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N2Ke NmF=B(|Ɍ^ 1KMweAaXz mP6s+Ňe:hż#!D UNe % 0(w@4!5UNDUN 1uNU 0DW^ U< 0c mh 0w 0 0 0  0 0 0v 1e 1 1s 1 0sG 0Le  0U N "X 0zUBjN BU<6Ul>^?? 0CM 1iU:M 2 1"U:@# 0z#<^$f$a$f$a$E$f$a$ 0B$N % 0D"%Mf%U.j%-%% B L' D3i''' 1k)-)*++++++++++++u-"----------------------- 0W-- 0////////////////////////////////////////////////////////////////////// C0000000000000000000f1a1\\DHR-TREE\hrb-401-sd-p20(hH  Z 6Times New Roman RegularX($ E{baEJ*\Z&$!|x(hH  Z6Times New Roman Regular(hH 9Z 6Times New Roman Regular3#37=CIQYag1.a.i.(1)(a)(i)1)a)(3$ !  =,c 3\  `$Times NewRoman(;3$2#  0  .3  0  U(O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#hG_cgkosw{Bullet ListBullet List(5hCEKQW]cioAutoList11.1.1.1.1.1.1.1.(EhCEKQW]cioAutoList21.1.1.1.1.1.1.1.(CEKQW]cioAutoList3A.A.A.A.A.A.A.A.1, 2, 3,Level 1Level 2Level 3Level 4Level 5B121, 2, 3,Numbers  .0  >c$"Small Circle"0  T :1Bullet List1Bullet List  >4XX` hp x (#%>XXXW(\  `*Times New RomanTTW        W(\  `*Times New RomanTTW>4X` hp x (#>  9 Z6Times New Roman Regular      8Kl6Plain TextK+<6X9`(Courier NewKS,\  `&Times New RomanS+ `*Times New RomanTT%  d<6X9`(Courier New\  `&Times New Roman TTRX3' LetterYD3'Or Letterhead3' Letter3'Or LetterheadT(2C$ !  $35;AGMU]c2I.A.1.a.(1)(a)i)a)2 Ha`$"Letter Gothic ( /C)  $      XX(K] H4X` hp x (#XH      E1XX` hp x (#XE??US.,(XC?X(K]US.,??.,UXXH4XX` hp x (#%XXXH#(K]X(XC?g#(CEKQW]cioAutoList4A.A.A.A.A.A.A.A.,  AZ"Arial Regularzh :Right Par[2]Right-Aligned Paragraph Numbers..` ..2A.3  Ԁ..0` ..` Information for CH Check FormTABLE CTABLE ATABLE E&2$ !  6b$Triangle0 %2A`ArialTT #E } /C)  X3XXk:\jhart\rfp\292\rfp292.wpd `     h      p      x   (#  %   1 X 9  #XWX37#&.%XXW dFFFF'dxd I  /C)    %XWXXX% X%XW.r#bI:\PROCURE\CENTRAL.KT\100000\101000\101917jsd.wpdrI:\PROCURE\CENTRAL.KT\100000\101000\101917jsd.wpd/  #  % 7#58  # 85E#%   (ʽCEKQW]cioAutoList51)1)1)1)1)1)1)1) #L } /C)  X3XXk:\jhart\rfp\292\rfp292.wpd `     h      p      x   (#  %   1 X 9  #XWX37#&.%XXW N  /C)    %XWXXX% X%XW.r#bI:\PROCURE\CENTRAL.KT\100000\101000\101917jsd.wpdrI:\PROCURE\CENTRAL.KT\100000\101000\101917jsd.wpd/  #  % 7#58  # 85E#%        ,   @0ApxTxt1ApxTxt1  XXXW(\  `*Times New RomanTTW        &&&W(\  `*Times New RomanTTWD2ApxHead3ApxHead3&    ;1` hp x (#;XXXCC%2A`ArialTTC          &&&W(\  `*Times New RomanTTW>4X` hp x (#>'   dTABLE D !  _XXXX  TRX3'"Oregon LetterheadX3' Letter3' Letter3'T8WXXdd8TRYD3'Or LetterheadX3' Letter3'Or Letterhead3'T-     `     h      p      x  Contract#101917   `      `     h      p      x    StateofOregonPersonal/ProfessionalServicesContract  h     ThiscontractisbetweentheStateofOregonactingbyandthroughitsDepartmentofHumanServices,OfficeofInformationServices,hereinafterreferredtoas  DHS ,and ,    _SBI_ԀEmerald,Inc.  2825ECottonwood,STE.480SaltLakeCity,Utah81421   * hereinafterreferredtoas"Contractor. `  'X,XXX'I.0  EFFECTIVEDATEandDURATION 8%% Thiscontractshallbecomeeffectiveonthedatethiscontracthasbeensignedbyeverypartyhereto,and,whenrequired,approvedbyDepartmentofAdministrativeServicesandDepartmentofJustice.Unlessterminatedorextended,thiscontractshallexpirewhenDHSacceptsContractorscompletedperformanceoron May20,2002 , T whicheverdateoccursfirst.ExpirationshallnotextinguishorprejudiceDHSsrighttoenforcethiscontractwithrespecttoanybreachofaContractorswarrantyoranydefaultordefectinContractorperformancethathasnotbeencured. II.0  PURPOSE %% ThiscontractprovidesforInformationTechnologyservicestomanageidentified,activeprojectelementsoftheDHS,_MMIS_ԀProject III.0  STATEMENTofWORK "L #%% Thestatementofwork(the Work)includingthedeliveryscheduleforsuchworkiscontainedinExhibitA,attachedandincorporatedbyreferenceintothiscontract.Contractoragreestoperformtheworkinaccordancewiththetermsandconditionsofthiscontract. IV.0  CONSIDERATION ,(%)%%  A .0  DHSagreestopayContractorforaccomplishingtheWorkasrequiredbythiscontract,plusanyallowable *'+ expensesandanytravelandotherexpensereimbursementwhennotedherein.Paymentforallworkperformedunderthiscontractshallbesubjecttotheprovisionsof_ORS_Ԁ293.462andshallnotexceedthetotalmaximumsumof$74,400.00tobepaidtherateof$120.00perhour. %%  &.%XX -`+/ - -TRX3' LetterYD3'Or Letterhead3' Letter3'Or LetterheadT -  B. 0  #XWX%&.[#InterimpaymentsshallbemadetoContractorfollowingDHSsreviewandapprovalofinvoicessubmitted X  byContractor. %%  C .0  Contractorshallnotsubmitinvoicesfor,andDHSwillnotpay,anyamountinexcessofthemaximum  compensationamountsetforthabove.Ifthismaximumcompensationamountisincreasedbyamendmentofthiscontract,theamendmentmustbefullyeffectivebeforeContractorperformsworksubjecttotheamendment.ContractorshallnotifyDHS'sContractAdministratorinwritingthirty(30)calendardaysbeforethiscontractexpires,oftheupcomingexpirationofthecontract.Nopaymentwillbemadeforanyservicesperformedbeforethebeginningdateoraftertheexpirationdateofthiscontract,asitmaybeamendedfrom&.%XXW  d%% #XWX%&.#   timetotimeinaccordancewithitsterms.  P   D. 0  Contractorshallsubmitmonthlyinvoicesforworkperformed.Theinvoicesshalldescribeallworkperformed  (  withparticularityandbywhomitwasperformedandshallitemizeandexplainallexpensesforwhichreimbursementisclaimed.TheinvoicesshallalsoincludethetotalamountinvoicedtodatebyContractorpriortocurrentinvoice.Contractorwillspecificallynotetheappropriateinvoicewhenonethirdandtwothirdsofthemaximumcontractamount,includingexpensereimbursement,hasbeenexpended.ContractorshallsendinvoicestoDHSsContractAdministrator(seeE.,below). %%  E. 0  TheDHSemployeeassignedtomonitorcontractcompliance,authorizepaymentandactasDHSsContract  Administratoronmattersconcerningthiscontractshallbe: %%   JimJoyce,ordelegate  OfficeofInformationServices  OregonDepartmentofHumanServices  500SummerSt,NE  SalemOR97310  &.%XXW  #XWX%&.#V.0  TRAVELandPERDIEM&.%XXW4%%  #XWX%&.#Notravelorotherexpensesshallbepaidinadditiontothecostherein.    VI.0  CONTRACTinitsENTIRETY %% 3X,XS` XX,XX3ThisContractconsistsofthisdocumentandincludesthefollowinglistedexhibitswhicharelistedindescendingorderofprecedenceandareattachedandincorporatedintothisContractbyreference: A. 0  ExhibitA:0S%%StatementofWork!P"S%S%  B. 0  ExhibitB:0S%%GeneralProvisions"@ #S%S%  C. 0  ExhibitC:0S%%CertificationStatementforIndependentContractor#0!$S%S%  D.   ExhibitD:0 S ConfidentialityAgreementx$ "%S%S% L 4(3 L 3   3 2  E  .3  0    ExhibitE:0S%%CriminalHistoryAgreement3 N݌h%#&S%S% Ќ  L ((4L F.   Exhibit F:0 S Solicitation#1096X&$'S%S%  G.   ExhibitG:0 S ContractorsProposaltoSolicitation#1096 H'$(S%S%  Therearenoothercontractdocumentsunlessspecificallyreferencedandincorporatedinthecontract.&.%XXW  $)&* 9X,X` XX,XS` X9#XWX%&.#VII.0  MERGERCLAUSE;WAIVER *(,%% Thiscontractandattachedexhibitsconstitutetheentireagreementbetweenthepartiesonthesubjectmatterhereof.Therearenounderstandings,agreements,orrepresentations,oralorwritten,notspecifiedhereinregardingthiscontract.Nowaiver,consent,modificationorchangeoftermsofthiscontractshallbindeitherpartyunlessinwritingandsignedbybothpartiesandallnecessaryStateapprovalshavebeenobtained.Suchwaiver,consent, .@,0 modificationorchange,ifmade,shallbeeffectiveonlyinthespecificinstanceandforthespecificpurposegiven.ThefailureofDHStoenforceanyprovisionofthiscontractshallnotconstituteawaiverbyDHSofthatoranyotherprovision.  0 &.%XXWCONTRACTOR,BYEXECUTIONofTHISCONTRACT,HEREBYACKNOWLEDGESTHATCONTRACTOR  HASREADTHISCONTRACT,UNDERSTANDSIT,ANDAGREESTOBEBOUNDBYITSTERMSANDCONDITIONS.#XWX%&.##2X!XXXW `  2&%X2X!#&.%%2&$# VIII.0  CONTRACTORDATAandCERTIFICATION;SIGNATURESH %%  #XWX%&.$# XXWName(exactlyasfiledwiththeIRS)________________________________________________    9X,XF XX,X` X9Address F ______________________________________________________________________ I   9X,XFXX,XF X90   F ______________________________________________________________________r  %% Telephone:()_________________Facsimile:()_________________Citizenship,ifapplicable:Nonresidentalien[]Yes[]No#XWX %# XXW l  XBusinessDesignation(checkone):[]Corporation(completionofExhibit C not requiredforCorporationsonly) [ []ProfessionalCorporation[]Partnership[]SoleProprietorship?X ,XFXhXX,XFX?