HomeMy WebLinkAbout20081862.tiff RESOLUTION
RE: APPROVE TASK ORDER CONTRACT FOR EMERGENCY PREPAREDNESS AND
RESPONSE PROGRAM AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Ryle 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 Emergency
Preparedness and Response Program 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 August 10, 2008, and ending August 9, 2009, with further terms and
conditions being as stated in said task order contract, and
WHEREAS,after review,the Board deems it dvisable 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 tore Emergency Preparedness and Response
Program between the County of Weld, State of Colbrado, 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 Publics 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.
I
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., 20084
BOARD OF COUNTY COMMISSIONERS
j ,p WELD COUNTY, COLORADO
ATTEST: ut "1 ni:.2_G✓
Sol ;' -c Wil . m H. Jerke, Chair
Weld County Clerk to th BA �` \P
Robert D. M9sden, Pro-Tem
BY: 17-
D puty Clerk t the oard
•
m F. Garcia
AEPRO 7 FORM:
vyt__-- David E. Long
i
Coun ttorney
Date of signature:
1�� Dougla ademacher
2008-1862
HL0035
Memorandum
(icrteL.-
TO: William H. Jerke, Chair
Board of County Commissioners
lFROM: Mark E. Wallace,MD, MPH
ODirector,Department of Public Health
• and Environment ! ' ', �.
COLORADO DATE: June 12,3008 .\
SUBJECT: Emergency Preparedness and Response
Task Order Contract
Enclosed for Board review and approval is a task order contract for the Emergency Preparedness
and Response Program. If approved, this will become part of the Master Contract between the
Colorado Department of Public Health and Environment (CDPHE) and Weld County on behalf
of the Department of Public Health and Environment (WCDPHE).
With this contract, CDPHE is awarding Weld County renewal funding in the amount of
$224,902 as pass through funding from the United States Department of Health and Human
Services, Centers for Disease Control and Prevention(CDC) to further develop WCDPHE's
preparedness for and response to terrorism and non-terrorism events including infectious disease,
environmental and occupational related emergencies. The scope of work included in the contract
lists goals and measurements that support the CDC Preparedness Cooperative Agreement and the
10 Essential Public Health Services.
The time period for this contract is August 10, 2008 through August 9, 2009. I recommend your
approval.
Enclosure
2008-1862
STATE OF COLORADO
Bill Ritter,Jr.,Governor
James B.Marlin,Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado re
4300 Cherry Creek Dr.S. Laboratory Services Division
Denver,Colorado 80246-1530 8100 Lowry Blvd. `1876
Phone(303)692-2000 Denver,Colorado 80230-6928
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
June 6,2008
Mark Wallace
Executive Director
Weld County Department of Public Health
1555 North 17th Avenue
Greeley,CO 80631
Dear Local Health Partner:
Thank you for your continued dedication to support emergency preparedness and response in Colorado.
Enclosed please find three copies of your 2008-2009 Emergency Preparedness and Response Division Core Task Order,
routing number 09 FHA 00056,(Contract#EPI0900056),with the Colorado Department of Public Health and Environment
for the term of August 10,2008—August 9,2009.
All three copies must be signed with the appropriate signature and returned at your earliest convenience to: Judy Yockey,
Colorado Department of Public Health and Environment,EPRD-A5,4300 Cherry Creek Drive South, Denver,Colorado
80246-1530.
Upon receipt of the signed documents, I will route them for approval by the proper authorities. Please be advised that is not
an official notification of finding award or authorization to begin performance and that these agreements shall not be deemed
valid until the State Controller authorizes it.Your verified copies will be returned to you as soon as possible.
Your assistance in expediting these agreements is greatly appreciated. Please feel free to contact me if you should have any
questions or concerns.
