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HomeMy WebLinkAbout2013-098 DSS - Assistance Travel & Transport, Inc for transportation to clients identified by the county $35,000 Contract 468-1020 Assistance Travel&Transport V Contract# 68-1020 Fiscal Year Begins April 1, 2013 Ends June 30, 2013 This contract is hereby entered into by and between the Orange County Department of Social Services(the "County") and Assistance Travel&Transport,Inc.(the"Contractor")(referred to collectively as the"Parties"). The Contractor's federal tax identification number or Social Security Number is 1. Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Terms and Conditions(Attachment A) 6 (3) The Scope of Work,description of services,and rate(Attachment B) (4) Federal Certification Regarding Drug-Free Workplace&Certification Regarding Nondiscrimination(Attachment C) (5) Conflict of Interest(Attachment D) (6) No Overdue Taxes(Attachment E) (7) Federal Certification Regarding Lobbying(Attachment G) (8) Federal Certification Regarding Debarment(Attachment IT) 4 (9) Certification Regarding Transportation(Attachment J) (9)Outcomes and Reporting(Attachment N) (10)Contract Determination Questionnaire These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Paragraph 1, above, with the first-listed document laving the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract Amendments,the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on April 1,2012 and shall terminate on June 30,2013. 4 This contract must be twelve months or less. f 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work,and shall meet the requirements set forth in Attachment N, Outcomes and Reporting. t r, 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed $35,000. This amount consists of$35,000 in Federal (CFDA # ), State and County funds, $0 (source of other funds if ' applicable). ® a. There are no matching requirements from the Contractor. . ❑ b. The Contractor's matching requirement is$ ,which shall consist of: ❑ In-kind ❑Cash ❑ Cash and In-kind ❑ Cash and/or In-kind The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed$35,000. _ 6. Reporting'Requirements: Contract-General (07/12) Page 1 of 3 Contract#68-1020 Assistance Travel&Transport t Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22&23 and OMB Circular A-133. and shall disclose all information required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106. 7. Payment Provisions: Payment shall be made in accordance with the Contract Documents as described in the Scope of Work, Attachment B. 8. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions about s the contract from one Party to the other shall be addressed and delivered to the other Party's Contract Administrator. The name,post office address,street address,telephone number,fax number,and email address of the Parties'respective initial Contract Administrators are set out below. Either Party may change the name, post office address, street address, telephone number,fax number,or email address of its Contract Administrator by giving timely written notice to the other Party. For the County: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Sharron Hinton,Human Services Manager Sharron Hinton,Human Services Manager Orange County Department of Social Services Orange County Department of Social Services P.O.Box 8181 113 Mayo Street Hillsborough,NC 27278 Hillsborough,NC 27278 (919)245-2840 € sliintoii@orangecouiiiync.gov For the Contractor: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Kenneth M. Williams,CEO Kenneth M. Williams,CEO Assistance Travel&Transport Assistance Travel&Transport 3710 University Drive 3710 University Drive Suite 240 Suite 240 Durham,NC 27707 Durham,NC 27707 (919)489-5050 Phone (919)489-5011 Fax Contract-General (07/12) Page 2 of 3 Contract#68-1024 Assistance Travel&Transport 9. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this agreement. The Contractor and the County have executed this contract in duplicate originals,with one original being retained by each party. ASSISTANCE TRAVEL&TRANSPORT,INC. Signature l5ate Printed Name Title ORANGE COUNT OLINA By: 7R Frank CA 44,County r r Date NAME OF SUPERVISING DEPARTMENT Nancy C "ston, S ial Services Department Director Signature Date This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. 4101,5 Clarence G. Grier,Asst. County Manager/CFO Date This c n ct b n approved as to form and legal sufficiency. Anne M. Moo e,County Attorney's Office Date Contract-General (07/12) Page 3 of 3 Contract#68-1020 Assistance Travel&Transport,Inc. ATrACEMNT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services Relationships of the Parties and Contractor that any such person or entity, other than the County or the Contractor,receiving services or benefits Independent Contractor: The Contractor is and shall be under this contract shall be deemed an incidental deemed to be an independent contractor in the performance beneficiary only. of this contract and as such shall be wholly responsible for the work to be performed and for the*supervision of its employees.The Contractor represents that it has,or shall Indemnity and Insurance secure at its own expense, all personnel required in performing the services under this agreement. Such Indemnification: The Contractor agrees to indemnify and employees shall not be employees of, or have any hold harmless the County and any of their officers,agents individual contractual relationship with the County. and employees,from any claims of third parties arising out or any act or omission of the Contractor in connection with Subcontracting: The Contractor shall not subcontract any the performance of this contract. of the work contemplated under this contract without prior written approval from the County. Any approved Insurance: During the term ofthe contract,the Contractor subcontract shall be subject to all conditions of this at its sole cost and expense shall provide commercial contract.Only the subcontractors specified in the contract insurance of such type and with such terms and limits as documents are to be considered approved upon award of may be reasonably associated with the contract. As a the contract. The County shall not be obligated to pay for minimum, the Contractor shall provide and maintain the any work performed by any unapproved subcontractor. following coverage and limits: The Contractor shall be responsible for the performance of (a) Worker's Compensation - The contractor shall all of its subcontractors. provide and maintain Worker's Compensation Insurance as required by the laws of North Assignment: No assignment of the Contractor's Carolina,as well as employer's liability coverage obligations or the Contractor's right to receive payment with minimum limits of$500,000.00,covering all hereunder shall be permitted. However, upon written of Contractor's employees who are engaged in any request approved by the issuing purchasing authority,the work under the contract. If any work is