[]LimitedLiabilityCompany[]LimitedPartnership[]LimitedLiabilityPartnership#XWX d(#H&.%XXW0   $$  FederalTaxID#:____________________OR_SSN_:_____________________   #XWX%&.*#U- XXW#XWX U-+#XH XXWAbovePaymentinformationmustbeprovidedpriortocontractapproval.ThisinformationwillbereportedtotheInternalRevenue  Services(IRS)underthenameandtaxpayeridentificationsubmitted.(SeeIRS1099foradditionalinstructionsregardingtaxpayerI.D.numbers.)InformationnotmatchingIRSrecordscouldsubjectContractorto31percentbackupwithholding.#XWX +# XXW#XWX  -# XXW Certification: TheindividualsigningonbehalfofContractorherebycertifiesandswearsunderpenaltyofperjury:(a)thenumbershown ; onthisformisContractorscorrecttaxpayeridentification;(b)Contractorisnotsubjecttobackupwithholdingbecause(_i_)Contractorisexemptfrombackupwithholding,(ii)ContractorhasnotbeennotifiedbytheIRSthatContractorissubjecttobackupwithholdingasaresultofafailuretoreportallinterestordividends,or(iii)theIRShasnotifiedContractorthatContractorisnolongersubjecttobackupwithholding;(c)s/heisauthorizedtoactonbehalfofContractor,s/hehasauthorityandknowledgeregardingContractorspaymentoftaxes,andtothebestofher/hisknowledge,ContractorisnotinviolationofanyOregontaxlawsasdefinedinOAR150305.385,referencedinExhibitB,paragraph12ofthiscontract;(d)Contractorisanindependentcontractorasdefinedin_ORS_Ԁ670.600;and(e)theaboveContractordataistrueandaccurate.#XWX -#+&.%XXW X < , XX ,XFXhX<#XWX%&.2#&.%XXWIX. 0  CONTRACTORS:YOUWILLNOTBEPAIDFORSERVICESRENDEREDPRIORTONECESSARY [' STATEAPPROVALS. %%  #XWX%&.'3#^g_XXW 0 ,  X , X0#XWX_^g4#&.%XXWA.#XWX%&.4#&.%XXW0  Contractor:?*%% #XWX%&.4#^g_XXW  #XWX_^gi5#&.%XXW<  IXX ,  X<0  By: I Title:     2     Date:_______________!`-%% 5Ӏ#XWX%&.5#&.%XXW ~"& .  #XWX%&.6#&.%XXWB.0  DepartmentofHumanServices,OfficeofInformationServices: #XWX%&.Q7#^g_XXWEX<VX  IXXEk#!/%% #XWX_^g7#4&.%XXW 9  e           q#XWX%&.8# XXWԀChiefInformationOfficer#XWX I9#&.%XXW X$"0 EX eV7XX<VXE     I   q#XWX%&.9# XXWԀDeputyChiefInformationOfficer#XWX u:#&.%XXW 0%"1 Q(  wI 2"XX eV7XQ  By:_________________________________Title:  q#XWX%&.:# XXWԀComputerCenterManager#XWX ;#&.%XXW      Date:_______________  #XWX%&.!<#8 XXWT"  wX2XY"X  wI 2"XT30  Address:500SummerStNE,SalemOR97310#XWX <#&.%XXW&$3%% #XWX%&.=#&.%XXW #XWX%&.>#&.%XXWC.0  #XWX%&.N>#9=&.%XXWREVIEWED:#XWX%&.>#&.%XXW (N&5%%  #XWX%&.?#^g_XXW #XWX_^gx?#&.%XXW  By:   *      2     Date:_______________#XWX%&.?#&.%XXW -*'7   #XWX%&.@# XXWJohnDotson,DHSContractsCoordinator,DepartmentofHumanServices,ordelegate>#XWX @#  +(8   8dXXd8  ^,*: ExhibitAStatementofWorkA_ ,XC?XXXW #XWXX,XC?nB#Acknowledged_ԀandAgreedbytheParties:   TheContractorshallprovidetheservicesofaProjectManagerwhoisskilledinprojectplanningandproject j management.ThetasksshallbeperformedusingestablishedDHS/_OIS_Ԁdevelopment,maintenanceandacceptancecriteriamethodologiessetforthinDHSsInformationSystemsStandardsandProceduresManual.WrittendocumentationshallbeupdatedandstoredinestablishedDHS/_OIS_ԀlibrariesusingexistingDHS/_OIS_ԀdocumentationstandardssetforthinDHSsInformationSystemsStandardsandProceduresManual.IntheabsenceestablishedDHS/_OIS_Ԁdevelopment,maintenanceandacceptancecriteriamethodologies,ContractorshallcompleteallworkdescribedintheStatementofWorkaccordingtomethodologiesandstandardsthatconformtodocumentationstandards,definitions,andrecommendedpracticesknowntobegenerallyacceptedintheindustry,unlessotherwiseapprovedinwritingbyDHS. (XC?XXXW$  `4XX` hp x (#%  wX2XY"X`(XC?XX(XC?XFnXX(XC?XFnXXXFnXFnXXXFn(XC?XXXFn      $cGnof    (XC?XX(XC?(XC?XX(XC?(XC?XX(XC?(XC?XX(XC?(XC?XX(XC?6"  wX2XY"XXXX6    #XWXX(XC?DG# ,XC?XXXWWorktask#1:    *        'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'uJ  X#XWXX+X(I#,XC?XXXW'uJ K݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'L  #XWXX+X(\K#,XC?XXXW Maintain_MMIS_ԀProjectSchedule !Provideprojectmanagementassistancetothe_MMIS_ԀProjectOfficebymaking J changestotheProjectScheduleusingtheMSProjectandotherrelatedsoftware.Coordinatechangesinactivitiesandresourcesbythestateteamand2contractorgroups.Trackscheduletomilestonesanddeliverables.Producemonthlyschedulemetricsandstatisticalreports.'LL݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'O  #XWXX+X(M#,XC?XXXW'O9P݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  ';Q  #XWXX+X({P#,XC?XXXW Deliverable: IntegratedProjectScheduleReportMonthly';QQ݌ P Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  ')S  #XWXX+X(R#,XC?XXXW Duration: Continuousandconstantthroughoutthelifeofthecontract.')SS݌ D Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '#U  #XWXX+X(T#,XC?XXXW'#UU݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  Kr r,z h^"  wX2XY"XK'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'W  #XWXX+X(U#,XC?XXXW AnticipatedHoursforCompletion:0  60 'WW݌%% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'X  #XWXX+X(W#,XC?XXXW 'XY݌̌,XC?XX,XC?,XC?XX,XC?  Worktask#2: J 'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'Z  X#XWXX+X(Y#,XC?XXXW'Z[݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'/\  #XWXX+X(o[#,XC?XXXWProjectPlanSupport: WorkwiththeProjectOfficeteamtodevelopperiodicupdatestotheIntegratedProjectPlan ! andtheassociatedProjectOfficefacilitatingplans(changecontrolplan,qualityassuranceplan,8).Planningefforts \" willincludesupportingthedevelopmentofaprojectsystemdevelopmentlifecyclemethodologywithassociatedstandardsandsupportingriskmanagementmitigationefforts.'/\\݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '_  #XWXX+X(]#,XC?XXXW'_3`݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '5a  #XWXX+X(u`#,XC?XXXW Deliverables: ProjectPlanRevisions.!Asrequired'5aa݌  & Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'c  #XWXX+X(b#,XC?XXXW S   'cc݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'd  #XWXX+X(c#,XC?XXXW Duration: Continuousthroughoutthedurationofthecontract.'dge݌ "0 ( Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'f  #XWXX+X(e#,XC?XXXW'fXg݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'Zh  #XWXX+X(g#,XC?XXXW AnticipatedHoursforCompletion:0  60 #XWXX,XC?3i#,XC?XXXW'Zhh݌$$!*%% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'j  #XWXX+X(i#,XC?XXXW 'jk݌̌,XC?XX,XC?,XC?XX,XC?  Worktask#3: &6$- 'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'l  X#XWXX+X(ok#,XC?XXXW'll݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'm  #XWXX+X(m#,XC?XXXW_MMIS_ԀProjectFinancialAnalysis !Monitorandreporttheprojectbudgetasitrelatestoplannedactivitiesand *(%/ expenditures.Prepareanysuchdocumentsandreportsasdeemednecessarybythe_MMIS_ԀProjectOfficeSupportManager.'min݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'p  #XWXX+X(n#,XC?XXXW'pBq݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'Dr  #XWXX+X(q#,XC?XXXW Deliverables: 󀀀Reportsandspreadsheetsthatdepictprojectfinancialanalysis.Monthly'Drr݌ b+ )3 Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'St  #XWXX+X(s#,XC?XXXW'Stt݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'u  #XWXX+X(,u#,XC?XXXW Duration: Continuousthroughoutthedurationofthecontract.'uv݌ ,*5 Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'w  #XWXX+X(v#,XC?XXXW'wtx݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'y  #XWXX+X(x#,XC?XXXW AnticipatedHoursforCompletion:0  60 #XWXX,XC?]z#,XC?XXXW'yz݌.B,7%% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '{  #XWXX+X(z#,XC?XXXW '{I|݌ h/-8  3   ь,XC?XX,XC?,XC?XX,XC?  Worktask#4: X 'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '}  X#XWXX+X(|#,XC?XXXW'}/~݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  3 X'?  #XWXX+X(~#,XC?XXXWCommunicationsPlanSupport !WorkwiththeProjectManagerandtheDHScommunicationsteamtoupdate  the_MMIS_ԀCommunicationsPlantomeettheongoingneedsoftheproject.Preparedraftnewsletterarticlesandwebpagesthatprovideprojectprogressinformationtotheprojectstakeholders.ManagethephasedgrowthoftheProjectwebsite.Managetheprojectwebsitetoensurecurrentprojectdocumentationforstakeholders.'?݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(;#,XC?XXXW'{݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '}  #XWXX+X(#,XC?XXXW Deliverable: CommunicationsPlanupdates.Projectarticles,factsheetsandprojectwebsitepages.Asrequired.'}݌  Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(V#,XC?XXXW':݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '<  #XWXX+X(|#,XC?XXXW Duration: Continuousthroughoutthedurationofthecontract.'<ӈ݌  >  Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '-  #XWXX+X(#,XC?XXXW'-Ċ݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'ԋ  #XWXX+X(#,XC?XXXW AnticipatedHoursforCompletion:0  180#XWXX,XC?#,XC?XXXW'ԋk݌2  %% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X("#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?  Worktask#5:  D  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  X#XWXX+X(َ#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'+  #XWXX+X(k#,XC?XXXWProjectSupportProcedures !Prepareproceduresusedtoaccomplishworktasks14.Presentthoseprocedures 8  totheProjectOfficeTeam.'+Б݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  't  #XWXX+X(#,XC?XXXW't ݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '   #XWXX+X(M#,XC?XXXW Deliverable: ProjectManagementAnalysisProceduresandpresentationmaterials.Asrequired.' ݌ J Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW Duration: Continuousthroughoutthedurationofthecontract.'N݌ > Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW '?݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'R  #XWXX+X(#,XC?XXXWAnticipatedHoursforCompletion:0  30#XWXX,XC?+#,XC?XXXW'R݌%% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'z  #XWXX+X(#,XC?XXXW'z݌̌,XC?XX,XC?,XC?XX,XC?  Worktask#6: D 'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  X#XWXX+X(S#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'  #XWXX+X(#,XC?XXXW_MMIS_ԀPhase2ProcurementPlanning! AssistwithupdatingtheprocurementplanforPhase2oftheproject.  ThiseffortshallincludedraftingprocurementdocumentsincludingStatementsofWork(SOW)andestablishingcontractdeliverablestandards.ThistaskwillincludecoordinatingtheprocurementplanandrelateddocumentswithinputsreceivedthroughtheDHSandStateofOregonprocurementprocess.'J݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '¦  #XWXX+X(#,XC?XXXW Deliverables: _MMIS_ԀPhase2ProcurementPlanwithupdates.ProcurementdocumentsAsrequired.'¦g݌ ! Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW'݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(ک#,XC?XXXW Durations: Continuousthroughoutthedurationofthecontract.'1݌ *# Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(s#,XC?XXXW '$݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '7  #XWXX+X(t#,XC?XXXWAnticipatedHoursforCompletion:0  210#XWXX,XC?#,XC?XXXW'7ή݌ %%% Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '`  #XWXX+X(#,XC?XXXW'`݌̌,XC?XX,XC?,XC?XX,XC?  Worktask#7: "0 ( 'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  X#XWXX+X(9#,XC?XXXW'{݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  X'  #XWXX+X(˲#,XC?XXXWStatusReporting !Prepareaweeklyreportwhichsummarizesworkperformedduringthepreviousweekand $$!* plannedworkfortheupcomingweek.Thestatusreportshouldidentifyaccomplishments,issuesforthe_MMIS_project.'0݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'I  #XWXX+X(r#,XC?XXXW'I݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X("#,XC?XXXW Deliverable: StatusReport.Weekly.'y݌ \'%. Ќ,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  '  #XWXX+X(#,XC?XXXW'Q݌̌,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?,XC?XX,XC?  'XFnXX,XC?XFnXXXFnXFnXXXFn+X(XXXFn  'S  #XWXX+X(#,XC?XXXW Duration: Continuousthroughoutthedurationofthecontract.#XWXX,XC?,#'S݌ (&0 Ќ,XC?XXXW  AnticipatedHoursforCompletion:0  20 XWXX,XC?*<(2%% #,XC?XXXW@#   XWXX,XC?#,XC?XXXW#TotalanticipatedHoursforCompletion:0  620 -t+6%%  AA  h/-8  T&Y/gZ[ExhibitB X GeneralProvisions  B    1.0 S IndependentContractor;ResponsibilityforTaxesandWithholding S%S% N(X u}L"Xrr,z h^"N0 S a. 0S%S%ContractorshallperformallrequiredWorkasanindependentcontractor.AlthoughDHSreservestheright  to(1)determine(andmodify)thedeliveryschedulefortheWorktobeperformedand(2)evaluatethequalityofthecompletedperformance,DHScannotandwillnotcontrolthemeansormannerofContractor'sperformance.ContractorisresponsiblefordeterminingtheappropriatemeansandmannerofperformingtheWork. %% 0 S b. 0S%S%IfContractoriscurrentlyperformingworkfortheStateofOregonorthefederalgovernment,Contractorby f   signaturetothiscontractdeclaresandcertifiesthat:ContractorsWorktobeperformedunderthiscontractcreatesnopotentialoractualconflictofinterestasdefinedby_ORS_Ԁ244andnorulesorregulationsofContractorsemployingagency(stateorfederal)wouldprohibitContractorsWorkunderthiscontract.Contractorisnotan officer, employee,or agentofDHS,asthosetermsareusedin_ORS_Ԁ30.265. %% 0 S c. 0S%S%Contractorshallberesponsibleforallfederalorstatetaxesapplicabletocompensationorpaymentspaidto  Contractorunderthiscontractand,unlessContractorissubjecttobackupwithholding,DHSwillnotwithholdfromsuchcompensationorpaymentsanyamount(s)tocoverContractorsfederalorstatetaxobligations.ContractorisnoteligibleforanySocialSecurity,unemploymentinsuranceorworkerscompensationbenefitsfromcompensationorpaymentspaidtoContractorunderthiscontract,exceptasaselfemployedindividual. %%  2.0 S SubcontractsandAssignment;SuccessorsinInterest HS%S% 0 S a. 0S%S%ContractorshallnotenterintoanysubcontractsforanyoftheWorkrequiredbythiscontract,orassignor  transferanyofitsinterestinthiscontract,withoutthepriorwrittenconsentofDHS.InadditiontoanyotherprovisionsDHSmayrequire,ContractorshallincludeinanypermittedsubcontractsunderthiscontractarequirementthatthesubcontractorbeboundbySections2,6,7,11,and13ofthisexhibitasifthesubcontractorweretheContractor.DHSsconsenttoanysubcontractshallnotrelieveContractorofanyofitsdutiesorobligationsunderthiscontract. %% 0 S b. 0S%S%Theprovisionsofthiscontractshallbebindinguponandshallinuretothebenefitofthepartieshereto,and  *! theirrespectivesuccessorsandpermittedassigns,ifany. %%  3.0 S NoThirdPartyBeneficiaries. DHSandContractoraretheonlypartiestothiscontractandaretheonlyparties @# $ entitledtoenforceitsterms.Nothinginthiscontractgives,isintendedtogive,orshallbeconstruedtogiveorprovideanybenefitorright,whetherdirectly,indirectlyorotherwise,tothirdpersonsunlesssuchthirdpersonsareindividuallyidentifiedbynamehereinandexpresslydescribedasintendedbeneficiariesofthetermsofthiscontract. S%S%  4.0 S FundsAvailableandAuthorized;Payments 'z%)S%S% 0 S a. 0S%S%ContractorshallnotbecompensatedforWorkperformedunderthiscontractbyanyotheragencyor )N'+ departmentoftheStateofOregon.DHShassufficientfundscurrentlyavailableandauthorizedforexpendituretofinancethecostsofthiscontractwithinDHS'sbiennialappropriationorlimitation.ContractorunderstandsandagreesthatDHS'spaymentofamountsunderthiscontractattributabletoWorkperformedafterthelastdayofthecurrentbienniumiscontingentonDHSreceivingfromtheOregonLegislativeAssemblyappropriations,limitations,orotherexpenditureauthoritysufficienttoallowDHS,intheexerciseofitsreasonableadministrativediscretion,tocontinuetomakepaymentsunderthiscontract."/,1%% & & X &  0 S b. 0S%S%DHSwillonlypayforcompletedworkthatisacceptedbyDHS. B%%     5.   