HomeMy WebLinkAboutResolution - 2007-R0466 - Contract - SPAG - DADS Pass Through Funds 2007-08 - 10_11_2007Resolution No. 2007-RO466
October 11, 2007
Item No. 5.17
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LU13BOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock, a Contract with the South
Plains Association of Governments (SPAG) for pass through funds from the Texas
Department of Aging and Disability Services for 2007-08 and any associated documents,
a copy of which Contract is attached hereto and which shall be spread upon the minutes
of this Council and as spread upon the minutes of this Council shall constitute and be a
part hereof as if fully copied herein in detail.
Passed by the City Council this llth day of October , 2007.
DAVID A. MILLER, MAYOR
ATTEST:
. A�ZJP �� , -
Rcb cca Garza, City Secretary
APPROVED AS TO CONTENT:
041
Randy Truesdell, Community Services Director
APPROVED AS TO FORM:
r.'
G. Vandiver, Attorney of Council
ddres/SPAGageGrant07-08res
October 1, 2007
.� The South Plains Association of Governments Area Agency
SPAG
Area Agency on Aging 7zon
A,�irzg
VENDOR AGGREENIENT
South Plains Association
of Governments
City of Lubbock hereinafter referred to as Vendor, and provide services
The South Plains Association of Governments Area Agency on Aging (AAA) do hereby agree to
effective beginning October 01, 2007, in accordance with the Older Americans Act of 1965 (OAA), as
amended, Texas Department of Aging and Disability Services (DADS), the AAA Direct Purchase of
Services program and the stated Scope of Services.
The AAA Direct Purchase of Services program is designed to promote the development of a
comprehensive coordinated service delivery system to meet the needs of older individuals (age 60 and
older). This agreement provides a mechanism for the creation of an individualized network of community
resources on a client -by -client basis through the Older Americans Act, as amended, and the Texas
Department of Aging and Disability Services' AAA Access and Assistance guidelines.
The purpose of this system of Access and Assistance is to develop cooperative working relationships with
other service providers to build an integrated service delivery system that ensures broad access to and
information about community services, maximizes the use of existing resources, avoids duplication of effort,
gaps in services, and facilitates the ability of people who need services to easily find the most appropriate
Vendor.
SCOPE OF SERVICES
A. The Vendor agrees to provide the following service(s) to clients authorized by the AAA
staff as identified below in accordance with the vendor application, all required
assurances, licences, certifications and rate setting documents, as applicable.
Service:
CONGREGATE MEALS
TRANSPORTATION
Service Definition:
CONGREGATE MEAL A hot or other appropriate meal served to an eligible
person which meets one-third (1/3) of the recommended dietary allowances (RDA) as
established by the Food and Nutrition Board of the Institute of Medicine of the
National Academy of Sciences and complies with the Dietary Guidelines for
Americans, published by the Secretary and the Secretary of Agriculture, and which is
served in a congregate setting.
There are two types of congregate meals:
• Standard meal - A regular meal from the standard menu that is served to the
majority or all of the participants.
• Therapeutic meal or liquid supplement - A special meal or liquid supplement that
has been prescribed by a physician and is planned specifically for the participant
by a dietician (e.g., diabetic diet, renal diet, pureed diet, tube feeding).
TRANSPORTATION Taking an older person from one location to another. This
does not include any other activity. Deniand/Response-transportation designed
to carry older persons from specific origin to specific destination upon request. Clients
request the transportation service in advance of their need, usually twenty-four to forty-
eight hours prior to the trip.
fumi4AIAAA-VA 1,0 SP.AG
t=d Date: %Hh004 1 of 5 10,15,2005
Unit Definition:
CONGREGATE :MEALS: One Meal.
TRANSPORTATION: One, One-way Trip.
Service Area:
City of Lubbock
All Texas Administrative Code standards may be accessed at the Texas Secretary of
State website: www.sos.state.tx.us
All Older Americans Act and other required rules and regulations may be accessed at
www.aoa.govraboutilegbud.g/oaa/legbudg oaa.asp
Targeting: Services are designed to identify eligible clients, with an emphasis on high -risk
clients and serving older individuals with greatest economic and social need, low-income
minorities and those residing in rural areas, as identified in the Older Americans Act.
B. Services & Reimbursement Methodology:
Service
Fixed Rate
(include rate)
Variable Rate
(identify range)
Cost
Reimbursement
Congregate
5.01
Transportation
3.82
II. TERMS OF THE AGREEMENT
A. The Vendor agrees to and/or understands:
1. Provide services in accordance with current or revised DADS policies and
standards and the OAA.
Target services to older individuals with greatest economic and social need,
including low-income minorities and older individuals residing in rural areas as
applicable.
a) Email roster(s) documentation as required by the AAA by the close of
business on the 2nd day of each month following the last day of the month in
which services were provided. If the 2nd day falls on a weekend or SPAG
holiday, the information shall be delivered by the close of business on the
preceding business day.
b) Submit appropriate documentation as required by the AAA by the close of
business on the 3rd Thursday of each month following the last day of the month
in which services were provided. If the 3rd Thursday fails on a SPAG
holiday, the information shall be delivered by the close of business on the
preceding business day.
