HomeMy WebLinkAbout20081861.tiff RESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR OFFICE OF LOCAL LIAISON PROGRAMS
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 the Office of
Local Liaison Programs 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, 2008, and ending June 30, 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 the Office of Local Liaison Programs 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 2nd day of July, A.D., 2008, nunc pro tunc July 1, 2008.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: 41 ts�, n---_
cre-?*?-cr. 'I ' �. Jerke, Chair
Weld County Clerk to the B���� � ' a --k
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j ' bertas fo-Tem
Deputy Clerk t� he Board `w ',_
W' ' m F. Garcia
APP E
David E. Long
n ttorney a d.C—
Dougl s Rademach r
Date of signature: O4201)
2008-1861
0e : h L ( ,1)- u-,.- 5 ) HL0035
Memorandum
TO: William H. Jerke, Chair
Board of County Commissioners
FROM: Mark E. Wallace, MD, MPH,Director
CODepartment of Public Health and C(
. Environment �✓, %I
COLORADO DATE: June 12, 2008
SUBJECT: Per Capita Task Order Contract
Enclosed for Board review and approval is a task order contract between the Colorado
Department of Public Health and Environment(CDPHE) and Weld County for per capita
funding.
The State of Colorado has allocated funding pursuant to Section 25-1-516, C.R.S and Section 24-
75.1104.5 (1.5) (a) (IV) C.R.S. to provide support on a per capita basis for local and regional
health services. Weld County Department of Public Health and Environment (WCDPHE) will
administer and enforce the laws pertaining to public health and orders, rules, regulations and
standards of the State Board of Health, State Commissions and other State Regulatory bodies.
WCDPHE will also participate in assessment and planning efforts at the state, regional and local
level facilitated by the CDPHE Office of Local Liaison and submit to the CDPHE a financial
report for the previous calendar year, a copy of any completed community health assessments,
and reports of progress made towards achieving local department goals and objectives.
The per capita funding for the time period of July 1, 2008 through June 30, 2009 will be
$412,171. Of this amount, no more than 85% is to be used to support local health services, and
at least 15%must be used to support regional health services. I recommend your approval of this
task order contract.
Enclosure
2008-1861
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO.09 FAA 00015
APPROVED TASK ORDER CONTRACT - WAIVER#154
This Task Order Contract is issued putsuant to Master Contract made on 01/23/2007,with muting number 08 FAA 00052
STATE: CONTRACTOR
State of Colorado for the use&benefit of the Board of County Commissioners of Weld
Department of Public Health and County 915 10th Street
Environment Greeley,Colorado 80632-0758
Office of Local Liaison for the use and benefit of the
4300 Cherry Creek Drive South Weld County Department of Public Health
Denver,Colorado 80246-1530 and Environment
1555 North 17th Avenue
Greeley,Colorado 80631
TASK ORDER MADE DATE: CONTRACTOR ENTITY TYPE:
03/28/2008 Colorado Political Subdivision
PO/SC ENCUMBRANCE NUMBER CONTRACTOR FEIN OR SCCIAI.SECURITY NUMBER
PO FAA OLL09000015 846000813
TERM; BILLING STATEMENTS RECEIVED:
This Task Order shall be effective upon Not Applicable
approval by the State Controller,or designee,
or on 07/01/2008,whichever is later. The STATUTORY AU-MORTIFY:
Task Order shall end on 06/30/2009. Not Applicable
PRICE STRUCTURE: CONTRACT PRICE NOT TO EXCEED:
Quarterly $412,171.00
PROCUREMENT METHOD: FEDERAL FUNDING DOLLARS: $
Exempt STATE FUNDING DOLLARS: $412,171.00
BID/REP/LIST PRICE AGREEMENT NUMBER MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR
Not Applicable FY 09: $412,171.00
TAW SPEQFIED VENDOR STATUTE:
Not Applicable
STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE:
Jeff Stoll Mark Wallace
Department of Public Health and Environment Weld County Department of Public Health and
Office of Local J iaison Environment
4300 Cherry Creek Drive South 1555 North 17th Avenue
Denver,CO 80246-1530 Greeley,CO 80631
SCOPE OF WORK:
The state shall provide support on a per capita basis for local and regional health services of which no
more than eighty-five percent shall be for supporting local health services and not less than an
additional fifteen percent of supporting regional health services.
