HomeMy WebLinkAboutPR 23178: CONTRACT WITH CITY OF PORT ARTHUR AND THE DEPARTMENT OF STATE HEALTH SERVICES IMMUNIZATION BRANCH. NO MATCH REQUIRED , 3 ,51
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Date: May 22, 2023
To: Ron Burton, City Manager
From: Judith A. Smith, RN, BSN, Director of Health Services
RE: Contract Agreement between the City of Port Arthur and the Department of
State Health Services Immunization Branch. No match required
Nature of the Request: This contract amendment will allow the Health Department to continue
its immunization program for children, adolescents, and adults to eliminate barriers, expand
immunization delivery, and establish uniform policies. The contract period is from September 1,
2023 to August 31, 2024. The total amount of the grant award will not exceed $162,630.00.
There is no cash match for this grant.
Staff Analysis, Considerations: These grant funds cover a portion of the salaries and fringe for
3 full-time employees, one licensed nurse, one administrative staff and one community outreach
staff.
Recommendations: It is recommended that the City Council approve P.R. No. 23178, the
contract between the City of Port Arthur and the Department of State Health
Services/Immunization Division. This grant will allow the Health Department to continue the
immunization program for children, adolescents, and adults.
Budget Considerations: This grant will cover personnel salaries and fringe benefits. The
additional funds will help fund staff for the COVID vaccination Hub.
"REMEMBER WE ARE HERE TO SERVE THE CITIZENS OF PORT ARTHUR
P.O.BOX 1089•PORT ARTHUR,TX 77641-1089.409/983-8101•FAX 409/982-6743
P. R. No. 23178
05/22/2023-js
RESOLUTION NO.
A RESOLUTION APPROVING THE FY 2024 CONTRACT AGREEMENT
BETWEEN THE CITY OF PORT ARTHUR AND THE DEPARTMENT
OF STATE HEALTH SERVICES, IMMUNIZATION BRANCH-LOCAL
FOR THE CONTRACT PERIOD STARTING SEPTEMBER 1, 2023,
THROUGH AUGUST 31, 2024. THE TOTAL AMOUNT OF THIS
CONTRACT WILL NOT EXCEED $162,630.00 NO CASH MATCH IS
REQUIRED.
WHEREAS, the contract between the City of Port Arthur and the Department of State
Health Services provides financial assistance to the Port Arthur City Health Department to
supplement the delivery of public health services. This contract agreement will allow the City's
Health Department to continue the immunization program for children, adolescents, and adults,
and will help to eliminate barriers, expand immunization delivery, and establish uniform
policies; and,
WHEREAS,the contract amount will not exceed $162,630.00.
NOW THEREFORE BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF PORT ARTHUR:
Section 1. That,the facts and opinions in the preamble are true and correct.
Section 2. That, the City Council of the City of Port Arthur hereby approves the
contract amendment between the City of Port Arthur and the Department of State Health
Services.
Section 3. That, the City Council deems it is in the best interest of the City to
approve and authorize the City Manager and the Director of the City's Health Department to
P. R. No. 23178
05/22/2023-js
execute the contract agreement between the Department of State Health Services and the City of
Port Arthur, Texas,to continue the immunization program as delineated in Exhibit"A".
Section 4. That, a copy of the caption of this Resolution be spread upon the Minutes
of the City Council.
READ, ADOPTED, AND APPROVED, this day of June, 2023 A.D., at a
Regular Meeting of the City Council of the City of Port Arthur, Texas by the following Vote:
AYES: Mayor:
Councilmembers:
NOES:
Mayor
ATTEST:
Sherri Bellard, City Secretary
APP VED TO FORM:
Val Tizeno, ity Att rney
P. R.No. 23178
05/22/2023-js
APPROVED FOR ADMINISTRATION:
u cL4i cry'
Ron Burton, City Manager Judi'Smith, RN, BSN, Director of Health
EXHIBIT "A"
DocuSign Envelope ID:06A02007-F7C1-4CC5-85E4-FD4A893BEBF4
SIGNATURE DOCUMENT FOR
DEPARTMENT OF STATE HEALTH SERVICES GRANT AGREEMENT,
CONTRACT No.HHS001331300034
UNDER THE
IMMUNIZATION LOCALS GRANT PROGRAM
The parties to this agreement("Grant Agreement"or"Contract") are the DEPARTMENT OF STATE
HEALTH SERVICES ("System Agency" or "DSHS"), a pass-through entity, and CITY OF PORT
ARTHUR("Grantee"),having its principal office at 449 Austin Avenue, Port Arthur Texas, 77640
(each a"Party"and collectively the"Parties").
I. PURPOSE
The purpose of this Grant Agreement is to prevent and control the transmission of vaccine-
preventable diseases in children and adults, with emphasis on accelerating strategic interventions
to improve their vaccine coverage levels.
II. LEGAL AUTHORITY
This Grant Agreement is entered into pursuant to Sections 317, 317(k)(2) of the Public Health
Service Act (42 USC Sections 247b, 247b(k)(2) and 247c), as amended. This Contract is
authorized by and in compliance with 42 USC 247b; 42 USC 243; 42 USC 300aa-3, 300aa-25,
and 300aa-26; 42 USC 1396s; Chapter 791 of the Texas Government Code; and Chapters 12, 81,
161 and 1001 of the Texas Health and Safety Code.
III. DURATION
This Grant Agreement is effective on September 1, 2023, and expires on August 31, 2024,unless
sooner terminated or renewed or extended. System Agency, at its sole discretion,may extend this
Grant Agreement for up to four(4)additional one-year terms for a maximum term of five(5)years.
IV. STATEMENT OF WORK
The Scope of Grant Project to which Grantee is bound is incorporated into and made a part of this
Grant Agreement for all purposes and included as ATTACHMENT A,STATEMENT OF WORK.
V. BUDGET AND INDIRECT COST RATE
The total amount of this Grant Agreement will not exceed$162,630.00. Grantee is not required to
provide matching funds.
The total not-to-exceed amount includes the following:
Total Federal Funds: $72,360.00
System Agency Grant Agreement,Contract#HIIS001331300034
Page 1 of 5
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Total State Funds: $90,270.00
All expenditures under the Grant Agreement will be in accordance with ATTACHMENT B,
BUDGET.
