Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney By:\s1\ MDWISE INC Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\tP1r\ esident and CEO Date:\5d/11\ 3/2021 | 11:37 EST Title:\tD3e\ puty Director11:45 EDT By:\s2\ Title:\tM2e\ dicaid director Date:\5d/2\13/2021 | 12:06 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 2.H HEALTHY INDIANA PLAN SCOPE OF WORK TABLE OF CONTENTS 1.0 Background 12 2.0 Managed Care Entity- Contractor Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health 14 2.1 State Licensure 14 2.2 National Committee for Quality Assurance (NCQA) Accreditation 14 2.3 Administrative and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to Organizational Structure 14 2.4 Staffing 15 2.4.1 Key Staff 15 2.4.2 Staff Positions 21 2.4.3 Training 23 2.4.4 Debarred Individuals 24 2.5 FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).OMPP Meeting Requirements 25 2.6 Financial Stability 25 2.6.1 Solvency 25 2.6.2 Insurance 26 2.6.3 Reinsurance 26 2.6.4 Financial Accounting Requirements 27
Appears in 1 contract
Samples: Contract #0000000000000000000018314
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Counsel and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting SCHAERR JAFFE LLP Office of the Indiana Attorney Indiana Family & Social Services Administration General By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1F\irm Administrator Title:\tC2\hief Deputy Attorney General Date:\d112\/13/2022 | 11:37 07:57 PST Date:\d122\/13/2022 | 11:01 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Commissioner
Appears in 1 contract
Samples: indianacitizen.org
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney TOWN OF XXXXXX By: Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Natural Resources Title: Mayor, Town of Xxxxxx By: Title: Deputy Director / CFO Date: 6/25/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 15:08 EDT Date: 6/25/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 16:38 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyExhibit A Project Narrative and Timeline NLT Project NLT-02-08: Department Xxxxxx will develop 1.25 miles of Health new trail consisting of two contiguous but distinct segments in the Town of Xxxxxx. A 0.5-mile natural-surface mountain bike and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) hiking trail will connect the Town of Xxxxxx to Vinegar Mill Overlook in Muscatatuck Park. Within Xxxxxx, a 0.75-mile asphalt trail will connect Xxxxxx Gym to Xxxxxx Commons. Exhibit B Project Budget Exhibit C Annual Financial Report for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, Non-governmental Entities Guidelines for filing the Grantee shall arrange for a annual financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).report:
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney United Healthcare Insurance Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1C\EO, Indiana M&R Title:\t2M\edicaid director Date:\d112\/22/2021 | 11:37 10:57 CST Date:\d122\/23/2021 | 10:31 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.A. SCOPE OF WORK Table of Contents 1.0 Background 13 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Subcontracts 14 2.4 Financial Stability 16 2.4.1 Solvency 16 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 17 2.4.4 Performance Bond Requirements 18 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 20 2.6 Disclosures 20 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Party in Interest 20
Appears in 1 contract
Samples: Contract #0000000000000000000051704
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney XXXXX XXXXXXXXX MENTAL HEALTH INC Indiana Family & and Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorAdministration, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Mental Health and Addiction Kuczora By: Title: Date: Xxxx X. Digitally signed by Xxxx X. Xxxxxxx DN: cn=Xxxx X. Xxxxxxx, o=Xxxxx- Xxxxxxxxx Mental Health, Inc., ou=GBMH, xxxxx=xxxxx@xxxxxxxxxxx.xxx, c=US Date: 2018.03.29 14:08:09 -04'00' By: Title: Date: Xxxxx X. Xxxxx Digitally signed by Xxxxx X. Xxxxx Date: 2018.04.02 10:24:29 -04'00' Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. XxxxxxxXxxxx X.Xxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General Refer to Electronic Approval History found after the final page of the Executed Contract for details. EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).GENERAL REQUIREMENTS AND SCOPE
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Learfield Communications Inc. Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Utility Regulatory Commission By: By: Title: Senior Manager-Business Development Title: Chairman Date: 7/21/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 15:27 EDT Date: 7/27/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 15:50 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award NameA STATE AGENCY NAME INDIANA UTILITY REGULATORY COMMISSION MEDIA BRIEF | 2023 Submitted to: (APC6Vendor name) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Learfield Contact: Xxxxx Xxxxxx Date: 8/1/21 Performance Period05/16/2023 E-mail address: 8/1/21 – 9/30/24 Liquidation DeadlineXxxxXxxxxx@xxx.xx.xxx Phone: November 29, 317-234- 5157 Vendor respectfully declines (please state reason): Media Budget (inclusive of agency costs/commission): $290,000 Creative Agency (if known): Xxxxxxxx Xxxxxxx creative run by Xxxxxxxxx State Agency Contact: Xxxxx Xxxxxx Creative Agency Contact: Xxxxx Xxxxxxxx Phone: 000-000-0000 Phone: 000-000-0000 Email: XxxxXxxxxx@xxx.xx.xxx Email: xxxxxxxxx@xxxxxxxxxxxxxxxxxxxxxx.xx m Campaign: 2024 IU/Purdue marketing Desired Campaign Timeframe: P.O. Number (if known): State Agency Billing Contact: Xxxx Xxxxx 000-000-0000 XxXxxxx@xxx.xx.xxx Funding Source: Underground Plant Protection Account (UPPA) Fund General Fund or Federal Amount Awarded to FSSAor Dedicated Dedicated PeopleSoft Fund ID: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).48691
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000074681
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Agreement to the State of Indiana. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee Counsel and the State have, through by their duly authorized representativesrepresentatives have executed this Agreement as of the dates set forth below. SCHAERR JAFFE LLP Office of the Indiana Attorney General By: Title: Date: Xxxxxxx X Xxxxxxxx Partner, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Schaerr Xxxxx LLP 7/9/2019 By: Title: Date: Xxxx Xxxxxxxxx General Counsel 07-10-19 Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronic Approval History User ID Approver Name Datetime Description 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/C256621 Xxxx,Xxxxxxx A 07/12/2019 2:35:58PM Agency Fiscal Approval 2 S004382 Xxxxxxx,Xxxxxx D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).07/22/2019 8:03:23PM IDOA Legal Approval 3 T278748 Xxxxxxxx,Xxxxxxx 07/24/2019 3:35:33PM IDOA Legal Approval 4 O277119 Egunyomi,Xxxxxxx 08/02/2019 1:50:03PM SBA Approval 5 M338811 Xxxxxxxx,Xxxxx X 08/02/2019 3:41:42PM Attorney General Approval
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Consultant and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, parties having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney WSP USA, INC. Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Transportation By: By: Title: Area Manager/Vice President Title: Deputy Commissioner Date: 9/29/2020 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 19:10 PDT Date: 9/30/2020 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 06:44 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAPPENDIX "A" Services to be furnished by CONSULTANT: In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Health Transportation (INDOT or Department) and Human Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services CFDA Number: 93.747 Award Name: (APC6services to be provided under a future amendment) American Rescue Task 5 Road Design and Plan Development (ARPincluding Signing, Lighting and Signal Plan Development, if applicable) for APS (up to Preliminary Field Check only) Task 6 Right of Way Plan Development (services to be provided under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirementsfuture amendment).
Appears in 1 contract
Samples: Consulting Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. therei n. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting XXXX LAW FIRM, P.C. Office of the Indiana Attorney Indiana Family & Social Services Administration General By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1P\rinciple, The Xxxx Law Firm, PC Title:\t2C\hief Deputy Attorney General Date:\d41/\6/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 14:29 EDT Date:\d42/\6/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 14:41 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department A Scope of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Legal Services
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney CareSource Indiana Inc. Indiana Family & and Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\t1P\resident, Indiana Market Date:\d51/\12/2021 | 11:37 EST Title:\tD3e\ puty Director14:40 EDT By:\s2\ Title:\t2M\edicaid director Date:\d52/\12/2021 | 22:51 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And 1.E HOOSIER HEALTHWISE SCOPE OF WORK Table of Contents 1.0 Background 9 2.0 Managed Care Entity- Contractor Requirements 10 2.1 State Licensure 10 2.2 National Committee for Quality Assurance (NCQA) Accreditation 10 2.3 Administrative and Organizational Structure 10 2.4 Staffing 11 2.4.1 Key Staff 12 2.4.2 Staff Positions 17 2.4.3 Training 18 2.4.4 Debarred Individuals 19 2.5 OMPP Meeting Requirements 20 2.6 Financial Stability 20 2.6.1 Solvency 20 2.6.2 Insurance 21 2.6.3 Reinsurance 21 2.6.4 Financial Accounting Requirements 22 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 24 2.6.6 Medical Loss Ratio 25 2.6.7 Health Insurance Providers Fee 26 2.7 Subcontracts 27 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November Other Information 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).
Appears in 1 contract
Samples: Contract #0000000000000000000032137
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Consultant and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, parties having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney HNTB INDIANA, INC. Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Transportation By: By: Title: Sr. Vice President Title: Deputy Commissioner Date: 3/24/2022 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 09:51 PDT Date: 3/24/2022 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 12:55 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAPPENDIX "A" Services to be furnished by CONSULTANT: In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Health Transportation (INDOT or Department) and Human Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services CFDA Number: 93.747 Award Name: Task 5 Road Design and Plan Development (APC6including Signing, Lighting and Signal Plan Development, if applicable) American Rescue Task 6 Pavement Design Services Task 7 Right of Way Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% Development • R/D Appropriation: No Indirect Costs: NW Engineering • Title Research • R/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services
Appears in 1 contract
Samples: Consulting Contract Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ hxxxx://xxxxxx.xx.xxx/xxxx/xxxx/xxxxxxxxxxxxxx/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney SYRA HEALTH CORP Indiana Family & and Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Administration, NeuroDiagnostic Institute By: /s/ Dxxxxxx Xxxxxxxxxxx By: /s/ Mxxxxxx Xxxxxx Title: Chief Executive Officer Title: CEO & Superintendent Date: 6/27/2022 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 06:34 PDT Date: 6/29/2022 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 08:56 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaRxxxxxx Xxxxxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: State Budget Agency Office of the Attorney General By: (for) Xxxxxxxx By: (for) Zxxxxxx X. Xxxxxxx, Director Txxxxxxx X Xxxxxx, Attorney General EXHIBIT Exhibit 2A NEURODIAGNOSTIC INSTITUTE (NDI) STAFFING YEARLY RATES AND FTES FOR UNITS AND FINANCIAL SUMMARY 37.5 HOURS WEEKLY/1950 HOURS ANNUALLY Hourly Rates: Position *Year 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 Hourly Rate Year 2 Hourly Rate Year 3 Hourly Rate Year 4 Hourly Rate Special Attendant $ 32.00 $ 32.64 $ 33.29 $ 33.96 Charge Nurse $ 70.00 $ 71.40 $ 72.83 $ 74.28 Nurse 4 $ 65.00 $ 66.30 $ 67.63 $ 68.98 Clinical Nurse Manager $ 65.00 $ 66.30 $ 67.63 $ 68.98 Special Attendant Supervisor $ 36.00 $ 36.72 $ 37.45 $ 38.20 LPN $ 45.00 $ 45.90 $ 46.81 $ 47.74 *** Effective 02.01.2022 applied hourly rate increase*** ***LPN Rate effective May 1, 2022***** Unit 2E - Psych – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Med Unit Position Position PT Position FT Total FTE Unit 2NW - Neuro-Cognitive Unit Position Position PT Position FT Total FTE
Appears in 1 contract
Samples: Syra Health Corp
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRC T S.GBL In Witness Whereof, the Grantee Consultant and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, parties having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney HNTB INDIANA, INC. Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Transportation By: By: Title: Sr. Vice President Title: Deputy Commissioner Date: 12/10/2021 | 11:37 13:14 PST Date: 12/10/2021 | 16:38 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAPPENDIX "A" Services to be furnished by CONSULTANT: In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Health Transportation (INDOT or Department) and Human Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Management and Coordination Task 2 Topographical Survey Task 3 Environmental Document Task 4 Permit Application Task 5 Public Involvement Task 6 Engineer Assessment Task 7 Roadway Design & Plan Development Task 8 Traffic Design Task 9 Transportation Management Plan Task 10 Geotechnical Investigation Task 11 Pavement Design Task 12 Utility Coordination Task 13 Construction Phase Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 Task 1 – 9/30/24 Liquidation Deadline: November 29Project Management and Coordination Objective The objective of this task is to manage the project, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial coordinate with discipline leads and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost PrinciplesINDOT, and Audit Requirements).communicate regularly with the INDOT project manager. Results / Deliverables Coordination with various disciplines of INDOT, preparation of monthly progress reports and monthly coordination calls with the INDOT project manager. Coordination Coordination is required with various departments within INDOT for project development, design review, contract preparation document, utility certification, asbestos reports, environment al document approval, permit determination, geotechnical report approval, pavement design approval, review of unique special provisions, and plan review. Activity The Consultant will perform the following activities: • Prepare and submit monthly progress reports • Coordinate with discipline leads and INDOT • Lead monthly coordination calls • Attend INDOT Meetings • Project/Task Management • Project Xxxxxxxx and Administration Assumptions • Project development will be 32 months (November 2021 to July 2024) • Travel will be limited to two visits to the project site or district office
Appears in 1 contract
