STANDARD AGREEMENT AMENDMENTStandard Agreement • May 2nd, 2019
Contract Type FiledMay 2nd, 2019CONTRACTOR CALIFORNIADepartment of General Services Use Only Contractor’s Name (If other than an individual, state whether a corporation, partnership, etc.) County of Santa Clara By(Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person Signing S. Joseph Simitian, President, Board of Supervisors Address 70 West Hedding Street San Jose, CA 95126 STATE OF CALIFORNIA Agency Name Department of Health Care Services By (Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person SigningDon Rodriguez, Chief, Contract Management Unit Exempt per: DGS memo dated07/10/96 and Welfare and Institutions Code 14087.4 Address 1501 Capitol Avenue, Suite 71.2048, MS 1400, P.O. Box 997413,Sacramento, CA 95899-7413
STANDARD AGREEMENT AMENDMENTStandard Agreement • April 19th, 2019
Contract Type FiledApril 19th, 2019
STANDARD AGREEMENT AMENDMENTStandard Agreement • April 10th, 2019
Contract Type FiledApril 10th, 2019CONTRACTOR CALIFORNIADepartment of General Services Use Only Contractor’s Name (If other than an individual, state whether a corporation, partnership, etc.) County of Yolo By(Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person Signing Oscar Villegas, Chairman of Board of Supervisors Address 137 N. Cottonwood Street, Suite 2500Woodland, CA 95695 STATE OF CALIFORNIA Agency Name Department of Health Care Services By (Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person SigningCarrie Talbot, Chief, Contract Management Unit Exempt per:W&I Code 14087.4 Address 1000 G Street, 4th Floor, MS 4200, P.O. Box 997413, Sacramento, CA 95899-7413
STANDARD AGREEMENTStandard Agreement • April 11th, 2018
Contract Type FiledApril 11th, 2018REGISTRATION NUMBER AGREEMENT NUMBER 17-94092 1. This Agreement is entered into between the State Agency and the Contractor named below: STATE AGENCY'S NAME (Also known as DHCS, CDHS, DHS or the State) Department of Health Care Services CONTRACTOR'S NAME (Also referred to as Contractor) County of Yolo 2. The term of this Agreement is: June 30, 2018 through June 30, 2020 3. The maximum amount of this Agreement is: $ 13,943,284 Thirteen Million, Nine Hundred Forty-Three Thousand, Two Hundred Eighty-Four Dollars 4. The parties agree to comply with the terms and condition of the following exhibits, which are by this reference made a part of this Agreement. Exhibit A – Scope of Work 4 pages Exhibit A, Attachment I – Program Specifications 157 pages Exhibit B – Budget Detail and Payment Provisions 14 pages Exhibit B, Attachment I – Funding Amounts 1 page Exhibit C * – General Terms and Conditions GTC 04/2017 Exhibit D (F) – Specia
STANDARD AGREEMENTStandard Agreement • January 19th, 2018
Contract Type FiledJanuary 19th, 2018Exhibit A, Attachment I- Program Specifications Exhibit B- Budget Detail and Payment Provisions Exhibit B, Attachment I - Funding Amounts Exhibit C * - General Terms and Conditions Exhibit D (F)- Special Terms and Conditions Exhibit E- Additional Provisions
STANDARD AGREEMENT AMENDMENTStandard Agreement • June 29th, 2017
Contract Type FiledJune 29th, 2017CONTRACTOR CALIFORNIADepartment of General Services Use Only Contractor’s Name (If other than an individual, state whether a corporation, partnership, etc.) County of San Mateo By(Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person Signing Louise Rogers, Chief, Health System Address 225 37th AvenueSan Mateo, CA 94403 STATE OF CALIFORNIA Agency Name Department of Health Care Services By (Authorized Signature) Date Signed (Do not type) Printed Name and Title of Person SigningDon Rodriguez, Chief, Contract Management Unit Exempt per: DGS memo dated07/10/96 and Welfare and Institutions Code 14087.4 Address 1501 Capitol Avenue, Suite 71.2048, MS 1400, P.O. Box 997413,Sacramento, CA 95899-7413