Common use of Term of Grant Agreement Clause in Contracts

Term of Grant Agreement. The term of the Grant shall begin on July 1, 2019 and terminates on June 30, 2024. No funds may be requested or invoiced for services performed or costs incurred after June 30, 2024. PROJECT REPRESENTATIVES: The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Attention: Xxxxxxxxx Xxxxxxx Xxxxx Manager Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Grantee: County of Merced Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Address: 000 X. 00xx Xxxxxx City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said changes shall not require an amendment to the agreement. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board of Supervisors County of Merced 000 X. 00xx Xxxxxx Xxxxxx, XX 00000 Date: Xxxxxx Xxxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1804 Sacramento, CA 95899-7377 Exhibit A

Term of Grant Agreement. The term of the Grant shall begin on July December 1, 2019 2019, or upon approval of this grant, and terminates on June 30, 2024. No funds may be requested or invoiced for services performed or costs incurred after June 30, 2024. PROJECT REPRESENTATIVES: The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Humboldt Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Xxxxx Program Services Coordinator Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx 0xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: MercedEureka, CA 95341 95501 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxx@xx.xxxxxxxx.xx.xx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Humboldt Attention: Xxxxxxxxx Xxxxxxx Xxxxx Manager NameAttention: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Xxxxx Xxxxx Program Analyst Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx 0xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: MercedEureka, CA 95341 95501 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxx@xx.xxxxxxxx.xx.xx All payments from CDPH to the Grantee shall be sent to the following address: Remittance Address Grantee: County of Merced Humboldt Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Xxxxxxx Xxxxxxx Address: 000 X. 00xx 0xx Xxxxxx City, Zip: MercedEureka, CA 95341 95501 Phone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xx.xxxxxxxx.xx.xx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said changes shall not require an amendment to the agreement. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD HEPATITIS C VIRUS (HCV) LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD INFORMATION PRIVACY AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT SECURITY REQUIREMENTS GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board of Supervisors Director HHS Public Health Branch County of Merced Humboldt 000 X. 00xx X Xxxxxx Xxxxxx, XX 00000 Date: Xxxxxx Xxxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1800-1804 Sacramento, CA 95899-7377 Exhibit A

Term of Grant Agreement. The term of the Grant shall begin on July will be February 1, 2019 2020 and terminates on June 30, 20242023. No funds may be requested or invoiced for services performed or costs incurred after June 30, 20242023. PROJECT REPRESENTATIVES: The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Placer Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section Xxxxxx Xx. Xxxx Name: Xxxxxxx Xxxxxxx-X. Xxxxx Address: 0000 Xxxxxxx Xxxxxx, M.S. Assistant Public Health Director XX 0000 Address: P.O. Box 9973770000 Xxxxxx Xxxxxx Xx, MS 7320 Address: Xxxxx 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 95814 City, Zip: Merced, Auburn CA 95341 95603 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx xxxxxx.xx.xxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxx@xxxxxx.xx.xxx Direct all inquiries to: California Department of Public Health STD Division of Communicable Disease Control Branch Grantee: County of Merced Placer Attention: Xxxxxxxxx Xxxxxxx Xxxxx Manager Xxxxxx Xx. Xxxx Name: Xxxxx Xxxxxxx Xxxxxxx-Address: 0000 Xxxxxxx Xxxxxx, M.S. Assistant Public Health Director XX 0000 Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx 00000 X Xxx City, Zip: Sacramento, CA 95899-7377 95814 City, Zip: Merced, Auburn CA 95341 95603 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx xxxxxx.xx.xxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xxxxxx.xx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Grantee: County of Merced Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Placer Address: 0000 Xxxxxx Xxxxxx Xx, Xxxxx 000 X. 00xx Xxxxxx City, Zip: Merced, Auburn CA 95341 95603 Phone: (000) 000-0000 Fax: (000) 000-0000 (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx XXxxxxxx@xxxxxx.xx.xxx • Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said changes shall not require an amendment to the agreement. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx XxxxxxxxX. Xxxxx, Chairman Board of Supervisors County of Merced 000 X. 00xx Director Health and Human Services Department 00000 X Xxxxxx Xxxxxx, XX 00000 Auburn CA 95603 Date: Xxxxxx XxxxxxXxxx Xxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1800- 1804 Sacramento, CA 95899-7377 Exhibit A

