HomeMy WebLinkAboutCommunity Fluoridation Program ,ANE A. REIMAN
MAYOR
40 East Main Street - Carmel Ind ana 46032 * (3171 844-6433
C
I
¥
Mr. Alien Kraven '.
-Indiana, State Board of Health
September 11, 1984
1330 ~!est'Michigan Street ..
.P. O. Box.1964 '
-Dear M~
' Enclose'd:',.p,lease:¢,f.lnd,'agreement, szgqed by Dorothy J. ,
,~or- fluoride., .,
.
CC: .J~mes Dougherty', Utilz,ties Mana~. ,, . ' , , '-' ·
W~lliam-~. Headley, ,,Division of 'Budget and Requirements
Charles W. Gish. D'~'D.S., Division'.of,'D~ntal Health,
,, EStaD ished
"' i837
TAT DIANA
STATE BOARD OF HEALTtt
AN [!()UAL OPPORTUNITY EMPI.OYI~R
INDIANAPOLIS
AUG 2 Z DB4
Ms. Dorothy J. Hancock
Clerk-Treasurer
Camel, IN 46032
Dear bls. Hancock:
We are enclosing an agreement covering our financial assistance
for the operation of your Community Fluoridation Program for the period
from September 1, 1984, through September 30, 1984. ·
The agreemdnt should be properly signed Jn ink and retarned, to
this office as soon as possible. After proper signatures for the State
Board of Health have been obtMned, we will mail you two (2) complete
copies of the agreement.
If we can be of any further assistance, please contact this
office at AC 317/633-Ol15.
Sincerely, f'-) /
WILLIAM E. HEADLEY, DIRECTOR ~
DIVISION OF BUDGET AND REQUIREMENTS
IMDIANA STATE BOA~J) OF HEALTH
Enclosure
cc: Charles Gish, D.D.S.
AGREEMENT
Pursuant to IC 5-~9-1-1 and by the following articles an
agreement ~e established whereby the Indiana State Board of Health (the
grantor) will provide financial assistance to the City of Carmel (the
grantee) for a Community Fluoridation Program in accordance with the
approved application. ~ amount of $350 is hereby granted for this
program for the period from September 1, i984 through September 30, 1984.
It is understood that this financial assistance will be on a
cost basis. Payment of the costs of the project will be made by the
grantee. Actual cost for the ~tems listed in the attached budget will
be paid by the grantor upon receipt of duly executed vouchers from the
grantee.
All equipment purchased shall be used for fluoridation purposes
only~.
It ~s further agreed that additional expenditures made on this
project by the gran~ee over and above the attached budget w~ll not be
reimbursed by the grantor. Expenditures reimbursed from this grant may
not be used by the grantee to match federal funds.
Grantee agrees to maintain accounting records which will
segregate grant funds from others, which will substantiate costs claimed
and will faciiitate any state or federal audit. Such records are to be
retained for five years after the agreement, or until a~federal audit
has been completed, and' all audit exceptions cleared.
The. Indiana State Board of Health agrees:
To provide the necessary fluoridation and surveillance equipment
according to the plans submitted by the grantee and approved
by the Water Supply Section of the Division of Sanitary Engineering
of the Indiana State Board of Health. The only items to be
provided are itemized in the attached budget and are limited
to one or more of the items listed below, or an approved
substitute.
a. Fluoride equipment unit--complete.
Chemical feed pump.
Flqoride water meter.
Non-corrosive plastic plumbing; with corporation injection
stop and anti-syphon device.
e. Fluoride analysis kit and glassware.
f, Necessary electrical and plumbing materials,
reasonable installation cost.
including a
2. To expedize equipment repairs during normal warranty.
To provide.sample bottles and mailing cartons for submitting
wa~ter samples to the Water Laboratory, Indiana State Board of
Health, 1330 West Michigan Street, Indianapolis, Indiana 46206.
To provide a l~st of equipment manufacturers and suppliers of
chemicals, if requested.