Sincerely,
Judy Yockey
Contract Administrator
Emergency Preparedness and Response Division
Phone: 303-692-2645
Fax: 303-691-7811
E-mail:judv.vockev(u state.co.us
Attachments
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO.09 FHA 00056
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: CONTRACTOR:
State of Colorado for the use& benefit of the Board of County Commissioners of Weld
Department of Public Health and County
Environment 915 10th Street
Emergency Preparedness and Response Greeley, Colorado 80632-0758
Division for the use and benefit of the
4300 Cherry Creek Drive South Weld County Department of Public Health
Denver, Colorado 80246 and Environment
1555 North 17th Avenue
Greeley, Colorado 80631
TASK ORDER MADE DATE: CONTRACTOR ENTITY TYPE:
June 6, 2008 Colorado Political Subdivision
PO/SC ENCUMBRANCE NUMBER:
PO FHA EPI0900056
TERM: BILLING STATEMENTS RECEIVED.
This Task Order shall be effective upon Monthly
approval by the State Controller, or designee,
or on 08/10/08,whichever is later. The Task STATUTORY AUTHORITY:
Order shall end on 08/09/09. Not Applicable
PRICE STRUCTURE: CONTRACT PRICE NOT TO EXCEED:
Cost Reimbursement $224,902.00
PROCUREMENT METHOD: FEDERAL FUNDING DOLLARS: $224,902.00
Exempt STATE FUNDING DOLLARS: $
BID/REP/LIST PRICE AGREEMENT NUMBER: MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR:
Not Applicable FY 09: $224,902.00
LAW SPECIFIED VENDOR STATUTE
Not Applicable
STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE:
Judy Yockey Mark Wallace
Department of Public Health and Environment Executive Director
Emergency Preparedness and Response Division 1555 North 17tx'Avenue
4300 Cherry Creek Drive South Greeley,CO 80631
Denver,CO 80246
SCOPE OF WORK:
Contractor shall work with and through state,regional and local partnerships to achieve the activities
identified under the attached Scope of Work. Contractor shall ensure collaboration with the Colorado
Department of Public Health and Environment(CDPHE),local public health agencies and regional
Epidemiologist, Planner and Trainer staff members within the designated All-Hazards Region.
Page 1 of 4
Exmerrs.
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-I,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.
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
Page 2 of 4
Additional Provisions- Exhibit A,and its attachments if included,to this Task Order Contract;4) 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.
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 Weld County BILL RITTER,JR. GOVERNOR
for the use and benefit of the
Weld County Department of Public Health and
Environment
Legal Name of Contracting Entity
Hy
For Executive Director
Department of Public Health and Environment
��
/ Department Program Approval:
Signature of Authorized Officer JUL 0 22008
William H. Jerke, Chair By
Print Name&Title of Authorized Officer
i
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:
David J.McDermott,CPA
By t.-
Date 7 3 v O
WELD COUNTY DEPARTMENT F
P LIC HEA TH EN L NT
BY.
Mark E. Wallace, MD, MPH-Director
Page 4 of 4
l'Oe(J — i'ge
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 06/06/2008 - Contract Routing Number 09 FHA 00056
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 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 Preventions("CDC")has awarded federal funds under Award number U90/CCU816827,
hereinafter"Award",to develop emergency-ready public health departments by upgrading, integrating and
evaluating state and local public health jurisdictions'preparedness for and response to terrorism,pandemic
influenza,and other public health emergencies.
The State has formulated a comprehensive State plan,with associated budgets,to disburse these funds
throughout the state of Colorado. Under this comprehensive State plan, the State shall allocate these funds
to qualified entities to develop emergency-ready public health departments by upgrading, integrating and
evaluating state and local public health jurisdictions'preparedness for and response to terrorism, pandemic
influenza, and other public health emergencies with federal,state, local,and tribal governments,the private
sector,and non-governmental organizations(NGOs)for the citizens of the state of Colorado on behalf of
the State. These emergency preparedness and response efforts are intended to support the National
Response Plan(NRP)and the National Incident Management System(NIMS).
