Common use of COST REPORT Clause in Contracts

COST REPORT. 29 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 following: 3 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 business day after the above specified due date that the accurate and complete Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 17 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two and Period 18 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 termination 19 of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable 20 federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract21 Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 22 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 23 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 24 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 25 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 26 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 27 following: 3 28 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 29 business day after the above specified due date that the accurate and complete Cost Report is not 5 30 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 31 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 32 CONTRACTOR. 7 33 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 34 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 35 accurate and complete Cost Report is delivered to ADMINISTRATOR.. 36 // 37 // 10 1 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 2 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 3 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 4 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 5 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 6 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 7 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 8 shall 18 be immediately reimbursed to COUNTY. 19 9 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 10 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 11 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 12 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 13 Cost Report shall be the final financial record for subsequent audits, if any. 24 14 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 15 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 16 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 17 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 18 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 19 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 20 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 21 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 22 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 23 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 24 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 25 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 26 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 27 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 28 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 29 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 30 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 31 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 32 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 33 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 34 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 35 attached to the Cost Report: 10 36 // 37 // 1 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 2 supporting documentation prepared by for the cost report period 12 3 beginning and ending and that, to the best of my 4 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 5 allowable and 14 directly or indirectly related to the services provided and that this Cost 6 Report is a true, 15 correct, and complete statement from the books and records of 7 (provider name) in 16 accordance with applicable instructions, except as noted. I also 8 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 9 10 Signed 20 11 Name 21 12 Title 22 13 Date " 2314

COST REPORT. 29 7 A. CONTRACTOR shall submit separate Cost Reports for each Period, Period or for a portion thereof, to 30 8 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 9 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 10 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 11 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 12 services, and funding sources in accordance with such requirements and consistent with prudent business 35 13 practice, which costs and allocations shall be supported by source documentation maintained by 36 14 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 15 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 16 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 17 following: 3 18 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 19 business day after the above specified due date that the accurate and complete Cost Report is not 5 20 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 21 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 22 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 23 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 24 and complete Cost Report is delivered to ADMINISTRATOR. 10 25 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 26 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 27 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 28 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 29 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 30 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 COUNTY, 31 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be 32 immediately reimbursed to COUNTY. 19 33 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 34 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 35 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 36 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 37 Cost Report shall be the final financial record for subsequent audits, if any. 24 1 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 2 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 to Exceed as set forth in 3 the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to 4 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 5 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 6 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 7 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 8 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 9 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 10 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 11 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 12 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 13 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 14 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 15 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 16 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 17 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 18 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 19 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 20 payment does not exceed the Aggregate Amount Not To to Exceed of COUNTY. 7 21 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 22 attached to the Cost Report: 10 24 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 25 supporting documentation prepared by for the cost report period 12 26 beginning and ending and that, to the best of my knowledge 13 27 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 28 directly or indirectly related to the services provided and that this Cost Report is a true, 15 29 correct, and complete statement from the books and records of (provider name) in 16 30 accordance with applicable instructions, except as noted. I also hereby certify that I 17 31 have the authority to execute the accompanying Cost Report. 18 19 32 Signed 20 33 Name 21 34 Title 22 35 Date " 2336 // 37 //

COST REPORT. 29 15 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 16 portion thereof, to 30 COUNTY ,Report no later than forty-five sixty (4560) calendar days following the period for which they are 17 prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report Reports in 18 accordance with all 32 applicable federal, state and COUNTY requirements, GAAP county requirements and the Special Provisions Paragraph of this 33 Contractgenerally accepted accounting 19 principles. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 20 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 21 business 35 practice, which costs and allocations shall be supported by source documentation maintained 22 by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 23 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 24 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 25 following: 3 26 a. CONTRACTOR may be assessed a late penalty of five-one hundred dollars ($500100) for each 4 27 business day after the above specified due date that the accurate and complete Cost Report is not 5 28 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The 29 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 30 CONTRACTOR. 7 31 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 32 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 33 Report is delivered to ADMINISTRATORCOUNTYADMINISTRATOR. 10 34 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 35 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 36 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 37 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 1 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 2 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 3 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 4 shall 18 be immediately reimbursed to COUNTY. 19 5 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report 6 submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to 7 CONTRACTOR for that period. .. CONTRACTOR shall document that costs are 22 reasonable and 8 allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report 9 shall be the final financial record for subsequent audits, if any. 24 10 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 11 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed the applicable Maximum Obligation for each 12 period as set forth in the Referenced Contract Provisions on Page 3 of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 13 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY county laws, regulations 14 and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently 15 determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 16 CONTRACTOR to COUNTY in cash, or other authorized form of payment, cash within thirty (30) 31 calendar days of submission of the Cost Report 17 Reports or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to 18 exceed the reimbursement due COUNTY. 33 19 D. If the Cost Report for the period indicates the actual and reimbursable costs of services 20 provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the 21 aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference 22 to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If 23 such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission 24 of the Cost ReportReports, COUNTY may, in addition to any other remedies, reduce any amount 2 owed 25 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 26 E. If the Cost Report for the period indicates the actual and reimbursable costs of services 27 provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the 28 aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the 29 difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTYCOUNTY for the 30 period. 7 31 F. All The Cost Reports Report for each period shall contain the following attestation, which may be typed 32 directly on or 8 attached to the Cost Report: 10 33 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 34 supporting documentation prepared by for the cost report period 12 35 beginning and ending and that, to the best of my 36 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 37 allowable and 14 directly or indirectly related to the services provided and that this Cost 1 Report is a true, 15 correct, and complete statement from the books and records of 2 (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 4 Signed 20 5 Name 21 6 Title 22 7 Date " 23"

COST REPORT. 29 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two, and Period Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 A. CONTRACTOR shall submit a Cost Report to COUNTY no later than sixty (60) calendar days following termination of this Agreement. CONTRACTOR shall prepare the Cost Report in accordance with all applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, services, and funding sources in accordance with such requirements and consistent with prudent business practice, which costs and allocations shall be supported by source documentation maintained by CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 following: 3 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 business day after the above specified due date that the accurate and complete Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. B. The Cost Report shall be the final financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis for final settlement to CONTRACTOR. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23“

COST REPORT. 29 2 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY County no later than forty-five sixty (4560) calendar days 3 following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 4 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions 5 Paragraph of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between 6 programs, cost centers, 34 services, and funding sources in accordance with such requirements and 7 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 8 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 9 reasonable notice. 37 10 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 11 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 12 following: 3 13 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 14 business day after the above specified due date that the accurate and complete Cost Report is not 5 15 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 16 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 17 CONTRACTOR. 7 18 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 19 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 20 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 21 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 22 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 23 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 24 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 25 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 26 CONTRACTOR has not entered into a subsequent or new agreement Contract for any other services with 17 27 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 28 be immediately reimbursed to COUNTY. 19 29 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 30 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 31 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 32 to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if 33 any. 24 34 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 35 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 36 forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 37 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 1 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 2 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 3 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 4 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 5 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 6 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 7 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 8 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 9 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 10 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 11 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 12 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 13 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 14 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 15 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 16 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 17 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 18 attached to the Cost Report: 10 20 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 21 supporting documentation prepared by for the cost report period 12 22 beginning and ending and that, to the best of my 23 knowledge 13 and belief, costs reimbursed through this Contract are reasonable and 24 allowable and 14 directly or indirectly related to the services provided and that this Cost 25 Report is a true, 15 correct, and complete statement from the books and records of 26 (provider name) in 16 accordance with applicable instructions, except as noted. I also 27 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 28 29 Signed 20 30 Name 21 31 Title 22 32 Date " 23"

COST REPORT. 29 7 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY County no later than forty-five sixty (4560) calendar days 8 following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 9 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions 10 Paragraph of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between 11 programs, cost centers, 34 services, and funding sources in accordance with such requirements and 12 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 13 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 14 reasonable notice. 37 15 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 16 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 17 following: 3 18 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 19 business day after the above specified due date that the accurate and complete Cost Report is not 5 20 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 21 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 22 CONTRACTOR. 7 23 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 24 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 25 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 26 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 27 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 28 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 29 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 30 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 31 CONTRACTOR has not entered into a subsequent or new agreement Contract for any other services with 17 32 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 33 be immediately reimbursed to COUNTY. 19 34 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 35 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 36 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 37 to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if 1 any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 232

COST REPORT. 29 2 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 3 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 4 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 5 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of 6 this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 7 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 8 business 35 practice, which costs and allocations shall be supported by source documentation maintained 9 by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. In the 10 event CONTRACTOR has multiple contracts for mental health services that are administered by HCA, 11 consolidation of the individual Cost Reports into a single consolidated Cost Report may be required, as 12 stipulated by ADMINISTRATOR. CONTRACTOR shall submit a consolidated Cost Report to 13 COUNTY no later than five (5) business days following approval by ADMINISTRATOR of all 14 individual Cost Reports to be incorporated into a consolidated Cost Report. 37 15 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 16 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 17 following: 3 18 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 19 business day after the above specified due date that the accurate and complete Cost Report is not 5 20 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 21 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 22 CONTRACTOR. 7 23 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 24 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 25 Report is delivered to ADMINISTRATOR. 10 26 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 27 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 28 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 29 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 30 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 31 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 32 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 33 be immediately reimbursed to COUNTY. 19 34 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report 35 submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to 36 CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and 37 // 1 allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report 2 shall be the final financial record for subsequent audits, if any. 24 3 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 4 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth 5 in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to 6 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 7 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 8 subsequently determined to have been for an unreimbursable a non-reimbursable expenditure or service, shall be 30 repaid by 9 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 10 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 11 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 12 D. If the Cost Report indicates the actual and reimbursable Unless approved by ADMINISTRATOR, costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to that exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this County Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of Rates (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23CCR)

