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HomeMy WebLinkAbout20121451.tiff RESOLUTION RE: APPROVE RESCINDING RESOLUTION 2012-1205, DATED MAY 14, 2012, AND APPROVE REVISED CONTRACT AMENDMENT #1 TO HEALTH DISPARITIES TASK ORDER 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, by Resolution #2012-1205, dated May 14, 2012, the Board approved Amendment #1 to Task Order Contract for the Cancer, Cardiovascular Disease, and Pulmonary Disease Prevention Competitive Grant, for the Weld County Cardiovascular Disease Prevention Program, from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Department of Public Health and Environment, Office of Health Disparities, and WHEREAS, after review, the Board deems it advisable to rescind Resolution#2012-1205, dated May 14, 2012, and WHEREAS, the Board has been presented with a revised Contract Amendment#1 to the Health Disparities Task Order, from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Department of Public Health and Environment, Office of Health Disparities, commencing July 1, 2012, and ending June 30, 2013,with further terms and conditions being as stated in said revised amendment, and WHEREAS, after review, the Board deems it advisable to approve said revised amendment, 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 Resolution #2012-1205, dated May 14, 2012, for Amendment#1 to Task Order Contract for the Cancer, Cardiovascular Disease, and Pulmonary Disease Prevention Competitive Grant, for the Weld County Cardiovascular Disease Prevention Program, from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Department of Public Health and Environment, Office of Health Disparities, be, and hereby is, rescinded. BE IT FURTHER RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the revised Contract Amendment#1 to the Health Disparities Task Order, from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Weld County Department of Public Health and Environment, to the Colorado Department of Public Health and Environment, Office of Health Disparities, be, and hereby is, approved. 3 oris-to-roi j Cc: ALL. -/c22--/a '7-//-/a 2012-1451 HL0039 RE: RESCIND RESOLUTION#2012-1205, DATED MAY 14, 2012,AND APPROVE REVISED CONTRACT AMENDMENT#1 TO HEALTH DISPARITIES TASK ORDER PAGE 2 BE IT FURTHER RESOLVED by the Board that the Chair be,and hereby is,authorized to sign said revised amendment. The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 11th day of June,A.D.,2012. BOARD OF COUNTY COMMISSIONERS WELD COUNTY,COLORADO ATTEST: ...00••••••2714.,,_--- Sean P Con Chair Weld County Clerk to the Board / illj,am F.Garcia,Pro- em A BY: • siA ' \' 4\' Deputy Cle to the Board Iasi i a Kirkmeyer APP D AS T • .. cd ll •\ a-vid .Long •'.untyA ey vrat Douglas)Rademac er Date of signature: 1-10"/ 2012-1451 HL0039 1 8 6 1 2 0 1 1 Memorandum TO: Sean P. Conway, Chair Board of County Commissioners WEL DEC O U N T 1 FROM: Mark E. Wallace, MD, MPH, Director Department of Public Health and Environment DATE: June 7, 2012 SUBJECT: Health Disparities Task Order Contract Enclosed for Board review and approval is the task order contract between the Colorado Department of Public Health and Environment's Office of Health Disparities and Weld County Department of Public Health and Environment for the"Love Your Life, Take Care of Your Heart" ( Ama Tu Vida, Cuida to Corazon) program for the prevention of cardiovascular disease (including diabetes and other precursors) among Hispanic and other minority populations in Weld County. This program expands on the Heart of Weld program (2008-2010) to address the issue of cardiovascular disease by targeting men, women and families who are among Weld County's low income, minority populations most affected by lack of insurance and access to health care. Strategies will include cardiovascular disease prevention and self management programs offered at sites already frequented by the target population, such as churches, community centers, food banks and other service agencies. We will also work with Sunrise Community Health Center, Salud Family Health Centers, other local health care providers and service agencies to recruit clients into the program. The task order includes funding for existing staff, a .5 FTE program coordinator, a .5 FTE bilingual health educator and operating expenses such as educational materials, office supplies, mileage, and travel expenses for state meetings. The total amount of the task order is $98,213.00 for the