S  0 S RepresentationsandWarranties S%S% 0 S a.0S%S%ContractorsRepresentationandWarranties :ContractorrepresentsandwarrantstoDHSthat(1)  Contractorhasthepowerandauthoritytoenterintoandperformthiscontract,(2)thiscontract,whenexecutedanddelivered,shallbeavalidandbindingobligationofContractorenforceableinaccordancewithitsterms,(3)theWorkunderthiscontractshallbeperformedinagoodandworkmanlikemannerandinaccordancewiththehighestprofessionalstandards,(4)Contractorshall,atalltimesduringthetermofthiscontract,bequalified,professionallycompetentanddulylicensedtoperformtheWork,(5)allcomputerhardwareandsoftwaredeliveredunderthiscontractwill,individuallyandincombination,correctlyprocess,sequence,andcalculatealldateanddaterelateddataforalldatespriorto,throughandafterJanuary1,2000and(6)anysoftwareproductsdeliveredunderthiscontractthatprocessdateordaterelateddatashallrecognize,storeandtransmitdatedatainaformatwhichexplicitlyandunambiguouslyspecifiesthecorrectcentury. %% 0 S b.0S%S%ContractorsLimitationofLiability :Contractorsliabilitywithrespecttoitems(5)and(6)ofsubsection  5aaboveshallnotexceed:(1)twicethetotalcontractamount(includinganyamendments)or(2)$100,000whicheverisgreater. %% 0 S c.0S%S%WarrantiesCumulative :Thewarrantiessetforthinthissectionareinadditionto,andnotinlieuof,any 2 otherwarrantiesprovided. %%  6.0 S OwnershipofWorkProduct. AllworkproductofContractorthatresultsfromthiscontract("theWork H Product")istheexclusivepropertyofDHS.DHSandContractorintendthatsuchWorkProductbedeemed workmadeforhireofwhichDHSshallbedeemedtheauthor.IfforanyreasontheWorkProductisnotdeemed workmadeforhire,ContractorherebyirrevocablyassignstoDHSallofitsright,title,andinterestinandtoanyandalloftheWorkProduct,whetherarisingfromcopyright,patent,trademark,tradesecret,oranyotherstateorfederalintellectualpropertylawordoctrine.ContractorshallexecutesuchfurtherdocumentsandinstrumentsasDHSmayreasonablyrequestinordertofullyvestsuchrightsinDHS.ContractorforeverwaivesanyandallrightsrelatingtotheWorkProduct,includingwithoutlimitation,anyandallrightsarisingunder17_USC_Ԁ106Aoranyotherrightsofidentificationofauthorshiporrightsofapproval,restrictionorlimitationonuseorsubsequentmodifications. S%S%  7.0 S Indemnity. V"#S%S%  S XC?XX,XC?a.GeneralIndemnity: Contractorshalldefend,holdharmlessandindemnifytheStateofOregon,DHSand @# $ 0 S itsagencies,subdivisions,officers,employeesandagentsfromandagainstallclaims,suits,actions,losses,damages,liabilities,costsandexpensesofanynatureresultingfrom,arisingoutof,orrelatingtotheactivitiesofContractororitsofficers,employees,subcontractors,oragentsunderthisContract. S%S%  S b.IntellectualPropertyIndemnity: Withoutlimitingthegeneralindemnityprovision,Contractorexpressly 'z%) 0 S agreestodefend,holdharmlessandindemnifytheStateofOregon,DHSanditsagencies,subdivisions,officers,employeesandagentsfromandagainstallclaims,suits,actions,losses,damages,liabilities,costsandexpensesofanynatureresultingfromorinconnectionwithanyclaimsthattheWork,Developments,SystemorDeliverablesorusethereofinfringeanypatent,copyright,tradesecret,orotherproprietaryright(referredtoas"IntellectualPropertyRights")ofanythirdparty;provided,thatDHSshallprovideContractorwithpromptwrittennoticeofanyinfringementclaim.Contractorshallhavecontrolofthedefenseandsettlementoftheclaim;providedthattheStateofOregonorDHSmayassumeitsowndefenseandsettlementintheeventthattheStateofOregonorDHSdeterminesthatContractorisnotadequatelydefendingitsinterestorthatan "/,1 importantgovernmentalprincipleisatissueandtheStateofOregonorDHSdesirestoassumeitsowndefense.IfContractor,initssolediscretion,believesatanytimethattheWork,Developments,SystemorDeliverablesinfringeathirdparty'sIntellectualPropertyRights,Contractormay,atitsownexpenseandoptionanduponreceiptofDHS'spriorwrittenconsent,replaceaninfringingitemwithanoninfringingitemthatmeetsorexceedstheperformanceandfunctionalityofthereplaceditem.#,XC?XXXC?#S%S%  8.0 S Insurance |S%S% 0 S a. 0S%S%DuringthetermofthiscontractContractorshallmaintaininforceatitsownexpense,eachinsurancenoted f below: %% ]+X 'u}L"XX u}L"X]0 S 0S%S% (1) 0%%WorkersCompensationinsuranceincompliancewith_ORS_Ԁ656.017,whichrequiressubjectemployers  :  toprovideOregonworkerscompensationcoverageforalltheirsubjectworkers. %%   0  0S%% S%S%  S   (2) 0  GeneralLiabilityinsurancewithacombinedsinglelimit,ortheequivalent,ofnotlessthan$1,000,000 P  eachoccurrenceforBodilyInjuryandPropertyDamage.Itshallincludecontractualliabilitycoveragefortheindemnityprovidedunderthiscontract.ItshallprovidethattheStateofOregon,DepartmentofHumanServices,andtheirdivisions,officersandemployeesareAdditional_Insureds_ԀbutonlywithrespecttotheContractorsservicestobeprovidedunderthiscontract. %%  0 S   (3)0S%S% AutomobileLiabilityinsuranceasrequiredbytheOregonFinancialResponsibilityLaw(_ORS_Ԁ806.060), t includingcoverageforowned,hiredornonownedvehicles,asapplicable. ,&%X,XC?^%% #,XC?X%,&#0 S   (4)0S%S% ProfessionalLiabilityinsurancewithacombinedsinglelimit,ortheequivalent,ofnotlessthan |$ $1,000,000eachclaim,incidentoroccurrence.Thisistocoverdamagescausedbyerror,omissionornegligentactsrelatedtotheprofessionalservicestobeprovidedunderthiscontract. P%% 0 S 0S%S% %% 0 S b. 0S%S% NoticeofCancellationorChange: Thereshallbenocancellation,materialchange,reductionoflimitsor $ intentnottorenewtheinsurancecoverage(s)without30dayspriorwrittennoticefromContractororitsinsurer(s)toContractsCoordinator,OregonDepartmentofHumanServices. %% 0 S c. 0S%S% CertificatesofInsurance: Asevidenceoftheinsurancecoveragesrequiredbythiscontract,Contractorshall t furnishacceptableinsurancecertificatestoContractsCoordinator,OregonDepartmentofHumanServicespriortocommencingtheWork.ThecertificatewillspecifyallofthepartieswhoareAdditional_Insureds_.InsuringcompaniesorentitiesaresubjecttoStateacceptance.Ifrequested,completecopiesofinsurancepolicies,trustagreements,etc.,shallbeprovidedtotheState.Contractorshallbefinanciallyresponsibleforallpertinentdeductibles,selfinsured_retentions_Ԁand/orselfinsurance. %%  9.0 S Termination 2# $S%S% 0 S a.0S%S%PartiesRighttoTerminateforConvenience :Thiscontractmaybeterminatedatanytimebymutual %"& writtenconsentoftheparties. %% 0 S b.0S%S%DHSsRighttoTerminateforConvenience :DHSmay,atitssolediscretion,terminatethiscontract,in 'l%) wholeorinpart,upon30daysnoticetoContractor. %% 0 S c.0S%S%DHSsRighttoTerminateforCause :DHSmayterminatethiscontract,inwholeorinpart,immediately **(, uponnoticetoContractor,oratsuchlaterdateasDHSmayestablishinsuchnotice,upontheoccurrenceofanyofthefollowingevents: %% 0 S 0S%S% (1)0%% DHSfailstoreceivefunding,orappropriations,limitationsorotherexpenditureauthorityatlevels *.+0 sufficienttopayforContractorsWork;/,1%% Ї0 S 0S%S% (2)0%% FederalorStatelaws,regulationsorguidelinesaremodifiedorinterpretedinsuchawaythateitherthe  WorkunderthiscontractisprohibitedorDHSisprohibitedfrompayingforsuchWorkfromtheplannedfundingsource; %% 0 S 0S%S% (3)0%% ContractornolongerholdsanylicenseorcertificatethatisrequiredtoperformtheWork;orj%% 0 S 0S%S% (4) 0%%Contractorcommitsanymaterialbreachordefaultofanycovenant,warranty,obligationoragreement >| underthiscontract,failstoperformtheWorkunderthiscontractwithinthetimespecifiedhereinoranyextensionthereof,orsofailstopursuetheWorkastoendangerContractorsperformanceunderthiscontractinaccordancewithitsterms,andsuchbreach,defaultorfailureisnotcuredwithin10businessdaysafterdeliveryofDHSsnotice,orsuchlongerperiodasDHSmayspecifyinsuchnotice. %% 0 S d.0S%S%ContractorsRighttoTerminateforCause :Contractormayterminatethiscontractupon30daysnotice   toDHSifDHSfailstopayContractorpursuanttothetermsofthiscontractandDHSfailstocurewithin30daysafterreceiptofContractorsnotice,orsuchlongerperiodofcureasContractormayspecifyinsuchnotice. %%   S e.0  Remedies :L%%  S   (1) 0  IntheeventofterminationpursuanttoSections9a,9b,9c(1),9c(2)or9dofthisexhibit,Contractors 6t soleremedyshallbeaclaimforthesumdesignatedforaccomplishingtheWorkmultipliedbythepercentageofWorkcompletedandacceptedbyDHS,lesspreviousamountspaidandanyclaim(s)whichStatehasagainstContractor.IfpreviousamountspaidtoContractorexceedtheamountduetoContractorunderthisSection,ContractorshallpayanyexcesstoDHSupondemand. %%   