COST REPORT. 29 15 A. CONTRACTOR shall submit separate Cost Reports for each Period, Period or for a portion thereof, to 30 16 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR 17 shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, 18 GAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct 19 and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with 20 such requirements and consistent with prudent business 35 practice, which costs and allocations shall be 21 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 22 ADMINISTRATOR upon reasonable notice. 37 23 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 24 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 25 following: 3 26 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 27 business day after the above specified due date that the accurate and complete Cost Report is not 5 28 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 29 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 30 CONTRACTOR. 7 31 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 32 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 33 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 34 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 35 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 36 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 37 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 1 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 2 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 3 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 4 shall 18 be immediately reimbursed to COUNTY. 19 5 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 6 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 7 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 8 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 9 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 10 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 11 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 12 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 13 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 14 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 15 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 16 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 17 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 18 D. If Unless otherwise approved by ADMINISTRATOR, costs that exceed the Cost Report indicates provisional rate as 19 specified in the actual and reimbursable costs Payments Paragraph of services provided pursuant Exhibit A to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement Agreement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23unreimbursable to

COST REPORT. 29 7 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two and Period 8 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period 9 for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost 10 Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the 11 Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect 12 costs to and between programs, cost centers, 34 services, and funding sources in accordance with such 13 requirements and consistent with prudent business 35 practice, which costs and allocations shall be 14 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 15 ADMINISTRATOR upon reasonable notice. 37 16 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 17 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 18 following: 3 19 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 20 business day after the above specified due date that the accurate and complete Cost Report is not 5 21 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 22 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 23 CONTRACTOR. 7 24 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 25 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 26 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 27 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 28 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 29 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 30 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 31 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 32 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 33 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during may be assessed a late penalty of $500 dollars for each business day after 34 the term above specified due date that an accurate and complete Cost Report is not submitted. No more than 35 $100,000 shall be assessed per Cost Report. Imposition of the Contract late penalty shall 18 be immediately reimbursed to COUNTYat the sole discretion 36 of the ADMINISTRATOR. The late penalty shall be assessed separately on each outstanding Cost 37 Report due the COUNTY by CONTRACTOR. 19 1 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 2 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 3 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 4 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 5 Cost Report shall be the final financial record for subsequent audits, if any. 24 6 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 7 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 8 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 9 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 10 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 11 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 12 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 13 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 14 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 15 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 16 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 17 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 18 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 19 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 20 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 21 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 22 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 23 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 24 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 25 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 26 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 27 attached to the Cost Report: 10 28 29 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 30 supporting documentation prepared by for the cost report period 12 31 beginning and ending and that, to the best of my 32 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 33 allowable and 14 directly or indirectly related to the services provided and that this Cost 34 Report is a true, 15 correct, and complete statement from the books and records of 35 (provider name) in 16 accordance with applicable instructions, except as noted. I also 36 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 37 // 1 Signed 20 2 Name 21 3 Title 22 4 Date " 235

COST REPORT. 29 17 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 18 following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance 19 with all 32 applicable federal, state and COUNTY requirements, GAAP county requirements and the Special Provisions Paragraph of this 33 Contractgenerally accepted accounting principles. 20 CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, 21 and funding sources in accordance with such requirements and consistent with prudent business 35 22 practice, which costs and allocations shall be supported by source documentation maintained by 36 23 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 24 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 25 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 26 following: 3 27 a. CONTRACTOR may be assessed a late penalty of five-one hundred dollars ($500100) for each 4 28 business day after the above specified due date that the accurate and complete Cost Report is not 5 29 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 30 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 31 CONTRACTOR. 7 32 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 33 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 34 Report is delivered to ADMINISTRATOR. 10 35 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 36 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 37 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 5 shall 18 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 7 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 8 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 9 to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if 10 any. 24 11 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 12 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in the Referenced Contract Provisions 13 on Page 3 of this ContractAgreement for state, Medi-Cal, and federal Block Grant Services; provided, however, 14 ADMINISTRATOR may modify the state Maximum Obligation and the Medi-Cal Maximum 15 Obligation in accordance with the Maximum Obligation paragraph of this Agreement. CONTRACTOR 16 shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, 17 state and 28 COUNTY county laws, regulations and requirements. Any payment made by COUNTY to 18 CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or 19 service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, 20 within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any 21 amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable 22 X. Xxxxxx approved by ADMINISTRATOR, costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not that exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23State Maximum Allowance per

COST REPORT. 29 1177 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 1188 1199 2200 2211 2222 2233 2244 2255 2266 2277 2288 portion thereof, ,Report to 30 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY countyCOUNTY requirements, GAAP generally accepted accounting principlesGAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 following:: 2299 3300 3311 3322 3333 3344 3355 3366 3377 3 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 business day after the above specified due date that the accurate and complete Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 315 of 3539 11 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 22 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 16 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five (45) calendar 17 days following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 18 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph 19 of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 20 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 21 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 22 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 23 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 24 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 25 following: 3 26 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 27 business day after the above specified due date that the accurate and complete Cost Report is not 5 28 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 29 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 30 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 31 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 32 and complete Cost Report is delivered to ADMINISTRATOR. 10 33 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 34 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 35 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 36 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 37 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 1 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 COUNTY, 2 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY.be 19 4 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 5 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 6 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 7 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 8 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 9 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as 10 set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 11 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 12 laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 13 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 14 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 15 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 16 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 17 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 18 attached to the Cost Report: 10 20 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 21 supporting documentation prepared by for the cost report period 12 22 beginning and ending and that, to the best of my knowledge 13 23 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 24 directly or indirectly related to the services provided and that this Cost Report is a true, 15 25 correct, and complete statement from the books and records of (provider name) in 16 26 accordance with applicable instructions, except as noted. I also hereby certify that I 17 27 have the authority to execute the accompanying Cost Report. 18 19 28 29 Signed 20 30 Name 21 31 Title 22 32 Date " 2333

COST REPORT. 27 CONTRACTOR shall exercise reasonable care and diligence to prevent any actions or conditions 28 that could result in a conflict with COUNTY interests. In addition to CONTRACTOR, this obligation 29 shall apply to CONTRACTOR’s employees, agents, and subcontractors associated with the provision of 30 goods and services provided under this Agreement. CONTRACTOR’s efforts shall include, but not be 31 limited to establishing rules and procedures preventing its employees, agents, and subcontractors from 32 providing or offering gifts, entertainment, payments, loans or other considerations which could be 33 deemed to influence or appear to influence COUNTY staff or elected officers in the performance of 34 their duties. 35 // 36 // 37 // 2 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 3 portion thereof, ,a Cost Report to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period 4 for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the 5 individual and/or consolidated Cost Report in accordance with all 32 applicable federal, state and 6 COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 ContractAgreement. 7 CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, 8 and funding sources in accordance with such requirements and consistent with prudent business 35 9 practice, which costs and allocations shall be supported by source documentation maintained by 36 10 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. In the event 11 CONTRACTOR has multiple Agreements for mental health services that are administered by HCA, 12 consolidation of the individual Cost Reports into a single consolidated Cost Report may be required, as 13 stipulated by ADMINISTRATOR. CONTRACTOR shall submit a consolidated Cost Report to 14 COUNTY no later than five (5) business days following approval by ADMINISTRATOR of all 15 individual Cost Reports to be incorporated into a consolidated Cost Report. 37 16 1. If CONTRACTOR fails to submit an accurate and complete individual and/or consolidated 17 Cost Report within the time 1 period specified above, ADMINISTRATOR shall have sole discretion to 18 impose one or both of the 2 following: 3 19 a. CONTRACTOR may be assessed a late penalty of five-hundred five -hundred dollars ($500) for 20 each 4 business day after the above specified due date that the accurate and complete Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23and/or

