1. No category

STATE OF CALIFORNIA
CONTRACT NUMBER
SHORT FORM CONTRACT
AM. NO.
FEDERAL TAXPAYER ID. NUMBER
(For agreements up to $9,999.99)
STD. 210 (Revised 7/2009)
REGISTRATION NUMBER
Invoice must show contract number, itemized expenses, service
dates, vendor name, address and phone number.
SUBMIT INVOICE IN TRIPLICATE TO:
FOR STATE USE ONLY
STD. 204
N/A
ON FILE
ATTACHED
CCCs
N/A
ON FILE
ATTACHED
DVBE
%
N/A
GFE
Late reason
Public Works Contractor’s License
Exempt from bidding
California Department of Corrections and Rehabilitation
North Coast RAO
PO Box 187016
Sacramento, CA 95818-7016
CERTIFIED SMALL BUSINESS
CERTIFICATE NUMBER
1. The parties to this agreement are:
STATE AGENCY’S NAME, hereafter called the State.
CONTRACTOR’S NAME, hereafter called the Contractor.
CA Department of Corrections and Rehabilitation
2. The agreement term is from Upon Approval
3. The maximum amount payable is $ $9,999.99
Wages/Labor $
through June 30, 2011
pursuant to the following charges:
Parts/Supplies $
4. Payment Terms (Note: All payments are in arrears.)
ITEMIZED INVOICE
Taxes $
Other $
(Attach list if applicable.)
ONE TIME PAYMENT (Lump sum)
MONTHLY
QUARTERLY
OTHER
5. The Contractor agrees to furnish all labor, equipment and materials necessary to perform the services described herein and
agrees to comply with the terms and conditions identified below which are made a part hereof by this reference. (Outline in
exact detail what is to be done, where it is to be done and include work specifications, if applicable.)
ADDITIONAL PAGES ATTACHED
•
•
•
This Short Form Contract is an award based on Short Form Bid OPS10.012.
The location of work to be performed for this Short Form Contract is CDCR – Pelican Bay State Prison located at 5905
Lake Earl Drive, Crescent City, CA 95531.
This Short Form Contract is for dental equipment maintenance and repair services. See attached exhibits for scope of
work, budget and payment details, all terms and conditions, and insurance requirements.
This Short Form Contract will be in effect upon approval through June 30, 2011, or until a Statewide Contract covering these
services goes into effect, whichever occurs first. Invoices outside the range of this agreement will not be approved or paid.
EXHIBITS (Items checked in this box are hereby incorporated by reference and made a part of this Agreement by this reference as if attached hereto.)
GTC*SF 610
GIA*
*If not attached, view at http://www.ols.dgs.ca.gov/Standard%20Language/default.htm.
Other Exhibits (List) Exhibits A, A-1, A-2, B, B-1, D, and E.
In Witness Whereof, this agreement has been executed by the parties identified below:
STATE OF CALIFORNIA
CONTRACTOR
CONTRACTOR’S NAME (If other than an individual, state whether a corporation,
partnership, etc.)
AGENCY NAME
California Department of Corrections and Rehabilitation
BY (Authorized Signature)
DATE SIGNED
BY (Authorized Signature)
DATE SIGNED
@
@
PRINTED NAME AND TITLE OF PERSON SIGNING
PRINTED NAME AND TITLE OF PERSON SIGNING
Terrie Reese, Manager
ADDRESS
ADDRESS
PO Box 4038, Suite 524 I
Administrative Support Services/Office of Procurement
Sacramento, CA 95812-4038
FUND TITLE
ITEM
FISCAL YEAR
CHAPTER
STATUTE
OBJECT CODE
General Fund
5225-001-0001
10/11
712
2011
9032334610
I hereby certify upon my own personal knowledge that budgeted funds are
available for the period and purpose of the expenditure stated above.
SIGNATURE OF ACCOUNTING OFFICER
@
DATE SIGNED
Contractor’s Name:
CA Department of Corrections And Rehabilitation
SCOPE OF WORK
Agreement Number:
Exhibit A
1.
Contractor agrees to provide to California Department of Corrections and Rehabilitation dental
equipment maintenance and repair services as described in Exhibit A-1. Contractor shall provide
services on all equipment listed in Exhibit A-2 and Exhibit B-1.
2.
The services shall be performed at California Department of Corrections and Rehabilitation (CDCR),
Pelican Bay State Prison, (PBSP), located at 5905 Lake Earl Drive, Crescent City, CA 95531.
3.
The services shall be provided during 8:00 a.m. to 4:30 p.m., Monday through Friday, State holidays
and weekends excluded.
4.
