HomeMy WebLinkAbout2014-176 Aging - NC Division of Aging and Adult Services $25,000 —Please return this copy to the Clerk to the Board's —
�U1 4 office for permanent agenda file. Contract Number 00028582,Amendment Number 1 /Page 1 of 13
AMENDMENT
This Agreement amends the contract bearing the effective date of 3/22/2013 between the North Carolina
Department of Health and Human Services, Division of Aging and Adult Services, hereinafter referred to
as the"Division"and Orange County, hereinafter referred to as the"Contractor." This Amendment is
hereby effective on 3/21/2014.
As provided for under the terms of this contract,the Division and the Contractor agree to amend the
following contract provisions:
1. Reference"Effective Period": The termination date of 3/21/2014 is changed to 3/21/2015
2. Reference"Contractor's Duties": The Contractor shall provide the amended services as
described in the scope of work.
3. Reference"Division's Duties": The total amount paid by the Division to the Contractor is being
increased by$25,000 from$25,000 to$50,000. This amended amount consists of$25,000
in State funds, $0 in Local funds, $0 in Other funds and $0 in Federal funds.
The total amendment amount is$25,000.
The total contract amount is$50,000.
All other terms and conditions as set forth in the original contract document shall remain in effect for the
duration of this Agreement.
Signatures follow on next page
NCDHHS ACT2007 (Amendment Template)(Rev. 9/12)
Contract Number 00028582,Amendment Number 1 /Page 2 of 13
In Witness Whereof, the Contractor and the Division have executed this contract in duplicate originals,
with one original being retained by each party.
Orange C
Si atur Date
Michael Talbert Interim County Manager
Printed Name Title
S
ignature Date
Pa yr�'��l�.avu�a/ -Ts �- l a�
Printed Name Title
Division of Aging and Adult Services, North Carolina Department of Health and Human Services
Signature Date
Dennis Streets Director
Printed Name Title
NCDHHS ACT2007(Amendment Template) (Rev. 9/12)
This instrument has been approved as to technical content.
Jan' a Tyler, Departmedt Director
This instrument has been pre-audited in the manner required by the Local Government Budget and
Fiscal Control Act.
qa""' -4�
Office of the Finance Director
Th1 i s me been approved as to form and legal sufficiency.
Office of the ty Attor ey
Contract Number 00028582,Amendment Number 1 /Page 3 of 13
SCOPE OF WORK
PURPOSE
This amendment permits the contractor to continue on to the second year of their proposed
two-year family caregiver to caregiver peer support pilot project to support family caregivers.
The second year includes an additional$25,000 and changes the termination date from
March 22, 2014 to March 21, 2015.All other performance requirements outlined in the
original scope of work shall remain the same for the duration of this contract.
Scope of Work(Rev. 06/11)
Contract Number 00028582,Amendment Number 1 /Page 4 of 13
PERFORMANCE MEASURES CHART
The Department of Health and Human Services uses performance measures rubrics as a tool to
determine the success of a project and how well services and products are being delivered.
Together they enable the Department to gauge efficiency, determine progress toward desired
results and assess whether the Department is on track with meeting its goals. The contractor
shall adhere to all of the performance requirements/standards in the scope of work, including
performance measures in the performance measures chart below.
Measure - Output Annual
Type r y 'J
Measure" Products/materials available for replication for use with other Chinese-speaking
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Vendor Reports
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Performance Measures(Rev.4//12)
Contract Number 00028582,Amendment Number 1 /Page 5 of 13
Vendor Reports
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