General Services Division REQUEST FOR PROPOSALS (RFP ... · Present the vendor’s project...
Transcript of General Services Division REQUEST FOR PROPOSALS (RFP ... · Present the vendor’s project...
Finance Department General Services Division
2180 Milvia Street, Berkeley, CA 94704 Tel: 510.981.7320 TDD: 510.981.6903 Fax: 510.981.7390
E-mail: [email protected] Website: http://www.ci.berkeley.ca.us/finance
REQUEST FOR PROPOSALS (RFP)
Specification No. 16-10974-C FOR
TARGETED CASE MANAGEMENT SYSTEM PROPOSALS WILL NOT BE OPENED AND READ PUBLICLY
Dear Proposer:
The City of Berkeley is soliciting written proposals from qualified firms or individuals for a new Targeted Case Management System. As a Request for Proposal (RFP) this is not an invitation to bid and although price is very important, other factors will be taken into consideration. The project scope, content of proposal, and vendor selection process are summarized in the RFP (attached).
Proposals must be received no later than 2:00 pm, on Tuesday, December 1, 2015. All responses must be in a
sealed envelope and have “TARGETED CASE MANAGEMENT SYSTEM” and Specification No. 16-10974-C clearly marked on the outer most mailing envelope. Please submit one (1) unbound original and five (5)
unbound copies of the proposal as follows:
Mail or Hand Deliver To:
City of Berkeley
Finance Department/General Services Division
2180 Milvia Street, 3rd Floor
Berkeley, CA 94704
Proposals will not be accepted after the date and time stated above. Incomplete proposal or proposals that do not
conform to the requirements specified herein will not be considered. Issuance of the RFP does not obligate the City
to award a contract, nor is the City liable for any costs incurred by the proposer in the preparation and submittal of
proposals for the subject work. The City retains the right to award all or parts of this contract to several bidders, to
not select any bidders, and/or to re-solicit proposals. The act of submitting a proposal is a declaration that the
proposer has read the RFP and understands all the requirements and conditions.
For questions concerning the anticipated work, or scope of the project, please contact Rebekah Lowe,
Department of Information Technology Senior Systems Analyst, via email at [email protected] no
later than Friday, November 6, 2015. Answers to questions will not be provided by telephone. Rather, answers to
all questions or any addenda will be posted on the City of Berkeley’s site at
http://www.cityofberkeley.info/ContentDisplay.aspx?id=7128. It is the vendor’s responsibility to check this site.
For general questions concerning the submittal process, contact purchasing at 510-981-7320.
We look forward to receiving and reviewing your proposal.
Sincerely,
Dennis Dang
Acting General Services Manager
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I. INTRODUCTION
1.1 Information about City of Berkeley
The City of Berkeley is located in Alameda County, California and has a population of approximately 118,000. The
City government's adopted budget for the 2015 fiscal year is approximately $311 million. The City has several large
departments: Police; Fire; Public Works; Health, Housing & Community Services; Planning; Parks and Recreation; plus
several support departments including Information Technology. In addition to these departments the City runs its own
library system, and an independent Rent Control Board. There is currently no significant operational relationship with
the Berkeley Unified School District.
1.2 Existing City Technical Environment
The City of Berkeley has approximately 1400 desktop computers, 200 notebooks, 1500 VoIP phones, 400 printers,
170 servers and 80 mobile computers. The City employs 1Gbit Ethernet for each location’s switching
infrastructure. Five City buildings within the central fiber campus area are linked by 2Gbit fiber (~1000
desktops). Fiber WAN links connect all remote buildings at varying speeds to the datacenters, including off-site
locations used by the Department of Health, Housing and Community Services.
The City’s network database engine is MS SQL Server; and enterprise applications, like the financial system, run on
the AS/400 under DB2. Microsoft Office 2013 is the standard office application suite. Microsoft Exchange and
Outlook provide the messaging environment at the City.
All new desktop machines currently run MS Windows 7 Pro. The servers run Windows 2008 and above, with a
diminishing number of legacy NetWare and MS Server 2003 systems.
1.3 City’s Department of Health, Housing and Community Services (HHCS)
The City’s Department of Health, Housing and Community Services (HHCS) includes five major divisions: Public
Health, Mental Health, Environmental Health, Aging Services, and Community Services.
HHCS provides a variety of important services in the community including the provision of Targeted Case
Management (TCM) program services to Berkeley residents and families. Targeted Case Management work
groups consist of Supervisors and Case Managers in Public Health Nursing and in the Division of Aging Services.
The TCM providers will be located at the West Berkeley Service Center (1900 Sixth Street); although, Case
Managers may also work out of other facilities, e.g., the South Berkeley Senior Center.
The State of California’s Targeted Case Management program provides case management services that assist Medi-
Cal eligible individuals within a target group gain access to needed medical, social, educational and other services.
TCM case management services are comprehensive and must include at least one of the following service
components: Comprehensive Assessment and Periodic Reassessment; Development of a Specific Care Plan;
Referral and Related Activities; and Monitoring and Follow-Up Activities.
The delivery of TCM services to individuals and families occurs at City offices, in homes, and throughout the
community in various settings such as childcare centers, homeless shelters, residential care facilities, social clubs,
churches, and other group settings.
The HHCS Department receives incoming referrals with requests for services from hospitals, medical professionals,
community organizations and clinics, social service agencies, other department and City programs, other health
jurisdictions, public safety officials, and from community members. The TCM case management teams focus on
the provision of Targeted Case Management services as defined in agreements with the State of California;
however, Case Managers may provide program services that fall outside TCM service definitions but such services
must be captured in the new TCM System. For example, Public Health Nurse Case Managers provide specialized
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services for pregnant and post-partum women and their children which may include some hands-on assessments of
infants, and the provision of consultation and teaching information on topics like breast feeding and immunizations.
1.4 Project Introduction
The City of Berkeley’s Department of Health, Housing and Community Services (HHCS) requires a new Targeted
Case Management (TCM) System and requests proposals for a comprehensive solution that securely manages client
and service data. The Targeted Case Management System will provide the platform and the architecture to
integrate all information and documentation about the client, as the organization moves away from paper-based
processes and charts. The ideal solution will be configurable and flexible with options for extending the application
to meet future growth.
The City will consider proposals for “best of breed” software products and from vendors who propose to expand
the City’s local NextGen EPM-EHR System to meet Targeted Case Management System requirements.
The new Targeted Case Management System will replace a Public Health legacy system that includes custom Target
Case Management modules, running on Intersystems Cache, currently used by Public Health Nursing and Aging
Services Case Managers. This legacy system will continue to be maintained as an inquiry-only data repository for a
period after implementation of the new TCM System; then it will be decommissioned.
II. SCOPE OF SERVICES
The selected vendor must bring the range of necessary capabilities and experience to implement and maintain the
Targeted Case Management System. Proposals may be submitted by a contractor that proposes to work in
conjunction with subcontractors or partners and/or proposes to utilize third party products to meet one or more of
the components. However, the bidding vendor must assume responsibility for all work and services performed
under the executed contract and demonstrate that the software systems can be seamlessly integrated.