The AAA cannot guarantee payment of a reimbursement request received
for more than 30 calendar days of service delivery. No reimbursement for
Form P A I AAA vA 1,0 SPAG
Ed Date: 9,8.2004 2 of 5 W0/2005
91
services provided will be made if vendor payment invoices are not submitted
to the AAA within the 30 days of service delivery.
Encourage client contributions (program income) on a voluntary and confidential
basis. Such contributions will be properly safeguarded and accurately accounted
for as receipts and expenditures on its financial reports if they are not required
to be forwarded to the AAA. Client contributions (program income) will be
reported fully, as required, to the AAA.
Vendor agrees to expend all program income to expand or enhance the program/
service under which it is earned.
Refer Medicaid eligible clients to the Health and Human Services Commission,
and/or the Medicaid participating suppliers/vendors for the purpose of securing
appropriate services, as applicable.
Notify the AAA Access and Assistance division within 24 hours if,
for any reason, the Vendor becomes unable to provide the service(s).
8. Maintain communication and correspondence concerning clients' status.
9. Establish a method to guarantee the confidentiality of all information relating
to the client in accordance with applicable Federal and State laws, rules, and
regulations. This provision shall not be construed, as limiting AAA or any
Federal, or State authorized representative's right of access to client case
records or other information relating to clients served under this agreement.
10. Keep financial and program supporting documents, statistical records, and any
other records pertinent to the services for which a claim for reimbursement
was submitted to the AAA. The records and documents will be kept for a
minimum of five years after close of contract year.
11. Make available at reasonable times and for required periods those client
records, books, and supporting documents pertaining to services provided, under
this agreement, for purposes of inspection, monitoring, auditing, or evaluations
by AAA staff, the Comptroller General of the United States and the State of
Texas, through any authorized representative's).
12. This agreement may be terminated for cause or without cause upon the
giving of 30 days advance written notice.
13. This agreement does not guarantee a total level of reimbursement other than
for individual units/services authorized; contingent upon receipt of funds.
14. It is an independent provider, NOT an agent of the AAA. Thus the Vendor
indemnifies, saves and holds harmless the South Plains Association of
Governments Area Agency on Aging against expense or liability of any kind
arising out of service delivery performed by the Vendor, and to immediately
notify the Area Agency on Aging if the Vendor becomes involved in or is
threatened with litigation related to Access Assistance participants.
15. Employees shall not solicit nor accept gifts or favors of monetary value by
or on behalf of clients as a gift, reward or payment.
Through the Direct Purchase of Service program,
Area Agency on Aging agrees to:
the South Plains Association of
Review original client intake and assessment forms completed by the Vendor,
as applicable, to determine client eligibility. Service authorization is based on
Fomi #'A1AAA_VA1.O SPAG
Fd Date: 9;8r2004 3 of 5 10/5/2005
client need and the availability of funds. Original client intake and assessment
forms will be housed at the South Plains Association of Governments —
Area Agency on Aging.
2. Provide timely written notification to Vendor of client's eligibility and
authorization to receive services.
3. Maintain communication and correspondence concerning the clients' status.
4. Provide timely technical assistance to Vendor as requested and as available.
5. Conduct quality -assurance procedures, which may include on -site visits, to
ensure quality services are being provided.
6. Provide written policy, procedures and standard documents concerning client
authorization to release information (both a general and medical/health related
release), ability to contribute to the cost of services provided, complaints/
grievances and appeals to all clients.
7. Reimburse the Vendor based on the agreed reimbursement methodology,
approved rate(s), service(s) authorized, and Section II.A.(3) and (4) of this
document within 45 days of receipt of invoice.
S. Reimburse the Vendor upon receipt of a properly prepared vendor payment
invoice, identified in Section II.B.(7), contingent upon the AAA's receipt of
funds authorized for this purpose from DADS.
III. ASSURANCES
A. Americans with Disabilities Act of 1990 —
The VENDOR shall comply with the requirements established under the Americans
with Disabilities Act in meeting statutory deadlines established under the Act as they
pertain to operations for employment, public accommodations, transportation, state and
local government operations and telecommunications.
B. Section 504 of the Rehabilitation Act of 1973 —
The VENDOR shall provide that each program activity, when viewed in its entirety is
readily accessible to and usable by persons with disabilities in keeping with 45 CFR,
Part 84.11, et. seq., and as provided for in Section 504 of the Rehabilitation Act of 1974,
as amended. When structural changes are required, these changes shall be in keeping
with 45 CFR, Part 74.
C. Age Discrimination in Employment Act of 1967 —
The VENDOR shall comply with Age Discrimination in Employment Act of 1967
(29 USC 621, et. seq.).
D. Drug Free Workplace
The VENDOR shall comply with the Drug -Free Workplace Act of 1988, and Texas
Senate Bill 1 - 1991, as applicable.
E. Certification Regarding Debarment
45CFR §92.35 Sub awards to debarred and suspended parties; this document is
required annually as long as this agreement is in affect.
F. hrdependent Audit
VENDOR receiving more than $500,000 in federal or state funding from all sources
will provide an audit in accordance with the standards for financial and compliance
audits contained in the Standards for Audit of Governmental Organizations, Programs,
Activities and Functions, issued by the U.S. General Accounting Office; the Single
Audit Act of 1984, including all updates and revisions; the provisions of OMB Circular
A-133, .Audits of States, Local Governments, and Nonprofit Organizations, as applicable,
and the Uniform Grant Management Standards.
