HomeMy WebLinkAbout20091500.tiffRESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR PER CAPITA FUNDING TO SUPPORT
LOCAL AND REGIONAL HEALTH SERVICES 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 Per Capita
Funding to Support Local and Regional Health Services 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 1, 2009, and ending June 30, 2010, 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 Per Capita Funding to Support Local and
Regional Health Services 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 day of June, A.D., 2009.
ATTEST: 41,44/1
Weld County Clerk to the B
y
BY: �./L.(,L(!�r f ;U6�
Derlut'V Clerk the Board
ounty Attorney
David E. Long
Date of signature -111 3 /eel
BOARD OF COUNTY COMMISSIONERS
WELD CQUt�PrY, COLORADO
X17 734
2009-1500
HL0036
1 t
COLORADO
Memorandum
TO: William F. Garcia, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH, Director
Department of Public Health and
Environment 0 5 /1 _ n„
ast
DATE: June 3, 2009
SUBJECT: Per Capita Task Order Contract
Enclosed for Board review and approval is a task order contract between the Board of Weld
County Commissioners for the use and benefit of the Weld County Department of Public Health
and Environment (WCDPHE) and the State of Colorado for the use and benefit of the Colorado
Department of Public Health and Environment (CDPHE) for per capita funding.
The purpose of the contract is to provide support for public health services, as established by the
State Board of Health pursuant to Section 25-1-503(1), C.R.S. and in accordance with Section
25-1-512 C.R.S. and Section 24-75,1104.5 (1.5) (a) (IV) C.R.S. WCDPHE shall participate in
assessment and planning efforts at the state, regional and local level facilitated by the Office of
Planning and Partnerships. These efforts shall include maintaining and improving local capacity
to provide services as established by the State Board of Health.
The per capita funding for the time period of July 1, 2009 through June 30, 2010 will be an
amount not to exceed 5413,315. I recommend your approval of this task order contract.
Enclosure
2009-1500
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO. 10 FAA 00091
APPROVED TASK ORDER CONTRACT - WAIVER # 154
This Task Order Contract is issued pursuant to Master Contract made on 01/23/2007, with muting number08 FAA00052
S'l'AIE:
State of Colorado for the use & benefit of the
Department of Public Health and
Environment
Office of Planning and Partnerships
4300 Cherry Creek Drive South
Denver, Colorado 80127
TASK ORDER MADE DATE::
05/04/2009
PO/SC ENCUMBRANCE NUMBER
PO FAA OLL10000091
TERM:
This Task Order shall be effective upon
approval bythe State Controller, or designee,
or on 07/01/2009, whichever is later. The
Task Order shall end on 06/30/2010.
PRICE STRUCTURE:
Fixed Price
PROCUREMENT METHOD:
Exempt
BID/REP/LIST PRICE AGREEMENT NUMBER
Not Applicable
lAW SPECIFIED VENDOR STATUTE:
Not Applicable
STATE REPRESENTATIVE:
Kathleen Matthews
Department of Public Health and Environment
Office of Planning and Partnerships
4300 Cherry Creek Drive South
Denver, CO 80246
CONTRACTOR
Board of County Commissioners of Weld
County
915 10th Street
Greeley, CO 80632-0758
for the use and benefit of the
Weld County Department of Public Health
and Environment
1555 North 17th Avenue
Greeley, CO 80631
CONTRACTOR ENn7Y TYPE:
Colorado Political Subdivision
BILLING STATEMENTS RECEIVED:
Not Applicable
STATUTORY AUTHORITY:
Not Applicable
CONTRACT PRICE NOT TO EXCEED:
$ 413,315.00
FEDERAL FUNDING DOLLARS: $
STATE FUNDING DOLIARS: $ 413,315.00
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR
FY 10:$413,315.00
FY XX: $
FY XX: $
FY XX: $
FY XX: $
CONTRACTOR REPRESENI'A'IIVE:
Judy Nero
Weld County Department of Public Health and
Environment
1555 North 17th Avenue
Greeley, CO 80631
SCOPE OF WORK:
Provide support for public health services, as established by the State Board of Health pursuant to §25-1-503(1),
CRS. and in accordance with Section §25-1-512 C.R.S. and Section §24-75.1104.5 (1.5) (a) (IV) C.RS. The district
public health agency shall participate in assessment and planning efforts at the state, regional and local level facilitated
by the Office of Planning and Partnerships. These efforts shall include maintaining and improving local capacity to
provide services as established bythe State Board of Health.