Samples: Consulting Contract Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies Inc Indiana Family & Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Date:\d112\/23/2021 | 11:37 10:11 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Title:\t2M\edicaid director Date:\d122\/23/2021 | 19:43 10:26 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 1.E SCOPE OF WORK – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).HOOSIER HEALTHWISE
Appears in 1 contract
Samples: Contract #0000000000000000000032136
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration «Legal_Name» (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxPrinted Name: S. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», Attorney General EXHIBIT 1 Federal «Contact_State» «Contact_ZIP» Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyProgram: Department of Health and Human Services CSBG 2020 Statutory Information: 42 U.S.C. § 9901 et. seq CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 1/1/20221 – 9/30/24 Liquidation Deadline9/30/20232 Close out Date (45 days following the close of the grant): 11/15/20232 IHCDA Grant Contact: November 29Xxxx Xxxxxx-May, 2024 Federal Amount Awarded Community Programs Analyst IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Pursuant to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351IM No. Therefore61 regarding, CSBG Carryover funds, the Grantee shall arrange for Sub-grantee must expend carryover funds during the next federal fiscal year. In order to track the amount of carryover that the Sub-grantee uses, the Sub-grantee must submit a financial and compliance audit Carryover Report to IHCDA’s Community Programs Analyst by November 15, 20221, which reflects any balance of the Total Grant Amount not expended as of September 30, 20221. Any funds that complies with 45 C.F.R. 75.500 etare not expended by September 30, 20232 will be recaptured by IHCDA. seq. if required by applicable provisions Activity Description Amount .1 Administration (Not to Exceed Percentage set forth in Subsection B of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Section 4 of Award Agreement) Actual Costs
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies Inc Indiana Family & Social Services Administration By:\s2\ Office of Medicaid Policy & Planning By:\s1\ Division Title:\t1P\resident, Anthem IN Medicaid Date:\d91/\24/2020 | 16:06 EDT Title:\t2M\edicaid director Date:\d92/\25/2020 | 08:02 EDT Electronically Approved by: (if applicable) Indiana Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 1.M SCOPE OF WORK Table of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Contents
Appears in 1 contract
Samples: Contract #0000000000000000000018225
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney By:\s1\ Coordinated Care Corporation Indiana Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Title:\Ct1E\O Date:1\d21/\28/2021 | 11:37 13:55 CST By:\s2\ Title:\t2M\edicaid director Date:\1d22\/28/2021 | 15:01 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.A. SCOPE OF WORK Table of Contents 1.0 Background 11 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 14 2.4.1 Solvency 14 2.4.2 Insolvency and Receivership 14 2.4.3 Reinsurance 15 2.4.4 Performance Bond Requirements 16 2.4.5 Financial Accounting Requirements 16 2.4.6 Insurance Requirements 17 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 18 2.6 Disclosures 18 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 Party in Interest 18 2.6.2 Types of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Transactions Which Must Be Disclosed 19
Appears in 1 contract
Samples: Contract #0000000000000000000051706
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment #1 by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment #1 to the State of Indiana. I understand that my signing and submitting this Contract Amendment #1 in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment #1 and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment #1 in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment #1 will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment #1. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment #1, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney [Contractor] _ _ Indiana Family & Social Department of Child Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorBy: _ By: _ Xxxxx X. Xxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Director _ Name and Title, Printed Date: Date: Approved by: Approved by: Indiana Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: _(for) By: _ (for) Xxxxxxx Xxxxxxxx, Commissioner Xxxxxxx X. Xxxxxxx, Director Electronically Approved Xxxxxxx Date: Date: _ APPROVED as to Form and Legality byLegality: Office of the Attorney General By: _ (for) Xxxxxxxx X X. Xxxxxx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Prepared by Xxxxxxxx X. Xxxxx, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. ThereforeDCS Contracts Attorney, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)Legal Contracts Division.
Appears in 1 contract
Samples: Placing Agency Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney ANTHEM INSURANCE COMPANIES INC Indiana Family & Social Services Administration Administration, Office of Medicaid Policy and Planning By:\s1\ Division By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Title:\t2M\edicaid director Date:\d91/\18/2020 | 12:23 EDT Date:\d92/\24/2020 | 11:55 EDT Electronically Approved by: Indiana Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).10.J HEALTHY INDIANA PLAN CAPITATION RATES
Appears in 1 contract
Samples: Contract #
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Lease by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Lease to the State of Indiana. I understand that my signing and submitting this Contract Lease in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Lease and this affirmation. I understand and agree that by electronically signing and submitting this Contract Lease in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Lease will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereofxxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTR CTS.GBL. SIGNATURE PAGE IN WITNESS to their agreement, the Grantee persons signing this lease execute it for the Lessor and the State haveXxxxxx: For Lessor: For Lessee: [NAME] [XXXXXX] Indiana Department of Environmental Management By: By: Xxxxxxxx Xxxxxx, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms Chief of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Staff [Name/Title] Date: Date: Approved by: Indiana Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Date: Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved Date: APPROVED as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded EXHIBIT A DEPICTION/DESCRIPTION OF SEABIN V5 [Applicable photo of Serial Number plate] Diagram courtesy of the Seabin Project EXHIBIT B SEABIN INSTALLATION SITE Description/Map to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described be provided by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Lessee 1 WARRANTY EXHIBIT C SEABIN MANUFACTURER’S WARRANTY
Appears in 1 contract
Samples: www.in.gov
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney By:\s1\ Coordinated Care Corporation Indiana Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Title:\Ct1E\O Date:1\d21/\28/2021 | 11:37 13:55 CST By:\s2\ Title:\t2M\edicaid director Date:\1d22\/28/2021 | 15:01 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.A. SCOPE OF WORK Table of Contents 1.0 Background 11 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 14 2.4.1 Solvency 14 2.4.2 Insolvency and Receivership 14 2.4.3 Reinsurance 15 2.4.4 Performance Bond Requirements 16 2.4.5 Financial Accounting Requirements 16 2.4.6 Insurance Requirements 17 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 18 2.6 Disclosures 18 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 Party in Interest 18 2.6.2 Types of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Transactions Which Must Be Disclosed 19
Appears in 1 contract
Samples: Contract #0000000000000000000051706
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Ohio Valley Gas Corporation Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Utility Regulatory Commission By: By: Title: Safety Administrator Title: Chairman Date: 11/28/2023 | 11:37 13:33 PST Date: 11/28/2023 | 16:34 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: _ By: Printed Name: Printed Name: Title: Executive Director Title: Chairman Date: 1/31/2023 | 11:37 14:26 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Date: 2/6/2023 | 19:43 16:34 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST _ Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon April 4, Attorney General 2022 FA 22-20 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration «Legal_Name» (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxPrinted Name: S. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», Attorney General EXHIBIT 1 Federal «Contact_State» «Contact_ZIP» Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyProgram: Department of Health and Human Services CSBG 2020 Statutory Information: 42 U.S.C. § 9901 et. seq CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 1/1/2021 – 9/30/24 Liquidation Deadline9/30/2022 Close out Date (45 days following the close of the grant): 11/15/2022 IHCDA Grant Contact: November 29Xxxx Xxxxxx-May, 2024 Federal Amount Awarded Community Programs Analyst IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Pursuant to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351IM No. Therefore61 regarding, CSBG Carryover funds, the Grantee shall arrange for Sub-grantee must expend carryover funds during the next federal fiscal year. In order to track the amount of carryover that the Sub- grantee uses, the Sub-grantee must submit a financial and compliance audit Carryover Report to IHCDA’s Community Programs Analyst by November 15, 2021, which reflects any balance of the Total Grant Amount not expended as of September 30, 2021. Any funds that complies with 45 C.F.R. 75.500 etare not expended by September 30, 2022 will be recaptured by IHCDA. seq. if required by applicable provisions Activity Description Amount .1 Administration (Not to Exceed Percentage set forth in Subsection B of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Section 4 of Award Agreement) Actual Costs
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney XXXXX COUNTY HEALTH DEPARTMENT Indiana Family & Social Services Administration Department of Health By:\s1\ Division By:\s2\ Title:\t1A\dministrator Title:\tI2\DOH Chief of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Staff Date:\d41/\13/2022 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 10:44 EDT Date:\d42/\13/2022 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 11:07 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency Approved as to Form and Legality: Office of Attorney General By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to (for) Form and Legality by: approval hasbeen granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on M arch 15, 2022 FA 22-18 Exhibit A Scope of Work The local health department ("LHD") shall complete the 2021 Local Health Department Annual Survey on or before May 6, 2022. Upon acceptance by the Local Health Department Outreach Division ("LHDOD") of the 2021 LHD Annual Survey ("Survey") and approval of a contract for services the local health department shall be paid the sum of One Thousand Dollars and No Cents ($1,000). The Survey is accessible online via RedCap. The LHD shall access the Survey via a unique link and code to be provided by the LHDOD. Exhibit B: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Budget Name of Organization: XXXXX COUNTY Program Description: 2021 Annual Survey Budget Period: 1/1/2022 - 5/6/2022 Salaries and Wages $ 1,000.00 Fringe Benefits $ - Consultants $ - Contractual $ - Supplies $ - Equipment $ - Travel $ - Other Operating Total Budget $ 1,000.00 Exhibit C: Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 93.354 Grant Award Number: NU90TP922179 Award Name: (APC6) American Rescue Plan (ARP) Cooperative Agreement for APS under SSA Title XX Section 2042(b) Award Dateemergency Response: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Public Health Crisis Response
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract Grant Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Grant Agreement to the State of Indiana. I understand that my signing and submitting this Contract Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Subrecipient and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe Xxxxx County Prosecuting Attorney Indiana Family & Social Services Administration Department of Homeland Security By:\s1\ Division By:\s2\ Title:\t1\ Title:\t2C\hief of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Staff Date:\d1\ Date:\d2\ Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon September 1, Attorney General 2020. FA 20-44 EXHIBIT 1 Federal Funding And Reporting Requirements A - FEDERAL FUNDING INFORMATION Federal Agency: Department REQUIREMENTS The Subrecipient agrees to comply with all of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” the following requirements as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)listed below.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment for Public Works Project Number XXXXX. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Contractor: XXXXXXXXXX Department of Administration By:\s1\ Public Works Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorBy: Printed Name: Title: By: Xxxxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Director For IDOA Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically if less than $10,000,000 Date: Date: Approved by: Approved by: Department of Administration State Budget Agency PURSUANT TO IC 4-13-2-14.1 APPROVAL OF THE BUDGET AGENCY IS NOT REQUIRED FOR CONTRACTS UNDER $100,000.00 By: (for) By: (for) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Date: Date: Approved as to Form and Legality byLegality: Form approval has been granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on October 5, 2022. FA 22-52 This document prepared and reviewed by: (for) Xxxxxxxx X XxxxxxCounsel, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Indiana Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) Administration AMENDMENT #_ EXHIBIT A See Documents to Follow for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Exhibit AMENDMENT #_ EXHIBIT B
Appears in 1 contract
Samples: www.in.gov
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Grant Agreement by accessing the State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Grant Agreement to the State of Indiana. I understand that my signing and submitting this Contract Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Subrecipient and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney City of Fort Xxxxx By:\s1\ Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Homeland Security By:\s2\ Title:\t1C\ity Engineer/Flood Control Mngr Date:\d51/\24/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 15:39 EDT Title:\t2G\eneral Counsel Date:\d52/\25/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 12:05 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department A Project Scope of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Work EXHIBIT B FEMA FFY 2019 PRE-DISASTER MITIGATION PROGRAM GRANT AGREEMENT ARTICLES