The City plans to begin Targeted Case Management System implementation work in early -2016 and targets July 1,
2016 as the go-live date for the baseline system. There may be some components or functionality implemented as
part of a second phase.
Companies selected as a result of this RFP must be prepared to begin work immediately upon contract signing.
2.1 General Description of Vendor Services
The scope of services will be finalized in the City’s Contract with the vendor; however, vendors should be prepared
to provide the following general scope of services to the City of Berkeley:
Provide information about platform and technical specifications for system hardware and software. (The
system may be hosted by the vendor.)
Present the vendor’s project management plan to the City that describes phases, activities, timelines, and
staffing. Provide regular status information to the City’s project manager and other individuals.
Work with City staff to install and configure any required new vendor software and third party software
components and/or equipment, as necessary. (The system may be hosted by the vendor.)
Work with City staff to establish separate technical environments that accommodate development, testing,
training and production.
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Work with the City staff to enhance software product(s) and develop necessary interfaces and data transfer
components as agreed on by contract. (Enhancements that are proposed to meet specifications outlined in this
RFP should be identified in the submitted proposal and included in the cost estimates.)
Work with City staff on the migration of current TCM patient and service data from legacy Public Health
MUMPS-based systems to new database(s). The City will provide the data in an agreed upon format.
Work with City staff on system back-up and disaster recovery plans, as necessary.
Work with City staff on conducting and documenting functional and end-to end testing.
Provide training to City technical and system administrator staff.
Provide onsite training to end users (Program Managers, TCM Supervisors, Case Managers, and support staff).
Provide written and electronic versions of technical documentation and training manuals.
Deliver ongoing software maintenance that provides regular technical support and software upgrades
throughout the contract period as part of annual maintenance fees.
Provide information in advance about requested assistance, expectations, or special arrangements that involve
City and/or other vendors, such as: site preparation requirements; needs for assistance from City technical
staff, etc.
2.2 City of Berkeley Project Management and Technical Services
The City of Berkeley will provide project management and technical assistance to help bring about successful
implementation of the new TCM system:
A City Department of Information Technology (IT) Analyst will provide project management services for the
City and work directly with vendor representatives to: finalize project implementation plans and timelines;
establish work teams; and facilitate project-related communication with HHCS managers, users, and City IT
staff;
The City’s IT Analyst/Project Manager will facilitate and coordinate with the vendor and internal City work
team members to complete the following: acquisition and installation of any required hardware and software,
as needed; provide detailed specifications required to tailor software and interfaces, as needed; set-up system
directory and menu information; configure system, tables, data collection forms; establish user classification
groups and access levels; oversee software testing and tuning; verify completed work components; assist with
documenting business processes; and coordinate technical and user training.
The City’s IT Analyst/Project Manager will work with the City’s project team to: finalize TCM system
configuration; identify gaps, assess options and prepare plan for enhancements; identify TCM work process
automation solutions; and organize end user acceptance testing for the TCM system.
The City will be responsible for working with the vendor on any required legacy data migration, and
downloading TCM data from current legacy applications in the agreed upon format. It is desirable that
information about active clients and recent service summary information can populate the new databases prior
to go-live. There may also be cutover claiming issues that need to be addressed during data migration to the
new system.
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2.3 TCM System Components and Functionality
The Health, Housing and Community Services Department (HHCS) seeks a Targeted Case Management (TCM)
System with a fully featured electronic client chart and the architecture to integrate secure data about clients, cases,
families, providers, care plans, assessments, services, billing and payment information, and ancillary documents
and images.
The system solution must collect and manage all the client and service data required of a Local Governmental
Agency (LGA) participating in the California State MAA and/or TCM program(s). It must be capable of ensuring
compliance with State TCM data and recordkeeping requirements.
The desired TCM System will improve case management work processes and recordkeeping. It should automate
workflow using business rules, whenever possible, as the organization moves away from paper-based processes.
The system must provide configurable reports and tools that support case assignment decisions and assist with
caseload and workload management.
The City’s Health, Housing and Community Services Department requests proposals for a comprehensive Targeted
Case Management system that should include or have the capacity to expand its functionality and incorporate these
application components:
Inbound Referral Tracking and Assignment
Client and Family Demographics
Insurance Coverage & Eligibility Verification
Manage Case Tools (Case Activation & Assignment, Case Status Changes)
Appointment Management
TCM Program Eligibility & SPA Designation
Client Consents, Authorizations & Required Enrollment Forms
Assessment Data Collection Instruments
Care Plan Data Collection Instruments
Encounter Data Collection Instruments
Case Progress Notes
Outbound Referrals
TCM Billing/Claiming Functionality
TCM Remittance Functionality (Desired)
Workflow/Process Configuration & Task Management Tools
Robust Report Options & Dashboard
Imaging & Document Management
Schedule & Time Tracking (Desired)
System Administration & Table/File Maintenance
System Interfaces / Data Extraction Utilities
Internal Messaging for Providers
Mobile Applications
The system must be modifiable and include options for extending the application to meet future growth and
changes to program and funding requirements. The City expects to augment the system with new data collection
instruments and must be able to add fields and modify values on out-of-the-box forms. The solution should include
or plan for options that support future system interface development and compliant methods of transferring data to
internal and external entities.
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The following information outlines Targeted Case Management System specifications.
Client & Family Management
System maintains a unique master patient record and manages data about clients who may have multiple
episodes of services that span time and include various case/program types.
System provides look up tools that search using various key data and help to prevent the entry of duplicate
client records.
System provides utility for authorized system administrator to merge duplicate client records.
System provides client registration forms for the entry and maintenance of client demographic data with
options for customer-defined fields and values.
System provides functionality necessary to add, update, and remove individuals as members of or support to a
family/household. Captures information about family/household members, such as, type/relationship, family
membership start & end dates, active/inactive case status, indication if member lives part-time in another
household, etc.
Case Status and Management
System manages case status information about inbound referrals and cases and allows authorized supervisors
and case managers to assign, open, transfer, pend, and close cases.
System maintains and displays the history of case status information that includes a minimum dataset of: client
name & id, residence address and geo-code, effective date, case/program type, case status, and assigned case
manager.
System allows a client to be associated simultaneously with more than one active case in different programs
and based on City's business rules.
System provides utilities/reports that allow case managers to produce lists of assigned referrals and active cases
with key data that includes priority/acuity, contact information, upcoming target dates based on business rules,
last contact date, etc.
System provides utilities/reports that allow supervisors to access a case manager's caseload list, selectively
transfer individuals from the caseload, or transfer an entire caseload (including all family members) en masse to
a new case manager.
Inbound Referrals
System captures information about inbound Referrals (service requests) and the related follow-up activities,
including disposition.
System provides tools to manage the workflow associated with review, assignment, follow-up, and disposition
of Referrals.
Eligibility, Claims & Remittance
System is capable of producing real-time Health Care Benefit Eligibility Inquiry transactions (270) and
receiving and storing Responses (271). The system should be configurable for use in verifying client's Medi-
Cal eligibility.
System identifies and flags Targeted Case Management billable services. It creates TCM claims for Medi-Cal
eligible clients and generates claim records in the California State TCM Program required record layout. (TCM
claim and remittance records are non-standard and do not adhere to 837/835 transaction formatting.)
