The URL can be used to link to this page

Browse Search

Home My WebLink About20132405.tiffRESOLUTION RE: APPROVE TASK ORDER CONTRACT FOR TOBACCO RETAILER INSPECTIONS AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Task Order Contract for Tobacco Retailer Inspections between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, commencing September 30, 2013, and ending September 29, 2014, with further terms and conditions being as stated in said task order contract, and WHEREAS, after review, the Board deems it advisable to approve said task order contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Task Order Contract for Tobacco Retailer Inspections between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the on behalf of the Department of Public Health and Environment, and the Colorado Department of Public Health and Environment, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said task order contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 26th day of August, A.D., 2013. BOARD OF COUNTY COMMISSIONERS WELD O COLORADO ATTEST: Weld County Clerk to the Board BY APP eputy • I; rk to the Boar .. AS o� torney William Ga c Dougl0s adema a, Chair Date of signatureSEP 1 2 2013 P. Conway USED Freeman her, Pro-Tem 71&{iaxt- %J rbara Kirkmeye 2013-2405 HL0040 TO: Memorandum William F. Garcia, Chair Board of County Commissioners FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment DATE: August 20, 2013 SUBJECT: Tobacco -FDA Contract Enclosed for Board review and approval is a contract between Colorado Department of Public Health and Environment (CDPHE) and the Weld County Department of Public Health & Environment to conduct Food and Drug Administration (FDA) regulated tobacco retailer inspections. These unannounced inspections are conducted across a 10 -county region, including Weld, for illegal tobacco sales to minors. Additionally, inspections are conducted for illegal tobacco product advertising and product placement. Currently two (2) part-time Health Department staff (equaling 1.0 FTE) conducts the inspections in partnership with a few undercover, specially trained minors. As a result of these inspections the FDA manages any enforcement actions toward a retailer who sells tobacco illegally to a minor. The contract period is September 30, 2013, to September 29, 2014, and the grant award is $100,432. The contract will result in continued unannounced tobacco retailer inspections, making it harder for youth to obtain tobacco products illegally, while also ensuring retailers do not make illegal tobacco sales to minors. The net result is lower smoking rates for youth. I recommend approval of the Tobacco FDA contract. 2013-2405 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ROUTING NO. 14 FLA 58226 APPROVED TASK ORDER CONTRACT — WAIVER #154 This Task Order Contract is issued pursuant to Master Contract made on 01/17/2012, with routing number 13 FAA 00051 STATE: State of Colorado for the use & benefit of the Department of Public Health and Environment Prevention Services Division Tobacco — FDA 4300 Cherry Creek Drive South Denver, Colorado 80246 TASK ORDER MADE DATE: 07/17/2013 PO/SC ENCUMBRANCE NUMBER: PO FLA PSD1458226 TERM: This Task Order shall be effective upon approval by the State Controller, or designee, or on 09/30/2013, whichever is later. The Task Order shall end on 09/29/2014. PRICES'I'RCCTERE, Cost Reimbursement PROCUREMENT METHOD: Exempt BID/REP/LIST PRICE AGREEMENT NUMBER: Not Applicable LAWSPECIFIED VENDOR STATUTE: Not Applicable STATE REPRESENTAtIVE: Jennifer Trainer Department of Public Health and Environment Prevention Services Division Tobacco — FDA — A5 4300 Cherry Creek Drive South Denver, CO 80246 CONTRACTOR: Board of County Commissioners of Weld County (a political subdivision of the state of Colorado) 915 10th Street Greeley, Colorado 80632-0758 for the use and benefit of the Weld County Department of Public Health and Environment 1555 17°x' Avenue Greeley, Colorado 80631 CONTRACTOR ENTI'I Y TYPE: Colorado Political Subdivision BILLING STATEMENTS RECEIVED: Monthly STATUTORY AUTI IORIT'Y: Not Applicable CONTRACT PRICE NOT TO EXCEED: $100,432.00 FEDERAL FUNDING DOLLARS: STATE FENDING DOLLARS: $100,432.00 $0 MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR: FY 14: $75,324.00 FY 15: $25,108.00 CONTRACTOR REPRESENTATIVE: Mark Wallace, MD Weld County Department of Public Health and Environment 1555 17"' Avenue Greeley, Colorado 80631 SCOPE OF WORK: Enforce provisions of the Family Smoking Prevention and Tobacco Control Act by conducting retail inspections in identified region(s). Page I of 6 Rev 6/25/09 EXHIBITS: The following exhibits are hereby incorporated: Exhibit A - Additional Provisions (and its attachments if any — e.g., A-1, A-2, etc.) Exhibit B - Statement of Work (and its attachments if any — e.g., B -I, B-2, etc.) Exhibit C - Budget (and its attachments if any — e.g., C-1, C-2, etc.) Rxhibit D - Option Letter (and its attachments if any — e.g., D-1, D-2, etc.) GENERAL PROVISIONS The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task Order Contract provide more specificity than these general clauses, the more specific provision shall control. 1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall be performed according to the standards, terms and conditions set forth in the Master Contract. 2. In accordance with section 2430-202(1), C.R.S., as amended, this Task Order Contract is not valid until it has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not authorized to, and shall not; commence performance under this Task Order Contract until this Task Order Contract has been approved by the State Controller or delegee. The State shall have no financial obligation to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order Contract on or before its proposed effective date, then the Contractor shall commence performance under this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order Contract after its proposed effective date, then the Contractor shall only commence performance under this Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through and including the date specified on page one of this Task Order Contract, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract. Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of the terms and conditions of this Task Order Contract. 3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated, the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the Page 2 of 6 Rev 6/25/09 Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the Additional Provisions - Exhibit A, and its attachments if included, to this Task Order Contract; 5) the Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other exhibits/attachments to this Task Order Contract in their order of appearance. 4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and attached hereto as "Exhibit B" and "Exhibit C". 5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment must be signed by the State and the Contractor, and be approved by the State Controller or an authorized delegate thereof. This contract is subject to such modifications as may be required by changes in Federal or State law, or their implementing regulations. Any such required modification shall automatically be incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein. 6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work - Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the Contractor shall also meet those standards of performance under this Task Order Contract. 7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date is on or after July I, 2009 and the maximum amount payable to Contractor hereunder is S100,000 or higher] By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Contractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Management System at intervals established in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract term. Contractor shall be notified following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor and Page 3 of 6 Rev 6/25/09 prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24-105-102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights provided in CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Director, upon showing of good cause. 8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws, state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be amended. Without limitation, these federal laws and regulations include the Federal Funding Accountability and Transparency Act of 2006 (Public Law 109-282), as amended by §6062 of Public Law 110-252, including without limitation all data reporting requirements required there under. This Act is also referred to as FFATA. Page 4 of 6 Rev 6/25/09 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT * Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY (a political subdivision of the state of Colorado) for the use and benefit of the Weld County Department of Public Health and Environment. Legal Name of Contracting Entity Signature of Authorized Of&cer William F. Garcia AUG 2 6 2013 Print Name of Authorized Officer Chair Print Title of Authorized Officer STATE OF COLORADO: John W. Hickenlooper, GOVERNOR For Executive Director Department of Public Health and Environment Dept Program Approval: ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER: Robert Jaros, CPA, MBA, JD Date Page 5 of 6 Rev 6/25/09 are 4,90.5 This page left intentionally blank. Page 6 of 6 Rev 6/25/09 EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 07/17/2013 - Contract Routing Number 14 FLA 58226 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. I. The list of acronyms attached hereto as Attachment A-1 may be referenced to in Exhibit A, Exhibit B, and all and any attachments thereof in this Task Order Contract. 2. This Task Order Contract contains federal funds. 3. The United States Department of Health and Human Services ("USHHS"), through the Food and Drug Administration ("FDA") has awarded federal funds under Contract number HHSF22320111009C, to perform the following — Inspection of Tobacco Retailers. 4. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 27, Annual Audit, for the purpose of this Task Order, the Contractor is a Vendor as defined by Office of Management and Budget (OMB) Circular A-133 (Audits of States, Local Governments, and Non -Profit Organizations). 5. To receive compensation under this Task Order Contract, the Contractor shall submit a signed monthly CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE Internet website http://www.colorado.gov/cs/Satellite/CDPHE-Main/CBON/125 1622941228 and is incorporated herein by reference. CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted within forty-five (45) calendar days of the end of the billing period for which services were rendered. Expenditures shall be in accordance with Federal Clauses of Contract HHSF22320111009C, attached hereto as Attachment A-2, Statement of Work attached hereto as Exhibit B and incorporated herein and the associated Budget attached hereto as Exhibit C and incorporated herein. All other expenditures shall not be reimbursed without prior written consent of the State. All expenditures must be reasonable and necessary for the performance of this Contract, and must comply with The State of Colorado, specifically the Colorado Department of Public Health and Environment, fiscal guidelines and rules. Submit completed CDPHE Reimbursement Invoice Form to: Colorado Department of Public Health and Environment FDA Enforcement Coordinator ND- STEPP — FDA — A5 4300 Cherry Creek Drive South Denver, CO 80246 To be considered for payment, billings for payments pursuant to this Task Order Contract must be received within a reasonable time after the period for which payment is requested, but in no event no later than forty-five (45) calendar days after the relevant performance period has passed. Final billings under this Task Order Contract must be received by the State within a reasonable time after the expiration or termination of this Task Order Contract; but in no event no later than forty-five (45) calendar days from the effective expiration or termination date of this Task Order Contract. Unless otherwise provided for in this Task Order Contract, "Local Match", if any, shall be included on all invoices as required by funding source. The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. To be attached to CDPHE Task Order v1.0 (3/12) contract template Page 1 of 3 Revised: 12/19/06 EXHIBIT A 6. Time Limit For Acceptance Of Deliverables. a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables that have a different time negotiated by the State and the Contractor. b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design specifications for that particular deliverable, or is otherwise deficient, then the State shall notify the Contractor of the failure or deficiencies, in writing, within thirty (30) calendar days of: 1) the date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or deficiency. The above time frame shall apply to all deliverables except for those deliverables that have a different time negotiated by the State and the Contractor in writing pursuant to the State's fiscal rules. c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed deliverable, the Contractor shall have a reasonable period of time, not to exceed ten (10) calendar days, to correct the noted deficiencies. If the Contractor fails to correct such deficiencies within ten (10) calendar days, the Contractor shall be in default of its obligations under this Task Order Contract and the State, at its option, may elect to terminate this Task Order Contract or the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract. 7. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination. The State has determined that this Task Order Contract does not constitute a Business Associate relationship under HIPAA. 8. Contractor shall request prior approval in writing from the State for all modifications to the Statement of Work/Work Plan or for any modification to the direct costs in excess of twenty-five percent (25%) of the total budget for direct costs. Any request for modifications to the Budget in excess of twenty-five percent (25%) of the total budget for direct costs or $250,000.00, whichever is less, shall be submitted to the State at least 90 days prior to the end of the contract period and may require an amendment in accordance with Section 5 of this Task Order Contract. 9. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in Data, Documents and Computer Software or Other Intellectual Property, or Section 23.i, General Provisions, Media or Public Announcements, the State of Colorado, specifically the Department of Public Health and Environment, shall be the owner of all printed materials, graphic representations, educational materials, audio-visual products, or any other media, in whatever form, created under this Task Order Contract. This requirement applies, but is not limited to, any brochure, flyer, presentation, billboard, radio spot, website, banner advertisement. The State reserves the right to require logos, or other wording on any material, representation, product or other media form created under this Task Order Contract. Any material, representation, product or other media form that will use the State's or logo or information must be approved by the State prior to production and distribution. A minimum of ten (10) business days is required for the review and approval process. 10. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in Data, Documents and Computer Software or Other Intellectual Properly, or Section 23.i, General Provisions, Media or Public Announcements, the State of Colorado, specifically the Department of Public Health and Environment, shall be the owner of all printed materials, graphic representations, educational materials, audio-visual products, or any other media, in whatever form, created under this Task Order Contract. This requirement applies, but is not limited to, any brochure, flyer, presentation, billboard, radio spot, website, banner advertisement. The State reserves the right to require logos, or other wording on any material, representation, product or other media form created under this Task Order Contract. To be attached to CDPHE Task Order v1.0 (3/12) contract template Page 2 of 3 Revised: 12/19/06 EXHIBIT A Any material, representation, product or other media form that will use the State's or logo or information must be approved by the State prior to production and distribution. A minimum of ten (10) business days is required for the review and approval process. 11. Notwithstanding the terms contained in the General Provisions of the Master Contract, Section 25, Conformance with Law, the Contractor shall comply with the provisions of Section 601 of Title VI of the Civil Rights Act of 1964, as amended, which states that "no person in the United States shall on the grounds of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program actively receiving Federal financial assistance." The Office for Civil Rights has established that it is the responsibility of any program that is a recipient of federal funds to ensure that any Limited English Proficient (LEP) person or beneficiary have meaningful access to programs, services and information. The Contractor and contract personnel shall adopt and implement policies and procedures in which reasonable steps are taken to provide language assistance in order to ensure equal access to LEP persons or beneficiaries. The Contractor and contract personnel shall advise LEP individuals that language assistance will be provided at no cost to the LEP person or beneficiary. 12. The State may increase or decrease the quantity of goods/services described in section/schedule/exhibit based upon the rates established in the Task Order Contract. If the State exercises the option, it will provide written notice to Contractor as least thirty (30) days prior to the end of the current contract term in a form substantially equivalent to Exhibit D. Delivery/performance of the goods/service shall continue at the same rates and terms. If exercised, the provisions of the Option Letter shall become part of and be incorporated into the original contract. To be attached to CDPHE Task Order v1.0 (3/12) contract template Page 3 of 3 Revised: 12/19/06 Attachment A -I Commonly Used Acronyms and Abbreviations That May Be Referenced In the Scope of Work: ACS ACNS ACF ADA ADAD AHA AIDS ALA ALA(C) AMCHP ANR ARC ARRA ASC ASSIST ASTHO B&G BACCHUS BAG BBLHC BC BCCP BCHD BCPH BCPHA BCDSS BCTEPP BGC BGCMD BHS BMTF BOCES BOH BRFSS BVBAG BVSD Bx CAD CASB CB CBE CBO CC CC CC CCAP CCC CCCHE CCGC CCIAA CCMC CCMC CCPD merican Cancer Society lamosa County Nursing Service dministration for Children and Families mericans with Disabilities Act Icohol and Drug Abuse Division merican Heart Association cquired Immune Deficiency Syndrome merican Lung Association merican Lung Association (of Colorado) ssociation of Maternal Child Health Programs mericans for Non -Smokers' Rights ddiction Recovery Centers merican Recovery and Reinvestment Act dams State College merican Stop Smoking Intervention Study ssociation of State and Territorial Health Office oys & Girls ACCHUS Peer Education Network uild a Generation oulder Broomfield Latino Health Coalition oulder County reast and Cervical Cancer Program ent County Health Dept oulder County Public Health aca County Public Health Agency aca County Dept Social Services ent County Tobacco Education Prevention Partnership oys & Girls Club oys & Girls of Metro Denver roomfield High School aby & Me Tobacco Free oard of Cooperative Educational Services oard of Health ehavioral Risk Factor Surveillance System uena Vista Build a Generation oulder Valley School District iopsy hoice oronary Artery Disease olorado Association of School Board ommunity-based System finical Breast Exam ommunity-based Organization tear Creek uster County ommunity Coordination/Coordinator arimer County Child Care Assistance Program olorado Cancer Coalition olorado Community Coalition for health Equity olorado Clinical Guidelines Collaborative olorado Clean Indoor Air Act otorado Clinical Managed Care Network ommission for Case Manager Certification ancer, Cardiovascular, and Pulmonary Disease Page 1of6 Attachment A-1 CCTCI Colorado Chew Tobacco Collaborative Initiative CCTEPP Custer County Tobacco Education Prevention Partnership CDC Centers for Disease Control and Prevention CDE Colorado Department of Education CDPHE Colorado Department of Public Health and Environment CDU Chronic Disease Unit CEC Career Education Center CEO Chief Executive Officer CFDA Catalog of Federal Domestic Assistance CFFC Colorado Foundation for Families and Children CFPI Colorado Family Planning Initiative CHIN Community Health Information Network CICP Colorado Indigent Care Program CJD Colorado Judicial Department CM Case Management CMC Colorado Mountain College CMS Contract Management System CMS Creative Media Solutions CNCC Colorado Northwestern Community College CNS County Nursing Service CO Colorado COD Colorado Donated Dental Services Program COPAN Colorado Physical Activity and Nutrition Program COV Colorado Van Program CPCF Colorado Parent and Child Foundation CPHA Colorado Public Health Association CPT Current Procedural Technology CRC Colorectal Cancer CRCCP Colorectal Cancer Screening Program CRUE Culturally Responsive Urban Education CSAP Colorado Student Assessment Program CSH Coordinated School Health CSU Colorado State University CSU-P Colorado State University -Pueblo's CTC Connect to Care CTEPA Colorado Tobacco Education and Prevention Alliance CTFK Campaign for Tobacco -Free Kids CTRP Colorado Tobacco Research Program CTP Crossroads Turning Point CU University of Colorado, Boulder CWCCI Colorado Women's Cancer Control Initiative CY Contract Year DAISI Denver At-home Intervention Service Initiative DASH Division of Adolescent & School Health (CDC) DCMH Delta County Memorial Hospital DH Denver Health DHHA Denver Health and Hospital Authority DHS Department of Human Services DHHS Unites States Department of Health and Human Services DOR Department of Revenue DOS Delta Opportunity School DSS Department of Social Services E&I Education and Information EAP Employee Assistance Program EBHV Evidence -Based Home Visiting to Prevent Child Maltreatment Grant Program ECC Early childhood council ECC Electrocardiogram ECCLC Early Childhood Council of Larimer County Page 2 of 6 Attachment A-1 ECLC Early Childhood Leadership Council/Commission E.D. Executive Director EHR Electronic Health Record EHS Early Head Start EMR Electronic Medical Record EMT Emergency Medical Technicians EPA Environmental Protection Agency EPE Epidemiology Planning and Evaluation ESL English as a Second Language ETS Environmental Tobacco Smoke (a.k.a. secondhand smoke) FIRC Family and Intercultural Resource Center FICA The Federal Insurance Contribution Act FDA Food and Drug Administration FIT/FOBT Fecal Immunochemical Test/Fecal Occult Blood Test FNA Final Needle Aspiration FPP Family Planning Program FPL Federal Poverty Level FRCC Front Range Community College FTE Full Time Equivalent FTP File Transfer Protocol FY Fiscal Year FYI Family Youth Initiatives GASO Great American Smoke -out GED General Education Development GASP CO Group to Alleviate Smoking Pollution of Colorado Get R! EAL (GR) Resist! Expose Advertising Lies (Youth Empowerment Program) GLBT Gay, Lesbian, Bisexual, and Transgender GYN Gynecological HCP Health Care Program For Children with Special Needs HCYS Huerfano County Youth Services HHS Health and Human Services HIPPA Health Insurance Portability and Accountability Act of 1996 HIPPY Home Instruction for Parents of Preschool Youngster HIT Health Improvement Team HIV Human Immunodeficiency Virus HPV Human Papillomamavirus HR Human Resources hr hour HRSA Health Resources and Services Administration HSL High School Leadership ID Identification IIK Invest in Kids ISHT Interagency School Health Team IT Information Technology JAC Juvenile Assessment Center KIS Keeping in STEPP KMH Keefe Memorial Hospital KPC Kevin Patrick Caleum LAHCDHD Las Animas Huerfano Counties District Health Department LBW Low Birth Weight LC Learning Community LGBT Lesbian, Gay, Bisexual, Transgender LEM Latins en Movimiento LHA Local Health Agency LHD Local Health Department LLC Limited Liability Company LRCC Latino Regional Community Coalition LRPC Latino a Research and Policy Center Page 3 of 6 Attachment A-1 LST Life Skills Training LSTPEN Latino Statewide Tobacco Prevention and Education Netw LWB Live Well Broomfield MCHA Montezuma Housing Authority MCHD Montezuma County Health Department MCHS Montezuma -Cortez High School MCPN Metro Community Provider Network MCRC Media Campaign Resource Center— CDC MD Medical Doctor MHCBBC Mental Health Center Serving Boulder and Broomfield Counties MIECHV Maternal, Infant and Early Childhood Home Visiting Program MO Month MOB Medical Office Building MOU Memorandum of Understanding MPA Master of Public Administration in Health and Human Services MPH Master of Public Health MRI Magnetic Resonance Imaging Scan MS Master of Science MSA Master Settlement