VI. REPORTING REQUIREMENTS
Grantee shall submit reports in accordance with the requirements specified in ATTACHMENT A,
STATEMENT OF WORK.
VII. CONTRACT REPRESENTATIVES
The following will act as the representative authorized to administer activities under this Grant
Agreement on behalf of their respective Party.
System Agency Grantee
Contract Manager: Shelva Mays Ron Burton
Department of State Health Services City of Port Arthur
P.O. Box 149347—Mail Code 1990 449 Austin Avenue
Austin, Texas 78714-9347 Port Arthur,Texas 77640
cros_covidimmAdshs.texas.gov ron.burton@portarthurtx.gov
VIII. NOTICE REQUIREMENTS
A. All notices given by Grantee shall be in writing, include the Grant Agreement contract
number, comply with all terms and conditions of the Grant Agreement, and be delivered to
the System Agency's Contract Representative identified above.
B. Grantee shall send legal notices to System Agency at the address below and provide a copy
to the System Agency's Contract Representative:
Health and Human Services Commission
4601 W. Guadalupe, Mail Code 1100
Austin, Texas 78751
Attn: Office of Chief Counsel
With a copy to:
Department of State Health Services
1100 W. 49th Street,Mail Code 1919
Austin,Texas 78756
Attention: Office of General Counsel
C. Notices given by System Agency to Grantee may be emailed, mailed or sent by common
carrier. Email notices shall be deemed delivered when sent by System Agency. Notices sent
by mail shall be deemed delivered when deposited by the System Agency in the United States
mail, postage paid, certified, return receipt requested. Notices sent by common carrier shall
System Agency Grant Agreement,Contract#HHS001331300034
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be deemed delivered when deposited by the System Agency with a common carrier,
overnight, signature required.
D. Notices given by Grantee to System Agency shall be deemed delivered when received by
System Agency.
E. Either Party may change its Contract Representative or Legal Notice contact by providing
written notice to the other Party.
IX. FEDERAL AWARD INFORMATION
GRANTEE'S UNIQUE ENTITY IDENTIFIER IS: NFHJD7V9MGN3
Federal funding under this Grant Agreement is a subaward under the following federal
award.
Federal Award Identification Number (FAIN): NH231P922616
A. Assistance Listings Title: Immunization Cooperative Agreements
B. Assistance Listing Number: 93.268
C. Assistance Listing Dollar Amount: $600,632,928.00
D. Federal Award Date: 07/01/2022
E. Federal Award Period: 07/01/2019—06/30/2024
F. Name of Federal Awarding Agency: Centers for Disease Control and Prevention, Office
of Financial Resources
G. Federal Award Project Description: CDC-RFA-IP19-1901, Immunization and Vaccines
for Children
H. Awarding Official Contact Information:
Name: Kathy Raible, GMS
Email: kcr8@cdc.gov
Phone: 770-488-2045
I. Total Amount of Federal Funds Awarded to System Agency: $23,869,537.00
J. Amount of Funds Awarded to Grantee: $162,630.00
K. Identification of Whether the Award is for Research and Development: No
X. CONTRACT DOCUMENTS
The following documents are incorporated by reference and made a part of this Grant
Agreement for all purposes.
Unless expressly stated otherwise in this Grant Agreement, in the event of conflict, ambiguity
or inconsistency between or among any documents, all System Agency documents take
precedence over Grantee's documents and the Data Use Agreement takes precedence over all
other contract documents.
ATTACHMENT A—STATEMENT OF WORK
System Agency Grant Agreement,Contract#HHS001331300034
Page 3 of 5
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ATTACHMENT B—BUDGET
ATTACHMENT C—HHS CONTRACT AFFIRMATIONS V.2.2(MAY 2022)
ATTACHMENT D—HHS UNIFORM TERMS AND CONDITIONS—GRANT V.3.2
(JULY 2022)
ATTACHMENT E—DATA USE AGREEMENT-TACCHO VERSION(OCTOBER 23,
2019)
ATTACHMENT E-1 DATA USE AGREEMENT-SECURITY AND PRIVACY INQUIRY
ATTACHMENT F—ADDITIONAL PROVISIONS
ATTACHMENT G—FEDERAL ASSURANCES
ATTACHMENT H—CERTIFICATION REGARDING LOBBYING
ATTACHMENT I—DISCLOSURE OF LOBBYING ACTIVITIES(SF-LLL)
ATTACHMENT J—FFATA CERTIFICATION FORM
XI. SIGNATURE AUTHORITY
Each Party represents and warrants that the person executing this Grant Agreement on its
behalf has full power and authority to enter into this Grant Agreement. Any services or work
performed by Grantee before this Grant Agreement is effective or after it ceases to be effective
is performed at the sole risk of Grantee.
SIGNATURE PAGE FOLLOWS
System Agency Grant Agreement,Contract#HHS001331300034
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SIGNATURE PAGE FOR SYSTEM AGENCY GRANT AGREEMENT,
CONTRACT No.HHS001331300034
DEPARTMENT OF STATE HEALTH CITY OF PORT ARTHUR
SERVICES
Signature Signature
Printed Name: Printed Name:
Title: Title:
Date of Signature: Date of Signature:
System Agency Grant Agreement,Contract#HHS001331300034
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ATTACHMENT A
STATEMENT OF WORK
I. GRANTEE RESPONSIBILITIES
Grantee shall:
A. Implement and operate an immunization program for children, adolescents, and adults,
with special emphasis on accelerating interventions to improve the immunization
coverage of children three (3) years of age or younger (birth to 35 months of age).
Grantee shall incorporate traditional and non-traditional systematic approaches
designed to eliminate barriers, expand immunization capacity, and establish uniform
operating policies, as described herein.
B. Be enrolled as a provider in the Texas Vaccines for Children (TVFC) and the Adult
Safety Net (ASN) Programs by the effective date of this Contract. This includes a
signed Deputization Addendum Form (EF11-13999).
C. Maintain staffing levels to meet required activities of the Contract and ensure staff
funded by this Contract attend required training.
D. Report all notifiable conditions as specified in Texas Administrative Code(TAC)Title
25, Part I §§ 97.1-97.6, as amended, and as otherwise required by law.