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It is desirable that the TCM system is capable of importing information about TCM claim payments, adjustments,
and denials and links the information to appropriate client service records. (TCM claim and remittance records
are non-standard and do not adhere to 837/835 transaction formatting.)
Appointment Scheduling
System provides an appointment scheduling module that supports scheduling and updating appointment times
with clients, providers, and resources.
System allows authorized users to export de-identified appointments to their Outlook system.
Assessments & Plans
System provides data collection instruments that capture all California TCM program-required information
about the initial assessment and re-assessments of individual needs including the need for any medical,
educational, social or other services. Assessment forms also include data like: presenting problem(s);
familial/social support systems; medical/mental health profile/status; housing/physical environment; physical
needs/food/clothing; vocational/educational needs; lifestyle and socio-economic risk factors.
System provides data collection instruments or supports development of other assessment forms that are
required for specific case types, e.g., newborn assessment, postpartum assessment, geriatric assessment,
depression screening, activities of daily living, etc.
System includes or supports development of assessment data collection instruments that are associated with the
family/household, e.g., family acuity assessment.
System provides a Care Plan data collection instrument that captures entry of initial and updated goals, actions,
activities and course of action planned to address the medical, social, educational, and other services needed by
the client as identified in the assessment or re-assessment.
Encounters / Services
System provides an encounter data collection instrument that manages the client service dataset, consisting of a
variety of configurable service types that include case management services categorized as TCM (both billable
and non-billable services) and other services to clients that are not reported as TCM encounters.
The encounter data collection instrument is not limited to but must include all data elements and associated
values that are required to produce TCM claims and to correct and resubmit TCM claims.
The encounter data collection instrument is not limited to but must include data elements and associated values
that produce information for TCM Cost reports and categorize all TCM-related encounters into three groupings:
1) Claimable TCM Medi-Cal Only Encounters; 2) Non-Claimable TCM Medi-Cal Only Encounters; and 3)
TCM Non-Medi-Cal Encounters.
System provides or allows the customer to develop special forms that record the use of Public Health Nursing
teaching instruments (examples: breastfeeding, immunizations, developmental milestones).
System captures information about outbound referrals made by Case Managers on behalf of clients and the
associated follow-up information from the agency or provider. System supports outbound referral forms that
can be generated, printed, and maintained in the electronic chart.
Progress Notes
System supports case/progress notes with entry of dated narrative that can be linked to client encounters,
assessment records, monitoring/follow-up activities, inbound referrals, outbound referrals, or can be associated
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with the family/household, etc. System provides an auditable process for amending and modifying
case/progress notes that have been filed.
Time Tracking & State MAA/TCM Time Study
It is desirable that the system provides a time tracking data collection instrument used to record staff time and
activities with the capacity to cross-map time to the State’s MAA/TCM service categories, document review
and approval of time surveys, etc.
Mobile Application
System includes a mobile application that supports secure collection of client data and case management case
records (e.g., assessments) at the point of service which is often the Client’s home.
Data Migration & Extract
It is desirable that the system has the capacity to import legacy client demographic data and Medi-Cal
identifiers for active clients and/or for clients who received TCM services during the prior period, along with
summary encounter data for a designated service period, prior to go-live.
Client and case data can be exported to City data warehouse for reporting and data analytics, etc.
System supports or will be able to support future development of interfaces.
Imaging / Scanning / Document Management
System supports scanning and importing case related documents, pdf files, faxes, letters and images that are
stored and linked to client and case records in the electronic client chart.
System supports customizable letter templates that can be developed to use system-generated information so
users can seamlessly generate and store letters that will be mailed to clients, referral agency representatives,
service providers, etc.
Workflow & Task Management
System supports automated work processes and/or provides workflows that support case management standards
of practice and care, enforce quality case management record keeping, and prevent omission of required case
records.
System provides tools that support workflow notifications at key process steps, e.g., when a case is opened,
transferred, pended, or closed.
System able to use business rules and automatically generate reminders and/or tasks to supervisors, case
managers, other service providers, and support staff.
It is desirable that the system offers or plans to include electronic signature functionality for use on appropriate
forms and to approve case records, where required, including: provider signatures, multiple providers and co-
signatures, client signatures, supervisor/authorization hierarchy.
Flexible Configuration & Extensibility
System is designed to allow the City to configure and modify for local changing needs without requesting the
vendor develop and upgrade the system, when possible.
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System provides tools that allow the City to make modifications to out of the box data forms and data field
values.
System provides tools that support the City’s development of data collection instruments.
Output Reports & Data
System supports caseload management and balancing with dashboards and configurable reports that provide
data to assist supervisors with assignment decisions, such as: case acuity information; number of referrals by
type and priority that are assigned to each case manager; number of active cases by type and acuity assigned to
each case manager; information about case managers' schedules; the case managers' specialties (e.g., language
skills).
System provides dashboards and configurable reports that produce up-to-date information for case managers
about their caseload size, case types, case acuity/criticality, priority and other workload markers.
System includes a robust report builder that provides client and service report options with user selection of
multiple parameters to sort and filter the data as needed.
The City is able to create and modify custom output reports. Ad hoc report development/configuration will be
critical in responding to the variety of data needs and studies required to assess program success and outcomes,
to prepare grant and funding reports, and for program planning purposes.
System produces reports with detailed TCM encounter logs for State required encounter categories: Claimable
TCM Medi-Cal Only; Non-Claimable TCM Medi-Cal Only; and TCM Non-Medi-Cal.
System produces encounter logs and monthly encounter statistics by Case Manager and encounter type, as
required for annual MAA/TCM Cost Reports.
System produces reports that identify queued-up TCM claimable encounters and provide information necessary
for quality review prior to generating claims.
System produces detailed information about TCM claim transactions (and payment information).
System report data can be exported to Excel, PDF, etc.
General System & Network
The City will consider both hosted and on-premise solutions. In the proposal, describe any hardware and
software requirements to implement the vendor’s system, including servers, desktops, network equipment,
notebooks, etc. Also include information about how the proposed solution will function in a virtual
environment. Include network architecture diagram that illustrates implementation option(s).
System Access, Security & Compliance
System is compliant with the Health Insurance Portability and Accountability Act (HIPAA) and includes
technology and/or cooperates with City’s technology infrastructure in order to ensure the confidentiality,
integrity, and security of sensitive and protected client information.
System provides audit features that capture information about data access, entry and changes, including audit
logs with user ID, date and time, location, client ID, system form and/or transaction type, user action (e.g., add,
modify, view, delete, etc.), previous value/entry. System provides authorized administrators with reports or
logs of audit information from audit records.
System maintains logs of user logins and access attempts. It is capable of locking out users after a specified
period of account inactivity.
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City will be able to authorize system administrators to manage restrictions or privileges associated with users,
groups and processes/operations, including: defining groups; defining levels of access; assigning levels of
access; modifying access; and removing levels of access.
City system administrators will be able to restrict access to confidential and sensitive information by user group
or by user id.
City system administrators will be able to view real-time list of users logged into system; terminate user
sessions; lock users out of application modules; and add user defined messages to log on screen.
System will support complex/strong passwords and require users to change passwords on defined schedule.