Agreement MUH Multi-user Housing MYAT Multi -Disciplinary Youth Assessment Team N/A Not Applicable NACCHO National Association of County and City Health Officials NACR Native American Cancer Research NAQC North American Quitline Consortium NASBE National Association of State Board of Education NCCRT National Colorectal Cancer Round Table NCHD Northeast Colorado Health Department NCI National Cancer Institute NE North East NFP Nurse -Family Partnership NFPNSO Nurse -Family Partnership National Service Office NHVP Nurse Home Visitor Program NIDA National Institute on Drug Abuse NIH National Institute of Health NJH National Jewish Medical and Research Center N -O -T Not -on -Tobacco, (ALA's Youth Smoking Cessation Program) NP Nurse Practitioner NPP Nurturing Parenting Program NRT Nicotine Replacement Therapy NSBA National School Boards Association OSH Office on Smoking or Health (CDC) OTC Over the Counter PA Physician's Assistant PAC Prevention Awareness Crew PACT Partners Assessing Chew Tobacco PAT Parents as Teachers PCCHD Pueblo City -County Health Department PPC Personal Care Providers PE Presumptive Eligibility PEN Parent Engagement Network PVCHC Peak Vista Community Health Center PHN Public Health Nurse PLO Public Information Officer PM Peer Mentor PMC Parkview Medical Center PMR Planning Management Region PN Patient Navigator Page 4 of 6 Attachment A -I PO Purchase Order PPC Policy Partner Committee PPFC Pikes Peak Family Connections PPN Prevention Policy Network PRA Policy Resource Alliance PRAMS Pregnancy Risk Assessment and Monitoring Survey PRIDE Pure Respect Initiative Direct Education PSA Public Service Announcement PSD Prevention Service Division PTEPP Pueblo Tobacco Education and Prevention Partnership PVC Prairie View Clinic QI Quarter One Q2 Quarter Two Q3 Quarter Three Q4 Quarter Four QI Quality Improvement QOL Quality of Life RDAC Regional Disparities Advisory Council RFA Request for Applications RFP Request For Proposals RIE Reach, Implementation and Effectiveness ftIHEL Regional Institute for Health and Environment RMC Rocky Mountain Center for Health Promotion & Education RMRH Rocky Mountain Rural Health RMYC Rocky Mountain Youth Corps RN Registered Nurse Rx Prescription RY Reconnecting Youth SafeCare SAMHSA Substance Abuse Mental Health Services Administration SB School -based System SBAG Salida Build A Generation SBHC School -Based Health Centers SCYC School Community Youth Coalition SCRHC Southern Colorado Regional Health Collaborative SD Service Delivery SECH Southeast Colorado Hospital SENMHS Southeast Mental Health Services SES Socio-Economic Status SEW School Employee Wellness SGR Surgeon General's Report SHAC Smoke -free Housing Action Committee SHI School Health Index SHS Secondhand Smoke SIDS Sudden Infant Death Syndrome SLV San Luis Valley SMART Staying Motivated at Reducing Temptations SMART OUTCOME OBJECTIVE Specific, Measurable, Achievable, Realistic, Time -Bound SMSU Self Management Service Unit SOW Scope of Work SRO School Resource Officer STD Sexually Transmitted Disease STEPP State Tobacco Education and Prevention Partnership STW Straight -to -Work SVVSD St. Vrain Valley School District SWOT Strengths, Weaknesses, Opportunities, Threats SYNAR Synar Regulation TA Technical Assistance Page 5 of 6 Attachment A -1 TABS Tobacco Attitudes and Behavior Survey TAG Technical Advisory Group (for evaluation & TPEG) TANF Temporary Aid to Needy Families TARP Tobacco Advocacy and Resource Partnership TBD To Be Determine TCP Tobacco Control Partners TDAC Tobacco Disparities Advisory Council TDG Tobacco Disparities Grant TDS Tobacco Disparities Subcommittee TEACH Teaching Equity to Advance Community Health TEFAP The Emergency Food Assistance Program TEPCGP Tobacco Education Prevention and Cessation Grant Program TEPP Tobacco Education Prevention Partnership TFCCI Tobacco -Free Colorado Communities Initiative TFLC Tobacco Free Larimer County TFS Tobacco -Free Schools TFS Law Tobacco -Free Schools Law TGYS Tony Grampsas Youth Services Title V Title V of the Social Security Act TND Project Toward No Drug Abuse TPEG Tobacco Program Evaluation Group TPI Tobacco Prevention Initiative TRC Tobacco Education and Prevention and Cessation Program Review Committee TRI Tobacco Rapid Improvement Activity TRIA Tobacco Rapid Improvement Assessment TTI Tony Grampsas Tobacco Initiative UCD University of Colorado — Denver UCDHSC Health Sciences Center at UCD (sometimes abr. UCHSC) UCDFISC University of Colorado at Denver and Health Sciences Center URL Uniform Resource Locator US United States of America USSTC US Smokeless Tobacco Company VP Vice President Well COA Wellness Councils of America WHU Women's Health Unit WIC Women, Infants, Children WWC Women's Wellness Connection Y@C Youth at Crossroads YE Youth Empowerment YPH Youth Partnership for Health Yr Year YRBS Youth Risk Behavior Survey YSAP Youth Substance Abuse Prevention Coalition YTS Youth Tobacco Survey YVNIC Yampa Valley Medical Center 5 A's Ask, Advise, Assess, Assist, Arrange 2A's R Ask, Advise, Refer Page 6 of 6 Attachment A-2 Enforcement Guidelines and Federal Clauses of Contract HHSF223201110091C/0001 These federal requirements are mandated by Contract HHSF223201110091C/0001 between USHHA FDA and CDPHE. I. PROVISIONS APPLICABLE TO DIRECT COSTS Notwithstanding Clause 52.216-7 "Allowable Cost and Payment" and Clause 52.244-2 "Subcontracts", of the Federal Acquisition Regulation (FAR), unless otherwise expressly provided elsewhere in the contract or in any modification thereto, the cost of the following items or activities shall be unallowable as direct costs: A. Acquisition by purchase or lease, of any interest in real property; B. Special rearrangement or alteration of facilities; C. Purchase or lease or rental of any item of general purpose; office furniture or office equipment (including data tapes); D. Travel to foreign countries; and E. Food and beverage costs unless part of per diem expenses paid in accordance with the Federal Travel Regulations. II. TRAVEL AND OTHER COSTS A. Travel claims shall be submitted and included with the monthly invoices for approval. Listed below is a description of receipts required as attachments to the invoice to support travel claims: B. Copy of common carrier ticket reflecting class of travel, dates of travel and amount of fare; 1. Lodging receipt; 2. Parking/tolls receipt; 3. Rental car receipt including receipts for gasoline; 4. Receipts for taxi travel. C. Any equipment having a unit acquisition cost in excess of $3,000, the cost of which the Contractor is to be reimbursed as a direct item of cost, shall not be acquired by the Contractor without the specific advance written approval of the CDPHE. Page 1 of 20 Attachment A-2 III. BACKGROUND The provisions of the Federal Food, Drug and Cosmetic Act (FDCA), as amended by the Tobacco Control Act, to be enforced under the resultant contract are as follows: • Section 907 (a)(1)(A) states, in relevant part, that "a cigarette or any of its component parts (including the tobacco, filter, or paper) shall not contain, as a constituent (including a smoke constituent) or additive, an artificial or natural flavor (other than tobacco or menthol) or an herb or spice, including strawberry, grape, orange, clove, cinnamon, pineapple, vanilla, coconut, licorice, cocoa, chocolate, cherry, or coffee, that is a characterizing flavor of the tobacco product or tobacco smoke." • Section 911 (a) states that "(n) no person may introduce or deliver for introduction into interstate commerce any modified risk tobacco product unless an order issued pursuant to subsection (g) is effective with respect to such product." The provisions of the Comprehensive Smokeless Tobacco Health Education Act of 1986 (CSTHEA) to be enforced under the resultant contract are referenced in Section 204 of the Tobacco Control Act which provide that advertising and packages of smokeless tobacco products must bear one of four specified warning label statements (warnings), and the warning area must occupy at least a specified percentage of the packaging (30%) and advertising (20%). Additionally, the warnings must be in either black text on a white background or white text on a black background. The burden is generally on retailers to ensure that a warning appears on smokeless tobacco packages and advertisements on display in their outlets. The Tobacco Control Act also required FDA to reissue the 1996 final rule, "Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents." The FDA has accordingly reissued the rule, which is at 21 Code of Federal Regulations (CFR) Part 1140, et seq. The Contractor shall conduct tobacco inspections for compliance with certain provisions of these regulations with respect to retail outlets on behalf of FDA and CDPHE. For illustration purposes, some, not all, of the provisions in 21 CFR Part 1140 that are subject to inspection by the Contractor under this contract include: A. Age and Photo Identification Restrictions — Retailers: 1. May not sell cigarettes or smokeless tobacco to anyone younger than 18 years of age; 2. Must verify that any person purchasing cigarettes or smokeless tobacco is at least 18 years old or older by means of photo identification containing the bearer's date of birth; B. Advertising and Labeling Restrictions - Retailers: 1. May only sell cigarettes or smokeless tobacco in direct, face-to-face transactions; 2. May not have impersonal modes of sales at their facility (e.g., vending machines or self-service displays that enable direct access by consumers to cigarettes or smokeless Page 2 of 20 Attachment A-2 3. tobacco) unless they ensure that persons younger than 18 years of age are not present or permitted to enter the facility at any time; 4. May not offer or cause to be offered coupons that may be redeemed by mail for cigarettes or smokeless tobacco; 5. May not break or otherwise open packages of cigarettes to sell or distribute single cigarettes or any package with less than 20 cigarettes; 6. May not break or otherwise open packages of smokeless tobacco product to sell or distribute any quantity of cigarette tobacco product or smokeless tobacco that is smaller than the smallest package distributed by the manufacturer for individual use; 7. May not distribute or cause to be distributed free samples of cigarettes or smokeless tobacco products, except for samples of smokeless tobacco products in limited circumstances, as defined by the regulations; 8. May not offer or cause to be offered any non -tobacco gift or item to any person in consideration for the purchase of cigarettes or smokeless tobacco including redemption of credits, proofs -of -purchase, or coupons towards the purchase of a non - tobacco item whether or not such redemption is for all or part value of the non - tobacco item; 9. May not sponsor or cause to be sponsored any athletic, musical, artistic, or other social or cultural event, or any entry or team in any event, in the brand name, logo, symbol, motto, selling message, recognizable color or pattern of colors, or any other indicia of product identification similar to, or identifiable with, those used for any brand of cigarettes or smokeless tobacco. The Synar Regulation, which is administered by the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention (SAMHSA/CSAP), requires the 50 states, the District of Columbia and 8 U.S. territories (American Samoa, Guam, Palau, Federated States of Micronesia, U.S. Virgin Islands, Puerto Rico, Marshall Islands and Commonwealth of the Northern Mariana Islands) to: • Have in effect a law prohibiting any manufacturer, retailer, or distributor of tobacco products from selling or distributing such products to any individual younger than age 18; • Enforce this law; • Conduct annual, unannounced inspections (referred to as the Synar survey) in a way that provides a valid probability sample of tobacco sales outlets accessible to minors; • Negotiate interim targets and a date to achieve a noncompliance rate (or retailer violation rate) of no more than 20 percent (SAMHSA required that each state reduce its retailer violation rate (RVR) to 20 percent or less by FY 2003); and • Submit an annual report detailing state activities to enforce its law. Page 3 of 20 Attachment A-2 The funds used for FDA's tobacco inspection program are restricted, by statute, for use only for FDA tobacco inspection efforts. IV. SCOPE OF WORK Independently and not as an agent of the Federal government, the Contractor shall furnish the necessary personnel, materials, services, equipment, facilities, and otherwise do all things necessary for the performance of the work