HomeMy WebLinkAbout20091499.tiffRESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR DISEASE SURVEILLANCE PROGRAM
(WEST NILE VIRUS SURVEILLANCE AND TESTING) 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 Disease
Surveillance (West Nile Virus Surveillance and Testing) between 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, and the Colorado Department of
Public Health and Environment, commencing July 20, 2009, and ending December 31, 2009, 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 Disease Surveillance (West Nile Virus
Surveillance and Testing) between 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, 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 29th da ., 2009.
ATTEST:
Weld County Clerk to the Boa
BYI` \?i'7t
Depiay Clerk
APPROVE
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ourity Attorney
Date of signature
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the Board
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ARD O " • NTY COMMISSIONERS
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David E. Lo
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2009-1499
HL0036
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Wine
COLORADO
Memorandum
TO: William F. Garcia, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH, Director
Department of Public Health and
Environment
DATE: June 11, 2009
SUBJECT: Task Order Contract for Disease
Surveillance (West Nile Virus
Surveillance and Testing)
Enclosed for Board review and approval is a task order contract from the Colorado Department
of Public Health and Environment for surveillance activities for West Nile Virus. These
activities include the collection, identification and submission for testing of dead birds and vector
mosquitoes.
The contract is for an amount not to exceed $9,600 for the term of July 20, 2009 through
December 31, 2009. These funds are passed through the Colorado Department of Public Health
and Environment from the Centers for Disease Control. I recommend your approval of this task
order contract.
Enclosure
2009-1499
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Martin, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1530
Phone (303) 692-2000
TDD Line (303) 691-7700
Located in Glendale, Colorado
http://www.cdphe.state.co.us
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
WORK STATUS CONFIRMATION LETTER
Colorado Department
of Public Health
and Environment
Vendor Name: Contract Routing Number:
CRS §24-30-202 requires the State Controller to approve all State Contracts. The above referenced (Circle one) Contract or
Amendment is not valid until it is signed and dated below by the State Controller or delegate. Therefore, your agency is not
authorized to begin performance until you are notified that it's signed. If your agency begins performing Contract tasks prior
to that date, the State of Colorado is not obligated to pay your agency for such performance or for any goods and/or services
provided prior to the date signed.
By signing below, your confirm that (Signature MUST be that of the person signing the Contract)
a) No work has been performed under this contract
b) No work will begin under this contract until the contract is signed by the State Controller or on the effective
date, whichever is later.
Signature of Authorized Officer
William F. Garcia
Print Name of Authorized Officer
Chair, Board of Weld County Commissioners
Print Title of Authorized Officer
JUN 2 9 2009
Date Signed
RETURN THIS LETTER TO:
Jessica Hubbard
Colorado Department of Public Health & Environment
Budget
4300 Cherry Creek Dr So
DCEED-A3
Denver CO 80246-1530
rxCr()-/ J
DI?P.1RrAiFNI'OI, I't]BJ.lC I II (:AIhI I :AND hNCIROiNNI1iN1
ROUTING NO. 10 FHA 00040
APPROVED TASK ORDER CONTRACT - WAIVER #154
This Task Order Contract is issued pursuant to Master Contract made on 01/23/2007, with routing number 08 FAA 00052
State of Colorado for the use & benefit of the
Department of Public Health and
Environment
Disease Control and Environmental
Epidemiology Division
Disease Surveillance Investigation
4300 Cherry Creek Drive South
Denver, Colorado 80246
ASk uRDIit Al.Auli Il:AT:"
06/09/2009
PO/SC ISNCUAIRRANCI, NCAIBIR.
PC) FHA EP11000040
-1118\r
This Task Order shall be effective upon
approval by the State Controller, or designee,
or on 07/20/2009, whichever is later. The
Task Order shall end on 12/31/2009.
PRICI: SrRLCrum'
Cost Reimbursement
PROLt IlI-AI1:N'IMINI] lull
Exempt
131D. RI9''l 1ST PRIt 4GRIiG.UI!h NCSIRER
Not Applicable
]AAC SPCCI PA ID vl •K DOR SI'Xl t Ili:
Not Applicable
SLAT L I2LPRI:SI iN l A INb_
Janell Kenfield
Department of Public I Iealth and Environment
DCEED
DSI
4300 Cherry Creek Drive South
Denver, CO 80246
(:(1\, rm,11Is.