System will also be able to require that user changes password at next login.
System will authenticate users and access to the system can be restricted based on Active Directory
authentication.
III. SUBMISSION REQUIREMENTS
All proposals shall include the following information, organized as separate sections of the proposal. The proposal
should be concise and to the point.
3.1 Vendor Proposal Format and Requirements
Vendor proposals must be comprehensive and include all required elements. The City may disqualify a proposal if
it does not contain all requested information. The City also reserves the right to request clarification or ask for
additional information before final decisions are made and contract negotiations begin with the successful company
or companies.
Five (5) unbound complete hard copy proposals must be submitted. The vendor may add an electronic version of
the proposal. A trial version of the software may also be included with the proposal but structured software
demonstrations will be required of all finalists.
Proposals must be submitted in binders with tabs to delineate sections and with material that is organized as
outlined below.
Proposal Packages must include the following:
1. Contractor Identification
Include a Transmittal Letter signed by Authorized Person
The transmittal letter should be on business stationery and accompany all copies of the proposal. An individual
authorized to bind the company to statements in the proposal, including services and prices, must sign the letter.
The letter provides the following:
Legal company name and company’s principal place of business (legal headquarters)
Company’s tax identification number
Name, titles, and telephone numbers of persons to be contacted for clarification of the proposal
Statement that person signing the proposal is authorized to propose and price goods and services for the
company
Name, title and telephone number of the person authorized to negotiate a contract on behalf of the
organization
Acknowledgement that conditions governing the RFP have been read and accepted
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Acknowledgement of receipt of any amendments to this RFP (or indicate “none” if no amendments
were received)
Additional information, as appropriate
2. Proposals Describing Software and Services
Proposals should provide information that describes a new comprehensive Targeted Case Management System
solution and outlines the vendor’s proposed services and implementation milestones, including installation,
configuration, integration, testing, training, documentation and maintenance.
Please include the following information that is organized in these sections:
Provide an executive summary that outlines key elements and features of the proposal. Include an overview
of the proposed TCM System solution that is appropriate for managers and non-technical staff. Highlight
business features and how the City can benefit from the products and by partnering with the company.
Provide details about system architecture and the proposed technical solution that are appropriate for
review by Information Technology managers and development staff. Include technical information about
third-party products that are proposed. Attach images, diagrams, and other material, as necessary.
Describe proposed system hardware and software platform. Include recommendations for hand-held devices,
laptops, and equipment that can be used with software at the point of service. Please provide network
architecture diagrams that illustrate implementation options.
The City will consider both hosted and on-premise solutions.
o If on-premise solution, describe and provide specifications for servers, backup system, and related
software and equipment required to operate the vendor’s system. The City will run the software in a
virtual environment so please demonstrate vendor system’s ability to function in a virtual environment.
o If the company is proposing a hosted solution, provide a description of the vendor’s responsibilities.
Include information about where the data will be stored and describe the security standards and methods
used by the vendor to protect the data. Provide information about the vendor’s approach to: ensuring
service levels, availability of the hosted application, server performance monitoring, backup and disaster
recovery, system maintenance, application and environment upgrades, outages and interruptions of
service.
Describe vendor’s responsibility for system’s security features and how the system protects confidential
client information. Provide information about the system’s capacity to maintain audit details about access &
changes to client data, and how information can be provided if an accounting of disclosures is required.
Provide a preliminary implementation plan that identifies proposed milestones and timelines.
Software License and Maintenance Agreements - Include copies of appropriate software license
agreements and support / maintenance agreements that are used by the company and partner company (if
third party product proposed).
Additional Information from Company - Vendors may attach marketing material, white papers, etc., but do
not answer proposal questions by simply referring to company brochures.
3. Completed Response to Attachment I, Features & Functionality
Responses to the Features & Functionality matrix should indicate if the vendor’s system solution can deliver each
feature. Use appropriate columns to designate if the feature is available out of the box, or if it’s already in
development and will be available within six (6) months, or if it can be built by the City (working with the vendor
and using vendors template builder and other tools), or if the feature requires new vendor development that the
vendor will deliver as part of the contract, or if it’s available with recommended third party software. If the
vendor suggests another solution, please describe it. If the desired feature is not addressable, please note that on
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the matrix. Provide adequate descriptions and details in the last column. Include information about timelines
and additional costs, as appropriate.
Please provide a response to all of the items listed on Attachment I. Proposals will not be eliminated solely
because the vendor indicates that a desired feature is currently not available in the product or cannot be addressed
at this time. It is important that proposals are complete and include all of the requested information, however.
4. Complete Price Proposal using Attachment J, Technology System RFP Cost Proposal
The City is soliciting a proposal that identifies all year-one (1) costs and includes separate maintenance and
other costs for year two (2) and year three (3). The proposal must include pricing for all services. Pricing shall
be all inclusive unless indicated otherwise on a separate pricing sheet. The Proposal will itemize all services,
including hourly rates for all professional, technical and support personnel, and all other charges related to
completion of the work must be itemized.
Please price goods and services separately. Summarize one-time costs versus recurring costs with a three (3)
year projection of recurring costs. Identify which components are part of the core solution and which are
optional add-ons. Identify whether any of the software components are from a third party vendor and, if so,
does the City have the option of purchasing these products elsewhere.
5. Client References
Provide a minimum of three (3) vendor references. References should include California cities or other public
sector entities, when possible. Provide the designated person's name, title, organization, address, telephone
number, and the system implementation projects that were completed under that client’s direction.
6. Contract Terminations:
If your organization has had a contract terminated in the last five (5) years, describe such incident. Termination for default is defined as notice to stop performance due to the vendor’s non-performance or poor
performance and the issue of performance was either (a) not litigated due to inaction on the part of the vendor,
or (b) litigated and such litigation determined that the vendor was in default.
Submit full details of the terms for default including the other party’s name, address, and phone number. Present
the vendor’s position on the matter. The City will evaluate the facts and may, at its sole discretion, reject the
proposal on the grounds of the past experience.
If the firm has not experienced any such termination for default or early termination in the past five (5) years, so
indicate.
IV. SELECTION CRITERIA
The following criteria will be considered, although not exclusively, in determining which firm is hired.
1. Company References Stability & Viability (15%)
2. Cost of Proposal (30%)
3. System Features, Functionality & Services (40%)
4. Technology & Configurability/Extensibility/Scalability (15%)
A selection panel will be convened of staff from multiple City of Berkeley departments.
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V. PAYMENT
Invoices: Invoices must be fully itemized, and provide sufficient information for approving payment and audit.
Invoices must be accompanied by receipt for services in order for payment to be processed. Mail invoices to the
Project Manager and reference the contract number.
City of Berkeley
Accounts Payable
PO Box 700
Berkeley, CA 94701
Attn: Rebekah Lowe, Department of Information Technology
Payments: The City will make payment to the vendor within 30- days of receipt of a correct and complete
invoice.