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. In consideration for those services timely and satisfactorily performed by the Contractor under this
Contract,the State shall cause to be paid to the Contractor a total sum not to exceed TWO HUNDRED
TWENTY FOUR THOUSAND NINE HUNDRED TWO DOLLARS($224,902.00)for the initial term
of this Contract from August 10,2008,through and including August 9,2009. Of this total amount,
$224,902.00 is identified as attributable to a funding source of the federal govemment.
5. This Contract is funded entirely with federal funds. Therefore,the State's liability for payment for all
services rendered, or goods supplied,under this Contract is contingent upon the State's receipt of those
federal funds. If the State does not receive all, or any part, of the federal funds necessary to pay its
obligations under this Contract,then the State may immediately amend or terminate this Contract without
further liability to the State.
To be attached to CDPHE Page I of 2 Revised: 12/19/06
Task Order v1.0(11/05)contract template
EXHIBIT A
6. To receive compensation under this Contract,the Contractor shall submit a signed monthly Emergency
Preparedness and Response Division Reimbursement Statement in accordance with the Emergency
Preparedness and Response Reimbursement Requirements. A sample Emergency Preparedness and
Response Division Reimbursement Statement is attached hereto as"Attachment A-1" and incorporated
herein by this reference. The Emergency Preparedness and Response Division Reimbursement
Requirements is attached hereto as"Attachment A-2"and incorporated herein by this reference. An
Emergency Preparedness and Response Division Reimbursement Statement must be submitted within thirty
(30)calendar days of the end of the billing period for which services were rendered. Final billings under
this Contract must be received by the State within a reasonable time after the expiration or termination of
this Contract; but in no event no later than thirty(30)calendar days from the effective expiration or
termination date of this Task Order Contract. Expenditures shall be in accordance with the Statement of
Work and Budget attached hereto as Exhibit B and incorporated herein, and in accordance with the work
requirements outlined in"Attachment B-1". Contractor shall be paid on a cost reimbursement basis only.
All items requested for reimbursement must be allowable and directly related to activities identified under
the Scope of Work. 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.
The State has the option to reduce the budget and the scope of work if the Contractor fails to submit
monthly invoice/cost reimbursement statements within thirty(30)calendar days. The monthly billing
performance shall also be used as a basis for calculating the Contractor's future funding levels, if any.
The State will notify the Contractor of the potential need to decrease the budget and scope of work. The
Contractor may supply the monthly invoice, back up documentation and request a re-determination, which
shall take place within fifteen(15)calendar days of the receipt of a written request. If no dispute is
received by the CDPHE within fifteen(15)calendar days,the State will take action and modify the contract
to reduce the budget and scope of work.
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:
Sonia Gonzales
Emergency Preparedness and Response Division
Colorado Department of Public Health and Environment
EPRD A-5
4300 Cherry Creek Drive South
Denver, CO 80246
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.
The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless
approved in writing by the appropriate federal agency.
To be attached to CDPHE Page 2 of 2 Revised: 12/19/06
Task Order v1.0(11/05)contract template
ATTACHMENT A
t ti ,, vs. . • {,� .. - y. gy 5y, tj1 s ...�e tess�apsl Res tas Is,,tany a „ � t' '
To: Colorado Dept.of Public Health&Environment From: -
Address. 4300 Cherry Creek Drive South,A-3 Address:
Denver,CO 80246
Attn: Sonia Gonzales Fax: (303)691-7811 Contact: Phone:
Program: Public Health Office of Emergency Preparedness Date of Expenditure: From:
and Response To:
Contract/PO: Final Invoice: Yes No FEIN:
•
gai4 :?. k -.�, a.�,��,_ �. ""-'r ` —_�-� .'o'e,.r'+-f��rru .�r.ara��.-x e
v3.,.i r :?} `fK. „.3,..' e*�at e ��}e��tvtO. c ��. A, t +" -1 d it e i� .
