STATE OF MISSISSIPPI Phil Bryant, Governor MISSISSIPPI DEPARTMENT … · 2017-08-01 · STATE OF...
Transcript of STATE OF MISSISSIPPI Phil Bryant, Governor MISSISSIPPI DEPARTMENT … · 2017-08-01 · STATE OF...
STATE OF MISSISSIPPI Phil Bryant, Governor
MISSISSIPPI DEPARTMENT OF CHILD PROTECTION SERVICES Dr. David A. Chandler, Commissioner
P. O. Box 346 ∙ 660 North Street ∙ Jackson, Mississippi 39205 Phone (601) 359-4368 ∙ Email: [email protected]
www.mdcps.ms.gov
Ms. Catoria Martin, Director
Personal Service Contract Review Board (PSCRB)
Mississippi State Personnel Board
210 East Capitol Street, Suite 800
Jackson, MS 39201
Dear Ms. Martin:
This letter is to provide PSCRB the information as outlined in PSCRB Rules and Regulations
Effective 7.1.16, Section 7-119 DHS or DCPS Personal Service Contracts.
CONTRACTOR: Hope Village for Children, Inc.
CONTRACT TERM: March 1, 2016 through February 28, 2018
MODIFICATION: August 15, 2017
METHOD OF PROCUREMENT: RFP
TOTAL COST OF CONTRACT: $2,942,874.70
PURPOSE OF CONTRACT: This vendor provides Comprehensive Therapeutic Care
Group Home Services to children placed in legal custody of the MS Department of Child
Protection Services.
STATEMENT OF USEFULNESS FOR ESTABLISHING AND OPERATING DCPS:
N/A
COPY OF PROPOSED CONTRACTUAL AGREEMENT: ATTACHED
If there are any questions, please contact me at (601) 359-4495.
Sincerely,
David A. Chandler
DAC:BL:jb
Attachment
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MODIFICATION #3
CONTRACT
AGREEMENT
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PSCM-009-01
March 2017
1
MODIFICATION NUMBER 3
TO THE AGREEMENT BY AND BETWEEN
MISSISSIPPI DEPARTMENT OF CHILD PROTECTION SERVICES
AND
HOPE VILLAGE FOR CHILDREN, INC.
The following Amendment, effective August 15, 2017 is made a part of the contract, dated
February, 24, 2016 entered into by and between the Mississippi Department of Child Protection
Services and Hope Village for Children, Inc.
Now, therefore, in consideration of the mutual agreements to modify the original contract
between them, MDCPS and “Independent Contractor”, do hereby agree that Paragraph 5 of said
contract shall be modified to reflect the following:
5. Consideration and Method of Payment.
A. As consideration of all services and performances under this Contract,
Independent Contractor shall be paid a fee not to exceed One Million One Hundred Twenty Four
Thousand Seven Hundred Seventy Dollars and Eighty Six Cents ($1,124,770.86) for all products,
services, salaries, travel, performances, costs, and expenses of whatever kind and nature of this
Contract. Modification #1 increased by Three Hundred Ninety Thousand Eight Hundred Fifty
Three Dollars and Eighty Four Cents ($390,853.84). Modification #2 increased by Two Million
Four Hundred Twenty Seven Thousand Two Hundred Fifty Dollars and Zero Cents
($2,427,250.00). Modification #3 decreased by One Million Dollars and Zero Cents
($1,000,000.00). It is expressly understood and agreed that in no event will the total compensation
paid hereunder exceed the specified amount Two Million Nine Hundred Forty Two Thousand Eight
Hundred Seventy Four Dollars and Seventy Cents ($2,942,874.70). (Exhibit C-3)
B. The Independent Contractor will bill MDCPS for its services on a monthly
basis. Following the satisfactory completion, as determined by MDCPS, of its monthly services, the
State requires the Independent Contractor to submit invoices electronically throughout the term of
the agreement. Invoices shall be submitted to MDCPS using the processes and procedures identified
by the State. The appropriate documentation shall be submitted on the last working day of the month,
with the final invoice to be submitted within five (5) working days after the contract ending date.
PAYMODE: Payments by state agencies using the Mississippi’s Accountability System
For Government Information and Collaboration (MAGIC) shall be made and remittance information
provided electronically as directed by the State. These payments shall be deposited into the bank
account of the Independent Contractor’s choice. The State may, at its sole discretion, require the
Independent Contractor to submit invoices and supporting documentation electronically, at any time,
during the term of this Agreement. Independent Contractor understands and agrees that the State is
exempt from the payment of taxes. All payments shall be in United States currency.