VI. CITY REQUIREMENTS
A. Non-Discrimination Requirements:
Ordinance No. 5876-N.S. codified in B.M.C. Chapter 13.26 states that, for contracts worth more than $3,000 bids
for supplies or bids or proposals for services shall include a completed Workforce Composition Form. Businesses
with fewer than five employees are exempt from submitting this form. (See B.M.C. 13.26.030)
Under B.M.C. section 13.26.060, the City may require any bidder or vendor it believes may have discriminated
to submit a Non-Discrimination Program. The Contract Compliance Officer will make this determination. This
applies to all contracts and all consultants (contractors). Berkeley Municipal Code section 13.26.070 requires
that all contracts with the City contain a non-discrimination clause, in which the contractor agrees not to
discriminate and allows the City access to records necessary to monitor compliance. This section also applies to
all contracts and all consultants. Bidders must submit the attached Non-Discrimination Disclosure Form
with their proposal
B. Nuclear Free Berkeley Disclosure Form:
Berkeley Municipal Code section 12.90.070 prohibits the City from granting contracts to companies that
knowingly engage in work for nuclear weapons. This contracting prohibition may be waived if the City Council
determines that no reasonable alternative exists to doing business with a company that engages in nuclear
weapons work. If your company engages in work for nuclear weapons, explain on the Disclosure Form the nature
of such work. Bidders must submit the attached Nuclear Free Disclosure Form with their proposal.
C. Oppressive States:
The City of Berkeley prohibits granting of contracts to firms that knowingly provide personal services to specified
Countries. This contracting prohibition may be waived if the City Council determines that no reasonable
alternative exists to doing business with a company that is covered by City Council Resolution No. 59,853-N.S.
If your company or any subsidiary is covered, explain on the Disclosure Form the nature of such work. Bidders
must submit the attached Oppressive States Disclosure Form with their proposal.
D. Conflict of Interest:
In the sole judgment of the City, any and all proposals are subject to disqualification on the basis of a conflict of
interest. The City may not contract with a vendor if the vendor or an employee, officer or director of the
proposer's firm, or any immediate family member of the preceding, has served as an elected official, employee,
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board or commission member of the City who influences the making of the contract or has a direct or indirect
interest in the contract.
Furthermore, the City may not contract with any vendor whose income, investment, or real property interest may
be affected by the contract. The City, at its sole option, may disqualify any proposal on the basis of such a conflict
of interest. Please identify any person associated with the firm that has a potential conflict of interest.
E. Berkeley Living Wage Ordinance:
Chapter 13.27 of the Berkeley Municipal Code requires that contractors offer all eligible employees with City
mandated minimum compensation during the term of any contract that may be awarded by the City. If the
Contractor is not currently subject to the Living Wage Ordinance, cumulative contracts with the City within a
one-year period may subject Contractor to the requirements under B.M.C. Chapter 13.27. A certification of
compliance with this ordinance will be required upon execution of a contract. The Living Wage rate is currently
$14.04 (if medical benefits are provided) or $16.37 (if medical benefits are not provided). The Living Wage rate
is adjusted automatically effective June 30th of each year commensurate with the corresponding increase in the
Consumer Price Index published in April of each year. If the Living Wage rate is adjusted during the term of
your agreement, you must pay the new adjusted rate to all eligible employees, regardless of what the rate was
when the contract was executed.
F. Berkeley Equal Benefits Ordinance: Chapter 13.29 of the Berkeley Municipal Code requires that contractors offer domestic partners the same access
to benefits that are available to spouses. A certification of compliance with this ordinance will be required upon
execution of a contract. G. Statement of Economic Interest:
The City’s Conflict of Interest Code designates “consultants” as a category of persons who must complete Form
700, Statement of Economic Interest, at the beginning of the contract period and again at the termination of the
contract. The selected contractor will be required to complete the Form 700 before work may begin.
VII. OTHER REQUIREMENTS
A. Insurance
The selected contractor will be required to maintain general liability insurance in the minimum amount of
$2,000,000, automobile liability insurance in the minimum amount of $1,000,000 and a professional liability
insurance policy in the amount of $2,000,000 to cover any claims arising out of the performance of the contract.
The general liability and automobile insurance must name the City, its officers, agents, volunteers and employees
as additional insureds.
B. Worker’s Compensation Insurance:
A selected contractor who employs any person shall maintain workers' compensation insurance in accordance
with state requirements. Sole proprietors with no employees are not required to carry Worker’s Compensation
Insurance.
C. Business License
Virtually every contractor that does business with the City must obtain a City business license as mandated by
B.M.C. Ch. 9.04. The business license requirement applies whether or not the contractor has an office within the
City limits. However, a "casual" or "isolated" business transaction (B.M.C. section 9.04.010) does not subject
City of Berkeley Specification No. 16-10974-C Page 15 of 27
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the contractor to the license tax. Warehousing businesses and charitable organizations are the only entities
specifically exempted in the code from the license requirement (see B.M.C. sections, 9.04.295 and 9.04.300).
Non-profit organizations are granted partial exemptions (see B.M.C. section 9.04.305). Persons who, by reason
of physical infirmity, unavoidable misfortune, or unavoidable poverty, may be granted an exemption of one
annual free license at the discretion of the Director of Finance. (see B.M.C. sections 9.04.290).
Vendor must apply for a City business license and show proof of application to Purchasing Manager within
seven days of being selected as intended contractor.
The Customer Service Division of the Finance Department located at 1947 Center Street, Berkeley, CA 94704,
issues business licenses. Contractors should contact this division for questions and/or information on obtaining
a City business license, in person, or by calling 510-981-7200.
D. Recycled Paper
All reports to the City shall be on recycled paper that contains at least 50% recycled product when such paper
is available at a cost of not greater than ten percent more than the cost of virgin paper, and when such paper is
available at the time it is required. If recycled paper is not available the Contractor shall use white paper. Written
reports or studies shall be printed on both sides of the page whenever practical.
E. State Prevailing Wage:
Certain labor categories under this project may be subject to prevailing wages as identified in the State of
California Labor Code commencing in Section 1770 et. seq. These labor categories, when employed for any
“work performed during the design and preconstruction phases of construction including, but not limited to,
inspection and land surveying work,” constitute a “Public Work” within the definition of Section 1720(a)(1) of
the California Labor Code requiring payment of prevailing wages.
Wage information is available through the California Division of Industrial Relations web site at:
http://www.dir.ca.gov/OPRL/statistics_and_databases.html
VIII. SCHEDULE (dates are subject to change)
Issue RFP to potential bidders: Tuesday, October 27, 2015
Questions Due Friday, November 6, 2015
Proposals Due from Potential Bidders Tuesday, December 1, 2015
Complete Selection Process Friday, January 1, 2016
Council Approval of Contract (over $50k) Tuesday, February 9, 2016
Award of Contract Wednesday, February 10, 2016
Sign and Process Contract Thursday, February 11, 2016
Notice to Proceed Friday, February 12, 2016
Thank you for your interest in working with the City of Berkeley for this service. We look forward to receiving
your proposal.