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies, Inc., d.b.a Anthem Blue Cross and Blue Shield Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and By: Planning By: Title: President, Anthem IN Medicaid Title: Medicaid director Date: 2/14/2023 | 11:37 11:17 PST Date: 2/15/2023 | 13:17 EST Title:\tD3e\ puty DirectorElectronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting SCOPE OF WORK – HOOSIER HEALTHWISE Table of Contents 1.0 Background 31 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health 32 2.1 State Licensure and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Compliance with Applicable Laws, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost PrinciplesRules, and Audit Requirements).Regulations 32 2.2 National Committee for Quality Assurance (NCQA) Accreditation 32 2.3 Administrative and Organizational Structure 32 2.3.1 Staffing 33 2.3.2 Key Staff 33 2.3.3 Other Required Staff Positions 39 2.3.4 Suggested Staff Positions 41 2.3.5 Staff Training and Qualifications 42 2.3.6 Debarred Individuals 43 2.4 FSSA Meeting Requirements 44 2.5 Financial Stability 44 2.5.1 Solvency 45 2.5.2 Insurance Requirements 45 2.5.3 Reinsurance 45 2.5.4 Financial Accounting Requirements 46
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000069767
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementGrant. The parties, having read and understood the foregoing terms of this Grant AgreementGrant, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney MIDWEST NATURAL GAS CORP Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Utility Regulatory Commission By: By: Xxxx X. Xxxxxx Title: Regional Area Mgr. Title: General Counsel Date: Date: 2/12/18 02/12/2018 Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxx X. XxxxxxxXxxxxx, Director Electronically Refer to Electronic Approval History found after the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon August 17, Attorney General EXHIBIT 2017. FA 17-29 Electronic Approval History User ID Approver Name Datetime Description 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/M220610 Xxxxxxx,Xxxx 02/12/2018 10:58:40AM Agency Fiscal Approval 2 S004382 Xxxxxxx,Xxxxxx D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).02/15/2018 4:50:24PM IDOA Legal Approval
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State Parties have, through their duly authorized representatives, entered into this Grant Agreement. The partiesParties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Metro Fibernet, LLC State of Indiana, through By: _ Title: Date: Executive Vice President 5/17/2019 Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTransportation By: _ , Division (for) Xxxxxx XxXxxxxxxx, Commissioner, Indiana Department of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved byTransportation Date: 05/21/2019 APPROVALS STATE OF INDIANA Budget Agency By: (FOR) Xxxxx X. Xxxxxx, Director Date: STATE OF INDIANA Department of Administration By: (forFOR) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved byDate: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (forFOR) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx. Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Indiana Date: 8/1/21 Performance PeriodExhibit A to Attachment 1: 8/1/21 – 9/30/24 Liquidation DeadlineImprovements \ Exhibit B to Attachment 1: November 29, 2024 Federal Amount Awarded Site Exhibit C to FSSAAttachment 1: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient NotificationRequired Studies and Reports Examples Include: The Grantee intent is a “subrecipient” to have on record any required reports and studies. Stamped and Sealed Construction Drawings Underground bore elevation/vault diagrams Structural Analysis Geotechnical Report Site walkthrough Land Survey Intermodulation Study AM Certification FCC Documents License FAA Approval NEPA/Programatic CE Land Rights/Title Review Other regulatory documents as defined under 45 C.F.R. 75.2 needed Exhibit D to Attachment 1: Traffic Control Plan Attachment 2: Urban/Rural Designation Exhibit A to Attachment 2: Urban Exhibit B to Attachment 2: Rural Map of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial Urban/Rural areas (this map is subject to change) xxxx://xxx.xx.xxx/indot/files/Schedule%20of%20Urban%20and%20Rural%20Boundaries.pdf Attachment 3: Forms Exhibit A to Attachment 3: Transfer and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions Assumption of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Agreement Form
Appears in 1 contract
Samples: Broadband Access Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Coordinated Care Corporation Indiana Indiana Family & and Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\tC1E\O Date:\6d/11\ /2021 | 11:37 EST Title:\tD3e\ puty Director11:43 CDT Title:\tM2e\ dicaid director By:\s2\ Date:6\d/21\ /2021 | 13:11 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And 2.H HEALTHY INDIANA PLAN SCOPE OF WORK TABLE OF CONTENTS 1.0 Background 11 2.0 Managed Care Entity- Contractor Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Administrative and Organizational Structure 13 2.4 Staffing 14 2.4.1 Key Staff 14 2.4.2 Staff Positions 20 2.4.3 Training 22 2.4.4 Debarred Individuals 23 2.5 FSSA/OMPP Meeting Requirements 24 2.6 Financial Stability 24 2.6.1 Solvency 24 2.6.2 Insurance 25 2.6.3 Reinsurance 25 2.6.4 Financial Accounting Requirements 26 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 28 2.6.6 Medical Loss Ratio 29 2.6.7 Health Insurance Providers Fee 30 2.7 Subcontracts 31 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: Other Information 34 2.9 Internet Quorum (APC6IQ) American Rescue Inquires 34 2.10 Material Change 34 2.11 Future Program Guidance 34 2.12 Conflict of Interest 35 2.13 Capitation Related to a Vacated Program 35 3.0 HIP Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial Design and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Member Eligibility 35 3.1 HIP Plus 35
Appears in 1 contract
Samples: Contract #0000000000000000000018315
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney CITY OF BEECHGROVE Indiana Family & Social Services Administration By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Community and Rural Affairs By: By: Title: Mayor Title: Executive Director Date: 2/2/2021 | 11:37 07:58 PST Date: 2/2/2021 | 14:45 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyA GRANTEE – City of Beech Grove - Cage Code: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).4Z8E1 PREVIOUSLY AWARDED & ONGOING GRANTS - Not Applicable CURRENT AWARD - WW-20-109 - $600,000.00 TOTAL AMOUNT OF AWARDED FUNDS $600,000.00 PROJECT DESCRIPTION
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained thereinherein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL? In Witness Whereof, the Grantee Designer and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Designer: XXXXXXXXXX Department of Administration By:\s1\ Public Works Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorBy: Printed Name: Title: By: Xxxxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Director For IDOA Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically if less than $1,000,000 Date: Date: Approved by: Approved by: Department of Administration State Budget Agency PURSUANT TO IC 4-13-2-14.1 For Contract in excess of $2,500 APPROVAL OF THE BUDGET AGENCY IS NOT REQUIRED FOR CONTRACTS UNDER $100,000.00 By: (for) By: (for) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Date: Date: Approved as to Form and Legality byLegality: Form approval has been granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on August 31, 2021. FA 21-43 This Instrument was prepared by: (for) Xxxxxxxx X Xxxxxx, Attorney General [INSERT NAME] on XX/XX/XXXX EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyA SCHEDULE OF RATES FOR USE IN JUSTIFYING COSTS OF STATE AUTHORIZED ADDITIONAL SERVICES FIRM NAME: Department INSERT DESIGN FIRM NAME PUBLIC WORKS PROJECT NUMBER: INSERT PROJECT NUMBER Terms of Health additional services are set forth in Articles 4 and Human Services CFDA Number7. RATE/HOUR: 93.747 Award Name[INSERT] Project Manager: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award DateProject Architect: 8/1/21 Performance PeriodJob Captain: 8/1/21 – 9/30/24 Liquidation DeadlineDraftsperson: November 29, 2024 Federal Amount Awarded to FSSASpecification Writer: Amount Awarded to GranteeTypist: $ 4,754,685.00 $ 28,687.56 Match RequirementsProject Representative: Federal 100% / State 0% RStructural Engineer: Structural Draftsperson: Mechanical Project Manager: Mechanical Engineer: Electrical Project Manager: Electrical Engineer: Draftsperson Mech/D AppropriationElect: No Indirect Costs: NMech/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Elect Representative:
Appears in 1 contract
Samples: Public Works Construction Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney CARESOURCE INDIANA INC Indiana Family & and Social Services Administration Administration, Office of Medicaid Policy and Planning By:\s1\ Division By:\s2\ Title:\t1P\resident, Indiana Market Title:\t2M\edicaid director Date:\d51/\12/2021 | 14:39 EDT Date:\d52/\12/2021 | 22:51 EDT Electronically Approved by: Indiana Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General TABLE OF CONTENTS EXHIBIT 1 Federal Funding And 2.H HEALTHY INDIANA PLAN SCOPE OF WORK 1.0 Background 11 2.0 Managed Care Entity- Contractor Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Administrative and Organizational Structure 13 2.4 Staffing 14 2.4.1 Key Staff 14 2.4.2 Staff Positions 20 2.4.3 Training 22 2.4.4 Debarred Individuals 23 2.5 FSSA/OMPP Meeting Requirements 24 2.6 Financial Stability 24 2.6.1 Solvency 24 2.6.2 Insurance 25 2.6.3 Reinsurance 25 2.6.4 Financial Accounting Requirements 26 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 28 2.6.6 Medical Loss Ratio 29 2.6.7 Health Insurance Providers Fee 30 2.7 Subcontracts 31 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: Other Information 34 2.9 Internet Quorum (APC6IQ) American Rescue Inquires 34 2.10 Material Change 34 2.11 Future Program Guidance 34 2.12 Conflict of Interest 35 2.13 Capitation Related to a Vacated Program 35 3.0 HIP Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial Design and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Member Eligibility 35 3.1 HIP Plus 35
Appears in 1 contract
Samples: Contract #0000000000000000000018313
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorVANDERBURGH COUNTY HEALTH DEPARTMENT INDIANA DEPARTMENT OF HEALTH By: By: Title: Xxxxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of President Xxxxxxxxxxx CoTuitnlet:y Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: ATTACHMENT A - Year One Local Health Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6LHD) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 School Liaison Grant July 1, 2023 – 9/30/24 Liquidation Deadline: November 29June 30, 2024 Federal Amount Awarded Year one of the school liaison grant is focused on capacity building and engagement. School liaisons will work to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Thereforeestablish trusting relationships with schools and school corps., the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principlesnursing staff, and Audit Requirements).administrative teams in all K-12 schools within their county. In
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementGrant. The parties, having read and understood the foregoing terms of this Grant AgreementGrant, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney XXX COUNTY REMC Indiana Family & Social Services Administration By:\s1\ Division Utility Regulatory Commission By: Xxxxx Xxxxxx _Cindy Xxxxxx, Director of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorMarketing Name and Title, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Printed Date: 08-14-19 Xxxxx X Xxxxxx Xxxxx X. Xxxxxx Chairman Date: 8-15-19 Xxxxx Xxxxxx Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Refer to Electronic Approval History found after the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon May 13, Attorney General 2019. FA 19-16 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) C -- Annual Financial Report for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, Non-governmental Entities Guidelines for filing the Grantee shall arrange for a annual financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).report:
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney TriCo Regional Sewer Utility Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Utility Regulatory Commission By: By: Title: Utility Director Title: Chairman Date: 7/5/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 11:34 PDT Date: 7/11/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 09:58 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Coordinated Care Corporation Inc Indiana Family & Social Services Administration Office of Medicaid Policy & Planning By:\s1\ Division By:\s2\ Title:\t1C\EO Title:\t2M\edicaid director Date:\d91/\24/2020 | 05:46 PDT Date:\d92/\24/2020 | 08:48 EDT Electronically Approved by: (if applicable) Indiana Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 1.M SCOPE OF WORK Table of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Contents
Appears in 1 contract
Samples: Contract #0000000000000000000018227
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementGrant. The parties, having read and understood the foregoing terms of this Grant AgreementGrant, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney City of Rensselaer Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Utility Regulatory Commission By: Title: Xxxxx Xxxxxxxxx Superintendent By: Xxxxx X. Xxxxxx Title:Chairman Date: 3-18-2019 Date: 3-21-19 Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxx X. XxxxxxxXxxxxx, Director Electronically Refer to Electronic Approval History found after the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon June 25, Attorney General EXHIBIT 2018. FA 18-12 Electronic Approval History User ID Approver Name Datetime Description 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/M220610 Xxxxxxx,Xxxx 03/21/2019 1:13:49PM Agency Fiscal Approval 2 S004382 Xxxxxxx,Xxxxxx D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).03/26/2019 5:44:09PM IDOA Legal Approval