Term of Grant Agreement. The term of the Grant shall begin on July October 1, 2019 2023 and terminates on June September 30, 20242026. No funds may be requested or invoiced for services performed or costs incurred after June September 30, 20242026. PROJECT REPRESENTATIVES: . The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Humboldt Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section X. Xxxx Name: Xxxxxxx XxxxxxxXxxx Xxxxxx-XxxxxxXxxxxxxxx, M.S. Assistant Public Health Project Director Address: P.O. Box 997377, MS 7320 1616 Capitol Avenue Address: 000 X. 00xx 0xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: Merced95814 Eureka, CA 95341 95501 Phone: 000-000-0000 Phone: 000-000-0000 E-mail: xxxxx.xxxx@xxxx.xx.xxx E-mail: xxxxxxx-xxxxxxxxx@xx.xxxxxxxx.xx.xx Direct all inquiries to the following representatives: California Department of Public Health, Project Officer] Grantee: County of Humboldt Attention: Xxxxxxxx Xxxxx Name: Xxxx Xxxxxx-Xxxxxxxxx, Project Director Address: 1616 Capitol Avenue Address: 000 0xx Xxxxxx Sacramento, CA 95814 Eureka, CA 95501 Phone: 000-000-0000 Phone: 000-000-0000 E-mail: xxxxxxxx.xxxxx@xxxx.xx.xxx E-mail: xxxxxxx-xxxxxxxxx@xx.xxxxxxxx.xx.xx Next Page All payments from CDPH to the Grantee; shall be sent to the following address: Remittance Address Grantee: County of Humboldt Attention: Xxxx Xxxxxx Address: 000 X Xxxxxx, Xxxxxx, XX 00000 Phone: (000) 000-0000 PhoneE-mail: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Attention: Xxxxxxxxx Xxxxxxx Xxxxx Manager Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Grantee: County of Merced Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Address: 000 X. 00xx Xxxxxx City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxx@xx.xxxxxxxx.xx.xx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said changes shall not require an amendment to the agreementthis agreement but must be maintained as supporting documentation. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form and the STD 205 Payee Data Supplement, which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board of Supervisors County of Merced 000 X. 00xx Xxxxxx Xxxxxx, XX 00000 Date: Xxxxxx Xxxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1804 Sacramento, CA 95899-7377 Exhibit A.

Term of Grant Agreement. The term of the Grant shall begin on July 1, 2019 and terminates on June 30, 2024. No funds may be requested or invoiced for services performed or costs incurred after June 30, 2024. PROJECT REPRESENTATIVES: . The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Placer Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section Name: Xxxxx Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Client Services Program Supervisor Address: P.O. Box 997377, MS 7320 Address: 0000 Xxxxxx Xxxxxx Xxxxx, Xxxxx 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: MercedAuburn, CA 95341 95603 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xxxxxx.xx.xxx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Placer Attention: Xxxxxxxxx Xxx Xxxx Grant Manager Attention: Xxxxx Xxxxxxx Xxxxx Manager Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Client Services Program Supervisor Address: P.O. Box 997377, MS 7320 Address: 0000 Xxxxxx Xxxxxx Xxxxx, Xxxxx 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: MercedAuburn, CA 95341 95603 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Xxx.Xxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xxxxxx.xx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Remittance Address Grantee: County of Merced Placer Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Administrative and Fiscal Operations Manager Address: 0000 Xxxxxx Xxxxxx Xxxxx, Xxxxx 000 X. 00xx Xxxxxx City, Zip: MercedAuburn, CA 95341 95603 Phone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xxxxxx.xx.xxx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said changes shall not require an amendment to the agreement. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form Form, which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board X. Xxxxx Director of Supervisors Health and Human Services County of Merced Placer 0000 Xxxxxx Xxxxxx Xxxxx, Xxxxx 000 X. 00xx Xxxxxx XxxxxxAuburn, XX 00000 CA 95603 Date: Xxxxxx XxxxxxXxxxxxx Xxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1804 Sacramento, CA 95899-7377 Exhibit A

