Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. Page 4 Revised 20150105 EXHIBIT A SCOPE OF SERVICES July 1, 2022 - June 30, 2023 Purpose and overview: serve children and families with children that are at risk of abuse or neglect through community based, supportive services. The services to be provided by CANAL ALLIANCE (Contractor) ACTIVITIES DELIVERABLES LONG TERM OUTCOMES CHILD ABUSE AND NEGLECT SERVICES Case Management for 20 high risk families Quality and Impact: • Number of families served • Demographic data collected • Number of families completing Program • Services provided • Method of service Family Resource case managers conduct brief interventions and support families with services such as: Making referrals to Center for Domestic Peace for emergency shelter; domestic violence support groups, legal services to file restraining orders and/or custody, housing search, access to emergency financial assistance via the Season of Sharing Fund (depending on availability of funds), public benefits and job search as well as one on one work referring Improved family functioning insuring that children are safe, and their basic needs are met. Families improve their safety stability and are empowered to advocate on their own behalf
Appears in 1 contract
Samples: Professional Services Contract
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. Page 4 Revised 20150105 EXHIBIT A SCOPE OF SERVICES July SERVICE October 1, 2022 - June 30– March 31, 2023 Purpose and overviewContractor: serve children and families with children that are at risk of abuse or neglect through community basedXxxxxx Xxxxxx, supportive services. The services to be provided by CANAL ALLIANCE (Contractor) ACTIVITIES DELIVERABLES LONG TERM OUTCOMES CHILD ABUSE AND NEGLECT SERVICES Case Management for 20 high risk families Quality and ImpactNP Address: • Number of families served • Demographic data collected • Number of families completing Program • Services provided • Method of service Family Resource case managers conduct brief interventions and support families with services such as0000 Xxxxxxx Xxxxx Xxxxx Xxxxxxx, XX 00000 Telephone: Making referrals to Center for Domestic Peace for emergency shelter; domestic violence support groups, legal services to file restraining orders and/or custody, housing search, access to emergency financial assistance via the Season of Sharing Fund (depending on availability of funds), public benefits and job search as well as one on one work referring Improved family functioning insuring that children are safe, and their basic needs are met. Families improve their safety stability and are empowered to advocate on their own behalf000-000-0000 Email: xxxxxx@xxx.xxx
Appears in 1 contract
Samples: Professional Services Contract
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. Page 4 Revised 20150105 EXHIBIT A SCOPE OF SERVICES July 1Contractor: Side by Side (Sunny Hills Services) Contract Services: Therapeutic Behavioral Services (TBS) Executive Director: Xxxx Xxxxxx Clinical Director: Xxxxx Xxxxxxxx Corporate Status: California non-profit corporation with exempt status under Section 501(c)3 of the Internal Revenue Incorporated: June 8, 2022 - June 301895 Tax I.D. Number: 00-0000000 Contractor Address: 0000 Xxxxxx Xxx. Suite C Santa Rosa, 2023 Purpose and overviewCA 95401 Telephone: serve children and families (000) 000-0000 Officers, Board of Directors: President Xxxxxx Xxxxxxx Vice President: Xxxxx Xxxxx Treasurer: Xxx Xxxxx Members of Board: Xxxxxxxxx Xxxxxxx, Xxxx Xxxxxx, Xxxxxxx Xxxxxxx, Xxx Xxxxxxx, Xxxxxx Xxxxxxx, Xxxxxxxxxx Xxxxxxxxx, Xxxxxxxx Xxxxxxx, Xxxxxx Xxxxx, Xxxxx Xxxxxxxxx, Xxxxx Xxxxx, Xxxxx Xxxxx ITEMS APPLICABLE TO SERVICE: Hours of Operation: 24 Hours a Day 7 Days a Week Geographic Area: Residents of Marin County Target Group: Students between the ages of 13-22 with children that are at risk of abuse or neglect through community based, supportive servicesidentified disabilities. The majority of these disabilities have been identified as Emotionally Disturbed (ED). Other student’s disabilities include Other Health Impaired (OHI), and Specific Learning Disability (SLD). Selection for Admission to Service: Upon referral only from Marin County Division of Social Services, Marin County Probation Department, or Marin County Division of Behavioral Health and Recovery Services (BHRS). In the event that the child is referred by an agency other than BHRS, COUNTY shall make no payment for services, and have no obligation to make payment to CONTRACTOR, unless the services to be provided by CANAL ALLIANCE (Contractor) ACTIVITIES DELIVERABLES LONG TERM OUTCOMES CHILD ABUSE AND NEGLECT SERVICES Case Management CONTRACTOR received prior authorization from the BHRS Contract Officer or designee. A child may be approved for 20 high risk families Quality services on the basis of verbal authorization from the COUNTY by mutual consent of the COUNTY and Impact: • Number of families served • Demographic data collected • Number of families completing Program • Services provided • Method of service Family Resource case managers conduct brief interventions and support families with services such as: Making referrals to Center for Domestic Peace for emergency shelter; domestic violence support groups, legal services to file restraining orders and/or custody, housing search, access to emergency financial assistance via the Season of Sharing Fund (depending on availability of funds), public benefits and job search as well as one on one work referring Improved family functioning insuring that children are safe, and their basic needs are met. Families improve their safety stability and are empowered to advocate on their own behalfCONTRACTOR.