Board of County Commissioners of Weld County
915 10it Street
Greeley, Colorado 80632-0758
for the use and benefit of the
Weld County Department of Public Health and
Environment,
1555 North 17th Avenue
Greeley, Colorado 80631
CUN I'RAC 1 OR hN1111"I11'11
Colorado Political Subdivision
Ill] l INC s'I,V1IS\1111x1S RI:CIfIv]fl>
Monthly
ST VII' FOIRA Al I l I( 1<II 1
Not Applicable
12 \C PRICY. NCI ' 111'lx
$24,000.00
I4DI.ILVI.P t:ADING DU].].AIRN I'RO(2 RI All NT VIISrIIUD
STAIN FUNDING INO].I.AR&
Exempt
NI:Ax]MrMAMOtNI AVAII,Alil II PI.R FISCAI YP.;AId.
FY 10: $24,000.00
coNIRACIOR RI PRI sl NUA'llvil.
Board of County Commissioners of Weld County
Mark U. Wallace, MPH, MD
1555 North 17'1' Avenue
Greeley, Colorado 80631
S( UPIS (n' Aculuo.
West Nile Virus (\VNV) surveillance including collection, identification, and submission of dead birds
and vector mosquitoes for testing, public education on prevention, and human case investigation.
Page 1 of 5 Rev 4/3/09
fxmmTs:
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 Budget (and its attachments if any — e.g., B-1, B-2, etc.)
Exhibit C - Limited Amendment Template for Task Orders
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.
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.
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 arc 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 5 Rev 4/3/09
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.
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".
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 "Limited Amendment for Task Orders" that is
substantially similar to the sample form Limited Amendment that is incorporated herein by this reference
and identified as Exhibit C. To be effective, this Limited Amendment must be signed by the State and the
Contractor, and be approved by the State Controller or an authorized delegate thereof. Upon proper
execution and approval, this Limited Amendment shall become a formal amendment to this Task Order
Contract. 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, §24-103.5-101 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 5 Rev 4/3/09
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.
Page 4 of 5 Rev 4/3/09
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 BIL RITTER, JR. C�6VERNOR
(a political subdivision of the state of Colorado)
Legal Name of Contracting Entity
Signature ornuthorized Officer
William F. Garcia
Print Name of Authorized Officer
Chair
Print Title of Authorized Officer
STATE OF COLORADO:
By e -.
For Executive Director
Department of Public Health and Environment
Signatory avers to the State Controller or delegate that
Contractor has not begun performance or that a Statutory
Violation waiver has been requested under Fiscal Rules
Department Program Approval:
By
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
By
Date
WELD COUNTY DEPARTMENT OF
BLiC HEALTH I /p/�,�� ) ENVIRONMQIT
GAAAPage 5 of 5 BV: V V /"'v^"` Ca �\ Rev 4/3/09
Mark E. Wallace, MD, MPH -Direr
�co9-/'79;
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 06/09/2009 - Contract Routing Number 10 FHA 00040
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
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.
This Task Order Contract contains federal funds (see Catalog of Federal Domestic Assistance (CFDA)
number 93.283)
3. The United State Department of Health and Human Services ("USHHS"), through the Centers for Disease
Control and Prevention ("CDC") has awarded federal funds under Award number 5U50CI823801-04,
hereinafter "Award", to perform the following — provide WNV surveillance including collection,
identification, and submission of dead birds and vector mosquitoes for testing, public education on
prevention, and human case investigation.
If the underlying Award authorizes the State to pay all allowable and allocable expenses of a contractor as
of the effective date of that Award, then the State shall reimburse the Contractor for any allowable and
allocable expenses of the Contractor that have been incurred by the Contractor since the proposed effective
date of this Task Order Contract. If the underlying Award does not authorize the State to pay all allowable
and allocable expenses of a contractor as of the effective date of that Award, then the State shall only
reimburse the Contractor for those allowable and allocable expenses of the Contractor that are incurred by
the Contractor on or after the effective date of this Task Order Contract, with such effective date being the
later of the date specified in this Task Order Contract or the date the Task Order Contract is signed by the
State Controller or delegee.
