facilities, if any. C. "Bodily Injury" means bodily injury, sickness or disease sustained by a person including death resulting from any of these. D. "Claim" means any notice or demand to the named member by or on behalf of a party seeking damages that reasonably communicates to the named member the party's intent to seek money damages from the member. E. "Covered Auto" means any vehicle designed for land transportation, whether or not licensed for highway use, and owned or operated by the member. F. "Damages" means all sums recoverable by law from any liability covered under this coverage agreement, including punitive damages if awarded, but not including any sums awarded for plaintiff's attorney fees, or expert fees, under any statute including but not limited to, 42 U.S. Code, 1988, in any case in which monetary damages are not sought or not awarded. Damages do not include: (1) Costs necessary to comply with injunctions or declaratory relief. (2) Sums recoverable for breach of contract; express or implied. CIS—GL/AL (7/1/18) Page 1 of 32 56693860 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page 2 of 6 DocuSign Envelope ID:WCAEOD-D921-4821-81FA9-ECO261BE67137 (3) Sums awarded as compensation due or accruing to the benefit of the employee while still employed by the named member. (4) Sums sought or awarded for claims of unjust enrichment, money had and received or replevin. (5) Sums due to taxing authorities, insurance programs, or retirement plans as a result of an award of damages or claim settlement. (6) Fines or penalties assessed to the Member for non-payment of taxes, insurance contributions or retirement plan contributions. G. "Employee benefit programs" shall mean group life insurance, group health insurance, profit sharing plans, pension plan, employee stock subscription plans, workers' compensation, unemployment insurance, social security, disability benefits insurance and travel, savings or vacation plans. H. "Fungus or fungi" includes but is not limited to any form or type of mold, mushroom or mildew. I. "Hazardous properties" means radioactive, toxic or explosive properties. J. "Hospital" or "nursing home" means any facility with an organized medical staff, with permanent facilities that include inpatient beds and with medical services, including physician services and continuous nursing services under the supervision of registered nurses, to provide diagnosis and medical or surgical treatment including but not limited to providing treatment for 1) acutely ill patients and accident victims, 2) mentally ill patients or 3) patients in special inpatient care facilities. However, in-patient care facilities incidental to correctional facilities shall not be considered a hospital or nursing home. K. "Member" means the entity named on the declarations page and its officers, employees and agents including volunteers, authorized to act on behalf of the named member, all acting within the scope of their employment or duties whether arising out of a governmental or proprietary function. The term member shall also include additional members to the extent coverage is afforded under the definition of additional member. (1) "Named member" means the entity named as such on the Declarations page of the coverage agreement, (2) "Additional member" means any party whom a public body covered under this coverage agreement has agreed to hold harmless, indemnify or defend pursuant to a contract or other agreement lawfully entered into by such public body. However, in no event shall coverage under this coverage agreement extend to such party for any claim arising out of an occurrence after the expiration of this coverage agreement or the expiration of the contract or agreement entered into by the public body, whichever shall occur first. Further, in no event shall coverage under this coverage agreement extend to such party for any claim, however or whenever asserted, arising out of such party's sole negligence. Except as specified in this paragraph, such party shall have no rights under the Trust Agreement, Bylaws or Rules of the Trust. The term "additional insured" if used on a certificate of coverage, shall be understood to mean the same as additional member. L. "Nuclear Facility" means: (1) Any nuclear reactor; CIS—GL/AL (7/1/18) Page 2 of 32 56693860 1 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page 3 of 6 DocuSign Envelope ID:WCAEOD-D921-4821-81FA9-ECO261BE67137 (2) Any equipment or device designed or used for: a. separating the isotopes of uranium or plutonium, b. processing or utilizing spent fuel, or C. handling, processing, or packaging nuclear waste; (3) any equipment or device used for the processing, fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the member at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (4) any structure, basin, excavation, premises or place prepared or used for the storage or disposal of nuclear waste; and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. M. "Nuclear material" means source material, special nuclear material or by-product material. N. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. O. "Nuclear waste" means any waste material: (1) containing by-product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore process primarily for its source material content, and (2) resulting from the operation by any person or organization of any nuclear facility included under the first two paragraphs of the definition of nuclear facility. P. "Nursing home" see Hospital. Q. "Occurrence" means: (1) an incident, event, act, error or omission which occurs during the coverage period: or (2) a series of related incidents, events, acts, errors or omissions; or a continuous or repeated exposure to substantially the same general conditions, which occur during the coverage period. If the occurrence begins in one coverage period and ends in another, the occurrence shall be deemed to have taken place during the last such coverage period. Such incidents, events, acts, errors or omissions, or continuous or repeated exposures to substantially the same conditions shall be deemed to be a single occurrence for purposes of determining the "per occurrence" limit of liability and deductible, if any. Only the coverage and limits in effect for the last coverage period shall apply and only one "per occurrence" limit shall be available for each such multi-period occurrence regardless of the number of coverages under this coverage agreement which may apply to such occurrence. CIS—GL/AL (7/1/18) Page 3 of 32 56693860 1 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page 4 of 6 DocuSign Envelope ID:AAKAEOD-D921-4821-81FA9-ECO261 BE67137 R. "Personal Injury" means false arrest, detention, imprisonment, malicious prosecution, libel, slander, or publication or utterance in violation of the individual's right of privacy, wrongful entry or eviction, or invasion of the right of private occupancy. S. "Pollutants,"as used in exclusion Section 4.1., means any solid, liquid, gaseous, or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkali, and chemicals, bacteria, organisms, and pathogens. However, pollutants does not include sewage which through the negligence of the member escapes the confines of a municipal sewage treatment system owned or operated by the member. T. "Property Damage" means injury to or destruction of tangible property. U. "Source material," "special nuclear material," or "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. V. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor. W. "Spore(s)" include any reproductive body produced or arising out of any fungus or fungi. X. "Trust Agreement" means the CITY COUNTY INSURANCE SERVICES DECLARATION AND AGREEMENT OF TRUST. Y. "Trust" means the CIS or CIS Trust, as described in the Trust Agreement. Z. "Waste" as used in exclusion Section 4.1., includes, but is not limited to, materials to be recycled, reconditioned, or reclaimed. 2. COVERAGES In accordance with and subject to the General & Auto Liability Coverage Declarations applicable to the named member to which this Coverage Agreement applies; the City County Insurance Services Declaration and Agreement of Trust (herein "Trust Agreement"); the Bylaws and Rules of the Trust; and the terms, conditions, and limitations of this Coverage Agreement and in consideration of the contribution for which this coverage agreement is written, the Trust will pay on behalf of the member all damages arising out of an occurrence, not to exceed the Limits of Liability as set further described in Section 4. of this Coverage Agreement because of: Coverage A: Liability arising under Oregon Revised Statutes 30.260 to 30.300; asserted pursuant to ORS 30.260 to 30.300. Coverage B: Liability arising under 42 U.S. Code 1983; 42 U.S. Code 2000e, et seq. (Title VII of the Civil Rights Act of 1964); 29 U.S. Code 621, et seq. (Age Discrimination in Employment Act of 1967); The Americans with Disabilities Act; The Civil Rights Act of 1991; 42 U.S. Code 1981; 42 U.S. Code 3601, et seq. (The Fair Housing Act); ORS Chapter 659; ORS Chapter 659A; ORS 652.355; ORS 654.062; 29 U.S. Code Sec. 261, et seq. (Family and Medical Leave Act); or any law amendatory thereof. Coverage C: Tort liability for bodily injury, personal injury and property damage for which the member is legally liable under the laws of any jurisdiction other than the State of Oregon and other than any United States Federal