Term of Grant Agreement. The term of the Grant shall begin on July 1, 2019 2023 and terminates on June 30, 20242028. No funds may be requested or invoiced for services performed or costs incurred after June 30, 20242028. PROJECT REPRESENTATIVES: . The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: County of Merced Name: Xxxxx Humboldt Xxxxxxxxxxx Xxxx, Chief 0000 Xxxxxxx Chief, Business Operations Support Section Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377Xxxxx 000, MS 7320 Address: 000 X. 00xx Xxxxxx CityXX 0000 Xxxxxxxxxx, Zip: Sacramento, CA 95899-7377 City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Phone: (000) 000-0000 FaxXX 00000 Telephone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Attention: Xxxxxxxxx xxxxx.xxxx@xxxx.xx.xxx Xxxxxxx Xxxxx Manager Name: Xxxxxxx Xxxxxxx-Xxxxx, Program Services Coordinator 000 0xx Xxxxxx Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899XX 00000-7377 City, Zip: Merced, CA 95341 Phone0000 Telephone: (000) 000-0000 PhoneEmail: (xxxxxx@xx.xxxxxxxx.xx.xx Direct all inquiries to the following representatives: California Department of Public Health County of Humboldt Xxxxxxx Xxxx, HOPWA Program Advisor 0000 Xxxxxxx Xxxxxx, Xxxxx 000) 000-, XX 0000 FaxXxxxxxxxxx, XX 00000 Telephone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Grantee: County Xxxxxxx.xxxx@xxxx.xx.xxx Xxxxx Xxxxxxx, Director of Merced Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Address: Public Health 000 X. 00xx 0xx Xxxxxx CityXxxxxx, Zip: Merced, CA 95341 Phone: (000) 000XX 00000-0000 FaxTelephone: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx xxxxxxxx@xx.xxxxxxxx.xx.xx All payments from CDPH to the Grantee; shall be sent to the following address: Remittance Address County of Humboldt Attention: Xxxxxxx Xxxxxxx, Xx. Fiscal Assistant 000 X. Xx Xxxxxx, XX 00000 Telephone: (000) 000-0000 Email: xxxxxxxx@xx.xxxxxxxx.xx.xx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said , said changes shall not require an amendment to the agreementthis agreement but must be maintained as supporting documentation. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form and the STD 205 Payee Data Supplement which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board of Supervisors County of Merced 000 X. 00xx Xxxxxx Xxxxxx, XX 00000 Date: Xxxxxx Xxxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1804 Sacramento, CA 95899-7377 Exhibit A.