COST REPORT. 29 17 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two and Period 18 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 termination 19 of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable 20 federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract21 Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 22 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 23 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 24 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 25 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 26 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 27 following: 3 28 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 29 business day after the above specified due date that the accurate and complete Cost Report is not 5 30 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 31 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 32 CONTRACTOR. 7 33 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 34 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 35 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 . 36 // 37 // 1 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 2 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 3 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 2 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 3 following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance 4 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions 5 Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and between 6 programs, cost centers, 34 services, and funding sources in accordance with such requirements and 7 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 8 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 9 reasonable notice. 37 10 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 11 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 12 following: 3 13 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 14 business day after the above specified due date that the accurate and complete Cost Report is not 5 15 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 16 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 17 CONTRACTOR. 7 18 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 19 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 20 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 21 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 22 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 23 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 24 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 25 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 26 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 27 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 28 shall 18 be immediately reimbursed to COUNTY. 19 29 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 30 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 31 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to 32 be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 33 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 34 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 35 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 36 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 37 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 1 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 2 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 3 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 4 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 5 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 6 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 7 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 8 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 9 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 10 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 11 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 12 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 13 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 14 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 15 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 16 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 17 attached to the Cost Report: 10 18 19 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 20 supporting documentation prepared by for the cost report period 12 21 beginning and ending and that, to the best of my 22 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 23 allowable and 14 directly or indirectly related to the services provided and that this Cost 24 Report is a true, 15 correct, and complete statement from the books and records of 25 (provider name) in 16 accordance with applicable instructions, except as noted. I also 26 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 27 28 Signed 20 29 Name 21 30 Title 22 31 Date " 2332

COST REPORT. 29 18 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two, and Period 19 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period 20 for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost 21 Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the 22 Special Provisions Paragraph of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs 23 to and between programs, cost centers, 34 services, and funding sources in accordance with such 24 requirements and consistent with prudent business 35 practice, which costs and allocations shall be 25 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 26 ADMINISTRATOR upon reasonable notice. 37 27 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 28 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 29 following: 3 30 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 31 business day after the above specified due date that the accurate and complete Cost Report is not 5 32 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 33 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 34 CONTRACTOR. 7 35 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 36 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 37 accurate and complete Cost Report is delivered to ADMINISTRATOR.. DocuSign Envelope ID: EB420B84-A9DF-43A3-AA5C-203CC47B4AED 10 1 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 2 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 3 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 4 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 5 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 6 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 7 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 8 be immediately reimbursed to COUNTY. 19 9 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 10 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 11 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 12 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 13 Cost Report shall be the final financial record for subsequent audits, if any. 24 14 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 15 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 16 forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 17 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 18 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 19 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 20 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 21 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 22 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 23 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 24 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 25 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 26 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 27 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 28 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 29 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 30 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 31 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 32 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 33 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 34 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 35 attached to the Cost Report: 10 36 // 37 // DocuSign Envelope ID: EB420B84-A9DF-43A3-AA5C-203CC47B4AED 1 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 2 supporting documentation prepared by for the cost report period 12 3 beginning and ending and that, to the best of my 4 knowledge 13 and belief, costs reimbursed through this Contract are reasonable and 5 allowable and 14 directly or indirectly related to the services provided and that this Cost 6 Report is a true, 15 correct, and complete statement from the books and records of 7 (provider name) in 16 accordance with applicable instructions, except as noted. I also 8 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 9 10 Signed 20 11 Name 21 12 Title 22 13 Date " 2314

COST REPORT. 29 2 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 3 following the period for which they are prepared or 31 termination of this ContractAgreement. . CONTRACTOR shall prepare the Cost Report in 4 accordance with all 32 applicable federal, state and COUNTY county requirements, GAAP generally accepted accounting 5 principles and the Special Provisions Paragraph SPECIAL PROVISIONS (Article) of this 33 ContractAgreement. CONTRACTOR shall allocate 6 direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in 7 accordance with such requirements and consistent with prudent business 35 practice, which costs and 8 allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at 9 any time to ADMINISTRATOR upon reasonable notice. 37 10 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 11 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 12 following: 3 13 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 14 business day after the above specified due date that the accurate and complete Cost Report is not 5 15 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 16 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 17 CONTRACTOR. 7 18 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 19 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 20 Report is delivered to ADMINISTRATOR. 10 21 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 22 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 23 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 24 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 25 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 26 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 27 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 28 shall 18 be immediately reimbursed to COUNTY. 19 29 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 30 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 31 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 32 to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if 33 any. 24 34 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 35 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 36 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 37 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY county laws, regulations 1 and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently 2 determined to have been for an unreimbursable un-reimbursable expenditure or service, shall be 30 repaid by 3 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 4 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 5 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 6 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 7 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 8 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 9 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 10 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 11 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 12 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 13 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 14 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 15 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 16 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 17 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 18 attached to the Cost Report: 10 20 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 21 supporting documentation prepared by for the cost report period 12 22 beginning and ending and that, to the best of my 23 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 24 allowable and 14 directly or indirectly related to the services provided and that this Cost 25 Report is a true, 15 correct, and complete statement from the books and records of 26 (provider name) in 16 accordance with applicable instructions, except as noted. I also 27 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 28 29 Signed 20 30 Name 21 31 Title 22 32 Date " 2333

COST REPORT. 29 15 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five (45) calendar 16 days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in 17 accordance with all 32 applicable federal, state and COUNTY requirementscounty requirements and , GAAP generally accepted accounting 18 principles. and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate 19 direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in 20 accordance with such requirements and consistent with prudent business 35 practice, which costs and 21 allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at 22 any time to ADMINISTRATOR upon reasonable notice. 37 23 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 24 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 25 following: 3 26 a. CONTRACTOR may be assessed a late penalty of five-onefive hundred dollars ($500100500) 27 for each 4 business day after the above specified due date that the accurate and complete Cost Report is 28 not 5 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The 29 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 30 CONTRACTOR. 7 31 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 32 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 33 Report is delivered to ADMINISTRATOR. 10 34 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 35 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 36 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall 37 extensions be granted for more than seven (7) calendar days. 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract thethis Agreement 5 shall 18 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 7 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 8 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 9 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 10 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 11 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation(s) as set 12 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 13 expenditures to COUNTY COUNTY, which are not reimbursable pursuant to applicable federal, state and 28 COUNTY county 14 laws, regulations regulations, and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 15 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 16 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 17 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 18 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 30 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two and Period 31 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period 32 for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and 33 indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with 34 such requirements and consistent with prudent business 35 practice, which costs and allocations shall be 35 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 36 ADMINISTRATOR upon reasonable notice. In the event CONTRACTOR has multiple Agreements for 37 mental health services that are administered by HCA, consolidation of the individual Cost Reports into a 1 single consolidated Cost Report may be required, as stipulated by ADMINISTRATOR. 2 CONTRACTOR shall submit a consolidated Cost Report to COUNTY no later than five (5) business 3 days following approval by ADMINSTRATOR of all individual Cost Reports to be incorporated into a 4 consolidated Cost Report. 37 5 1. If CONTRACTOR fails to submit an accurate and complete individual and/or consolidated 6 Cost Report within the time 1 period specified above, ADMINISTRATOR shall have sole discretion to 7 impose one or both of the 2 following: 3 8 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 9 business day after the above specified due date that the accurate and complete individual and/or 10 consolidated Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion 11 of the ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding individual 12 and/or consolidated Cost Report due COUNTY by CONTRACTOR. 7 13 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 14 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 15 accurate and complete individual and/or consolidated Cost Report is delivered to ADMINISTRATOR. 10 16 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 17 individual and/or consolidated Cost Report setting forth good cause for justification of the request. 18 Approval of such requests 12 shall be at the sole discretion of ADMINISTRATOR and shall not be 19 unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 20 3. In the event that CONTRACTOR does not submit an accurate and complete individual 21 and/or consolidated Cost Report 15 within one hundred and eighty (180) calendar days following the 22 termination of this ContractAgreement, and 16 CONTRACTOR has not entered into a subsequent or new 23 agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by 24 COUNTY during the term of the Contract Agreement shall 18 be immediately reimbursed to COUNTY. 19 25 B. The individual and/or consolidated individual and/or consolidated Cost Report prepared for 26 each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, 27 and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR 28 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 29 to be provided hereunder. The 23 individual and/or consolidated Cost Report shall be the final financial 30 record for subsequent audits, if any. 24 31 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 32 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 33 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 34 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 35 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 36 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 37 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 1 calendar days of submission of the individual and/or consolidated Cost Report or COUNTY may elect 2 to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due 3 COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable 4 D. Unless approved by ADMINISTRATOR, costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not that exceed the Amount Not To Exceed Statewide Maximum Allowance 5 (SMA) rates per Medi-Cal Unit of COUNTY. 7 F. All Cost Reports Services, as determined by the DHCS, shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23unreimbursable to

COST REPORT. 29 16 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 17 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 18 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 19 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of 20 this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 21 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 22 business 35 practice, which costs and allocations shall be supported by source documentation maintained 23 by 36 CONTRACTORXXXXXXXXXX, and available at any time to ADMINISTRATOR upon reasonable notice. 37 24 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 25 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 26 following: 3 27 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 28 business day after the above specified due date that the accurate and complete Cost Report is not 5 29 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 30 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 31 CONTRACTOR. 7 32 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 33 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 34 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 35 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 36 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 37 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar daysDocuSign Envelope ID: BBC078E7-729B-419E-B12E-7B6CBBE65AEA 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 5 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 7 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 8 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 9 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 10 Cost Report shall be the final financial record for subsequent audits, if any. 24 11 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 12 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 13 forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 14 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 15 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 16 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 17 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 18 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 19 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 20 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 21 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 22 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 23 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 24 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 25 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 26 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 27 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 28 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 29 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 30 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 31 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 32 attached to the Cost Report: 10 33 // 34 // 35 // 36 // 37 // DocuSign Envelope ID: BBC078E7-729B-419E-B12E-7B6CBBE65AEA 1 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 2 supporting documentation prepared by for the cost report period 12 3 beginning and ending and that, to the best of my 4 knowledge 13 and belief, costs reimbursed through this Contract are reasonable and 5 allowable and 14 directly or indirectly related to the services provided and that this Cost 6 Report is a true, 15 correct, and complete statement from the books and records of 7 (provider name) in 16 accordance with applicable instructions, except as noted. I also 8 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 9 10 Signed 20 11 Name 21 12 Title 22 13 Date " 2314