Page 1 of 4
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
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;5)the
Additional Provisions- Exhibit A,and its attachments if included,to this Task Order Contract;4) the
Page 2 of 4
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.
Page 3 of 4
IN WITNESS WHEREOF,the State has executed this Task Order Contract as of 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 and
accept personal responsibility for any and all damages the State may incur for any errors in such
representation.
CONTRACTOR: STATE OF COLORADO:
BOARD OF COUNTY COMMISSIONERS OF BILL RITTER,JR.GOVERNOR
WELD COUNTY
For the use and benefit of the
WE
LD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
Legal Name of Contracting Entity
By 9)(-)(44--'
For Executive Director
846000813 Department of Public Health and Environment
Social Security Number or FEIN
Department Program Approval:
Signature of Authorized Officer JUL 0 22008
•
William H. Jerke, Chair By �Gc`� ,.i.
(I
Print Name&Title of Authorized Officer
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State
Controller,or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until
the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be
obligated to pay for the goods and/or services provided.
STATE CONTROLLER:
avid J.McD ott,CPA
By Q�
Date , `7 b `t
WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH AND ENVIR9NMENT
BY: iT ' � ` ( � ‘.1rG
Mark E. Wallace, MD, MPH-Director
Page 4 of 4
&CAS' -/N /
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 03/28/2008- Contract Routing Number 09 FAA 00015
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
The State has determined that this contract does not constitute a Business Associate relationship under
HIPAA.
2. This Task 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 Page 1 of 1 Revised: 12/19/06
Task Order v1.0(11/05)contract template
EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 03/28/2008-Contract Routing Number 098 FAA 00015
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 Page 1 of 1 Revised: 12/19/06
Task Order v1.0(11/05)contract template
Attachment B-1
Weld County Health Department
Statement of Work and Budget
The Office of Local Liaison desires to strengthen the capacity to provide public and environmental health services in Colorado.
The current practice of Public Health uses the core public health functions model(assessment,assurance,and policy
development)as a framework for organizing,delivering,and evaluating interventions aimed at improving health. "The
Operational Definition of a Functional Local Health Department"by the National Association of City and County Health
Officials delineates and describes the core public health functions and services.This model can be referenced to guide strategic
decisions for provision of public health services within a jurisdiction.
This scope of work is designed to:
1. Provide accountability to assure State monies are being used effectively for Basic and Optional Public Health
Services,as define by the Colorado BOH.
2. Develop and maintain a consistent planning framework that integrates local efforts to mobilize their communities
and address public health issues with state initiatives.
3. Inform state level decisions and policy development.
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 local 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. Local Health Services. The local health department shall use these moneys to provide support for basic and optional
public health services,as defined by the State Board of Health in accordance with Section 25-1-516 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 public health services shall be posted
at the Office of Local Liaison website.
The current practice of Public Health uses the core public health functions model(assessment,assurance,and policy
development)as a framework for organizing,delivering,and evaluating interventions aimed at improving health. The ten
essential public health services,outlined in the"The Operational Definition of a Functional Local Health Department"by
the National Association of City and County Health Officials delineate and describe the core public health functions.This
model can be referenced to guide strategic decisions for provision of public health services within a jurisdiction.
2. Regional Health Services. The State shall provide support on a per capita basis of which no more than 85%shall be for
supporting local health services and not less than an additional 15%for supporting regional health services.
A. According to Section 25-1-516,C.R.S.,regional health services shall be construed to mean two or more local
county or district health departments or county boards of health providing joint services.
B. The contractor understands and hereby agrees that the State Board of Health shall have review power over the
formation,establishment and support of regional health services.
3. Statewide,Regional and Local Planning. The local health department shall participate in assessment and planning
efforts at the state,regional and local level facilitated by the Office of Local Liaison(Colorado Public Health Performance
Improvement Plan). These efforts shall include maintaining and improving local capacity to provide essential services
outlined in"The Operating Definition of a Functional Local Health Department"by the National Association of
City/County Health Officials and"Basic and Optional Public Health Services"defined by the State Board of Health.
A. Agency Representative. Each agency will designate someone to represent the agency in planning meetings and
work with the OLL as needed in developing statewide plans.
B. Community Health Assessment(Optional). The Contractor is encouraged to perform a community health
assessment at least once every five(5)years or in any other frequency that is consistent with current accepted
public health practice and standards.