4. To receive compensation under this Task Order Contract, the Contractor shall submit a signed monthly
Invoice/Cost Reimbursement Statement in a format acceptable to the State. An Invoice/Cost
Reimbursement Statement must be submitted within thirty (30) calendar days of the end of the billing
period for which services were rendered. Expenditures shall be in accordance with the Statement of Work
attached hereto as Exhibit B and incorporated herein. These items may include, but are not limited to, the
Contractor's salaries, fringe benefits, supplies, travel, operating, indirect costs which are allowable, and
other allocable expenses related to its performance under this Task Order Contract.
Invoice/Cost Reimbursement Statements shall: 1) reference this Task Order Contract by its contract routing
number, which number is located on page one of this Task Order Contract; 2) state the applicable
performance dates; 3) state the names of payees; 4) include a brief description of the services performed
during the relevant performance dates; 5) describe the incurred expenditures if reimbursement is allowed
and requested; and, 6) show the total requested payment. Payment during the initial, and any renewal or
extension, term of this Task Order Contract shall be conditioned upon affirmation by the State that all
services were rendered by the Contractor in accordance with the terms of this Task Order Contract.
Invoice/Cost Reimbursement Statements shall be sent to:
Janell Kenfield
DCEED
DSI
Colorado Department of Public Health and Environment
A3
4300 Cherry Creek Drive South
Denver, CO 80246
To be attached to CDPHE
Task Order vl .0 (11/05) contract template
Page 1 of 2 Revised: 12/19/06
EXHIBIT A
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 sixty
(60) 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 sixty (60) 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
billing statements as required by the funding source.
"Ile Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
5. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have sixty (60) 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 sixty (60) 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
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 or
the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract.
To be attached to CDPHE
Task Order v1.0 (11/05) contract template
Page 2 of 2 Revised: 12/19/06
Exhibit B
DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 17th Avenue
Greeley, CO 80631
WEBSITE: www.co.weld.co.us
ADMINISTRATION: (970) 304-6410
FAX: (970) 304-6412
PUBLIC HEALTH EDUCATION & NURSING: (970) 304-6420
FAX: (970) 304-6416
ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415
FAX: (970) 304-6411
Subject: West Nile Virus Surveillance Grant, Scope of Work for 2009
The following is our understanding of the scope of work that the Weld County Department of
Public Health & Environment will perform under the 2009 West Nile virus surveillance grant.
Weld County Department of Public Health & Environment (WCDPHE)
Method of Selection: Sole Source
Period of Performance: 7/20/2009-12/31/2009
Description of Activities: The contract supports WNV surveillance including
collection, identification and submission of dead birds and vector mosquitoes
for testing, public education on prevention and human case investigation.
Method of accountability: Submission of copies of receipts for equipment purchases.
Completed records of environmental samples tested in zoonotic disease database.
Completed CEDRS records for human cases investigation.
Surveillance $2,000
Costs related to the collection and submission of bird and mosquito samples for
testing and investigation of human cases including personnel, travel and equipment
Laboratory Supplies $4,000
Costs to purchase kits and reagents to perform 100 RT-PCR tests for WNV on birds
and mosquito pools submitted from the region. Provide back-up to CDPHE lab.
Sentinel Mosquito Zones S18,000
Maintenance of three sentinel mosquito trap zones following established protocol.
TOTAL AWARD $24,000
Page 1 of 1
EXHIBIT C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ADD DIVISION -PROGRAM ACRONYMS
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
ELIMINATE ALL INFORMATION APPEARING IN RED
LIMITED AMENDMENT FOR TASK ORDERS #*
This Limited Amendment is made this **** day of *********, 200*, by and between the State of Colorado, acting
by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal
place of business is 4300 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the
"State"; and, LEGAL NAME OF ENTITY, (legal type of entity), whose address or principal place of business is
Street Address, City. State & Zip Code, hereinafter referred to as the "Contractor".
FACTUAL RECITALS
The parties entered into a Master Contract, dated ******** **, ****, with contract routing number ** *** *****.
Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated
******** **. ****, with contract encumbrance number PO *** **********, and contract routing number ** ***
*****,'insert the following if previous amendment(s), change order(s), renewal(s) have been processed: as
amended by] 'include all previous amendment(s), change order(s), renewals) and their routing numbers',
'insert the following if previous anrendrnenl(s), change order(s), renewal(s) have been processed: collectively)
referred to herein as the "Original Task Order Contract, whereby the Contractor was to provide to the State the
following:
(Briefly describe what the Contractor was to do under the Original Task Order Contract — indent
this paragraph'
]Please choose one of the following four options and delete the other three options not selected'
The State promises to [choose one and delete the other] increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, (S*.**) during the current term of the Original Task Order Contract in exchange
for the promise of the Contractor to perform the 'choose one and delete the other] increased/decreased work
under the Original Task Order Contract.
The State promises to pay the Contractor the sum of ********** Dollars, ($*.**) in exchange for the promise of
the Contractor to continue to perform the work identified in the Original Task Order Contract for the renewal term
of **** years/months, ending on ******** **, ****.
The State promises to 'choose one and delete the other' increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, ($*.**Z for the renewal term of **** Ichoose one and delete the other'
years/months, ending on ******** **, ****, in exchange for the promise of the Contractor to perform the 'choose
one and delete the other] increased/decreased work described herein.
The State hereby exercises a "no cost" change to the 'choose those that apply and delete those that don't apply)
budget, specifications within the Statement of Work, project management/manager identification, notice
address or notification personnel , or performance period within the !choose one and delete the other I current
term of the Original Task Order Contract or renewal term of the Original Task Order Contract.
Page 1 of 4 Rev 4/3/09
EXHIBIT C
NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the parties hereto agree
as follows:
1. Consideration for this Limited Amendment to the Original Task Order Contract consists of the payments
and services that shall be made pursuant to this Limited Amendment, and promises and agreements herein
set forth.
2. It is expressly agreed to by the parties that this Limited Amendment is supplemental to the Original Task
Order Contract, contract routing number ** *** *****, [insert the following language here if previous
alucnd111ent(s), change order(s). renewal(s) have been processed] as amended by [include all previous
a men d111e1►t(s), change order(s), renewals) and their routing numbers', (insert the following word if
previous amendment(s). change order(s). renewals) have been processed, otherwise delete
"collectively"[collectively referred to herein as the Original Contract, which is by this reference
incorporated herein. All terms, conditions, and provisions thereof, unless specifically modified herein, are
to apply to this Limited Amendment as though they were expressly rewritten, incorporated, and included
herein.
3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall be modified,
altered, and changed in the following respects only:
Incase choose one of the following three options and delete the two options not selected I
A. [Use this paragraph when changes to the funding level of the Original Task Order Contract
occur during the current term of the Original Task Order C:onti•actl This Limited
Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by
contract routing number ** *** *****. This Limited Amendment is for the current term of
********* ** ****, through and including ********* **, ****. The maximum amount payable
by the State for the work to be performed by the Contractor during this current term is /choose
one and delete the other[ increased/decreased by ********** Dollars, ($*.**) for an amended
total financial obligation of the State of ********** DOLLARS, ($*.**). [Delete the following
sentence if not applicable in your situation] The revised Statement of Work is incorporated
herein by this reference and identified as "Attachment *". [Delete the following sentence if not
applicable in your situation] The revised Budget is incorporated herein by this reference and
identified as "Attachment *". The Original Task Order Contract is modified accordingly. All
other terms and conditions of the Original Task Order Contract are reaffirmed.
A. !Use this paragraph when the Original Task Order Contract will be renewed for another
term) This Limited Amendment is issued pursuant to paragraph 5 of the Original Task Order
Contract identified by contract routing number ** *** *****. This Limited Amendment is for the
renewal term of ********* **, ****, through and including ********* ** ****. The
maximum amount payable by the State for the work to be performed by the Contractor during this
renewal term is ********** Dollars, ($*.**) for an amended total financial obligation of the
State of ********** DOLLARS, ($*.**). [Delete the following sentence if not applicable in
your situation] The revised Statement of Work is incorporated herein by this reference and
identified as "Attachment *". [Delete the following sentence if not applicable in your
situation[ The revised Budget is incorporated herein by this reference and identified as
"Attachment *". The Original Task Order Contract is modified accordingly. All other terms and
conditions of the Original Task Order Contract are reaffirmed.