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PSCM-009-01
March 2017
2
All other terms, conditions, and provisions set out in the original contract other than those
modified and amended, which are not in conflict with this Modification Number 3, shall remain in
full force and effect for the duration of the contract.
IN WITNESS WHEREOF, the parties have executed this Modification Number 3, in duplicate, on
the date appearing with their respective signature below.
MISSISSIPPI DEPARTMENT OF CHILD HOPE VILLAGE FOR CHILDREN
PROTECTION SERVICES
By: ________________________________
By: ________________________________
Authorized Signature Authorized Signature
Printed Name: Dr. David A. Chandler
Printed Name: Tina Aycock
Title: Commissioner
Title: Executive Director
Date: ______________________________
Date: _______________________________
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EXHIBIT C-3
BUDGET
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Exhibit C-3, Budge Narrative
BUDGET FOR HOPE VILLAGE FOR CHILDREN, INC.
March 1, 2017 – February 28, 2018
Budget Narrative
The budget is based on the child’s placement type, at a per diem rate, per therapeutic child per
day. All other children placed with the therapeutic child will receive a per diem rate of $45.79
per day.
Therapeutic resource/group homes will only receive the therapeutic rate for those children
with a therapeutic designation; all others will receive a per diem rate of $45.79 per day.
Therefore, if a sibling does not have a therapeutic designation and is placed in the therapeutic
home with a sister/brother who has a therapeutic designation in order to place the siblings in
the same home, the therapeutic resource/group home will receive the therapeutic rate for only
one of the children in the sibling group. If a child is placed with a foster teen parent, the
therapeutic rate will only be received for the parent, unless the child has a therapeutic
designation. (MDCPS Policy Section D/Resource Board Payment Schedule, pages 137-138)
The facility shall have the flexibility to transfer funds for the payment type for therapeutic and
sibling placements based on the needs of the agency at any given time during the contract period, as
long as it does not exceed the total amount budgeted for the contract.
The total amount of this Contract will not exceed Two Million Nine Hundred Forty Two
Thousand Eight Hundred Seventy Four Dollars and Seventy Cents ($2,942,874.70).
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E-Verify
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FEDERAL
DEBARMENT
VERIFICATION
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CERTIFICATE
OF
INSURANCE
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07/17/2017
The Insurance Center
of Meridian, LLC
P. O. Box 1351
Meridian MS 39302-1351
(601) 693-4405
Arch Insurance Company
Stonetrust Insurance CompanyHope Village for Children, Inc.
P.O. Box 26
Meridian MS 39302-
Hope Village for Children
Fran Aycock
(601) 693-0545
X
X
01-LX-066416200-1A 03/01/2017 03/01/2018 1,000,000
100,000
5,000
1,000,000
3,000,000
3,000,000
X
X
X X
01-CA-069968310-0A 03/01/2017 03/01/2018 1,000,000
WCV0086515-04B 05/17/2017 05/17/2018 X
1,000,000
1,000,000
1,000,000
Commercial Crime - Employee Theft 01-LX-066416200-1A 03/01/2017 03/01/2018 $1,000,000 $500 Ded.
HOPE VILLAGE FOR CHILDREN, INC. IS COVERED FOR EMPLOYEE USE OF BOTH COMPANY OWNED VEHICLES AND VEHICLES OWNED BY THE EMPLOYEES WHILE BEING USED IN THE COURSE OF BUSINESS FOR THE LIMITS SHOWN ABOVE.
AI 049930
Jackson MS -
MS Department of Child Protection
ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
INSR ADDL SUBRLTR INSR WVD
DATE (MM/DD/YYYY)
PRODUCER CONTACTNAME:
FAXPHONE(A/C, No):(A/C, No, Ext):
E-MAILADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBERPOLICY EFF POLICY EXP
TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
GENERAL LIABILITY
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurrence)
CLAIMS-MADE OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
$PRO-POLICY LOCJECT
COMBINED SINGLE LIMIT$(Ea accident)
BODILY INJURY (Per person) $ANY AUTO
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS AUTOS
HIRED AUTOSNON-OWNED PROPERTY DAMAGE $AUTOS (Per accident)
$
OCCUR EACH OCCURRENCE $
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WC STATU- OTH-TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $If yes, describe under
E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothe terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2010/05)
CERTIFICATE OF LIABILITY INSURANCE
W9
FORM
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ORIGINAL
CONTRACT
AGREEMENT
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