SAMPLE AGREEMENT BETWEEN THE WESTERN PLACER CONSOLIDATED TRANSPORTATION SERVICE AGENCY AND FOR THE SOUTH PLACER BUS PASS SUBSIDY PROGRAM Recitals WHEREAS, the South Placer Bus Pass Subsidy Program has been created to help meet the needs of low income individuals for basic transportation to access non-emergency medical care and general public assistance services; and WHEREAS, the Western Placer Consolidated Transportation Services Agency wishes to encourage local social service agencies and organizations to distribute discounted bus passes to eligible clients to enable access to non-emergency medical care and public assistance services; and WHEREAS the wishes to provide its clients with improved access to non-emergency medical services and general public assistance services by participating in the South Placer Bus Pass Subsidy Program; THEREFORE, the Western Placer Consolidated Transportation Services Agency and the hereby enter into this Bus Pass Subsidy Agreement [ Agreement ] setting forth the responsibilities attendant to participation in the South Placer Bus Pass Subsidy Program. I) Description of Participant Agencies a) The Western Placer Consolidated Transportation Services Agency, hereafter referred to as WPCTSA, is a joint power authority with the power to provide social service transportation for the western portion of Placer County. b) The, hereafter referred to as partner agency, is a focused in the health and social services fields. The assist adults and older adults by providing services. II) Overview of South Placer Bus Pass Subsidy Program The South Placer Bus Pass Subsidy Program [ Program ] will reimburse 75% of the cost of transit day passes for fixed route public transit trips on any of the three fixed route providers operating in South Placer County (Auburn Transit, Placer County Transit and/or Roseville Transit) by qualified social service agencies for distribution to their agency clients. Partner agencies will purchase transit day passes at the published fare for those passes and will request reimbursement of 75% of the cost of purchased passes from the WPCTSA. South Placer Bus Pass Subsidy Program Agreement 2015/16 Page 1
The passes will be issued to facilitate the participation of clients in any of the following programs: Aid to Families with Dependent Children GENERAL AID California Medical Assistance (Medi-Cal) - MEDICAL County Medical Services Programs - MEDICAL Food Stamps (CalFresh) - FOOD Multipurpose Senior Service Program SENIOR SERVICES CalWORKS - EMPLOYMENT Medi-CAL - MEDICAL Housing Choice Voucher Program - HOUSING SSI/SSP GENERAL AID Women, Infants, and Children s Program (WIC) FOOD General Relief / General Assistance (GR / GA) GENERAL AID III) Roles and Responsibilities It is hereby agreed that the roles and responsibilities of the parties shall be as follows: WPCTSA Shall be responsible for the overall administration of the program, including development and approval of budget, policy, and program design; Shall provide seventy-five percent (75%) of the funding for the program; Shall establish and administer an annual application process for social service agencies and organizations who desire to participate in the program; Shall establish an annual allocation of transit day passes for each approved participant agency/organization; Shall provide training as needed for participating agencies/organizations in program policies, guidelines, administration and reporting; Shall review, approve and issue reimbursement for 75% of the cost of purchased transit day passes in response to documented reimbursement requests submitted by agencies monthly or less often at the agencies discretion; and Shall collect data on program activities and monitor and report on program performance on a monthly, quarterly and annual basis. Shall complete an application for annual participation in the program including execution of this Agreement; Shall commit to a maintenance of effort on existing transportation programs where possible; Shall provide a cash match of twenty-five percent (25%) of the cost of transit day passes purchased to support client transportation needs; Shall ensure that agency staff attend and participate in any training provided by WPCTSA; Shall purchase transit day passes from any of the three fixed route transit providers (Auburn Transit, Placer County Transit and/or Roseville Transit) as needed and distribute those transit day passes to the agency s/organization s clients according to program guidelines; Shall record, maintain and report to WPCTSA on a monthly basis or as required on the number of passes issued, the clients receiving these passes, the nature of clients eligibility and trip purpose as depicted in Exhibit A, and Shall make the records and data required to be maintained available to WPCTSA and shall give agents and/or representatives of WPCTSA access to the systems and records used to collect and maintain that data upon request. South Placer Bus Pass Subsidy Program Agreement 2015/16 Page 2
IV) Scope of Services The application the following estimate of monthly and annual total of number of transit day passes to have subsidized through this Program. The total cost for of transit day passes to be purchased for fixed route public transit trips by the shall not exceed Dollars ($ ) with reimbursement by WPCTSA not to exceed Dollars ($ ). V) Timeline This Agreement will be effective for the period 2015 through June 30, 2017, unless terminated earlier in accordance with the terms described herein. Contract provisions that contain report deadlines or record obligations, which occur after contract termination survive as enforceable continuing obligations. This Agreement may be extended for up to one additional year at the mutual agreement of the parties through a written amendment hereto. VI) Termination This Agreement may be terminated prior to the expiration date indicated above as follows: WPCTSA may terminate this Agreement at any time without notice in the event of: Failure of Partner Agency to collect, maintain or report required data as indicated herein; Misuse of distributed tickets/passes in violation of program guidelines; and Loss or exhaustion of program funding. Partner Agency may terminate this Agreement at any time without notice in the event of: Loss of program funding or inability to provide required 25% cash match; and Agency decision to cease participation in program. In the event of termination by the WPCTSA, the WPCTSA shall honor requests for reimbursement of the subsidy value of transit day passes purchased prior to the date termination notice was or should have been received by Partner Agency. South Placer Bus Pass Subsidy Program Agreement 2015/16 Page 3
VII) Execution We, the undersigned have read and agree with this South Placer Bus Pass Subsidy Program Agreement. WESTERN PLACER CONSOLIDATED TRANSPORTATION SERVICES AGENCY COUNTY OF PLACER ( COUNTY ) Celia McAdam, AICP Executive Director Date: Director Department of Date: With concurrence of the : Date:, Director Date: Approved as to Form Counsel Date: South Placer Bus Pass Subsidy Program Agreement 2015/16 Page 4
Exhibit A South Placer Bus Pass Subsidy Program Agreement 2015/16 Page 5