Page 1 of 5 Rev 4/3/09
o?Gsl /506
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 Budget (and its attachments if any - e.g., B-1, B-2, etc.)
Exhibit C - Limited Amendment Template for Task Orders
Exhibit D - Option Letter
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 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.
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".
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 "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
For the use and benefit of the
Weld County Department of Public Health and
Environment
Legal Name of Contracting Entity
Signature of Authorized Officer
William F. Garcia
Print Name of Authorized Officer
Chair
Print Title of Authorized Officer
STATE OF COLORADO:
BILL RITTER, JR. GOVERNOR
By _
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
r
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
WELD COUNTY DEPARTMENT OF
R�P°l
Liw`/fil At0NMO1L\
Page S of 5 BY.
E. Wallace, MD, MPH - Direc
Rev 4/3/09
3
&c c`9 -/HOC)
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 05/04/2009 - Contract Routing Number 10 FAA 00091
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.
2. This 'Cask Order Contract contains state funds.
3. Compensation under this Task Order Contract. The contractor will receive automatic quarterly payments
within thirty (30) calendar days after the quarter ends. 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.
4. 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
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.
5. The State may unilaterally increase/decrease the maximum amount payable under this contract based upon
the unit prices established in the contract and the schedule of services required, as set by the State. If the
State exercises its option, it shall provide written notice to the contractor at least 30 days before the increase
is effective in a form substantially equivalent to Exhibit D, immediately upon signature of the State
Controller or his delegate. Performance of the service shall continue at the same rates and under the same
terms as established in the contract.
6. Survival of Certain Contract Terms. Notwithstanding anything in this contract to the contrary, the parties
understand and agree that all terms and conditions of this contract which may require continued
performance, compliance, or effect beyond the termination date of the contract and shall survive such
termination date and shall be enforceable by the State as provided herein in the event of failure to perform
or comply by the Contractor.
To be attached to CDPHE
Task Order v1.0 (11/05) contract template
Page I of 1 Revised: 12/19/06
EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 05/04/2009 - Contract Routing Number 10 FAA 00091
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
1. The Contractor, in accordance with the terms and conditions of this contract, shall perform and complete, in
a timely and satisfactory manner, all activities described in the approved Statement of Work and Budget
that is attached hereto as Attachment B-1 and incorporated herein.
2. The Contractor will be required to submit reports as required and outlined in the statement of work,
Attachment B-1.
To be attached to CDPHE
Task Order v1.0 (11/05) contract template
Page 1 of 1 Revised: 12/19/06
Attachment B-1
Weld County Department of Public Health and Envorinment
Statement of Work and Budget
The Office of Planning and Partnerships desires to strengthen the capacity to provide public and
environmental health services in Colorado. This scope of work is designed to:
1. Provide accountability to assure State monies are being used effectively to provide public
health services.
2. Develop and maintain a consistent planning framework that integrates local public health
planning with statewide public health planning.
3. Inform state level decisions and policy development by integrating county and district public
health plans with Colorado Department of Public Health and Environment (CDPHE) strategic
planning.
4. Build state and local partnerships focused on strengthening Colorado's public health system.
5. Identify areas in the state system that need improvement to better support county and district
agencies through the state system functions of 1) Planning and Implementation; 2) Technical
Assistance and Support; 3) Evaluation and Quality Improvement; and 4) Resources.
It is hereby agreed that for and in consideration of their mutual promises to each other, hereinafter stated,
the parties hereto agree as follows:
1. Public Health Services. The county or district public health agency shall use these moneys to
provide support for public health services, as established by the State Board of Health pursuant to
§25-1-503(1), C.R.S. and in accordance with Section §25-1-512 C.R.S. and Section §24-75.1104.5
(1.5) (a) (IV) C.R.S. A copy of the current definition of Basic and Optional Services shall be posted at
the Office of Planning and Partnerships website.
2. Statewide and County/District Public Health Planning. The county or district public health agency
shall participate in assessment and planning efforts at the state, regional and local level facilitated by
the Office of Planning and Partnerships. These efforts shall include maintaining and improving local
capacity to provide services as established by the State Board of health.
3. Reports and Audits. The contractor shall provide to the State an agency annual report for the
previous calendar year to be submitted by April 1, 2010. A template shall be provided on the Office
of Planning and Partnerships website by January 1, 2010. The quarterly advance of funds for the
period April, May and June of the current fiscal year shall be withheld until all reports are received by
the State. The contractor shall maintain such records as may be necessary to provide the information
herein required by the State and submit to such reasonable audits and evaluations as may be
necessary.