COST REPORT. 29 35 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 36 portion thereof, to 30 COUNTY no later than forty-five (45) calendar days following the period for which 37 they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in 1 accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special 2 Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and 3 between programs, cost centers, 34 services, and funding sources in accordance with such requirements and 4 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 5 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 6 reasonable notice. 37 7 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 8 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 9 following: 3 10 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 11 business day after the above specified due date that the accurate and complete Cost Report is not 5 12 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 13 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 14 CONTRACTOR. 7 15 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 16 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 17 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 18 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 19 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 20 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 21 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 22 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 23 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 24 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 25 shall 18 be immediately reimbursed to COUNTY. 19 26 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 27 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 28 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 29 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 30 Cost Report shall be the final financial record for subsequent audits, if any. 24 31 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 32 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 33 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 34 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 35 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 36 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 37 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 12 of 3234 1 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 2 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 3 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 4 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 5 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 6 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 7 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 8 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 9 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 10 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 11 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 12 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 13 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 14 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 15 attached to the Cost Report: 10 17 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 18 supporting documentation prepared by for the cost report period 12 19 beginning and ending and that, to the best of my 20 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 21 allowable and 14 directly or indirectly related to the services provided and that this Cost 22 Report is a true, 15 correct, and complete statement from the books and records of 23 (provider name) in 16 accordance with applicable instructions, except as noted. I also 24 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 25 26 Signed 20 27 Name 21 28 Title 22 29 Date " 2330

COST REPORT. 29 11 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 12 portion thereof, to 30 COUNTY no later than forty-five (45) calendar days following the period for which they are 13 prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in 14 accordance with all 32 applicable federal, state and COUNTY county requirements, GAAP generally accepted accounting 15 principles and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate 16 direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in 17 accordance with such requirements and consistent with prudent business 35 practice, which costs and 18 allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at 19 any time to ADMINISTRATOR upon reasonable notice. 37 20 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 21 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 22 following: 3 23 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 24 business day after the above specified due date that the accurate and complete Cost Report is not 5 25 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 26 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 27 CONTRACTOR. 7 28 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 29 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 30 Report is delivered to ADMINISTRATOR. 10 31 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 32 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 33 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days34 // 35 // 36 // 37 // 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 // 5 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 6 shall 18 be immediately reimbursed to COUNTY. 19 7 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report 8 submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to 9 CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and 10 allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report 11 shall be the final financial record for subsequent audits, if any. 24 12 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 13 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed the applicable Maximum Obligation for each 14 period as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 15 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 16 county laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 17 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 18 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 19 calendar days of submission of the Cost Report Reports or COUNTY may elect to reduce any amount owed 32 20 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 21 D. If the Cost Report for each period indicates the actual and reimbursable costs of services 22 provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the 23 aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference 24 to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with 25 the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty 26 (30) calendar days after 1 submission of the Cost ReportReports, COUNTY may, in addition to any other 27 remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due 28 COUNTY. 3 29 E. If the Cost Report for each period indicates the actual and reimbursable costs of services 30 provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the 31 aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the 32 difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY.COUNTY for the 33 period. 34 // 35 // 36 // 37 // 7 1 F. All Cost Reports for each period shall contain the following attestation, which may be typed 2 directly on or 8 attached to the Cost Report: 10 4 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 5 supporting documentation prepared by for the cost report period 12 6 beginning and ending and that, to the best of my 7 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 8 allowable and 14 directly or indirectly related to the services provided and that this Cost 9 Report is a true, 15 correct, and complete statement from the books and records of 10 (provider name) in 16 accordance with applicable instructions, except as noted. I also 11 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 12 13 Signed 20 14 Name 21 15 Title 22 16 Date " 2317 18 VII. DEBARMENT AND SUSPENSION CERTIFICATION 19 A. CONTRACTOR certifies that it and its principals: 20 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or 21 voluntarily excluded by any federal department or agency. 22 2. Have not within a three-year period preceding this Agreement been convicted of or had a 23 civil judgment rendered against them for commission of fraud or a criminal offense in connection with 24 obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract 25 under a public transaction; violation of federal or state antitrust statutes or commission of 26 embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or 27 receiving stolen property; 28 3. Are not presently indicted for or otherwise criminally or civilly charged by a federal, state, 29 or local governmental entity with commission of any of the offenses enumerated in Subparagraph A.2. 30 above; 31 4. Have not within a three-year period preceding this Agreement had one or more public 32 transactions (federal, state, or local) terminated for cause or default; 33 5. Shall not knowingly enter into any lower tier covered transaction with a person who is 34 proposed for debarment under federal regulations (i.e., 48 CFR Part 9, Subpart 9.4), debarred, 35 suspended, declared ineligible, or voluntarily excluded from participation in such transaction unless 36 authorized by the State of California; and 37 // 1 6. Shall include without modification, the clause titled “Certification Regarding Debarment, 2 Suspension, Ineligibility, and Voluntary Exclusion Lower Tier Covered Transaction,” (i.e., transactions 3 with sub-grantees and/or contractors) and in all solicitations for lower tier covered transactions in 4 accordance with 2 CFR Part 376.

COST REPORT. 29 7 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period two, and Period 8 Three, or for a portion thereof, to 30 COUNTY no later than forty-five (45) calendar days following the 9 period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the 10 Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the 11 Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect 12 costs to and between programs, cost centers, 34 services, and funding sources in accordance with such 13 requirements and consistent with prudent business 35 practice, which costs and allocations shall be 14 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 15 ADMINISTRATOR upon reasonable notice. 37 16 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 17 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 18 following: 3 19 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 20 business day after the above specified due date that the accurate and complete Cost Report is not 5 21 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 22 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 23 CONTRACTOR. 7 24 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 25 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 26 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 27 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 28 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 29 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 30 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 31 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 32 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 33 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 34 shall 18 be immediately reimbursed to COUNTY. 19 35 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 36 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 37 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 1 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 2 Cost Report shall be the final financial record for subsequent audits, if any. 24 3 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 4 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 5 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 6 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 7 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 8 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 9 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 10 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 11 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 12 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 13 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 14 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 15 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 16 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 17 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 18 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 19 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 20 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 21 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 22 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 23 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 24 attached to the Cost Report: 10 26 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 27 supporting documentation prepared by for the cost report period 12 28 beginning and ending and that, to the best of my 29 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 30 allowable and 14 directly or indirectly related to the services provided and that this Cost 31 Report is a true, 15 correct, and complete statement from the books and records of 32 (provider name) in 16 accordance with applicable instructions, except as noted. I also 33 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 34 35 Signed 20 36 Name 21 37 Title 22 1 Date " 232

COST REPORT. 29 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 30 portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they 31 are prepared or 31 termination of this ContractAgreement. 32 CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY 33 countyCOUNTY requirements, GAAP generally accepted accounting principlesGAAP and the Special 34 Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and 35 between programs, cost centers, 34 services, and funding sources in accordance with such requirements and 36 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 37 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 1 reasonable notice. 37 2 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 3 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 4 following:: 5 // 3 6 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 7 business day after the above specified due date that the accurate and complete Cost Report is not 5 8 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 9 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 10 CONTRACTOR. 7 11 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 12 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 13 Report is delivered to ADMINISTRATOR. 10 14 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 15 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 16 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 17 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 18 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 19 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 20 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 21 shall 18 be immediately reimbursed to COUNTY. 19 22 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 23 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 24 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 25 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 26 Cost Report shall be the final financial record for subsequent audits, if any. 24 27 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 28 less 25 applicable revenues and any late penalty, not to exceed COUNTYthe applicableCOUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation 29 for each period as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR 30 shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, 31 state and 28 COUNTY countyCOUNTY laws, regulations and requirements. Any payment made by COUNTY to 32 CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or 33 service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, 34 within thirty (30) 31 calendar days of submission of the Cost Report ReportsReport or COUNTY may elect to 35 reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due 36 COUNTY. 33 37 D. If the Cost Report for each period indicates the actual and reimbursable costs of services 1 provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the 2 aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference 3 to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with 4 the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty 5 (30) calendar days after 1 submission of the Cost ReportReportsReport, COUNTY may, in addition to any other 6 remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due 7 COUNTY. 3 8 E. If the Cost Report for each period indicates the actual and reimbursable costs of services 9 provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the 10 aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the 11 difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTYCOUNTY for the 12 period. 7 13 F. All Cost Reports for each period shall contain the following attestation, which may be typed 14 directly on or 8 attached to the Cost Report: 10 16 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 17 supporting documentation prepared by for the cost report period 12 18 beginning and ending and that, to the best of my 19 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 20 allowable and 14 directly or indirectly related to the services provided and that this Cost 21 Report is a true, 15 correct, and complete statement from the books and records of 22 (provider name) in 16 accordance with applicable instructions, except as noted. I also 23 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 24 25 Signed 20 26 Name 21 27 Title 22 28 Date " 23"