sublet,the County may: Contractor shall require the subcontractor to (a) Forward the Contractor's payment check(s) provide the same coverage for any of his directly to any person or entity designated by the employees engaged in any work under the Contractor,or contract. (b) Include any person or entity designated by (b) Commercial General Liability - General Contractor as a joint payee on the Contractor's Liability Coverage on a Comprehensive Broad payment check(s). Form on an occurrence basis in the minimum In no event shall such approval and action obligate the amount of$1,000,000.00 Combined Single Limit. County to anyone other than the Contractor and the (Defense cost shall be in excess of the limit of Contractor shall remain responsible for fulfillment of all liability.) contract obligations. (c)Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a Beneficiaries: Except as herein specifically provided combined single limit of$500,000.00 for bodily otherwise,this contract shall inure to the benefit of and be injury and property damage; a limit of binding upon the parties hereto and their respective $500,000.00 for uninsured/under insured motorist successors.It is expressly understood and agreed that the coverage; and a limit of$25,000.00 for medical enforcement of the terms and conditions of this contract, payment coverage. The Contractor shall provide and all rights of action relating to such enforcement,shall this insurance for all automobiles that are: be strictly reserved to the County and the named (a) owned by the Contractor and used in the Contractor.Nothing contained in this document shall give performance of this contract; or allow any claim or right of action whatsoever by any (b) hired by the Contractor and used in the other third person.It is the express intention of the County performance of this contract; and General Terms and Conditions-3-28-2013 Page 1 of 5 Contract#68-1020 Assistance Travel&Transport,Inc. (c) Owned by Contractor's employees and The contractor will maintain Insurance requirements if used in performance of this contract("non- required as noted under Article 7 Rule R2-36 of the North owned vehicle insurance"). Non-owned Carolina Utilities Commission. vehicle insurance protects employers when employees use their personal vehicles for work purposes. Non-owned vehicle Default and Termination insurance supplements, but does not replace,the car-owner's liability insurance. Termination Without Cause: The County may terminate this contract without cause by giving 30 days written The Contractor is not required to provide and maintain notice to the Contractor. automobile liability insurance on any vehicle—owned, hired,or non-owned--unless the vehicle is used in the Termination for Cause: If, through any cause, the performance of this contract. Contractor shall fail to fulfill its obligations under this (d) The insurance coverage minimums specified in contract in a timely and proper manner,the County shall subparagraph(a)are exclusive of defense costs. have the right to terminate this contract by giving written (e) The Contractor understands and agrees that the notice to the Contractor and specifying the effective date insurance coverage minimums specified in thereof. In that event,all finished or unfinished deliverable subparagraph (a) are not limits, or caps, on the items prepared by the Contractor under this contract shall, Contractor's liability or obligations under this contract. at the option of the County, become its property and the (f) The Contractor may obtain a waiver of any one or more Contractor shall be entitled to receive just and equitable of the requirements in subparagraph (a) by compensation for any satisfactory work completed on such demonstrating that it has insurance that provides materials,minus any payment or compensation previously protection that is equal to or greater than the coverage made. Notwithstanding the foregoing provision, the and limits specified in subparagraph(a). The County Contractor shall not be relieved of liability to the County shall be the sole judge of whether such a waiver for damages sustained by the County by virtue of the should be granted. Contractor's breach of this agreement,and the County may (g) The Contractor may obtain a waiver of any one or more withhold any payment due the Contractor for the purpose of the requirements in paragraph(a)by demonstrating of setoff until such time as the exact amount of damages that it is self-insured and that its self-insurance due the County from such breach can be determined. In provides protection that is equal to or greater than the case of default by the Contractor, without limiting any coverage and limits specified in subparagraph(a). The other remedies for breach available to it,the County may County shall be the sole judge of whether such a procure the contract services from other sources and hold waiver should be granted. the Contractor responsible for any excess cost occasioned (h) Providing and maintaining the types and amounts of thereby. The filing of a petition for bankruptcy by the insurance or self-insurance specified in this paragraph Contractor shall be an act of default under this contract. is a material obligation of the Contractor and is of the essence of this contract. Waiver of Default: Waiver by the County of any default (i) The Contractor shall only obtain insurance from or breach in compliance with the terms of this contract by companies that are authorized to provide such the Provider shall not be deemed a waiver of any coverage and that are authorized by the Commissioner subsequent default or breach and shall not be construed to of Insurance to do business in the State of North be modification of the terms of this contract unless stated Carolina.All such insurance shall meet all laws of the to be such in writing, signed by an authorized State of North Carolina. representative of the County and the Contractor and (j) The Contractor shall comply at all times with all lawful attached to the contract. terms and conditions of its insurance policies and all lawful requirements of its insurer. Availability of Funds: The parties to this contract agree (k) The Contractor shall require its subcontractors to and understand that the payment of the sums specified in comply with the requirements of this paragraph. this contract is dependent and contingent upon and subject (1) The Contractor shall demonstrate its compliance with to the appropriation, allocation, and availability of funds the requirements of this paragraph by submitting for this purpose to the County. certificates of insurance to the County before the Contractor begins work under this contract. Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is Transportation of Clients by Contractor: prevented from performing such obligations by any act of General Terms and Conditions-3-28-2013 Page 2 of 5 Contract#68-1020 Assistance Travel&Transport,Inc. war,hostile foreign action,nuclear explosion,riot,strikes, execute such agreements and practices as the County civil insurrection,earthquake,hurricane,tornado,or other may require to ensure compliance. catastrophic natural event or act of God. Trafficking Victims Protection Act of 2000 Survival of Promises: All promises,requirements,terms, The Contractor will comply with the requirements of conditions, provisions, representations, guarantees, and Section 106(g)of the Trafficking Victims Protection Act warranties contained herein shall survive the contract of 2000,as amended(22 U.S.C. 7104) expiration or termination date unless specifically provided otherwise herein, or unless superseded by applicable Confidentiality Federal or State statutes of limitation. Confidentiality: Any information, data, instruments, Intellectual Property Rights documents, studies or reports given to or prepared or assembled by the Contractor under this agreement shall be Copyrights and Ownership of Deliverables: All kept as confidential and not divulged or made available to deliverable items produced pursuant to this contract are the any individual or organization without the prior written exclusive property of the County. The Contractor shall not approval of the County.The Contractor acknowledges that assert a claim of copyright or other property interest in in receiving,storing,processing or otherwise dealing with such deliverables. any confidential information it will safeguard and not further disclose the information except as otherwise Federal Intellectual Property Bankruptcy Protection provided in this contract. Act:The Parties agree that the County shall be entitled to all rights and benefits of the Federal Intellectual Property Oversight Bankruptcy Protection Act,Public Law 100-506,codified at 11 U.S.C. 365 (n)and any amendments thereto. Access to Persons and Records:The State Auditor shall have access to persons and records as a result of all Compliance with Applicable Laws contracts or grants entered into by State agencies or political subdivisions in accordance with General Statute Compliance with Laws: The Contractor shall comply 147-64.7. Additionally,as the State funding authority,the with all laws, ordinances, codes, rules, regulations, and Department of Health and Human Services shall have licensing requirements that are applicable to the conduct of access to persons and records as a result of all contracts or its business, including those of federal, state, and local grants entered into by State agencies or political agencies having jurisdiction and/or authority. subdivisions. Title VI,Civil Rights Compliance: In accordance with Record Retention: Records shall not be destroyed, Federal law and U.S.Department of Agriculture(USDA) purged or disposed of without the express written consent and U.S. Department of Health and Human Services of the County. The North Carolina State basic records (HHS) policy, this institution is prohibited from retention policy requires all grant records to be retained for discriminating on the basis of race,color,national origin, a minimum of five years or until all audit exceptions have sex, age or disability. Under the Food Stamp Act and been resolved, whichever is longer. If the contract is USDA policy, discrimination is prohibited also on the subject to federal policy and regulations,record retention basis of religion or political beliefs. may be longer than five years since records must be retained for a period of three years following submission of Equal Employment Opportunity: The Contractor shall the final Federal Financial Status Report,if applicable,or comply with all federal and State laws relating to equal three years following the submission of a revised final employment opportunity. Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other Health Insurance Portability and Accountability Act action involving this Contract has been started before (HIPAA): The Contractor agrees that, if the County expiration of the five-year retention period described determines that some or all of the activities within the above,the records must be retained until completion ofthe scope of this contract are subject to the Health Insurance action and resolution of all issues which arise from it, or Portability and Accountability Act of 1996,P.L. 104-91, until the end of the regular five-year period described as amended("HIPAA"),or its implementing regulations, above,whichever is later. it will comply with the HIPAA requirements and will Warranties and Certifications General Terms and Conditions-3-28-2013 Page 3 of 5 Contract#68-1020 Assistance Travel&Transport,Inc. and all other provisions and requirements of this contract Date and Time Warranty: The Contractor warrants that shall remain in full force and effect. the product(s) and service(s) furnished pursuant to this contract("product"includes,without limitation,any piece Headings: The Section and Paragraph headings in these of equipment,hardware,firmware,middleware,custom or General Terms and Conditions are not material parts of the commercial software,or internal components,subroutines, agreement and should not be used to construe the meaning and interfaces therein)that perform any date and/or time thereof. data recognition function,calculation, or sequencing will support a four digit year format and will provide accurate Time of the Essence: Time is of the essence in the date/time data and leap year calculations. This warranty performance of this contract. shall survive the termination or expiration of this contract. Executive Order#24: `By Executive Order 24,issued Certification Regarding Collection of Taxes: G.S. 143- by Governor Perdue, and N.C. G.S.§ 133-32, it is 59.1 bars the Secretary of Administration from entering unlawful for any vendor or contractor(i.e. architect, into contracts with vendors that meet one of the conditions bidder,contractor, construction manager, design of G.S. 105-164.8(b)and yet refuse to collect use taxes on professional,engineer, landlord,offeror, seller, sales of tangible personal property to purchasers in North subcontractor,supplier, or vendor),to make gifts or to Carolina. The conditions include: (a) maintenance of a give favors to any State employee of the Governor's retail establishment or office; (b) presence of Cabinet Agencies(i.e.,Administration,Commerce, representatives in the State that solicit sales or transact Correction, Crime Control and Public Safety,Cultural business on behalf of the vendor; and (c) systematic Resources,Environment and Natural Resources,Health exploitation of the market by media-assisted, media- and Human Services,Juvenile Justice and Delinquency facilitated, or media-solicited means. The Contractor Prevention,Revenue,Transportation,and the Office of certifies that it and all of its affiliates (if any) collect all the Governor). This prohibition covers those vendors required taxes. and contractors who have a contract with a governmental agency; or have performed under such a contract within Miscellaneous the past year;or anticipate bidding on such a contract in the future. Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the For additional information regarding the specific parties to this contract,are governed by the laws of North requirements and exemptions,vendors and contractors Carolina.The Contractor,by signing this contract,agrees are encouraged to review Executive Order 24 and G.S. and submits,solely for matters concerning this Contract,to Sec. 133-32. the exclusive jurisdiction of the courts of North Carolina and agrees, solely for such purpose, that the exclusive Executive Order 24 also encouraged and invited other venue for any legal proceedings shall be Orange County, State Agencies to implement the requirements and North Carolina. The place of this contract and all prohibitions of the Executive Order to their agencies. transactions and agreements relating to it, and their situs Vendors and contractors should contact other State and forum,shall be Orange County,North Carolina,where Agencies to determine if those agencies have adopted all matters,whether sounding in contract or tort,relating to Executive Order 24." the validity,construction,interpretation,and enforcement shall be determined. Key Personnel: The Contractor shall not replace any of Amendment: This contract may not be amended orally or the key personnel assigned to the performance of this by performance. Any amendment must be made in written contract without the prior written approval of the County. form and executed by duly authorized representatives of The term "key personnel" includes any and all persons the County and the Contractor. identified as such in the contract documents and any other persons subsequently identified as key personnel by the Severability: In the event that a court of competent written agreement of the parties. jurisdiction holds that a provision or requirement of this contract violates any applicable law, each such provision Care of Property: The Contractor agrees that it shall be or requirement shall continue to be enforced to the extent it responsible for the proper custody and care of any property is not in violation of law or is not otherwise unenforceable furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, General Terms and Conditions-3-28-2013 Page 4 of 5 Contract#68-1020 Assistance Travel&Transport,Inc. or damage to, such property. At the termination of this expenditures before the expenses are entered.in their contract, the Contractor shall contact the County for reimbursement reports. instructions as to the disposition of such property and shall comply with these instructions. Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial Travel Expenses: Reimbursement, if provided in this advertising. Agreement, to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in the Orange County Living Wage: Orange County is performance of this contract shall not exceed the rates committed to providing its employees with a living wage established in County policy. and encourages agencies to which it provides funding to pursue the same goal. The County's living wage hourly Sales/Use Tax Refunds: If eligible,the Contractor and all standard, as adopted by the Orange County Board of subcontractors shall: (a) ask the North Carolina County Commissioners annually, can be found in the Department of Revenue for a refund of all sales and use Orange County Budget Ordinance. To the extent possible, taxes paid by them in the performance of this contract, Orange County recommends that the Contractor and all pursuant to G.S. 105-164.14; and (b) exclude all subcontractors provide a living wage, as defined in this refundable sales and use taxes from all reportable section,to their employees. General Terms and Conditions-3-28-2013 Page 5 of 5 Contract#68-1020 Assistance Travel&Transport,Inc. ATTACHMENT B SCOPE OF WORK Orange County Department of Social Services Federal Tax Id.or SSN Contract# 68-1020 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Assistance Travel&Transport,Inc. 2. If different from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program(s): Transportation Services 4. Status: ( )Public ( )Private,Not for Profit (X)Private,For Profit 5. Contractor's Financial Reporting Year April 1,2013 through June 30,2013 B. Explanation of Services to be provided and to whom(include SIS Service Code): The Contractor will provide transportation services to clients identified by the County. The Contractor will transport clients to and from da y care,job interviews,work, job fairs,vocational trainings, and any other destinations requested by the County. The Contractor is required to meet all,goals and outcomes listed in Attachment N. C. Rate per unit of Service(define the unit): 1.If Standard Fixed Rate,Maximum Allowable,(See Rates for Services Chart) 2.Negotiated County Rate. For able-bodied clients: 1. One-way(1-10 miles)$16.00 2. One-way(over 10 miles)calculated at$1.60 per mile 3. Round-trip(1-20 miles) $32.00 4. Round-trip(over 20 miles)calculated at$1.60 per mile 5. Wait-time after first 30 minutes-$15.00 ler hour For wheelchair-bound clients: 1. Rate of$1.60 per mile plus a load fee of$32.50 each way For additional approved passengers 1. Same pick up address& same destination-an additional rate of$6.00 one-way per passenger. D.Number of units to be provided: Contract-Scope of Work(07/08) Page lof 2 Contract#68-1020 Assistance Travel&Transport,Inc. E.Details of Billing process and Time Frames; The County will reimburse the Contractor for services described in this contract up to the budgetary limits of the contract allotment For reimbursement the Contractor must submit an original and two conies of an invoice by the fifth of the month for the preceding month's expenditures to the designated County Administrator. The County will reimburse the Contractor monthly upon receipt of a complete and correctl filed report. The Contractor shall be compensated at the rates set out in this Attachment for all approved trips F.Area to be served/Delivery site(s): Orange County (Sign ture County Authorized Person) (Signature of Contractor) (Date Submitted) (Date Submitted) Contract-Scope of Work(07/08) Page 2of 2 Contract#68-1020 Assistance Travel&Transport,Inc. ATTACHMENT C CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS AND CERTIFICATION REGARDING NONDISCRIMINATION Orange County Department of Social Services I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by: A. Publishing a statement notifying employees that the unlawful manufacture,distribution, dispensing,possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; B. Establishing a drug-free awareness program to inform employees about: (1)The dangers of drug abuse in the workplace; (2)The Contractor's policy of maintaining a drug-free workplace; (3)Any available drug counseling,rehabilitation,and employee assistance programs;and (4)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph(A); D. Notifying the employee in the statement required by paragraph(A)that,as