4. Supplanting of Funds. In order to qualify each county and city and county shall comply with the
statutory requirements for contribution as set forth in C.R.S. § 25-1-512 for its local health services.
Each board of health may contribute such additional amounts as it may determine to be necessary to
meet their local health needs.
5. Payment. Payment equal to (1/4) of the total allocation shall be paid automatically in the last month
of each quarter as follows:
Page 1 of 2
Quarter
Amount
July 1 through September 30, 2009
$ 103,329.00
October 1 through December 31, 2009
$ 103,329.00
January 1 through March 31, 2010
$ 103,329.00
April 1 through June 30, 2010
$ 103,328.00
Page 2 of 2
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 I: A1.1. INFORMI,Vl I()N APPEARI\t. IN Rl•:l)
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 ** ***
*****, Iinsert the following if previous amendment($), change order(s), renewal(s) have been processed: as
amended by] linchtde all previous antendntent(s), change order(s), renewal(s) and their routing numbers',
[insert the following if previous atnendnteut(s). change order(s). renew As) have been processed: collectivelyl
referred to herein as the "Original Task Order Contract, whereby the Contractor was to provide to the State the
following:
[Briefly describe what the Contractor was to do under the Original 'Cask Order Contract -- indent
this paragraph I
(Please choose one of the following flour options and delete the other three options not selected[
The State promises to [choose one and delete the other[ increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, ($*.**) during the current term of the Original Task Order Contract in exchange
for the promise of the Contractor to perform the I 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, ($*.**) in exchange for the promise of
the Contractor to continue to perform the work identified in the Original Task Order Contract for the renewal term
of **** years/months, ending on ******** **, ****.
The State promises to [choose one and delete the other' increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, ($*.**) for the renewal term of **** [choose one and delete the other I
years/months, ending on ******** **, ****, in exchange for the promise of the Contractor to perform the [choose
one and delete the other I increased/decreased work described herein.
The State hereby exercises a "no cost" change to the Ichoose those that appl 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 [chose one and delete the of her' 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
amendment(s), change order(s). renewals) have been processed' as amended by [include all previous
amendntent(s), change order(s), renewal(s) and their routing numbers', {insert the following word if
previous amendinent(s). change orderts). renewal(s) have been processed, otherwise delete
"collectiv elf"leollectively 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:
{Please choose one of the following three options and delete the tvvo options riot selected{
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 Contract' 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 sour 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. {llse this paragraph when the Original Task Order Contract will he 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 fi►iluw ing 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. [Usk. 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 apple and delete those that don't) modifies the Budget in
{identify location in contract', modifies the Statement of Work in Iideniifr' location in
Page 2 of 4 Rev 4/3/09
EXHIBIT C
emttractl, modifies the project management/manager identification in !identify location in
emitractl, modifies the notice address or notification personnel in Iidentify location in
contract!, modifies the period of performance in (hientit) 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 *-*. III you are changing the performance period, choose the following Inn
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:
[LEGAL NAME OF CONTRACTOR]
(Legal type of entity)
Signature of Authorized Officer
Print Name of Authorized Officer
Print Title of Authorized Officer
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
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
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EXHIBIT D
SAMPLE OPTION LETTER
Date:
State Fiscal Year:
Option Letter No. I CLIN 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, Department of Public Health and Environment, 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
Bill Ritter, Jr. GOVERNOR
Department of Public Health and Environment
By: Lisa Ellis, 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
David J. McDermott, CPA
By:
Donald Rieck
Date:
Page 1 of 1
Effective Date: 1/6/09
STATE OF COLORADO
Bill Owens, Governor
Dennis E. Ellis. 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. cdp he. state. co. us
July 2, 2009
Enclosed is your copy of the fully executed Local Public Health Agency Contract for fiscal year 2010
(which replaces the nursing/per capita contract from previous years).
Please contact me if you have any questions pertaining to the financial aspect of this contract and
contact Kathleen Matthews at (303) 692-2361 for questions pertaining to the technical aspect of this
contract.
Laboratory Services Division
8100 Lowry Blvd.
Denver. Colorado 80230-6928
(303) 692-3090
Thank you,
Tracey Clark
Contracts Manager
Administration & Financial Services Division
(303) 692-2154
tracev.clarlastate.co.us
Colorado Department
of Public Health
and Environment
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