COST REPORT. 29 15 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 16 following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance 17 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions 18 Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and between 19 programs, cost centers, 34 services, and funding sources in accordance with such requirements and 20 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 21 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 22 reasonable notice. 37 23 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 24 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 25 following: 3 26 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 27 business day after the above specified due date that the accurate and complete Cost Report is not 5 28 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 29 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 30 CONTRACTOR. 7 31 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 32 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 33 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 34 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 35 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 36 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days37 // 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 5 shall 18 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 7 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 8 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 9 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 10 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 11 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 12 forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim 13 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 14 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 15 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 16 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 17 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 18 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 19 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 20 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 21 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 22 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 23 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 24 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 25 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 26 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 27 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 28 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 29 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 30 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 31 attached to the Cost Report: 10 32 // 33 // 34 // 35 // 36 // 37 // 1 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 2 supporting documentation prepared by for the cost report period 12 3 beginning and ending and that, to the best of my 4 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 5 allowable and 14 directly or indirectly related to the services provided and that this Cost 6 Report is a true, 15 correct, and complete statement from the books and records of 7 (provider name) in 16 accordance with applicable instructions, except as noted. I also 8 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 9 10 Signed 20 11 Name 21 12 Title 22 13 Date " 2314

COST REPORT. 29 A. 23 CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 24 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 25 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 26 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of 27 this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 28 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 29 business 35 practice, which costs and allocations shall be supported by source documentation maintained 30 by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 31 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 32 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 33 following: 3 34 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 35 business day after the above specified due date that the accurate and complete Cost Report is not 5 36 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 37 // DocuSign Envelope ID: 82EB619D-7DC3-4671-8EF5-62EFAEB48C02 1 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 2 CONTRACTOR. 7 3 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 4 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 5 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 6 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 7 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 8 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall 9 extensions be granted for more than seven (7) calendar days. 14 10 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 11 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 12 CONTRACTOR has not entered into a subsequent or new agreement Contract for any other services with 17 13 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 14 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 7 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 8 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 9 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 10 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract11 Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 12 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 13 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 14 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 15 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 16 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 17 following: 3 18 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 19 business day after the above specified due date that the accurate and complete Cost Report is not 5 20 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 21 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 22 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 23 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 24 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 25 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 26 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 27 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 28 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 29 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 30 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 31 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 32 shall 18 be immediately reimbursed to COUNTY. 19 33 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 34 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 35 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 36 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 37 Cost Report shall be the final financial record for subsequent audits, if any. 24 1 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 2 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 3 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 4 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 5 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 6 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 7 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 8 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 9 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 10 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 11 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 12 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 13 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 14 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 15 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 16 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 17 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 18 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 19 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 20 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 21 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 22 attached to the Cost Report: 10 24 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 25 supporting documentation prepared by for the cost report period 12 26 beginning and ending and that, to the best of my knowledge 13 27 and belief, costs reimbursed through this Contract Agreement are reasonable and allowable and 14 28 directly or indirectly related to the services provided and that this Cost Report is a true, 15 29 correct, and complete statement from the books and records of (provider name) in 16 30 accordance with applicable instructions, except as noted. I also hereby certify that I 17 31 have the authority to execute the accompanying Cost Report. 18 19 32 33 Signed 20 34 Name 21 35 Title 22 36 Date " 23“ 37 //

COST REPORT. 29 15 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five (45) calendar 16 days following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 17 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph 18 of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 19 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 20 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 21 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 22 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 23 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 24 following: 3 25 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 26 business day after the above specified due date that the accurate and complete Cost Report is not 5 27 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 28 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 29 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 30 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 31 and complete Cost Report is delivered to ADMINISTRATOR. 10 32 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 33 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 34 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 35 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 36 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 37 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 COUNTY, 1 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY.be 19 3 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 4 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 5 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 6 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 7 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 8 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as 9 set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 10 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 11 laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 12 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 13 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 14 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 15 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 16 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 17 attached to the Cost Report: 10 18 19 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 20 supporting documentation prepared by for the cost report period 12 21 beginning and ending and that, to the best of my knowledge 13 22 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 23 directly or indirectly related to the services provided and that this Cost Report is a true, 15 24 correct, and complete statement from the books and records of (provider name) in 16 25 accordance with applicable instructions, except as noted. I also hereby certify that I 17 26 have the authority to execute the accompanying Cost Report. 18 19 27 28 Signed 20 29 Name 21 30 Title 22 31 Date " 2332

COST REPORT. 29 5 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 6 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 7 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 8 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract9 Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 10 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 11 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 12 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 13 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 14 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 15 following: 3 16 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 17 business day after the above specified due date that the accurate and complete Cost Report is not 5 18 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 19 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 20 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 21 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 22 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 23 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 24 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 25 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 26 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 27 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 28 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 29 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 30 shall 18 be immediately reimbursed to COUNTY. 19 31 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 32 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 33 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 34 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 35 Cost Report shall be the final financial record for subsequent audits, if any. 24 36 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 37 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 1 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 2 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 3 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 4 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 5 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 6 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 7 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 8 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 9 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 10 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 11 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 12 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 13 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 14 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 15 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 16 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 17 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 18 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 19 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 20 attached to the Cost Report: 10 22 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 23 supporting documentation prepared by for the cost report period 12 24 beginning and ending and that, to the best of my knowledge 13 25 and belief, costs reimbursed through this Contract Agreement are reasonable and allowable and 14 26 directly or indirectly related to the services provided and that this Cost Report is a true, 15 27 correct, and complete statement from the books and records of (provider name) in 16 28 accordance with applicable instructions, except as noted. I also hereby certify that I 17 29 have the authority to execute the accompanying Cost Report. 18 19 30 31 Signed 20 32 Name 21 33 Title 22 34 Date " 23“ 35 // 36 //

COST REPORT. 29 4 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 5 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 6 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 7 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 Contract8 Agreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 9 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 10 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 11 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 12 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 13 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 14 following: 3 15 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 16 business day after the above specified due date that the accurate and complete Cost Report is not 5 17 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 18 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 19 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 20 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 21 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 22 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 23 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 24 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 25 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 26 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 27 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 28 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 29 shall 18 be immediately reimbursed to COUNTY. 19 30 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 31 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 32 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 33 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 34 Cost Report shall be the final financial record for subsequent audits, if any. 24 35 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 36 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 37 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 1 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 2 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 3 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 4 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 5 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 6 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 7 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 8 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 9 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 10 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 11 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 12 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 13 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 14 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 15 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 16 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 17 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 18 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 19 attached to the Cost Report: 10 20 21 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 22 supporting documentation prepared by for the cost report period 12 23 beginning and ending and that, to the best of my knowledge 13 24 and belief, costs reimbursed through this Contract Agreement are reasonable and allowable and 14 25 directly or indirectly related to the services provided and that this Cost Report is a true, 15 26 correct, and complete statement from the books and records of (provider name) in 16 27 accordance with applicable instructions, except as noted. I also hereby certify that I 17 28 have the authority to execute the accompanying Cost Report. 18 19 29 30 Signed 20 31 Name 21 32 Title 22 33 Date " 23“ 34

COST REPORT. 29 31 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 32 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 33 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 34 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 35 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 36 services, and funding sources in accordance with such requirements and consistent with prudent business 35 37 practice, which costs and allocations shall be supported by source documentation maintained by 36 1 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 2 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 3 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 4 following: 3 5 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 6 business day after the above specified due date that the accurate and complete Cost Report is not 5 7 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 8 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 9 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 10 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 11 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 12 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 13 date of the Cost Report setting forth good cause for justification of the request. Approval of such requests 12 14 shall be at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 15 shall extensions be granted for more than seven (7) calendar days 14 16 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 17 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 18 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 19 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 20 be immediately reimbursed to COUNTY. 19 21 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 22 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 23 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 24 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 25 Cost Report shall be the final financial record for subsequent audits, if any. 24 26 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 27 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 28 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 29 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 30 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 31 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 32 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 33 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 34 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 35 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 36 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 37 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 1 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 2 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 3 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 4 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 5 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 6 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 7 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 8 payment does not exceed the Amount Not To Exceed of COUNTY. 7 9 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 10 attached to the Cost Report: 10 11 12 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 13 supporting documentation prepared by for the cost report period 12 14 beginning and ending and that, to the best of my knowledge 13 15 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 16 directly or indirectly related to the services provided and that this Cost Report is a true, 15 17 correct, and complete statement from the books and records of (provider name) in 16 18 accordance with applicable instructions, except as noted. I also hereby certify that I 17 19 have the authority to execute the accompanying Cost Report. 18 19 20 21 Signed 20 22 Name 21 23 Title 22 24 Date " 2325

