201212013-5WHATCOM COUNTY CONTRACT Whatcom County Contract No.
INFORMATION SHEET 201212013 -5
Originating Department:
Health
Program/Project: (i.e. Dept. Division and Project
Human Services
Contract or Grant Administrator:
Anne Deacon
Contractor's / Agency Name:
Sea Mar Community Health Centers
Is this a New Contract? If not, is this an Amendment or Renewal to an Existing Contract? Yes ® No ❑
Yes ❑ No ® If Amendment or Renewal, (per WCC 3.08.100 (a)) Original Contract #: 201212013
Does contract require Council Approval? Yes ❑ No ® If No, include WCC: 3.08.100A
(see Whatcom County Codes 3.06.010, 3.08.090 and 3.08. 100)
Is this a grant agreement?
Yes ❑ No ® If yes, grantor agency contract number(s): CFDA#:
Is this contract grant funded?
Yes ❑ No ® If yes, Whatcom County grant contract number(s):
Is this contract the result of a RFP or Bid process? Contract
Yes ® No ❑ If yes, RFP and Bid number(s): 12-40 Cost Center: 124100
Is this agreement excluded from E- Verify? No ❑ Yes ® If no, include Attachment D Contractor Declaration form.
If YES, indicate exclusion(s) below:
® Professional services agreement for certified/licensed professional.
® Contract work is for less than $100,000. ❑ Contract for Commercial off the shelf items (COTS).
❑ Contract work is for less than 120 days. ❑ Work related subcontract less than $25,000.
❑ Interlocal Agreement (between Governments). ❑ Public Works - Local Agency/Federally Funded FHWA.
Contract Amount: (sum of original contract amount and any Contracts that require Council Approval (incl. agenda bill & memo)
prior amendments): • Professional Services Agreement above $20,000.
• Bid is more than $50,000.
Varies depending on County authorization • Professional Service Contract Amendments that have an
increase greater than $20,000 and other contracts with a
cumulative increase greater than $50,000.
RENEWALS: Council approval is not required when exercising an
option to renew that is provided in the original contract.
Summary of Scope:
The purpose of this contract is to provide outpatient mental health treatment services to Whatcom County residents who have no
other readily available source of funding for mental health services.
Term of Contract: 1 year Expiration Date: 12/31/2017
Contract Routing:
1. Prepared by: li
2. Attorney signoff: rb
3. AS Finance reviewed:
4. IT reviewed (if IT related): _
5. Contractor signed:
6. Submitted to Exec.:
7. Council approved (if necessary):
8. Executive signed:
9. Original to Council: ,/
Date: 9/21/16
Date:
10/25/16
Date:
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Whatcom County Contract No.
201212013 -5
WHATCOM COUNTY HEALTH DEPARTMENT CONTRACT EXTENSION
PARTIES:
Whatcom County
Whatcom County Courthouse
311 Grand Avenue
Bellingham, WA 98225
AND CONTRACTOR:
Sea Mar Community Health Centers
1040 south Henderson St.
Seattle, WA 98108
Whatcom County # 201212013
AMENDMENT NUMBER: 5
CONTRACT PERIODS:
Original: 01/01/2013 — 12/31/2013
Amendment #1 01/01/2014 — 12/31/2014
Amendment #2 01/01/2015 — 12/31/2015
Amendment #3 05/01/2015 — 12/31/2015
Amendment #4 01/01/2016 — 12/31/2016
Amendment #5 01/01/2017 — 12/31/2017
THE CONTRACT IDENTIFIED HEREIN, INCLUDING ANY PREVIOUS AMENDMENTS THERETO,
IS HEREBY EXTENDED AS SET FORTH IN THE DESCRIPTION OF THE EXTENSION BELOW
BY MUTUAL CONSENT OF ALL PARTIES HERETO
DESCRIPTION OF EXTENSION:
1. Extend the duration and other terms of this contract for 1 year, as per the original contract
"General Terms, Section 10.2, Extension ".
2. All other terms and conditions remain unchanged.
3. The effective start date of the extension is January 1, 2017.
HL 010117_Sea_Mar- BHAP_Services Amend #5 Page 1 of 2
ALL OTHER TERMS AND CONDITIONS OF THE ORIGINAL CONTRACT AND ANY PREVIOUS
AMENDMENTS THERETO REMAIN IN FULL FORCE AND EFFECT.
ALL PARTIES IDENTIFIED AS AFFECTED BY THIS EXTENSION HEREBY ACKNOWLEDGE AND
ACCEPT THE TERMS AND CONDITIONS OF THIS EXTENSION.
Signature is required below.
____ --_-____ --=_-_ ____-_____________________ -_ -__
APPROVAL AS TO PROGRAM:
Anne Bacon, Human Services Division Manager lbat6
DEPARTMENT HEAD APPROVAL:
APPROVAL AS TO FORM:
Royce Bu
FOR
Pielahunt Healt, Department Director Date
Prosecuting Attorney Date
ContrActor Sigtfat&e Print Nairn6 and Title
STATE OF WASHINGTON)
COUNTY OF WHATCOM )
, D �s,�' , to me known to be the
instru nt and who acknowledged to me the act of
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NOTARY PUBLIC in an'Tor
the State of Wa49�n
Residing at
My Commission expires: �q N
• c UTMNULCPYA .
Jack Louws,
STATE OF WASHINGTON)
COUNTY OF WHATCOM )
and sealing
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Date
, 2016, before me personally appeared
d who executed the above
tbery
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On this day of '�''��`� , 2016, before me personally appeared Jack
Louws, to me known to be the Executive of Whatcom County and wh, R6 ?cuted the above instrument and who
acknowledged to me the ac signing and sealing thereof. ,.�'' d LA r►44
NOTARY PUBLIC in and for
the State of Washington
Residing at Bellingham.
My Commission expires: D � � S . O)� � 4,
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HL- 010117— Sea — Mar -BHAP— Services Amend #5 Page 2 of 2
WHATCOM COUNTY
Health Department
509 Girard Street
Bellingham, WA 98225
OM 0o
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MEMORANDUM
Regina A. Delahunt
Director
RECEIVED
DEC 5 - 7016
TO: Jack Louws, County Executive JACK LOOS
A46 COUNTY EXECUTIVE
FROM: Regina A. Delahunt, Director
RE: Sea Mar Community Health Centers, Mental Health Treatment Services,
Contract Amendment #5
DATE: November 15, 2016
Enclosed are two (2) originals of a contract amendment between Whatcom County and Sea
Mar Community Health Centers for your review and signature.
■ Background and Purpose
The purpose of this contract is to provide outpatient mental health treatment services to
Whatcom County residents who have no other readily available source of funding to procure
mental health services.
■ Funding Amount and Source
The contract is funded by the Chemical Dependency /Mental Health Program Fund and is
included in the 2017 budget. The agreement establishes reimbursement rates for services
provided to clients. Total compensation will vary depending on the number of services
provided and will be authorized by the Health Department. It's estimated that this contract
will be funded at $5,000 in 2017. County Council approval is not required because this is a
contract extension as allowed by section 10.2 of the original agreement.
• Differences from Previous Contract
The amendment serves only to extend the agreement another year with no other changes.
Please contact Anne Deacon at extension 6054 if you have any questions regarding this
amendment.
Encl.