The project representatives during the term of this agreement will be:
Contract Manager
State Agency: California Department of
Corrections and Rehabilitation
Name: Cynthia Gorospe
Phone: 707-465-1000 ext. 7890
E-mail: [email protected]
Fax: 707-465-9072
Project Representative
Contractor:
Name:
Phone:
E-mail:
Fax:
Direct all contract inquiries to:
Contract Analyst
State Agency: California Department of
Corrections and Rehabilitation
Section/Unit: Office of Procurement Services
Attention: Annie Luyen
Address: PO Box 4038, Suite 524 I
Sacramento, CA 95812-4038
Phone: 916-445-0555
E-mail: [email protected]
Fax: 916-324-5645
5.
Contractor Representative
Contractor:
Section/Unit:
Attention:
Address:
Phone:
E-mail:
Fax:
Contractor Agrees to provide services in the manner specified herein and as detailed in Attachment
A-1, Detailed Scope of Work.
Contractor’s Name:
CA Department of Corrections And Rehabilitation
DETAILED SCOPE OF WORK
Agreement Number:
Exhibit A-1
DENTAL EQUIPMENT MAINTENANCE/INSPECTION AND REPAIR
1.
CONTRACT DESCRIPTION
Contractor shall furnish all labor, including travel and per diem, materials, non-consumable supplies,
transportation, equipment, and every other item of expense necessary to perform preventative
maintenance and repair services of the dental equipment specified in Exhibit A-2 and Exhibit B-1
herein for the California Department of Corrections and Rehabilitation (CDCR), Pelican Bay State
Prison, (PBSP), located at 5905 Lake Earl Drive, Crescent City, CA 95531.
The State assumes no responsibility for any work commenced by the Contractor and will not
reimburse the Contractor for any work performed prior to approval and scheduling by the
Institution Contract Liaison.
Contractor shall report to the Institution Contract Liaison upon arrival at the institution to
pickup the Service Reports. Upon completion of either the maintenance/inspection or repairs,
the Contractor shall return to the Institution Contract Liaison the Service Reports for signature.
Invoices will only be paid if accompanied by Service Report approved by either the Institution
Contract Liaison or designee.
2.
SCOPE OF WORK
See attached Equipment List, Exhibit A-2, hereby incorporated into this agreement by this reference.
Contractor will provide repair services at Pelican Bay State Prison for all equipment listed on
Exhibit A-2.
The State reserves the right to add equipment similar to the list established at the commencement of
this agreement and delete equipment that has become obsolete. Additional equipment will be
serviced at the unit rates specified herein. Contractor will be notified in writing, through a contract
amendment, that equipment has been added and/or removed from the list.
3.
MAINTENANCE/INSPECTION SERVICES
Contractor shall perform all maintenance/inspection services as specified herein and as necessary to
maintain the optimum level of efficiency for each specified piece of equipment. Services shall include,
as applicable, but not be limited to: cleaning, oiling, lubrication, adjustment, calibration, alignment,
timing, replacement of any filters, and operational testing of each piece of equipment, furnishing all
necessary lubricants, cleaning supplies, filters, and testing equipment, and providing any necessary
repairs and parts replacement. Any parts requiring replacement will be replaced in accordance with
the Parts Replacement section specified herein.
Maintenance/inspection services shall be paid by the State at the Contractor’s Maintenance/Inspection
Services rate, as specified herein.
Any services performed by the Contractor are to be inspected by the State after completion. The
State is solely responsible for determining acceptability of the work performed and the operability of
the equipment.
4.
EQUIPMENT CALIBRATION
Contractor’s Name:
CA Department of Corrections And Rehabilitation
DETAILED SCOPE OF WORK
Agreement Number:
Exhibit A-1
All equipment requiring calibration shall be identified by placing inspection stickers on the equipment.
The sticker shall show the date of calibration and/or date of service, and signature of service technician
servicing the equipment. All instruments used to calibrate the equipment shall be certified and traceable
to the National Institute of Standards Technology (NIST). Conductivity tests will be performed in
accordance with applicable rules and regulations. Upon request, Contractor shall maintain an instrument
log book and provide a calibration certificate signifying that a continuing quality control program is in
existence.
5.
MAINTENANCE/INSPECTION SCHEDULE
Contractor agrees to provide maintenance/inspection services for the equipment specified herein on a
quarterly basis. Dates of service will be as indicated by the Institution Contract Liaison upon approval of
the contract. Services shall be performed during normal business hours 8:00 a.m. to 4:30 p.m., Monday
through Friday, State holidays and weekends excluded. Contractor agrees to provide the requested
services on the dates specified by the State or within seven (7) working days. The State reserves the
right to request additional maintenance services at the Contractor’s bid rate or to decrease the scheduled
number of services, should equipment be added or old equipment becomes obsolete.