Form 9 AIAAA—VA 1.0 SPAG
Ed Date: 9, SI2004 4 of 5 101512005
IV. SIGNATURES
For the faithful performance of the terms of this agreement, the parties affix their signatures and bind
themselves effecti� e October 1, 2007
City of Lubbock
Legal Name of Contracted Provider
Signature
David A. Miller, Mayor
Printed/Typed Name of Signer
October 11, 2007
Date
ATTEST:
41-�
Mecca Garza
City Secretary
APPROVED AS T ONTENT:
Randy Truesdell
Community Services Director
South Plains Association of Governments
Namc of Area Agency on Aging
ywo(,e�e%,
Signature
Tim C. Pierce
Printed/Typed Name of Signer
October 1, 2007
Date
r
APP OVED A TO FO
J
ald G. Vandiver
Attorney of Council
Form =:AIAAA—VA LU $PAG
Gd Date: 1),S.2004 5 of 5 10;5�2005
BUDGET WORKSHEET
A B C D E
F G H
1
2
AAA/Region Name:
SPAG
Contract Number.
A-100
Congregate Meals
October 1 , 2007 - September 30, 2008
3
Provider Name: JCIty
of Lubbock
Service:
4
Period covered in YTD:1
Oct 1, 2006-May 31, 2007
New Contract Year:
6
NOTE: You must identify the number of months the YTD actual expenses are based on in Column D,
7
under "Annuafized
Exp. Months YTD Based on." The worksheet is currently set at 8 months.
8
_ Reason for Difference/Explanation j
(If Over Routine Inflation Percentage-1.02%)
9
10
11
Annualized Exp.
Months YTD Based on Budgeted Exp. for
Cost Area
YTD Actual
Percent Difference
(Budget to Annualized)
Expenses
8 New Contract Yr.
12
13
1. Personnel
14
Salaries, PR Taxes &
Benefle
86 232M
129,348.99
105,160.00
--18.70%
Minimum wage increased; thereby, generating increases
for all City PT staff of $.70 per hour as of 7/07. In
addition, PT staff will receive another $.70/hour In both
2008 and in 2009. Additionally, staff changes/deletions
overset this increase.
15
Contract staff,
Compensation
Total
-
16
86 232.66
129 348.99
105 160.00
-18.70%
17ir
18
2. Nutrition Education
191
Salaries, PR Taxes &
Benefits
20
21
Contract staff,
Compensation
Materials
-
-
22
Conference
23
Totel
24
25
3. Professional Develo ment _
26
Conference _
J
550.00
_ _ -
825.00
-100.00%
_
We had several supervisorststaff become certified in
2007. Certification is good for 5 years_
27
Dues
Materials
281
-
29
Total
550.00
825.00
-
-100.00%
4. Meals/Food
r
Raw Food Nutrition Supplement Freight
-
6,000.00
_ 113,818.95
20% increase in contracted cost meal as of 5107 from
$2.50 to $3.
_
36
37
—
Storage
_
6,000.00
132,000.00
-
0.00%
15.97%
Consumables
Contracted Meals/Food
Other
4,000.00
75,879.30
38
39
_
-
Total
79 879.30
119,818.95
138 000.00
15.17%
40
I - - — -
Version 2
BUDGET WORKSHEET CALCULATION OF THE PER MEAL UNIT RATE
1. Total Budgeted Expenses for Contract Year
2. Total Number of Anticipated Meals to be Provided
Title XIX/Title XIX
DADS A&I AAA 23,592 Title XX 0 Managed Care 0
Program Income 12,746 Other Eligible 8,662 Non -Eligible 0
3, Cost per meal (Line 1 divided by Line 2)
Reimbursement Calculation
DADS AW raft,
& Title XX
4. Projected NSIP per Meal Value 0.61
5. Rate Less NSIP per Meal Value $ 4.89
6. Mandatory Local Match of 10% $ 0.49
" If Applicable, Match Reduction
From the In -kind Match
Certification form $
Required Match $ 0.49
7. Proposed Meal Rate (Line 3 minus Line 6) $ 5.01
Rate Cap Applicable to DADS A&I AAA and XX
i. $ 247.324,00
2, 45,000
3. $ 5.50
Title X1X, Title XIX
Managed Care
N/A Attest:
NIA
lebecca Garza
City Secretary
Approved ain Form t
NIA ,��Vandiver
n
Attornev of Council
Common Providers Only $ 4.95 $ 6.12
8. Excess of Cap Rate Reduction $ (0.06) $ -
DADS A&I AAA/Title XXTitle XIX/Title XIX Managed Care $ 4.95 $ 5.50
(Line 7 minus Line 8)
If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form.