C. Annual Community Health Plan(Optional).The Contractor is encouraged to develop a community health plan to
respond to a community assessment.
4. Reports and Audits. The contractor shall provide to the State the following information as specified. 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.
A. Local Health Department Financial Report An agency financial report for the previous calendar year shall be
submitted by April 1,2009. A template shall be provided by the OLL and posted on the OLL website.
B. Community Health Assessment. A copy of any completed community health assessment(s) shall be submitted to
the OLL upon completion.
C. Annual Community Health Plan(Optional).The Contractor is encouraged to submit an"Annual Community
Health Plan"to the Office of Local Liaison. The Annual Community Health Plan could consist of three parts as
follows:
1) Contractors opting to submit its Annual Community Health Plan are encouraged to do so on or before
January 31. A reporting template will be provided on the OLL website. The Annual Community
Health Plan could include,but is not limited to,the following information:
a) An outline of the Contractor's goals and objectives for the calendar year covered by the Plan
to address the primary local public health issues identified in the a community assessment or
other assessments submitted in response to 4.B. of this Scope of Work;
b) The public health interventions and supporting basic and optional public health services that
the Contractor intends to provide in the calendar year covered by the Plan to meet the annual
goals and objectives;
2) The Contractor is encouraged to collaborate with the OLL to identify any short or long-term support
needs from the State to build capacity to provide basic and optional public health services.
D. Annual Progress Report. An Annual Progress Report shall be completed and submitted for the previous calendar
year by April 1,2009. The OLL will provide technical assistance as needed.The report shall discuss:
1) The progress made on priority health needs of the community.
2) The effectiveness of basic and optional public health services shall be discussed;and
3) Success stories provided as appropriate to demonstrate the effective use of these funds; and
4) A description of how 15%of funds were expended on regional services.
5) A description of how the agency utilized 85%of funds for local health services.
5. 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. §25-1-516 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.
6. Payment. Payment equal to(1/4)of$412,171.00 total allocation shall be paid automatically in the last month of each
quarter as follows:
Quarter Amount
July I through September 30,2008 $103,043.00
October 1 through December 31,2008 $103,043.00
January 1 through March 31,2009 $103,043.00
April 1 through June 30, 2009 $103,042.00
LXlilli11 C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
(ADD PROGRAM NAME HERE)
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
** *****
ELIMINATE ALL INFORMATION APPEARING IN RED
LIMITED AMENDMENT FOR TASK ORDERS #*
This Limited Amendment is made this **** day of*********, 200*,by and between the State
of Colorado, acting by and through the DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive
South,Denver, Colorado 80246,hereinafter referred to as the "State"; and, LEGAL NAME
OF ENTITY, (legal type of entity), whose address or principal place of business is Street
Address, City, State& Zip Code,hereinafter referred to as the"Contractor".
FACTUAL RECITALS
The parties entered into a Master Contract, dated ******** **, ****,with contract routing
number** *** ***** "the Master Contract").
Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order
Contract, dated ******** ** ****, with contract encumbrance number PO *** **********
and contract routing number ** *** *****, [insert the following if previous amendment(s),
change order(s), renewal(s) have been processed: as amended by] [include all previous
amendment(s), change order(s), renewal(s) and their routing numbers], [insert the
following if previous amendment(s), change order(s), renewal(s) have been processed:
collectively] referred to herein as the"Original Task Order Contract, whereby the Contractor was
to provide to the State the following:
[Briefly describe what the Contractor was to do under the Original Task Order
Contract—indent this paragraph)
[Please choose one of the following four options and delete the other three options not
selected]
The State promises to [choose one and delete the other] increase/decrease the amount of finds
to be paid to the Contractor by ********** Dollars, ($*.**) during the current term of the
Original Task Order Contract in exchange for the promise of the Contractor to perform the
[choose one and delete the other] increased/decreased work under the Original Task Order
Contract.
Page 1 of 5
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] 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] current term of the
Original Task Order Contract or renewal term of the Original Task Order Contract.
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), renewal(s) have
been processed] as amended by [include all previous amendment(s), change
order(s), renewals) and their routing numbers], [insert the following word if
previous amendment(s), change order(s), renewal(s) 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:
[Please choose one of the following three options and delete the two options not
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********* **,
Page 2 of 5
LXH1M 1' C
****, 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 [identify location in
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 [identify 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, or period of performance is
incorporated by this reference and identified as. 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.