described below. The Contractor shall provide support in accordance with the timelines stated in the implementation plan. Attachment A -2-A contains a list of materials necessary for conducting FDA tobacco compliance check inspections. A. Inspectors The Contractor shall conduct compliance check inspections using law enforcement, health, food, or drug officers or employees of the state, local, or tribal government. These individuals must be United States citizens and be able to be commissioned as officers of the United States Department of Health and Human Services (HHS), Food and Drug Administration, under the authority of the FDCA. All persons to be commissioned must have enforcement authority from the state or local Government to be able to conduct inspections under this contract. B. Background Investigations/Commissioning Process Prior to carrying out compliance check inspection activities inspectors, and other employees working under this contract and/or with FDA inspection data or evidence (e.g., administrative personnel, supervisors) must be commissioned by FDA. In addition, should the program include chaperones (staff dedicated to overseeing the safety of the minors), they also require background investigations. Chaperones will not be commissioned by FDA. In general, the commissioning process begins with a background investigation, including a fingerprint check, credit check, and childcare check facilitated by FDA. Several parties within HHS may be involved in the process, with oversight by the Center for Tobacco Products (CTP). Any of these parties may contact the Contractor for additional information to facilitate the process. Upon clearance of the fingerprint check, a person may be commissioned while the background investigation continues, if applicable. The Contractor must submit contact information for the person(s) or entity most familiar with their agency's background investigation procedure. If applicable, the Contractor must also provide security contact information for individuals that the Contractor intends to subcontract. Upon award of the contract, CDPHE will work with the Contractor's security contact(s) to assess whether the Contractor's existing background investigation is Page 4 of 20 Attachment A-2 equivalent to FDA's, which is a federal Level 5 minimum background investigation (MBI) public trust background investigation. Upon award, the Contractor shall provide information for the available employees to be commissioned/receive background investigations, and subsequently, immediately upon identifying new staff it wishes to have commissioned (see F.2 reporting requirements). More specifically, the Contractor shall provide CDPHE with each such person's name, work address, work number or cell number, and email address. The Contractor shall provide CDPHE with information related to all minors and chaperones as determined by CDPHE. The Contractor shall notify CDPHE if any of this information changes. Receiving a commission signifies that the employee has accepted a position of public trust and must comply with all applicable federal laws and ethical standards. Each FDA commission is issued for a period of five years. Each employee is responsible for immediately notifying his/her Program Coordinator of any event or occurrence that could affect or change his/her status. The status of a background investigation may be continuously monitored by the Contractor, the Program Coordinator, and FDA. The issuance of a commission is discretionary, and FDA may revoke a commission at any time. Reasons for revocation may include: • The abuse or misuse of the commission; • The transmittal of confidential information from a commissioned official to individuals who are not employees or commissioned officials of HHS. • A conflict of interest; • Change in criminal or credit history; • Substance abuse; and • Behavior that may discredit FDA. Upon separation of a commissioned employee, the Contractor shall ensure the commissioning credentials and all equipment are returned to CDPHE. C. Information Regarding Minors The Contractor shall keep one photo on file of the minors involved in the Program. The Contractor may determine that minors should be photographed with frequent regularity and/or prior to conducting any undercover buy assignments in order to document their appearance. FDA protocol does not require minors to carry photo identification for the undercover buy assignments. However, the Contractor may determine that minors should carry valid photo identification and present identification if requested. Such decisions are left to the discretion of CDPHE. Page 5 of 20 Attachment A-2 D. Contractor Responsibilities Regarding Minors The Contractor (or designated person or entity), rather than FDA, has the oversight responsibility for minors involved in the Program. The Contractor shall ensure that the minor is within the required age range (See Section C.3.E, "Compliance Check Inspections") by obtaining a copy of his/her birth certificate and minor's identification (if available) and an original parental/legal guardian consent form and submitting these to CDPHE. The Contractor must obtain permission from the minor's parents/legal guardian and school if the minor is going to conduct undercover buy assignments during school hours. The Contractor shall secure a grant of immunity from the proper authorities prior to using minors in any jurisdiction where it would be illegal to use minors to conduct undercover buy assignments. The Contractor shall maintain the confidentiality of the minor, although, in the event of a possible enforcement or judicial action, the minor's identity may be revealed and the minor may need to provide a narrative report, declaration, and/or give oral testimony in a hearing. This information must be contained in the parental consent form. All minors selected shall be insured against accidents or other injuries. If the minors are not covered under the Contractor's policy, the Contractor shall purchase the insurance. Proof of insurance shall be maintained by the Contractor and must be submitted to CDPHE. E. Conflicts of Interest The individuals conducting compliance check inspections or responsible for compliance information or evidence ("covered persons") shall not have significant financial interests in the following ("covered companies"): (1) any company that the covered person inspects; (2) any company whose compliance information and/or evidence the covered person is responsible for gathering, maintaining, or reporting; or (3) any manufacturer, distributor, or importer of cigarettes or smokeless tobacco products. Examples of significant financial interests include: • the covered person or a close family member owns stock in a covered company, other than through ownership of shares of a mutual fund that invests in a covered company; • the covered person or a close family member serves as an employee, trustee, officer, or director of a covered company. Page 6 of 20 Attachment A-2 In addition, a covered person shall not participate personally or substantially in any matter under the contract that may significantly affect that person's own financial interests or the financial interests of: • His or her spouse or minor child; • His or her general partner; • An organization in which he or she serves as an officer, director, trustee, general partner or employee; and • A person with whom he or she is negotiating for or has an arrangement concerning prospective employment. These requirements are contractual, and do not alter, modify, or replace obligations imposed on program coordinators or commissioned officers by any applicable federal law or ethical standard. V. RETAIL INSPECTION PROGRAM TRAINING A. Initial Training for contracted staff who have not previously held a FDA Retail Inspection Contract CDPHE officials will provide the initial FDA Tobacco Compliance Check Inspection training materials and conduct the initial training of the Program inspectors. Inspectors must be commissioned by FDA before reviewing the training materials. The CDPHE Program Coordinator shall ensure that all inspectors are trained and begin conducting compliance check inspections within two (2) weeks of successfully completing their initial training. B. Training for Minors The Contractor must ensure that minors are appropriately trained. Minors shall be trained by the Contractor. The training program may include mock undercover buy assignments so newly recruited minors may observe experienced minors conduct undercover buy assignments before conducting them on their own. C. Training Records and Annual Refresher Training The Contractor shall ensure that each inspector, chaperone and minor shall have their initial training documented and, at a minimum, receive annual refresher training. CDPI-IE will consider requests for additional training by the Contractor and may require additional training as needed and determined by CDPHE and FDA. Page 7 of 20 Attachment A-2 VI. FDA'S TOBACCO INSPECTION MANAGEMENT SYSTEM (TIMS) FDA's Tobacco Inspection Management System (TIMS) is designed to receive and store data and information, but currently has limitations on data analysis and reporting. The TIMS Application can work in conjunction with a specific handheld mobile device that will be provided by FDA and allows for the electronic transmission of information. The TIMS Application provides FDA and Contractors with a front-end web interface for accessing and managing FDA tobacco inspection assignment information and related processes. Inspectors not using the handheld device for data submission shall submit paper forms or enter data using a computer. The mobile device currently provided to some inspectors by FDA is the iPhone, serviced by AT&T. FDA will also provide the service plans for these devices. Not all inspectors/contractors will be issued mobile devices by FDA. Therefore, all inspectors will be trained to use paper forms whether given a government furnished mobile device or not. The Contractor must notify CDPHE immediately of any hardware and software problems so that CDPHE can work to resolve them. VII. COMPLIANCE CHECK INSPECTIONS A. Overview of General Inspection Procedures CDPHE will assign tobacco compliance check inspections of entities that sell or advertise cigarettes and/or smokeless tobacco products for the inspector to determine whether those entities are complying with the Tobacco Control Act and the implementing regulations (See Section C.1). Generally,* the Contractor shall carry out two types of tobacco compliance check inspection assignments: (1) undercover buy, to determine a retailer's compliance with age and photo identification requirements; and (2) advertising and labeling to cover other provisions of the Tobacco Control Act. FDA prefers an equal mix of each type of tobacco compliance check assignments be conducted. In some instances, FDA may request that both types of assignments be conducted within a short timeframe (specified during training) of each other at a particular retail outlet. *Note: some retail outlets that never permit anyone under the age of 18 to enter may be inspected using only the advertising and labeling assignment form. Each inspector shall conduct and document each assignment according to FDA protocol (provided in the training). Documentation of the assignment requires the inspector to: (1) record the findings on a compliance check inspection form, which will be provided by FDA via the handheld device, a computer, or hardcopy form; (2) prepare a narrative report revealing potential violations (according to the FDA template); (3) collect evidence, such as tangible items of potentially violative tobacco products or photographs of conditions observed via the handheld device or a digital camera; and (4) record any additional observations as instructed by CDPHE and FDA. Page 8 of 20 Attachment A-2 If the retail outlet is found to be out of compliance, CDPHE may request assistance from the Contractor in researching the ownership information of a particular retail outlet or entity. The Contractor is responsible for the collection, handling, sealing, documentation, storage, and submission of evidence pursuant to CDPHE protocol to ensure that evidence is maintained in a manner that shall allow the FDA to use the evidence to support an enforcement action. The Contractor shall ensure procedures and standards for data and evidence security. This should include but is not limited to ensuring anonymity of compliance check inspection participants, confidentiality of data and evidence collection, transmission, and storage of property