Apeyvrue
s o Co ent
Ran dell
Community Services Director
City of Lubbock David A. Miller, Mayor
Legal Name of Co tracted Provider PrintedlTyped Name of Signer
October 11, 2007 _
Signature Date
South Plains Association of Governments
Name of Area Agency on Aging
Tim C. Pierce
Pri ted Nped 19me Sign
Signature
October 1, 2007
Date
Department on Aging and Disabilities Services
Title XIX, Title XIX Managed Care &Title XX
Printed/Typed Name of Signer I O
Signature
Date
BUDGET NVORKSHEET CERTIFICATION
AS SIGNER OF THIS BUDGET NVORKSHEET, I HEREBY" CERTIFY THAT:
o I have read the note below and the instructions applicable to this budget worksheet.
I have reviewed this budget worksheet after its preparation.
a To the best of my knowledge and belief, this budget worksheet is true, correct and
complete, and was prepared in accordance with the instructions applicable to this
budget worksheet.
a This budget worksheet was prepared from the books and records of the contracted
provider.
Note: The person legally responsible for the conduct of the contracted provider must
sign this Budget Worksheet Certification. If a sole proprietor, the owner
must sign the Budget Worksheet Certification. If a partnership, a partner must
sign the Budget Worksheet Certification. If a corporation, the person authorized by the
Board of Directors Resolution must sign the Budget Worksheet Certification.
Misrepresentation of information contained in the budget worksheet may result in
adverse action, up to and including contract termination. Furthermore, falsification of
information in the budget worksheet may result in a referral for prosecution.
City of Lubbock
Name of Contracted Provider
October 11, 2007
Date
Signer Authority: r— Sole Proprietor
(check one) I— Partner
David A. Miller, Mayor
Printed/Typed Name of Signer
Association Officer
Board Member
A
ignature
r Corporate Officer Iv— Governmental Official
Attest: Approved as to orm Approv to onten
ebecca Garza ald G. ndiver I �—� F.andy ruesd t
City Secretary Attorney of Council Community Services
Director
DEFINITIONS:
Item Line -Item number & inclusions
Cost Area I Line -Item Name
YTD Expenses 1 Actual Expenditures
Annualized Exp. Enter the number of months included in the YTD Expenses
{Column B}
Budgeted Exp. for New
Contract Year Your agency/service budget
I% Difference Bud. Vs (calculation to give percent of increase/decrease in current year)
Ann. budget vs last year's actuals
Description 1.
detail reason for incr/decr based on variance,
2.
indicate the FTEs for both salaries & contract staff, optional
3.
specify individual items that are included in each line -item
within reason,
4.
list description/purpose, cost, & position attending for both
conferences and training.
BUDGET WORKSHEET
A B C D I E I F G H
I
J
1
2
I ces,0tber
AAA Name: SPAG
8
Contract Number. A-100
Service: Transportation —Demand Response
New Contract Year. October 1 2007 - Se ber 30 2008
3
Provider Name:
City of Lubbock
4
Period covered in YTD:
_
OCtober 1 2006-Ma 31 2007
5
6
NOTE: You must ideri ft the number of months the YTD actual expenses are based on in Column D, _
under "Annualized Exp. Months YTD Based on." The worksheet Is currently set at 8 months.
- Annualized
7
8
9
10
YTD Actual Months YTD Based
=BudgetsdPercent Difference Reason for Difference
Cost Area Expenses 8
(Budget to Annualized) (If Over Routine Inflation Percentage - 1.02%
12
13
--- _
1. Personnel
14
Salaries, PR Taxes &
Benefits
25 706.66
38,559.99
29,683.00
-23.02%
Minimum wage increased; thereby, generating increases
for all City PT staff of $.70 per hour as of 7107. In addition,
PT staff will receive another 5101hour In both 2008 and In
2009.
151
Contract staff,
Compensation
-
16
Total
25 706,66
1 38 559.99
29 683.00
-23.02%
is
2. Professional Development
19
(Arlfefent@
-
-
--
20
Dues
-
21
Materiels
22
23
24
Total -
IL-
4. Equipment
251
IDepreciation
-
-
—
261
1 Interest
271
1 Leasing
281Maintenance
Total - -
--
29
31
_.
S. Occu anc (Buildin
32
Rent-
— -
-
33
Utilities
-
- - -
—
34
Depreciation
Mo a Interest
-
35
_
_
36
Insurance
37
Security -
Janitorial
—
38
-
39
_
Repair-
40
Taxes
-
41
_
ITOWI
42
43
_ • ��.___a ,_.,. ----,.�..,_ a _.-_.,_i.___
_ 8. Trans rtadon/Travel
44
Mileage Reimbursement
_
-
-
-
-
--
_
45
Delivery-
- -
46
47
48
_
Gas & Oil
Re irs
Insurance _
Depredation/Lease
5,000.00
7,500.00
7,500.00
0.60%
-
_
_
49
50
Interest
51
Togs & Licenses
�i _
-
BUDGET WORKSHEET
A B
C D
E
F
G
H
1
J
2
AAA Name:
SPAG
Contract Number:
A-100
3
Provider Name:
City of Lubbock
Service:
Transportation -Demand Response
4
Period covered in YTD:
October 1 2006-May 31, 2007
New Contract Year:
October 1 2007 -September 30 2008
-
- --
-
NOTE: You must Identify the number of months the YTD actual expenses are based on in Column D,
under "Annualized Exo. Months YTD
Based on. 'The worksheet is currently set at 8 months.