COST REPORT. 29 27 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 28 COUNTY no later than forty-five sixty (4560) calendar days following the period for which they are prepared or 31 29 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 30 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of this 33 31 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 32 services, and funding sources in accordance with such requirements and consistent with prudent business 35 33 practice, which costs and allocations shall be supported by source documentation maintained by 36 34 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 35 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 36 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 37 following:: DocuSign Envelope ID: E5AE8BAB-5E7C-4DEB-8DC8-AE5BADE1E241 3 1 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 2 business day after the above specified due date that the accurate and complete Cost Report is not 5 3 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 4 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 5 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 6 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 7 and complete Cost Report is delivered to ADMINISTRATOR. 10 8 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 9 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 10 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 11 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 12 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 13 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 COUNTY, 14 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be 15 immediately reimbursed to COUNTY. 19 16 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 17 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 18 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 19 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 20 Cost Report shall be the final financial record for subsequent audits, if any. 24 21 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 22 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed 23 as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 24 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 25 laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 26 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 27 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 28 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 29 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 30 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 31 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 32 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 33 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 34 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 35 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 36 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY.. 37 // DocuSign Envelope ID: E5AE8BAB-5E7C-4DEB-8DC8-AE5BADE1E241 3 1 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 2 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 3 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 4 payment does not exceed the Aggregate Amount Not To Exceed of COUNTY. 7 5 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 6 attached to the Cost Report: 10 8 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 9 supporting documentation prepared by for the cost report period 12 10 beginning and ending and that, to the best of my knowledge 13 11 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 12 directly or indirectly related to the services provided and that this Cost Report is a true, 15 13 correct, and complete statement from the books and records of (provider name) in 16 14 accordance with applicable instructions, except as noted. I also hereby certify that I 17 15 have the authority to execute the accompanying Cost Report. 16 17 Signed 18 Name 19 Signed Title 20 Name 21 Title 22 Date " 2321

COST REPORT. 29 2 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 3 following termination of this Agreement. CONTRACTOR shall submit a Cost Report to COUNTY no 4 later than sixty (60) calendar days following the period for which they are prepared or 31 termination of this Contract. Agreement.. CONTRACTOR shall 5 prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY county requirements, GAAP 6 generally accepted accounting principles and the Special Provisions Paragraph SPECIAL PROVISIONS (Article) of this 33 ContractAgreement. 7 CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, 8 and funding sources in accordance with such requirements and consistent with prudent business 35 9 practice, which costs and allocations shall be supported by source documentation maintained by 36 10 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 11 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 12 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 13 following: 3 14 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 15 business day after the above specified due date that the accurate and complete Cost Report is not 5 16 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 17 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 18 CONTRACTOR. 7 19 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 20 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 21 Report is delivered to ADMINISTRATOR. 10 22 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 23 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 24 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 25 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 26 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 27 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 28 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 29 shall 18 be immediately reimbursed to COUNTY. 19 30 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 31 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 32 shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services 33 to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if 34 any. 24 35 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 36 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 37 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 1 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY county laws, regulations 2 and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently 3 determined to have been for an unreimbursable unreimbursableun-reimbursable expenditure or service, shall be 30 repaid 4 by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 5 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 6 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 7 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 8 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 9 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 10 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 11 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 12 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 13 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 14 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 15 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 16 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 17 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 18 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 19 attached to the Cost Report: 10 21 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 22 supporting documentation prepared by for the cost report period 12 23 beginning and ending and that, to the best of my 24 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 25 allowable and 14 directly or indirectly related to the services provided and that this Cost 26 Report is a true, 15 correct, and complete statement from the books and records of 27 (provider name) in 16 accordance with applicable instructions, except as noted. I also 28 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 29 30 Signed 20 31 Name 21 32 Title 22 33 Date " 2334

COST REPORT. 29 25 A. CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, ReportsReport to 30 COUNTY no later than forty-forty- 26 five (45) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the 27 Cost Report in accordance with all 32 applicable federal, state and COUNTY countyCOUNTY requirements, GAAP 28 generally accepted accounting principlesGAAP and the Special Provisions Paragraph of this 33 ContractAgreement. 29 CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, 30 and funding sources in accordance with such requirements and consistent with prudent business 35 31 practice, which costs and allocations shall be supported by source documentation maintained by 36 32 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 33 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 34 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 35 following: 3 36 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 37 business day after the above specified due date that the accurate and complete Cost Report is not 5 1 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 2 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 3 CONTRACTOR. 7 4 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 5 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 6 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 7 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 8 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 9 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 10 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 11 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 12 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 13 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract thisthe 14 Agreement shall 18 be immediately reimbursed to COUNTY.. for that period.. 19 15 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 16 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. 17 CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly 18 related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for 19 subsequent audits, if any. 24 20 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 21 less 25 applicable revenues and any late penalty, not to exceed COUNTYthe applicableCOUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum 22 Obligation as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall 23 not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 24 countyCOUNTY laws, regulations and requirements. Any payment made by COUNTY to 25 CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or 26 service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, 27 within thirty (30) 31 calendar days of submission of the Cost Report ReportsReport or COUNTY may elect to 28 reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due 29 COUNTY. 33 30 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 31 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim 32 monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 33 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 34 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 35 after 1 submission of the Cost ReportReportsReport, COUNTY may, in addition to any other remedies, reduce 36 any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 37 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 1 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim 2 monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided 3 such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTYCOUNTY for the period. 7 F. All 4 X. XxxXxx Cost Reports ReportReports shall contain the following attestation, which may be typed directly 5 on or 8 attached to the Cost Report: 10 7 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 8 supporting documentation prepared by for the cost report period 12 9 beginning and ending and that, to the best of my 10 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 11 allowable and 14 directly or indirectly related to the services provided and that this Cost 12 Report is a true, 15 correct, and complete statement from the books and records of 13 (provider name) in 16 accordance with applicable instructions, except as noted. I also 14 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 15 16 Signed 17 Name 18 Title 19 Signed 20 Name 21 Title 22 Date " 2320 //

COST REPORT. 29 2288 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 2299 3300 3311 3322 3333 3344 3355 3366 3377 portion thereof, ,Report to 30 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY countyCOUNTY requirements, GAAP generally accepted accounting principlesGAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 3415 of 3539 11 22 33 44 55 66 77 88 99 1100 1111 1122 1133 1144 1155 1166 1177 1188 1199 2200 2211 2222 2233 2244 2255 2266 2277 2288 2299 3300 3311 3322 3333 3344 3355 3366 3377 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 following: 3 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 business day after the above specified due date that the accurate and complete Cost Report is not 5 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement shall 18 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. .. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTYthe applicableCOUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation for each period as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY countyCOUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report ReportsReport or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report for each period indicates the actual and reimbursable costs of services provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of 3416 of 3539 11 22 33 44 55 66 77 88 99 1100 1111 1122 1133 1144 1155 1166 1177 1188 1199 2200 2211 2222 2233 2244 2255 2266 2277 2288 2299 3300 3311 3322 3333 3344 3355 3366 3377 the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost ReportReportsReport, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report for each period indicates the actual and reimbursable costs of services provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTYCOUNTY for the period. 7 F. All Cost Reports for each period shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23//

COST REPORT. 29 6 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One and Period Two, or for a 7 portion thereof, to 30 COUNTY no later than forty-five (45) calendar days following the period for which they are 8 prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report in 9 accordance with all 32 applicable federal, state and COUNTY county requirements, GAAP generally accepted accounting 10 principles and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate 11 direct and indirect costs to and between programs, cost centers, 34 services, and funding sources in 12 accordance with such requirements and consistent with prudent business 35 practice, which costs and 13 allocations shall be supported by source documentation maintained by 36 CONTRACTOR, and available at 14 any time to ADMINISTRATOR upon reasonable notice. 37 15 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 16 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 17 following: 3 18 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 19 business day after the above specified due date that the accurate and complete Cost Report is not 5 20 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 21 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 22 CONTRACTOR. 7 23 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 24 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 25 Report is delivered to ADMINISTRATOR. 10 26 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 27 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 28 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 29 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 30 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 31 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 32 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 33 shall 18 be immediately reimbursed to COUNTY. 19 34 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report 35 submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to 36 CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and 37 // 1 allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report 2 shall be the final financial record for subsequent audits, if any. 24 3 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 4 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed the applicable Maximum Obligation for each 5 period as set forth in the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 6 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 7 county laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 8 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 9 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 10 calendar days of submission of the Cost Report Reports or COUNTY may elect to reduce any amount owed 32 11 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 12 D. If the Cost Report for each period indicates the actual and reimbursable costs of services 13 provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the 14 aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference 15 to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with 16 the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty 17 (30) calendar days after 1 submission of the Cost ReportReports, COUNTY may, in addition to any other 18 remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due 19 COUNTY. 3 20 E. If the Cost Report for each period indicates the actual and reimbursable costs of services 21 provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the 22 aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the 23 difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY.COUNTY for the 24 period. 25 // 26 // 27 // 28 // 29 // 30 // 31 // 32 // 33 // 34 // 35 // 36 // 37 // 7 1 F. All Cost Reports for each period shall contain the following attestation, which may be typed 2 directly on or 8 attached to the Cost Report: 10 3 4 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 5 supporting documentation prepared by for the cost report period 12 6 beginning and ending and that, to the best of my 7 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 8 allowable and 14 directly or indirectly related to the services provided and that this Cost 9 Report is a true, 15 correct, and complete statement from the books and records of 10 (provider name) in 16 accordance with applicable instructions, except as noted. I also 11 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 12 13 Signed 20 14 Name 21 15 Title 22 16 Date " 2317