time period of July 1, 2012—June 30, 2013. I recommend approval of this task order contract with the Office of Health Disparities. UPDATE: The State Contract Administrator for this program, Kim Phi, notified us on June 6, 2012, that the State had to revise the task order because the master contract had expired. Therefore, the contract was updated with the new contract number and the formatting of the revised contract has changed. Otherwise, the terms and conditions of the original contract remain the same. 2012-1451 Esther Gesick From: Mark Wallace Sent: Monday,June 11,2012 7:31 AM To: Commissioners Cc: Monica Mika;Tanya Geiser;Esther Gesick Subject: Health Disparities Grant on agenda this morning Importance: High Commissioners, On May 14,2012 the Board approved a task order contract between the Colorado Department of Public Health and Environment's Office of Health Disparities and Weld County Department of Public Health and Environment for the"Love Your Life,Take Care of Your Heart"program for the prevention of cardiovascular disease(including diabetes and other precursors)among Hispanic and other minority populations in Weld County. On June 6,2012,the State Contract Administrator notified us that the State had to revise the task order because our master agreement had expired.With the new master agreement,the health disparities task order contract was updated with the new contract number and reformatted.Otherwise,the terms and conditions of the oriainal task order contract remain the same. I recommend the Board rescind Resolution#2012-1205,dated May 14,2012,and approve Revised Contract Amendment#1 for Health Disparities Task Order and authorize the Chair to sign. As a reminder,this grant program expands on the Heart of Weld program(2008-2010)to address the issue of cardiovascular disease by targeting men,women and families who are among Weld County's low income,minority populations most affected by lack of insurance and access to health care.Strategies will include cardiovascular disease prevention and self management programs offered at sites already frequented by the target population,such as churches,community centers,food banks and other service agencies. We will also work with Sunrise Community Health Center,Salud Family Health Centers,other local health care providers and service agencies to recruit clients into the program. The task order includes funding for existing staff,a.5 FTE program coordinator,a.5 FTE bilingual health educator and operating expenses such as educational materials,office supplies,mileage,and travel expenses for state meetings. The total amount of the task order is$98,213.00 for the time period of July 1,2012—June 30,2013. Thank you Mark E.Wallace,MD,MPH Director,Department of Public Health&Environment 1555 N.17th Avenue-Greeley,Colorado-80631 Tele:970.304.6410-Fax:970.304.6412 Web: htte://www.weldhealth.org 1 Donna Bechler From: Talya DeAngelis Sent: Thursday, June 07, 2012 9:28 AM To: Donna Bechler Subject: FW: FY13 Weld County Attachments: Task Order.pdf; Exhibit A-Additional Provisions.pdf; Exhibit B- Statement of Work.pdf; Exhibit C - Budget.pdf Hi Donna- Here is the email that the State sent us. The contract is the Health Disparities Contract-Amendment#1. The document number is 2012-1205. Is this okay to send down 3 original hard copies of the contracts to be placed on the agenda? If you need anything else, please let me know. Thanks Again! 7a1ya DeAngelis Office Technician III-Administrative Assistant Weld County Department of Public Health and Environment 1555 N. 17th Avenue Greeley, CO 80631 970-304-6410 ext 2102 I _ � A r I Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Tanya Geiser Sent: Wednesday, June 06, 2012 4:22 PM To: Talya DeAngelis Cc: Wendy Paris Subject: FW: FY13 Weld County Talya, what can we do about this? From: Phi, Kim N. [mailto:Kim.Phi@dphe.state.co.us] Sent: Wednesday, June 06, 2012 4:20 PM To: Cassandra Kauffman; Gaye Morrison; Tanya Geiser; Mark Wallace Subject: FY13 Weld County Weld County, Our contract's department had to re-do the task order because of an expired master contract. If you can get 3 signed originals by next Friday, June 15`h, that would be very helpful. I do apologize for the rush and if you can't meet that deadline, please let me know. 1 Thanks, Kim Phi Health Disparities Grant Program Contract Monitor Office of Health Disparities, Community Relations Division Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, CO 80246-1530 