I
AnnualizedEx .
YTD Actual
Months YTD Based on
Budgeted Fxp. for Percent Merence
Reason for Difference
Cost Area
Expenses
8
New Contract Yr. (Budget to Annualized)
(If Over Routine Inflation Percentage - 1.02%)
12
72
ITotal 5,005.00 7 500.00 1 7,500.00 0.00%
53
54
7. Administrative S General
55
Advertising
200.00
300.00
300.00
0,00%
56
Printing
-
_
571
Copying
r
_ 80.00
80.00
120.00
120.00
0.00%
58
Me Supplies
_
120.00
120.00
0.00%
59
Contractual Agreements
-
60
Postage
61
Telecommunications
62
Liabil' Insurance
-
63
Interest -Mg. Capital-
64
65
Leqal Fees
Accounting Fees
661
Consulting Fees
67
Other Fees Explain
68
Audit
-
69
Other Misc. (Ex lain)
-
70
ITotal
360.00
1 540.00
540.00
0.00%
71
72
Total of all Cost Areas
1 31 066.66 1 46,599.991
37 723.00
-19.05%
_
73
1
Total Number of Units
Provided
4,706.00 7,059.00
74
Total Number of
Anticipated Units
7,412
5.fl0°�
75
Budgeted Cost per Unit
$5.09
76
77
Reason for DI ferencelEx lanation
If Over Routine Inflation Percentage 1.02%
78
FY07 VS FY08
FY07
FY08
Difference
Percentage Difference
_
79
lWhole UnlitRate
5.16
5.09
0.07
-1.36%
80
Enter the Total Number of Anticipated Units or the Proposed units by Funding Source
_
81
82
Funding_Source
Proposed Units
83
Calculated Rate
Revenue
84
jAAArrDaA - Match Required
2,985
3.82
_
11,403
Proposed Units • Calculated Units
85
AAA/TDoA - Full Unit Rate
5.09
0
PTpsed Units • (a" ated Units
ProposjWUnits"Calculated Units
86
Source 3
570
5.09
2.901
_
87
Source 4 _
Source 5 _ _
3,857
_5.09
19,632
Proposed Units " Calculated Units
88
_ _ _ _
5.09
0
Proposed UnitsCalculated Units
89
Source 6
5.09
0
Proposed Units' Calculated Units
TDoAfAAA Proposed Units 'Calculated Rate
90
d Match
Local Funds - Require _
NA 1.27
3 7"
91
7,4121
37 727
BUDGET WORKSHEET
A B
C D E
IF
I G
H
I
J
2
AAA Name:
SPAG
Contract Number.
A-100
3
Provider Name:
City of Lubbock
Service:
I Transportation -Demand Response
4
Period covered in YTQ:
October 1, 2006-Ma 31, 2007
New Contract Year:
October 1 2007 - Se tember 30 2008
B
NOTE: You must identl the number of months the YTD actual expenses are based on in Column D,
under "Annualized ExD. Months YTD Based on." The worksheet is currently set at 8 months.
7
_
9
10
11
Cost Area
Annualized Exp.
Budgeted Exp. for
New Contract Yr.
Percent Difference
(Budget to Annualized)
Reason forDifference
YTD Actual
Months YTD Based on
Expenses
a
(If Over Routine Inflation Percentage - 1.02%)
12-
92
93
94
Service.
BUDGET WORKSHEET CALCULATION OF THE UNIT RATE
1.Total Budgeted Expenses for Contract Year 1. $ 37,723.00
2.Total Number of Anticipated Units to be Provided
AAA/rDcA - Match
Required 2.985 Source 3 570 Source 5 0
AAAlTDoA - Full Unit
Rate 0 Source 4 3,857 Source 6 0 2. 7,412
3. Cost per unit (Line 1 divided by Line 2) - Full Unit Rate 3. $ 5.09
Reimbursement Calculation for Contracts Requiring Unit Rate Match Reduction
4. Mandatory Local Match of 25% $ 1.27
If Applicable, Match Reduction From the In -kind Match Certification form $
Required Match 4. $ 1.27
5. Full Unit Rate Less Required Match (Line 3 minus Line 5. $ 3.82
"If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form.
Contract Reimbursed at Full Cost Per Unit Rate. Match Requirement Ws a Met Through Provision of Additional Units
$ 5.09 M1JAJ �jj 1f1
Contractor initial AAA lnitial
Contract Reimbursed at the Full Cost Per Unit Less Required Match.
$ 3.82 mo %_
Contractor Initial AAA Irfitial
ega ame of &Arkce rovider
_ P
Signature
F. David A. Miller Mayor
tedlTyped Name of Signer
South Plains Association of Governments
Na tte of ea Ag ging
f// t
I � `
Signatu
Tim C. Pierce
Printed/Typed Name of Signer
October 11, 2007 October 1, 2007
Date Date
Attest: Approved as to Form Approved o C ntent
C- _
R ecca Garza Id G. Vandiver Randy Truesdell
City Secretary Attorney of Council Community Services
Director
Certification Regarding Debarment
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS
Federal Executive Order 125.49 requires the Texas Department of Aging and Disability
Services (DADS)) to screen each covered potential vendor/grantee to determine whether each
has a right to obtain a contract/grant in accordance with federal regulations on debarment,
suspension, ineligibility, and voluntary exclusion. Each covered vendor/grantee must also
screen each of its covered sub vendors/providers.