a condition of employment under the agreement,the employee will: (1)Abide by the terms of the statement; and (2)Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; E. Notifying the County within ten days after receiving notice under subparagraph(D)(2)from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions,within 30 days of receiving notice under subparagraph (D)(2),with respect to any employee who is so convicted: (1)Taking appropriate personnel action against such an employee,up to and including termination;or (2)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State,or local health, law enforcement,or other appropriate agency; and Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(A), (B),(C),(D),(E), and(F). Federal Certification-Drug-Free Workplace(07/10) Page 1 of 2 Contract#68-1020 Assistance Travel&Transport,Inc. 11. The site(s)for the performance of work done in connection with the specific agreement are listed below: 1. (Street address) (City,county, state,zip code) 2. (Street address) (City,county,state,zip code) Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,suspension or termination of grants, or government-wide Federal suspension or debarment(45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620). CERTIFICATION REGARDING NONDISCRD41NATION The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a)Title VI of the Civil Rights Act of 1964(P.L. 88-352)which prohibits discrimination on the basis of race,color or national origin;(b)Title IX of the Education Amendments of 1972,as amended(20 U.S.C. §§1681-1683,and 1685-1686),which prohibits discrimination on the basis of sex;(c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C. §794),which prohibits discrimination on the basis of handicaps;(d)the Age Discrimination Act of 1975,as amended(42 U.S.C. §§6101-6107),which prohibits discrimination on the basis of age; (e)the Drug Abuse Office and Treatment Act of 1972(P.L. 92-255),as amended,relating to nondiscrimination on the basis of drug abuse;(f)the Comprehensive Alcohol Abuse and Alcoholism Prevention,Treatment and Rehabilitation Act of 1970(P.L. 91-616),as amended,relating to nondiscrimination on the basis of alcohol abuse or alcoholism;(g)Title VIII of the Civil Rights Act of 1968(42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale,rental or financing of housing; (h)the Food Stamp Act and USDA policy,which prohibit discrimination on the basis of religion and political beliefs; and(i)the requirements of any other nondiscrimination statutes which may apply to this Agreement. SIgnature Title I/ ej Agency/Organization Ae Date I (Certification signature should be same as Contract signature.) Federal Certification-Drug-Free Workplace(07/10) Page 2 of 2 Contract 968-1020 Assistance Travel&Transport,Inc. ATTACHMENT D CONFLICT OF INTEREST POLICY Orange County Department of Social Services The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid any conflict of interest, even the appearance of a conflict of interest. The Organization's Board of Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the best interest of the organization. This obligation requires that any Board member or other governing person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance of the Organization mission. At all times, Board members or other governing persons, officers, employees or agents, are prohibited from using their job title, the Organization's name or property,for private profit or benefit. A. The Board members or other governing persons, officers, employees, or agents of the Organization should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from the actions of any Board member or other governing person, officer, employee or agent. This is not intended to preclude bona-fide Organization fund raising- activities. B. A Board or other governing body member may, with the approval of Board or other governing body, receive honoraria for lectures and other such activities while not acting in any official capacity for the Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If a Board or other governing body member, officer, employee or agent is acting in any official capacity, honoraria received in connection with activities relating to the Organization are to be paid to the Organization. C. No Board member or other governing person, officer, employee, or agent of the Organization shall participate in the selection, award, or administration of a purchase or contract with a vendor where,to his knowledge, any of the following has a financial interest in that purchase or contract: 1. The Board member or other governing person,officer,employee,or agent; 2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law; 3. An organization in which any of the above is an officer, director, or employee; 4. A person or organization with whom any of the above individuals is negotiating or has any arrangement concerning prospective employment or contracts. D. Duty to Disclosure--Any conflict of interest,potential conflict of interest, or the appearance of a conflict of interest is to be reported to the Board or other governing body or one's supervisor immediately. E.Board Action--When a conflict of interest is relevant to a matter requiring action by the Board of Directors/Trustees or other governing body,the Board member or other governing person,officer,employee,or agent(person(s))must disclose the existence of the conflict of interest and be given the opportunity to disclose all material facts to the Board and members of Conflict of Interest Policy(06104) Page I of 3 Contract 968-1020 Assistance Travel&Transport,Inc. committees with governing board delegated powers considering the possible conflict of interest. After disclosure of all material facts, and after any discussion with the person,he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In addition,the person(s)shall not participate in the final deliberation or decision regarding the matter under consideration and shall leave the meeting during the discussion of and vote of the Board of Directors/Trustees or other governing body. F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other governing body determines the member, officer, employee or agent has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. G. Record of Conflict -- The minutes of the governing board and all committees with board delegated powers shall contain: 1. The names of the persons who disclosed or otherwise were found to have an actual or possible conflict of interest, the nature of the conflict of interest, any action taken to determine whether a conflict of interest was present, and the governing board's or committee's decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement that presents a possible conflict of interest, the content of the discussion, including any alternatives to the transaction or arrangement, and a record of any votes taken in connection with the proceedings. Approved by:Name of Organization Signature of Organization Official