CSP018731_AGE004_-_REV_Contract__SA5_.pdf

Index No.: AGE004

Eff. Date: 07/01/25

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) EXPANSION

(SA5)

CONTRACT NUMBER: CSP018731 EFFECTIVE DATES: 12/15/23 TO 06/30/25

* Renewal through 06/30/26

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

SRC7632 that opened on 07/16/23. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the Ohio Department of Aging as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

https://procure.ohio.gov/

*Indicates a renewal through 06/30/26, per amendment 4.

Eff. Date.: 02/07/25

MUTUALLY AGREED UPON CLARIFICATIONS / MODIFICATIONS TO THE RFP

AGE004 - Service Area 5 Clarifications - Acutecare Service Area 5 Response to Request for Clarifications

EFFECTIVE 03/15/24:

Attachment 2-Section 20 REVISED-Service Area 5

EFFECTIVE 12/13/2024:

The below document is incorporated into the contract:

Jeremy_Dias_Acutecare_Resume

The following key personnel modification is incorporated into the contract:

James Sawyer is replaced by Jeremy Dias.

The Financial Related Questionnaire is updated by making the following change:

The Contractor will no longer use some of the provided funds to purchase vehicles upfront and instead utilize a leasing model.

These funds will be reallocated to be spent on Brick and Mortar Capital Costs.

*EFFECTIVE 02/07/2025:

The spend by date for funds is updated to March 31st, 2025 with all funds requested by February 15th, 2025.

*Denotes a correction to an administrative error and an update to the date funds need to be spent and requested by, per amendment 3.

Eff. Date.: 12/13/24

COST SUMMARY FORM

Program of All-Inclusive Care for the Elderly (PACE) Expansion

DESCRIPTION COST

*Brick and Mortar Capital Costs – Upfront Funds *$5,800,000.00

Brick and Mortar Capital Costs – Total Cost subject to Monthly Reimbursement $0.00

*Establishing a Transportation Network - Upfront Funds *$0.00

Establishing a Transportation Network – Total Cost subject to Monthly Reimbursement $0.00

IT Infrastructure - Upfront Funds $200,000.00

IT Infrastructure – Total Cost subject to Monthly Reimbursement $0.00

Workforce Training and Development - Upfront Funds $175,000.00

Workforce Training and Development – Total Cost subject to Monthly Reimbursement $0.00

The above costs are to be paid in accordance with the Financial-Related Questionnaire responses provided in the provided RFP response.

All costs must be in U.S. Dollars.

The State will not be responsible for any costs not identified.

There will be no additional reimbursement for travel or other related expenses.

Amounts paid to the Contractor are paid as reimbursement for costs defined above. No profit or mark-ups are permitted.

All funds related to this project must be spent by the Offeror before submitting its CMS application and/or no later than December 31, 2024.

*Denotes an update to the pricelist by reallocating the Establishing a Transportation Network deliverable funding to the Brick and Mortar Capital Costs deliverable, effective on all orders placed on or after 12/13/2024, per amendment 2.

Eff. Date: 12/15/23 Page No. 4

CONTRACTOR INDEX

CONTRACTOR AND TERMS:

0000315353 Acutecare Health Systems LLC TERMS: Per Contract 1075 Stephenson Avenue, Suite B Oceanport, NJ 07757

CONTRACTOR’S CONTACT: Mr. Michael Czermak Telephone: (732) 608-1975 Email: MichaelC@BoldAgePACE.com

APPROVED SUBCONTRACTOR(S):

Beacon Care Ventures, LLC d/b/a BoldAge PACE Palmetto PACE Advisory Group file://s.dasdesktop.isi.oitfs.ohio.gov/DASShares/gsd/purchasing/CONTRACTS/OPS%20Contracts/AGE/AGE004/SRC7632%20AGE004/Contracts/Service%20Area%201/MichaelC@BoldAgePACE.com

Eff. Date.: 07/01/25

SUMMARY OF AMENDMENTS

Amendment Number

Effective Date Description

4 07/01/25

This amendment is issued to notify that as a result of mutual agreement between the State of Ohio and the Contractor, this contract is renewed for an additional twelve months, effective 07/01/25 through 06/30/26.

All other prices, terms and conditions remain unchanged.

3 02/07/25

This amendment is issued to correct an administrative error and an update the spending date for contract funds to March 31st, 2025 with all funds requested by February 15th, 2025.

All other prices, terms and conditions remain unchanged.

2 12/13/24

This amendment is issued to denote an update to the staffing plan by replacing James Sawyer with Jeremy Dias, an update to the pricelist by reallocating the Establishing a Transportation Network deliverable funding to the Brick and Mortar Capital Costs deliverable, effective on all orders placed on or after 12/13/24, and an update to the Financial Related Questionnaire.

All other prices, terms and conditions remain unchanged.

1 03/15/24

This amendment is issued to denote an update to the Financial Related Questionnaire, an update the pricelist by reallocating the "total cost subject to monthly reimbursement" to "upfront funds", effective on all orders placed on or after 03/15/2024, and to add a Summary of Amendments page.

All other prices, terms and conditions remain unchanged.