A. [Use this paragraph when there are "no cost changes" to the Budget. the specifications
within the original Statement of Work, allowable contract provisions as noted, or
performance period.[ This Limited Amendment is issued pursuant to paragraph 5 of the Original
Task Order Contract identified by contract routing number ** *** *****. This Limited
Amendment (choose those that apply and delete those that don't[ modifies the Budget in
[identify location in contract], modifies the Statement of Work in [identity location in
Page 2 of 4 Rev 4/3/09
EXHIBIT C
contract], modifies the project management/manager identification in ]identify location in
contract], modifies the notice address or notification personnel in [identify location in
contract], modifies the period of performance in lialentify location in contract] of the Original
Task Order Contract. The revised ]choose those that apply and delete those that don't]
Budget, Statement of Work, project management/manager identification, notice address or
notification personnel is incorporated by this reference and identified as Exhibit * or
Attachment *-*. ]If you are changing the performance period, choose the following two
sentences or delete both sentences] The period of performance of the (choose one and delete
the other] current/renewal term is hereby (choose one and delete the other] extended/reduced
by ***** (*) months, changing the current ending date from ********* **. **** to *********
** ****. The revised period of performance is ********* **, **** through and including
********* **, ****. The Original Task Order Contract is modified accordingly. All other terms
and conditions of the Original Task Order Contract are reaffirmed.
4. The effective date of this Limited Amendment is ******** **, ****, or upon approval of the State
Controller, or an authorized delegate thereof, whichever is later.
5. Except for the Special Provisions and other terms and conditions of the Master Contract and the General
Provisions of the Original Task Order Contract, in the event of any conflict, inconsistency, variance, or
contradiction between the terms and provisions of this Limited Amendment and any of the terms and
provisions of the Original Task Order Contract, the terms and provisions of this Limited Amendment shall
in all respects supersede, govern, and control. The Special Provisions and other terms and conditions of the
Master Contract shall always control over other provisions of the Original Task Order Contract or any
subsequent amendments thereto. The representations in the Special Provisions to the Master Contract
concerning the absence of personal interest of state of Colorado employees and the certifications in the
Special Provisions relating to illegal aliens are presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR
ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED,
AND OTHERWISE MADE AVAILABLE.
Page 3 of 4 Rev 4/3/09
EXHIBIT C
IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on the day first above
written.
., 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:
[LEGAL NAME OF CONTRACTOR] STATE OF COLORADO
(Legal type of entity) Bill Ritter, Jr. Governor
By:
Signature of Authorized Officer
Print Name of Authorized Officer
Print Title of Authorized Officer
For the Executive Director
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Signatory avers to the State Controller or
that Contractor has not begun performance or
that a Statutory Violation waiver has been
requested under Fiscal Rules
PROGRAM APPROVAL:
By:
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.
By:
Date:
STATE CONTROLLER
David J. McDermott, CPA
Page 4 of 4 Rev 4/3/09
EXHIBIT D
Budget
To Task Order Contract Dated 06/09/2009 - Contract Routing Number 10 FHA 00040
Weld County Health Department
Surveillance
Costs related to the collection and submission of bird and mosquito samples for testing and
investigation of human cases including personnel, travel, and equipment.
$2,000
Laboratory Supplies
Costs to purchase kits and reagents to perform 100 RT-PCR tests for WNV on birds and
mosquito pools submitted from the region. Provide back-up to CDPHE lab.
$4,000
Sentinel Mosquito Zones
Maintenance of two sentinel mosquito trap zones following established protocol.
$18,000
Total
$24,000
To be attached to CDPHE
Task Order vl .0 (11/05) contract template
Page 1 of 1 Revised: 12/19/06
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Martin, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1530
Phone (303) 692-2000
TDD Line (303) 691-7700
Located in Glendale, Colorado
http://www.cdphe.state.co.us
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
August 4, 2009
Re: Contract Number PO FHA EPI1000040 (routing number 10 FHA 00040)
Dear Contractor,
Colorado Department
of Public Health
and Environment
Enclosed please find your fully approved contractual documents with the Colorado Department of
Public Health and Environment. Please keep these original documents for your records.
If you have any questions or require further information, please feel free to contact mc.
Sincerely,
Jijica Hubbard
Contracts Administrator
Disease Control Division
Phone: (303) 692-2702
Fax: (303) 782-0904
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