S 0  (2)0%% IntheeventofterminationpursuanttoSection9c(3)or9c(4)ofthisexhibit,DHSshallhaveanyremedy  availabletoitinlaworequity.IfitisdeterminedforanyreasonthatContractorwasnotindefaultunderSection9c(3)or9c(4)ofthisexhibit,therightsandobligationsofthepartiesshallbethesameasifthecontractwasterminatedpursuanttoSection9bofthisexhibit. %%   S f.0  ContractorsTenderUponTermination: Uponreceivinganoticeofterminationofthiscontract, D Contractorshallimmediatelyceaseallactivitiesunderthiscontract,unlessDHSexpresslydirectsotherwiseinsuchnoticeoftermination.Uponterminationofthiscontract,ContractorshalldelivertoDHSalldocuments,information,worksinprogressandotherpropertythatareorwouldbedeliverableshadthecontractbeencompleted.UponDHSsrequest,ContractorshallsurrendertoanyoneDHSdesignates,alldocuments,researchorobjectsorothertangiblethingsneededtocompletetheWork. %%  Xw 10.0 S LimitationofLiabilities.EXCEPTFORLIABILITYARISINGUNDERORRELATEDTO " $ SECTION5aOR9e(2)OFTHISEXHIBIT,NEITHERPARTYSHALLBELIABLEFOR(A)ANYINDIRECT,INCIDENTAL,CONSEQUENTIALORSPECIALDAMAGESUNDERTHECONTRACTOR(B)ANYDAMAGESOFANYSORTARISINGSOLELYFROMTHETERMINATIONOFTHISCONTRACTINACCORDANCEWITHITSTERMS. R&$(S%S%  11.0 S RecordsMaintenance;Access. Contractorshallmaintainallfiscalrecordsrelatingtothiscontractin &(d&* accordancewithgenerallyacceptedaccountingprinciples.Inaddition,ContractorshallmaintainanyotherrecordspertinenttothiscontractinsuchamannerastoclearlydocumentContractor'sperformance.ContractoracknowledgesandagreesthatDHS,theOregonSecretaryofState'sOffice,theFederalGovernment,andtheirdulyauthorizedrepresentativesshallhaveaccesstosuchfiscalrecordsandallotherbooks,documents,papers,plans,andwritingsoftheContractorthatarepertinenttothiscontractforthepurposeofperformingexaminationsandaudits,andmakingexcerptsandtranscripts.Contractorshallretainandkeepaccessibleallsuchfiscalrecords,books,documents,papers,plans,andwritingsforaminimumofthree(3)years,orsuch longerperiodasmayberequiredbyapplicablelaw,followingfinalpaymentandterminationofthiscontract, v/-2 oruntiltheconclusionofanyaudit,controversyorlitigationarisingoutoforrelatedtothiscontract,whicheverdateislater. S%S%  12.0 S CompliancewithApplicableLaw. Contractorshallcomplywithallfederal,stateandlocallaws,regulations,  executiveordersandordinancesapplicabletotheWorkunderthiscontract.Withoutlimitingthegeneralityoftheforegoing,Contractorexpresslyagreestocomplywith:(_i_)TitleVIofCivilRightsActof1964;(ii)SectionVoftheRehabilitationActof1973;(iii)theAmericanswithDisabilitiesActof1990and_ORS_Ԁ659.425;(iv)allregulationsandadministrativerulesestablishedpursuanttotheforegoinglaws;and(v)allotherapplicablerequirementsoffederalandstatecivilrightsandrehabilitationstatutes,rulesandregulations.DHSsperformanceunderthiscontractisconditioneduponContractorscompliancewiththeprovisionsof_ORS_279.312,279.314,279.316,279.320,and279.555,whichareincorporatedbyreferenceherein. S%S%  13.0 S ForeignContractor. IfContractorisnotdomiciledinorregisteredtodobusinessintheStateofOregon,   ContractorshallpromptlyprovidetotheOregonDepartmentofRevenueandtheSecretaryofStateCorporationDivisionallinformationrequiredbythoseagenciesrelativetothiscontract.ContractorshalldemonstrateitslegalcapacitytoperformtheWorkunderthiscontractintheStateofOregonpriortoenteringintothiscontract. S%S%  14.0 S ForceMajeure. NeitherDHSnorContractorshallbeheldresponsiblefordelayordefaultcausedbyfire,riot, L naturaldisasters,orwarwheresuchcausewasbeyondthereasonablecontrolofDHSorContractor,respectively.Contractorshall,however,makeallreasonableeffortstoremoveoreliminatesuchacauseofdelayordefaultandshall,uponthecessationofthecause,diligentlypursueperformanceofitsobligationsunderthiscontract. S%S%  15.0 S Survival. Allrightsandobligationsshallceaseuponterminationorexpirationofthiscontract,exceptforthe  rightsandobligationssetforthintheContractSectionI.EFFECTIVEDATEANDDURATION,andinparagraphs5,6,7,9,10,11,15and21ofthisexhibit. S%S%  16.0 S TimeisoftheEssence. Contractoragreesthattimeisoftheessenceunderthiscontract.S%S%  17.0 S WrittenNotice. Allnoticesregardingthiscontractmustbegiventothepartiesinwritingbypersonaldelivery Z ormailingthesame,postageprepaid,tothefollowingaddresses: S%S%  S `+X 'u}L"XX 'u}L"X` S DHS:0   m JohnDotson,ContractsCoordinator,ordelegateV%% 0 S    m OregonDepartmentofHumanServices S%S% 0 S    m 500SummerStreetNE/MailingCodeE03 S%S% 0 S    m SalemOR973101080 S%S% `+X ' }L"XX 'u}L"X` S    m FacsimileNumber:5033737365 S    m PhoneNumber:50394561560 S  S%S%  S Contractor:  m _SBI_ Emerald,Inc. ~$"&  S 0  0m%%attn:Ron_Hittner_ m%m%  S 0  0m%%6052LopezCt.N m%m%  S 0  0m%%_Keizer_,Oregon_97303 m%m% __ S __  __ m FacsimileNumber:(503)2762900/PhoneNumber:(503)2762901_ m%m% 0 S Anynoticedeliveredbyfacsimileshallbedeemedtobegivenwhenreceiptofthetransmissionisgeneratedbythetransmittingmachine.TobeeffectiveagainstDHS,suchfacsimiletransmissionmustbeconfirmedbytelephonenoticetoDHSsContractAdministrator. S%S%  18.0 S Severability. Thepartiesagreethatifanytermorprovisionofthiscontractisdeclaredbyacourtofcompetent ,*/ jurisdictiontobeillegalorinconflictwithanylaw,thevalidityoftheremainingtermsandprovisionsshallnotbeaffected,andtherightsandobligationsofthepartiesshallbeconstruedandenforcedasifthecontractdidnotcontaintheparticulartermorprovisionheldtobeinvalid. S%S%  `0.3  19.0 S Counterparts. Thiscontractmaybeexecutedinseveralcounterparts,allofwhichwhentakentogethershall  constituteoneagreementbindingonallparties,notwithstandingthatallpartiesarenotsignatoriestothesamecounterpart.Eachcopyofthecontractsoexecutedshallconstituteanoriginal. S%S%  20.0 S DisclosureofSocialSecurityNumber. ContractormustprovideContractorsSocialSecuritynumberunless j ContractorprovidesafederaltaxInumber.Thisnumberisrequestedpursuantto_ORS_Ԁ305.385,OAR12520410(3)andOAR150305.100.SocialSecuritynumbersprovidedpursuanttothisauthoritywillbeusedfortheadministrationofstate,federalandlocaltaxlaws. S%S%  21.0 S GoverningLaw;Venue;ConsenttoJurisdiction. Thiscontractshallbegovernedbyandconstruedin  :  accordancewiththelawsoftheStateofOregonwithoutregardtoprinciplesofconflictsoflaw.Anyclaim,action,suitorproceeding(collectively,"Claim")betweenDHS(and/oranyotheragencyordepartmentoftheStateofOregon)andContractorthatarisesfromorrelatestothiscontractshallbebroughtandconductedsolelyandexclusivelywithintheCircuitCourtofMarionCountyfortheStateofOregon;provided,however,iftheclaimmustbebroughtinafederalforum,thenitshallbebroughtandconductedsolelyandexclusivelywithintheUnitedStatesDistrictCourtfortheDistrictofOregon.CONTRACTOR,BYTHEEXECUTIONOFTHISCONTRACT,HEREBYCONSENTSTOTHEINPERSONAMJURISDICTIONOFSAIDCOURTS. S%S%  22.0 S Amendment. Thetermsofthiscontractmaynotbewaived,altered,modified,supplementedoramended,in 6t anymannerwhatsoever,exceptbywrittenagreementsignedbytheparties.Thiscontractwillnotbeamendedaftertheexpirationdate. S%S%  23.0 S ConfidentialityofClientInformation S%S% ](X u}L"XX ' }L"X]0 S a. 0S%S%AllinformationastopersonalfactsandcircumstancesobtainedbytheContractorontheclientshallbe  treatedasprivilegedcommunications,shallbeheldconfidential,andshallnotbedivulgedwithoutthewrittenconsentoftheclient,hisorherattorney,theresponsibleparentofaminorchild,orhisorherguardianexceptasrequiredbyothertermsofthiscontract.Nothingprohibitsthedisclosureofinformationinsummaries,statistical,orotherformwhichdoesnotidentifyparticularindividuals. %% 0 S b. 0S%S%Theuseordisclosureofinformationconcerningclientsshallbelimitedtopersonsdirectlyconnectedwith .l theadministrationofthiscontract.Confidentialitypoliciesshallbeappliedtoallrequestsfromoutsidesources. D   @ %% 0 S c. 0S%S%DHS,ContractorandanysubcontractorwillshareinformationasnecessarytoeffectivelyserveDHSclients.