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract Grant Agreement by accessing the State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Grant Agreement to the State of Indiana. I understand that my signing and submitting this Contract Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Subrecipient and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe Xxxxx County Prosecuting Attorney Indiana Family & Social Services Administration Department of Homeland Security By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorBy:\s2\ Title:\t1P\resident, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Title:\t2\ Date:\d1\ Date:\d2\ Electronically Approved by: :Department of Administration By: (for) Xxxxxxx for)Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: :State Budget Agency By: (for) Xxxxxxx for)Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyApproved by: Department Form approval has been granted by the Office of Health and Human Services CFDA Number: 93.747 Award Name: (APC6the Attorney General pursuant to IC 4-13-2-14.3(e) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November on July 29, 2024 Federal Amount Awarded 2021. In Process FA 21-32 EXHIBIT A - FEDERAL REQUIREMENTS The Subrecipient agrees to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” comply with all of the following requirements as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)listed below.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Title: Executive Director Title: Chairman Date: 5/12/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 10:16 EDT Date: 5/16/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 15:49 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney CISCO SYSTEMS Indiana Family & Social Services Administration By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: Xxxx Title:Giampetr Dateo: ni Digitally signed by Xxxx Xxxxxxxxxxx DN: cn=Xxxx Xxxxxxxxxxx, Division o=Cisco Systems, Inc, ou=US Public Sector, xxxxx=xxxxxxxx@xxxxx.xxx, c=US Date: 2016.03.29 17:32:42 -04'00' By: Title: Date: Xxxxx Xxxxxxx Digitally signed by Xxxxx Xxxxxxx DN: cn=Xxxxx Xxxxxxx, o=State of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board Indiana, ou=Office of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Technology, xxxxx=xxxxxxxx@xxx.xx.xxx, c=US Date: 2016.03.30 07:38:03 -04'00' Approved by: Indiana Office of Technology By: (for) Xxxxxx Xxxxx, Chief Information Officer This document will be reviewed and approved electronically. Please refer to the final page of the Executed Contract for details. Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxxx, Commissioner Electronically This document will be reviewed and approved electronically. Please refer to the final page of the Executed Contract for details. Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxx X. XxxxxxxXxxxxx, Director Electronically This document will be reviewed and approved electronically. Please refer to the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxxx X. Xxxxxxx, Attorney General EXHIBIT This document will be reviewed and approved electronically. Please refer to the final page of the Executed Contract for details. Electronic Approval History User ID Approver Name Datetime Description 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) T222139 Xxxxxxxx,Xxxxxx 03/30/2016 6:55:30PM Agency Fiscal Approval 2 W004728 Xxxxxx,Xxxxxxx D 04/01/2016 11:21:54AM IOT Approval 3 M225528 Xxxxxx,Xxxx Xxxx 04/04/2016 2:02:27PM IDOA Approval for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/IT 4 R282681 Xxxxxx,Xxxx X 04/04/2016 2:15:18PM SBA Approval 5 A233897 Xxxxxxxx,Xxxxx A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).04/04/2016 3:22:11PM Attorney General Approval
Appears in 1 contract
Samples: www.cisco.com
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies Inc. Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Date:\d31/\29/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 15:54 EDT Title:\t2M\edicaid director Date:\d32/\29/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 15:58 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And SCOPE OF WORK Table of Contents 1.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of Records 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-Referral Services 59 3.2 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the MTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).68
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000051705
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Title: Executive Director Title: Chairman Date: 9/15/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 10:57 EDT Date: 9/15/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 17:39 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Consultant and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, parties having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney HNTB INDIANA, INC. Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Transportation By: By: Title: Sr. Vice President Title: Deputy Commissioner Date: 8/13/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 14:21 PDT Date: 8/13/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 17:24 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAPPENDIX "A" Services to be furnished by CONSULTANT: In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Health Transportation (INDOT or Department) and Human Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services CFDA Number: 93.747 Award Name: Task 5 Road Design and Plan Development (APC6including Signing, Lighting and Signal Plan Development, if applicable) American Rescue Task 6 Pavement Design Services Task 7 Right of Way Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% Development • R/D Appropriation: No Indirect Costs: NW Engineering • Title Research • R/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).W Staking Task 8 Utility Coordination Services Task 9 Construction Phase Services
Appears in 1 contract
Samples: Consulting Contract Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies Inc Indiana Family & and Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Title:\t2M\edicaid director Date:\d51/\14/2021 | 11:37 EST Title:\tD3e\ puty Director12:56 EDT Date:\d52/\14/2021 | 13:22 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General Table of Contents EXHIBIT 1 Federal Funding And Reporting 1.E HOOSIER HEALTHWISE SCOPE OF WORK 1.0 Background 10 2.0 Managed Care Entity- Contractor Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).11
Appears in 1 contract
Samples: Contract #0000000000000000000032136
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney NTT DATA, INC. Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Early Childhood By: and Out of School Learning By: Title: Vice President Title: Director OECOSL Date: 12/20/2022 | 11:37 13:28 EST Title:\tD3e\ puty DirectorDate: 1/4/2023 | 13:00 EST Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Statement of Work Version Effective Date Brief Description of Change Affected Section(s) Prepared By Reviewed By Approved By 1.0 10/13/2022 Initial Version. All Xxx Xxxxxxxxx Xxxx Xxxx Social Services Data Warehouse (SSDW) OECOSL - COVID - Voucher File Updates NOMENCLATURE AND DEFINITIONS Acronym or Term Definition AIS Automated Intake System DST Division of Strategy and Technology EPPIC Electronic Payment Processing and Information Control ETL Extraction, Transformation and Load FSSA Family and Social Services Administration OECOSL Office of Early Childhood and Out-of-School Learning SME Subject Matter Experts SSDW Social Services Data Warehouse T&M Time and Materials History The FSSA Office of Early Childhood and Out-of-School Learning (OECOSL) oversees early childcare, education, and out-of-school-time programs. OECOSL’s AIS application currently sends 3 files (Provider, Application and Voucher) to Conduent every day (12pm and 8pm). Conduent’s EPPIC system processes these files, sends exception records and provider payment reports back to AIS and makes payment to providers. OECOSL received Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health Relief funding to help families and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351providers with the pandemic situation. ThereforeTo implement this, the Grantee shall arrange co-pay and the weekly subsidy amount in the Voucher file needs to be updated. After brainstorming the implementation options with TCC, NTT DATA and Conduent, OECOSL decided to engage NTT DATA for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)making updates to the Voucher file.
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000069368
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY HEALTH Indiana Family & Social Services Administration By:\s1\ Division State Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Health DEPARTMENT By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Attachment A Vanderburgh County Health Department January 1, 2020 TO December 31, 0000 Xxx Xxxxxxx Xxxxx Department of Health Health’s (ISDH) Division of Trauma and Human Services CFDA Number: 93.747 Award Name: Injury Prevention (APC6DTIP) American Rescue Plan has been awarded a grant from the Centers for Disease Control and Prevention (ARPCDC) to increase comprehensiveness and timeliness of drug overdose surveillance data; make the Prescription Drug Monitoring Program more user-friendly; work with health systems, insurers, and communities to improve opioid prescribing; and build state and local capacity for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded public health programs related to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 substance use disorder. As part of federal grant funds as described by 45 C.F.R. 75.75.351. Thereforethese efforts, the Grantee shall arrange for ISDH is implementing the Indiana Communities Advancing Recovery Efforts (IN CAREs) ECHO. The ECHO model is an innovative framework that uses videoconferencing technology to increase the knowledge, skills and performance of community stakeholders, particularly those located in rural and underserved areas. The IN CAREs ECHO connects a financial group of faculty experts (referred to as the “Hub”) who have experience in reducing overdose deaths with a set of community-based teams (referred to as “Spokes”) made up of leaders within each community. The Spoke teams are committed to working together to implement strategies and compliance audit that complies coordinate efforts to reduce opioid misuse, reduce morbidity and mortality associated with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 opioid use disorder (Uniform Administrative Requirements, Cost PrinciplesOUD), and Audit Requirements).increase linkage to care for those with OUD. The ECHO model requires Spoke teams to participate in monthly 90-minute sessions over the course of ten months. A session will consist of a short, expert-led lecture (didactic) presentation to improve content knowledge and share evidence-based best practices, followed by one community case presentation with clarifying questions and recommendations. Spoke teams will identify and share stories that illustrate progress, successes and challenges associated with their efforts. Each participating Spoke will also have post-ECHO action meetings to ensure that participants are applying the knowledge learned in the virtual ECHO sessions to implement changes in their communities. As part of this funding opportunity, all selected grantees are required to complete the following activities:
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained thereinherein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee Designer and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Designer: XXXXXXXXXX Department of Administration By:\s1\ Public Works Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorBy: Printed Name: Title: By: Xxxxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Director For IDOA Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically if less than $1,000,000 Date: Date: Approved by: Approved by: Department of Administration State Budget Agency PURSUANT TO IC 4-13-2-14.1 For Contract in excess of $2,500 APPROVAL OF THE BUDGET AGENCY IS NOT REQUIRED FOR CONTRACTS UNDER $100,000.00 By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxx X. Xxxxx, Commissioner Xxxxxxx X. Xxxxxxx, Director Electronically Date: Date: Approved as to Form and Legality byLegality: Form approval has been granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on September 9, 2019. FA 19-41 This Instrument was prepared by: (for) Xxxxxxxx X Xxxxxx, Attorney General [INSERT NAME] on XX/XX/XXXX EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyA SCHEDULE OF RATES FOR USE IN JUSTIFYING COSTS OF STATE AUTHORIZED ADDITIONAL SERVICES FIRM NAME: Department INSERT DESIGN FIRM NAME PUBLIC WORKS PROJECT NUMBER: INSERT PROJECT NUMBER Terms of Health additional services are set forth in Articles 4 and Human Services CFDA Number7. RATE/HOUR: 93.747 Award Name[INSERT] Project Manager: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award DateProject Architect: 8/1/21 Performance PeriodJob Captain: 8/1/21 – 9/30/24 Liquidation DeadlineDraftsperson: November 29, 2024 Federal Amount Awarded to FSSASpecification Writer: Amount Awarded to GranteeTypist: $ 4,754,685.00 $ 28,687.56 Match RequirementsProject Representative: Federal 100% / State 0% RStructural Engineer: Structural Draftsperson: Mechanical Project Manager: Mechanical Engineer: Electrical Project Manager: Electrical Engineer: Draftsperson Mech/D AppropriationElect: No Indirect Costs: NMech/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Elect Representative:
Appears in 1 contract
Samples: Public Works Construction Contract
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department De partment of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective respecti ve signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorHealth By: By: Title: Xxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of President Xxxxxxxxxxx XxxxXxxxxxx:Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyATTACHMENT A Contract Amount: $320,387.00 Grantee Name: Vanderburgh County Health Department Length of Contract: August 1, 2022, to June 30, 2024 Division: Health Issues and Challenges Program Type: Community Health Worker, Lead Purpose In Process The Indiana Department of Health (IDOH) receives funding from House Enrolled Xxx 0000 to prevent the prevalence of health issues and Human Services CFDA Number: 93.747 Award Name: (APC6) improve the physical and behavioral health of all Indiana residents. This funding is supported through the American Rescue Plan Act (ARPARPA) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded and allows the IDOH to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal implement programs focused on health issues and challenges. This proposed grant funds as described by 45 C.F.R. 75.75.351. Therefore, will focus on the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)area disease prevention utilizing community health workers.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney By:\s1\ MDWISE INC Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\tP1r\ esident and CEO Date:5\d/11\3/2021 | 11:37 EST Title:\tD3e\ puty Director11:43 EDT Title:\Mt2e\dicaid director By:\s2\ Date5:\d/21\3/2021 | 12:09 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.E HOOSIER HEALTHWISE SCOPE OF WORK Table of Contents 1.0 Background 10 2.0 Managed Care Entity- Contractor Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).11
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Government Indiana Family & Social Services Administration By:\s1\ d/b/a Tippecanoe Villa Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s1\ By:\s2\ Title:\t1c\ommissioner Title:\tD2\irector, Div Aging Date:\d31/\16/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 06:23 PDT Date:\d32/\20/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 10:23 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department SCOPE OF WORK Indiana Code 12-10-6-2.1(a)(3) limits the Residential Care Assistance Program (RCAP) program to persons who require a degree of Health care less than that provided by a health facility licensed under Indiana Code 16-28-3-2. No resident who meets nursing facility level of care will receive RCAP reimbursement. It is the responsibility of the RCAP facility to conduct the individual’s level of care assessment prior to applying to RCAP in order to determine whether the individual meets nursing facility level of care, and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) is therefore not eligible for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351RCAP. ThereforeFor enrolled RCAP participants, the Grantee shall arrange Contractor must contact the local Area Agency on Aging (AAA) to initiate pre-admission screening when a resident’s decline in health, or other condition, may make the resident eligible for nursing facility care or any of the programs that require Medicaid nursing facility level of care, including Assisted Living Services under the Aged and Disabled Waiver. The facility may be required to coordinate with the AAA to conduct a nursing facility level of care assessment for any resident. Residents who refuse to have a nursing facility level of care assessment performed will be terminated from the RCAP program. RCAP reimbursement for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions resident will stop on the day the resident meets nursing facility level of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)care or refuses the level of care assessment.