To provide the technical assistance necessary to determine the
need and feasibility of fluoridation.
J
To provide the fluoride chemicals needed f~r the start-up of
fluoridation.
The grantee agrees:
To submit fluoridation plans to the grantor for approval prior
to the ordering and installation of equipment.
To provide the storage are~ for the fluoride componnd, which
area must be dr~ and secure.
To furnish soft make-up water to the fluoride equipment,
'preferably by the use of an exchange water ~oftening tank.
:(Applies to sodium fluoride saturator installations only.)
To provide manpower for necessary installation at no cos{
to the State, if qualified personnel are available.
To assign personnel to be responsible for the mainteeance and
routine surveillance of the fluoride system and to send their
personnel to fluoridation workshops when requested by the
grantor.
To maintain the Indiana State Board of Health Policy And
Standards For Fluoridation or.Public Water Supplies, a copy of
which is attached.
7. To assume cdst of fluoride chemicals after the start-up ~supply.
Not to discontinue or alter fluoridation process without first
contacting the Dental Health Division, Indiana State Board of
Health at 317/633-8417.
It is understood {hat this equipment must be operational and
should the community disclaim need for the equipment, the Indiana State
Board of Health can reclaim the equipment.
Financial assistance is contingent on the availability of
federal funds for ~his purpose. This agreement may be cancelled after
30 days from the day of written notice to the other party.
.PurJuAnt to IC 22-9-1-10, the Grantee and his subcontractorg,
if any, shall not discriminate against any employee or appl~can~ for
employment, to be employed ~n the performance of th~s contract', with
respect to his hire,-tenure, terms, conditions or privileges of employment
or any matter directly or indirectly related to employment, because of
h~s race, color, religion, sex, handicap, national or~gin.or ancestry.
Breach of this convenant may be regarded as a mater~al breach of contract.
Acceptance of this agreement also signifies compliance with applicable
federal laws, regulations and executive orders prohibiting d~scr~minat~on
in the provision of services based on race, color, national or~g~n, age,
Rex or handicapping conditions.
The Grante~ agrees to indemnify, defend and hold harmless the
· State bf Indiana, and its agents, officers, and employees from all claims
and suits ~ecludJng coert costs, attorneys' fees, and other expenses,
caused by any act or omission of the Grantee and/or subcontractors.
This grant w~ll be funded through the U.S. Preventive Health
Services, Part A, Title XIX, PHS Act/45 CFR 96.
Approved for Grantor by:
CHARLES W. GISH, D.D.S, DIRECTOR
DIVISION OF DENTAL HEALTH
INDiANA STATE BOAI~ OF HEALTH
Date
Certification of Funds:
Approved for Gr~D~ee by:
~TY OF CARbIEL
DOROTHY J.~NCOCK
CLERK-TREASURER
CITY OF CARMEL
Da te
Da t e
WILLiAM E. HEADLEY, DIRECTOR
DIVISION OF BUDGET & REQUIREMENTS
INDiANA STATE BOARD OF HEALTH
Da te
Approved:
Approved and Ratified:
T. S. DANIELSON, JR., M.D., M.P.H~
ACTING STATE' HEALTH COMMISSIONER
INDIANA STATE BOARDOF HEALTH
Date
ORVAL LUNDY, COb~MISSIONER
DEPARTMENT OF ADMINISTRATION
STATE OF INDIANA
Approved:
Date
JUDITH Go PALMER, DIRECTOR
STATE BUDGET AGENCY
STATE OF INDIANA
Date
Approved as to legality and form this
day of , 198
LINLEY E. PEARSON
ATTORNEY GENERAL OF INDIANA
AGREEMENT BETWEEN THE INDIANA STATE BOARD OF HEA~TH AND THE
CITY OF CARMEL
FOR THE PERIOD SEPTEMBER 1, 1984, THROUGH SEPTEMBER 30, 1984
BUDGET
Equ{pment:
One sodium fluoride saturator
and appurtenances
$35O