Contract Instructions and Forms

Home > Provider Resources > Contract Instructions and Forms

Below are instructions for completing specific sections of the contract, and the forms associated with each section. You can either download just the forms and instructions as needed listed at the end of each section below.

Specific Contract Sections

Contract Preparation Checklist
Contract Narrative
Resource Allocation by BRP Form
Logic Model
Budget
Materials Review
Certificate of Insurance
Program Client Demographic
Human Rights Commission Forms
Business Registration Certificate
Board Members and Community Advisory Board Members
Federal Employer Tax ID
Agency DUNS Number
Other Important Information to Ensure Contract Compliance

1. Contract Preparation Checklist

This is a word document that must be submitted with your contract and contains a list of all the documents/material you must summit for contract approval.

Contract Preparation Checklist

2. Contract Narrative

These two documents that will assist you in the development of your Program Narrative. The Contract Narrative Instructions is a Word document that was developed in the format necessary for your narrative. The other Word document is the HPS Additional Narrative Instructions. This provides you with additional information required for HIV prevention providers. Please note that the narrative text in boxes can be cut and pasted into the contract narrative.

3. Resource Allocation by BRP Form

This worksheet is a tool to help you ensure that you are allocating your resources by BRP in accordance with your award. You will not need to use this worksheet if you provide services to only one BRP.

4. Logic Model

The Logic Model is discontinued effective January 1, 2009

5. Budget

Overview of Major Changes to Appendix Documents

This overview is meant for those agencies which are familiar and adept at working with the previous Appendix B workbook utilized for the Non-CBHS sections listed above.

More detailed descriptions for each of the three different types of budget page (or worksheets) in the Appendix B workbook, follow this section.

There is only one new form in the Appendix B workbook for Non-CBHS

funded programs. This form replaces the previous “Budget Summary by Program” (DPH #1). The “Summary of Client Services by Program” (DPH #1A) has been eliminated to reduce duplication of information. Non-CBHS Providers will continue to use the “UOS Cost Allocation by Service Mode” document and the “Budget Justification” to describe the details of their programs in exactly the same manner as previously submitted.

The only change to the “UOS Cost Allocation by Service Mode” is the addition of the “UDC per Service Mode” at the bottom of each Service Mode on the page (Row 45).

There were no changes made to the Budget Justification page.

Each column in the “Budget Summary by Program” page represents a summary of the information in the “Contracts Total” column, from each “UOS Cost Allocation by Service Mode” page in your budget workbook.

In the “Budget Summary by Program” page(s)

Break out the summary of program expenses in the “Expenses” section
at the top of this page.
Identify relevant funding sources for each Non-CBHS Section that are applicable (beginning on row 23). (Note: rows can be hidden and unhidden to reveal Funding Sources by Section, and to allow the document to print onto one page.)
List Other/ Non-DPH Revenues at the bottom of the page in the area indicated. (Note: the amount for “Total Expenses” (Row 19) must equal the amount in “Total Revenues (DPH and Non-DPH)” (Row 91).
Allocate the program costs covered by “Other/ Non-DPH Revenues” into
the “Expenses” section in the top of this page.

6. Materials Review

The Centers for Disease Control and Prevention (CDC) requires that all HIV prevention programs and agencies utilizing CDC funds to develop educational or promotional purposes must submit these materials through their local Materials Review Process. These materials include content of AIDS-related materials, pictorials, audio/visual presentations, questionnaires, survey instruments, educational sessions, and website content.

7. Certificate of Insurance

Without in any way limiting contractor’s liability pursuant to the Indemnification and General Liability, section of this agreement, contractors must maintain in force, during the full term of the agreement, insurance in the amounts and coverages listed on the following files.

SFDPH Insurance Requirements
General liability and worker’s compensation certificate (example)
Endorsements (example)

8. Program Client Demographic

Describe entire client demographic information such as age group, gender, ethnicity for the entire program, whether funded in whole or in part by SFDPH.

Program Client Demographic Form

9. Human Rights Commission Forms

Employment affirmative action requirements and non-discrimination provisions. To be completed by the prime provider and returned with the proposal. If this form is not returned with the proposal, the proposal may be determined non-responsive and rejected.

Indicate key personnel designated to work on this project for the entire project team (prime consultant, joint venture partners, subconsultants).

The employees listed should include all those listed in descriptions of key personnel in other sections of the proposal, if this form is submitted in response to an RFP.

10. Business Registration Certificate

Nonprofit organizations are exempt from the registration fee. However, tax-exempt

organizations are required to provide proof of their nonprofit status in

order to receive and Exemption from Business Tax Registration.

They must provide a copy of the statement from the Internal Revenue Service

verifying exempt status under Section 501(c), 501(d), or 401(a) of Title

26 of the United States Code as qualified by Sections 502, 503, 504, and

508. Organizations under these sections are liable for the tax on payroll

expense attributable to unrelated business taxable income. You can get a

copy of your Registration ticket by mail or by walking a copy of you nonprofit

status to the office at City Hall.

Office of the Treasurer & Tax Collector

City Hall

1 Dr. Carlton B. Goodlett Place, Room 140

San Francisco, CA 94102-4638

For questions, please contact Taxpayer Assistance at (415) 554-4400,

Monday through Friday, 8:00 AM to 5:00 PM PST, or by email at [email protected].

11. Board Members and Community Advisory Board Members

Attach a current board roster with the following regarding each of its members:

Name
Title
Affiliation
Membership term

Contractors must attempt to include “members of the community” on its board.

12. Federal Employer Tax ID

Your Federal Employer Tax ID is a nine digit number provided by the Internal Revenue Service which establishes that your organization is 501(c)3 organization.

13. Agency DUNS Number

The Federal government require that all applicants for Federal grants and cooperative agreements with the exception of individuals other than sole proprietors have a DUNS number. The Federal government will use the DUNS number to better identify related organizations that are receiving funding under grants and cooperative agreements, and to provide consistent name and address data for electronic grant application.