COST REPORT. 29 16 A. CONTRACTOR shall submit separate a Cost Reports for each PeriodPeriod One and Period Two, or for a 17 portion thereof, to 30 COUNTY ,Report no later than forty-five sixty (4560) calendar days following the period for which they are 18 prepared or 31 termination of this ContractAgreement. CONTRACTOR shall prepare the Cost Report Reports in 19 accordance with all 32 applicable federal, state and COUNTY requirements, GAAP county requirements and the Special Provisions Paragraph of this 33 Contractgenerally accepted accounting 20 principles. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 21 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 22 business 35 practice, which costs and allocations shall be supported by source documentation maintained 23 by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 24 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 25 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 26 following: 3 27 a. CONTRACTOR may be assessed a late penalty of five-one hundred dollars ($500100) for each 4 28 business day after the above specified due date that the accurate and complete Cost Report is not 5 29 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The 30 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 31 CONTRACTOR. 7 32 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 33 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 accurate and complete Cost 34 Report is delivered to ADMINISTRATORCOUNTYADMINISTRATOR. 10 35 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 36 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 37 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 5 shall 18 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report 7 submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to 8 CONTRACTOR for that period. .. CONTRACTOR shall document that costs are 22 reasonable and 9 allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report 10 shall be the final financial record for subsequent audits, if any. 24 11 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 12 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed the applicable Maximum Obligation for each 13 period as set forth in the Referenced Contract Provisions on Page 3 of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 14 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY county laws, regulations 15 and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently 16 determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 17 CONTRACTOR to COUNTY in cash, or other authorized form of payment, cash within thirty (30) 31 calendar days of submission of the Cost Report 18 Reports or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to 19 exceed the reimbursement due COUNTY. 33 20 D. If the Cost Report for the period indicates the actual and reimbursable costs of services 21 provided pursuant to 34 this ContractAgreement, less applicable revenues and late penalty, are lower than the 22 aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference 23 to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If 24 such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission 25 of the Cost ReportReports, COUNTY may, in addition to any other remedies, reduce any amount 2 owed 26 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 27 E. If the Cost Report for the period indicates the actual and reimbursable costs of services 28 provided pursuant to 4 this ContractAgreement, less applicable revenues and late penalty, are higher than the 29 aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the 30 difference, provided such 6 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTYCOUNTY for the 31 period. 7 32 F. All The Cost Reports Report for each period shall contain the following attestation, which may be typed 33 directly on or 8 attached to the Cost Report: 10 34 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 35 supporting documentation prepared by for the cost report period 12 36 beginning and ending and that, to the best of my 37 knowledge 13 and belief, costs reimbursed through this Contract Agreement are reasonable and 1 allowable and 14 directly or indirectly related to the services provided and that this Cost 2 Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also 3 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 5 Signed 20 6 Name 21 7 Title 22 8 Date " 23"

COST REPORT. 29 2 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five (45) calendar 3 days following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 4 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph 5 of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 6 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 7 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 8 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 9 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 10 period specified above, ADMINISTRATOR shall have has sole discretion to impose one or both of the 2 following: 3 11 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 12 business day after the above specified due date that the accurate and complete Cost Report is not 5 13 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 14 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 15 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 16 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 17 and complete Cost Report is delivered to ADMINISTRATOR. 10 18 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 19 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be at 20 the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 21 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 22 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 23 CONTRACTOR has not entered into a subsequent or new agreement Contract for any other services with 17 COUNTY, 24 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract contract shall 18 be 25 immediately reimbursed to COUNTY. 19 26 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 27 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 28 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 29 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 30 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 31 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 32 the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to 33 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 34 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 35 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 36 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 1 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 5 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 6 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 7 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 8 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 9 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 10 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 11 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 12 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 13 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 14 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 15 attached to the Cost Report: 10 17 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting 18 documentation prepared by for the cost report period 12 beginning and 19 ending and that, to the best of my knowledge 13 and belief, costs reimbursed through 20 this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided 21 and that this Cost Report is a true, 15 correct, and complete statement from the books and records of 22 (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify 23 that I 17 have the authority to execute the accompanying Cost Report. 18 19 24 25 Signed 20 26 Name 21 27 Title 22 28 Date " 2329

COST REPORT. 29 16 A. CONTRACTOR shall submit separate Cost Reports for each Period, Period or for a portion thereof, to 30 17 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 termination of this ContractAgreement. CONTRACTOR 18 shall prepare the Cost Report in accordance with all 32 applicable federal, state and COUNTY requirements, 19 GAAP and the Special Provisions Paragraph of this 33 ContractAgreement. CONTRACTOR shall allocate direct 20 and indirect costs to and between programs, cost centers, 34 services, and funding sources in accordance with accordancewith 21 such requirements and consistent with prudent business 35 practice, which costs and allocations shall be 22 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice.to 37 24 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 25 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 26 following: 3 27 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 28 business day after the above specified due date that the accurate and complete Cost Report is not 5 29 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 30 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 31 CONTRACTOR. 7 32 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 33 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 34 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 35 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 36 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 37 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this ContractAgreement, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract Agreement 5 shall 18 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 7 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 8 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 9 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 10 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 11 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set forth in 12 the Referenced Contract Provisions of this ContractAgreement. CONTRACTOR shall not 27 claim expenditures to 13 COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, 14 regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 15 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 16 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 17 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 18 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 19 D. If Unless otherwise approved by ADMINISTRATOR, costs that exceed the Cost Report indicates provisional rate as 20 specified in the actual and reimbursable costs Payments Paragraph of services provided pursuant Exhibit A to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement Agreement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23unreimbursable to

COST REPORT. 29 14 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five (45) calendar 15 days following the period for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance 16 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph 17 of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 18 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 19 business 35 practice, which costs and allocations shall be supported by source documentation maintained by 36 20 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 21 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 22 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 23 following: 3 24 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 25 business day after the above specified due date that the accurate and complete Cost Report is not 5 26 submitted. Imposition of the late penalty shall be at the sole discretion of ADMINISTRATOR. The late 6 27 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by CONTRACTOR. 7 28 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 29 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 accurate 30 and complete Cost Report is delivered to ADMINISTRATOR. 10 31 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 32 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 33 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 34 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 35 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 36 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 COUNTY, 37 then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 be immediately reimbursed to COUNTY.be 19 2 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 3 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR shall 4 document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be 5 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 6 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 7 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as 8 set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 9 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY 10 laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is 11 subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by 12 CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar 13 days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 14 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 15 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 16 attached to the Cost Report: 10 18 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 19 supporting documentation prepared by for the cost report period 12 20 beginning and ending and that, to the best of my knowledge 13 21 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 22 directly or indirectly related to the services provided and that this Cost Report is a true, 15 23 correct, and complete statement from the books and records of (provider name) in 16 24 accordance with applicable instructions, except as noted. I also hereby certify that I 17 25 have the authority to execute the accompanying Cost Report. 18 19 26 27 Signed 20 28 Name 21 29 Title 22 30 Date " 2331

COST REPORT. 29 A. 23 CONTRACTOR shall submit separate Cost Reports for each Period, or for a portion thereof, to 30 24 COUNTY no later than forty-five (45) calendar days following the period for which they are prepared or 31 25 termination of this Contract. CONTRACTOR shall prepare the Cost Report in accordance with all 32 26 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions Paragraph of 27 this 33 Contract. CONTRACTOR shall allocate direct and indirect costs to and between programs, cost 28 centers, 34 services, and funding sources in accordance with such requirements and consistent with prudent 29 business 35 practice, which costs and allocations shall be supported by source documentation maintained 30 by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon reasonable notice. 37 31 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 32 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 33 following: 3 34 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 35 business day after the above specified due date that the accurate and complete Cost Report is not 5 36 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 37 // DocuSign Envelope ID: D712A8FC-B99D-45C6-96F9-F6E1A826A659 1 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 2 CONTRACTOR. 7 3 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 4 pursuant to any or all agreements between COUNTY and CONTRACTOR until such time that the 9 5 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 6 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 7 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 8 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall 9 extensions be granted for more than seven (7) calendar days. 14 10 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 11 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 12 CONTRACTOR has not entered into a subsequent or new agreement Contract for any other services with 17 13 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 14 be immediately reimbursed to COUNTY. 19 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed as set forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 payment does not exceed the Amount Not To Exceed of COUNTY. 7 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 attached to the Cost Report: 10 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and belief, costs reimbursed through this Contract are reasonable and allowable and 14 directly or indirectly related to the services provided and that this Cost Report is a true, 15 correct, and complete statement from the books and records of (provider name) in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 Signed 20 Name 21 Title 22 Date " 23