E. Report all vaccine adverse event occurrences in accordance with the 1986 National
Childhood Vaccine Injury Act (NCVIA) 42 U.S.C. § 300aa-25 (located at
http://vaers.hhs.gov/ or 1-800-822-7967, as amended.
F. Sustain a network of TVFC/ASN providers to administer vaccines to program-eligible
populations by conducting the following activities:
1. Ensuring New Provider Checklist is completed;
2. Conducting quality assurance reviews;
3. Ensuring annual influenza pre-book survey is completed;
4. Conducting compliance site visits;
5. Conducting unannounced storage and handling visits; and
6. Ensuring providers adhere to the vaccine borrowing procedure.
G. Participate in audits and assessments through the following activities:
1. Completing and submitting through Child Health Reporting System(CHRS)all
audits and assessments conducted on childcare facilities and Head Start
Centers;
2. Completing audits, assessments and retrospective surveys of public and private
schools;
3. Reviewing monthly reports to ensure data quality;
4. Reviewing the monthly Provider Activity Reports;
DSHS Contract No.HHS001331300034 Page 1 of 5
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5. Reviewing the quarterly Consent Accepted Rate Evaluations; and
6. Conducting quality improvement assessments of Texas Immunization Registry
organizations.
H. Provide education and outreach activities regarding vaccines and vaccine-preventable
diseases, Texas Immunization Registry, and TVFC and ASN Programs to the
following:
1. American Indian Tribes;
2. Schools and childcare facilities;
3. Healthcare workers; and
4. Community and general public.
I. Not deny vaccinations to recipients because they do not reside within Grantee's
jurisdiction or because of an inability to pay an administration fee.
J. Be responsible for identification and case management of all hepatitis B surface antigen
(HBsAg)-positive pregnant women. Grantee shall ensure timely newborn post-
exposure prophylaxis (PEP)with hepatitis B vaccine and hepatitis B immune globulin
(HBIG), timely completion of doses two and three of hepatitis B vaccine, and timely
completion of post-vaccination serologic testing(PVST).
K. Be responsible for assessing and/or auditing coverage rates and/or compliance with
vaccine requirements at assigned schools and childcare facilities in accordance with the
Population Assessment Manual, which is distributed annually from DSHS.
L. Transfer(which may include shipping)overstocked vaccines and vaccines approaching
expiration to alternate providers for immediate use when instructed to do so by the
DSHS Public Health Region(PHR) Immunization Program Manager to avoid vaccine
waste. Grantee is responsible for covering the cost to ship overstocked vaccines and
vaccines approaching expiration.
M. Receive written approval from DSHS before varying from applicable policies,
procedures, protocols, and/or work plans, and must update and disseminate its
implementation documentation to its staff involved in activities under this Contract
within forty-eight (48) hours of making approved changes.
N. Review monthly Contract funding expenditures and salary savings from any Contract-
paid staff vacancies and revise spending plan to ensure that all funds will be properly
expended under this Contract before the end of the Contract term.
O. Submit out-of-state travel requests to the Immunization Section for approval when
utilizing Contract funds or program income.
II. REPORTING REQUIREMENTS
Grantee shall:
DSHS Contract No.HHS001331300034 Page 2 of 5
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A. Report the number of doses administered to underinsured children monthly, as directed by
DSHS.
B. Report the number of unduplicated underinsured clients served, as directed by DSHS.
C. Complete and submit Immunization Inter-Local Agreement (ILA) Quarterly Report form,
utilizing the format provided by the DSHS Immunization Section and available at
https://dshs.texas.gov/immunize/lhd.shtm by the report due date. If the due date falls on a
weekend or state approved holiday, the report is due the next business day.
Report Type Reporting Period Report Due Date
Programmatic 09/01/2023 to 11/30/2023 12/31/2023
Programmatic 12/01/2023 to 02/29/2024 03/31/2024
Programmatic 03/01/2024 to 05/31/2024 06/30/2024
Programmatic 06/01/2024 to 08/31/2024 09/30/2024
Submit quarterly reports electronically through an online tool according to the
timeframes stated above. DSHS Immunization Section will provide instructions at the
beginning of each state fiscal year through CMS. Supplemental report documents
(PEAR and AFIX reports, vacancy letters, etc.) should be sent to
dshsi mmunizationcontractsAdshs.texas.gov.
D. Submit the Financial Status Report(FSR-269A)biannually as outlined
below. Grantee shall email the Financial Status Report(FSR-269A)to the following
email address: FSRgrants@,dshs.texas.gov.
Period Covered Due Date
September 1, 2023 —February 29, 2024 February 29, 2024
March 1, 2024 -August 31, 2024 September 31, 2024
E. Maintain an inventory of equipment, supplies defined as Controlled Assets, and real
property. Submit an annual cumulative report of the equipment and other property on HHS
System Agency Grantee's Property Inventory Report to the designated DSHS Contract
Manager and fsoequip(a,dshs.texas.gov by email not later than October 15 of each year.
Controlled Assets include firearms, regardless of the acquisition cost, and the following
assets with an acquisition cost of$500 or more, but less than $5,000: desktop and laptop
computers (including notebooks, tablets and similar devices), non-portable printers and
copiers,emergency management equipment,communication devices and systems,medical
and laboratory equipment, and media equipment. Controlled Assets are considered
Supplies.
F. Provide written notification of budget transfers by submission of a revised Categorical
Budget Form to the designated DSHS Contract Manager, highlighting the areas affected
by the budget transfer. Grantee is advised as follows:
DSHS Contract No.HHS001331300034 Page 3 of 5
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1. Transferring funds between budget categories, other than the equipment and indirect
cost categories, is allowable,but cannot exceed 25%of the total Contract value during
a Contract budget period. If the budget transfer(s) exceeds 25% of the total Contract
value, alone or cumulatively, a formal Contract amendment is required; and
2. After review, the designated DSHS Contract Manager shall provide notification of
acceptance to Grantee via email, upon receipt of which, the revised budget shall be
incorporated into the Contract.
3. Grantee's budget revision is not authorized, and funds cannot be utilized until the
contract amendment is executed.
III. RULES
Grantee shall:
A. Provide services in accordance with all applicable federal and state laws, rules,
regulations, standards and guidelines, as amended, including, but not limited to, the
following:
1. Written policies and procedures provided by DSHS in managing vaccines supplied
through the ASN and TVFC Programs, including guidelines for proper storage,
handling, and safeguarding of vaccines in the event of natural disaster.
