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LRC Child Development Services Funding FY2020-21 (missing State signature)California Department of Education FY 20-21 Page 1 of 17 California Department of Education (CDE) DIRECTIONS AND FORMS FOR CHILD CARE AND DEVELOPMENT CONTRACTS Please read the entire document carefully. This document contains: • Directions for Contract Execution (page 2) • Issues that will Delay Contract Execution (page 3) • Resolution/Signature Authority (page 4) • Sample Resolution (page 5) Frequently Asked Questions (pages 6-7) • Checklist (page 8) • Contractor Certification Clauses (CCC -04-2017) (pages 9-12) • California Civil Rights Laws Certification (CO -005) (page 13) Federal Certifications CO.8 (page 14-15) • Contract (page 16-17) California Department of Education FY 20-21 Page 2 of 17 DIRECTIONS FOR CONTRACT EXECUTION 1. Review the Funding Terms and Conditions (FT&C), applicable Program Requirements, and the General Terms and Conditions (GTC 04/2017). If you are a State Agency or University, review the General Terms and Conditions for Interagency Agreements (GIA 610). All of the above can be found at the following link: hftp://www.cde.ca.gov/fq/aa/cd/ftc202O.asp 2. Print two (2) copies of this document beginning with the CCC 04/2017 (pages 9-17), single -sided only. Do not alter documents in any way. a. Confirm that the printed pages are legible. If the contract language is cut off at the margin, follow the link below to correct the problem: http://helpx. adobe. com/acrobat/kb/scale-or-resize-printed-pages. htm I 3. Have both copies of the contract and all required documents filled out completely and signed by the authorized official. Sign documents in blue ink only, or via Adobe Acrobat digital signature. Contracts signed in black ink, stamped signatures, or copies will NOT be accepted. Print name, title, and address where requested. 4. Public agencies only - Attach a copy of a resolution by the local governing body authorizing the execution of each contract. Contracts will not be executed prior to board approval. 5. Email Adobe digitally signed contract and documents with certifying statement to childdevelopmentcontracts@cde.ca.gov, or mail signed contract and all completed documents as soon as possible to: Contracts, Purchasing, and Conference Services California Department of Education 1430 N Street, Suite 2213 Sacramento, CA 95814-5901 California Department of Education FY 20-21 Page 3 of 17 ISSUES THAT DELAY CONTRACT EXECUTION The following issues will delay contract execution and payment: • Documents are unsigned, incomplete, or not returned. • Contracts are mailed to the incorrect address. • Contracts are e-mailed without a password protected Adobe Acrobat digital signature and certifying statement. • The contract is not signed with original signatures in blue ink. • The contract was printed illegibly, double -sided, or formatting has been changed. • The contract was printed with the left side cut-off and language missing. • The individual signing the contracts does not have signature authority to enter into contractual agreements with the CDE. California Department of Education FY 20-21 Page 4 of 17 RESOLUTION/SIGNATURE AUTHORITY PUBLIC AGENCIES According to the State Contracting Manual, Volume 1, when one of the contracting parties is a county, city, district, or other local public body, the contract shall be accompanied by one of the following documents from the local governing body authorizing execution of the agreement: Board resolution; or Board minutes; or Board policy Please submit one resolution per contract type. County Offices of Education A resolution is not required IF the County Superintendent signs the contract. If anyone else signs, signature authority is required. If someone other than the County Superintendent signs the contract, signature authority is required. This can be provided by a resolution or letter on letterhead signed by the County Superintendent. PRIVATE AGENCIES Generally, the Executive Director, Owner, President, etc. are the authorized signers. If an individual with a different title than above signs the contract, provide one of the following indicating the signee has the authority to enter into and sign contractual agreements with the CDE: • Letter on company letterhead; • Board Resolution; or • Board Minutes California Department of Education FY 20-21 Page 5 of 17 RESOLUTION This resolution is adopted in order to certify the approval of the Governing Board to enter into this transaction with the California Department of Education for the purpose of providing child care and development services and to authorize the designated personnel to sign contract documents for Fiscal Year 2020-2021. RESOLUTION BE IT RESOLVED that the Governing Board of authorizes entering into local agreement number and that the person/s who is/are listed below, is/are authorized to sign the transaction for the Governing Board. NAME TITLE SIGNATURE PASSED AND ADOPTED THIS day of Governing Board of of County, in