Appears in 1 contract
Samples: Professional Services Contract
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. Page 4 Revised 20150105 EXHIBIT A SCOPE OF SERVICES Exhibit A: Scope of Work Community Action Marin Encampment Resolution Funds-2: Xxxxxxxx Xxxxx July 1, 2022 - 2023 – June 30, 2023 2025 Purpose The purpose of Marin County’s Division of Homelessness and overview: serve children and families with children that are at risk Whole Person Care is to improve the wellbeing of abuse or neglect Marin’s homeless population through community evidence-based, supportive servicestrauma-informed practices. The services to be provided included in this scope of work serve as a critical element of the County’s implementation of a unified coordinated entry and care management system by CANAL ALLIANCE (Contractor) ACTIVITIES DELIVERABLES LONG TERM OUTCOMES CHILD ABUSE AND NEGLECT SERVICES Case Management for 20 high risk families Quality and Impact: • Number of families served • Demographic data collected • Number of families completing Program • Services provided • Method of service Family Resource case managers conduct brief interventions and support families with services such as: Making referrals to Center for Domestic Peace for emergency shelter; domestic violence support groupsstandardizing screening, legal services to file restraining orders and/or custody, housing search, access to emergency financial assistance via the Season of Sharing Fund (depending on availability of funds), public benefits and job search as well as one on one work referring Improved family functioning insuring that children are safeassessments, and their basic needs are metcare coordination; and by promoting bi-directional information sharing and care coordination among providers. Families The goal for this systems-level change is new, coordinated, and sustainable approaches that will improve their safety stability and are empowered to advocate on their own behalfoutcomes for people experiencing homelessness in Marin.
Appears in 1 contract
Samples: Professional Services Contract
Exhibit D - Debarment Certification. By signing and submitting this Contract, the Contractor is agreeing to abide by the debarment requirements as set out below. • The certification in this clause is a material representation of fact relied upon by County. • The Contractor shall provide immediate written notice to County if at any time the Contractor learns that its certification was erroneous or has become erroneous by reason of changed circumstances. • Contractor certifies that none of its principals, affiliates, agents, representatives or contractors are excluded, disqualified or ineligible for the award of contracts by any Federal agency and Contractor further certifies to the best of its knowledge and belief, that it and its principals: • Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal Department or Agency; • Have not been convicted within the preceding three-years of any of the offenses listed in 2 CFR 180.800(a) or had a civil judgment rendered against it for one of those offenses within that time period; • Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or Local) with commission of any of the offenses listed in 2 CFR 180.800(a); • Have not had one or more public transactions (Federal, State, or Local) terminated within the preceding three-years for cause or default. • The Contractor agrees by signing this Contract that it will not knowingly enter into any subcontract or covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction. Page 4 Revised 20150105 EXHIBIT A SCOPE OF SERVICES SERVICE July 1, 2022 - 2020 – June 30, 2023 Purpose and overview2021 Contractor: serve children and families with children that are at risk of abuse or neglect through community basedXxxxx Xxxxxxxx D/B/A Amrita Eating Disorder Treatment 00 X. Xxx Xxxxx Xxxx, supportive services. Suite 265 San Rafael, CA 94903 Telephone: 000-000-0000 Email: xxxxxxxxxxxxx@xxxxxxx.xxx SCOPE OF SERVICES AND DUTIES The services to be provided by CANAL ALLIANCE (Contractor and the scope of Contractor) ACTIVITIES DELIVERABLES LONG TERM OUTCOMES CHILD ABUSE AND NEGLECT SERVICES Case Management for 20 high risk families Quality and Impact’s duties include the following: • Number of families served • Demographic data collected • Number of families completing Intensive Outpatient Evening Program • Services provided • Method of service Family Resource case managers conduct brief interventions and support families with services such as: Making referrals to Center for Domestic Peace for emergency shelter; domestic violence support groupsMon-Thurs, legal services to file restraining orders and/or custody, housing search, access to emergency financial assistance via the Season of Sharing Fund (depending on availability of funds), public benefits and job search as well as one on one work referring Improved family functioning insuring that children are safe, and their basic needs are met. Families improve their safety stability and are empowered to advocate on their own behalf5:00-8:00pm Program includes:
Appears in 1 contract
Samples: Professional Services Contract