303-692-22751 kim.bhi@state.co.us • DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ROUTING NO.13 FAA 43648 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: CONTRACTOR: State of Colorado for the use&benefit of the Board of County Commissioners of Weld County Department of Public Health and (a political subdivision of the state of Colorado) Environment 915 10th Street Administration Greeley,Colorado 80632-0758 Office of Health Disparities for the use and benefit of the 4300 Cherry Creek Drive South Weld County Department of Public Health and Denver, Colorado 80246 Environment 1555 North 17th Avenue Greeley, Colorado 80631 TASK ORDER.WADE.DATE_: (:( NTRACTI)R ENTITY TYPE: 05/23/2012 Colorado Political Subdivision PO/SC ENCUMBRANCE NUMBER: PO FAA ADM13043648 TERM: ISII.I.ING STATEMENTS RECEIVED: This Task Order shall be effective upon Monthly approval by the State Controller,or designee, or on 07/01/2012,whichever is later. The STATUTORY AUTHORITY. Task Order shall end on 06/30/2013. Not Applicable PRICE STRUCTURE: CONTRACT PRICE NOT TO EXCEED: Cost Reimbursement $ 98,213.00 PROCUREMIE;NT.HETFIOD: FEDE:RAI.FINDING DOLLARS: $ Exempt STATE FUNDING DOI EARS: $ 98,213.00 BID/REP/LIST PRICE AGREEMENT NUMBER: M IAXINIUM1 AMOUNT AVAILABLE PER FISCAL.YEAR: Not Applicable FY 12: $ 98,213.00 FY XX: $ IA\r'sPE:CIFIE.D VENDOR sTATUTO FY XX: $ Not Applicable FY XX: $ FY XX: $ STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE: Deanna Butler Dr. Mark Wallace Department of Public Health and Environment Weld County Department of Public Health and Administration Environment Office of Health Disparities 1555 North 17'h Avenue 4300 Cherry Creek Drive South Greeley,CO 80631 Denver,CO 80246 SCOPE OF WORK: The project will implement a linguistic and culturally specific, multi-faceted, risk factor reduction program,within the Hispanic/Latino community. The interventions are targeted to reduce cardiovascular disease (CVD). Page 1 of 6 Rev 6/25/09 rimer /Ys/ FXHIanS, The following exhibits arc hereby incorporated: Exhibit A - Additional Provisions Exhibit B- Statement of Work Exhibit C- Budget 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 24-30-202(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 1, 2009 and the maximum amount payable to Contractor hereunder is$100,000 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, §24-103.5-10I 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: STATE OF COLORADO: Board of County Commissioners of Weld County John W.Hickenlooper, GOVERNOR For the use and benefit of the Weld County Department of Public Health and Environment ��//�� Legal Name of Contracting Entity /"t , n For Executive Director u V"w�� Al Department of Public Health and Environment Signature of Authorized Officer 1 1 2U1? Sean P. Conway Print Name of Authorized Officer Department Program Approval: Chair By 0.X � Print Title of Authorized Officer 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: David J.McDermott,CPA • Date G- %fir '/� Page 5 of 6 Rev 6/25/09 erica7 /Y.S/ This page left intentionally blank. Page 6 of 6 Rev 6/25/09 EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 05/23/2012 - Contract Routing Number 13 FAA 43648 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. 1. Health Insurance Portability and Accountability Act(HIPAA) Business Associate Determination. The State has determined that this contract does not constitute a Business Associate relationship under HIPAA. 2. To receive compensation under this Contract,the Contractor shall submit a signed Monthly CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website htgr//www.cdphe.state.co.us/Standardizedlnvoice/index.html CDPHE will provide technical assistance in accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted within thirty(30)calendar days of the end of the billing period for which services were rendered. All Counties, Local Public Health Agencies and select intergovernmental Contractors will undergo a financial risk assessment conducted by the CDPHE Financial Risk Management System. Until such assessment is completed and the Contractor has been notified of the results,the Contractor shall provide the supporting documentation with the completed invoice(see//3). This supporting documentation shall be submitted with the completed CDPHE Reimbursement Invoice Form and sent to your assigned contract monitor at: Office of Health Disparities Grant Program Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver,CO 80246-1530 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 thirty (30)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 thirty(30)calendar days from the effective expiration or termination date of this Task Order Contract. 