6.
SAFETY INSPECTIONS
Contractor will perform a safety inspection of the equipment quarterly. Inspections will be performed in
conjunction with the preventative maintenance schedule. Contractor shall ensure, when applicable, that
equipment meets the manufacturer’s specifications for operation.
7.
REPAIR SERVICE
Contractor shall provide unlimited visits for any repair services requested or necessary to keep the
equipment fully operational. Repair services that are not provided during regularly scheduled
maintenance visits, or not covered by the Guarantee section of the Scope of Work, shall be paid by the
State at the Contractor’s Repair Hourly Rate, as specified herein. Any parts requiring replacement will be
replaced in accordance with the Parts Replacement section as specified herein.
Repair services will be provided upon telephone request from the Institution Contract Liaison. Contractor
shall respond to requests for repair service within forty-eight (48) hours. Every effort shall be made to
perform repair services during normal business hours 8:00 a.m. to 4:30 p.m., Monday through Friday,
State holidays and weekends excluded. The State may, as its discretion, allow access to the equipment
during non-business hours when necessary. Non-emergency repair services performed outside of
normal business hours as specified herein must be approved in advance in writing by the Institution
Contract Liaison.
Contractor shall make every attempt to complete repairs the same working day. Unless the repair
requires part(s) that must be ordered, no repair may take longer than five (5) working days to complete.
When a delay in repair will occur due to part(s) that must be ordered, written notification must be
presented to the Institution Contract Liaison immediately.
8.
LOAN EQUIPMENT
For approved repair(s) lasting more than five working days, the State reserves the right to require the
Contractor to provide loan equipment to the State at no additional cost. Contractor is to provide loan
equipment at the time it is known the repair of the equipment will take longer than five (5) days.
Contractor’s Name:
CA Department of Corrections And Rehabilitation
DETAILED SCOPE OF WORK
Agreement Number:
Exhibit A-1
The equipment provided shall be the same or equivalent to the equipment being repaired. If loan
equipment is requested, Contractor shall provide the equipment to the State within twenty-four (24)
hours after notification. Requests by the State for loan equipment shall only be made for those pieces
of equipment considered by the State to be vital to daily operations. Any loan equipment provided by
the Contractor to the State under this provision shall remain in the possession of the State until such
repair has been completed and approved by the Institution Contract Liaison.
The State shall be relieved of all risks of loss or damage during the entire time the loan equipment is in
the possession of the State, except when loss or damage is due to fault or neglect of the State. All
loan equipment will be returned to the Contractor in good condition subject to reasonable wear and
tear, except for any loss or damage arising from circumstances beyond the control of the State.
Contractor’s Name:
CA Department of Corrections And Rehabilitation
EQUIPMENT LIST
Agreement Number:
Exhibit A-2
Non-Adec
Equipment
Description
Qty
Manufacturer
Model No.
Serial No.
Equipment
Location
Handpiece
20
Star
Star
Star
Star
Star
Henry Schein
Henry Schein
Henry Schein
Henry Schein
Impact Air 45
Star
Star
Star
Star
Star
Henry Schein
Henry Schein
Henry Schein
Henry Schein
Impact Air 45
430SWL
430SWL
430SWL
430SWL
430SWL
F Type
1:1 102-7294
1:1 102-7294
1:1 102-7294
K18274
I07586
I07737
I07620
I06722
D3571832
D3678950
D3678950
D3571830
P42047
K18274
I07586
I07737
I07620
I06722
D3571832
D3678950
D3678950
D3571830
P42047
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
B Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
PSU Clinic
B Clinic
Air Techniques
Air Techniques
Air Techniques
Air Techniques
Air Star 30
Air Star 30
Air Star 30
Air Star 30
Air Techniques
Air Star 30
Air Techniques
Air Star 30
Air Techniques
Air Star 30
Air Techniques
Air Techniques
Air Techniques
Air Techniques
Air Techniques
3505
1859
553884
3506
1855
A Clinic
B Clinic
C Clinic
D Clinic
Level 1 Clinic
Apollo Dental
Air Techniques
STS-3
STS-3
VacStarSOH
711
54090
UG155X-Gold
Series
STS-3
97093-080
3950
CTC
PSU Clinic
Plan Meca OY
Plan Meca OY
Plan Meca OY
Plan Meca OY
Plan Meca OY
Plan Meca OY
Intra Oral
Intra Oral
Intra Oral
Intra Oral
Intra Oral
Intra Oral
ITHa58223
IXRF070570
IXRF070571
*IXRF070587
IXRF070589
TBD
A Clinic
B Clinic
C Clinic
D Clinic
Level 1 Clinic
PSU Clinic
Plan Meca
Plan Meca
Plan Meca
Plan Meca
Plan Meca
Intra Oral
Intra Oral
Intra Oral
Intra Oral
Intra Oral
IXRF065607
ITHa63325
ITHA63318
ITHA63315
ITHA63336
A Clinic
B Clinic
C Clinic
D Clinic
Level 1 Clinic
Air
Compressor
Vacuum
Pump
430SWL
430SWL
430SWL
430SWL
430SWL
F Type
1:1 102-7294
1:1 102-7294
1:1 102-7294
7
830029812
313129
308448
830-029821
830-029822
830029770
830029769
830-029782
830-029781
CTC
A Clinic
B Clinic
C Clinic
D Clinic
Level 1 Clinic
PSU Clinic
7
Digital X-ray
Unit
6
Digital X-ray
Head
6
Contractor’s Name:
CA Department of Corrections And Rehabilitation
EQUIPMENT LIST
Non-Adec
Equipment
Description
Digital X-Ray
Head (cont’d)
Assistina
Vital Signs
Station
Mobile X-ray
Unit
Mobile X-ray
Head
Delivery Unit
Ultrasonic
Cleaner
Non-Adec
Agreement Number:
Exhibit A-2
Manufacturer
Model No.