and evidence. Further details shall be provided in FDA's State Compliance Inspection Check Program Training. B. Undercover Buy Assignments The Contractor shall ensure that compliance check assignments to determine retailer compliance with the age and photo identification provisions of the regulations follow FDA and CDPHE protocol. Generally, undercover buy assignments shall be conducted by teams comprised of an inspector and a minor. The minor must be supervised at all times. The inspector shall position him/herself so that they can observe and hear the minor during the entire undercover buy assignment to ensure that they can later complete a narrative report attesting that they have witnessed the violation. In certain circumstances, minors may be required to complete narrative reports regarding inspections they conducted. A representative mix of 15, 16 and 17 year old minors who look their age should be used. The minor group should also reflect a representative mix of male and female minors and should reflect the racial/ethnic composition of the population where the undercover buy is conducted. The Contractor shall ensure that Minors used in the undercover buy assignments are not related to the inspectors. The Contractor shall ensure that undercover buy assignments using minors shall be conducted during the hours deemed.. If it is required under state law to issue a citation after a violation, the Contractor shall not issue the state citation until all compliance check assignments for that day are completed and the minor is returned to his/her proper end location. C. Advertising and Labeling Assignments The Contractor shall conduct compliance check assignments to determine compliance with the provisions of the Tobacco Control Act and the implementing regulations, other than age and photo identification requirements. The Contractor may either conduct Page 9 of 20 Attachment A-2 advertising and labeling check assignments at the same time as the undercover buy compliance check assignments, or at a separate time, using one or more inspectors. Generally, a minor should not accompany an inspector during an advertising and labeling assignment to ensure that the minor's identity remains anonymous. Minors must be supervised at all times. In some circumstances, the inspector may be required to provide his/her FDA credentials during this type of compliance check assignment. D. Timing of Routine Compliance Check Inspections When instructed by CDPHE, the Contractor shall, to the extent practicable, conduct both undercover buy and advertising and labeling assignments within a short timeframe of each other at a specified retail outlet to expeditiously initiate and support a potential enforcement action. The timing of the assignments is discussed further in the FDA training program. E. Compliance Follow-up Inspections CDPHE shall assign follow-up compliance check inspections for retail outlets found to be out of compliance with the Tobacco Control Act and/or the implementing regulations. Follow-up compliance check inspections are to be completed by the Contractor within ninety (90) days of receipt of the follow-up inspection request from CDPHE. CDPHE shall provide specific instructions regarding the conduct of follow-up inspections during the initial training session. F. Complaint Follow -Up Inspections CDPHE may issue complaint follow-up inspections after the FDA receives a complaint or report that may pose a public health risk or other regulatory concern. Specific compliance check inspections and investigations assigned by CDPHE shall be scheduled and completed no later than ninety (90) days after assigned by CDPHE. CDPHE shall provide specific instructions regarding the conduct of follow-up inspections during the initial training session and when assignments are issued. G. Data Transmission FDA and CDPHE will supply the Contractor with handheld devices (if applicable) and/or hardcopy forms and access to the TIMS application for recording information related to each compliance check inspection. Inspectors shall record compliance check inspection data and manage compliance check inspection work. Page 10 of 20 Attachment A-2 The inspectors shall submit the results of each compliance check assignment, including the narrative report and evidence if applicable; within 72 hours after the compliance check assignment was initiated. The Contractor shall follow protocol provided by CDPI-IE. H. Compliance Check Inspection Follow-up — FDA Inquiries If the inspection data and evidence submitted by the Contractor requires clarification or is not sufficient, CDPHE may request that the Contractor provide clarification and/or collect additional evidence. Within 48 hours of receiving a request from CDPHE, the Contractor shall provide CDPHE with information about a compliance check inspection and investigation unless citing extenuating circumstances. I. FDA Enforcement Actions FDA intends to review the results of every compliance check inspection recommendation and the accompanying evidence submitted by the Contractor. If FDA determines that enforcement action shall be taken against a retailer, FDA has several enforcement tools that it may use, including: (I) issuance of a Warning Letter, (2) imposing an administrative civil money penalty (CMP) and/or a no -tobacco sale order, (3) initiating judicial actions, such as a seizure or injunction, or (4) initiating criminal prosecution. If FDA takes enforcement action, the Contractor shall assist CDPHE and FDA with any needed follow-up related to the compliance check inspections. For example, the Contractor shall be responsible for securing prompt and continuing cooperation from witnesses. In addition, if requested, the inspector and minor must remain available to testify as a witness and provide oral testimony following any compliance check inspection in support of an FDA enforcement action. Apart from FDA enforcement actions for violations of the Tobacco Control Act and its implementing regulations, the Contractor may pursue separate enforcement actions against retail outlets that are found to have also violated state or local laws. These efforts must be coordinated with FDA and not compromise FDA's compliance check inspection procedures, data, or evidence. VIII. REPORTING REQUIREMENTS/DELIVERABLE AND ACTIVITY SCHEDULE All deliverables required by this contract shall be delivered to CDPHE except where indicated that the Contracting Officer (CO) and the COTR receive copies. The description of each deliverable is identified below. All deliverables shall be subject to the inspection and acceptance of CDPHE. All Page 11 of20 Attachment A-2 deliverables shall be submitted electronically to the State Program Coordinator, whose contact information shall be supplied by CDPHE. A. DESCRIPTION OF DELIVERABLES/ACTIVITIES: 1. Notification of Changes - The Contractor shall inform the contract monitor/program coordinator when there are any changes to the inspector's , or Minors information. (e.g., phone number, e-mail address, change of personnel, etc.). 2. Completion of Initial Training - The Contractor shall ensure that all inspectors are trained and begin conducting compliance check inspections within two (2) weeks of successfully completing their initial training. 3. Follow-up Inspections for Non -Compliance. Follow-up inspections for establishments found to be out of compliance with the Tobacco Control Act shall be completed by the Contractor within ninety (90) days of receipt of the follow-up inspection request from CDPHE. 4. Complaint Follow -Up Inspections. CDPHE may issue complaint follow-up inspections after the FDA receives a complaint or report that may pose a public health risk or other regulatory concern. Specific compliance check inspections and investigations assigned by CDpHE shall be scheduled and completed no later than ninety (90) days after assigned by FDA. 5. Inspection Follow-up Information - If the inspection data and evidence submitted by the Contractor requires clarification or is not sufficient, CDPHE may request clarification and/or collect additional evidence. The Contractor shall provide CDPHE with additional information about a compliance check inspection and investigation within 48 hours. 6. Quarterly Reports - A quarterly report is a quantitative description of overall progress and applicable supporting data in sufficient detail to comprehensively explain progress to date. Appropriate topics include, for example: a) Total number of retail outlets inspected. b) Total number of undercover buy compliance check assignments conducted. c) Total number advertising and labeling compliance check assignments conducted. d) Percent of retail outlets checked compared to total number of retail outlets on state list. e) Violation rates among retail outlets checked. A breakdown of rates in minority vs. non -minority populations. Page 12 of 20 Attachment A-2 f) Total number of follow up inspection assignments conducted. (Breakout to specify Undercover Buy and Advertising and Labeling assignments) g) Total number of complete inspections conducted in response to complaint follow- up assignments. (Breakout to specify Undercover Buy and Advertising and Labeling assignments) h) Number of follow-up questions answered concerning compliance check inspections; number pending and reasons why. i) Media coverage, contact, and/or inquiries, if any. j) Dates on which inspectors received training and updates. k) Feedback regarding the use of handheld devices and other hardware, TIMS, and the online compliance check inspection process. I) Feedback regarding the FDA program in general. The Contractor shall abide by Program changes needed to maintain efficiency of Program operations and accuracy of compliance check inspection data and evidence. Such changes may include, but are not limited to compliance check inspection procedures, evidence collection, training, report submissions, and IT system improvements. 7. FDA 1350 Access To Non -Public Information — All Contractor and Subcontractor employees are required to sign the Contractor's Commitment to Protect Non -Public Information Agreement form provided as an attachment to this contract (see Attachment A -2-B). If a person who has signed this agreement resigns, is dismissed, or is otherwise no longer working on this contract, the contractor shall notify CDPHE. Any new Contractor and subcontractor employees assigned to this contract shall sign the form. The signed form shall be submitted to CDPHE within ten (10) days prior to commencement of any work under this contract. IX. GOVERNMENT FURNISHED PROPERTY (GFP) Equipment Return - Upon the departure or reassignment of an inspector, or upon expiration of the contract ALL FDA and CDPHE provided IT equipment shall be returned to CDPHE immediately. X. SPECIAL CONTRACT REQUIREMENTS A. FDA 1350 ACCESS TO NON-PUBLIC INFORMATION All Contractor employees assigned to this contract are required to sign the Contractor's Commitment to Protect Non -Public Information Agreement form (see Attachment A -2- B). If a person who has signed this agreement resigns, is dismissed, or is otherwise no Page 13 of 20 Attachment A-2 longer working on this contract, the contractor shall notify CDPHE. Any new Contractor employees assigned to this contract shall sign the form and shall submit to CDPHE within ten (l0) days prior to commencement of any work under this contract. The prime contractor, subcontractors, and consultants shall not be provided nor possess non-public information in any form unless written approval and a facility clearance have been granted by FDA's Contracting Officer. B. FDA 1354 PHYSICAL SECURITY REQUIREMENTS FOR RELEASING NON- PUBLIC INFORMATION Under the provisions of Title 21, United States Code, Section 331(j), the Contractor shall establish and maintain comprehensive security measures for controlling access to non- public information released under a contract involving the processing of such information. This clause applies to the contractor, any subcontractors, and any consultants. Non- public information shall be released to only those persons who will be using the contractor's approved facility unless the off -site facility has been reviewed by the FDA Physical Security Staff and approved in writing by the FDA Physical Security Office. For transmittal of documents the Contractor shall adhere to the following: 1. Documents to be transmitted internally shall be transmitted on a person -to -person basis between approved employees only. 2. Documents to be transmitted outside the contractor's facility shall be double - wrapped with the inner wrapping marked "CDPHE/FDA Privileged Information - Access Controlled". The names and addresses of the sender and addressee shall be typed on both the inner and outer wrappings. 