3. To receive payment against this cost reimbursement contract,proof of expenditure is required. The following forms of documentation for each category must be submitted with the cost reimbursement statement: A. Personnel Expenses: "Personnel"are staff employed by the grantee organization. If not, staff should be included under the Subcontracts/Contracts category. • Timesheet documentation, listing the employees name,title, days and times worked,and amount of time charged to the HDGP. or • A copy of a general ledger that provides timeframe, personnel,and amount charged to the HDGP. B.Travel: • A signed mileage reimbursement form must be completed which includes name of traveler,number of miles traveled,mileage rate,amount,and origin/destination. • Mileage will be reimbursed at the state's current approved mileage rate of.50 per mile. To be attached to CDPHE Page 1 of 3 Revised: 12/19/06 Task Order v1.0(11/05)contract template EXHIBIT A • Travel expenses may include mileage, lodging and meals for overnight out-of-town stays. Meals for staff may not be charged to this grant program for in-town meetings or travel within one day. C. Contracts/Subcontracts: • Copy of invoice to grantee on contractor or subcontractor's letterhead addressed to the grantee or a copy of check from grantee to contractor/subcontractor. • Copy of proof of payment to contractor/subcontractor • Invoices must include: subcontractor name, address, telephone number, dates worked, description of work, location(s) work performed, hourly rate, total hours work and total amount billed). • Subcontractors should report their mileage(if any)on a signed travel form with the information listed in the previous section. D. Operating,Supplies, Equipment: • Detailed copy of receipt for all purchases(not just credit card summary) from vendor to grantee,including food item purchases. E. Indirect: • No backup is required,but the indirect rate must coincide with the approved budget up to a maximum 20%of the total cost of Personnel,Operating/Supplies,Travel,and Contract/Subcontract totals submitted for the month. 4. Funding levels within the Budget, attached to this Task Order Contract,may be modified as follows: • Up to ten percent(10%)of funds originally set forth in each major budget category(e.g., Personal Services,Operating,Travel,Contractual,and Other Costs) may be transferred to other budget categories with prior approval by completing the budget revision form and attaching a revised budget narrative and obtaining approval from the Contract Monitor. • Fund transfers between line items within the same budget category are allowable and require a completed budget revision form and a revised budget narrative with the proposed changes highlighted. Submit the request to your Contract monitor for review and approval. • The deadline for budget revision requests is May 1'. 5. 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 thirty(30) calendar days,to correct the noted deficiencies. If the Contractor fails to correct such deficiencies To be attached to CDPHE Page 2 of 3 Revised: 12/19/06 Task Order v1.0(11/05)contract template EXHIBIT A within thirty(30)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. To be attached to CDPHE Page 3 of 3 Revised: 12/19/06 Task Order v1.0(11/05)contract template O E = O 101,-` N VO O N ' so d > T y T C'. 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Project: Reduce CVD within Hispanic/Latino community Agency/Organization: Weld County Department of Public Health&Environment Fiscal Year 12-13 (Year 2) Personnel Expenses (including salaries or wages and fringe benefits) $ 77,398.00 Operating/Itemized Supplies $ 2,000.00 In-State Travel Expenses $ 1,500.00 _ Contracts/Subcontracts $ 9,500.00 K i yyRt `• y. ,..' 'Y" '�-'• r t�t i ! ` 1*''�. F. �. Fr_� y.• £ y vr, iij k r ' , t, 444: _ K 'r gets ,.�.o-:�' ��o ,:d,?�, .. is,. Z r ;n : Indirect Costs* (Not to exceed 20%of Direct Costs listed above:Personnel, Operating,Travel,Contractual/ Subcontracts budget categories) $ 7,815.00 • Total Project Cost $ 98,213.00 To be attached to CDPHE Page 1 of 2 Revised: 12/19/06 Task Order v1.0(11/05)contract template EXHIBIT C 48.1NE ITElClii E. .r ti ARRATINE,.;3: :aA"illi .; giW•r '?