the State of California. Clerk of the Governing Board of 2020, by the of , County, in the State of California, certify that the foregoing is a full, true and correct copy of a resolution adopted by the said Board at a meeting thereof held at a regular public place of meeting and the resolution is on file in the office of said Board. (Clerk's signature) (Date) California Department of Education FY 20-21 Page 6 of 17 FREQUENTLY ASKED QUESTIONS BOARD RESOLUTIONS/SIGNATURE AUTHORITY Do I need to provide a resolution and signature authority for an original contract? Public Agency Yes, you need a resolution authorizing the contract. You also need to provide signature authority for the person signing the contract, if someone other than the Superintendent signs. See the sample provided on the previous page. Private Agency The CDE does not require a resolution from a private agency. However, if an employee who is not the Executive Director, Owner, or President, etc. has signed the contract, signature authority is required. This can be provided by a resolution or letter on letterhead from the Executive Officer. Do I need a resolution for an amendment? If the resolution for the original contract specified the contract amount, a resolution containing the amended contract amount is required. In addition, signature authority will be required if the person signing the amendment was not included as an authorized signer on the original resolution. I work for a County Superintendent of Schools. Does my contract need a resolution? Because County Superintendents have the authority to enter into contracts without board approval, a resolution is not required IF the County Superintendent signs the contract. If someone other than the County Superintendent signs the contract, signature authority is required. This can be provided by a resolution or letter on letterhead signed by the County Superintendent. CONTRACT COPIES Can we e-mail copies of the signed contract? No. CDE can only accept contracts with original signatures at this time. Why do I have to make two copies of the contract? So that once the contract is executed, CDE can send you a signed original. FEDERAL ID NUMBER What is my Federal ID number? An Employer Identification Number (EIN) is also known as a Federal Tax Identification California Department of Education FY 20-21 Page 7 of 17 Number, and is used to identify a business entity. Use this number to fill in the CCC - 4/2017 form. PRINTING ERRORS What is a misprint? A misprint occurs when the contract is printed illegibly, double -sided, or a change has been made to the formatting. Common examples are: • The text on the left margin of the contract has been cut off. Fix problem here: http://helpx.adobe.com/acrobat/kb/scale-or-resize-printed-pages.htmI • Toner issues cause the print to be illegible. • The contract has been printed double -sided. • Space has been added or deleted. If this occurs, and the contract is sent to CDE, you will receive an e-mail asking you to re -print, re-sign and return a correctly printed contract. Contracts that have been altered in any way are unacceptable. CONTACT INFORMATION When should I contact the Contracts Office? If you have a question regarding the status of the contract or questions about any of the attached documents, please contact your Child Care and Development Contract Analyst listed here: https://www.cde.ca.gov/fg/aa/cd/directory13.asp For counties 01-29, contact Cindy Rodriguez at CiRodriguez@cde.ca.gov For counties 30-58, contact Favio Flores at FFlores@cde.ca.gov For questions regarding contract terms such as MDO, MRA, etc., contact the assigned Fiscal Analyst or EESD Consultant listed here: https://www.cde.ca.gov/fg/aa/cd/faad.asp or https://www.cde.ca.gov/sp/cd/ci/assignments.asp Direct all contract correspondence to: Contracts, Purchasing, and Conference Services California Department of Education 1430 N Street, Suite 2213 Sacramento, CA 95814-5901 California Department of Education FY 20-21 Page S of 17 CONTRACT CHECKLIST Please note that every form is required. Contractor name City of San Rafael Contract # 0287 Place a check mark next to each item being returned. B Checklist M Two (2) signed (in blue ink) child care contracts with original signatures • Did you include your printed name, title, and address? • Is all of the contract language visible? M Two (2) signed Contractor Certification Clauses (CCC -4/2017) Did you fill in ALL spaces including Federal ID Number? 8 Two (2) signed California Civil Rights Laws Certifications (CO -005) 8 Board resolution or minutes authorizing execution of contract and/or authorizing delegation of authority (if applicable) Mail all signed contracts and completed documents as soon as possible to: Contracts, Purchasing, and Conference Services California Department of Education 1430 N Street, Suite 2213 Sacramento, CA 95814-5901 Contractor Certification Clauses CCC 04/2017 CERTIFICATION I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California. Contractor/Bidder Firm Name (Printed) I Federal ID Number City Of San Rafael 94 6000424 by (Hutnonzea signature) 4L7�� w _ _ Prin dN me and Titl ftrson Signing Jim Schutz City Manager Date Executed Executed in the County of 3 �u M10 arin CONTRACTOR CERTIFICATION CLAUSES 1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a -f) and CCR, Title 2, Section 11102) (Not applicable to public entities.) 