Serial No.
Equipment
Location
Plan Meca
W&H Dentalwerk
W&H Dentalwerk
W&H Dentalwerk
W&H Dentalwerk
W&H Dentalwerk
W&H Dentalwerk
Intra Oral
301 Plus
301 Plus
301 Plus
301 Plus
301 Plus
301 Plus
LBI-Z-0518
67121
70771
70693
70692
70621
67120
PSU Clinic
PSU Clinic
A Clinic
B Clinic
C Clinic
D Clinic
Level 1 Clinic
Welch Allyn
Welch Allyn
Welch Allyn
Welch Allyn
Welch Allyn
Welch Allyn
53T0
53T0
53T0
53T0
53T0
53T0
JA053225
JA053211
JA067713
JA067724
JA067720
Level 1 Clinic
A Clinic
B Clinic
C Clinic
D Clinic
PSU Clinic
1
Phillips
DENS-O-MAT
9220279
A Gym Clinic
1
2
Phillips
Beaver State
Dental
Oralix-70
9200349
A Gym Clinic
54150
CTC
Vacudent
1-700SB
41-1297-137
04890222019UL-C
A Gym Clinic
Waledent/Biosonic
Waledent/Biosonic
Waledent/Biosonic
Waledent/Biosonic
Waledent/Biosonic
Sultan 600 ProSonic
UC100
UC100
UC100
UC100
UC100
990-417-961
990-417-964
TBD
TBD
TBD
C Clinic
A Clinic
B Clinic
D Clinic
PSU Clinic
600MT
TBD
Level 1 Clinic
Qty
6
6
6
Contractor’s Name:
CA Department of Corrections And Rehabilitation
BUDGET DETAIL AND PAYMENT PROVISIONS
Agreement Number:
Exhibit B
1. Invoicing and Payment
A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the
State agrees to compensate the Contractor for actual expenditures incurred in
accordance with the rates listed below or specified in Exhibit B-1, which is attached
hereto and made a part of this Agreement.
B. All services performed under this Agreement shall be identified by the Contractor on the
Service Report and invoiced accordingly. All invoices must accompany the Service
Reports for every service performed and, if applicable, also include the Maintenance
Checklists for Preventive Maintenance service. Each invoice shall list each service as a
separate line item and shall include the minimum requirements listed within this Section.
Any invoices received that do not include the minimum requirements below shall not be
reimbursed.
(1)
(2)
(3)
Service Report number(s).
Hours of work or service performed and date of Service
OEM part numbers and quantity.
C. Invoices shall be sent to appropriate accounting office, based on the institution that the
service was performed in. The accounting office is listed below for Pelican Bay State
Prison:
Regional Accounting Office – Sacramento
P.O. Box 187015
Sacramento, CA 95858-7015
AND
ATTN: Cynthia Gorospe
CDCR - Pelican Bay State Prison
PO Box 7200
Crescent City, CA 95532
2. Budget Contingency Clause
A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent
years covered under this Agreement does not appropriate sufficient funds for the
program, this Agreement shall be of no further force and effect. In this event, the State
shall have no liability to pay any funds whatsoever to Contractor or to furnish any other
considerations under this Agreement and Contractor shall not be obligated to perform
any provisions of this Agreement.
B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this
program, the State shall have the option to either cancel this Agreement with no liability
occurring to the State, or offer an agreement amendment to Contractor to reflect the
reduced amount.