Term of Grant Agreement. The term of the Grant shall begin on July 11st, 2019 2022 and terminates on June 3030th, 20242026]. No funds may be requested or invoiced for services performed or costs incurred after June 3030th, 20242026. PROJECT REPRESENTATIVES: . The Project Representatives during the term of this Grant will be: California Department of Public Health Grantee: Humboldt County of Merced Public Health Name:Xxxxxxx Xxxxxxxx Name: Xxxxx Xxxxxxx Chief, Business Operations Support Section Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Xxxxxx Xxxxxxxxx Address: P.O. Box 997377, MS 7320 0000 Xxxxxxx Xxx. Address: 000 X. 00xx X Xxxxxx City, ZIP: Sacramento, CA City, ZIP: Eureka CA 95501 Phone: 000-000-0000 Phone: n/a E-mail: Xxxxxxx.xxxxxxxx@xxxx.xx.xxx E-mail: xxxxxxxxxx@xx.xxxxxxxx.xx.xx Direct all inquiries to the following representatives: California Department of Public Health Grantee: Humboldt County Public Health Attention: Xxxxxxx Xxxxxxxx Attention: Xxxxxx Xxxxxxxxx Address 0000 Xxxxxxx Xxx. Address: 000 X Xxxxxx City, Zip Sacramento, CA City, Zip: Eureka CA 95501 Phone 000-000-0000 Phone: n/a E-mail Xxxxxxx.xxxxxxxx@xxxx.xx.xxx E-mail: xxxxxxxxxx@xx.xxxxxxxx.xx.xx All payments from CDPH to the Grantee; shall be sent to the following address: Remittance Address Grantee: Humboldt County Public Health Attention “Cashier”: PH Fiscal Address: 000 X Xxxxxx City, Zip: Sacramento, Eureka CA 95899-7377 City, Zip: Merced, CA 95341 95501 Phone: (000) 000-0000 PhoneE-mail: (000) 000-0000 FaxXXXxxxxx@xx.xxxxxxxx.xx.xx cc: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx Direct all inquiries to: California Department of Public Health STD Control Branch Grantee: County of Merced Attention: Xxxxxxxxx Xxxxxxx Xxxxx Manager Name: Xxxxxxx Xxxxxxx-Xxxxxx, M.S. Assistant Public Health Director Address: P.O. Box 997377, MS 7320 Address: 000 X. 00xx Xxxxxx City, Zip: Sacramento, CA 95899-7377 City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Phone: (000) 000-0000 Fax: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxxxxxxx.Xxxxxxx@xxxx.xx.xxx Email: Xxxxxxx.Xxxxxx@xxxxxxxxxxxxxx.xxx All payments from CDPH to the Grantee shall be sent to the following address: Grantee: County of Merced Attention “Cashier:” Xxxx Xxxxx Xxxxxxxxx Support Service Analyst II Address: 000 X. 00xx Xxxxxx City, Zip: Merced, CA 95341 Phone: (000) 000-0000 Fax: (000) 000-0000 Email: Xxxx.Xxxxxxxxx@xxxxxxxxxxxxxx.xxx Xxxxxx@xx.xxxxxxxx.xx.xx Either party may make changes to the Project Representatives, or remittance address, by giving a written notice to the other party. Said , said changes shall not require an amendment to the agreementthis agreement but must be maintained as supporting documentation. Note: Remittance address changes will require the Grantee to submit a completed CDPH 9083 Governmental Entity Taxpayer ID Form or STD 204 Payee Data Record Form and the STD 205 Payee Data Supplement which can be requested through the CDPH Project Representatives for processing. STANDARD PROVISIONS. The following exhibits are attached and made a part of this Grant by this reference: Exhibit A SCOPE OF WORK Exhibit B BUDGET DETAIL AND PAYMENT PROVISIONS Exhibit C STANDARD GRANT CONDITIONS Exhibit D ADDITIONAL PROVISIONS Exhibit E STD LOCAL ASSISTANCE FUNDS – STANDARDS AND GENERAL TERMS AND CONDITIONS Exhibit F CALIFORNIA STD AND ENHANCED HIV/AIDS CASE REPORTING SYSTEM DATA USE AND DISCLOSURE AGREEMENT GRANTEE REPRESENTATIONS: The Grantee(s) accept all terms, provisions, and conditions of this grant, including those stated in the Exhibits incorporated by reference above. The Grantee(s) shall fulfill all assurances and commitments made in the application, declarations, other accompanying documents, and written communications (e.g., e-mail, correspondence) filed in support of the request for grant funding. The Grantee(s) shall comply with and require its contractors and subcontractors to comply with all applicable laws, policies, and regulations. IN WITNESS THEREOF, the parties have executed this Grant on the dates set forth below. Executed By: Date: Xxxxxxx Xxxxxxxx, Chairman Board of Supervisors County of Merced 000 X. 00xx Xxxxxx Xxxxxx, XX 00000 Date: Xxxxxx Xxxxxx, Chief Contracts Management Unit California Department of Public Health 0000 Xxxxxxx Xxxxxx, Xxxxx 00.000 P.O. Box 997377, MS 1800 - 1804 Sacramento, CA 95899-7377 Exhibit A.