D to Conflict of Interest Policy(06/04) Page 2 of 3 Contract#68-1020 Assistance Travel&Transport,Inc. NOTARIZED CONFLICT OF INTEREST POLICY g. State of North Carolina County of Orange Notary Public for said County and State, certify that person lly a geared before me this da and acknowledged that he/she is � �� � of r 4:4d by that authority duly given and as the act of the corporation, affirmed that the foregoing Co ict of Interest Policy w adopted by the in a meeting held on the L�f� da of Board of Directors g Y Sworn to and subscribed before me this day of (Official Seal) Notary Public M Commission expires `7" 4 7" ✓` ,20 / Y p -- i I ,1 t k r t i Conflict of Interest Policy(06/04) Page 3 of 3 ASSISTANCE 0 40.Travel Al Transport, Inc. M Employee Conflict of Interest Policy General An employee shall not engage in any activities which create a conflict of interest, or might appear to conflict, with the employee's responsibilities and obligations with the Company. Good judgment of employees is essential, and no list of rules can provide for all of the possible circumstances that arise. Decisions by employees involving a conflict of interest may create an appearance of impropriety which should be avoided. This would include, but is not limited to, making any decisions; taking any actions; or seeking to influence any decision or action that may appear to create or does create a conflict of interest, whether involving the Company, the Company's business or personnel actions involving any employee of the Company. Best Interest of the Company Each employee should act in the best interests of the Company,always using good judgment. Suppliers of Goods or Services An employee who has a direct or indirect interest(whether through family or business connections) in suppliers of products or services to the Company, or an interest in contractors or potential contractors who would do business with the Company, should not act or be involved in decisions with respect to that interest. No employee should participate in a potential contract, partnership, or other business relationship with any party that the employee is discussing potential employment. Disclosure An employee should provide full disclosure of any business, personal or financial interest in which the employee might influence (or might appear to influence) his or her official decisions or actions on behalf of the Company. Disclosure should be made on a timely basis in writing to the employee's immediate supervisor. Personal Gifts Personal gifts from or to people whom the Company has a business relationship are discouraged. Personal gifts of more than nominal value should be politely declined or returned to avoid any appearance of improper behavior. Federal, state or local laws may also prohibit the solicitation or acceptance of gifts or money from contractors or other third parties. Outside Employment or Business Activities Employees should avoid outside employment, business or personal activities which may conflict with the Company's interests. Directorships or consultation services for which an employee will receive compensation must be cleared by the employee's supervisor in writing. Excluded from this prohibition are charitable or pro bono activities where the employee will not receive compensation and where the time involved will not interfere with the employee's responsibilities on behalf of the Company. An employee should refrain from personal activities such as purchasing or selling securities,real estate,or other goods or services which involve confidential information gained by the employee as result of the employee's activities on behalf of the Company. Use of Company Resources or Assets An employee should not make unauthorized use of Company resources or assets for the benefit of the employee or for the benefit of any third party. Company resources or assets(such as pens,office supplies, computers,etc.)are to be used for the benefit of the Company. 101, �— q&I V/J Signature Date 3710 University Drive,Suite 240 Durham, NC 27707 Phone:919-489-5050 Fax:919-489.5011 ASSISTANCE Travel Transport, Inc. Contract 968-1020 Assistance Travel&Transit,Inc. ATTACHMENT E OVERDUE TAXES Orange County Department of Social Services Instructions: Grantee/Provider should complete this certification for all funds received.Entity should enter appropriate data in the yellow highlighted areas. The completed and signed form must be provided to the County Department of Social Services. [Date of Certification(04-04-2013)] To: Orange County Department of Social Services Certification: We certify that the Assistance Travel&Transport,Inc. does not have any overdue tax debts,as defined by N.C.G.S. 105-243.1 t,at the federal,State,or local level. We further understand that any person who makes a false statement in violation of N.C.G.S. 1430-6-23(c)is guilty of a criminal offense punishable as provided by N.C.G.S. 143C-10-1(b). Sworn Statement: Kenneth M.Williams and Tonya R.Williams being duly sworn,say that we are the President and Secretdry,respectively,of Assistance Travel&Transport,Inc.of Durham in the State of North Carolina;and that the foregoing certification is true,accurate and complete to the best of our knowledge and was made and subscribed by us. We also acknowledge and understand that any misuse of Stat funds will be reported to the appropriate authorities for further action. J*aLCbair C-J)a444 Secret Sworn to and subscribed before me on the day of the date of said certification. A- 4�1k4 My Commission Expires: otary Signature and Seal) G.S.105-243.1 defines:Overdue tax debt-Any part of a tax debt that remains unpaid 90 days or more after the notice of final assessment was mailed to the taxpayer.The term does not include a tax debt,however,if the taxpayer entered into an installment agreement for the tax debt under G.S.105-237 within 90 days after the notice of final assessment was mailed'and has not failed to make any payments due under the installment agreement." Overdue Taxes-(07/12) Page I of I 3710 University Drive,Suite 240 Durham,NC 27707 Phone:919-489-5050 Fax:919-489-5011 Contract#68-1050 Assistance Travel&Transport,Inc. ATTACHMENT G CERTIFICATION REGARDING LOBBYING Orange County Department of Social Services Certification for Contracts,Grants,Loans and Cooperative Agreements The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal, state or local government agency,a Member of Congress,a Member of the General Assembly,an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress,or an employee of a Member of the General Assembly in connection with the awarding of any Federal or state contract,the making of any Federal or state grant,the making of any Federal or state loan,the entering into of any cooperative agreement, and the extension,continuation, renewal, amendment,or modification of any Federal or state 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 Federal,state or local government agency,a Member of Congress,a Member of the General