2. DSHS Immunization updated guidance according to the FY2024 Contractors
Guide, located at:
http s://www.dshs.texas.gov/immunize/Responsible-Entities/Contract-
Management/.
3. Texas Health and Safety Code § 1001.089 and maintain the confidentiality of any
public health data obtained through provision of essential public health services as
those services are defined in Texas Health and Safety Code §121.002.
4. Those terms and conditions set forth in ATTACHMENT E, DATA USE AGREEMENT.
IV. PERFORMANCE MEASURES
System Agency will monitor the Grantee's performance of the requirements in this
ATTACHMENT A and compliance with the Contract's terms and conditions.
V. INVOICE AND PAYMENT
Grantee shall request monthly payments by the 30th day following the service month using
the State of Texas Purchase Voucher (Form B-13) at
http://www.dshs.texas.gov/grants/forms.shtm. System Agency will issue reimbursement
payments to Grantees on a monthly basis for reported actual cash disbursements which are
supported by adequate documentation. Invoices must be submitted monthly to prevent
delays in subsequent months. Grantees that do not incur expenses within a month are
required to submit a"zero dollar" invoice on a monthly basis. Grantee must submit a final
DSHS Contract No.HHS001331300034 Page 4 of 5
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close-out invoice and final financial status report no later than 45 days following the end
of the Contract term. Invoices received more than 45 days after the end of the Contract
term are subject to denial of payment. Grantee shall electronically submit all invoices with
supporting documentation to: invoices@,dshs.texas.gov and
CMSinvoices@,dshs.texas.gov and a copy to the assigned DSHS Contract Representative
identified in the Signature Document.
A. At a minimum, voucher should include:
1. Grantee name, address, email address,vendor identification number, and
telephone number;
2. DSHS Contract or Purchase Order number;
3. Dates services were completed and/or products were delivered;
4. The total invoice amount; and
5. Any additional supporting documentation which is required by the Statement
of Work or as requested by DSHS.
Failure to submit required information may result in delay of payment or return of
invoice. Billing invoices must be legible. Illegible or incomplete invoices which
cannot be verified will be disallowed for payment.
B. DSHS will pay Grantee monthly on a cost reimbursement basis and in accordance
with ATTACHMENT B, BUDGET, of this Contract. DSHS will reimburse Grantee
only for allowable and reported expenses incurred within the grant term.
DSHS Contract No.HHS001331300034 Page 5 of 5
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ATTACHMENT B
BUDGET
Organization Name: City of Port Arthur
Program ID: IMM/LOCALS
Contract Number: HHS001331300034
Budget Category Budget Period Category
9/1/2023-8/31/2024 Total
Personnel $132,395.00 $132,395.00
Fringe Benefits $30,235.00 $30,235.00
Travel $0.00 $0.00
Equipment $0.00 $0.00
Supplies $0.00 $0.00
Contractual $0.00 $0.00
Other $0.00 $0.00
Total Direct $162,630.00 $162,630.00
Charges
Indirect Charges $0.00 $0.00
Total $162,630.00 $162,630.00
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HEALTH AND HUMAN SERVICES
Contract Number HHS001331300034
Attachment C CONTRACT AFFIRMATIONS
For purposes of these Contract Affirmations,HHS includes both the Health and Human Services
Commission(HHSC) and the Department of State Health Services (DSHS). System Agency
refers to HHSC, DSHS, or both, that will be a party to this Contract. These Contract
Affirmations apply to all Contractors and Grantees (referred to as "Contractor")regardless of
their business form(e.g., individual,partnership, corporation).
By entering into this Contract, Contractor affirms, without exception,understands, and agrees to
comply with the following items through the life of the Contract:
1. Contractor represents and warrants that these Contract Affirmations apply to Contractor
and all of Contractor's principals, officers, directors, shareholders,partners, owners,
agents, employees, subcontractors, independent contractors, and any other representatives
who may provide services under, who have a financial interest in, or otherwise are
interested in this Contract and any related Solicitation.
2. Complete and Accurate Information
Contractor represents and warrants that all statements and information provided to HHS
are current, complete, and accurate. This includes all statements and information in this
Contract and any related Solicitation Response.
3. Public Information Act
Contractor understands that HHS will comply with the Texas Public Information Act
(Chapter 552 of the Texas Government Code) as interpreted by judicial rulings and
opinions of the Attorney General of the State of Texas. Information, documentation, and
other material prepared and submitted in connection with this Contract or any related
Solicitation may be subject to public disclosure pursuant to the Texas Public Information
Act. In accordance with Section 2252.907 of the Texas Government Code, Contractor is
required to make any information created or exchanged with the State pursuant to the
Contract, and not otherwise excepted from disclosure under the Texas Public Information
Act, available in a format that is accessible by the public at no additional charge to the
State.
4. Contracting Information Requirements
Contractor represents and warrants that it will comply with the requirements of Section
552.372(a) of the Texas Government Code. Except as provided by Section 552.374(c) of
the Texas Government Code, the requirements of Subchapter J(Additional Provisions
Related to Contracting Information), Chapter 552 of the Government Code, may apply to
the Contract and the Contractor agrees that the Contract can be terminated if the
Contractor knowingly or intentionally fails to comply with a requirement of that
subchapter.
Health and Human Services
Contract Affirmations v.2.2
Effective May 2022
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5. Assignment
A. Contractor shall not assign its rights under the Contract or delegate the performance
of its duties under the Contract without prior written approval from System Agency.
Any attempted assignment in violation of this provision is void and without effect.
B. Contractor understands and agrees the System Agency may in one or more
transactions assign, pledge, or transfer the Contract. Upon receipt of System
Agency's notice of assignment,pledge, or transfer, Contractor shall cooperate with
System Agency in giving effect to such assignment, pledge, or transfer, at no cost to
System Agency or to the recipient entity.
6. Terms and Conditions
Contractor accepts the Solicitation terms and conditions unless specifically noted by
exceptions advanced in the form and manner directed in the Solicitation, if any,under
which this Contract was awarded. Contractor agrees that all exceptions to the Solicitation,
as well as terms and conditions advanced by Contractor that differ in any manner from
HHS' terms and conditions, if any, are rejected unless expressly accepted by System
Agency in writing.
