HomeMy WebLinkAbout20120077.tiff STATE OF COLORADO
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Colorado Department of Human Services
people who help people
OFFICE OF LONG TERM CARE John W.Hlotenlooper
Joacelyn Gay,Office Director Governor
DIVISION OF AGING AND ADULT SERVICES Reggie Bichs
1676 Sherman Street,10e Floor Executive Director
Denver,Colorado 00203-1714
Phone:303-866-2800
TDD 303486.2660
FAX 303.868-2696
vim"colorado.00v/cdh8
Dan Daly,Director
January 4, 2012
Region 2-B
Judy A. Griego, Director
Weld County Department of Human Services
Weld County Area Agency on Aging
315 B North 11th Ave., PO Box A
Greeley, CO 80632
Dear Ms. Griego:
Enclosed is your original executed Option Letter between Colorado Department of Human Services
(CDHS), Division of Aging and Adult Services, and the Weld County, Colorado, Weld County
Department of Human Services, Weld County Area Agency on Aging. This option letter increases the
contract value to include Federal Carryover funds for contract number 12 IHA 30636 from July 1,
2011 through June 30, 2012. Weld County, Colorado, Weld County Department of Human Services,
Weld County Area Agency on Aging is not required to return or sign the Option Letter.
If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303-
866-2867 or email peggv.spauldinu@state.co.us or me at 303-866-2750 or email
todd.coffevaistate.co.us.
Sincerely,
j
Todd Coffey, Manager
State Unit on Aging
cc: Eva Jewell, AAA Director, Region 2-B
Peggy Spaulding, Contract Specialist
Dan Daly, Director, Aging and Adult Services
SUA Master File
`k 2012-0077
3 - 3 t ) t/,CoocPj
Our Mission lab Design and Deliver Duality Human Services that Improve the Safety and Independence of the People of Colors
OPTION LETTER
I Date: 12/6111 I State Fiscal Year: 2012 I Option Letter No. 1 I CMS Routing#12 IHA 38869
1) OPTIONS:
Change in the amount of goods within current term
2) REQUIRED PROVISIONS.
In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636
between the State of Colorado, Department of Human Services, Division of Aging and Adult
Services, and Weld County, Colorado,Weld County Department of Human Services,Weld County
Area Agency on Aging, the State hereby exercises its option for an increase in the amount of
goods/services at the same rate(s)as specified in Exhibit D.
The amount of the current Fiscal Year contract value is increased by$50,253 to a new contract
value of$1,197,391 as consideration for services/goods ordered under the contract for the current
fiscal year 2012. On Page 1, Contract price not to exceed is hereby modified accordingly.The total
contract value including all previous amendments, option letters, etc. is $ 1,197,391. The attached
Revised Exhibit F funding document shall apply to said increase.
3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or
December 15, 2011,whichever is later.
STATE OF COLORADO
John W. Hickeslooper,GOVERNOR
Department of Human Services
Reggie Bicha, Executive Director Lre
War I.YAAL:% 1_
By: Nikki Hatch, Deputy Exec a Director of Operations
Date: 121/IJ ( I
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
I/David J McDermott,
,CCPA
By: t�t�W� `om • f WWtep�
Mark NinkeNalri Gimple
Date: 12_- la- 11
Effective Date:118109-Rev 8125109
Reuksed ExAU F
2012 TITLE III FUNDING REQUEST
Region 28
Funding # 028-88
Revision # 1
Date 7/1/2011
Funding Request Period: from July 1 , 2010 through June 30, 2011
Add this FY Percentages for Admin
Distribution: B C1 C2 E Total
30.77% 37.80% 19.05% 12.38% 100.00%
ADMINISTRATION Potential Funding Transfer Re . nest Funding Request
CarryOver/Reallocated $ - $ -
ADMIN NEW ALLOC $ 69,089 $ •
- $ 69,089
TOTAL ADMIN $ 69,089 $ __.__ r. 69,089
SERVICES
CarryOver/Reallocated $ 24,047 $ 24,047
PART B NEW ALLOC $ 204,409 $ 57,276 $ 261 ,685
,, OTAL PART $ i k l';
CarryOver/Reallocated $ - $ -
PART C1 NEW ALLOC $ 251 ,330 $ 37,858 $ 289, 188
TOTAL PART C1 $ 241,338 $1 ailaal $ 289,188
CarryOver/Reallocated $ 7 $ 7
PART C2 NEW ALLOC $ 126,127 $ 95,134 $ 30,993
CarryOver/Reallocated $ 1 ,314 $ 1 ,314
PART D NEW ALLOC $ 11 ,888 $ 11 ,888
TOTAL PART D $ 13;26 ,
CarryOver/Reallocated $ 7,435 $ 7,435
PART E NEW ALLOC $ 75,830 $ 75,830
TOTAL SVC CO/REALLOC. $ 32,803 $ 32,803
TOTAL SVC. NEW ALLOC $ 669,584 $ 669,584
TOTAL SERVICES 7_ 702,387 $ - $ 702,387
Title VII Funding Request
Total Programmatic Programmatic
Funding Transfer Total
EAP CARRYOVER/REALLOCATED $ 5 $ 5
EAP NEW ALLOC $ 2,097 $ - $ 2,097
LTC OMB CARRYOVER/REALLOCAT $ 148 $ 148
LTC OMB NEW ALLOC $ 7,307 $ - $ 7,307
TOTAL TITLE VII $ 9,557 $ - $ 9,557
Annual Funding Request (AAS 200)
Region 2B
Fiscal Year 2012
Revision # 1
Date 7/1/2011
AREA AGENCY ADMINISTRATION BUDGET
Line Item Budget Federal Budget Local Cash Budget In-Kind Budget Total Budget
Personnel $ 54,835 $ - $ 23,030 $ 77,865
Travel $ - $ - $ - $ -
Equipment $ - $ - $ - $ -
Other Direct $ 8,381 $ - $ - $ 8,381
Indirect $ 5,873 $ - $ - $ 5,873
Total I $ 69,089 $ - $ 23,030 $ 92,119
Total Admin from AAS 200
Match must be 25% of total budget:
(Match = Local Cash Budget + In-Kind budget)
Federal Funds = $ 69,089.00 / 3 = , $ 23,030.00 + This is the minimum
match required.
Actual Match = $ 23,030 .00
Over/(Under) Match $ -
Annual Funding Request (AAS 220)
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