Assembly,an officer or employee of Congress,an officer or employee of the General Assembly, an employee of a Member of Congress,or an employee of a Member of the General Assembly in connection with the awarding of any Federal or state contract,the making of any Federal or state grant,the making of any Federal or state loan,the entering into of any cooperative agreement,and the extension,continuation, renewal, amendment,or modification of any Federal or state contract, grant,loan,or cooperative ff agreement,the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned 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 shall certify and disclose accordingly. (4) This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352,Title 31,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. Notwithstanding other provisions of federal OMB Circulars A-122 and A-87,costs associated with the following activities are unallowable: Paragraph A. (1) Attempts to influence the outcomes of any Federal,State,or local election,referendum,initiative,or similar procedure,through in kind or cash contributions, endorsements,publicity,or similar activity; (2) Establishing,administering,contributing to,or paying the expenses of a political party,campaign, political action committee,or other organization established for the purpose of influencing the outcomes of elections; (3) Any attempt to influence: (i)The introduction of Federal or State legislation;or(ii)the enactment or modification of any pending Federal or State legislation through communication with any member or employee of the Congress or State legislature(including efforts to influence State or local Federal Certification—Lobbying(07/08) Page 1 of 3 Contract#68-1050 Assistance Travel&Transport,Inc. officials to engage in similar lobbying activity),or with any Government official or employee in connection with a decision to sign or veto enrolled legislation; (4) Any attempt to influence: (i)The introduction of Federal or State legislation;or(ii)the enactment or modification of any pending Federal or State legislation by preparing, distributing or using publicity or propaganda,or by urging members of the general public or any segment thereof to contribute to or participate in any mass demonstration,march,rally,fundraising drive, lobbying campaign or letter writing or telephone campaign; or (5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering information regarding legislation,and analyzing the effect of legislation,when such activities are carried on in support of or in knowing preparation for an effort to engage in unallowable lobbying. The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A: Paragraph B. 1 (1) Providing a technical and factual presentation of information on a topic directly related to the 1 performance of a grant,contract or other agreement through hearing testimony, statements or letters to the Congress or a State legislature, or subdivision,member, or cognizant staff member thereof, in l response to a documented request(including a Congressional Record notice requesting testimony or i statements for the record at a regularly scheduled hearing)made by the recipient member, legislative 1 body or subdivision, or a cognizant staff member thereof; provided such information is readily obtainable and can be readily put in deliverable form;and further provided that costs under this section for travel, lodging or meals are unallowable unless incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee conducting such hearing. (2) Any lobbying made unallowable by subparagraph A(3)to influence State legislation in order to directly reduce the cost,or to avoid material impairment of the organization's authority to perform the grant,contract, or other agreement. (3) Any activity specifically authorized by statute to be undertaken with funds from the grant,contract, or other agreement. Paragraph C. (1) When an organization seeks reimbursement for indirect costs,total lobbying costs shall be separately identified in the indirect cost rate proposal,and thereafter treated as other unallowable activity costs in accordance with the procedures of subparagraph B.(3). (2) Organizations shall submit,as part of the annual indirect cost rate proposal,a certification that the requirements and standards of this paragraph have been complied with. (3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being allowable or unallowable pursuant to this section complies with the requirements of this Circular. (4) Time logs, calendars,or similar records shall not be required to be created for purposes of complying with this paragraph during any particular calendar month when: (1)the employee engages in lobbying(as defined in subparagraphs(a)and(b))25 percent or less of the employee's compensated hours of employment during that calendar month, and(2)within the preceding five- year period,the organization has not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs. When conditions(1)and(2)are met,organizations are not required to establish records to support the allowability of claimed costs in addition to records already required or maintained. Also,when conditions(1)and(2)are met,the absence of time logs, calendars, or similar records will not serve as a basis for disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month. Federal Certification—Lobbying(07/08) Page 2 of 3 Contract 468-1050 Assistance Travel&Transport,Inc. (5) Agencies shall establish procedures for resolving in advance, in consultation with OMB,any significant questions or disagreements concerning the interpretation or application of this section. Any such advance resolution shall be binding in any subsequent settlements,audits or investigations with respect to that grant or contract for purposes of interpretation of this Circular;provided, however,that this shall not be construed to prevent a contractor or grantee from contesting the lawfulness of such a determination. Paragraph D. Executive lobbying costs.Costs incurred in attempting to improperly influence either directly or indirectly, an employee or officer of the Executive Branch of the Federal Government to give consideration or to act regarding a sponsored agreement or a regulatory matter are unallowable.Improper influence means any influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter. Signature Title 4lZq Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification—Lobbying(07/08) Page 3 of 3 Contract#68-1050 Assistance Travel&Transport,Inc. ATTACHMENT H CERTIFICATION REGARDING DEBARMENT, SUSPENSION,INELIGIBILITY AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS Orange County Department of Social Services Instructions for Certification 1. By signing and submitting this proposal,the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of the fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government,the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant will provide immediate written notice to the person to t which the proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered n "participant," " n " " # transaction, participant, person, primary covered transaction,rr "principal," proposal," and "voluntarily excluded," as used in this clause,have the meanings set out in the Definitions and 4i! Coverage sections of rules implementing Executive Order 12549. You may contact the person to .i which this proposal is submitted for assistance in obtaining a copy of those regulations. ' 5. The prospective lower tier participant agrees by submitting this proposal that, should the c proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation in this covered transaction unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension,Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction,"without modification, in all lower tier fW!. covered transactions and in all solicitations for lower tier covered transactions. 