7. HHS Right to Use
Contractor agrees that HHS has the right to use,produce, and distribute copies of and to
disclose to HHS employees, agents, and contractors and other governmental entities all or
part of this Contract or any related Solicitation Response as HHS deems necessary to
complete the procurement process or comply with state or federal laws.
8. Release from Liability
Contractor generally releases from liability and waives all claims against any party
providing information about the Contractor at the request of System Agency.
9. Dealings with Public Servants
Contractor has not given, has not offered to give, and does not intend to give at any time
hereafter any economic opportunity, future employment, gift, loan, gratuity, special
discount, trip, favor, or service to a public servant in connection with this Contract or any
related Solicitation, or related Solicitation Response.
10. Financial Participation Prohibited
Under Section 2155.004, Texas Government Code(relating to financial participation in
preparing solicitations), Contractor certifies that the individual or business entity named
in this Contract and any related Solicitation Response is not ineligible to receive this
Contract and acknowledges that this Contract may be terminated and payment withheld if
this certification is inaccurate.
11. Prior Disaster Relief Contract Violation
Under Sections 2155.006 and 2261.053 of the Texas Government Code (relating to
convictions and penalties regarding Hurricane Rita, Hurricane Katrina, and other
disasters), the Contractor certifies that the individual or business entity named in this
Contract and any related Solicitation Response is not ineligible to receive this Contract
Health and Human Services
Contract Affirmations v.2.2
Effective May 2022
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and acknowledges that this Contract may be terminated and payment withheld if this
certification is inaccurate.
12. Child Support Obligation
Under Section 231.006(d) of the Texas Family Code regarding child support, Contractor
certifies that the individual or business entity named in this Contract and any related
Solicitation Response is not ineligible to receive the specified payment and acknowledges
that the Contract may be terminated and payment may be withheld if this certification is
inaccurate. If the certification is shown to be false, Contractor may be liable for additional
costs and damages set out in 231.006(f).
13. Suspension and Debarment
Contractor certifies that it and its principals are not suspended or debarred from doing
business with the state or federal government as listed on the State of Texas Debarred
Vendor List maintained by the Texas Comptroller of Public Accounts and the System for
Award Management(SAM)maintained by the General Services Administration. This
certification is made pursuant to the regulations implementing Executive Order 12549 and
Executive Order 12689, Debarment and Suspension, 2 C.F.R. Part 376, and any relevant
regulations promulgated by the Department or Agency funding this project. This
provision shall be included in its entirety in Contractor's subcontracts, if any, if payment
in whole or in part is from federal funds.
14. Excluded Parties
Contractor certifies that it is not listed in the prohibited vendors list authorized by
Executive Order 13224, "Blocking Property and Prohibiting Transactions with Persons
Who Commit, Threaten to Commit, or Support Terrorism, "published by the United States
Department of the Treasury, Office of Foreign Assets Control.'
15. Foreign Terrorist Organizations
Contractor represents and warrants that it is not engaged in business with Iran, Sudan, or a
foreign terrorist organization, as prohibited by Section 2252.152 of the Texas Government
Code.
16. Executive Head of a State Agency
In accordance with Section 669.003 of the Texas Government Code, relating to
contracting with the executive head of a state agency, Contractor certifies that it is not(1)
the executive head of an HHS agency, (2) a person who at any time during the four years
before the date of this Contract was the executive head of an HHS agency, or(3) a person
who employs a current or former executive head of an HHS agency.
17. Human Trafficking Prohibition
Under Section 2155.0061 of the Texas Government Code, Contractor certifies that the
individual or business entity named in this Contract is not ineligible to receive this
Contract and acknowledges that this Contract may be terminated and payment withheld if
this certification is inaccurate.
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18. Franchise Tax Status
Contractor represents and warrants that it is not currently delinquent in the payment of
any franchise taxes owed the State of Texas under Chapter 171 of the Texas Tax Code.
19. Debts and Delinquencies
Contractor agrees that any payments due under this Contract shall be applied towards any
debt or delinquency that is owed to the State of Texas.
20. Lobbying Prohibition
Contractor represents and warrants that payments to Contractor and Contractor's receipt
of appropriated or other funds under this Contract or any related Solicitation are not
prohibited by Sections 556.005, 556.0055, or 556.008 of the Texas Government Code
(relating to use of appropriated money or state funds to employ or pay lobbyists, lobbying
expenses, or influence legislation).
21. Buy Texas
Contractor agrees to comply with Section 2155.4441 of the Texas Government Code,
requiring the purchase of products and materials produced in the State of Texas in
performing service contracts.
22. Disaster Recovery Plan
Contractor agrees that upon request of System Agency, Contractor shall provide copies of
its most recent business continuity and disaster recovery plans.
23. Computer Equipment Recycling Program
If this Contract is for the purchase or lease of computer equipment, then Contractor
certifies that it is in compliance with Subchapter Y, Chapter 361 of the Texas Health and
Safety Code related to the Computer Equipment Recycling Program and the Texas
Commission on Environmental Quality rules in 30 TAC Chapter 328.
24. Television Equipment Recycling Program
If this Contract is for the purchase or lease of covered television equipment,then
Contractor certifies that it is compliance with Subchapter Z, Chapter 361 of the Texas
Health and Safety Code related to the Television Equipment Recycling Program.
25. Cybersecurity Training
A. Contractor represents and warrants that it will comply with the requirements of
Section 2054.5192 of the Texas Government Code relating to cybersecurity training
and required verification of completion of the training program.
B. Contractor represents and warrants that if Contractor or Subcontractors, officers, or
employees of Contractor have access to any state computer system or database, the
Contractor, Subcontractors, officers, and employees of Contractor shall complete
cybersecurity training pursuant to and in accordance with Government Code, Section
2054.5192.
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26. Restricted Employment for Certain State Personnel
Contractor acknowledges that,pursuant to Section 572.069 of the Texas Government
Code, a former state officer or employee of a state agency who during the period of state
service or employment participated on behalf of a state agency in a procurement or
contract negotiation involving Contractor may not accept employment from Contractor
before the second anniversary of the date the Contract is signed or the procurement is
terminated or withdrawn.