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney TOWN OF LIZTON By: Indiana Family & Social Services Administration By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Community and Rural Affairs Title: Council President By: Title: Executive Director Date: 11/7/2022 | 11:37 17:03 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Date: 11/9/2022 | 19:43 08:02 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyA GRANTEE – Town of Lizton - Cage Code: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).82ET5 PREVIOUSLY AWARDED & ONGOING GRANTS - None CURRENT AWARD - WW-22-104 - $700,000.00 TOTAL AMOUNT OF AWARDED FUNDS $700,000.00 PROJECT DESCRIPTION
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Coordinated Care Corporation Indiana Indiana Family & and Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\tC1E\O Date:6\d/11\/2021 | 11:37 EST Title:\tD3e\ puty Director11:44 CDT Title:\Mt2e\ dicaid director By:\s2\ Date:6\d/21\ /2021 | 13:12 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And 1.E HOOSIER HEALTHWISE SCOPE OF WORK Table of Contents 1.0 Background 9 2.0 Managed Care Entity- Contractor Requirements 10 2.1 State Licensure 10 2.2 National Committee for Quality Assurance (NCQA) Accreditation 10 2.3 Administrative and Organizational Structure 10 2.4 Staffing 11 2.4.1 Key Staff 12 2.4.2 Staff Positions 17 2.4.3 Training 18 2.4.4 Debarred Individuals 19 2.5 OMPP Meeting Requirements 20 2.6 Financial Stability 20 2.6.1 Solvency 20 2.6.2 Insurance 21 2.6.3 Reinsurance 21 2.6.4 Financial Accounting Requirements 22 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 24 2.6.6 Medical Loss Ratio 25 2.6.7 Health Insurance Providers Fee 26 2.7 Subcontracts 27 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November Other Information 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).
Appears in 1 contract
Samples: Contract #0000000000000000000032139
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY HEALTH DEPARTMENT Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Health By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Attachment A Firearm Fatality Prevention in Vanderburgh County and Surrounding Region Firearm Safety Locks In Process Child Fatality Review Team case reviews have yielded recommendations that gun safety be addressed as part of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29its regional injury prevention work. In 2018, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described 10 Vanderburgh County children were injured by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principlesfirearms, and Audit Requirements)four of them died from their injuries. In 2019, 12 Vanderburgh County children were injured by firearms, and three died from their injuries. These injuries required treatment at one of the two verified trauma centers located in Vanderburgh County. Two recommendations were identified in CFR team meetings. First, parents need to be provided the education and equipment to secure guns to prevent their children from getting access. Second, mental health providers need to have crucial conversations with potential suicidal individual’s families about securing firearms. Goal: Development and implementation of a strategy to provide gun securing education and equipment improving the home safety of children in the Vanderburgh County and surrounding community. Home visitors in the Pre to 3 Program will distribute the gun locks to families in need. These home visitors have the unique opportunity to assess the safety of the home weekly and offer onsite education and safety equipment related to home safety, including gun safety. Combination cable gun locks can be purchased for approximately $7.49/piece and combination trigger locks for approximately $ 9.99/piece.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Selge Construction Company Inc. Indiana Family & Social Services Administration By:\s1\ Division Utility Regulatory Commission By: By: Title: Manager of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Safety and Resources Title: Chairman Date: 4/9/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 08:25 PDT Date: 4/9/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 13:33 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxxx X. XxxxxxxXxxxx, Acting State Budget Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29on February 13, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/FA 24-02 EXHIBIT A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney United Healthcare Insurance Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1C\EO, Indiana M&R Title:\t2M\edicaid director Date:\d112\/22/2021 | 11:37 10:57 CST Date:\d122\/23/2021 | 10:31 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.A. SCOPE OF WORK Table of Contents 1.0 Background 13 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Subcontracts 14 2.4 Financial Stability 16 2.4.1 Solvency 16 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 17 2.4.4 Performance Bond Requirements 18 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 20 2.6 Disclosures 20 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Party in Interest 20
Appears in 1 contract
Samples: Contract #0000000000000000000051704
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Learfield Communications Inc Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Utility Regulatory Commission By: By: Title: General Manager Title: Chairman Date: 8/13/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 11:56 CDT Date: 8/20/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 15:09 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Exhibit A The Contractor will provide a public awareness concerning underground plant protection, 2024 Federal Amount Awarded also referred to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds excavation damage prevention, as described required by 45 C.F.R. 75.75.351Ind. Code § 8-1-26-24(a)(1). ThereforeSpecifically, the Grantee Contractor shall arrange provide the following: Fall 2021 Kick-off Campaign on August 11th (8-11 day) o MAKE A SPLASH! A landing page will be built essentially restricting fans before they enter xxx.xxxxxxxxxx.xxx and xxx.xxxxxxxxxxxx.xxx announcing Indiana 811 day and educating fans on the importance of calling before you dig. o Website Takeover - The websites above will have Indiana 811 for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirementsall ad elements on August 11, Cost Principlesincluding but not limited to ad banners, displays, and Audit Requirements)logos. o Mobile App Takeover - All initial ads on each respective mobile app will be related to using the Indiana 811 service. o A push notification will be sent to all app user fans announcing Indiana 811 day. o Contractor will create organic posts and tweets from each respective school on Facebook/Twitter recognizing Indiana 811 day. Football Game Sponsorships o Away Game for XX Xxxxxxxx MAKE A SPLASH! A landing page will be built essentially restricting fans before they enter xxx.xxxxxxxxxx.xxx and xxx.xxxxxxxxxxxx.xxx announcing Indiana 811 day and educating them on the importance of calling before you dig. Website Takeover - The websites above will have Indiana 811 for all ad elements on August 11, including but not limited to ad banners, displays, and logos. Mobile App Takeover - All initial ads on each respective mobile app will be related to using the Indiana 811 service. A push notification will be sent to all app user fans announcing Indiana 811 day. Contractor will create organic posts and tweets from each respective school on Facebook/Twitter recognizing Indiana 811 day. Contractor will add the logo on the cover of the Digital Gameday Program. The Digital Gameday Program will include one full page ad. Two additional (2) :30 second radio spots on the IU Radio Network One additional (1) :10 second live read during the broadcast. One (1) two-minute interview during the halftime radio show. Logo recognition on social media that is promoting the game.
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY HEALTH DEPARTMENT Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorHealth By: By: Title: Xxx Xxxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of President Vanderburgh CounTtityle:Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx Holw erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAttachment A: Scope of Work Safety PIN Vanderburgh County Health Department January 1, 2022- December 31, 2023 Description of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient NotificationWork: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. ThereforeVanderburgh County Health Department (VCHD) will continue to deliver their Pre to 3 home visiting program for parents and families starting with pregnancy (first trimester) to the child’s 3rd birthday in the southwest region in Vanderburgh, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative RequirementsGibson, Cost PrinciplesPosey, and Audit RequirementsXxxxxxx Counties. Pre to 3 staff will provide weekly home visits and the evidenced-based Growing Great Kids (GGK) curriculum. The updated GGK curricula, Next Generation will launch in January, which focuses on secure attachment relationships and developmentally enriched, empathic parenting that supports family stress reduction and builds protective buffers in children. A client intake assessment includes a review of home safety, Adverse Childhood Experiences (ACEs), ASQ-3 and ASQ SE for physical and social-emotional development, interpersonal violence, depression (prenatally and postnatally), social determinants of health and preeclampsia. Services that will be provided include nurse support visits, health care access through referrals, lactation counseling, postpartum screenings, safe sleep classes and car seat checks, and connections to other services. Pre to 3 uses the evidence-based GGK curriculum and client access is not limited by typical factors. Clients will be encouraged to remain actively engaged in the program for at least 90 days because previous data shows 90 day participation supports retention. After 30 days of no-contact and four CHW attempts to connect, clients receive a letter to notify enrollment has terminated. Goals & Objectives: Goal 1: Strengthen and expand the Vanderburgh County Health Department Pre -to 3 program capacity, reach and delivery. Objective 1: Establish an advisory board that is culturally, demographically, and geographically representative of the Pre to 3 target population. Objective 2: Implement a process to regularly share program information and progress with Pre to 3 partners and stakeholders.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness WhereofIN WITNESS to their agreement, the Grantee persons signing this lease execute it for the Landlord and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Tenant: Landlord: Tenant: By: BDE FARMS LLC Indiana Family & and Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Disability and Rehabilitative Services By: Printed Name: Xxxx Xxxxxxx Title: Director of DDRS Date: 11/22/2022 | 11:37 16:10 CST Date: 11/28/2022 | 19:58 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department A LEGAL DESCRIPTION State Parcel Number 42-12-28-309-001.000-022 Parcel Number 42-12-28-309-001.000-022 Map Number 02-201.2C0-89100001 Routing Number MAP 3 OF 39 Legal Description CLDA Pt Lots 89 EXHIBIT B FLOOR PLAN EXHIBIT C LANDLORD'S WORK LETTER Landlord shall provide, at Xxxxxxxx’s sole cost and expense, improvements and renovations to the Leased Premises according to Xxxxxx’s exact standards and specifications (“turnkey”) and in accordance with this Work Letter. All building materials must be new. Selection of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) colors will be made by Tenant. No substitutions for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded items listed below will be permitted unless they are pre-approved by the Tenant or its representative prior to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351installation. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost PrinciplesUnauthorized substitutions will not be accepted, and Audit Requirements)the Landlord will be required to replace with the appropriate item(s) listed below at their own expense prior to delivery to Tenant. Landlord to provide construction documents, including elevations for all millwork, to Tenant for review, comment, and approval prior to submittal for permits and build-out. Until construction documents are reviewed, final specifications and layout are not confirmed and subject to change. Construction documents to be sent to Tenant for review/comment/approval within 30 days of a fully executed lease. Tenant to provide any approvals/comments/changes to the construction documents within 10 business days of receipt. Based on the plan in Exhibit B, in addition to a white box, general layout of the space to include: General layout: • Lobby to seat 4 to 6 customers • Built in reception area to seat receptionist – this is to be a room that is of the lobby similar to a doctor’s office. The receptionists will sit at an opening with glass. Xxxxx to have two speaking holes and two pass throughs for paper. Reception counter to be built in and have a counter at seating height for the receptionists to sit and work and a transaction top on the customer side at standing height. Counter to be ADA compliant on customer side. Counter to have grommet holes and grommets. • Reception area and back office to be secured from lobby • Conference room • 4 Meeting Rooms • One private office • Open area for 4 to 5 workstations • IT room • Storage room • Restrooms – Must have an employee restroom in back of space. Can be unisex. Need to have public restroom and prefer it to be in the lobby or closer to the lobby. • Break room – Approx. 15x15 with upper and lower cabinets, full size sink, refrigerator, and microwave • Landlord to install signage on building facade based on artwork provided by Tenant. This to be created and installed by the landlord. Sign to go over the entrance to the DFR space. Any permits/fees necessary to install to be obtained/paid by Landlord. All finishes, power, data conduit to be confirmed once a plan is provided. Landlord is responsible for all power needs throughout the space including 3 20 AMP dedicated circuits for printers and server equipment. Landlord to run conduit for data but Tenant will run its own wiring. Tenant requires carpet squares, LVT for hard surface flooring, vinyl cove base, and laminate counters and cabinets. All HVAC, lighting, ceiling tiles/grid, electrical systems, plumbing, to be in place and in good working condition.