8
Contractor’s Name:
CA Department of Corrections And Rehabilitation
BUDGET DETAIL AND PAYMENT PROVISIONS
Agreement Number:
Exhibit B
3. Prompt Payment Clause
A. Payment will be made in accordance with, and within the time specified in, Government
Code Chapter 4.5, commencing with Section 927.
4. Travel Reimbursement
California Department of Corrections and Rehabilitation will not reimburse for Contractor’s travel
expenses.
9
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
1.
Agreement Number
Exhibit E
Blood borne Pathogens
Provider shall adhere to California Division of Occupational Safety and Health (CALOSHA) regulations and guidelines pertaining to blood borne pathogens.
2.
Clothing Restrictions
While on institution grounds, contractor and all its agents, employees, and/or
representatives shall be professionally and appropriately dressed in clothing distinct from
that worn by inmates at the institution. Specifically, blue denim pants and blue
chambray shirts, orange/red/yellow/white/chartreuse jumpsuits and/or yellow rainwear
shall not be worn onto institution grounds, as this is inmate attire. The contractor should
contact the institution regarding clothing restrictions prior to requiring access to the
institution to assure the contractor and their employees are in compliance.
3.
Digest of Laws
If the requirements of the Agreement require the contractor to enter an Institution, the
contractor shall sign the "Digest of Laws related to Association with Inmates",
incorporated herein by reference, and ensure that all his/her employees are aware of
and abide by these rules. Employees of the Contractor, while upon State grounds, are
subject to the search of their person, property, and vehicle (Section 3288 of the CDC
Director's Rules).
4.
Disclosure
Neither the State nor any State employee will be liable to the contractor or its staff for
injuries inflicted by inmates or parolees of the State. The State agrees to disclose to the
contractor any statement(s) known to State staff made by any inmate or parolee which
indicate violence may result in any specific situation, and the same responsibility will be
shared by the contractor in disclosing such statement(s) to the State.
5.
Employment of Ex-Offenders
Contractor cannot be and will not either directly, or on a sub-contract basis, employ in
connection with this Agreement:
• Ex-Offenders on active parole or probation;
o Ex-Offenders at any time if they are required to register as a sex offender
pursuant to Penal Code Section 290 or if such ex-offender has an offense
history involving a "violent felony" as defined in subparagraph (c) of Penal Code
Section 667.5; or
o Any ex-felon in a position which provides direct supervision of parolees.
• Ex-Offenders who can provide written evidence of having satisfactorily completed
parole or probation may be considered for employment by the contractor subject to
the following limitations:
o Contractor shall obtain the prior written approval to employ any such exoffender from the Authorized Administrator; and Such ex-offender whose
assigned duties are to involve administrative or policy decision making,
accounting, procurement, cashiering, auditing, or any other business- related
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
Agreement Number
Exhibit E
administrative function shall be fully bonded to cover any potential loss to the
State or contractor.
6.
Excise Tax
The State of California is exempt from federal excise taxes, and no payment will be
made for any taxes levied on employees' wages. The State will pay for any applicable
State of California or local sales or use taxes on the services rendered or equipment or
parts supplied pursuant to this Agreement. California may pay any applicable sales and
use tax imposed by another state.
7.
Fingerprinting
The contractor and any employees of the contractor may be subject to fingerprinting and
clearance by the State through the Department of Justice, Bureau of Criminal
Identification and Information.
8.
Force Majeure
Neither party shall be liable to the other for any delay in or failure of performance, nor
shall any such delay in or failures of performance constitute default, if such delay or
failure is caused by “Force Majeure.” As used in this section, “Force Majeure” is defined
as follows: Acts of war and acts of God such as earthquakes, floods, and other natural
disasters such that performance is impossible.
9.
Gate Clearance
Contractor and contractor’s employee(s) and/or subcontractor(s) must be cleared prior to
providing services. The contractor will be required to complete a Request for Gate
Clearance for all persons entering the facility a minimum of ten (10) working days prior to
commencement of service. The Request for Gate Clearance must include the person’s
name, social security number, valid state driver’s license number or state identification
card number and date of birth. Information shall be submitted to the Contract Liaison or
his/her designee. CDCR uses the Request for Gate Clearance to run a California Law
Enforcement Telecommunications System (CLETS) check. The check will include
Department of Motor Vehicles check, Wants and Warrants check, and Criminal History
check.
Gate clearance may be denied for the following reasons: Individual’s presence in the
institution presents a serious threat to security, individual has been charged with a
serious crime committed on institution property, inadequate information is available to
establish positive identity of prospective individual, and/or individual has deliberately
falsified his/her identity.