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Attachments:
Check List of Required items for Submittal Attachment A
Non-Discrimination/Workforce Composition Form Attachment B
Nuclear Free Disclosure Form Attachment C
Oppressive States Form Attachment D
Living Wage Form Attachment E
Equal Benefits Certification of Compliance Attachment F
Right to Audit Form Attachment G
Insurance Endorsement Attachment H
Features and Functionality Matrix Attachment I
Technology System RFP Cost Proposal Attachment J
Business Associates Agreement Attachment K
City of Berkeley Specification No. 16-10974-C Page 17 of 27
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ATTACHMENT A
CHECKLIST
Proposal includes all requested materials (one (1) unbound original and five (5) unbound copies) and an
electronic file.
Contractor Identification and Company Information – Transmittal Letter
Proposal describing system and services (include all information requested in Item 2 of the Submission
Requirements section)
Completed Response to Attachment I, Features and Functionality Matrix
Completed Response to Attachment J, Technology System RFP Cost Proposal
Review and acknowledgement of Attachment K, Business Associates Agreement
Three (3) Client References
Statement including Contract Terminations or an indication that the firm has not experienced any such
termination for default or early termination in the past five (5) years
The following City forms, completed and signed in blue ink (attached):
o Non-Discrimination/Workforce Composition Form Attachment B
o Nuclear Free Disclosure Form Attachment C
o Oppressive States Form Attachment D
o Living Wage Form (may be optional) Attachment E
o Equal Benefits Ordinance Certification of Compliance (EBO-1) Attachment F
ADDITIONAL SUBMITTALS REQUIRED FROM SELECTED VENDOR AFTER COUNCIL
APPROVAL TO AWARD CONTRACT.
Provide original-signed in blue ink Evidence of Insurance
o Auto
o Liability
o Worker’s Compensation
Right to Audit Form Attachment G
Commercial General & Automobile Liability Endorsement Form Attachment H
Berkeley Business License
For informational purposes only: Sample of Personal Services Contract can be found on the City’s website
on the current bid and proposal page at the top of the page.
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NON-DISCRIMINATION/WORKFORCE COMPOSITION FORM FOR NON-CONSTRUCTION CONTRACTS
To assist the City of Berkeley in implementing its Non-Discrimination policy, it is requested that you furnish information
regarding your personnel as requested below and return it to the City Department handling your contract:
Organization: _____________________________________________________________________________________
Address: _______________________________________________________________
Business Lic. #: ___________
Occupational Category:
__________________________
(See reverse side for explanation of
terms)
Total
Employees
White
Employees
Black
Employees
Asian
Employees
Hispanic
Employees
Other
Employees
Female Male Female Male Female Male Female Male Female Male Female Male
Official/Administrators
Professionals
Technicians
Protective Service Workers
Para-Professionals
Office/Clerical
Skilled Craft Workers
Service/Maintenance
Other (specify)
Totals:
Is your business MBE/WBE/DBE certified? Yes _____ No _____ If yes, by what agency? _______________________
If yes, please specify: Male: _____ Female: _____ Indicate ethnic identifications: ___________________________
Do you have a Non-Discrimination policy? Yes: _____ No: _____
Signed: ________________________________________________________________ Date: __________________
Verified by: _____________________________________________________________ Date: __________________
City of Berkeley Contract Compliance Officer
Attachment B
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Occupational Categories
Officials and Administrators - Occupations in which employees set broad policies, exercise overall responsibility
for execution of these policies, or provide specialized consultation on a regional, district or area basis. Includes:
department heads, bureau chiefs, division chiefs, directors, deputy superintendents, unit supervisors and kindred
workers.
Professionals - Occupations that require specialized and theoretical knowledge that is usually acquired through
college training or through work experience and other training that provides comparable knowledge. Includes:
personnel and labor relations workers, social workers, doctors, psychologists, registered nurses, economists,
dietitians, lawyers, systems analysts, accountants, engineers, employment and vocational rehabilitation counselors,
teachers or instructors, and kindred workers.
Technicians - Occupations that require a combination of basic scientific or technical knowledge and manual skill
that can be obtained through specialized post-secondary school education or through equivalent on-the-job training.
Includes: computer programmers and operators, technical illustrators, highway technicians, technicians (medical,
dental, electronic, physical sciences) and kindred workers.
Protective Service Workers - Occupations in which workers are entrusted with public safety, security and
protection from destructive forces. Includes: police officers, fire fighters, guards, sheriffs, bailiffs, correctional
officers, detectives, marshals, harbor patrol officers, and kindred workers.
Para-Professionals - Occupations in which workers perform some of the duties of a professional or technician in a
supportive role, which usually requires less formal training and/or experience normally required for professional or
technical status. Such positions may fall within an identified pattern of a staff development and promotion under a
"New Transporters" concept. Includes: library assistants, research assistants, medical aides, child support workers,
police auxiliary, welfare service aides, recreation assistants, homemaker aides, home health aides, and kindred
workers.
Office and Clerical - Occupations in which workers are responsible for internal and external communication,
recording and retrieval of data and/or information and other paperwork required in an office. Includes:
bookkeepers, messengers, office machine operators, clerk-typists, stenographers, court transcribers, hearings
reporters, statistical clerks, dispatchers, license distributors, payroll clerks, and kindred workers.
Skilled Craft Workers - Occupations in which workers perform jobs which require special manual skill and a
thorough and comprehensive knowledge of the processes involved in the work which is acquired through on-the-
job training and experience or through apprenticeship or other formal training programs. Includes: mechanics and
repairpersons, electricians, heavy equipment operators, stationary engineers, skilled machining occupations,
carpenters, compositors and typesetters, and kindred workers.
Service/Maintenance - Occupations in which workers perform duties which result in or contribute to the comfort,
convenience, hygiene or safety of the general public or which contribute to the upkeep and care of buildings,
facilities or grounds of public property. Workers in this group may operate machinery. Includes: chauffeurs,
laundry and dry cleaning operatives, truck drivers, bus drivers, garage laborers, custodial personnel, gardeners and
groundskeepers, refuse collectors, and construction laborers.
City of Berkeley Specification No. 16-10974-C Page 20 of 27
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CITY OF BERKELEY
Nuclear Free Zone Disclosure Form
I (we) certify that:
1. I am (we are) fully cognizant of any and all contracts held, products made or otherwise handled by
this business entity, and of any such that are anticipated to be entered into, produced or handled for
the duration of its contract(s) with the City of Berkeley. (To this end, more than one individual may
sign this disclosure form, if a description of which type of contracts each individual is cognizant is
attached.)
2. I (we) understand that Section 12.90.070 of the Nuclear Free Berkeley Act (Berkeley Municipal
Code Ch. 12.90; Ordinance No. 5784-N.S.) prohibits the City of Berkeley from contracting with any
person or business that knowingly engages in work for nuclear weapons.
3. I (we) understand the meaning of the following terms as set forth in Berkeley Municipal Code Section
12.90.130:
"Work for nuclear weapons" is any work the purpose of which is the development, testing,
production, maintenance or storage of nuclear weapons or the components of nuclear weapons; or
any secret or classified research or evaluation of nuclear weapons; or any operation, management or
administration of such work.
"Nuclear weapon" is any device, the intended explosion of which results from the energy released
by reactions involving atomic nuclei, either fission or fusion or both. This definition of nuclear
weapons includes the means of transporting, guiding, propelling or triggering the weapon if and only
if such means is destroyed or rendered useless in the normal propelling, triggering, or detonation of
the weapon.