*!%%  24.0 S CompliancewithApplicableFederalLaw. Contractoragreestocomplywithallfederallawsandregulations !# applicabletoworkperformedunderthiscontractinclusiveofbutnotlimitedto: S%S% 0 S a.0S%S% Totheextentitisrequiredtodosobylaw,Contractorshallabidebyallmandatorystandardsandpolicies ~$"& whichrelatetoenergyefficiencyandwhicharecontainedinthestateofOregonenergyconservationplanwhichwasissuedincompliancewiththeEnergyPolicyandConservationAct(PL94-163).Allsubcontractsshallalsobeincompliancewiththeforegoing. %% 0 S  S%S%  0 S b. 0S%S%Bysignatureonthiscontract,theundersignedcertifies,tothebestofhisorherknowledgeandbelief,that:)N'+%% Z(X wu}L"XX u}L"XZ0 S 0S%S% (1)0A%% Nofederallyappropriatedfundshavebeenpaidorwillbepaid,byoronbehalfofContractor,toany *")- personforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,amemberofCongress,anofficeroremployeeofCongress,oranemployeeofamemberofCongressinconnectionwiththeawardingofanyfederalcontract,themakingofanyfederalgrant,themakingofanyfederalloan,theenteringintoofanycooperativeagreement,andtheextension,continuation,renewal,amendment,ormodificationofanyfederalcontract,grant,loan,orcooperativeagreement. A%A%  `0.3 Z[  Z,w Z  Z(X '}L"XX wu}L"XZ0 S 0S%S% (2)0%% Ifanyfundsotherthanfederallyappropriatedfundshavebeenpaidorwillbepaidtoanypersonfor , influencingorattemptingtoinfluenceanofficeroremployeeofanyagency,amemberofCongress,anofficeroremployeeofCongress,oranemployeeofamemberofCongressinconnectionwiththisfederalcontract,grant,loan,orcooperativeagreement,ContractoragreestocompleteandsubmitStandardForm_LLL_Ԁ"DisclosureFormtoReportLobbying,"inaccordancewithitsinstructions. %% 0 S 0S%S% (3) 0%%Theundersignedshallrequirethatthelanguageofthiscertificationbeincludedintheawarddocuments | forall_subawards_Ԁatalltiers(includingsubcontracts,_subgrants_,andcontractsundergrants,loans,andcooperativeagreements)andthatall_subrecipients_Ԁshallcertifyanddiscloseaccordingly. %% 0 S 0S%S%Thiscertificationisamaterialrepresentationoffactuponwhichreliancewasplacedwhenthistransactionwasmadeorenteredinto.Submissionofthiscertificationisaprerequisiteformakingorenteringintothistransactionimposedbysection1352,title31,U.S.Code.Anypersonwhofailstofiletherequiredcertificationshallbesubjecttoacivilpenaltyofnotlessthan$10,000andnotmorethan$100,000foreachsuchfailure. %% 0 S c. 0S%S%ContractoragreestocomplywithExecutiveOrder11246entitledEqualEmploymentOpportunityas  amendedbyExecutiveOrders11375and12086andassupplementedinDepartmentofLaborRegulation41_CFR_Ԁpart60.Allsubcontractsshallalsocomplywiththeseprovisions. %%   S d. 0  Ifthesumpayableunderthiscontractexceedsormayexceed$100,000,ContractorshallprovideDHSa tH writtenassurancethatContractorwillcomplywithallapplicablestandards,orders,orrequirementsissuedunderSection306oftheCleanAirAct(42_USC_Ԁ7401_et.seq_.),theFederalWaterPollutionControlAct,asamended(33_USC_Ԁ1251_et.seq_.),Section508oftheCleanWaterAct(33_USC_Ԁ1368),ExecutiveOrder11738andEnvironmentalProtectionAgencyregulations(40_CFR_ԀPart15).ContractorfurtheragreestopromptlyreportallinfractionstotheStateofOregon,andtotheDepartmentofHealthandHumanServices,andtotheU.S.RegionalOfficeoftheEnvironmentalProtectionAgency.Allsubcontractsshallalsobeincompliancewiththeseprovisions. %%  25.0 S DepartmentofJusticeApproval. Whenthecontractoramendmentstheretocausethecontractpaymentto  beinexcessof$75,000,theDepartmentofJusticemustapprovethecontractandanyamendmentsastoLegalSufficiency.Suchapprovalisrequiredbeforeanyworkmaybeginunderthiscontractoramendmentsthereto,orthecontractisnotbindingontheStateofOregonorDHS. S%S%  26.0 S KeyPerson. ContractoracknowledgesandagreesthatDHSselectedContractor,andisenteringintothis @ " Contract,becauseofthespecialqualificationsofContractors KeyPerson(s).Inparticular,DHSthroughthisContract,isengagingtheexpertise,experience,judgmentandpersonalattentionof Ron_Hittner_ ( KeyPerson). " $ ContractorsKeyPersonshallnotdelegateperformanceoftheresponsibilitieshe/sheisrequiredtoprovideunderthisContracttoanother(other)ofContractorsemployee(s)withoutfirstobtainingthewrittenconsentofDHS.Further,Contractorshallnotre-assignortransferanyKeyPersontootherdutiesorpositionssuchthatanyKeyPersonisnolongeravailabletoprovideDHSwithhis/herexpertise,experience,judgment,andpersonalattention,withoutfirstobtainingDHSspriorwrittenconsenttosuchre-assignmentortransfer.IntheeventContractorrequeststhatDHSapproveare-assignmentortransferofanyKeyPerson,DHSshallhavetherighttointerview,reviewthequalificationsof,andapproveordisapprovetheproposedreplacementfortheKeyPerson.AnyapprovedsubstituteorreplacementforaKeyPersonshallbedeemedaKeyPersonunderthisContract.Inaddition, XWXX,XC?theContractormustprovideareplacementforanyConsultantwhoceasesaffiliationwith N*")- theContractor,whomDHSdeemsisnotperformingatanacceptablelevelorishinderingthesuccessfulcompletionofassignment(s),isunabletoperformassignedwork,orasrequiredbyDHS.TransitionschedulemustbeapprovedbyDHS.IntheeventthatDHSrequiressuchreplacement,theContractorshallpromptlysubstituteorengageotherqualifiedindividuals.AllsuchreplacementsaresubjecttoDHSspriorreviewandacceptance.IntheeventthatContractorisunabletomeetitsobligationtofurnishareplacementConsultant,DHSmay,atitsoption,terminatethatportionoftheContractwithoutliability,ortocontinuetheContractwithoutreplacement.#,XC?XX XWF# 0/4S%S% XC?XX,XC?&%XXC?   ExhibitC , #XC?X%&XJ#zJ#,XC?XXXC?9J#  IndependentContractorCertification     ,&%X,XC?,K]%,& ThisformistobecompletedbyContractor;Corporationsarenotrequiredtocompletethisform.   _ORS_Ԁ670.600IndependentContractor;standards.Asusedinvariousprovisionsof_ORS_Ԁchapters316,656,657and701,anindividual zN orbusinessentitythatperformslabororservicesfor_renumeration_'sshallbeconsideredtoperformthelabororservicesasanIndependentContractorifthestandardsofthissectionaremet:X  Contractorunderstandsthat:   P BXX '}L"XB1.0  Theindividualorbusinessentityprovidingthelabororservicesisfreefromdirectionandcontroloverthemeansandmannerof d  providingthelabororservices,subjectonlytotherightoftheAgencyforwhomthelabororservicesareprovidedtospecifythedesiredresults; %% 2.0  Theindividualorbusinessentityprovidinglabororservicesisresponsibleforobtainingallassumedbusinessregistrationsor    professionaloccupationlicensesrequiredbystatelaworlocalgovernmentordinancesfortheindividualorbusinessentitytoconductthebusiness; %% 3.0  Theindividualorbusinessentityprovidinglabororservicesfurnishesthetoolsorequipmentnecessaryforperformanceofthe  T  contractedlabororservices; %% 4.0  Theindividualorbusinessentityprovidinglabororserviceshastheauthoritytohireandfireemployeestoperformthelaboror Z.  services; %% 5.0  Paymentforthelabororservicesismadeuponcompletionoftheperformanceofspecificportionsoftheprojectorismadeonthe 4 basisofanannualperiodicretainer. %% *XX*6.0  Theindividualorbusinessentityprovidinglabororserviceisregisteredunder_ORS_Ԁchapter701,iftheindividualorbusinessentity  provideslabororservicesforwhichsuchregistrationisrequired; %% 7.0  FederalandstateincometaxreturnsinthenameofthebusinessorabusinessScheduleCorfarmScheduleFaspartofthepersonal  incometaxreturnwerefiledforthepreviousyeariftheindividualorbusinessentityperformedlabororservicesasanindependentcontractorinthepreviousyear;and %% 8.0  Theindividualorbusinessentityrepresentstothepublicthatthelabororservicesaretobeprovidedbyanindependentlyestablished `4! business.ExceptwhenanindividualorbusinessentityfilesaScheduleFaspartofthepersonalincometaxreturnsandtheindividualorbusinessentityperformsfarmlabororservicesthatarereportableonScheduleC,anindividualorbusinessentityisconsideredtobeengagedinanindependentlyestablishedbusinesswhenfourormoreofthefollowingcircumstancesexist.Contractormustmeetfour(4)ormoreofthefollowing: %% *X*  A.0  Thelabororservicesareprimarilycarriedoutatalocationthatisseparatefromtheresidenceofanindividualwhoperformsthe ' labororservices,orareprimarilycarriedoutinaspecificportionoftheresidence,whichportionissetasideasthelocationofthebusiness; %%   B.0  Commercialadvertisingorbusinesscardsasiscustomaryinoperationofsimilarbusinessesarepurchasedforthebusiness,or `+ theindividualorbusinessentityhasatradeassociationmembership; %%   C.0  Telephonelistingandserviceareusedforthebusinessthatisseparatefromthepersonalresidencelistingandserviceusedby f:. anindividualwhoperformsthelabororservices; %%   D.0  Labororservicesareperformedonlypursuanttowrittencontracts;@ 1%%   E.0  Labororservicesareperformedfortwoormoredifferentpersonswithinaperiodofoneyear;or|!P 3%%   F.0  Theindividualorbusinessentityassumesfinancialresponsibilityfordefectiveworkmanshiporforservicenotprovidedas "!5 evidencedbytheownershipofperformancebonds,warranties,errorsandomissioninsuranceorliabilityinsurancerelatingtothelabororservicestobeperformed. %% 9.0  PursuanttoOAR1250200410(4),thecontractshallprovidethattheContractorisresponsibleforfederalSocialSecurity,except 0%$9 thosecategoriesexcludedbylaw,andforanyfederalorstatetaxesapplicabletothecontractpayment. %%  IndependentContractorcertifieshe/shemeetstheabovestandardsandagreestoperformthelabororservicesrequiredbythiscontractasanIndependentContractor. P'  '*   *ContractorSignature ________________________________________________Date_________________  *(A '   ' MH XMHXEntityName(printedortyped): _____________________________________________________________________ +*D  HaXHa#,&%,K]nK#K  ,l+E  ,XC?X%,&  ExhibitD , ConfidentialityAgreement#,&%X,XC?b#,K]%,&   #,&%,K]c#c,K]%,&ToallcontractorsworkingonOregonDepartmentofHumanServices(DHS)projects:  Forthepurposesofthiscertificatetheterm contractorwillmeanallConsultantsassignedtotheprojectbythecontractor.Oregonslawscontainprovisionsrelationtoconfidentialityofrecords,listsandinformationaboutclientapplicants/clients/recipientsandaboutStateemployees.Theselaws,andthepenaltiesforviolationofthem,pertaintoeverycontractorworkingonDHSprojects,atalllevelsandinanycapacity.AsaconditionofyourcontinuedworkforDHS,youarerequiredtocompletetheconfidentialitytrainingexerciseandsignthiscertificateverifyingthatyouunderstandthelawsandareawareofthepenaltiesforviolation.Ifatsomefuturedate,youhavedoubtsaboutthelegalityofanactionyoumaybeabouttotake,asktherespectiveprojectmanagerforaninterpretation.You R&  personallyarelegallyresponsibleforanyviolationoftheselaws.    ConfidentialityofPersonnelInformation :_ORS_Ԁ192.500 ThePublicRecords Actcontainsanumberofexemptionsforinformation ,   maintainedonStateemployeesincludinga personalprivacyexemptionwhichstates: Thefollowingpublicrecordsareexemptfromdisclosure...Informationofapersonalnaturesuchasthatkeptinapersonal,medicalorsimilarfile,ifthepublicdisclosurethereofwouldconstituteanunreasonableinvasionofprivacy,unlessthepublicinterestbyclearandconvincingevidencerequiresdisclosureintheparticularinstance.Thepartyseekingdisclosureshallhavetheburdenofshowingthatpublicdisclosurewouldnotconstituteanunreasonableinvasionofprivacy.(_ORS_Ԁ196.500(2)(b)) ConfidentialityofWelfareApplicants/RecipientsInformation :_ORS_Ԁ411.300 Regulationsconcerninguseandcustodyofrecords.  ~ R  (1)DHSshallmakeandenforcereasonablerulesandregulationsgoverningthecustody,useandpreservationoftherecords,tapes,filesandcommunicationsofDHS.Theuseofsuchrecords,papers,filesandcommunicationsbyanyotheragencyordepartmentofgovernmentorpersontowhichtheymaybefurnishedshallbelimitedtothepurposesforwhichtheyarefurnishedandbytheprovisionsofthelawunderwhichtheymaybefurnished._ORS_Ԁ411.320 Disclosureanduseofrecordslimited;contentsasaprivilegedcommunication. Fortheprotectionofclients,DHS 2 contractors...shallnotdiscloseorusethecontentsofanyrecords,files,papersorcommunicationsforpurposesotherthanthosedirectlyconnectedwiththeadministrationofthepublicassistancelawsofOregon,andtheserecords,filespapersandcommunicationareconsideredconfidentialsubjecttotherulesandregulationsofDHSanditsDivisions,exceptasotherwiseprovidedin_ORS_Ԁ411.325to411.335.Inanyjudicialproceedings,exceptproceedingsdirectlyconnectedwiththeadministrationofpublicassistancelaws,theircontentsareconsideredprivilegedcommunications.(Note:_ORS_Ԁ421.325and411.330havebeenvoidedbycourtaction.)_ORS_Ԁ411.335 Prohibiteduseoflistsornames. Nopersonoragencyshallsolicit,disclose,receive,makeuseof,orauthorize,knowingly X  permit,participateinaoracquiesceintheuseof,anylistsofnamesforcommercialorpoliticalpurposesofanynature,foranypurposenotdirectlyconnectedwiththeadministrationofpublicassistancelaws.(Note:_ORS_Ԁ411.325and41.330havebeenvoidedbycourtaction.)_ORS_Ԁ411.990 Penalties (1)Violationof_ORS_Ԁ411.320to411.335ispunishable,uponconviction,byafineofnotmorethan$1,000or n% byimprisonmentinthecountyjailfornotmorethan60days,orbyboth.Violationof_ORS_Ԁ192.500iscausefordisciplinaryactionunder_ORS_Ԁ240.555. Instructions: Contractorandsupervisorwillsignpriortostartofwork.ReturnoriginaltotheDHSProjectManagerordesignee. ) IcertifythatIhavereadtheforegoing.MysignaturebelowmeansthatIunderstandtheprovisionsoflawpertainingtotheconfidentialityofDHSrecordsandinformation.IalsounderstandthattheselawsmaychangefromtimetotimeandthatitismyresponsibilitytoreadandunderstandthesechangesasIamnotifiedofthem.9%X ,X9er4 hX 79  Name(pleaseprint):  ___________________________________________________________________________ d80 Signature:_______________________________________________  Date_____________________ >! 3 SupervisorsSignature:________________________________________________Date_____________________|w#,&%,K]c#  #"7 X     @F  @r  @  @  @A  @  @  @u ,XC?X%,&0 @ #,&%X,XC?y# ,XC?X%,&0@%(#(# ExhibitE ,  7 INFORMATIONFORCRIMINALHISTORYCHECK#,&%X,XC?z#,%%,&   *8F9Xddd Xdd Xdd Xr%r%,m dd ,dd , dd +  %  %@X X *** 53J)%,HIRINGSUPERVISORTOCOMPLETETHISSECTION #,%)53J|#*** * j> *_3pNameofDHSSupervisor=p_3 $: $_3pAgency/Address=p_3  : _3pPhoneNumber/Extension=p_3(:    (*:F;dXdm dd m dd  dd 8F9r%r%,s#dd +  !   !@ ***53J)%, TOBECOMPLETEDBYAPPLICANT/EMPLOYEE #,%)53J~#***(l@   (KX X (#X ,X9er4 hXK  Name(PleasePrint) Last    h First     p Middle    DateofBirth I  AF<) xdEr#A Y OtherName(s)Used:(MaidenName,PreviousMarriedName(s),Aliases,LegalNameChanges,AssumedNames,etc.)#,&%%,z#,XC?X%,&AF<)V' s#dEV' s#A#,&%X,XC?o#,%%,&^ 2 o #,&%%,#,3+%,&33#,&%+,3L#33k,%%,&Sex     SocialSecurityNumber(PerSignedConsentBelow) p     DriversLicenseNumber/IssuingState } Q    #,&%%,#,%%,&Male#,&%%,Ƀ#,%%,&  Female#,&%%,#,%%,& #,&%%,{#,%%,&   AF<)Vs#dEVs#A %W+ 2 WARNING:Falselyrespondingtoanyofthequestionslistedbelowdisqualifiesyourapplicationbylaw.  W+  EX  X (#X X XE1.  Yes  No0 HaveyoulivedoutsidetheStateofOregonanytimeduringthefive(5)yearpriortodaysdate?  % % -2.  Yes  No0 Haveyoueverbeenconvictedofanycrimelistedonthebackofthisform(orthesubstantialequivalentofanyofthe  crime(s)iftheconvictionoccurredinanotherjurisdictionorinOregonunderadifferentstatutorynameornumber)?  % % IfYES,placean(X)intheboxbesidethecrime(orthesubstantiallyequivalentcrime)and,onaseparatesheetofpaper,describethecircumstancesbywhichyouwereconvictedofthecrime(s)andprovideanyinformationyouhavetohelpusunderstandwhyyoubelieveyourconviction(s)WILLNOTposearisktopersonsinthecareoforreceivingservicesfromDHS,orotherpreventyoufromfulfillingtheresponsibilitiesofyourjob.3.  Yes  No0 Doyouhaveaconcealedhandgunlicense?"$ % % @a a %4 53J)%,AUTHORIZATIONTODISCLOSESOCIALSECURITYNUMBER#,%)53J#  4' %OAR410070000authorizesDHStorequestyoutovoluntarilyprovideyourSocialSecurityNumbertoDHSforuseasanidentificationnumberforcriminalrecordchecks.FailuretoprovideyourSocialSecurityNumberwillnotbeusedasabasistodenyyouanyrightorbenefit,orprivilegeprovidedbylaw.IfyouprovideyourSocialSecurityNumberandconsenttoitsuse,itwillbeusedonlyforthepurposestatedaboveandwillnotbegiventothegeneralpublic.BysigningthisconsenttodiscloseyourSocialSecurityNumber,youauthorizeDHStodiscloseyourSocialSecurityNumbertoothersifsuchdisclosureisnecessaryforthepurposestatedabove.