All persons entering the facilities must have a valid state driver’s license or photo
identification card on their person.
10.
Inspection of Services
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
Agreement Number
Exhibit E
Services performed by Contractor under this Agreement shall be subject to inspection by
the CPHCS at any and all times during the performance thereof.
If the CPHCS official conducting the inspection determines that the services performed
by Contractor (and/or materials furnished in connection therewith) are not in accordance
with the specification, CPHCS may, at its option, have the work performed by an
alternate provider, charging the Contractor with any excess cost occasioned thereby.
11.
Liability for Loss and Damages
Any damages by the contractor to the State's facility including equipment, furniture,
materials or other State property will be repaired or replaced by the contractor to the
satisfaction of the State at no cost to the State. The State may, at its option, repair any
such damage and deduct the cost thereof from any sum due contractor under this
Agreement.
12.
Liability for Nonconforming Work
The contractor will be fully responsible for ensuring that the completed work conforms to
the agreed upon terms. If nonconformity is discovered prior to the contractor's deadline,
the contractor will be given a reasonable opportunity to cure the nonconformity. If the
nonconformity is discovered after the deadline for the completion of the project, CDC, in
its sole discretion, may use any reasonable means to cure the nonconformity. The
contractor shall be responsible for reimbursing CDC for any additional expenses
incurred to cure such defects.
13.
License and Permits
The Contractor shall be an individual or firm licensed to do business in California and
shall obtain at his/her expense all license(s) and permit(s) required by law for
accomplishing any work required in connection with this contract.
A.
If you are a Contractor located within the State of California, a business license
from the city/county in which you are headquartered is necessary; however, if
you are a corporation, a copy of your incorporation documents/letter from the
Secretary of State’s Office can be submitted. If you are a Contractor outside the
State of California, you will need to submit to CPHCS a copy of your business
license or incorporation papers for your respective State showing that your
company is in good standing in that state.
B.
In the event, any license(s) and/or permit(s) expire at any time during the term of
this contract; Contractor agrees to provide CPHCS with a copy of the renewed
license(s) and/or permit(s) within 30 days following the expiration date. In the
event the Contractor fails to keep in effect at all times all required license(s) and
permit(s), the State may, in addition to any other remedies it may have, terminate
this contract upon occurrence of such event.
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
14.
Agreement Number
Exhibit E
Primary Laws, Rules, and Regulations Regarding Conduct and Association
with State Prison Inmates
Individuals who are not employees of the California Department of Corrections and
Rehabilitation (CDCR), but who are working in and around inmates who are incarcerated
within California’s institutions/facilities or camps, are to be apprised of the laws, rules
and regulations governing conduct in associating with prison inmates. The following is a
summation of pertinent information when non-departmental employees come in contact
with prison inmates.
By signing this contract, the Contractor agrees that if the provisions of the contract
require the Contractor to enter an institution/facility or camp, the Contractor and any
employee(s) and/or subcontractor(s) shall be made aware of and shall abide by the
following laws, rules and regulations governing conduct in associating with prison
inmates:
a.
Persons who are not employed by CDCR, but are engaged in work at any
institution/facility or camp must observe and abide by all laws, rules and
regulations governing the conduct of their behavior in associating with prison
inmates. Failure to comply with these guidelines may lead to expulsion from
CDCR institutions/facilities or camps.
SOURCE:
California Penal Code (PC) Sections 5054 and 5058; California
Code of Regulations (CCR), Title 15, Sections 3285 and 3415.
b.
CDCR does not recognize hostages for bargaining purposes. CDCR has a “NO
HOSTAGE” policy and all prison inmates, visitors, and employees shall be made
aware of this.
SOURCE:
c.
PC Sections 5054 and 5058; CCR, Title 15, Section 3304.
All persons entering onto institution/facility or camp grounds consent to search of
their person, property or vehicle at any time. Refusal by individuals to submit to
a search of their person, property, or vehicle may be cause for denial of access
to the premises.
SOURCE:
PC Sections 2601, 5054 and 5058; CCR, Title 15, Sections 3173,
3177, and 3288.
d.
Persons normally permitted to enter an institution/facility or camp may be barred,
for cause, by the CDCR Director, Warden, and/or Regional Parole Administrator.
SOURCE:
e.
PC Sections 5054 and 5058; CCR, Title 15, Section 3176(a)
It is illegal for an individual who has been previously convicted of a felony offense
to enter into CDCR institutions/facilities or camps without the prior approval of the
Warden. It is also illegal for an individual to enter onto these premises for
unauthorized purposes or to refuse to leave said premises when requested to do
so. Failure to comply with this provision could lead to prosecution.
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
SOURCE:
and 3289.
f.