�� _ :L.� -�.E� �'�i�. ��"4+G ti ..rs .... w. —f.�� `4 .1 f �._ }.F �. o-...3 -�,
7 • f5 �i o ` ' nt e.` `y' 1 -.i d i �RI��� iii". ei ci .? .Z.'.!.:i.I�,! r
Personnel:
Salary&Fringe
+ .1 se cloa k alL I,PIIA/EPR Scope of Wo k - .. (ih rn$ok ,,, x''" — _ a
snnjtTaug.Ex P‘Re � e e �r.1 F
❑ Eptdenttbfogy Regiotia P{t t. ' ' r + ',:-,', c
is l4aalthdat7Preparedness ' Cr RegionalTrat r " 1;; „ ry' o_; ,"I
"t[3 ITi .t hiuttttIhuctpn a Other.[Piease=ex�ri rf}`�. ' ` tW�t'�I . ''
+"rte 5aa mow. { r { '4" *yam =,. , . *.,,f e .4e ° • �trff Swims _ •Nt—',,�.+"- 44:-..i..u� �wu;7'!S : �"".'` '"!'•17=:::-:•'4,•';‘G 'C;4., ..
Personnel Related Expenses Sub-Total: $0.00
Equipment:
Equipment Related Expenses Sub-Total $0.00
Travel:
Travel Related Expenses Sub-Total $0.00
Operating/Supplies:
l
Operating/Supplies Related Expenses Sub-Total $0.00
Indirect:
Indirect Total: $0.00
TOTAL REQUESTED REIMBURSEMENT AMOUNT: $0.00
I/We affirm the claimed expenses comply with the budget provisions of the contract and are reasonable and necessary,that all relevant progress and
other reports have been timely filed,and all contract milestones and/or tasks related to the billing period have been achieved.
Contractor Signature: Date:
FOR CDPHE APPROVAL ONLY
I affirm that I or my staff have reviewed the contractor's invoice and supporting documentation(as required,progress reports and other
communications with the contractor,and believe to the best of my knowledge,that the contractor is in compliance with all contract provisions.
CDPHE Contractor Monitor: Date:
I certify that the claimed expenses have been reviewed by me for compliance with requirements of funding source and State of Colorado's Fiscal
Rules,and are charged to the appropriate funding source.
CDPHE Fiscal Officer/Delegate: Date:
♦i--- , _r 1
ATTACMENT A-2
Emergency Preparedness and Response Division
2008 - 2009 Reimbursement Requirements
EXAMPLES OF REQUIRED EXPENDITURE DESCRIPTIONS - REQUIRED AGENCY RECORDS
TO BE INCLUDED ON lt►LL REIMBURSEMENT STATEMENTS FOR SITE VISIT VERIFICATION
PERSONNEL ➢ Breakout of actual amounts for salary,fringe
benefits and indirect rates
John Doe, 100%of Full Time Equivalent(FTE), $5,000.00
➢ Documentation of EPR activities and
Emergency Preparedness and Response(EPR)Planner,
projects for employees and time periods
Scope of Work(SOW)Reference
listed on invoice
Jane Black, 15 Flours, EPR Admin Support, $1.000.00
SOW Reference ➢ Activities must be directly related to EPR
➢ All of above information is needed even if
Fringe $1.236 00
personnel time is contracted out
• Invoice for actual time spent on EPR grant
• Include Name,Title, SOW Reference and Percent of FTE or
Flours Worked
• Select all Local Public Health Agency(LPHA)/EPR Scope of
Work categories that apply to this invoice(check appropriate
boxes)
EQUIPMENT—LIST ALL EQUIPMENT OVER$500.00 ➢ Original receipts
2 Computers $5,000.00 > Actual equipment being used appropriately to
2 Pagers $1,000.00 accomplish EPR activities
3 800 MHz Radios $3,500.00 > Documented check-out system if equipment
1 Fax Machine $500.00 is loaned out to other programs to track and
verify location and availability of all
equipment purchased with EPR funds
TRAVEL ➢ Signed mileage expense forms with itemized
list of travel related expenses for each traveler
Jane Dough,EPR Training $1,000.00 (including applicable receipts for hotel,
John Smith,Planning Conference $500.00 parking,per diem etc.)