COST REPORT. 29 18 A. CONTRACTOR shall submit separate Cost Reports for each PeriodPeriod One, Period Two, and Period 19 Three, or for a portion thereof, to 30 COUNTY no later than forty-five sixty (4560) calendar days following the period 20 for which they are prepared or 31 termination of this Contract. CONTRACTOR shall prepare the Cost 21 Report in accordance with all 32 applicable federal, state and COUNTY requirements, GAAP and the 22 Special Provisions Paragraph of this 33 Contract. CONTRACTOR shall allocate direct and indirect costs 23 to and between programs, cost centers, 34 services, and funding sources in accordance with such 24 requirements and consistent with prudent business 35 practice, which costs and allocations shall be 25 supported by source documentation maintained by 36 CONTRACTOR, and available at any time to 26 ADMINISTRATOR upon reasonable notice. 37 27 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 28 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 29 following: 3 30 a. CONTRACTOR may be assessed a late penalty of five-hundred dollars ($500) for each 4 31 business day after the above specified due date that the accurate and complete Cost Report is not 5 32 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 33 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 34 CONTRACTOR. 7 35 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 36 pursuant to any or all agreements contracts between COUNTY and CONTRACTOR until such time that the 9 37 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 1 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 2 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 3 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 4 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 5 within one hundred and eighty (180) calendar days following the termination of this Contract, and 16 6 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 7 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 8 be immediately reimbursed to COUNTY. 19 9 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 10 financial and statistical report submitted by CONTRACTOR to COUNTY, and shall serve as the basis 21 11 for final settlement to CONTRACTOR for that period. CONTRACTOR shall document that costs are 22 12 reasonable and allowable and directly or indirectly related to the services to be provided hereunder. The 23 13 Cost Report shall be the final financial record for subsequent audits, if any. 24 14 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 15 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 16 forth in the Referenced Contract Provisions of this Contract. CONTRACTOR shall not 27 claim 17 expenditures to COUNTY which are not reimbursable pursuant to applicable federal, state and 28 18 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 19 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 20 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 21 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 22 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 23 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 24 this Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 25 payments to CONTRACTOR, CONTRACTOR shall remit the difference to COUNTY. Such 36 26 reimbursement shall be made, in cash, or other authorized form of payment, with the submission of the 37 27 Cost Report. If such reimbursement is not made by CONTRACTOR within thirty (30) calendar days 28 after 1 submission of the Cost Report, COUNTY may, in addition to any other remedies, reduce any 29 amount 2 owed CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 3 30 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 31 this Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 32 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 33 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 34 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 35 attached to the Cost Report: 10 36 // 37 // 1 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 2 supporting documentation prepared by for the cost report period 12 3 beginning and ending and that, to the best of my 4 knowledge 13 and belief, costs reimbursed through this Contract are reasonable and 5 allowable and 14 directly or indirectly related to the services provided and that this Cost 6 Report is a true, 15 correct, and complete statement from the books and records of 7 (provider name) in 16 accordance with applicable instructions, except as noted. I also 8 hereby certify that I 17 have the authority to execute the accompanying Cost Report. 18 19 9 10 Signed 20 11 Name 21 12 Title 22 13 Date " 2314

COST REPORT. 29 16 A. CONTRACTOR shall submit separate a Cost Reports for each Period, or for a portion thereof, Report to 30 COUNTY no later than forty-five sixty (4560) calendar days 17 following the period for which they are prepared or 31 termination of this the Contract. CONTRACTOR shall prepare the Cost Report in accordance 18 with all 32 applicable federal, state and COUNTY requirements, GAAP and the Special Provisions 19 Paragraph of this 33 the Contract. CONTRACTOR shall allocate direct and indirect costs to and between 20 programs, cost centers, 34 services, and funding sources in accordance with such requirements and 21 consistent with prudent business 35 practice, which costs and allocations shall be supported by source 22 documentation maintained by 36 CONTRACTOR, and available at any time to ADMINISTRATOR upon 23 reasonable notice. 37 24 1. If CONTRACTOR fails to submit an accurate and complete Cost Report within the time 1 25 period specified above, ADMINISTRATOR shall have sole discretion to impose one or both of the 2 26 following: 3 27 a. CONTRACTOR may be assessed a late penalty of five-five hundred dollars ($500) for each 4 28 business day after the above specified due date that the accurate and complete Cost Report is not 5 29 submitted. Imposition of the late penalty shall be at the sole discretion of the ADMINISTRATOR. The 30 late 6 penalty shall be assessed separately on each outstanding Cost Report due COUNTY by 31 CONTRACTOR. 7 32 b. ADMINISTRATOR may withhold or delay any or all payments due CONTRACTOR 8 33 pursuant to any or all agreements Contracts between COUNTY and CONTRACTOR until such time that the 9 34 accurate and complete Cost Report is delivered to ADMINISTRATOR. 10 35 2. CONTRACTOR may request, in advance and in writing, an extension of the due 11 date of the 36 Cost Report setting forth good cause for justification of the request. Approval of such requests 12 shall be 37 at the sole discretion of ADMINISTRATOR and shall not be unreasonably denied. In no case 13 shall extensions be granted for more than seven (7) calendar days. 14 1 3. In the event that CONTRACTOR does not submit an accurate and complete Cost Report 15 2 within one hundred and eighty (180) calendar days following the termination of this the Contract, and 16 3 CONTRACTOR has not entered into a subsequent or new agreement contract for any other services with 17 4 COUNTY, then all amounts paid to CONTRACTOR by COUNTY during the term of the Contract shall 18 5 be immediately reimbursed to COUNTY. 19 6 B. The individual and/or consolidated Cost Report prepared for each period shall be the final 20 financial and statistical report submitted by CONTRACTOR 7 to COUNTY, and shall serve as the basis 21 for final settlement to CONTRACTOR for that periodCONTRACTOR. CONTRACTOR 8 shall document that costs are 22 reasonable and allowable reasonable, allowable, and directly or indirectly related to the services to be 9 provided hereunder. The 23 Cost Report shall be the final financial record for subsequent audits, if any. 24 10 C. Final settlement shall be based upon the actual and reimbursable costs for services hereunder, 11 less 25 applicable revenues and any late penalty, not to exceed COUNTY’s Total Aggregate Amount Not To 26 Exceed Maximum Obligation as set 12 forth in the Referenced Contract Provisions of this the Contract. CONTRACTOR shall not 27 claim 13 expenditures to COUNTY COUNTY, which are not reimbursable pursuant to applicable federal, state and 28 14 COUNTY laws, regulations and requirements. Any payment made by COUNTY to CONTRACTOR, 29 15 which is subsequently determined to have been for an unreimbursable expenditure or service, shall be 30 16 repaid by CONTRACTOR to COUNTY in cash, or other authorized form of payment, within thirty (30) 31 17 calendar days of submission of the Cost Report or COUNTY may elect to reduce any amount owed 32 18 CONTRACTOR by an amount not to exceed the reimbursement due COUNTY. 33 19 D. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 34 this 20 the Contract, less applicable revenues and late penalty, are lower than the aggregate of interim monthly 35 payments to CONTRACTOR, 21 CONTRACTOR shall remit the difference to COUNTY. Such 36 reimbursement shall be made, in cash, or 22 other authorized form of payment, with the submission of the 37 Cost Report. If such reimbursement is not 23 made by CONTRACTOR within thirty (30) calendar days after 1 submission of the Cost Report, 24 COUNTY may, in addition to any other remedies, reduce any amount 2 owed CONTRACTOR by an 25 amount not to exceed the reimbursement due COUNTY. 3 26 E. If the Cost Report indicates the actual and reimbursable costs of services provided pursuant to 4 this 27 the Contract, less applicable revenues and late penalty, are higher than the aggregate of interim monthly 5 28 payments to CONTRACTOR, COUNTY shall pay CONTRACTOR the difference, provided such 6 29 payment does not exceed the Amount Not To Exceed Maximum Obligation of COUNTY. 7 30 F. All Cost Reports shall contain the following attestation, which may be typed directly on or 8 31 attached to the Cost Report: 10 32 33 "I HEREBY CERTIFY that I have executed the accompanying Cost Report and 11 34 supporting documentation prepared by for the cost report period 12 beginning and ending and that, to the best of my knowledge 13 and 36 belief, costs reimbursed through this the Contract are reasonable and allowable and 14 37 directly or indirectly related to the services provided and that this Cost Report is a 1 true, 15 correct, and complete statement from the books and records of (provider name) 2 in 16 accordance with applicable instructions, except as noted. I also hereby certify that I 17 3 have the authority to execute the accompanying Cost Report. 18 19 4 5 Signed 20 6 Name 21 7 Title 22 8 Date " 23"