3. Documents to be transmitted back to CDPHE or to another address designated by the FDA shall be transmitted by an approved employee or by U. S. Registered mail (return receipt requested). It shall be double -wrapped or wrapped by such a method as specifically approved in writing by the FDA Physical Security Office. 4. A receipt log shall be maintained for all external transmittals. 5. The Contractor shall follow up all transmittals in order to obtain signed receipt within five (5) working days of transmittal. Failure of recipient to furnish such receipt shall be reported to the FDA Physical Security Office within ten (10) working days of transmittal. Page 14 of 20 Attachment A-2 Non-public information shall not be released to the Contractor unless all required security precautions have been met as demonstrated during an inspection by the Food and Drug Administration (FDA) Physical Security Staff, and written procedures for enforcing them have been provided by the contractor and approved in writing by the Physical Security Staff The FDA Physical Security Office shall notify the Contractor of the approval. When the Contractor facilities have a current certification from the Defense Contract Administration Services/Defense Logistics Agency (DCAS/DLA) as a "Secret" or higher classification, such rating will satisfy the FDA security requirements for the contractor's facility. Loss of such certification during the period of the contract will be cause for a possible issuance of a Stop Work Order pending review by the FDA's Physical Security Staff of the contractor's facility. The contractor shall notify the FDA Physical Security Office in the event their DCAS/DLA rating is expected to be terminated. Pending the outcome of any subsequently required investigation, additional requirements on the contractor shall include, but not be limited to, the following: restrictions on access to data by contractor employees, subcontractor employees, and consultants; special storage requirements; restrictions on transmission and disclosure of information; changes in periods of retention and in methods of destruction of source documents or related material; and disclosure statements for all contractor employees, subcontractor employees, and consultants. The FDA Physical Security Staff may review the contractor's facility and assess the contractor's compliance. Recommendations for bringing noncompliant areas into compliance shall be provided to the contractor by the FDA Physical Security Office. The Contractor shall make any changes necessary within thirty (30) days after written notice from the FDA Physical Security Office in order to comply with FDA security requirements. When appropriate changes have been made the Contractor shall contact the FDA Physical Security Office to request further review by the FDA. The FDA Physical Security Office will notify the Contractor in writing of the outcome of the second inspection. Failure of the contractor to satisfy FDA security requirements within thirty (30) days after the first written notification from the Contracting Officer may be cause for termination of the contract. In addition to the above, if this is an automated data processing/telecommunications (ADP/TC) contract, special requirements are necessary. Contractor and subcontractor employees and consultants participating in the design, operation, maintenance or use of FDA automated information systems or ADP/TC resources shall comply with the DHHS Automated Information Systems Security Program Handbook. Chapter VII, entitled, "Personnel Security/Suitability and Training," which establishes criteria for assigning positions to the three (3) computer/ADP position risk levels: Level 6, high risk public trust position; Level 5, moderate risk public trust position; and Level 1, low risk position. Chapter VIII, entitled, "AIS Facilities," requires contractors to meet or exceed the security requirements described therein. Page 15 of 20 Attachment A-2 C. COMMISSIONG OF INSPECTORS The Government requires that certain Contractor personnel be commissioned by the Government to enable the Contractor to conduct activities under this contract including, but not limited to, undertaking examinations, inspections, and investigations, and related activities to protect the public health in accordance with federal law, such as the provisions of "Public Health Security and Bioterrorism Preparedness and Response Act of 2002" (Public Law 107-188). The Government has an established procedure to commission the Contractor's employee to perform certain functions pursuant to the Federal Food, Drug, and Cosmetic Act, such as conducting FDA examinations, inspections, and investigations, collecting and obtaining samples, copying and verifying records, and receiving and reviewing official FDA documents. D. FEDERALLY FUNDED RESEARCH AND DEVELOPMENT CENTERS AND SUPPORT CONTRACTORS The Government may contract with federally funded research and development centers (FFRDC) and support contractors for services to support in technical and management oversight of the Contractor's efforts and products under this contract. Employees of these FFRDCs and support contractors may attend meetings between the Contractor and the Government and may observe and participate with Government personnel in function and performance tests, may review any and all documentation and underlying data supporting work performed under this contract, and may have access to the Contractor's facilities as related to any effort under this contract. No employee of an FFRDC or support contractor has the authority to issue directions to the Contractor or effect changes to the contract. The Contracting Officer will identify to the Contractor the FFRDCs and support contractors who will be supporting this contract. The Contractor shall be provided the names of the FFRDC and support contractor personnel who will sign appropriate non- disclosure and conflict of interest statements. The Contractor agrees to cooperate with the FFRDCs and support contractors by engaging in technical discussions with their personnel, and permitting access to information and data relating to technical, cost, and schedule matters concerning this contract to the same degree such access is accorded to Government personnel. E. HHSAR 352.270-10 - ANTI -LOBBYING (JANUARY 2006) Pursuant to the current HHS annual appropriations act, except for normal and recognized executive -legislative relationships, the Contractor shall not use any HHS contract funds for (i) publicity or propaganda purposes; (ii) the preparation, distribution, or use of any kit, pamphlet, booklet, publication, radio, television or video presentation designed to support or defeat legislation pending before the Congress or any State legislature, except in presentation to the Congress or any State legislature itself; or (iii) payment of salary or Page 16 of 20 Attachment A-2 expenses of the Contractor, or any agent acting for the Contractor, related to any activity designed to influence legislation or appropriations pending before the Congress or any State legislature (see Attachment A -2-C). Page 17 of 20 Attachment A-2 XI. CONTRACT CLAUSES A. FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): FAR — http://www.acquisition.gov/far and HHSAR - http://www.hhs.govioampipoliciesthssar.doc. 1. FAR Clause No. Title and Date 52.246-5 Inspection of Services - Cost Reimbursement (APR 1984) 52.242.15 Stop Work Order (AUG 1989) 2. Federal Acquisition Regulation (FAR) (48 CFR Chapter 1) Clauses . z��: +c r--7-' ;' ''r...�.ri-:.� ra.� J ...., .}g aK,. w il J. l4J . C ups :.-•�..w• w .. R:_ .. tam•, 7,;tYtar' * , 3 • . it 6 I. ,. r•4uRi r 5` i'. X# FAR 52.202-1 Jul -04 Definitions FAR 52.203-3 Apr -84 Gratuities FAR 52.203-5 Apr -84 Covenant Against Contingent Fees FAR 52.203-6 Sep -06 Restrictions on Subcontractor Sales to the Government FAR 52.203-7 OCT 2010 Anti -Kickback Procedures FAR 52.203-8 Jan -97 Cancellation, Rescission, and Recovery of Funds for Illegal or Improper Activity FAR 52.203-10 Jan -97 Price or Fee Adjustment for Illegal or Improper Activity FAR 52.203-12 Oct -10 Limitation on Payments to Influence Certain Federal Transactions FAR 52.203-13 Apr -10 Contractor Code of Business Ethics and Conduct FAR 52.203-14 Dec -07 Display Hotline Poster(s) FAR 52.204-4 Aug -00 Printed or Copied Double -Sided on Recycled Paper FAR 52.204-7 Apr -08 Central Contractor Registration FAR 52.209-6 Sep -06 Protecting the Governments Interests When Subcontracting With Contractors Debarred, Suspended, or Proposed for Debarment FAR 52.215-2 Oct -10 Audit and Records — Negotiation Page 18 of 20 Attachment A-? FAR 52.215-8 Oct -97 Order of Precedence - Uniform Contract Format FAR 52.215-10 Oct -10 Price Reduction for Defective Cost or Pricing Data (Over $650,000) FAR 52.21-l5 Oct -10 Pension Adjustments and Asset Reversions FAR 52.215-18 Jul -05 Reversion or Adjustment of Plans for Post -Retirement Benefits (PRB) other than Pensions FAR 52.215-19 Oct -97 Notification of Ownership Changes FAR 52.215-20 Oct -10 Requirements for Cost or Pricing Data or Information Other Than Cost or Pricing Data FAR 52.215-21 Oct -10 Requirements for Cost or Pricing Data or Information Other Than Cost or Pricing Data - Modifications FAR 52.216-5 Oct -97 Price Redetermination - Prospective FAR 52.216-7 Dec -02 Allowable Cost and Payment modify paragraph (a) The words 31.2 and substitute 31.6 FAR 52.216-11 Apr -84 Cost Contract -No Fee FAR 52.219-8 May -04 Utilization of Small Business Concerns FAR 52.222-3 Jun -03 Convict Labor FAR 52.222-26 Mar -07 Equal Opportunity FAR 52.222-35 Sep -10 Equal Opportunity for Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans FAR 52.222-36 Oct -10 Affirmative Action for Workers with Disabilities FAR. 52.222-37 Sep -10 Employment Reports on Special Disabled Veterans, Veterans of the Vietnam Era, and Other Eligible Veterans FAR 52.222-50 Feb -09 Combating Trafficking in Persons FAR 52.222-54 Jan -09 Employment Eligibility Verification FAR 52.223-6 May -01 Drub Free Workplace FAR 52.223-14 Aug -03 Toxic Chemical Release Reporting FAR 52.225-1 Feb -09 Buy American Act - Supplies FAR 52.225-13 Jun -08 Restrictions on Certain Foreign Purchases FAR 52.227-1 Dec -07 Authorization and Consent FAR 52.227-2 Dec -07 Notice and Assistance Regarding Patent and Copyright Infringement FAR 52.229-3 Apr -03 Federal, State and Local Taxes FAR 52.232-1 Apr -84 Payments FAR 52.232-8 Feb -02 Discounts for Prompt Payment FAR 52.232-9 Apr -84 Limitation on Withholding of Payments Page 19 of 20 Attachment A-2 FAR 52.232-11 Apr -84 Extras FAR 52.232-17 Oct -10 Interest FAR 52.232-20 Apr -84 Limitation of Cost FAR 52.232-23 Jan -86 Assignment of Claims FAR 52.232-25 Oct -08 Prompt Payment FAR 52.232-33 Oct -03 Payment by Electronic Funds Transfer --Central Contractor Registration FAR 52.233-1 Jul -02 Disputes FAR 52.233-3 Aug -96 Protest After Award FAR 52.2334 Oct -04 Applicable Law for Breach of Contract Claim FAR 52.242-1 Apr -84 . Notice of Intent to Disallow Costs FAR 52.243-2 Aug -87 Changes — Cost Reimbursement Alternate II (Apr 1984) FAR 52.245-1 Jun -07 Government Property FAR 52.246-25 Feb -97 Limitation of Liability - Services FAR 52.249-4 Apr -84 Termination for Convenience of the Government (Services) (Short Form) FAR 52.253-1 Jan -91 Computer Generated Forms 3. Department of Health and Human Services Acquisition Regulation (HHSAR) (48 CFR Chapter 3) Contract Clauses HHSAR 352.201-70 Jan -06 Paperwork Reduction Act HHSAR 352.202-1 Jan -06 Definitions HHSAR 352.203-70 Jan -06 Anti -Lobbying HHSAR 352.216-70 Jan -06 Additional Cost Principles HHSAR 352.222.70 Jan -10 Contractor Cooperation in Equal Employment HHSAR 352.233-71 Jan -06 Litigation and Claims HHSAR 352.239-72 Jan -10 Security Requirements for Federal Information and Technology Accessibility HHSAR 352.242-73 Jan -06 Withholding of Contract Payments HHSAR 352.242-74 Apr -84 Final Decisions on Audit Findings Page 20 of 20 Attachment A -2-A Material List (Revised 12/9/10) Provided by FDA to the State Contractor Providediii FDA to State - Contractor via the T1MS Provided by Contractor (Local Health ,Agency) Equipment/Supplics: Forms/Tools: Equipment/Supplies: • iPhones (built-in camera) o 2 levels of passwords • Undercover buy compliance check • Digital cameras (including memory cards and batteries for cameras) o Battery pack inspection form • Computers (including keyboard and o Wall charger • Advertising and labeling mouse if applicable) o Car charger compliance check Printers/fax/scanner (including ink o Stylus (upon request) inspection form cartridges) o iPhone case • TIMS Web Application • Regulatory notebooks (bound) • Commissioning Credentials Quick Guide • Ballpoint pens for inspectors and Program • TIMS Mobile (iPhone) • Permanent marker pens Coordinators (sent by Application Quick Guide • Resealable plastic bags FDA/DFSR to Program CD -Rs for the official CD copy (for Coordinator to hold until manual, digital camera process) appropriate time to disseminate) • Commissioning Certificates "other" • CD-RWs or CD -Rs for working CD copy (for manual, digital camera process) • Envelopes for CDs for personnel (sent by Boxes and/or large envelopes for FDA/DFSR to Program Coordinator to hold until inspection packages appropriate time to • Secure storage for records and inspection disseminate) packages • Clear packing tape Forms/Tools: Forms/Tools*: • Form FDA -415A (FDA • Proof of insurance for minors against Official Seal) accidents or other injuries • Form FDA -482 (Notice of Inspection) carbon copies • Parental consent forms for minors • Contractor Programs High- Permission slips from the school for the Level Workflow minors (if applicable) • Grant of immunity from proper • iPhone return form authorities for minors, if applicable • Narrative Report Templates • Sample Quarterly Report Form • Employee records for all employees, including identification verification • FDA State Contract Invoice records form (Recommended form to Training record/log for all employees submit invoice info) Training completion certificate for • Invoice Request Instructions "other" personnel, minors, and, if for FDA Cost Reimbursement applicable, adult supervisors/chaperones Type Contracts (document • Time and attendance records for all providing guidance for employees submitting invoices) • Inspection log or other activity tracking tool Training Materials: • Time tracking tool for minors and, if • Training manual and other applicable, adult supervisors/chaperones resource materials during inspections for reimbursement • Exam purposes • Overnight mail service that includes tracking • Evidence/Chain-of-Custody Log while in Page 1 of 2 Attachment A -2-A Pro idedby FIM to the State Contractor : .., . P>ovid''d by I -DA to state" Contractor s a the,TIM S ' Dtabasc Provided by.Contractor(Local Health Agency) storage with the Contractor The non-exclusive list of the prohib'ted items is as follows: • Recording equipment (e.g., electronic surveillance or wiretapping) • Guns or ammunition • Purchase of vehicles. Contractors may lease vehicles or personnel may be reimbursed for mileage used on POVs.. * All documents are to be maintained by Contractor and made available to FDA upon request. Page 2 of 2 Attachment A -2-B DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service FOOO AND DRUG ADMINISTRATION CONTRACTOR'S COMMITMENT TO PROTECT NON-PUBLIC INFORMATION (NPI) AGREEMENT Whereas access to non-public information (NPI) from the files of the Food and Drug Administration (FDA) is required in the performance of my official duties, under Contract Number and between FDA and my employer I, , hereby agree that I shall not further release, publish or disclose such information and I shall protect such information entrusted to me in accordance with the provisions of 21 U.S.C. § 3310),21 U.S.C. § 3600), 18 U.S.C, § 1905, as well as other applicable statutory and regulatory provisions. Further, I agree to: 1 Store NPI in the secured offices of the FDA or in FDA approved contractor facility containers if work is performed off an FDA site. 2. Grant access to NPI only to known employees of the FDA or to other persons designated in writing by the FDA. 3. Return all NPI and any pertinent notes to the FDA Project Officer I am assigned to upon completion of the contract, or at any time upon the FDA's request. 4. Report in writing to the FDA Project Officer I am assigned to, all incidents in which unauthorized persons may have gained access to any NPI entrusted to me. I understand the provisions of 21 U.S,C. § 331(j), 21 U.S.C. § 3600), 18 U.S.C. § 1905 and that I am subject to criminal penalties prescribed by law for any violation thereof. Signature: Date: Type or Print Name: Witnessed by: Date: Type or Print Name: Page 1 of 1 Attachment A -2-C Disclosure of Lobbying Activities DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post -award For Material Change Only: d. loan year quarter e. loan guarantee date of last report f. loan insurance 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: Tier , if known: Congressional District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable: 8. Federal Action Number, if known: 9. Award Amount, if known: $ 10. a. Name and Address of Lobbying Registrant b. Individuals Performing Services (including address if (if individual, last name, first name, MI): different from No. 10a) (last name, first name, MI): 11. Signature: Print Name: Title: Telephone No.: Authorized for Local Reproduction Standard Form LLL (Rev. T97) Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant 10 31 U.S.C. 1352. This information will be available for public inspection. required disclosure shall be subject to a not more than $100,000 for each such failure. Prime Subawardee Federal Use Only: Date: who fails to file the Any person $10,000 and than civil penalty of not less Page 1 of 2 Attachment A -2-C INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreementto make paymenttoanylobbyingentityforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,aMemberof Congress,anofficer oremployeeof Congress, oranem ployeeofa Mem berofC ongress i nconnectionwithacove redFederalaction. Com pleteallitemsthatapplyforboththeinitialfili ng andmaterial change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identify the status of the covered Federal action. ' Identify the appropriateclassification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enterthefullname,address,city,Stateandzipcodeofthereportingentity.l ncludeCongressionalDistrict,ifknown.Checktheappropriateclassif ication ofthereportingentitythatdesignatesif itis, orexpectstobe,aprimeorsubawardrecipient.ldentifythetierof thesubawardee,e.g.,thefirst subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks "Subawardee," then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal agency making the award or loan commitment. include at least one organizationallevel below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. s Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (REP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g.. "RFP-DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI). 11. The certifying official shall sign and date the form, print his/her name, title, and telephone number. According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington. DC 20503. Page 2 of 2 EXHIBIT B N GO Vl a R 3Y FL O OC.,i I 4 e o cn W r L U d ns are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. Project Description: R O e d Lx. C O m . O C T. O. T. C y C J v C J C O L Cc 0 O Cc 0 F^ cC 0 > - 0 0.1 O - O9 C G v O i E T Q E w .E N y c o L O o C C O N > w O O y O p n W W 11. Performance Requirements/Deliverables: M 1 8 E d M N 0 E su.o a RR M E co G 1 L 9 y E_� t C U v C C O U N c_ m 0 O O w cc E O O 4 c ct L_ m U m C a O E o U 4� 0.i Q O 0O L d U O N CO " ct F C R R 11) o U 0 v 0. O' 1 N 'c V) T O U al N U. L E- 0 0 a O O C O O 2 O U O n uTo) E — a] s. V] ti d 7 O C ≥ o O N M S O o aaaaaa ©< Primary Task 1.0 Beginning September 30, 2013 and as needed throughout the contract term, allinspectors and direct superve cninf inspectors mast maintain commissioning anti participate in training as requiredby the Food°and Drug administration (FDA) and The Colorado Department of Public Health and Environment (CI)PHE), Commissioning and training must be completed ; prior to initiating inspections. Person/ Agency Responsible Weld County Dept of Public Health and Environment (WCDPHE) Qtr. of Completion V a Key Deliverable Deadlines • Staff hired • commissioning process complete Quarters of activity St R 1.1. a. As needed, hire staff responsible for conducting compliance checks 1.1. b. Provide information to CDPHE to initiate and complete the commissioning process EXHIBIT B WCDPHE Primary Task 2.0 Beginning September 30, 2013 and ongoing throughout the contract term, maintain an evidence storage area in facility in alignment with FDA. and CDPIIE guidance and policy Person Responsible WCDPHE Commissioned Officer 2.2 FDA Commissioned Officer will maintain the QI-4 I Security of evidence maintained. Q 1-4 WCDPHE security of the storage area and keys. I i Commissioned Officer Primary Tad't.1xi Beginning September 30, 2013 and ongoing throughout **contract term, recruit and train minors to conduct inspections for age and identification restrictions in alignment with policies and procedures set by CDPHE and FDA: Minors must be 16 or 17 years old Person Responsible CDPHE staff will provide training, WCDPHE Commissioned Officer will attend WCDPHE Commissioned Officer '_!Primary Task 4.0 Beginning September 30, 2013 and ongoing throughout the contract term, conduct tobacco retail compliance checks based on assignments made by CD and. FDA, Person Responsible WCDPHE Commissioned Officer WCDPHE 1 q O' Qtr. of Completion q a Qtr. of Completion -t d yr a Qtr. of Completion 1- a Cl • FDA training scheduled • Documentation of final exam score Key Deliverable Deadlines Evidence storage area identified and established. Key Deliverable Deadlines 1 Training completed. Minors hired and properly trained. Required paperwork submitted to CDPHE. Key Deliverable Deadlines Acknowledgement of assignment receipt is documented. Inspections conducted in organized, 1 Cl Quarters of activity I Cl Quarters of activity I Cl a Quarters of activity II a I s 1.2.a When new staffs join the program, coordinate with CDPHE to schedule and participate in FDA training. 1.2.b Pass final training exam with a score of at least 80%. x Zi .6 ci) 2.1 Establish a secure evidence storage area consisting of a locked cabinet in a secure area for the purpose of storing evidentiary items. s so d Cl) 3.1 Receive training and guidance from CDPHE on protocols and procedures for working with and training minors. 3.2 Follow protocols to hire and train and maintain minors. Sub Task 4.1 Acknowledge receipt of assignments within 48 hours. 4.2 Prepare for inspections: Gather materials, arrange O O EXHIBIT B I Q1-4 WCDPHE Commissioned Officer, CDPHE will provide assignments. Q1-4 WCDPHE Commissioned Officer Q1-4 WCDPHE Commissioned Officer as directed by CDPHE Primary Task 5.0 Beginning September 30, 2013 and agoing throughout the contract term; complete reporting, documentation and evidence handling procedures and protacOl"s. . Person Responsible WCDPHE Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer Primary Task 6.0 ... Beginning September 30, 2013 and ongoing throughout the contract term, mainta1n communication with CDPHE.. :. Person Responsible WCDP1 IE Commissioned Officer Documentation of participation in Q I -4 WCDPHE - Qtr. of Completion I a I a 7 a 7 a I a I Sub Task Quarters of Key Deliverable Deadlines Qtr. of activity - Completion Participation documented Q 1-4 efficient manner. Q1-4 Assignments completed as directed in region. Q1-4 Conduct both a UB and A&L inspection in establishments with violations. Q1-4 Complaint follow-up inspections as directed. Key Deliverable Deadlines After each inspection: Results submitted within 48 hours. Reporting completed. Corrections submitted within 72 hours. Evidence handled and paperwork submitted according to protocols. Reports and invoices submitted accurately and on time. Quarters of activity a q a a 7 a q a 6.1 Participate in monthly conference calls with Q1-4 CDPHE. 6.2 Participate in annual site visits with CDPHE. I Q1-4 schedule with minor (if applicable), determine most efficient travel route, 4.3 Complete routine Undercover Buy (UB) and Advertising and Labeling (A&L) assignments as directed by CDPHE and the FDA training manual. 4.4 As directed by CDPHE and FDA, conduct compliance follow up inspections in establishments with violations in region. As feasible, conduct inspections outside of regions if asked by CDPHE and FDA. 4.5 As directed by CDPHE and FDA, conduct complaint follow up inspections when citizens have called to indicate a potential violation in a retail establishment. Sub Task 5.1 Document inspection results and submit to CDPHE within 48 hours of each inspection. 