"Component of a nuclear weapon" is any device, radioactive or non-radioactive, the primary intended
function of which is to contribute to the operation of a nuclear weapon (or be a part of a nuclear
weapon).
4. Neither this business entity nor its parent nor any of its subsidiaries engages in work for nuclear
weapons or anticipates entering into such work for the duration of its contract(s) with the City of
Berkeley.
Based on the foregoing, the undersigned declares under penalty of perjury under the laws of the State of California
that the foregoing is true and correct.
Printed Name: ___________________________________Title:______________________________________
Signature: _______________________________________Date:_____________________________________
Business Entity: ___________________________________________________________________________
Contract Description/Specification No.: Targeted Case Management System/16-10974-C
Attachment C
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CITY OF BERKELEY
Oppressive States Compliance Statement
The undersigned, an authorized agent of__________________________________________________(hereafter "Vendor"),
has had an opportunity to review the requirements of Berkeley City Council Resolution No. 59,853-N.S. (hereafter
"Resolution"). Vendor understands and agrees that the City may choose with whom it will maintain business relations and may
refrain from contracting with those Business Entities which maintain business relationships with morally repugnant regimes.
Vendor understands the meaning of the following terms used in the Resolution:
"Business Entity" means "any individual, firm, partnership, corporation, association or any other commercial
organization, including parent-entities and wholly-owned subsidiaries" (to the extent that their operations are
related to the purpose of the contract with the City).
"Oppressive State" means: Tibet Autonomous Region and the Provinces of Ado, Kham and U-Tsang
“Personal Services” means “the performance of any work or labor and shall also include acting as an independent contractor or
providing any consulting advice or assistance, or otherwise acting as an agent pursuant to a contractual relationship.”
Contractor understands that it is not eligible to receive or retain a City contract if at the time the contract is executed, or at any
time during the term of the contract it provides Personal Services to:
a. The governing regime in any Oppressive State.
b. Any business or corporation organized under the authority of the governing regime of any Oppressive State.
c. Any person for the express purpose of assisting in business operations or trading with any public or private entity
located in any Oppressive State.
Vendor further understands and agrees that Vendor's failure to comply with the Resolution shall constitute a default of the
contract and the City Manager may terminate the contract and bar Vendor from bidding on future contracts with the City for
five (5) years from the effective date of the contract termination.
The undersigned is familiar with, or has made a reasonable effort to become familiar with, Vendor's business structure and the
geographic extent of its operations. By executing the Statement, Vendor certifies that it complies with the requirements of the
Resolution and that if any time during the term of the contract it ceases to comply, Vendor will promptly notify the City
Manager in writing.
Based on the foregoing, the undersigned declares under penalty of perjury under the laws of the State of California that the
foregoing is true and correct.
Printed Name: ___________________________________Title:________________________________________
Signature: _______________________________________ Date:_______________________________________
Business Entity: ______________________________________________________________________________
Contract Description/Specification No.: Targeted Case Management System/16-10974-C
I am unable to execute this Statement; however, Vendor is exempt under Section VII of the Resolution. I have attached a
separate statement explaining the reason(s) Vendor cannot comply and the basis for any requested exemption.
Signature: _______________________________________ Date:_______________________________________
Attachment D
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CITY OF BERKELEY
Living Wage Certification for Providers of Services
TO BE COMPLETED BY ALL PERSONS OR ENTITIES ENGAGING IN A CONTRACT FOR PERSONAL
SERVICES WITH THE CITY OF BERKELEY.
The Berkeley Municipal Code Chapter 13.27, Berkeley's Living Wage Ordinance (LWO), provides that contractors who
engage in a specified amount of business with the City (except where specifically exempted) under contracts which furnish
services to or for the City in any twelve (12) month period of time shall comply with all provisions of this Ordinance. The
LWO requires a City contractor to provide City mandated minimum compensation to all eligible employees, as defined in the
Ordinance. In order to determine whether this contract is subject to the terms of the LWO, please respond to the questions
below. Please note that the LWO applies to those contracts where the contractor has achieved a cumulative dollar contracting
amount with the City. Therefore, even if the LWO is inapplicable to this contract, subsequent contracts may be subject to
compliance with the LWO. Furthermore, the contract may become subject to the LWO if the status of the Contractor's
employees change (i.e. additional employees are hired) so that Contractor falls within the scope of the Ordinance.
Section I.
1. IF YOU ARE A FOR-PROFIT BUSINESS, PLEASE ANSWER THE FOLLOWING QUESTIONS
a. During the previous twelve (12) months, have you entered into contracts, including the present contract, bid, or proposal,
with the City of Berkeley for a cumulative amount of $25,000.00 or more?
YES ____ NO ____
If no, this contract is NOT subject to the requirements of the LWO, and you may continue to Section II. If yes, please
continue to question 1(b).
b. Do you have six (6) or more employees, including part-time and stipend workers?
YES ____ NO ____
If you have answered, “YES” to questions 1(a) and 1(b) this contract IS subject to the LWO. If you responded "NO" to
1(b) this contract IS NOT subject to the LWO. Please continue to Section II.
2. IF YOU ARE A NON-PROFIT BUSINESS, AS DEFINED BY SECTION 501(C) OF THE INTERNAL
REVENUE CODE OF 1954, PLEASE ANSWER THE FOLLOWING QUESTIONS.
a. During the previous twelve (12) months, have you entered into contracts, including the present contract, bid or
proposal, with the City of Berkeley for a cumulative amount of $100,000.00 or more?
YES ____ NO ____
If no, this Contract is NOT subject to the requirements of the LWO, and you may continue to Section II. If yes, please
continue to question 2(b).
b. Do you have six (6) or more employees, including part-time and stipend workers?
YES ____ NO ____
If you have answered, “YES” to questions 2(a) and 2(b) this contract IS subject to the LWO. If you responded "NO" to
2(b) this contract IS NOT subject to the LWO. Please continue to Section II.
Section II
Please read, complete, and sign the following:
THIS CONTRACT IS SUBJECT TO THE LIVING WAGE ORDINANCE.
THIS CONTRACT IS NOT SUBJECT TO THE LIVING WAGE ORDINANCE.
Attachment E
City of Berkeley Specification No. 16-10974-C Page 23 of 27
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The undersigned, on behalf of himself or herself individually and on behalf of his or her business or organization, hereby
certifies that he or she is fully aware of Berkeley's Living Wage Ordinance, and the applicability of the Living Wage
Ordinance, and the applicability of the subject contract, as determined herein. The undersigned further agrees to be bound by
all of the terms of the Living Wage Ordinance, as mandated in the Berkeley Municipal Code, Chapter 13.27. If, at any time
during the term of the contract, the answers to the questions posed herein change so that Contractor would be subject to the
LWO, Contractor will promptly notify the City Manager in writing. Contractor further understands and agrees that the failure
to comply with the LWO, this certification, or the terms of the Contract as it applies to the LWO, shall constitute a default of
the Contract and the City Manager may terminate the contract and bar Contractor from future contracts with the City for five
(5) years from the effective date of the Contract termination. If the contractor is a for-profit business and the LWO is
applicable to this contract, the contractor must pay a living wage to all employees who spend 25% or more or their
compensated time engaged in work directly related to the contract with the City. If the contractor is a non-profit business and
the LWO is applicable to this contract, the contractor must pay a living wage to all employees who spend 50% or more or their
compensated time engaged in work directly related to the contract with the City.