27. No Conflicts of Interest
A. Contractor represents and warrants that it has no actual or potential conflicts of
interest in providing the requested goods or services to System Agency under this
Contract or any related Solicitation and that Contractor's provision of the requested
goods and/or services under this Contract and any related Solicitation will not
constitute an actual or potential conflict of interest or reasonably create an appearance
of impropriety.
B. Contractor agrees that, if after execution of the Contract, Contractor discovers or is
made aware of a Conflict of Interest, Contractor will immediately and fully disclose
such interest in writing to System Agency. In addition, Contractor will promptly and
fully disclose any relationship that might be perceived or represented as a conflict
after its discovery by Contractor or by System Agency as a potential conflict. System
Agency reserves the right to make a final determination regarding the existence of
Conflicts of Interest, and Contractor agrees to abide by System Agency's decision.
28. Fraud,Waste, and Abuse
Contractor understands that HHS does not tolerate any type of fraud, waste, or abuse.
Violations of law, agency policies, or standards of ethical conduct will be investigated,
and appropriate actions will be taken. Pursuant to Texas Government Code, Section
321.022, if the administrative head of a department or entity that is subject to audit by the
state auditor has reasonable cause to believe that money received from the state by the
department or entity or by a client or contractor of the department or entity may have
been lost, misappropriated, or misused, or that other fraudulent or unlawful conduct has
occurred in relation to the operation of the department or entity, the administrative head
shall report the reason and basis for the belief to the Texas State Auditor's Office (SAO).
All employees or contractors who have reasonable cause to believe that fraud,waste, or
abuse has occurred(including misconduct by any HHS employee, Grantee officer, agent,
employee, or subcontractor that would constitute fraud, waste, or abuse) are required to
immediately report the questioned activity to the Health and Human Services
Commission's Office of Inspector General. Contractor agrees to comply with all
applicable laws, rules,regulations, and System Agency policies regarding fraud,waste,
and abuse including,but not limited to, HHS Circular C-027.
A report to the SAO must be made through one of the following avenues:
• SAO Toll Free Hotline: 1-800-TX-AUDIT
• SAO website: http://sao.fraud.state.tx.us/
All reports made to the OIG must be made through one of the following avenues:
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• OIG Toll Free Hotline 1-800-436-6184
• OIG Website: ReportTexasFraud.com
• Internal Affairs Email: InternalAffairsReferral@hhsc.state.tx.us
• OIG Hotline Email: OIGFraudHotline@hhsc.state.tx.us.
• OIG Mailing Address: Office of Inspector General
Attn: Fraud Hotline
MC 1300
P.O. Box 85200
Austin, Texas 78708-5200
29. Antitrust
The undersigned affirms under penalty of perjury of the laws of the State of Texas that:
A. in connection with this Contract and any related Solicitation Response, neither I nor
any representative of the Contractor has violated any provision of the Texas Free
Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15;
B. in connection with this Contract and any related Solicitation Response,neither I nor
any representative of the Contractor has violated any federal antitrust law; and
C. neither I nor any representative of the Contractor has directly or indirectly
communicated any of the contents of this Contract and any related Solicitation
Response to a competitor of the Contractor or any other company, corporation, firm,
partnership or individual engaged in the same line of business as the Contractor.
30. Legal and Regulatory Actions
Contractor represents and warrants that it is not aware of and has received no notice of
any court or governmental agency proceeding, investigation, or other action pending or
threatened against Contractor or any of the individuals or entities included in numbered
paragraph 1 of these Contract Affirmations within the five(5) calendar years immediately
preceding execution of this Contract or the submission of any related Solicitation
Response that would or could impair Contractor's performance under this Contract,relate
to the contracted or similar goods or services, or otherwise be relevant to System
Agency's consideration of entering into this Contract. If Contractor is unable to make the
preceding representation and warranty, then Contractor instead represents and warrants
that it has provided to System Agency a complete, detailed disclosure of any such court
or governmental agency proceeding, investigation, or other action that would or could
impair Contractor's performance under this Contract, relate to the contracted or similar
goods or services, or otherwise be relevant to System Agency's consideration of entering
into this Contract. In addition, Contractor acknowledges this is a continuing disclosure
requirement. Contractor represents and warrants that Contractor shall notify System
Agency in writing within five(5)business days of any changes to the representations or
warranties in this clause and understands that failure to so timely update System Agency
shall constitute breach of contract and may result in immediate contract termination.
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31. No Felony Criminal Convictions
Contractor represents that neither Contractor nor any of its employees, agents, or
representatives, including any subcontractors and employees, agents, or representative of
such subcontractors, have been convicted of a felony criminal offense or that if such a
conviction has occurred Contractor has fully advised System Agency in writing of the
facts and circumstances surrounding the convictions.
32. Unfair Business Practices
Contractor represents and warrants that it has not been the subject of allegations of
Deceptive Trade Practices violations under Chapter 17 of the Texas Business and
Commerce Code, or allegations of any unfair business practice in any administrative
hearing or court suit and that Contractor has not been found to be liable for such practices
in such proceedings. Contractor certifies that it has no officers who have served as
officers of other entities who have been the subject of allegations of Deceptive Trade
Practices violations or allegations of any unfair business practices in an administrative
hearing or court suit and that such officers have not been found to be liable for such
practices in such proceedings.
33. Entities that Boycott Israel
Contractor represents and warrants that(1) it does not, and shall not for the duration of
the Contract, boycott Israel or(2) the verification required by Section 2271.002 of the
Texas Government Code does not apply to the Contract. If circumstances relevant to this
provision change during the course of the Contract, Contractor shall promptly notify
System Agency.
34. E-Verify
Contractor certifies that for contracts for services, Contractor shall utilize the U.S.
Department of Homeland Security's E-Verify system during the term of this Contract to
determine the eligibility of:
1. all persons employed by Contractor to perform duties within Texas; and
2. all persons, including subcontractors, assigned by Contractor to perform work
pursuant to this Contract within the United States of America.
35. Former Agency Employees—Certain Contracts
If this Contract is an employment contract, a professional services contract under Chapter
2254 of the Texas Government Code, or a consulting services contract under Chapter
2254 of the Texas Government Code, in accordance with Section 2252.901 of the Texas
Government Code, Contractor represents and warrants that neither Contractor nor any of
Contractor's employees including,but not limited to,those authorized to provide services
under the Contract, were former employees of an HHS Agency during the twelve (12)
month period immediately prior to the date of the execution of the Contract.