Appears in 1 contract
Samples: contracts.idoa.in.gov
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana na Family & Social By: Coordinated Care Corporation India Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By: Title: CEO Title: Medicaid director Date: 12/1/2022 | 11:37 16:56 CST Date: 12/2/2022 | 09:19 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.B. SCOPE OF WORK Table of Contents 1.0 Background 11 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 20 2.6 Disclosures 20 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Party in Interest 20
Appears in 1 contract
Samples: Contract
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe VANDERBURGH COUNTY HEALTH DEPARTMENT Indiana Department of Health By: By: Title: President, Vanderburgh County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST CommissioneTritsle: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyATTACHMENT A CARES ACT CORONAVIRUS RELIEF FUND & EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES September 1st, 2020 – June 30th, 2021 GRANT INFO: Epidemiology and Laboratory Capacity for Infection Diseases CFDA #93.323 & CARES Act Coronavirus Relief Fund CFDA #21.019 In INTRODUCTION Process The Division of Emergency Preparedness (DEP) and Epidemiology Resource Center (ERC) within the Indiana State Department of Health (ISDH) are responsible for administering the Epidemiology and Human Services CFDA Number: 93.747 Award Name: Laboratory Capacity Control of Emerging Infectious Diseases (APC6ELC) American Rescue Plan Grant received from the Centers for Disease Control and Prevention (ARPCDC) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded support COVID-19 response activities. A portion of this grant involves expanding testing capacity through community-based options. Access to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% Rlocal testing is critical to Indiana’s response to the COVID-19/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee SARS-CoV-2 pandemic response and through this grant ISDH is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351enabling local health departments to engage local communities and partners in COVID-19 testing. ThereforeAdditionally, the Grantee shall arrange State of Indiana has designated $12.5M from the COVID-19 CARES Act Coronavirus Relief Fund for a financial the first year of LHD clinic funding. The ISDH-DEP administers these funds through sub-recipient agreements which require locally operated testing activities aimed at enhancing local COVID-19 testing. These agreements include supplies and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required funding provided by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements)ISDH.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies, Inc. Indiana Family & Social Services Administration By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy & Planning By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Date:\d112\/10/2020 | 11:37 13:20 EST Title:\tD3e\ puty DirectorTitle:\t2M\edicaid director Date:\d122\/10/2020 | 13:29 EST Electronically Approved by: (if applicable) Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).5.M CAPITATION RATES Hoosier Care Connect Capitation Rates
Appears in 1 contract
Samples: Contract #0000000000000000000018225
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementGrant. The parties, having read and understood the foregoing terms of this Grant AgreementGrant, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney %%VENDOR_NAME%% Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorUtility Regulatory Commission By:___________________________ __________________________________ Xxxxx X. Xxxxxx _____________________________ Name and Title, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Printed Date:_________________________ Date:_____________________________ Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxx X. XxxxxxxXxxxxx, Director Electronically Refer to Electronic Approval History found after the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General Bypursuant to IC 4-13-2-14.3(e) on July 2, 2020. FA 20-35 Attach text of Exhibits A and B, Grant Application, here. Update PDF footer to include page numbers, centered and formatted as: Page X of Y. Remove these instruction from final draft. EXHIBIT C -- Annual Financial Report for Non-governmental Entities Guidelines for filing the annual financial report: Filing an annual financial report called an Entity Annual Report (forE-1) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions IC 5-11-1-4. This is done through Gateway which is an on-line electronic submission process. There is no filing fee to do this. This is in addition to the similarly titled Business Entity Report required by the Indiana Secretary of 45 C.F.R. 75 (Uniform Administrative RequirementsState. The E-1 electronical submission site is found at xxxxx://xxxxxxx.xxxxxxxxx.xxx/login.aspx The Gateway User Guide is found at xxxxx://xxxxxxx.xxxxxxxxx.xxx/userguides/E1guide The State Board of Accounts may request documentation to support the information presented on the E-1. Login credentials for filing the E-1 and additional information can be obtained using the xxxxxxxxxxxx@xxxx.xx.xxx email address. A tutorial on completing Form E-1 online is available at xxxxx://xxx.xxxxxxx.xxx/watch?time_continue=87&v=nPpgtPcdUcs Based on the level of government financial assistance received, Cost Principles, and Audit Requirements)an audit may be required by IC 5-11-1-9.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY HEALTH DEPARTMENT Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorHealth By: By: Title: Xxxxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of President Xxxxxxxxxxx CoTuitnlet:y Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAttachment A: Scope of Work 10/1/2023-9/30/2025 $150,000.00 Vanderburgh County Health Department Funded from Safety Pin Indiana Department of Health Health, Division of Fatality Review and Human Services CFDA NumberPrevention Description of Work: 93.747 Award Name: In Process The Fetal and Infant Mortality Review (APC6FIMR) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Program is dedicated to reviewing fetal and infant mortality cases in each proposed County to identify service gaps across the spectrum of prenatal, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee perinatal, postpartum, and pediatric care and develop creative prevention strategies aimed at improving collaboration of care and overall health of women, infants, and families. This is a “subrecipient” two-tiered multidisciplinary team process. The Case Review Team (CRT) reviews de- identified maternal and infant records and interview information for all fetal and infant deaths (20 weeks gestation up to one year) and use this information to recognize trends and make recommendations for prevention initiatives or systems gap changes. These findings become recommendations that are then brought to the Community Action Team (CAT) who develop action plans and strategies to implement change throughout the community and healthcare systems. Both teams should aim to meet on a quarterly basis but shall meet monthly depending on case load. The FIMR Process includes the following: • Selection of cases based on the infant mortality issues of the community • Collection of appropriate records from medical, social service and other providers • Maternal interview • Abstraction of available records to produce a de-identified case summary • Presentation of de-identified case summary to case review team • Development of data-driven recommendations • Implementation of recommendations to prevent future deaths The classic FIMR includes two components: a case review team (CRT) and a community action team (CAT). • CRT — reviews case summaries and develops recommendations o Diversity and community involvement in the CRT is key o CRT members should have influence and commitment to improve services o CRT members should use person-first language and not place blame on providers, agencies, or families o Members should be those who provide services for families as defined under 45 C.F.R. 75.2 of federal grant funds well as described by 45 C.F.R. 75.75.351community advocates. ThereforeRecommended professionals include: representatives from local health department, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative RequirementsOB/GYN, Cost PrinciplesPediatricians, social services, Medicaid, WIC, minority advocacy, child care providers, drug treatment centers, and Audit Requirements).hospital administrators or other medical professionals • CAT — reviews the recommendations presented by the CRT and develops a plan to implement these interventions o Existing community groups can serve as the CAT, rather than creating a new team, if possible. o The CAT coordinates their plan with the CRT and shares their interventions. Goals & Objectives: In
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Printed Name: Printed Name: Title: Date: Executive Director 11/7/2022 | 11:37 18:01 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Title: Date: Chairman 11/15/2022 | 19:43 15:35 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST _ Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon April 4, Attorney General 2022 FA 22- 20 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana na Family & Social By: Anthem insurance Companies Inc. India Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By: Title: President, Anthem IN Medicaid Title: Medicaid director Date: 11/27/2022 | 11:37 14:52 PST Date: 11/27/2022 | 21:02 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.B. SCOPE OF WORK Table of Contents 1.0 Background 11 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 20 2.6 Disclosures 20 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Party in Interest 20
Appears in 1 contract
Samples: Contract #0000000000000000000051705
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUS TOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance d.b.a Anthem Blue Companies, Inc., Cross and Blue Shield Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid and Policy Planning By: By: Title: President, Anthem IN Medicaid Title: Medicaid director Date: 12/29/2022 | 11:37 10:20 PST Date: 12/29/2022 | 15:16 EST Title:\tD3e\ puty DirectorElectronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting SCOPE OF WORK – HEALTHY INDIANA PLAN Table of Contents 1.0 Background 32 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health 33 2.1 State Licensure and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Compliance with Applicable Laws, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost PrinciplesRules, and Audit Requirements).Regulations 33 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Administrative and Organizational Structure 34 2.3.1 Staffing 35 2.3.2 Key Staff 35 2.3.3 Other Required Staff Positions 41 2.3.4 Suggested Staff Positions 43 2.3.5 Staff Training and Qualifications 44 2.3.6 Debarred Individuals 45 2.4 FSSA Meeting Requirements 46 2.5 Financial Stability 47 2.5.1 Solvency 47 2.5.2 Insurance Requirements 47 2.5.3 Reinsurance 48 2.5.4 Financial Accounting Requirements 49 2.5.5 Reporting Transactions with Parties of Interest 50 2.5.6 Medical Loss Ratio 52 2.5.7 Reserved 53 2.6 Subcontracts 53
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000069649
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCTS.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney United Healthcare Insurance Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1C\EO, Indiana M&R Title:\t2M\edicaid director Date:\d31/\29/2021 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 09:16 CDT Date:\d32/\29/2021 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 16:16 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And SCOPE OF WORK Table of Contents 1.0 Background 34 2.0 Administrative Requirements 34 2.1 State Licensure 34 2.2 National Committee for Quality Assurance (NCQA) Accreditation 34 2.3 Subcontracts 35 2.4 Financial Stability 37 2.4.1 Solvency 37 2.4.2 Insolvency and Receivership 37 2.4.3 Reinsurance 38 2.4.4 Performance Bond Requirements 39 2.4.5 Financial Accounting Requirements 39 2.4.6 Insurance Requirements 41 2.5 Maintenance of Records 41 2.6 Disclosures 41 2.6.1 Definition of a Party in Interest 41 2.6.2 Types of Transactions Which Must Be Disclosed 42 2.7 Debarred Individuals 42 2.8 Medical Loss Ratio 43 2.9 Health Insurance Providers Fee 44 2.10 Administrative and Organizational Structure 44 2.10.1 Staffing 45 2.10.2 Key Staff 45 2.10.3 Other Required Staff Positions 51 2.10.4 Suggested Staff Positions 51 2.10.5 Staff Training and Qualifications 52 2.11 FSSA Meeting Requirements 54 2.12 Maintenance of Written Policies and Procedures 54 2.13 Participation in Readiness Review 54 2.14 Confidentiality of Member Medical Records and Other Information 55 2.15 Material Change to Operations 55 2.16 Response to State Inquiries & Requests for Information 55 2.17 Dissemination of Information 55 2.18 FSSA Ongoing Monitoring 56 2.19 Future Program Guidance 56 2.20 Dual Eligible Special Needs Plans (D-SNPs) Requirements 56 2.21 Capitation Related to a Vacated Program 57 EXHIBIT 1 SCOPE OF WORK 3.0 Covered Benefits 58 3.1 Self-Referral Services 59 3.2 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services 60 3.3 Emergency Services 61 3.3.1 Emergency Room Services Copayment 62 3.3.2 Post-Stabilization Services 63 3.4 Inpatient Services 64 3.5 Care Conference Coverage 64 3.6 Medication Therapy Management Services 64 3.6.1 Goals of the MTM Program 64 3.6.2 General Requirements 65 3.6.3 Target Members 66 3.6.4 Reporting 66 3.7 Diabetes Supplies Coverage 67 3.8 Drug Coverage 67 3.8.1 Drug Rebates 67 3.8.2 Preferred Drug List Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).68
Appears in 1 contract
Samples: Professional Services Contract Contract #0000000000000000000051704
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Printed Name: Printed Name: Title: Date: Executive Director 2/14/2023 | 11:37 16:54 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Title: Date: Chairman 2/19/2023 | 19:43 15:52 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST _ Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon April 4, Attorney General 2022 FA 22- 20 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Grant Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Grant Agreement to the State of Indiana. I understand that my signing and submitting this Contract Grant Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Grant Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Grant Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Grant Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST VANDERBURGH COUNTY HEALTH INDIANA STATE DEPARTMENT OF HEALTH DEPARTMENT By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. XxxxxxxXxxxx X.Xxxxxx, Director Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Refer to Electronic Approval History found after the final page of the Executed Contract for details. Attachment A-2 Vanderburgh County Health Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: Grant Total $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).56,236.00 Grant Period 1/1/2018 –6/30/2018
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney By:\s1\ CARESOURCE INDIANA INC Indiana Family & and Social Services Administration By:\s1\ Division Administration, Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning By:\s2\ Title:\t1P\resident, Indiana Market Date:\d91/\16/2020 | 11:37 EST Title:\tD3e\ puty Director11:16 EDT Title:\t2M\edicaid director Date:\d92/\22/2020 | 10:00 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxXxxxxx X. Xxxx, Xx., Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).10.J HEALTHY INDIANA PLAN CAPITATION RATES
Appears in 1 contract
Samples: Contract #0000000000000000000018313
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana na Family & Social By: United Healthcare Insurance Company India Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By: Title: Chief Executive Officer Title: Medicaid director Date: 12/1/2022 | 11:37 18:36 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 Date: 12/2/2022 | 19:43 09:23 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 1.B. SCOPE OF WORK Table of Contents 1.0 Background 11 2.0 Administrative Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department 11 2.1 State Licensure 11 2.2 National Committee for Quality Assurance (NCQA) Accreditation 11 2.3 Subcontracts 12 2.4 Financial Stability 15 2.4.1 Solvency 15 2.4.2 Insolvency and Receivership 16 2.4.3 Reinsurance 16 2.4.4 Performance Bond Requirements 17 2.4.5 Financial Accounting Requirements 18 2.4.6 Insurance Requirements 19 2.5 Maintenance of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is Records 20 2.6 Disclosures 20 2.6.1 Definition of a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Party in Interest 20
Appears in 1 contract
Samples: Contract #0000000000000000000051704
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney VANDERBURGH COUNTY HEALTH DEPARTMENT Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorHealth By: By: Title: Xxxx Xxxxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of President Xxxxxxxxxxx XxxxXxxxxxx:Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyATTACHMENT A (Base) PUBLIC HEALTH EMERGENCY PREPAREDNESS BUDGET PERIOD 4 (July 1st, 2022 – June 30th, 2023) GRANT INFO CFDA: 93.069 INTRODUCTION In Process The Division of Emergency Preparedness (DEP) within the Indiana Department of Health (IDOH) is the entity responsible for administering the Public Health Emergency Preparedness (PHEP) grant received from the Centers for Disease Control and Human Services CFDA NumberPrevention (CDC). The IDOH DEP administers these funds through sub-recipient agreements with local health departments which require various activities aimed at enhancing state and local preparedness to better respond to public health and healthcare emergencies. This Attachment explains the minimum preparedness requirements each local health department must complete to remain eligible to receive funding under the agreement. WORKFORCE DEVELOPMENT-PUBLIC HEALTH PREPAREDNESS Each Local Health Department (LHD) must have a designated Preparedness Coordinator and a backup if possible. Preparedness Coordinators will coordinate with LHD leadership to identify department staff that contribute to public health preparedness and response within the department. Identified staff should be encouraged to complete National Incident Management System (NIMS) Independent Study Courses: 93.747 Award Incident Command System (ICS) 700, 800, 100 and 200. In addition, LHD Preparedness Coordinator shall possess an Indiana PSID# along with a FEMA SID# (It is highly encouraged multiple LHD staff obtain as well). ▪ Deliverable(s): o Preparedness Coordinator & Back up (if applicable): Name, Email and 24/7 contact information submitted to District Coordinator including the below information: ▪ Primary Preparedness Coordinator status: Full Time/Part Time (APC6If Part time approx. # hrs. week dedicated to PHEP) American Rescue ▪ Additional job titles that are assigned to the LHD Public Health Preparedness Coordinator o ICS Course completion verification for all applicable LHD staff: ▪ IS Course Transcript: xxxxx://xxxxxxxx.xxxx.xxx/student/residenttranscript.aspx ▪ IDHS PSID #: xxxxx://xxx.xx.xxx/dhs/fire-and-building- safety/public-safety-identification-psid-information/ ▪ FEMA SID#: xxxxx://xxx.xxx.xxx/FEMASID ▪ Due Date: 9/30/2022 RESPONSE ACTIVITIES AND FUTURE IMPROVEMENT PLANNING Preparedness Coordinator in coordination with LHD staff must select three areas of improvement and associated corrective actions identified in their COVID-19 After Action Report (AAR) and Improvement Plan to address and complete. In • Deliverable: LHD will complete and submit reporting template for corrective actions and improvement planning activities conducted during the entire budget period. (IDOH Provided Template by May 1, 2022) ▪ Due Date: 06/30/2023 Process ESF8 JURISDICTIONAL PLANNING CONTACTS Public Health Preparedness Coordinator must maintain a current contact list of ESF8 partners in EMResources. Primary and secondary after hours 24/7 emergency contact information must be entered (*NOTE: LHD Partners not required to maintain accounts) • Deliverable: Ongoing maintenance of ESF-8 partners contact information in EMResource ▪ Due Date: Initial completion due by March 30, 2023 ▪ Must continue to update as necessary throughout grant period LOCAL PUBLIC HEALTH ALL-HAZARDS EMERGENCY OPERATIONS PLAN SHARING Emergency Operation Plan (ARPEOP) Sharing: share completed EOP with local government officials and partners, including private and public community partners to develop and share plans for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded responding to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351and recovering public health emergencies and other disasters or events. Therefore, Local Health Departments must share with their Local Public Health Emergency Operations Plan with their county partners including county emergency management agency for incorporation into the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 County Emergency Operations Plan (Uniform Administrative Requirements, Cost Principles, and Audit RequirementsEOP).