______________________________________________________________________________________________________________________ConsultantsSignature     h      p       Date I/ % @  53J)%,AFFIRMATIONOFACCURATEINFORMATION#,%)53J#   0 %~Ihavereviewedandcompletedbothsidesofthisformasapplicabletome.Iunderstandthatsubmittingfalseinformationwilldisqualifymefromworkingat/forDHS.Bymysignaturebelow,Iherebyaffirmthatallinformationprovidedonbothsidesofthisform,andallattachmentsthereto,aretrueandaccurate.    3    @  @  @ ***53J)%, CONSULTANTSSIGNATUREMUSTBEWITNESSED#,%)53J# 󀀀*** G5   _________________________________________________0  0%%______________________________________________________ W7%% ConsultantsSignature    Date h   0  SignatureofWitness     Date!!8%%              h       0  0%%0 %%0 % %   h   0 % % %%   0  0%%0 %%0 % %0 % %0h%%0h%h%0%%_______________________________________________________ %% h           h   0   %%   0  0%%0 %%0 % %0 % %0h%%0h%h%0%%TitleofWitness %% h *e=F>dds#dd s#:F;r%r%e,dd ,Wdd +  % &$C %@ i***53J)%, DHSPERSONNELSERVICESUSEONLY #,%)53Jb#Ԁ*** 'h&<%D 'DateofLEDS_CCH_/WARRANTS/_DMV_ԀCheck:______/______/_____  '&F DHS_PERS_Ԁ_SVCS_ԀRECORDSSPEC: 'n&G   ]4X^ ; N <u|,,Xh4!XX  X X]Conviction : x Yes  No U  h Warrant:  V Yes  No    Valid_ODL_ :YesQ<No )'H  ContinuedEmployment :  Approved h Denied#,&%%,Ʉ# B*)J      x    U  h  V   ,%%,&Թ*xFdddd Wdd W=F>r%r%x, $dd +   .h-Q #,&%%,#,XC?X%,&@U U i IMPORTANTNOTICETOCONSULTANT    .-R #,&%X,XC?#,|11%,&YOURSIGNATUREONTHEFRONTOFTHISFORMMEANSYOUHAVEREVIEWEDTHISLISTOFCRIMESANDCHECKMARKED(4)THOSE d CRIMESFORWHICHYOUHAVEBEENCONVICTED. YOURSIGNATUREALSOGRANTSPERMISSIONFORDHSTOVERIFYANYANDALLINFORMATIONYOUHAVEPROVIDEDONTHISFORMANDATTACHEDDOCUMENTS,IFANY.#,&%1,|1(#,%%,&   #,&%%,#,3+%,&ffӀ#,&%+,3#,%%,&  ff.#,&%%,d#,|11%,&SpecificCrimes:(_ORS_):#,&%1,|1Ѡ#,|11%,&  #,&%1,|1J#,XC?X%,&ffff`" F X XX^ ; N <u|,,Xh4!X`#,&%X,XC?#,%%,&( r%r%(o0 q 162.0250ququBribeReceivinguu o0 q 162.0650ququPerjurypD uu o0 q 162.1550ququEscapeII uu o0 q 162.165  EscapeIl@ ququ o q 162.185  SupplyingContraband   o0 q 162.2050ququFailuretoAppearIh< uu o0 q 162.2350ququObstructingGovernmentalorJudicialAdministrationuu o0 q 162.2650ququBribingaWitnessd 8uu o0 q 162.2750ququBribeReceivingByaWitness uu o0 q 162.2850ququTamperingWithaWitness` 4 uu o0 q 162.3050ququTamperingWithPublicRecords uu o0 q 162.3250ququHinderingProsecution\ 0 uu o q 163.095  AggravatedMurder   o q 163.115  Murder X ,  o q 163.118  ManslaughterI   o q 163.125  ManslaughterII T (  o q 163.145  CriminallyNegligentHomicide   o0 q 163.1600ququAssaultIVP$ uu o q 163.165  AssaultIII   o q 163.175  AssaultII L  o q 163.185  AssaultI  o0 q 163.1900ququMenacingHuu o0 q 163.1950ququRecklesslyEndangeringAnotheruu o q 163.200  CriminalMistreatmentII D o q 163.205  CriminalMistreatmentI   o q 163.225  KidnapingII @! o q 163.235  KidnapingI " o q 163.275  Coercion <# o q 163.355  RapeIII $ o q 163.365  RapeII 8 % o q 163.375  RapeI & o q 163.385  SodomyIII 4' o q 163.395  SodomyII ( o q 163.405  SodomyI 0) o q 163.408  UnlawfulSexualPenetrationII * o q 163.411  UnlawfulSexualPenetrationI ,+ o q 163.415  SexualAbuseIII ~, o q 163.425  SexualAbuseII (- o q 163.427  SexualAbuseI z. o q 163.435  ContributingtotheSexualDelinquencyofaMinor $/ o q 163.445  SexualMisconduct v0 o0 q 163.4550ququAccostingforDeviatePurposes 1uu o q 163.465  PublicIndecency r2 o q 163.515  Bigamy 3 o q 163.525  Incest n4 o q 163.535  AbandonmentofaChild 5 o q 163.545  ChildNeglectII j6 o q 163.547  ChildNeglectI 7 o q 163.555  Criminal_Nonsupport_ f8 o q 163.575  EndangeringtheWelfareofaMinor 9 o q 163.670  UsingChildinDisplayofSexuallyExplicitConduct b: o q 163.6730  DealinginDepictionsofSexualConductInvolvinga  ; Child uu o0 q 163.6750ququSaleofExhibitionofVisualReproductionofSexual  = ConductbyChild uu o q 163.680  PayingforViewingSexualConduct !? o q 163.732  Stalking !V @ o0 q 164.0430ququTheftIII" Auu o0 q 164.0450ququTheftII~"R!Buu o0 q 164.0550ququTheftI"!Cuu o0 q 164.0570ququAggravatedTheftIz#N"Duu o q 164.075  TheftbyExtortion #"E o q 164.225  BurglaryI v$J#F o q 164.325  ArsonI $#G H,F$ 4 X F X XHo S 164.395  RobberyIII r%F$H o S 164.405  RobberyII %$I o S 164.415  RobberyI n&B%J o0 S 165.0130SuSuForgeryintheFirstDegree&%Kuu o0 S 165.0220SuSuCriminalPossessionofaForgedInstrumentinthe j'>&L FirstDegree uu BX,F$ 4 XBo0 S 165.0320SuSuCriminalPossessionofaForgeryDevicef(:'Nuu o0 S 165.0550SuSuFraudulentUseofCreditCard(Over$750)('Ouu o0 S 165.0650SuSuNegotiatingaBadCheck(ClassFelonyClause)b)6(Puu o0 S 165.0700SuSuPossessionaFraudulentCommunicationDevice)(Quu o0 S 165.0740SuSuUnlawfulFactoringofaCreditCardTransaction^*2)Ruu o0 S 165.0850SuSuSportsBribery*)Suu o0 S 165.0900SuSuSportsBribeReceivingZ+.*Tuu o0 S 166.0150SuSuRiot+*Uuu o S 166.085  AbuseofCorpseII V,*+V o S 166.087  AbuseofCorpseI ,+W o S 166.155  IntimidationII R-&,X o S 166.165  IntimidationI -,Y o S 166.220  UnlawfulUseofWeapon N."-Z o S 166.270  FeloninPossessionofFirearm .-[ o0 S 166.2720SuSuUnlawfulPossessionofMachineGuns,CertainShort J/.\ barreledFirearms&FirearmsSilencers uu o S 166.275  PossessionofWeaponsbyInmatesofInstitutions F0/^ o S 166.3700  DischargingFirearmatSchool/PossessionofFirearm 0/_ orDangerousWeaponinPublicBuildingB10`uu o  166.382 O PossessionofDestructiveDevice ` o  166.384 O UnlawfulManufactureofDestructiveDevice pDa o  166.429 O UseofFirearmsinFelony b o  166.480 O SaleorGiftofExplosivestoChildren l@c o  166.660 O UnlawfulParamilitaryActivity d o  166.720 O Racketeering h<e o0  167.0070O&&ProstitutionfO&O& o  167.012 O PromotingProstitution d 8g o  167.017 O CompellingProstitution  h o  167.0620 O SadomasochisticAbuseorSexualConductinLiveShow#,&%%,~#,|11%,&(engaging ` 4 i in)#,&%1,|1#,%%,& jO&O& o  167.0620 O SadomasochisticAbuseorSexualConductinLiveShow \ 0 k (directing,managing,financing,orpresenting) O&O& o  167.065 O FurnishingObsceneMaterialstoMinors X , m o  167.070 O SendingObsceneMaterialstoMinors  n o  167.075 O ExhibitinganObscenePerformancetoaMinor T ( o o  167.080 O DisplayingObsceneMaterialstoMinors  p o  167.087 O DisseminatingObsceneMaterial P$ q o  167.090 O PubliclyDisplayingNudityorSexforAdvertisingPurposes  r o  167.212 O TamperingwithDrugRecords L s o  167.2620 O AdultUsingMinorinCommissionofControlledSubstance t Offense(LessThanFiveGramsMarijuana) O&O& o  411.630 O UnlawfullyObtainingofPublicAssistance v o  411.840 O UnlawfullyUsingStampsorCommodities Dw o0  471.4100O&&ProvidingLiquortoaPersonUnder21ortoIntoxicatedPerson; x MandatoryMinimumPenalties O&O& o0  475.9920O&&ProhibitedActsGenerally;Penalties;AffirmativeDefensefor z CertainPeyoteUses O&O& o0  475.9930O&&ProhibitedActsforRegistrants;Penalties|O&O& o0  475.9940O&&ProhibitedActsInvolvingRecordsandFraud;Penalties8 }O&O& o0  475.9950O&&DistributionofControlledSubstancetoMinors~O&O& o0  475.9960O&&CrimeCategoryClassificationforViolationof475.992;Proofof 4 CommercialDrugOffense O&O& o0  475.9990O&&ManufactureorDeliveryofControlledsubstancetoMinoror 0 StudentWithin1,000FeetofSchool O&O& o0  811.1400O&&RecklessDriving,O&O& o0  811.1820O&&CriminalDrivingWhileSuspendedorRevokedorinViolationof ~ aPermit O&O& o0  811.5400O&&FleeingorAttemptingtoEludePolicezO&O& o0  811.7000O&&FailuretoPerformdutiesofDriverWhenPropertyisDamaged$O&O& o0  811.7050O&&HitandRunVehicle(Injury)vO&O& o0  813.0100O&&DrivingUndertheInfluenceofIntoxicant#,&%%,z#I O&O&    O    - Q==<=  a"  $    O   __ x&L% ( ruru(  ,XC?X%,&%XWXX,XC?#,XC?XX%XW H##,&%X,XC?#,XC?X%,&  X #,&%X,XC?+#DHX,XK,XC?X%,&  %XWXX,XC?M83dd8 S    N  z Q   V    S     S    N  z Q   V      ^     J#%&.%X%XW# #,&%%%&.#&  ,K]%,& ,K]  #,K] #% ,K]#%&.% %#%XWX%%&.W#%&.%X%XWJ##,&%%%&.#'X