➢ Meeting/conference(reason for travel)
• List each employee who traveled separate documentation,i.e.registration confirmation,
meeting minutes/attendance list etc.
OPERATING/SUPPLIES > Original Receipts
Copies $100.00 ➢ Actual existence of supplies
Office supplies $23.46
Postage $10.34 ➢ Documentation of operating expenses(phone
Telephone service(Cell and Main Line) $200.00 records,rental agreements,etc.)
Rent $300.00 > Documented formula for expenses that are
Equipment Maintenance $250.00 billed against multiple grants or programs
Audio Visual Equipment Rental $40.00
Task based funding for online course $1,000.00
• Itemize by type of expense(i.e.copies,office supplies)
Page 1 of 2
ATTACMEN I A-2
Emergency Preparedness and Response Division
2008 - 2009 Reimbursement Requirements
tiaii S Or REQUIRED EXPENDITURE D SCRII IO S REQUIRED AGENCY-REGORIIS ..
I Flit 4N taftWO!ON ALL REIMBURSEMENT STATEMENTS FOR SITE SIT VERT1 Ic 1IX0N
• * LABORTORY: Itemize separately by type of expense& item
• A copy of the receipt for any single item with a value of $1,000
or greater must be submitted with the invoice
INDIRECT ➢ Documentation of approved%of indirect
LPHA Approved Indirect Rate 10% ➢ Specific documentation may be required and
of Direct Salaries& Wages $1,243.00 will be identified on an individual basis
• List approved percentage, or requested percentage if less
• Indirect costs that exceed the approved contractual amount
will not be reimbursed
• Approved indirect rats are effect for the entire term of the
contractual agreement
• Per Capita is not an allowable category for expense reimbursement.
• All expenses must be directly related to specific Emergency Preparedness and Response Division activities
as identified in the Scope of Work.
• Contractor shall be paid on a cost reimbursement basis only.
• All expenses must be invoiced under the appropriate budget categories of Personal Services, Equipment,
Travel, Operating/Supplies or Indirect and in accordance with the above criteria.
• Cooperative agreement funds under this program may not be used to purchase vehicles or supplant any
current state or local expenditures. Supplantation means using Federal funds to replace local funds. The
Public Health Service Act,title I, Section 319 (c)specifically state: SUPPLEMENT NOT SUPPLANT.
Funds appropriated under this section shall be used to supplement and not supplant other Federal, State, and
local public funds provided for activities under this section. Therefore, the law strictly and expressly
prohibits supplanting.
• Department of Public Health &Environment, Emergency Preparedness and Response Division may request
additional back up information including copies of receipts on any item at any time.
• All Expenses must be encumbered by the grant end date, and all invoices must be submitted no later than 30
days after the grant end date.
Page 2 of 2
EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 06/06/2008-Contract Routing Number 09 FHA 00056
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 the Master Contract and this Task
Order, 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 "Attachment B-1" and incorporated herein.
To be attached to CDPHE Page 1 of I Revised: 12/19/06
Task Order v1.0(11/05)contract template
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Contract Term: August 10, 2008 through August 9, 2009.
Contract Objective: The Centers for Disease Control and Preventions(CDC)has developed Preparedness
Goals designed to measure urgent public health system response performance parameters that are directly
linked to health protection of the public. The Preparedness Goals are intended to measure urgent public health
system response performance for terrorism and non-terrorism events including infectious disease,
environmental and occupational related emergencies. For the purposes of this contractual agreement urgent
response is intended to indicate non-routine public health system reaction to limit possible mortality,
morbidity, loss of quality of life, or economic damage. The primary intent of this contractual agreement is to
fund the active participation of the Contractor in the immediate establishment, use, and continuous
improvement of a response system using the CDC Preparedness Goals to measure public health system
response performance.