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx00.xxxx.xx.xxx/psp/pa91prd/EMPLOYEE/EMPL/h/?tab=PAPP_GUEST In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant AgreementGrant. The parties, having read and understood the foregoing terms of this Grant AgreementGrant, do by their respective signatures dated below agree to the terms thereof. Tippecanoe XXXXXX COUNTY Indiana Utility Regulatory Commission By: Xxxxx Xxxxxxx ByJ: xxxx X. Xxxxxx Title: Xxxxxx County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorAuditor Title: Chairman Date: March 27, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 2018 Date: 4-13-18 Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxxxxx, Commissioner Refer to Electronic Approval History found after the final page of the Executed Contract for details. Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxx X. XxxxxxxXxxxxx, Director Electronically Refer to Electronic Approval History found after the final page of the Executed Contract for details. Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon August 17, Attorney General EXHIBIT 2017. FA 17-29 Electronic Approval History User ID Approver Name Datetime Description 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/M220610 Xxxxxxx,Xxxx 04/17/2018 9:07:01AM Agency Fiscal Approval 2 S004382 Xxxxxxx,Xxxxxx D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).04/18/2018 4:08:00PM IDOA Legal Approval
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Agreement to the State of Indiana. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Agreement will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTR CTS.GBL In Witness Whereof, the Grantee and the State Parties have, through their duly authorized representatives, entered into this Grant Agreement. The partiesParties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorREMAINDER OF XXXX INTENTIONALLY LEFT BLANK CITY OF FISHERS, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County INDIANA Executed by: Xxxxx Xxxxxxx, Mayor Date: Attest: Xxxxxxxx Xxxx, Clerk Date: CITY OF NOBLESVILLE, INDIANA Executed by: Xxxxx Xxxxxx, Mayor Date: Attest: Xxxxxx Xxxx, Clerk Date: XXXXXXXX COUNTY, INDIANA Executed by: Board of Commissioners By:\s2\ Title:\t2T\ippecanoe of Xxxxxxxx County, Indiana Xxxxxxxxx Xxxxxx, Commissioner Date: Xxxxx Xxxxxxxxx, Commissioner Date: Xxxx Xxxxxxxxxx, Commissioner Date: Attest: Xxxxx X. Xxxxx, County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved Auditor Date: STATE OF INDIANA Indiana Department of Transportation Recommended for approval by: Xxxxx X. Xxxxxx Xxxxxxxxxx District Deputy Commissioner Indiana Department of Transportation Date: Executed By: (FOR) Xxxxxxx Xxxxx, Commissioner Indiana Department of Transportation Date: APPROVALS STATE OF INDIANA Office of Management and Budget By: (FOR) Xxxxxxx X Xxxxxxx, Director Date: _ STATE OF INDIANA Department of Administration By: (forFOR) Xxxxxxx Xxxx erdaXxxxxxxx, Commissioner Electronically Approved byDate: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically _ Approved as to Form and Legality byLegality: Office of the Attorney General By: (forFOR) Xxxxxxxx X X. Xxxxxx Attorney General of Indiana Date: This instrument was prepared for the Indiana Department of Transportation, 000 X. Xxxxxx Xxxxxx, Xxxxxxxxxxxx, XX 00000, by the undersigned attorney. Xxxxxxxx X. Xxxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award NameNo. 21748-36 000 Xxxxx Xxxxxx Xxxxxx Xxxxxxxxxxxx, Xxxxxxx 00000 PHONE: (APC6000) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date000-0000 EMAIL: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29xxxxx@xxxxx.xx.xxx Xxxx Xxxxxxx, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. ThereforeGovernor Xxx XxXxxxxxxx, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Commissioner
Appears in 1 contract
Samples: www.cityofnoblesville.org
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically, I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration «Legal_Name» (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxPrinted Name: S. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», Attorney General EXHIBIT 1 Federal «Contact_State» «Contact_ZIP» «Email» Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyProgram: Department of Health and Human Services CSBG 2021 Statutory Information: 42 U.S.C. § 9901 et. seq CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 1/1/2024 – 9/30/24 Liquidation Deadline9/30/2025 Close out Date (45 days following the close of the grant): 11/15/2025 IHCDA Grant Contact: Xxxx Xxxxxxx, CSBG Manager IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Pursuant to IM No. 61 regarding, CSBG Carryover funds, the Sub-grantee must expend carryover funds during the next federal fiscal year. In order to track the amount of carryover that the Sub- grantee uses, the Sub-grantee must submit a Carryover Report to IHCDA’s Community Programs Analyst by November 2915, 2024, which reflects any balance of the Total Grant Amount not expended as of September 30, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant Any funds as described that are not expended by 45 C.F.R. 75.75.351September 30, 2025, will be recaptured by IHCDA. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Activity Description Amount
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Counsel and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting XXXXXXX XXXXX LLP Office of the Indiana Attorney Indiana Family & Social Services Administration General By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 By:\s2\ Title:\t1F\irm Administrator Title:\tC2\hief Deputy Attorney General Date:\d112\/13/2022 | 11:37 07:57 PST Date:\d122\/13/2022 | 11:01 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Commissioner
Appears in 1 contract
Samples: indianacapitalchronicle.com
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney 811 Outdoors LLC Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Utility Regulatory Commission By: By: Printed Name: Printed Name: Title: Xxxx Xxxxx Title: Chairman Date: 11/3/2022 | 11:37 17:39 PDT Date: 11/10/2022 | 16:47 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST _ Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon April 4, Attorney General 2022 FA 22-20 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Title: Executive Director Title: Chairman Date: 9/13/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 13:29 EDT Date: 9/15/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 16:25 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney GOODWILL INDUSTRIES OF CENTRAL AND Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Health SOUTHERN INDIANA By: By: Title: President and CEO Title: IDOH Chief of Staff Date: 1/25/2023 | 11:37 06:31 PST Date: 1/25/2023 | 18:18 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department ATTACHMENT A Scope of Health Work Goodwill of Central and Human Services CFDA Number: 93.747 Award Name: Southern Indiana Nurse Family Partnership (APC6NFP) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29December 1, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore2022 through June 30, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).2024
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts DatabaseDatabas e: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Underground Plant Protection Service Indiana Utility Regulatory Commission By: By: Title: Executive Director Title: Chairman Date: 5/17/2023 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 15:46 EDT Date: 5/24/2023 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 16:39 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality byLegality: Office of Attorney General Form approval has been granted by the Office of the Attorney General By: (forpursuant to IC 4-13-2-14.3(e) Xxxxxxxx X Xxxxxxon February 23, Attorney General 2023 FA 23-03 EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Underground Plant Protection Account Grant Application Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Information
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. Process I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ In Witness Whereof, the Grantee and the State have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST In VANDERBURGH COUNTY HEALTH INDIANA DEPARTMENT OF HEALTH DEPARTMENT By: By: Title: Title: Date: Date: Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx Xxxxxx X. XxxxxxxXxxxx, Acting State Budget Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Attachment A Indiana Department of Health and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29Immunization Division Local Health Department Grants Vanderburgh County Health Department July 1, 2024 Federal Amount Awarded – June 30, 2025 Vanderburgh County Health Department Local Health Department Immunization Grant Scope of Work The Vanderburgh County Health Department will conduct the following activities: • Promote all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). • Provide direct vaccination services to FSSA: Amount Awarded in accordance with ACIP recommendations to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 all individuals regardless of federal grant funds as described by 45 C.F.R. 75.75.351insurance status to meet the needs of your jurisdiction. Therefore• Conduct school-located vaccination clinics at schools with the lowest vaccination coverage rates for kindergarten and first grade, the Grantee shall arrange for a financial sixth and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principlesseventh grade, and Audit Requirements)12th grade. Schools should be selected by using the data in the School Supplemental Report.