2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug -Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish a Drug -Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; 2) the person's or organization's policy of maintaining a drug-free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations. c. Every employee who works on the proposed Agreement will: 1) receive a copy of the company's drug-free workplace policy statement; and, 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.) 3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.) 4. CONTRACTS FOR LEGAL SERVICES $50.000 OR MORE- PRO BONO REQUIREMENT: Contractor hereby certifies that Contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003. Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm's offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State. Failure to make a good faith effort may be cause for non -renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services. 5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California. 6. SWEATFREE CODE OF CONDUCT: a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108. b. The contractor agrees to cooperate fully in providing reasonable access to the contractor's records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor's compliance with the requirements under paragraph (a). 7. DOMESTIC PARTNERS: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3. 8. GENDER IDENTITY: For contracts of $100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35. DOING BUSINESS WITH THE STATE OF CALIFORNIA The following laws apply to persons or entities doing business with the State of California. 1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification. Current State Employees (Pub. Contract Code §10410): 1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment. 2). No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services. Former State Employees (Pub. Contract Code §10411): 1). For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency. 2). For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12 -month period prior to his or her leaving state service. If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub. Contract Code §10420) Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e)) 2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) 3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.) 4. CONTRACTOR NAME CHANGE: An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment. 5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA: a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax. c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State. 6. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement. 7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be: (1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution. 8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. California Department of Education Fiscal & Administrative Services Division CO -005 (NEW 4/2020) CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION Pursuant to Public Contract Code section 2010, if a bidder or proposer executes or renews a contract in the amount of $100,000 or more on or after January 1, 2017, the bidder or proposer hereby certifies compliance with the following: 1. CALIFORNIA CIVIL RIGHTS LAWS: For contracts $100,000 or more, executed or renewed after January 1, 2017, the contractor certifies compliance with the Unruh Civil Rights Act (Section 51 of the Civil Code) and the Fair Employment and Housing Act (Section 12960 of the Government Code); and 2. EMPLOYER DISCRIMINATORY POLICIES: For contracts $100,000 or more, executed or renewed after January 1, 2017, if a Contractor has an internal policy against a sovereign nation or peoples recognized by the United States government, the Contractor certifies that such policies are not used in violation of the Unruh Civil Rights Act (Section 51 of the Civil Code) or the Fair Employment and Housing Act (Section 12960 of the Government Code). CERTIFICATION I, the official named below, certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 1. Proposer/Bidder Firm Name (Printed): City of San Rafael 2. Federal ID Number: 94 6000424 3. By (Authorized Signature): K -e--- n I 4. PMte ji Name and T40 of Person Signing: Jim Schutz, City Manager 5. Date Executed: r �(✓ C 6. Executed in the County and State of: Marin Page 1 of 1 California Department of Education Fiscal and Administrative Services Division CO -007 (Rev. 04/2020) FEDERAL CERTIFICATIONS Certifications regarding lobbying, debarment, suspension and other responsibility matters; and drug-free workplace requirements Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 