In this certification "vendor/grantee" refers to both vendor/grantee and sub vendor/sub-
grantee: "contract/grant" refers to both contract/grant and subcontract/sub-grant.
By signing and submitting this certification the potential vendor/grantee accepts the
following terms:
1. The certification herein below is a material representation of fact upon which reliance
was placed when this contract/grant was entered into. It is later determined that the
potential vendor/grantee knowingly rendered an erroneous certification, in addition to
other remedies available to the federal government, the Department of Health and
Human Services. United States Department of Agriculture or other federal
department or agency, or the Texas Department of Aging and Disability Services
may pursue available remedies, including suspension and/or debarment.
2. The potential vendor/grantee shall provide immediate written notice to the person to
which this certification is submitted if at any time the potential vendor/grantee learns
that the certification was erroneous when submitted or has become erroneous by
reason of changed circumstances.
3. The words "covered contract," " debarred," "suspended," "ineligible," "participant,"
"person," "principal," "proposal," and "voluntarily excluded," as used in this
certification have meanings based upon materials in the Definitions and Coverage
sections of federal rules implementing Executive Order 12549. Usage is as defined in
the attachment.
4. The potential vendor/grantee agrees by submitting this certification that, should the
proposed covered contract/grant be entered into, it shall knowingly into any
subcontract with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized
by the Department of Health and Human Services, United States Department of
t Y O
CERTIFICATE OF SELF-INSURANCE
The undersigned officer of the City of Lubbock, Texas, a Texas home rule
municipality, hereby certifies that the City of Lubbock has a $500,000.00 self -
insured retention for Automobile and General Liability in accordance with the laws
of the State of Texas. The City of Lubbock has a policy that covers Property/Bodily
Injury over $500,000.00 per occurrence with St. Paul Fire and Marine under policy
#GPP06301452 which expires on 10/01/08. The current net asset balance of the self-
insurance fund is $3,397,295. The existing cash asset balance is $8,650,340 as of the
date stated below.
By:
Leisa Hutcheson
Risk Management Coordinator
Date: September 30, 2006
//AreaAgency
Resolution Na. 2007-RQ465
Onto in
I OCP NM C)FTTIF SCSI "i 11 PI [\;
�I If f�; (H 0 f\.I R\\II \Ti
CONTRACT AMENDMENT
DATE: June 19, 2008
TO: City of Lubbock
FROM: Liz Castro, Interim Director of Aging Programs
RE: Vendor Agreement
In the Vendor Agreement
Section II. Terms of Agreement
3. b) Submit appropriate documentation as required by the AAA by the close of
business on the 3`d Thursday of each month following the last day of the month in which
services were provided. If the 3`d Thursday falls on a SPAG holiday, the information shal
be delivered by the close of business on the preceding business day.
This paragraph shall be amended to read:
Section II. Terms of Agreement
3. b) Submit appropriate documentation as required by the AAA by the close of
business on the 2nd working day of each month following the last day of the month in
which services were provided. If the 2nd working day falls on a SPAG holiday, the
information shall be delivered by the close of business on the preceding business day.
I i i;t}t 5t. • f'.l! j~ o\ ' in Ff zfrflom tiI'llioll • I qhh".T . �r'i.r. '1 ?_;';If . ,r'rf(,_nS-Il)11f . j-y5fi-41 C-bi64 . Fax 06- of -0i44
I'd rtiAIIl I ufl�IA t, Ilia I ;;i; t) parim�nt oai arm:,
3. c) If a revision for documentation is required, these revised reports will be due
by the 101h working day of each month aand funding will be delayed. A letter to the
director and the board president will be sent if the AAA is not receiving required
documentations; the letter will indicate the reason for the delay and a corrective action
plan will be required. These actions will further delay the funding request.
Section III. ASSURANCES
IV. Attachment
List of Focal Points in South Plains Association of Governments Area Agenc
on Aging Region.
FOCAL POINTS
FOR
THE SOUTH PLAINS ASSOCIATION OF GOVERNMENTS REGION
FY 2007-2008
CENTER:
DIRECTOR:
BOOKKEEPER:
ADDRESS:
CITY:
PHONE:
DAYS & HRS. OPEN:
SERVICES:
COUNTY:
CENTER:
DIRECTOR:
BOOKKEEPER:
ADDRESS:
CITY:
PHONE:
DAYS & HRS. OPEN:
SERVICES:
COUNTY:
CENTER:
DIRECTOR:
* Abernathy Sr. Citizens Association, (A-005)
Louise Thomason H — 298-4055/C — 298 -2514 Friday
Louise Thomason
717 Avenue C
Abernathy, Texas 79311
(806) 298-2842 E-mail:abernathysrcenter afpgrb.com
Tues. 8-12, Wed., & Thurs. 8-4, Mon. 5-9(2" & 4`h days of thi
REC. month)
Lubbock
Anton Sr. Citizens Association, Inc. (A-015)
Carol Rendon
Carol Rendon
Box 378 (201 Main Street)
Anton, Texas 79313
(806) 997-2781 E-mail: antonsr@windstream.net
Mon. —Fri. 8-2
CONG., H.D., REC.