Colorado Department of Public Health and Environment(CDPHE)shall be responsible for setting precedents
for actual response to a disease outbreak or emergency over the activity requirements of this contractual
agreement. The Contractor shall be responsible for the accomplishment of all Local Health Agency Activities
through State, Regional and Local partnerships and shall comply with Colorado Revised Statute 25-1.5-102.
Contractor shall work with and through state, regional and local partnerships to achieve the activities identified
under this Scope of Work. Contractor shall ensure collaboration with CDPI-IE, local public health agencies and
regional Epidemiologist, Planner and Trainer staff members within the designated All-Hazards Region.
Contractor shall ensure agency representation at the requested meetings, training sessions and conference calls.
Contractor shall designate at least one staff member as the point of contact for Emergency Preparedness and
Response activities, public information, communications, or media relations.
Any Contractor receiving funding to support regional staff and accomplish the regional Epidemiologist,
Planner and/or Trainer tasks, as identified and incorporated in this Scope of Work, shall ensure full
collaboration with and support for all agencies within the respective All-Hazards Region. Any Contractor
receiving regional funding shall be directly responsible for the accomplishment of the applicable
Epidemiologist, Planner and/or Trainer tasks as designated in the budget section of this Scope of Work.
Contractor shall utilize the Colorado Preparedness Reporting System (PRS) to document and monitor progress
and accomplishments on a regular basis. The due dates of the progress reports are February 28, 2009 and
August 8, 2009.
If the Contractor has expended 25% or more of the funds prior to February 28, 2009,the Contractor must
document activities and justify expenditures by entering progress data into PRS. Expenditure requests of 25%
or more may be held until progress data is entered.
Contractor understands and agrees that no amount of funding made available pursuant to this contractual
agreement can be used for any work or project other than that specified in this Scope of Work. Contractor
further understands that Contractor is not to include any work not related to the Scope of Work on any
reimbursement statements to the State. If Contractor mistakenly includes any unrelated work on an
reimbursement statement submitted pursuant to this contractual agreement, then Contractor hereby agrees to
return this amount of money to the State immediately upon becoming or being made aware.
Contractor shall ensure that all service related expenses will be completed and all goods related expenses
committed by August 09, 2009.
Page 1 of 21
Attachment B-t
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Contractor shall comply with all applicable Office of Management and Budget(OMB)circulars and shall be
subject to performance and financial site visits as requested by CDPHE. Contractor shall provide status
information periodically as requested by CDPHE and/or the CDC.
The Contractor shall maintain a complete file of all records, documents, communications, and other materials
that pertain to the operation of the activities under this contractual agreement. Such files shall be sufficient to
properly reflect all direct and indirect costs of labor, materials, equipment, supplies and services, and other
costs of whatever nature for which a reimbursement was made. These records shall be maintained according to
generally accepted accounting principles and shall be easily separable from other Contractor records.
Contactor's auditor shall perform audits in accordance with the requirements of the OMB Circulars A-87 (Cost
Principles for State, Local, and Tribal Governments), A-122 (Cost Principles for Non-Profit Organizations)
and A-133 (Audits of States, Local Governments, and Non-Profit Organizations), as applicable.
Contractor shall ensure that reimbursement requests are not duplicated under any other Public Health
Emergency Preparedness funding or utilized to supplant non-related activities or programs. Contractor shall
ensure appropriate distribution of costs in direct relation to the activities performed.
Supplantation: Cooperative agreement funds cannot supplant any current state or local expenditures.
Supplantation refers to the replacement of non-federal funds with federal fund intended to support the same
activities. The Public Health Service Act, Title I, Section 319 (c)specifically States: "SUPPLEMENT NOT
SUPPLANT. --Funds appropriated under this section shall be used to supplement and not supplant other
federal, state, and local public funds provided for activities under this section." Therefore, the law strictly and
expressly prohibits supplantation.
Unallowable Costs:
• Funds may not be used for research
• Reimbursement of pre-award costs is not allowed
• Funds under this program can not be used to purchase vehicles of any kind
• Funds may not be used to purchase incentive items
Page 2 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Contract Budget: Contractor's total award shall not exceed $224,902.00.