5.2 Complete all FDA/CDPHE required reporting and documentation following each inspection. 5.3 Respond to all requests for corrections to documentation within 72 hours. 5.4 Follow all procedures and policies for handling and storing evidence and submitting physical and electronic paperwork and evidence. 5.6 Submit monthly invoices and quarterly reports as directed by CDPHE EXHIBIT B Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer WCDPHE Commissioned Officer, Supervisor, and Cha erones q a 9' a a a 0' site visits. Participation documented Quarterly: Documentation of participation Annually: Participation documented Annually: Update and submit NPI form v a -- a 7 a a oa 01 6.3 Participate in annual webinar training with FDA 6.4 Participate in webinar training with FDA 6.5 Participate in annual on -site training with CDPHE 6.6 Submit Non -Public Information (NPI) form Annually A. Progress Reports: O m O U L U p U a O C C o a O 0 U ▪ R T 6 C 2 Lc. O U G 0 O o 6 u L. • PO O • 6 O O p U U O C _ U O E0a L F U E o o 'E Y v a a r o ' o • O O • y U ≥a o O E o N 4 > C p .0 - ▪ N CJ N E E R U a o a L W 3 c O > O O 3 y U - > _O 4, - o Lt. .UG 3 W a = 0 U t U t „..▪ •14 E o v 3 c -0 .o U C O a C s E -o o e pC C GC O CU 0 U G O ` U c OU a O F F U U .O t - t 0o m Wo UP c 0 • a a. E e m z o_ O o C mW o c o t' bi E ._ U Y • N ^ E o G c.o -.o C U C . Resolution of Non -Compliance: — -o = v a) L O to V .= y0 a a ✓ 3 as C = = -c>.-, c a v y u C T C y o a X O a j � N U P WE_NF nn NaII: yO"UO 6. Q Na) L N Na o p Enrol: D N C9 T i • NC .O ,O aGNF y00U U ��0�L_ a • GO cG O F y f 3 't�1C U 01 —0 O.° N d = p C p' F O y T 3 U„Lel a) C sO. v • C a - U aai c. c4.. v a 2 p c ,.. F c c a. o C O C: E c F F a F O U w U.. Co CS C O O o a ' E o E U p T R .UC E a 'j' O Li ,C a o 3 O U Ccla - 0i rUii O C 0 to a CF I a c• o F'- p o e.;�UE m a 0 c 2 c4 -.g a O O O a N =_ a • U 4+ .E U to 0 c as O u b), 2 F o '7. c E La a O. - O 0N0 = o O o O. U Mcc. C M • t° o 3 oC 3 3 • O 0 c c p V) . C Gq `�' C N m O F p 3 v -- X W r. "j i-C F C U N O n F U F g n c a o a a F _u v E Fl O - -o - a • -c c 4 E v o + m 3 `o v ✓ m a m c m v fF -=F n � oL v v 2 (2 p o 3 .0 1J - U c s Ea m v .o o 'a > O F c F U 0. --. run C C R 6 F Z d o • F v v a U ≥ ≥ v O C .9 p U O 5 E-- U a)"u 200 2C ATTACHMENT B-1 FDA REGIONAL MAP FY14/15 jjj Cu«y i j San Aigua) ."i'jfll�i' e ire ...,_,--.....,/ z ear;es sew I eam 1 m uPdrsuzu• I i Puatia 7, ri t ' O431c ��.--"-•• _I..: F62 Gram's. i Atan-Fa5a! i r,,' 44 _ -1_,,...../ j,,_.-. krditica t REGION AGENCY 1 Mesa County Health Department 2 Weld County Department of Public Health and Environment 3 Jefferson County Public Health 4 City and County of Denver/Denver Environmental Health 5 Pueblo City -County Health Department Page loft EXHIBIT C oWkk X8;8 Colorado Department of Public Health and Environment Colorado Department of Public Health and Environment PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM To Task Order Contract Dated 07/17/2013 - Contract Routing Number 14 FLA 58226 Contractor Name Weld County Dept of Public Health and Environment Budget Period September 30, 2013 to September 29, 2014 Project Name FDA Tobacco Retail Inspections Program Contact Name, Title, Phone and Email Eric Aakko; Division Director, Health Communication and Education 970.304.6470 x 2380 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Administrative Services Director 970-304-6410 x 2122 Expenditure Categories Match or In- Kind (If Applicable) Total Amount Requested from CDPHE Personal Services Gross Salary or Hourly Wage Fringe Percent of FTE or # of Hours Position Title/Employee Name Description of Work Health Communication Specialist II (Inspector)/Cassie Kauffman The Inspector will be responsible for conducting approximately 300 retail site inspections for compliance with provisions of the Family Smoking Prevention and Tobacco Control Act (including follow-up and citizen complaint inspections); recruitment, training, and supervision of minors; evidence collection and documentation; reporting; and following all FDA and CDPHE protocols and procedures. This inspector will also be the coordinator for the program and will be the main contact for the state. $58,517.94 $ 22,781 50.00% $40,649 Health Educator (Inspector)/Adriana Chairez The Inspector will be responsible for conducting approximately 300 retail site inspections for compliance with provisions of the Family Smoking Prevention and Tobacco Control Act (including follow-up and citizen complaint inspections); recruitment, training, and supervision of minors; evidence collection and documentation; reporting; and following all FDA and CDPHE protocols and procedures. Inspections for the region will be approx. 600 in total. $40,214.34 $15,655.44 50.00% $27,935 Minors/Assistants Minors will assist the inspector during undercover buy inspections to determine retailer compliance with the age and identification provisions of the regulations by attempting to purchase tobacco as underaged persons. It is anticipated that minors will be needed for 50% or 300 total inspections needed for this region at approximately 1 hour per inspection. As nearly 60% of the buys will occur outside of the agency's home county, travel time for minors from Weld County is requested at an additional 360 hours (2 hours per trip x 180 trips = 360 hours). 360+ 300= 660 hours and also includes training. The hourly rate takes into the account the need to insure the minors. The minor's rate is based on the amount of travel, and high level of responsibility of this position. This rate is competitive with other youth -oriented positions in this geographic area. A core team of at least six (6) minors will be trained for inspections. $12.00 660 $7,920 Page 1 of 3 EXHIBIT C l Bti�b Colorado Department of Public Hedth and Environment Colorado Department of Public Health and Environment PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM To Task Order Contract Dated 07/17/2013 - Contract Routing Number 14 FLA 58226 Contractor Name Weld County Dept of Public Health and Environment Budget Period September 30, 2013 to September 29, 2014 Project Name FDA Tobacco Retail Inspections Program Contact Name, Title, Phone and Email Eric Aakko; Division Director, Health Communication and Education 970.304.6470 x 2380 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Administrative Services Director 970-304-6410 x 2122 Total Personal Services (including fringe benefits) $0 $76,504 Supplies & Operating Expenses Item Description of Item Rate Quantity Match or In kind (if applicable) Total Amount Requested from CDPHE Evidence Handling/ Postage Evidence costs include materials such as plastic storage bags, boxes, packing tape, and shipping packages to CDPHE. Cost is based on data from previous year. $33.34 12 $400 Tobacco Purchase Minors attempting to purchase tobacco during inspections. Calculated at $6 per pack of cigarettes per inspection and a violation rate of 15% (300 inspections x 15% = 45) $6.00 45 $270 Other Supplies Office supplies: pens, paper, printing training material, etc.. $40.00 1 $40 Total Supplies & Operating Expenses $o $710 Travel Item Description of Item Rate Quantity Match or In kind OF applicable) Total Amount Requested from CDPHE Mileage 2 staff X 592.3 miles (1184.6 miles total) per month X 12 months = 14215.2 miles. Mileage is estimated at the current county rate of .545/mile. 0.545 14,215 $7,747 Meal Per Diem Meals are based on average of actual costs and based on historical data. Average meal is $10 X 10 meals per month = $100 X 12 months. $10 120 $1,200 Rental Car Car rental (compact) and fuel at $85/day X 8 days = $680. The rental car is requested by an inspector for doing inspections during the winter months in mountain areas (e.g. Estes Park and Red Feather Lakes region). $85 8 $680 Total Travel $0 $9,627 Contractual (payments to third parties or entities) Item Subcontractor Entity Name and/or Description of Item. Rate Quantity Match or in kind (if applicable) Total Amount Requested from CDPHE Total Contractual $0 $0 SUB -TOTAL BEFORE INDIRECT $86,842 Indirect Page 2 of 3 EXHIBIT C Colorado Department of Public Health and Environment PREVENTION SERVICES DIVISION- BUDGET WITH JUSTIFICATION FORM To Task Order Contract Dated 07/17/2013 - Contract Routing Number 14 FLA 58226 Colorado Department of Public Health and Environment Contractor Name Weld County Dept of Public Health and Environment Budget Period September 30, 2013 to September 29, 2014 Project Name FDA Tobacco Retail Inspections Program Contact Name, Title, Phone and Email Eric Aakko; Division Director, Health Communication and Education 970.304.6470 x 2380 Fiscal Contact Name, Title, Phone and Email Tanya Geiser, Administrative Services Director 970-304-6410 x 2122 Item Description of Item (description is not necessary for the negotiated rate agreement) Match or In kind (if applicable) Total Amount Requested from COPHE Negotiated Indirect cost rate WCDPHE 2013-2014 indirect rate of 15.65% of direct costs. $13,591 Total Indirect $0 $13,591 TOTAL MATCH OR IN KIND $0 TOTAL $100,432 I I I I I L Page 3 of 3 EXHIBIT D OPTION LETTER Date: I State Fiscal Year: I Option Letter No. I CMS Routing # 1) OPTIONS: Choose all applicable options listed in §1 and in §2 and delete the rest. a. Option to renew only (for an additional term) b. Change in the amount of goods within current term c. Change in amount of goods in conjunction with renewal for additional term d. Level of service change within current term e. Level of service change in conjunction with renewal for additional term f. Option to initiate next phase of a contract 2) REQUIRED PROVISIONS. All Option Letters shall contain the appropriate provisions set forth below: a. For use with Options 1(a -e): In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Insert Name of Department or Higher Ed Institution , and Contractor's Name, the State hereby exercises its option for an additional term beginning Insert start date and ending on Insert ending date at a cost/price specified in Section , AND/OR an increase/decrease in the amount of goods/services at the same rate(s) as specified in Identify the Section, Schedule, Attachment, Exhibit etc. b. For use with Option 1(f), please use the following: In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Insert Name of Department or Higher Ed Institution , and Contractor's Name, the State hereby exercises its option to initiate Phase indicate which Phase: 2, 3, 4, etc for the term beginning Insert start date and ending on Insert ending date at the cost/price specified in Section c. For use with all Options 1(a -f): The amount of the current Fiscal Year contract value is increased/decreased by $ amount of change to a new contract value of Insert New $ Amt to as consideration for services/goods ordered under the contract for the current fiscal year indicate Fiscal Year. The first sentence in Section is hereby modified accordingly. The total contract value including all previous amendments, option letters, etc. is Insert New $ Amt. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Public Health and Environment PROGRAM APPROVAL: By: By: Lisa McGovern, Purchasing & Contracts Unit Director Date: ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Date: Page 1 of 1 CDPHE-Weld County -Tobacco FDA -14 FLA 58226 -Notification STATE OF COLORADO Moritz - CDPHE, Heather <heather.moritz@state.co.us> To: Tanya Geiser <tgeiser@co.weld.co.us>, eaakko@co.weld.co.us Cc: Jennifer Trainer - CDPHE <jennifer.trainer@state.co.us>, Deborah Borek - CDPHE <deborah.borek@state.co.us> Dear Tanya, Mon, Sep 9, 2013 at 11:29 AM This email serves as notification of your FULLY EXECUTED Colorado Department of Public Health & Environment (CDPHE) Contract listed below: Contractor Name: Board of County Commissioners of Weld County for the use and benefit of the Weld County Department of Public Health and Environment Contract Number: 14 FLA 58226 Original Contract Number: n/a Division: Prevention Services Division/PSD Program Name: Tobacco FDA Project Name: FY 14-15 FDA Retail Inspections Reason for Contract: New Contract Please "Reply to Sender" acknowledging the receipt of this email. The Contract listed above has been fully executed and you may begin work on September 30, 2013. An original hard copy of the Contract will be mailed to you soon. Please contact me with questions or concerns. My contact information is listed below. Kind regards, Heather Moritz Contract Administrator Prevention Services Division Colorado Department of Public Health & Environment 4300 Cherry Creek Drive South Denver, CO 80246-153O Phone: (303) 692-6271 heather.moritz@state.co.us Hello