PC Sections 602, 4570.5 and 4571; CCR, Title 15, Sections 3173
Encouraging and/or assisting prison inmates to escape is a crime. It is illegal to
bring firearms, deadly weapons, explosives, tear gas, drugs or drug
paraphernalia on CDCR institutions/facilities or camp premises. It is illegal to
give prison inmates firearms, explosives, alcoholic beverages, narcotics, or any
drug or drug paraphernalia, including cocaine or marijuana.
SOURCE:
and 4574.
g.
Agreement Number
Exhibit E
PC Sections 2772, 2790, 4533, 4535, 4550, 4573, 4573.5, 4573.6
It is illegal to give or take letters from inmates without the authorization of the
Warden. It is also illegal to give or receive any type of gift and/or gratuities from
prison inmates.
SOURCE:
PC Sections 2540, 2541 and 4570; CCR, Title 15, Sections 3010,
3399, 3401, 3424 and 3425.
h.
In an emergency situation the visiting program and other program activities may
be suspended.
SOURCE:
i.
For security reasons, visitors must not wear clothing that in any way resembles
state issued prison inmate clothing (blue denim shirts, blue denim pants).
SOURCE:
j.
CCR, Title 15, Section 3171(b)(3).
Interviews with SPECIFIC INMATES are not permitted. Conspiring with an
inmate to circumvent policy and/or regulations constitutes a rule violation that
may result in appropriate legal action.
SOURCE:
15.
PC Section 2601; CCR, Title 15, Section 3383.
CCR, Title 15, Sections 3261.5, 3315 (3) (W), and 3177.
Right to Terminate (SCM 7.85)
A. The State reserves the right to terminate this Agreement subject to thirty (30) days
written notice to the Contractor. Contractor may submit a written request to
terminate this Agreement only if the State should substantially fail to perform its
responsibilities as provided herein.
B. However, the Agreement can be immediately terminated for cause. (Refer to GTC,
Exhibit C, Item 7. Termination for Cause)
C. This agreement may be suspended or cancelled without notice, at the option of the
Contractor, if the Contractor or State’s premises or equipment are destroyed by fire
or other catastrophe, or so substantially damaged that it is impractical to continue
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
Agreement Number
Exhibit E
service, or in the event the Contractor is unable to render service as a result of any
action by any governmental authority.
16.
Security Clearance
The State reserves the right to conduct a background check on the contractor and/or the
contractor's personnel as the State deems necessary prior to award or during the term of
the Agreement. The State further reserves the right to terminate the Agreement should a
threat to security be determined.
.
17.
Security Regulations
a.
Unless otherwise directed by the entrance gate officer and/or Contract Manager,
the contractor, contractor’s employees and subcontractors shall enter the
institution through the main entrance gate and park private and nonessential
vehicles in the designated visitor’s parking lot.
Contractor, contractor’s
employees and subcontractors shall remove the keys from the ignition when
outside the vehicle and all unattended vehicles shall be locked and secured while
on institution grounds.
b.
Any State- and contractor-owned equipment used by the contractor for the
provision of contract services, shall be rendered temporarily inoperative by the
Contractor when not in use, by locking or other means unless specified
otherwise.
c.
In order to maintain institution safety and security, periodic fire prevention
inspections and site searches may become necessary and contractor must
furnish keys to institutional authorities to access all locked areas on the worksite.
The State shall in no way be responsible for contractor’s loss due to fire.
d.
Due to security procedures, the contractor, contractor’s employees and
subcontractors may be delayed at the institution vehicle/pedestrian gates and
sally ports. Any loss of time checking in and out of the institution gates and sally
ports shall be borne by the contractor.
e.
Contractor, contractor’s employees and subcontractors shall observe all security
rules and regulations and comply with all instructions given by institutional
authorities.
f.
Electronic and communicative devices such as pagers, cell phones and
cameras/microcameras are not permitted on institution grounds.
g.
Contractor, contractor’s employees and subcontractors shall not cause undue
interference with the operations of the institution.
h.
No picketing is allowed on State property.
.
Contractor’s Name
California Department of Corrections and Rehabilitation
ADDITIONAL PROVISIONS – INSURANCE REQUIREMENTS
18.
Agreement Number
Exhibit E
Temporary Nonperformance
If, because of mechanical failure or for any other reason, the contractor shall be
temporarily unable to perform the work as required, the State, during the period of the
contractor's inability to perform, reserves the right to accomplish the work by other
means and shall be reimbursed by the contractor for any additional costs above the
Agreement price. person, firm or corporation furnishing or supplying work services,
materials or supplies in connection with the performance of this Agreement, and from
any and all claims and losses accruing or resulting to any person, firm or corporation
who may be injured or damaged by the contractor in the performance of this Agreement.