Page 3 of 5
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 4 of 5
EXHiI31'1 1:
IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on the
day first above written.
CONTRACTOR: STATE:
[LEGAL NAME OF CONTRACTOR] STATE OF COLORADO
(a political subdivision of the State of Colorado) Bill Ritter,Jr. Governor
By: By:
Name: For the Executive Director
Title: DEPARTMENT OF PUBLIC
HEALTH
FEIN: AND ENVIRONMENT
ATTEST: PROGRAM APPROVAL:
Because the Contractor is a governmental
entity, an attestation is required By:
(Seal, required)
By:
City, City and County, County,
Special District, or Town Clerk or Equivalent
[Delete inapplicable language.]
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This limited
amendment is not valid until the State Controller, or such assistant as he may delegate, has
signed it. The contractor is not authorized to begin performance until the contract is
signed and dated below. If performance begins prior to the date below, the State of
Colorado may not be obligated to pay for goods and/or services provided.
STATE CONTROLLER
Leslie M. Shenefelt
By:
Date:
Page 5 of 5
Exhibit D
OPTION LETTER
Exhibit
Date: State Fiscal Year: Option Letter No.
SUBJECT: (Choose only one below)
1 - Option to renew only )for an additional term)
2 - Change in the amount of goods within current term
3 - Change in amount of goods in conjunction with renewal for additional term
4 - Level of service change within current term
5- Level of service change in conjunction with renewal for additional term
6 -Option to initiate next phase in contract
For use with Options #1 - 5: In accordance with Paragraphs) of contract routing number
(FY) (Agency or
institution of higher education)(Routing#), between the State of Colorado, Department of/or Higher Ed
Institution (agency or
institution of higher education name), (division name), and (contractor's name)the State hereby exercises the option for
an additional
term of(include performance period here)at a cost/price specified in Paragraph/Section/Provision ,AND/OR an
increase/decrease in the amount of goods/services at the same rate(s)as specified in Paragraph/Schedule/Exhibit
For use with Option #6, please use the following: In accordance with the terms set out in the original contract
(include CLIN routing number, FY,&Agency or institution of higher education)between the State of Colorado,
Department of/or Higher Ed Institution(agency or institution of higher education name), (division name), and
( contractor's
name I the State hereby exercises the option to initiate Phase (indicate which Phase:2,3,4,etc.)for the term of
(State Performance period)at the cost/price specified in Paragraph/Section/Provision
For use with Options #1 — 6: The amount of the current Fiscal Year contract value is increased/decreased by($amount
of
change)to a new contract value of($ )to satisfy services/goods ordered under the contract for the current fiscal year
(indicate Fiscal Year). The first sentence in Paragraph/Section/Provision is hereby modified accordingly.
The total contract value to include all previous amendments,option letters,etc.is($ ).
APPROVALS:
State of Colorado:
Bill Ritter,Jr.Governor
By: Date:
Executive Director/College President]
Colorado Department of/or Higher Ed Institution
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all State contracts.This contract is not valid until the State
Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance
until
the contract is signed and dated below. If performance begins prior to the date below, the State of Colorado may not be
obligated to pay for goods and/or services provided.
State Controller
Leslie M. Shenefelt
By:
STATE OF COLORADO
Bill Owens,Governor
Dennis E. Ellis, Executive Director 0V cozo
Dedicated to protecting and improving the health and environment of the people of Colorado re
' of
4300 Cherry Creek Dr.S. Laboratory Services Division
Denver,Colorado 80246-1530 8100 Lowry Blvd. *`� . �*
Phone(303)692-2000 Denver,Colorado 80230-6928 r876
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado
of Public Health
http://www.cdphe.state.co.us and Environment
July 15, 2008
Weld County Department of Public Health & Env.
Attn: Mark Wallace
1555 North 17th Avenue
Greeley, CO 80631
Dear Mark,
Enclosed is your copy of the fully executed contract (#09 FAA 00015) with the Office of Local Liaison
for the Per Capita contract. Work under this contract order may begin anytime.
Please contact me if you have any questions pertaining to the financial aspect of this contract and
contact Jeff Stoll at (303) 692-3479 for questions pertaining to the technical aspect of this contract.
Tha you,
Tracey Cl k
Contracts Manager
Administration & Financial Services Division
(303) 692-2154
tracey.clark@state.co.us
Hello