Contractor's total award includes $50,000.00 to ensure sustainability of laboratory services and
accomplishment of laboratory specific activities as identified under this Scope of Work.
Contractor's total award includes $120,000.00 for 1.50 Full Time Equivalent(FTE) in regional
funding to ensure accomplishment of the Epidemiologist and Planner tasks for the Northeast All-
Hazards Region. Contractor will utilize regional funding to support regional activities and all position
related costs including salary, fringe, equipment, travel, operating and supplies.
Contractor will ensure that Epidemiologist and Planner deliverables are accomplished for Weld
County.
The contractor will ensure participation in Epidemiologist and Planner regional meetings, county
meetings, and emergency preparedness conferences, as requested. This participation to include
meetings with the following counties: Cheyenne, Kit Carson, Larimer, Lincoln, Logan, Morgan,
Phillips, Sedgwick, Washington, Weld and Yuma.
Regional Staff Positions: Contractor will notify CDPHE of Regional Emergency Preparedness and
Response staff(Epidemiologists, Planners, and Trainers) turnover. Upon notification of the vacancy
the Colorado Department of Public Health and Environment (CDPHE) with support from the Local
Advisory Committee (LAC) will review agency and regional circumstances and decide if the position
needs to be maintained.
Real Event Deployment and meetings requested by CDPHE: Regional and other associated
emergency preparedness staff may be deployed to support a real emergency event, including
assistance to counties, as requested by local public health agencies and CDPHE.
Regional and other associated emergency preparedness staff should work with their respective
agencies to arrange for emergency travel reimbursement. All meals, hotel expenses, and other
associated travel costs will be eligible for reimbursement, through the current invoicing process.
Agency management must approve terms of deployment for an emergency event or meeting,
including timeline and location.
Contractor shall ensure compliance with the Emergency Preparedness and Response Division
Reimbursement Requirements and shall have the liberty to allocate funds across and in accordance
with the following budget categories:
Personnel: Contractor shall dedicate the necessary funds to support salary and fringe for any staff
member devoting time and effort towards the accomplishment of any activities identified under this
Scope of Work.
Page 3 of 21
Attachment B-t
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Equipment: Contractor shall dedicate the necessary funds to purchase equipment, as well as
maintain the working order of any existing equipment, required to meet any activity identified under
this Scope of Work. This shall include, but is not limited to, personal and portable computers,
communication radios, cellular telephones, facsimile machines, laboratory equipment, training
equipment, public information kits, etc.
Travel: Contractor shall dedicate the necessary funds to support travel related costs to ensure
accomplishment of activities identified under this Scope of Work. This shall include, but is not
limited to, regional planning meetings, local partner planning meetings, attendance at training
sessions, conferences, agency representation at the Emergency Preparedness and Response
conference calls and annual strategic planning meetings.
Operating and Supplies: Contractor shall dedicate the necessary funds for operating and supply
costs directly associated with any activities identified under this Scope of Work. This shall include,
but is not limited to, high-speed Internet connections, notification systems, telephone and
communication systems, office supplies, copying, printing, postage, room rental, software purchase
and upgrades, laboratory supplies, etc.
Indirect: The allowable indirect rate charged to this contractual agreement may be lower but shall
not exceed 13.96% of Total Direct Costs.
This indirect rate shall be in effect for the entire term of this contractual agreement. Contractor may
request a modification if a different indirect rate is negotiated within this term. Contractor must
provide written documentation identifying a significant financial impact in order to justify the
contractual agreement modification. All contractual agreement modifications will be reviewed on an
individual basis.
Contractor shall establish a process to track all obligations and expenditures related to this contractual
agreement separately from other funds awarded through the Public Health Preparedness and
Response Cooperative Agreement.