19.
Settlement of Disputes
In the event of a dispute, Contractor shall file a "Notice of Dispute" with the California
Prison Health Care Services (CPHCS) representative within ten (10) days of discovery
of the problem. Within ten (10) days, CPHCS representative shall meet with the
Contractor representative for purposes of resolving the dispute. The decision of CPHCS
shall be final.
In the event of a dispute, the language contained within this Agreement shall prevail over
any other language including that of the bid proposal
20.
Tobacco-Free Environment
Pursuant to Penal Code Section 5030.1, the use of tobacco products by any person on
the grounds of any institution or facility under the jurisdiction of the Department of
Corrections and Rehabilitation is prohibited.
21.
Tuberculosis (TB) Testing
In the event that the services required under this Agreement will be performed within a
CDCR institution/parole office/community based program, prior to the performance of
contracted duties, contractors and their employees who are assigned to work with
inmates/parolees on a regular basis shall be required to be examined or tested or
medically evaluated for TB in an infectious or contagious stage, and at least once a year
thereafter or more often as directed by CDCR. Regular basis is defined as having
contact with inmates/parolees in confined quarters more than once a week.
Contractors and their employees shall be required to furnish to CDCR, at no cost to
CDCR, a form CDCR 7336, “Employee Tuberculin Skin Test (TST) and Evaluation,”
prior to assuming their contracted duties and annually thereafter, showing that the
contractor and their employees have been examined and found free of TB in an
infectious stage. The form CDCR 7336 will be provided by CDCR upon contractor’s
request.
Contractor’s Name:
CA Department of Corrections And Rehabilitation
ADDITIONAL PROVISIONS – Insurance Requirements
Agreement Number:
Exhibit E
Insurance Requirements
A. When Contractor submits a signed contract to the State, Contractor shall furnish to the
State a certificate of insurance, stating that there is commercial general liability
insurance presently in effect for the Contractor of not less than $1,000,000.00 per
occurrence for bodily injury and property damage liability combined.
B. The certificate of insurance will include provisions below in their entirety:
1) That the insurer will not cancel the insured’s coverage without 30 days prior written
notice to the State.
2) That the State of California, its officers, agents, employees, and servants are
included as additional insured, but only insofar as the operations under this contract
are concerned.
3) That the State will not be responsible for any premiums or assessment on the policy.
C. Contractor agrees that the bodily injury liability insurance herein provided for shall be in
effect at all times during the term of this contract. In the event said insurance coverage
expires at any time or times during the term of this contract, Contractor agrees to provide
at least 30 days prior to said expiration date, a new certificate of insurance evidencing
insurance coverage as provided for herein for not less than the remainder of the term of
the contract, or for a period of not less than one year. New certificates of insurance are
subject to the approval of the Department of General Services, and Contractor agrees
that no work or services shall be performed prior to the giving of such approval. In the
event the Contractor fails to keep in effect at all times insurance coverage as herein
provided, the State may, in addition to any other remedies it may have, terminate this
contract upon occurrence of such event.
D. The Department will not provide for nor compensate Contractor for any insurance
premiums or costs for any type or amount of insurance.
E. In addition, the certificate evidencing general liability must include evidence of one of the
following if applicable to the service:
1) Pesticide/Herbicide Endorsement, OR
2) An endorsement deleting the general liability pollution exclusion, OR
3) A separate environmental/pollution liability policy with limits not less than
$1,000,000.00 covering bodily injury and property damage from pollution and related
clean up costs incurred arising out of the work or services to be performed under this
contract.
F. Automobile Liability Insurance – The Contractor shall furnish to the State a certificate of
insurance evidencing automobile liability insurance presently in effect for the Contractor
for not less than $1,000,000.00 per accident while utilizing a motor vehicle in the
performance of this contract. Such insurance shall cover liability arising out of a motor
vehicle including owned, hired, and non-owned motor vehicles. For contracted services
involving transportation of hazardous materials, evidence of an MCS-90 endorsement is
required.
17
Contractor’s Name:
CA Department of Corrections And Rehabilitation
ADDITIONAL PROVISIONS – Insurance Requirements
Agreement Number:
Exhibit E
G. Worker’s Compensation Insurance – The Contractor shall furnish to the State a
certificate of insurance evidencing workers compensation insurance and employer’s
liability presently in effect with limits not less than $1,000,000.00 by an insurance carrier
licensed to write Workers’ Compensation Insurance in California. Such certificate shall
include the name of the carrier, policy inception and expiration dates. If the Contractor is
self-insured for workers compensation, a certificate must be presented evidencing
Contractor is a qualified self insurer in the State of California.
18