34 CFR Part 82 "New restrictions on Lobbying," and 34 CFR Part 85, "Government -wide Debarment and Suspension (Non procurement) and Government -wide requirements for Drug -Free Workplace (Grants)." The Certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Education determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING As required by Section 1352, Title 31 of the U.S. Code, and implemented at 34 CFR Part 82, for persons entering into a grant or cooperative agreement over $100,000 as defined at 34 CFR Part 82, Section 82.105 and 82.110, the applicant certifies that: (a.)No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress in connection with the making of any federal grant, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal grant or cooperative agreement; (b.)lf any funds other than federal appropriated funds have been or will be paid to any person for influencing or attempting to influence an employee of Congress, or any employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form —LLL, "Disclosure Form to Report Lobbying," in accordance with this instruction; (c.)The undersigned shall require the language of this certification be included in the award documents for all subawards at all tiers (including subgrants, contracts under grants cooperative agreements, and subcontracts) and that all subrecipients shall certify and disclose accordingly. Page 1 of 4 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS As required by executive Order 12549, Debarment and Suspension, and other responsibilities implemented at 34 CFR Part 85, for prospective participants in primary or substantive control over a covered transactions, as defined at 34 CFR Part 85, Sections 85.105 and 85.110- A. The applicant certifies that it and its principals: (a.)Are not presently debarred, suspended proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency: (b.)Have not within a three-year period preceding this application been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction violation of federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (c.)Have not within a three-year period proceeding this application had one or more public transactions (federal, state, or local) terminated for cause or default; and B. Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach an explanation to this application. 3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS) As required by the Drug -Free Workplace Act of 1998, and implemented at 34 CFR Part 85, Subpart F, for grantees, as defined at 34 CFR Part 85, Section 85.605 and 85.610- A. The applicant certifies that it will or will continue to 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 grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition. (b.)Establishing an on-going drug-free awareness program to inform employees about - Page 2 of 4 (1.)The danger of drug abuse in the workplace; (2.)The grantee's policy of maintaining a drug-free workplace; (3.)Any available drug counseling, rehabilitation, and employee assistance programs; and (4.)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c.)Making it a requirement that each employee to be engaged in performance of the grant 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 grant, the employee will- (1.)Abide by the terms of the statement; and (2.)Notify the employer in writing of his or her conviction for a violation; (e.)Notifying the agency, in writing, within 10 calendar days after receiving notice under subparagraph (d) (2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to: Director, Grants, and Contracts Service, U.S. Department of Education 400 Maryland Avenue, S.W. (Room 3124, GSA Regional Office Building No.3), Washington, DC 20202-4571. Notice shall include the identification number(s) of each affected grant; (f.) Taking one of the following actions, within 30 calendar days of receiving notice under 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, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2.)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a federal, state, or local health, law enforcement, or other appropriate agency: (g.)Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e), and (f). B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Page 3 of 4 Place of Performance (Street address, city, county, state, zip code) Address: 50 Canal Street City: San Rafael State: CA Zip Code: 94901 Check if there are workplaces on file that are not identified here. 4. DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS) As required by the Drug -Free Workplace Act of 1988, and implemented at 34 CFR Part 85, Subpart F, for grantees, as defined at 34 CFR Part 85, Sections 85.605 and 85.610 (a.)As a condition of the grant, I certify that I will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in conducting any activity with the grant, and (b.)If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, I will report the conviction, in writing, within 10 calendar days of the conviction, to: Director, Grants and Contracts Service, U.S. Department of Education, 400 Maryland Avenue, S.W. (Room 3124, GSA Regional Office Building No.3) Washington, DC 20202-4571. Notice shall include the identification number(s) of each affected grant. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications. NAME OF APPLICANT: City of San Rafael CONTRACT #: 0287 PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE: Jim Schutz SIGNATURE: DATY'__ � j Page 4 of 4 •..No. ��/., "t . ; ,•;;•, CALIFORNIA DEPARTMENT OF EDUCATION 1430NStreet 20 - 21 +s Sacramento, CA 95814-5901 F. Y. DATE: July 01, 2020 LOCAL AGREEMENT FOR CHILD DEVELOPMENT SERVICES CONTRACTOR'S NAME: CITY OF SAN RAFAEL CONTRACT NUMBER: CSPP-0287 PROGRAM TYPE: CALIFORNIA STATE PRESCHOOL PROGRAM PROJECT NUMBER: 21-02193-00-0 This Agreement is entered into between the State Agency and the Contractor named above. The Contractor agrees to comply with the CONTINUED FUNDING APPLICATION FY 20-21, the GENERAL TERMS AND CONDITIONS* (GTC 04/2017), the STATE PRESCHOOL PROGRAM REQUIREMENTS*, and the FUNDING TERMS AND CONDITIONS* (FT&C), which are by this reference made a part of the Agreement. Where the GTC 04/2017 conflicts with either the Program Requirements or the FT&C, the Program Requirements or the FT&C will prevail. Funding of this Agreement is contingent upon appropriation and availability of sufficient funds. This Agreement may be terminated immediately by the State if funds are not appropriated or available in amounts sufficient to fund the State's obligations under this Agreement. The period of performance for this Agreement is July 01, 2020 through June 30, 2021. For satisfactory performance of the required services, the Contractor shall be reimbursed in accordance with the Determination of Reimbursable Amount section of the FT&C, at a rate not to exceed $49.85 per child day of full time enrollment and a Maximum Reimbursable Amount (MRA) of $238,821.00. Service Requirements Minimum Child Days of Enrollment (CDE) Requirement 4,791.0 Minimum Days of Operation (MDO) Requirement 175 Any provision of this Agreement found to be in violation of Federal or State statute or regulation shall be invalid, but such a finding shall not affect the remaining provisions of this Agreement. Items shown with an asterisk (*) can be viewed at https://www.cde.ca.gov/fg/aa/cd/ftc202O.asp STATE OF CALIFORNIA CONTRACTOR BY (AUTHORIZED SIGNATURE) BY HORIZ D SIGN UR PRINTED NAME OF PERSON SIGNING PFtINTED tME AND TITL F PE SON SIGNING Jaymi Brown, Ji Schutz, CIO Mana er TITLE Contract Manager ADDRESS 1400 Fifth Avenue, San Rafael , CA 94901 AMOUNT ENCUMBERED BY THIS PROGRAM/CATEGORY (CODE AND TITLE) FUND VTLE Department of General Services DOCUMENT Child Development Programs General use only 5 238,821 (OPTIONAL USE) 0656 PRIOR AMOUNT ENCUMBERED FOR 25451-2193 THIS CONTRACT O ITEM 30.10.020. 001 CHAPTER STATUTE FISCA YEAR S 6100-194-0001 B/A 12020 12020-2021 TOTAL AMOUNT ENCUMBERED TO DATE OBJECT OF EXPENDITURE (CODE AND TITLE) $ 238,821 706 SACS: Res -0000 Rev -0000 I hereby certify upon my own personal kno iledge that budgeted funds are available for the period and TBA NO B R NO purpose of the expenditure slated above SIGNATURE OF ACCOUNTING OFFICER DATE CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Library and Recreation Project Manager: Kelly Albrecht Extension: 3386 Contractor Name: California State Preschool Contract Contractor's Contact: Bryant Campos Fiscal Analyst Contact's Email: bcampos@cde.ca.gov ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION COMPLETED REVIEWER DEPARTMENT DATE Check/Initial 1 Project Manager a. Email PINS Introductory Notice to Contractor ❑ 8/24/2020 b. Email contract (in Word) and attachments to City Attorney c/o Laraine.Gittens@cityofsanrafael.org ❑ 2 City Attorney a. Review, revise, and comment on draft agreement ❑ and return to Project Manager ❑ b. Confirm insurance requirements, create Job on (n/a) PINS, send PINS insurance notice to contractor 3 Department Director Approval of final agreement form to send to Click or tai ❑ _KA_ contractor to enter a date. 4 Project Manager Forward three (3) originals of final agreement to ❑ contractor for their signature 5 Project Manager When necessary, contractor -signed agreement © N/A agendized for City Council approval * *City Council approval required for Professional Services ^ Agreements and purchases of goods and services that exceed Or $75,000; and for Public Works Contracts that exceed $175,000 7/20/2020 PRINT Project Manager Date of City Council approval CONTINUE ROUTING PROCESS WITH HARD COPY 6 Forward signed original agreements to City Attorney with printed copy of this routing form Review and approve hard copy of signed 8 L 7 City Attorney agreement 8 City Attorney Review and approve insurance in PINS, and bonds (for Public Works Contracts) o .4 sk 4teid2-D �—A; 9 City Manager/ Mayor Agreement executed by City Council authorizedj )✓� I official 10 City Clerk Attest signatures, retains original agreement and tg forwards copies to Project Manager a p