1� 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or it voluntarily excluded from covered transaction,unless it knows that the certification is erroneous. A participant may decide the method and frequency of which it determines the eligibility of its principals. Each participant may,but is not required to, check the Nonprocurement List. f 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. it Federal Certification-Debarment(07/08) Pagel of 2 `o Contract#68-1050 Assistance Travel&Transport,Inc. 9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended,debarred, ineligible,or voluntarily excluded from participation in this transaction, in �4 n addition to other remedies available to the Federal Government,the department or agency with f which this transaction originated may pursue available remedies, including suspension,and/or } debarment. 4 Certification Regarding Debarment, Suspension,Ineligibility and Voluntary Exclusion-Lower i! Tier Covered Transactions (1) The prospective lower tier participant certifies,by submission of this proposal,that neither it nor its principals is presently debarred, suspended,proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal Signature Title �� s Y" Agency/Organization 15ate (Certification signature should be same as Contract signature.) k I� f p7 t Federal Certification-Debarment(07108) Page 2 of 2 i Contract#68-1020 Assistance Travel&Transport,Inc. ATTACHMENT J CERTIFICATION REGARDING TRANSPORTATION Orange County Department of Social Services By execution of this Agreement the Contractor certifies that it will provide safe client transportation by: 1. Insuring that all drivers(including employees,contractors,contractor's employees, and volunteers)shall be at least 18 years of age; 2. Insuring that all drivers(including employees,contractors,contractor's employees,and volunteers)shall be licensed to operate the specific vehicle used in transporting clients in accordance with Chapter 20-7 of the General Statutes of North Carolina and the Division of Motor Vehicle requirements; 3. Insuring that all vehicles transporting clients shall have at least the minimum level of liability insurance appropriate for the type of vehicle as defined by Article 7,Rule R2-36 of the North Carolina Utilities Commission; 4. Insuring that the contractor shall have written policies and procedures regarding how drivers handle and report client emergencies and/or vehicle crashes involving clients to contractor and how contractor notifies the Orange County Department of Social Services; S. Contractor will maintain records documenting the following(County may require contractor to provide): a.Valid current copies of Drivers License for all drivers; b. Current valid Vehicle Registration,for all vehicles transporting clients;. c. Driving records for all drivers for the past three years and with annual updates; d. Criminal Background checks through North Carolina Law Enforcement or NCIC quarterly; f e. Alcohol and Drug Testing policy to meet the Federal Transit Authority guidelines. 6. Disclosing,at the outset of the contract,upon renewal and upon request,any criminal convictions or other reasons for disqualifications from participation in Medicare,Medicaid or Title XX programs. Signature on this form confirms this statement. ignature Title - Agency/Organization �— Date (Certification signature should be same as Contract signature.) �4 Transportation Certification(07-12) Page 1 of 1 r r Contract#68-1020 Assistance Travel&Transport,Inc. ATTACHMENT N OUTCOMES AND REPORTING Orange County Department of Social Services By signing and submitting this document,the Contractor certifies that it agrees to the following: 1. The Contractor agrees to participate in program,fiscal and administrative monitoring and/or audits, making records and staff time available to Federal, State and County staff. 2.The Contractor agrees to take necessary steps for corrective action,as negotiated within a corrective action plan, for any items found to be out of compliance with Federal, State, and County laws,regulations, standards and/or terms of the Contract. 3. The Contractor agrees that continuation of and/or renewal of this Contract is contingent on meeting the following requirements. The Contractor agrees to: A. Adhere to all Federal and State transportation laws&regulations. B. Transport clients to and from: (1)Work,(2)Daycare,(3)Job Interview,(4)Job Fair,(5) Vocational Training,and/or other destinations as requested by the County. C. Transport approved, authorized clients to specified destinations within and outside of Orange County upon request, on time, and in accordance with arrangements made by the County. D. Transport clients only to approved destinations.Any additional destinations cannot be provided without the expressed consent and authorization of the County. E. Provide safe,reliable and on-time transportation to clients. F. Maintain sufficient records to document that service was provided. Such documentation shall include: (1)name of the driver who provided each trip,(2)the vehicle number used to provide the trip, (3)the client's name(4)the beginning location and ending destination for each trip. ! G. Allow a wait time of ten(10)minutes before classifying a client as a no-show. i H. Notify the County of any no-shows as soon as possible. I. Provide a separate monthly invoice for each client. J. Not enter into a client's home for any reason. r 4. To facilitate the work of the Contractor,the County agrees to: A. Have the client contact the Contractor and provide(1)name,(2)address,(3)phone number, (4) appointment time,(5)pick up location,and(6)destination. B. Notify the Contractor of any plans to discontinue service within five(5)calendar days of the proposed action. C. Notify the Contractor at least 4 business hours prior to scheduled appointments. ' D. Notify the Contractor of any known trip cancellations within three(3)hours prior to the ?� scheduled trips. ` Signature Title Agency/Organization Date i;. t (Certification signature should be same as Contract signature.) Page Iof1 Outcomes (06/04) 4ir