-i. :'x 4 :.'4 % .iiS fti_ .':,s.:. a Personnel Expenses Total for Year 2=577,398 • .50 FM: Cassie will be responsible for managing the day-to-day activities of the program,including Cassie Kauffman,MA program implementation,staff supervision, overseeing contracts(w/sub-contractors), progress monitoring Program Coordinator and reports.She will also be responsible for program outreach and marketing,coordinating referrals with local providers and service organizations,overseeing promoter training,facilitating the steering group, securing locations for classes,and assisting with platicas and classes. Annual salary is$56,250 X.50(FTE)_$28,125 • Fringe calculated at 38.93%($28,125)=$10,949 $39,074 Total salary and fringe requested=$39,074 Ofelia Orozco,MA .50 FIT: Ofelia will be the lead educator for the platicas and lifestyle intervention classes. She will also Health Educator help lead the support group and oversee the promotores. Annual salary is$55,170 X.50(FM)=$27,585 • $38,324 Fringe calculated at 38.93%($27,585)=$10,739 Total salary and fringe requested=$38,324 Operating/Supplies Total for Year 2=$2,000 Office Supplies An annual budget for office supplies needed to implement the program is estimated at$500 for the year. Example of supplies needed include printer toner,paper,pens/pencils,file folders,etc. Actual expenses $500 will be charged to the grant as incurred. Punting Miscellaneous copying for the program is budgeted at approximately 500 copies per month at.10 cents/copy. Items to be copied included class handouts,program flyers,and other outreach materials. 500(copies)X.10(cents)X 12 months=$600 $600 Platica Host Stipends If e Plating is held in someone's home,we would like to be able to provide a$25 dollar gift card to off-set • any expenses they may incur as the host. As the host, most will want to provide refreshments for their quests. We do not want them to have to cover this expense out-of-pocket. $900 3 platicas per month @$25 per Platica X 12 months=$900 • • In-State Travel Total for Year 2= $1,500 Mileage reimbursement Actual mileage will be charged to the grant as incurred. Mileage will be used by program staff and promotores for travel related to the program including travel to and from sites where platicas and educational classes. An annual budget for mileage has been set at$1,500(estimated 250 miles per $1,500 month for all staff at.50 cents/mile X 12 months=$1,500). Contracts/Subcontracts Total for Year 2= $9,500 Promoter Training In the event that all three promotores from year one are not retained,we are budgeting tor the training of at least two additional promotores in year two. Either a subcontractor will be hired or a training program $1000 will be found for the training. It is estimated that the training will cost$1000. Promotores Promotores will be contracted to provide community presentations(platicas),assist with community outreach,implement physical activity opportunities in their communities,and provide backup for the lifestyle intervention classes. $8,100 3 promotores X 180 hrs./year X$15/hr.=$8,100 Contract Nurse Practitioner or We will contract with a either a Nurse Practitioner or ODE to teach 4 diabetes sell-management classes Certified Diabetes Educator(CDE) during the grant year. Each class will be for 1 hr.with 1 hr.of prep time per class. $400 2 hrs.X 4 classes X$50/hr.=$400 Indirect Costs Total for Year 2=$7,815 • Total of Personnel+Operating+Travel+Subcontractors=$90,398 $7,815 $90,398 X.087=$7,815 Total Program Cost (Year 2) $98,213 • To be attached to CDPHE Page 2 of 2 Revised: 12/19/06 Task Order v1.0(11/05)contract template 1 6 6 1 2 0 1 1 Memorandum TO: Office of Clerk to the Board to the Weld County Commissioners W E L DEC C U N T Y FROM: Administration Division-Department of Public Health and Environment DATE: 3-1J n 1% Lo, 9.0) ?. SUBJECT: RNIiN Disioae1ties Colt-0cr Attached to this memo is the finalized contract that the Health Department has received. Please sign and date below indicating you have received the finalized contract and return this signed memo to the Administration Division of the Health Department. Please send the confirmation receipt to my attention. Thank you for your assistance with the processing of this document. ATTN: LI Contract Name: [4(31 174 D1Spavitie5 TOSX Of-dtic Con iract Resolution Number: C901@ 14'15i Finalized Contract Received By: I(31,11- Lam. ISYI C1- Date Received: Art-6 a x e1 D I A m c Trn rn - o rn--t Enclosure Po� J Hello