jurisdiction to which this coverage agreement applies. CIS—GL/AL (7/1/18) Page 4 of 32 56693860 1 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page 5 of 6 DocuSign Envelope ID:WCAEOD-D921-4821-81FA9-ECO261BE67137 Coverage D: Tort liability for the negligence of others assumed by the named member under contract, except as limited in the definition of the term "member" in Section 1. of this Coverage Agreement. Coverage E: Liability to a named member's employee, prospective employee, former employee or the beneficiaries or legal representatives thereof, arising out of, and asserted pursuant to, ORS 30.260 to 30.300, and caused by an occurrence consisting of or based upon the member's negligent errors or omissions in the administration of the named member's employee benefits program. Coverage F: Uninsured/Underinsured Motorists Coverage as set forth in Section 10. of this coverage agreement, pursuant to ORS 278.215. The Limits of Liability of such coverage with respect to a member shall the Per Occurrence Limit for General and Auto Liability Coverage as set forth in the General and Auto Liability Declarations. The limits of liability of such coverage with respect to a permissive user of a covered auto, other than a member, shall be the amounts set forth in ORS 806.070 that is the minimum liability limits of the Financial Responsibility Law as provided in the Oregon Vehicle Code and as set forth in Section 8. of this coverage agreement. In accordance with and subject to the Declarations, the Trust Agreement, Bylaws and Rules of the Trust, and in consideration of the contribution for which this Coverage Agreement is written, and independent of Coverages A- F above, the Trust will pay: Coverage G: Legal expenses reasonably incurred by a public official of the named member arising out of defense of a complaint alleging violation of ORS 244.040 or 244.120 to 244.135, subject to the terms and conditions set forth in Section 7. ETHICS LEGAL EXPENSE COVERAGE of this coverage agreement. Coverage H: The actual or alleged accidental discharge, dispersal, release or escape of pollutants, subject to the terms, conditions, and limitations set forth in this Coverage Agreement, specifically including, without limitation, Section 11. LIMITED POLLUTION LIABILITY COVERAGE. Coverage I: Unless such expenses or damages are otherwise covered by this Coverage Agreement, CYBER SECURITY EXPENSE COVERAGE as set forth in Section 12. The Trust shall have the right and duty to defend, with legal counsel selected by the Trust, any claim or suit against the member seeking damages, even if any of the allegations of the suit are groundless, false or fraudulent, and may make such investigation and settlement of any claim or suit as it deems expedient. The duty to defend any claim or suit shall terminate, except as provided hereafter, when such claim or suit ceases to seek damages against the member. Provided, however, that the duty to defend any claim or suit shall not terminate so long as the claim or suit includes an allegation of breach of an implied contract arising out of an employment relationship with the named member. 3. DEDUCTIBLES A. CONDITIONAL DEDUCTIBLE: Employment Practices CIS—GL/AL (7/1/18) Page 5 of 32 56693860 1 20-21 CIS Certificate I Cathi Pham 1 7/23/2020 3:33:09 PM (PDT) I Page 6 of 6 Docu5�". 6 S E C U R E 6 Certificate Of Completion Envelope Id:AA3CAEODD92148218FA9ECO261 BE6767 Status:Completed Subject: Please DocuSign:Contract#20-1318:City of Tigard Source Envelope: Document Pages:46 Signatures: 1 Envelope Originator: Certificate Pages: 1 Initials:0 Kittie Kong AutoNav: Enabled 155 N. First Ave,Suite 270 Envelopeld Stamping: Enabled MS28 Time Zone: (UTC-08:00)Pacific Time(US&Canada) Hillsboro,OR 97124-3087 kittie_kong@co.washington.or.us IP Address:204.147.152.15 Record Tracking Status:Original Holder:Kittie Kong Location: DocuSign 8/7/2020 2:43:09 PM kittie_kong@co.washington.or.us Security Appliance Status:Connected Pool:StateLocal Storage Appliance Status:Connected Pool:Washington County Location: DocuSign Signer Events Signature Timestamp Ruth Osuna S'g dby' Sent:8/7/2020 2:48:01 PM ruth_osuna@co.washington.or.us '"" Viewed:8/7/2020 4:54:03 PM De ut Count Administrator ED 801MC28o8c4E, Signed:8/7/2020 4:54:34 PM Deputy Y 9 Washington County,Oregon Security Level: Email,Account Authentication Signature Adoption: Pre selected Style (None),Access Code Using IP Address:99.203.114.213 Signed using mobile Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 8/7/2020 2:48:01 PM Certified Delivered Security Checked 8/7/2020 4:54:03 PM Signing Complete Security Checked 8/7/2020 4:54:34 PM Completed Security Checked 8/7/2020 4:54:34 PM Payment Events Status Timestamps