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36. Disclosure of Prior State Employment—Consulting Services
If this Contract is for consulting services,
A. In accordance with Section 2254.033 of the Texas Government Code, a Contractor
providing consulting services who has been employed by, or employs an individual
who has been employed by, System Agency or another State of Texas agency at any
time during the two years preceding the submission of Contractor's offer to provide
services must disclose the following information in its offer to provide services.
Contractor hereby certifies that this information was provided and remains true,
correct, and complete:
1. Name of individual(s)(Contractor or employee(s));
2. Status;
3. The nature of the previous employment with HHSC or the other State of Texas
agency;
4. The date the employment was terminated and the reason for the termination; and
5. The annual rate of compensation for the employment at the time of its
termination.
B. If no information was provided in response to Section A above, Contractor certifies
that neither Contractor nor any individual employed by Contractor was employed by
System Agency or any other State of Texas agency at any time during the two years
preceding the submission of Contractor's offer to provide services.
37. Abortion Funding Limitation
Contractor understands, acknowledges, and agrees that, pursuant to Article IX of the
General Appropriations Act(the Act), to the extent allowed by federal and state law,
money appropriated by the Texas Legislature may not be distributed to any individual or
entity that, during the period for which funds are appropriated under the Act:
1. performs an abortion procedure that is not reimbursable under the state's Medicaid
program;
2. is commonly owned, managed, or controlled by an entity that performs an abortion
procedure that is not reimbursable under the state's Medicaid program; or
3. is a franchise or affiliate of an entity that performs an abortion procedure that is not
reimbursable under the state's Medicaid program.
The provision does not apply to a hospital licensed under Chapter 241, Health and Safety
Code, or an office exempt under Section 245.004(2), Health and Safety Code. Contractor
represents and warrants that it is not ineligible, nor will it be ineligible during the term of
this Contract, to receive appropriated funding pursuant to Article IX.
38. Funding Eligibility
Contractor understands, acknowledges, and agrees that,pursuant to Chapter 2272 (eff.
Sept. 1, 2021, Ch. 2273) of the Texas Government Code, except as exempted under that
Chapter,HHSC cannot contract with an abortion provider or an affiliate of an abortion
provider. Contractor certifies that it is not ineligible to contract with HHSC under the
terms of Chapter 2272 (eff. Sept. 1, 2021, Ch. 2273) of the Texas Government Code.
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39. Prohibition on Certain Telecommunications and Video Surveillance Services or
Equipment(2 CFR 200.216)
Contractor certifies that the individual or business entity named in this Response or
Contract is not ineligible to receive the specified Contract or funding pursuant to 2 CFR
200.216.
40. COVID-19 Vaccine Passports
Pursuant to Texas Health and Safety Code, Section 161.0085(c), Contractor certifies that
it does not require its customers to provide any documentation certifying the customer's
COVID-19 vaccination or post-transmission recovery on entry to, to gain access to, or to
receive service from the Contractor's business. Contractor acknowledges that such a
vaccine or recovery requirement would make Contractor ineligible for a state-funded
contract.
41. Entities that Boycott Energy Companies
In accordance with Senate Bill 13, Acts 2021, 87th Leg., R.S.,pursuant to Section
2274.002 of the Texas Government Code(relating to prohibition on contracts with
companies boycotting certain energy companies), Contractor represents and warrants
that: (1) it does not, and will not for the duration of the Contract,boycott energy
companies or(2)the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
42. Entities that Discriminate Against Firearm and Ammunition Industries
In accordance with Senate Bill 19, Acts 2021, 87th Leg., R.S.,pursuant to Section
2274.002 of the Texas Government Code(relating to prohibition on contracts with
companies that discriminate against firearm and ammunition industries), Contractor
verifies that: (1) it does not, and will not for the duration of the Contract,have a practice,
policy, guidance, or directive that discriminates against a firearm entity or firearm trade
association or(2)the verification required by Section 2274.002 of the Texas Government
Code does not apply to the Contract. If circumstances relevant to this provision change
during the course of the Contract, Contractor shall promptly notify System Agency.
43. Security Controls for State Agency Data
In accordance with Senate Bill 475, Acts 2021, 87th Leg., R.S., pursuant to Texas
Government Code, Section 2054.138, Contractor understands, acknowledges, and agrees
that if, pursuant to this Contract, Contractor is or will be authorized to access, transmit,
use, or store data for System Agency, Contractor is required to meet the security controls
the System Agency determines are proportionate with System Agency's risk under the
Contract based on the sensitivity of System Agency's data and that Contractor must
periodically provide to System Agency evidence that Contractor meets the security
controls required under the Contract.
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44. Cloud Computing State Risk and Authorization Management Program (TX-RAMP)
In accordance with Senate Bill 475, Acts 2021, 87th Leg., R.S., pursuant to Texas
Government Code, Section 2054.0593, Contractor acknowledges and agrees that, if
providing cloud computing services for System Agency, Contractor must comply with
the requirements of the state risk and authorization management program and that System
Agency may not enter or renew a contract with Contractor to purchase cloud computing
services for the agency that are subject to the state risk and authorization management
program unless Contractor demonstrates compliance with program requirements. If
providing cloud computing services for System Agency that are subject to the state risk
and authorization management program, Contractor certifies it will maintain program
compliance and certification throughout the term of the Contract.
45. Office of Inspector General Investigative Findings Expert Review
In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it
possesses the necessary occupational licenses and experience.
46. Contract for Professional Services of Physicians,Optometrists, and Registered
Nurses
In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 2254.008(a)(2)is applicable to this Contract, Contractor affirms that it
possesses the necessary occupational licenses and experience.
47. Foreign-Owned Companies in Connection with Critical Infrastructure
If Texas Government Code, Section 2274.0102(a)(1) (relating to prohibition on contracts
with certain foreign-owned companies in connection with critical infrastructure) is
applicable to this Contract,pursuant to Government Code Section 2274.0102, Contractor
certifies that neither it nor its parent company, nor any affiliate of Contractor or its parent
company, is: (1) majority owned or controlled by citizens or governmental entities of
China, Iran,North Korea, Russia, or any other country designated by the Governor under
Government Code Section 2274.0103, or(2)headquartered in any of those countries.