Hockley
Bailey County Commissioners Court (A-020)
Debbie Crabtree
BOOKKEEPER:
Debbie Crabtree
ADDRESS:
300 South First Street Room 110
CITY:
Muleshoe, Texas 79347
PHONE:
(806) 272-3647 E-mail: bcaging@fivearea.com
DAYS & HRS. OPEN:
Mon. - Fri. 8:30-12 & 1:00-5:00 Fax: (806) 272-3124
SERVICES:
H.D., TRANS., B.C.
COUNTY:
Bailey
CENTER:
Bailey County Senior Citizens Assoc., Inc. (A-007)
DIRECTOR:
Laverne Winn H (806)272-4071 C — (806) 893-1125
BOOKKEEPER:
Laverne Winn
ADDRESS:
319 S. Main St f PO Box 292
CITY:
Muleshoe, Texas 79347
PHONE:
(806) 272-4969 E-mail: seniors@fivearea.com
DAYS & HRS. OPEN:
Mon. — Fri.. 8:00 4:00 Fax: (806) 272-4460
SERVICES:
CONG, REC.
COUNTY:
Bailey
CENTER:
Brownfield Senior Citizens, Inc. (A-025)
DIRECTOR:
Betty Charlebois
BOOKKEEPER:
Faye Carroll
ADDRESS:
P.O. Box 1021 (500 W. Bridges)
CITY:
Brownfield, Texas 79316
PHONE:
(806) 637-6933 E-mail: bfldsrcit@yahoo.com
DAYS & HRS. OPEN:
Mon. - Fri. 8:30-2:00
SERVICES:
CONG., H.D., REC., TRANS.
COUNTY:
Terry
CENTER:
Cochran Co. Senior Citizens Assoc., Inc. (A-045)
DIRECTOR:
Nancy Luper C - (806) 523-3362
BOOKKEEPER:
Nancy Luper
ADDRESS:
120 West Wilson
CITY:
Morton, Texas 79346
PHONE:
(806) 266-5121 E-mail: ccsci@windstream.ne
DAYS & HRS. OPEN:
Mon. — Fri. 8-4 Fax #: (806) 266-9027
SERVICES:
CONG., REC., TRANS.
COUNTY:
Cochran
CENTER:
Crosby Co. Senior Citizens Assoc., Inc. (A-050)
DIRECTOR:
Sue Cornelius
BOOKKEEPER:
Sue Cornelius
ADDRESS: 119 North Berkshire
CITY: Crosbyton, Texas 79322
PHONE: (806) 675-2107 E-mail: crosb_ysrl(d),windstream.net
DAYS & HRS. OPEN: Mon. —Fri. 8-3
SERVICES: CONG., H.D., REC.
COUNTY: Crosby
CENTER:
Floydada Senior Citizens, Inc. (A-055)
DIRECTOR:
Sylvia Bueno
BOOKKEEPER:
Sylvia Bueno
ADDRESS:
P.O. Box 573 (301 Georgia St.)
CITY:
Floydada, Texas 79235
PHONE:
(806) 983-2032 E-mail: senior.citizens@att.net
DAYS & HRS. OPEN:
Mon. — Fri. 8-2
SERVICES:
CONG., H.D., REC.
COUNTY:
Floyd
CENTER:
Garza County Trailblazers, Inc. (A-070)
DIRECTOR:
Lana McGee
BOOKKEEPER:
ADDRESS:
205 E. 10th
CITY:
Post, Texas 79356
PHONE:
(806) 495-2998 E-mail:trailblazersl@postgarza.net
DAYS & HRS. OPEN:
Mon. — Fri. 8-2
SERVICES:
CONG., H.D., REC.
COUNTY:
Garza
CENTER: Hale Center Senior Citizens Assoc., Inc. (A-075)
DIRECTOR: Vickie Rosales
BOOKKEEPER: Vickie Rosales
ADDRESS: P.O. Box 205 (416 West 2na St.)
CITY: Hale Center, Texas 79041
PHONE: (806) 839-2428 E-mail: hcsrcenter@sbcglobal.net
DAYS & HRS. OPEN: Mon. — Fri. 8-2
SERVICES: CONG., H.D., REC., TRANS., H.D.
COUNTY: Hale
CENTER: Hockley County Senior Citizens Assoc., Inc. (A-085)
DIRECTOR: Gayla Underwood
BOOKKEEPER:
ADDRESS: 1202 Houston
CITY: Levelland, Texas 79336
PHONE:
(806) 894-2228 E-mail: lanacamp@valornet.com
DAYS & HRS. OPEN:
Mon. — Fri. 8-4:30 (Smyer: Tues & Fri, 8-3)
SERVICES:
CONG., H.D., REC., TRANS.
COUNTY:
Hockley
CENTER:
Lorenzo Senior Citizens Assoc., Inc. (A-095)
DIRECTOR:
Debbie Majors
BOOKKEEPER:
Debbie Majors
ADDRESS:
P.O. Box 571 (606 61h St.)