Appears in 1 contract
Samples: Grant Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract to the State of Indiana. I understand that my signing and submitting this Contract in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract and this affirmation. I understand and agree that by electronically signing and submitting this Contract in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/. In Witness Whereof, the Grantee Consultant and the State have, through their duly authorized representatives, entered into this Grant AgreementContract. The parties, parties having read and understood the foregoing terms of this Grant AgreementContract, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney HNTB INDIANA, INC. Indiana Family & Social Services Administration By:\s1\ Division Department of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Transportation By: By: Title: Sr. Vice President Title: Deputy Commissioner Date: 3/24/2022 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 09:50 PDT Date: 3/24/2022 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST 12:53 EDT Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyAPPENDIX "A" Services to be furnished by CONSULTANT: In fulfillment of this Contract, the CONSULTANT shall comply with the requirements of the appropriate regulations and requirements of the Indiana Department of Health Transportation (INDOT or Department) and Human Federal Highway Administration (FHWA). The CONSULTANT shall be responsible for performing the following activities: Task 1 Project Intent Definition Task 2 Environmental Document Preparation Task 3 Topographic Survey Data Collection Task 4 Geotechnical Services CFDA Number: 93.747 Award Name: Task 5 Road Design and Plan Development (APC6including Signing, Lighting and Signal Plan Development, if applicable) American Rescue Task 6 Pavement Design Services Task 7 Right of Way Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% Development • R/D Appropriation: No Indirect Costs: NW Engineering • Title Research • R/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).W Staking Task 8 Public Involvement Services Task 9 Utility Coordination Services Task 10 Construction Phase Services
Appears in 1 contract
Samples: Consulting Contract Contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Anthem Insurance Companies Inc Indiana Family & Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning By:\s2\ Title:\t1P\resident, Anthem IN Medicaid Title:\t2Me\ dicaid director Date:\d51/\14/2021 | 11:37 EST Title:\tD3e\ puty Director12:58 EDT Date:\d52/\14/2021 | 13:21 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting 2.H HEALTHY INDIANA PLAN SCOPE OF WORK TABLE OF CONTENTS 1.0 Background 12 2.0 Managed Care Entity- Contractor Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health 14 2.1 State Licensure 14 2.2 National Committee for Quality Assurance (NCQA) Accreditation 14 2.3 Administrative and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to Organizational Structure 14 2.4 Staffing 15 2.4.1 Key Staff 15 2.4.2 Staff Positions 21 2.4.3 Training 23 2.4.4 Debarred Individuals 24 2.5 FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).OMPP Meeting Requirements 25 2.6 Financial Stability 25 2.6.1 Solvency 25 2.6.2 Insurance 26 2.6.3 Reinsurance 26 2.6.4 Financial Accounting Requirements 27
Appears in 1 contract
Samples: Contract #
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Coordinated Care Corporation Indiana Indiana Family & and Social Services Administration Administration, By:\s1\ Division Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 Medicaid Policy and Planning Title:\tC1E\O Date:6\d/11\/2021 | 11:37 EST Title:\tD3e\ puty Director11:44 CDT Title:\tM2e\ dicaid director By:\s2\ Date:6\d/21\ /2021 | 13:12 EDT Electronically Approved by: Indiana Office of Technology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And 1.E HOOSIER HEALTHWISE SCOPE OF WORK Table of Contents 1.0 Background 9 2.0 Managed Care Entity- Contractor Requirements 10 2.1 State Licensure 10 2.2 National Committee for Quality Assurance (NCQA) Accreditation 10 2.3 Administrative and Organizational Structure 10 2.4 Staffing 11 2.4.1 Key Staff 12 2.4.2 Staff Positions 17 2.4.3 Training 18 2.4.4 Debarred Individuals 19 2.5 OMPP Meeting Requirements 20 2.6 Financial Stability 20 2.6.1 Solvency 20 2.6.2 Insurance 21 2.6.3 Reinsurance 21 2.6.4 Financial Accounting Requirements 22 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 24 2.6.6 Medical Loss Ratio 25 2.6.7 Health Insurance Providers Fee 26 2.7 Subcontracts 27 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November Other Information 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).
Appears in 1 contract
Samples: Contract #0000000000000000000032139
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Amendment by accessing State of Indiana Supplier Portal using the secure password assigned to me and by electronically submitting this Contract Amendment to the State of Indiana. I understand that my signing and submitting this Contract Amendment in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Amendment and this affirmation. I understand and agree that by electronically signing and submitting this Contract Amendment in this fashion I am affirming to the truth of the information contained therein. I understand that this Contract Amendment will not become binding on the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ xxxxx://xx.xxxx.xx.xxx/psp/guest/SUPPLIER/ERP/c/SOI_CUSTOM_APPS.SOI_PUBLIC_CNTRCT S.GBL In Witness Whereof, the Grantee Contractor and the State have, through their duly authorized representatives, entered into this Grant AgreementAmendment. The parties, having read and understood the foregoing terms of this Grant AgreementAmendment, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney CARESOURCE INDIANA INC Indiana Family & and Social Services Administration Administration, Office of Medicaid Policy and Planning By:\s1\ Division By:\s2\ Title:\t1Pr\ esident, Indiana Market Title:\t2Me\ dicaid director Date:\d51/\12/2021 | 14:39 EDT Date:\d52/\12/2021 | 22:51 EDT Electronically Approved by: Indiana Office of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty DirectorTechnology By: (for) Xxxxx X. Xxxxxx, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Chief Information Officer Electronically Approved by: Department of Administration By: (for) Xxxxxxx Xxxx erdaXxxxxx X. Xxxxx, Commissioner Electronically Approved by: State Budget Agency By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form and Legality by: Office of the Attorney General By: (for) Xxxxxxxx X X. Xxxxxx, Attorney General TABLE OF CONTENTS EXHIBIT 1 Federal Funding And 2.H HEALTHY INDIANA PLAN SCOPE OF WORK 1.0 Background 11 2.0 Managed Care Entity- Contractor Requirements 13 2.1 State Licensure 13 2.2 National Committee for Quality Assurance (NCQA) Accreditation 13 2.3 Administrative and Organizational Structure 13 2.4 Staffing 14 2.4.1 Key Staff 14 2.4.2 Staff Positions 20 2.4.3 Training 22 2.4.4 Debarred Individuals 23 2.5 FSSA/OMPP Meeting Requirements 24 2.6 Financial Stability 24 2.6.1 Solvency 24 2.6.2 Insurance 25 2.6.3 Reinsurance 25 2.6.4 Financial Accounting Requirements 26 2.6.5 Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department Transactions with Parties of Interest 28 2.6.6 Medical Loss Ratio 29 2.6.7 Health Insurance Providers Fee 30 2.7 Subcontracts 31 2.8 Confidentiality of Member Medical Records and Human Services CFDA Number: 93.747 Award Name: Other Information 34 2.9 Internet Quorum (APC6IQ) American Rescue Inquires 34 2.10 Material Change 34 2.11 Future Program Guidance 34 2.12 Conflict of Interest 35 2.13 Capitation Related to a Vacated Program 35 3.0 HIP Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 Performance Period: 8/1/21 – 9/30/24 Liquidation Deadline: November 29, 2024 Federal Amount Awarded to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial Design and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Member Eligibility 35 3.1 HIP Plus 35
Appears in 1 contract
Samples: Contract #0000000000000000000018313
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration «Legal_Name» (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxPrinted Name: X. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», Attorney General EXHIBIT 1 Federal «Contact_State» «Contact_ZIP» Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyProgram: Department of Health and Human Services CSBG 2020 Statutory Information: 42 U.S.C. § 9901 et. seq CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 1/1/20221 – 9/30/24 Liquidation Deadline9/30/20232 Close out Date (45 days following the close of the grant): 11/15/20232 IHCDA Grant Contact: November 29Xxxx Xxxxxx-May, 2024 Federal Amount Awarded Community Programs Analyst IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Pursuant to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351IM No. Therefore61 regarding, CSBG Carryover funds, the Grantee shall arrange for Sub-grantee must expend carryover funds during the next federal fiscal year. In order to track the amount of carryover that the Sub-grantee uses, the Sub-grantee must submit a financial and compliance audit Carryover Report to IHCDA’s Community Programs Analyst by November 15, 20221, which reflects any balance of the Total Grant Amount not expended as of September 30, 20221. Any funds that complies with 45 C.F.R. 75.500 etare not expended by September 30, 20232 will be recaptured by IHCDA. seq. if required by applicable provisions Activity Description Amount .1 Administration (Not to Exceed Percentage set forth in Subsection B of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Section 4 of Award Agreement) Actual Costs
Appears in 1 contract
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by«Legal_Name»: Department of Administration (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: Printed Name: X. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number: «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT CARES ACT COVID IMPACT AWARD AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», «Contact_State» «Contact_ZIP» Email Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding Program: CSBG-D CARES Statutory Information: CARES Act, Public Law 116, 136 (for2020) Xxxxxxxx X Xxxxxx, Attorney General EXHIBIT 1 Federal Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal Agency: Department of Health and Human Services CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 9/1/2021 – 9/30/24 Liquidation Deadline8/31/2022 Close out Date (45 days following the close of the grant): 10/15/2022 IHCDA Grant Contact: November 29Xxxxxx Xxxxxx, 2024 Federal Community Programs Analyst IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Any funds that are not expended by August 31, 2022 will be recaptured by IHCDA. Activity Description Amount Awarded .1 Administration (Not to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Exceed Percentage set forth in Subsection B of Section 4 of Award Agreement) Actual Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351. Therefore, the Grantee shall arrange for a financial and compliance audit that complies with 45 C.F.R. 75.500 et. seq. if required by applicable provisions of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).
Appears in 1 contract
Samples: Award Agreement
Agreement to Use Electronic Signatures. I agree, and it is my intent, to sign this Contract Agreement by accessing State of Indiana Supplier Portal using the secure password assigned electronic signature tool in Adobe to me and by electronically submitting submit this Contract Agreement to the State of IndianaIHCDA. I understand that my signing and submitting this Contract Agreement in this fashion is the legal equivalent of having placed my handwritten signature on the submitted Contract Agreement and this affirmation. I understand and agree that by electronically signing and submitting this Contract Agreement in this fashion I am affirming to the truth of the information contained thereintherein and my authority to bind the Subgrantee. I also understand that if I decide not to sign this Contract will not become binding on Agreement electronically I must notify IHCDA so that this Agreement may be re-submitted to me and I may sign it and return it to IHCDA in the State until it has been approved by the Department of Administration, the State Budget Agency, and the Office of the Attorney General, which approvals will be posted on the Active Contracts Database: xxxxx://xxxxxx.xx.xxx/apps/idoa/contractsearch/ traditional manner. In Witness Whereof, the Grantee Sub-grantee and the State IHCDA have, through their duly authorized representatives, entered into this Grant Agreement. The parties, having read and understood the foregoing terms of this Grant Agreement, do by their respective signatures dated below agree to the terms thereof. Tippecanoe County Prosecuting Attorney Indiana Family & Social Services Administration By:\s1\ Division of Aging By:\s3\ Title:\t1T\ippecanoe County Prosecutor Date:\d21/\12/2024 | 11:37 EST Title:\tD3e\ puty Director, Division of Aging Date:\d23/\12/2024 | 19:43 EST Tippecanoe County Board of Commissioners By:\s2\ Title:\t2T\ippecanoe County Commissioner Date:\d22/\12/2024 | 10:02 PST Electronically Approved by: Department of Administration «Legal_Name» (Where Applicable) By: (for) Xxxxxxx Xxxx erda, Commissioner Electronically Approved by: State Budget Agency Attested By: (for) Xxxxxxx X. Xxxxxxx, Director Electronically Approved as to Form Printed Name:«Contact_CEO» «Contact_Last_Name» Title: «Contact_CEO_Title» Date: Indiana Housing and Legality byCommunity Development Authority: Office of the Attorney General By: (for) Xxxxxxxx X XxxxxxPrinted Name: X. Xxxxxx Xxxxxxx Title: Chief of Staff and Chief Operating Officer Date: Grant Number «CS_Award_No_» COMMUNITY SERVICES BLOCK GRANT AWARD AGREEMENT ATTACHMENT A Financial Summary Agency’s Legal Name: «Legal_Name» Agency’s Mailing Address: «Contact_Address1» «Contact_Address2»«Contact_City», Attorney General EXHIBIT 1 Federal «Contact_State» «Contact_ZIP» Agency Grant Contact: «Contact_CEO» «Contact_Last_Name» Funding And Reporting Requirements FEDERAL FUNDING INFORMATION Federal AgencyProgram: Department of Health and Human Services CSBG 2022 Statutory Information: 42 U.S.C. § 9901 et. seq CFDA Number: 93.747 Award Name93.569 IHCDA Grant Number: (APC6) American Rescue Plan (ARP) for APS under SSA Title XX Section 2042(b) Award Date: 8/1/21 «CS_Award_No_» Performance Period: 8/1/21 1/1/2022 – 9/30/24 Liquidation Deadline9/30/2023 Close out Date (45 days following the close of the grant): 11/15/2023 IHCDA Grant Contact: November 29Xxxx Xxxxxxx, 2024 Federal Amount Awarded CSBG Manager IHCDA Phone and Email: 000-000-0000, XXXX@xxxxx.xx.xxx Awarding Official: Xxxxx Xxxx, Executive Director, 00 X. Xxxxxxxx Xxxxxx 000, Xxxxxxxxxxxx, XX, XXxxx@xxxxx.XX.xxx Pursuant to FSSA: Amount Awarded to Grantee: $ 4,754,685.00 $ 28,687.56 Match Requirements: Federal 100% / State 0% R/D Appropriation: No Indirect Costs: N/A Subrecipient Notification: The Grantee is a “subrecipient” as defined under 45 C.F.R. 75.2 of federal grant funds as described by 45 C.F.R. 75.75.351IM No. Therefore61 regarding, CSBG Carryover funds, the Grantee shall arrange for Sub-grantee must expend carryover funds during the next federal fiscal year. In order to track the amount of carryover that the Sub- grantee uses, the Sub-grantee must submit a financial and compliance audit Carryover Report to IHCDA’s Community Programs CSBG Manager by November 15, 2022, which reflects any balance of the Total Grant Amount not expended as of September 30, 2022. Any funds that complies with 45 C.F.R. 75.500 etare not expended by September 30, 2023 will be recaptured by IHCDA. seq. if required by applicable provisions Activity Description Amount .1 Administration (Not to Exceed Percentage set forth in Subsection B of 45 C.F.R. 75 (Uniform Administrative Requirements, Cost Principles, and Audit Requirements).Section 4 of Award Agreement) Actual Costs
Appears in 1 contract