48. Critical Infrastructure Subcontracts
For purposes of this Paragraph, the designated countries are China, Iran, North Korea,
Russia, and any countries lawfully designated by the Governor as a threat to critical
infrastructure. Pursuant to Section 113.002 of the Business and Commerce Code,
Contractor shall not enter into a subcontract that will provide direct or remote access to or
control of critical infrastructure, as defined by Section 113.001 of the Texas Business and
Commerce Code, in this state, other than access specifically allowed for product warranty
and support purposes to any subcontractor unless (i)neither the subcontractor nor its
parent company, nor any affiliate of the subcontractor or its parent company, is majority
owned or controlled by citizens or governmental entities of a designated country; and(ii)
neither the subcontractor nor its parent company, nor any affiliate of the subcontractor or
its parent company, is headquartered in a designated country. Contractor will notify the
System Agency before entering into any subcontract that will provide direct or remote
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access to or control of critical infrastructure, as defined by Section 113.001 of the Texas
Business & Commerce Code, in this state.
49. Enforcement of Certain Federal Firearms Laws Prohibited
In accordance with House Bill 957, Acts 2021, 87th Leg., R.S., if Texas Government
Code, Section 2.101 is applicable to Contractor, Contractor certifies that it is not
ineligible to receive state grant funds pursuant to Texas Government Code, Section
2.103.
50. Prohibition on Abortions
Contractor understands, acknowledges, and agrees that, pursuant to Article II of the
General Appropriations Act, (1)no funds shall be used to pay the direct or indirect costs
(including marketing, overhead, rent,phones, and utilities) of abortion procedures
provided by contractors of HHSC; and(2)no funds appropriated for Medicaid Family
Planning, Healthy Texas Women Program, or the Family Planning Program shall be
distributed to individuals or entities that perform elective abortion procedures or that
contract with or provide funds to individuals or entities for the performance of elective
abortion procedures. Contractor represents and warrants that it is not ineligible, nor will it
be ineligible during the term of this Contract, to receive appropriated funding pursuant to
Article II.
51. False Representation
Contractor understands, acknowledges, and agrees that any false representation or any
failure to comply with a representation,warranty, or certification made by Contractor is
subject to all civil and criminal consequences provided at law or in equity including,but
not limited to, immediate termination of this Contract.
52. False Statements
Contractor represents and warrants that all statements and information prepared and
submitted by Contractor in this Contract and any related Solicitation Response are
current, complete, true, and accurate. Contractor acknowledges any false statement or
material misrepresentation made by Contractor during the performance of this Contract
or any related Solicitation is a material breach of contract and may void this Contract.
Further, Contractor understands, acknowledges, and agrees that any false representation
or any failure to comply with a representation, warranty, or certification made by
Contractor is subject to all civil and criminal consequences provided at law or in equity
including,but not limited to, immediate termination of this Contract.
53. Permits and License
Contractor represents and warrants that it will comply with all applicable laws and
maintain all permits and licenses required by applicable city, county, state, and federal
rules,regulations, statutes, codes, and other laws that pertain to this Contract.
54. Equal Employment Opportunity
Contractor represents and warrants its compliance with all applicable duly enacted state
and federal laws governing equal employment opportunities.
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55. Federal Occupational Safety and Health Law
Contractor represents and warrants that all articles and services shall meet or exceed the
safety standards established and promulgated under the Federal Occupational Safety and
Health Act of 1970, as amended(29 U.S.C. Chapter 15).
56. Signature Authority
Contractor represents and warrants that the individual signing this Contract Affirmations
document is authorized to sign on behalf of Contractor and to bind the Contractor.
Signature Page Follows
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Authorized representative on behalf of Contractor must complete and sign the following:
Legal Name of Contractor
Assumed Business Name of Contractor, if applicable (d/b/a or `doing business as')
Texas County(s) for Assumed Business Name (d/b/a or `doing business as')
Attach Assumed Name Certificate(s) filed with the Texas Secretary of State and Assumed
Name Certificate(s),if any,for each Texas County Where Assumed Name Certificate(s) has
been filed.
Signature of Authorized Representative Date Signed
Printed Name of Authorized Representative Title of Authorized Representative
First, Middle Name or Initial, and Last Name
Physical Street Address City, State,Zip Code
Mailing Address, if different City, State, Zip Code
Phone Number Fax Number
Email Address DUNS Number
Federal Employer Identification Number Texas Identification Number (TIN)
Texas Franchise Tax Number Texas Secretary of State Filing
Number
SAM.gov Unique Entity Identifier(UEI)
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•.•`• .•.... ..••••
ti*. TExAs
••••:"..b-dgri Health and Human Services
••--......••
Health and Human Services (HHS)
Uniform Terms and Conditions - Grant
Version 3.2
Published and Effective — July 2022
Responsible Office: Chief Counsel
DocuSign Envelope ID:06A02007-F7C1-4CC5-85E4-FD4A893BEBF4
ABOUT THIS DOCUMENT
In this document,Grantees(also referred to in this document as subrecipients or contractors)will find
requirements and conditions applicable to grant funds administered and passed-through by both the Texas Health
and Human Services Commission(HHSC)and the Department of State Health Services(DSHS). These
requirements and conditions are incorporated into the Grant Agreement through acceptance by Grantee of any
funding award by HHSC or DSHS.
The terms and conditions in this document are in addition to all requirements listed in the RFA, if any,under
which applications for this grant award are accepted, as well as all applicable federal and state laws and
regulations. Applicable federal and state laws and regulations may include,but are not limited to: 2 CFR Part 200,
Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards;
requirements of the entity that awarded the funds to HHS; Chapter 783 of the Texas Government Code; Texas
Comptroller of Public Accounts' agency rules(including Uniform Grant and Contract Standards set forth in Title
34,Part 1, Chapter 20, Subchapter E,Division 4 of the Texas Administrative Code);the Texas Grant
Management Standards(TxGMS)developed by the Texas Comptroller of Public Accounts; and the Funding
Announcement, Solicitation, or other instrument/documentation under which HHS was awarded funds. HHS,in
its sole discretion,reserves the right to add requirements,terms,or conditions.
HHS Uniform Terms and Conditions—Grant v 3.2
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