CITY:
Lorenzo, Texas 79343
PHONE:
(806) 634-5957 E-mail: debbielsc@nts-online.net
DAYS & HRS. OPEN:
Mon. —Fri. 8-3
SERVICES:
CONG., H.D., REC.
COUNTY:
Crosby
CENTER:
Lubbock - City of Lubbock (A-100)
DIRECTOR:
Nancy Neill, Supervisor: 775-2685
ADDRESS:
P.O. Box 2000 (1010 9th St.)
CITY:
Lubbock, Texas 79457
PHONE:
(806) 775-2685 (806) 775-2686 fax
E-mail: nneill(d),mylubbock.us
DAYS & HRS. OPEN:
Mon. —Fri. 8-5 Fax: 775-2686
SERVICES:
CONG., TRANS.
COUNTY:
Lubbock
Mae Simmons — 767-2708, Edwin
Harris (2004 Oak Avenue 79404), Copper Rawlings — 767-
2704, Herminia Martinez (213 40`h
Street 79404) 140`h & Ave. B}, Maggie Treio — 767-2705,
Herminia Martinez (3200 Amherst 79415), Homestead - 687-7898, Paula Brown (5401 56`h
Street 79414); Lubbock Senior Center — 767-2710, Paula Brown (2001 19`' Street 79401)
CENTER:
Lynn County Pioneers (A-110)
DIRECTOR:
Bianca Baker
BOOKKEEPER:
Bianca Baker
ADDRESS:
P.O. Box 223 (1600 S. 3rd St.)
CITY:
Tahoka, Texas 79373
PHONE:
(806) 561-5264 E-mail: lcp a�door.net
DAYS & HRS. OPEN:
Mon. —Fri. 9-3 Fax: 561-5571
SERVICES:
LONG., H.D., REC., TRANS. (No Cong. in
(O'Donnell)
COUNTY:
Lynn
CENTER: Motley County Sr. Citizens Association, Inc. (A-1 12)
DIRECTOR: Tommye Keith
BOOKKEEPER: Tommye Keith
ADDRESS: P. O. Box 184 (621 Stewart Street)
CITY: Matador, Texas 79244
PHONE: (806) 347-2496 E-mail: mcsenior*caprock-spur.com
DAYS & HRS. OPEN: Monday - Friday 8-3
SERVICES: CONG., H.D., REC.
COUNTY: Motley
CENTER: N. Dickens Co. Senior Citizens Assoc., Inc. (A-115)
DIRECTOR:
BOOKKEEPER:
ADDRESS: P.O. Box 163 (511 Montgomery)
CITY: Dickens, Texas 79229
PHONE: (806) 623-5520 E-mail: ndcscc@caprock-spur.com
DAYS & HRS. OPEN: Mon. —Fri. 8-2
SERVICES: CONG., H.D., REC., B.C.
COUNTY: Dickens
CENTER:
Senior Citizens Assoc. of S. Dickens County (A-130)
DIRECTOR:
Beverly Watson
BOOKKEEPER:
Jean Hoover
ADDRESS:
210 Burlington
CITY:
Spur, Texas 79370
PHONE:
(806) 271-4472 E-mail: sscaosdc@caprock-spur.con
DAYS & HRS. OPEN:
Mon. —Fri. 8-3
SERVICES:
CONG., H.D., REC.
COUNTY:
Dickens
CENTER:
Slaton Senior Citizens Assoc., Inc. (A-135)
DIRECTOR:
Charlotte O'Connell
BOOKKEEPER:
Charlotte O'Connell
ADDRESS:
230 West Lynn
CITY:
Slaton, Texas 79364
PHONE:
(806) 828-3784 E-mail: coconnell@door.net
DAYS & HRS. OPEN:
Mon. — Fri. 8-4
SERVICES:
CONG., H.D., REC.
COUNTY:
Lubbock
CENTER: Yoakum County Senior Citizens Assoc., Inc. (A- 150)
DIRECTOR: Elsie White
BOOKKEEPER: Ayde Gandara
ADDRESS:
CITY:
PHONE:
DAYS & HRS. OPEN:
SERVICES:
COUNTY:
412 West 51h St., #8
Denver City, Texas 79323
(806) 592-8000 E-mail: Ayde
Mon. —Fri. 9-2 Elsie
CONG., H.D., REC., TRANS. Fax
Yoakum
ycsc1@,crosswind.ne1
ycsc2@crosswind-ne
(806) 592-2835
LEGEND
CONG. - Congregate (on -site) Meals
H.D. - Home Delivered Meals
REC. - Recreation Services
B.C. - Benefits Counseling
TRAN. - Transportation Service
IV. SIGNATURES
For the faithful performance of the terms of this agreement, the parties affix their
signatures and bind themselves effective June 19, 2008.
City of Lubbock
Legal Name of Contracted Provider
Signature
Tom Martin
Mayor, City of Lubbock
August 12, 2008
Date
ATTEST:
C�_' I& — '_�c
Rebecca Garza
City Secretary
South Plains Association of Governments
Name of Area Agency on Aging
Signature
Tim C. Pierce
Printed/Typed Name of Signer
KIIsit)
Date
APPROVE;) S G t: ENT: APPROVED AS TO FORM:
andy esdell Donald Vandiver
Community Services Director Attorney of Council