These statements are made under penalty of perjury under the laws of the state of California.
Printed Name: ___________________________________Title:________________________________________
Signature: _______________________________________ Date:_______________________________________
Business Entity: ______________________________________________________________________________
Contract Description/Specification No: Targeted Case Management System /16-10974-C
Section III
_____________________________________________________________________________________________
* * FOR ADMINISTRATIVE USE ONLY -- PLEASE PRINT CLEARLY * * *
I have reviewed this Living Wage Certification form, in addition to verifying Contractor's total dollar amount contract
commitments with the City in the past twelve (12) months, and determined that this Contract IS / IS NOT (circle one)
subject to Berkeley's Living Wage Ordinance.
_________________________________ _________________________________________
Department Name Department Representative
Attachment E Page 2
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Form EBO-1 CITY OF BERKELEY
CERTIFICATION OF COMPLIANCE WITH EQUAL BENEFITS ORDINANCE If you are a contractor, return this form to the originating department/project manager. If you are a vendor (supplier of goods), return this form to the Purchasing Division of the Finance Dept.
SECTION 1. CONTRACTOR/VENDOR INFORMATION
Name: Vendor No.:
Address: City: State: ZIP:
Contact Person: Telephone:
E-mail Address: Fax No.:
SECTION 2. COMPLIANCE QUESTIONS
A. The EBO is inapplicable to this contract because the contractor/vendor has no employees. Yes No (If “Yes,” proceed to Section 5; if “No”, continue to the next question.)
B. Does your company provide (or make available at the employees’ expense) any employee benefits? Yes No
If “Yes,” continue to Question C. If “No,” proceed to Section 5. (The EBO is not applicable to you.)
C. Does your company provide (or make available at the employees’ expense) any benefits to
the spouse of an employee? ......................................................................................... Yes No D. Does your company provide (or make available at the employees’ expense) any benefits to
the domestic partner of an employee? .......................................................................... Yes No If you answered “No” to both Questions C and D, proceed to Section 5. (The EBO is not applicable to this contract.) If you answered “Yes” to both Questions C and D, please continue to Question E. If you answered “Yes” to Question C and “No” to Question D, please continue to Section 3.
E. Are the benefits that are available to the spouse of an employee identical to the benefits that
are available to the domestic partner of the employee? ............................................... Yes No If you answered “Yes,” proceed to Section 4. (You are in compliance with the EBO.) If you answered “No,” continue to Section 3.
SECTION 3. PROVISIONAL COMPLIANCE A. Contractor/vendor is not in compliance with the EBO now but will comply by the following date:
By the first effective date after the first open enrollment process following the contract start date, not to
exceed two years, if the Contractor submits evidence of taking reasonable measures to comply with the EBO; or
At such time that administrative steps can be taken to incorporate nondiscrimination in benefits in the
Contractor’s infrastructure, not to exceed three months; or
Upon expiration of the contractor’s current collective bargaining agreement(s).
To be completed by
Contractor/Vendor
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B. If you have taken all reasonable measures to comply with the EBO but are unable to do so, do you agree to provide employees with a cash equivalent?* ..................................... Yes No
* The cash equivalent is the amount of money your company pays for spousal benefits that are unavailable for domestic partners.
SECTION 4. REQUIRED DOCUMENTATION
At time of issuance of purchase order or contract award, you may be required by the City to provide documentation (copy of employee handbook, eligibility statement from your plans, insurance provider statements, etc.) to verify that you do not discriminate in the provision of benefits.
SECTION 5. CERTIFICATION
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that I am authorized to bind this entity contractually. By signing this certification, I further agree to comply with all additional obligations of the Equal Benefits Ordinance that are set forth in the Berkeley Municipal Code and in the terms of the contract or purchase order with the City. Executed this _______day of _________________, in the year __________, at __________________, ________ (City) (State) _____________________________________ ______________________________________ Name (please print) Signature _____________________________________ ______________________________________ Title Federal ID or Social Security Number
FOR CITY OF BERKELEY USE ONLY
Non-Compliant (The City may not do business with this contractor/vendor)
One-Person Contractor/Vendor Full Compliance Reasonable Measures
Provisional Compliance Category, Full Compliance by Date: _________________________________________
Staff Name(Sign and Print): _____________________________________Date: ____________ ________________
_____________________
Attachment F
City of Berkeley Specification No. 16-10974-C Page 26 of 27
Targeted Case Management System Release Date 10/27/15
Revised December 2014
CITY OF BERKELEY
Right to Audit Form
The contractor agrees that pursuant to Section 61 of the Berkeley City Charter, the City Auditor’s office
may conduct an audit of Contractor’s financial, performance and compliance records maintained in
connection with the operations and services performed under this contract.
In the event of such audit, Contractor agrees to provide the Auditor with reasonable access to Contractor’s
employees and make all such financial, performance and compliance records available to the Auditor’s
office. City agrees to provide Contractor an opportunity to discuss and respond to/any findings before a
final audit report is filed.
Signed:______________________________________ Date:__________________
Print Name & Title:_______________________________________________________
Company:_______________________________________________________________
Contract Description/Specification No.: Targeted Case Management System/16-10974-C
Please direct questions regarding this form to the Auditor's Office, at (510) 981-6750.
Attachment G
City of Berkeley Specification No. 16-10974-C Page 27 of 27
Targeted Case Management System Release Date 10/27/15
Revised December 2014
CITY OF BERKELEY
Commercial General and Automobile Liability Endorsement
The attached Certificates of Insurance are hereby certified to be a part of the following policies having the
following expiration dates:
Policy No. Company Providing Policy Expir. Date _______________ __________________________ _________
_______________ __________________________ _________
_______________ __________________________ _________
_______________ __________________________ _________
The scope of the insurance afforded by the policies designated in the attached certificates is not less than that
which is afforded by the Insurance Service Organization's or other "Standard Provisions" forms in use by the
insurance company in the territory in which coverage is afforded.
Such Policies provide for or are hereby amended to provide for the following:
1. The named insured is ________________________________________.
2. CITY OF BERKELEY ("City") is hereby included as an additional insured with respect to liability
arising out of the hazards or operations under or in connection with the following agreement:
_______________________________________________________.
The insurance provided applies as though separate policies are in effect for both the named insured
and City, but does not increase the limits of liability set forth in said policies.
3. The limits of liability under the policies are not less than those shown on the certificate to which this
endorsement is attached.
4. Cancellation or material reduction of this coverage will not be effective until thirty (30) days following
written notice to __________________________________, Department of
___________________________, Berkeley, CA.
5. This insurance is primary and insurer is not entitled to any contribution from insurance in effect for
City.
The term "City" includes successors and assigns of City and the officers, employees, agents and
volunteers.
_______________________________________
Insurance Company
Date: _____________ By: ______________________________________
Signature of Underwriter's
Authorized Representative
Contract Description/Specification No.: Targeted Case Management System/16-10974-C
Attachment H