Sustainability: Contractor shall establish and maintain a sustainability plan, detailing how
emergency preparedness work is integrated, supported, and absorbed into the public health agency
and regional infrastructure. Sustainability plan must include agency provisions for program activities,
staff, and equipment needed to continue operations in the event of CDC Preparedness Cooperative
Agreement grant reductions. This plan should be updated and kept on file at the agency.
Page 4of21
•
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Contract Work Plan: This Task List supports the Centers for Disease Control and Prevention (CDC)
Preparedness Cooperative Agreement and the 10 Essential Public Health Services. Both resources provide a
working definition for public health, and guide the framework for Colorado preparedness responsibilities and
local public health systems. All activities below have been linked to the Essential Public Health Services and CDC
Goals
For additional information on the Essential Public Health Services or the CDC Cooperative Agreement,please go
to:
I. http://www.cdc.gov/od/ocphp/nphpsp/EssentialPHServices.htm
2. http://www.bt.cdc.gov/planning/coopagreement/
C. Local Agency Year Three Activities=2008-2009 Agency Deliverables to be completed
o Colorado Department of Public Health and Environment(CDPHE)Measure=Deliverable criteria used to report
activity progress in the Colorado Preparedness Reporting System(PRS)
• All agencies receiving these funds will be required to report progress to Progress Reporting System(PRS)by
February 28,2009, and August 1,2009. Pending reimbursement requests will only be considered for agencies that
have completed reports in PRS
o All agencies receiving these funds must attach required documents to the Colorado Health Alert Network(COHAN)
portal as indicated
o All agencies receiving these funds must sustain the security and reliability of computer and communication systems
C. If the CDC requests further information before this reporting deadline, all agencies receiving these funds may be
contacted to provide additional information
o Only Essential Services with applicable deliverables will be listed under the Local Agency Scope of Work for 2008-
2009
I.
Essential Public Health Service#3: Inform, educate, and empower people about health issues
Essential Public Health Service#4: Mobilize community partnerships to identify and solve
health problems
Essential Public Health Service #5: Develop policies that support individual and community
health efforts
CDC Goals /, 6, 9
Local Agency Activity CDPHE Measure
1.1.Participate in at least one local medical surge tabletop 1.1 (I). Documented participation in at least one
exercise by June 1,2009. local medical surge tabletop exercise by June I,
2009.
• Utilize objectives provided by CDPHE and developed by the region,based on areas for improvement from past
exercises;the medical surge target capability;and results
from the 2008 Emergency Preparedness and Response
(EPR)training and exercise needs assessment.
• At minimum, invite public health, emergency
management,hospitals, Emergency Medical Service
(EMS), outpatient clinics,rural and community health,
long-term care,nursing homes,and mental health.
Page 5 of 21
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Local Agency Activity CDPHE Measure
1.2. Enhance collaboration with federal, state,and local 1.2(I). Document meetings and other collaborative
governmental and private agencies in the community,that efforts with federal,state, local governmental and
investigate,respond, and provide support regarding issues private agencies in the community, who can respond,
related to health and environmental hazards and disparities. and provide support regarding issues related to health
• Develop partnerships with the local business and environmental hazards and disparities.
to enlist their participation in All- Suggested documentation to be kept on file, includes:
community(s) • Agenda
Hazards planning activities. • Meeting minutes
1.3 Plan and document procedures to restore health services 1.3 (1). Documented meetings with emergency
and environmental safety to pre-incident levels. preparedness partners to review and establish
Continue post incident recovery planning and operations protocols for restoring health services and
meetings to review existing policies and processes,and environmental safety to pre-incident levels.
establish additional protocols as needed.
Suggested documentation to be kept on file, includes:
1.3a. Work with(at minimum) local emergency management, • Sign-in roster
environmental health partners, and local medical professionals • Agenda
to establish the following criteria:
• Specifically delineate what the roles of specific 1.3a(1)Included incident recovery planning
agencies are during incident recovery stages after an specifications in local Public Health Emergency
emergency. Operations Plan(PHEOP). Post PHEOP plan to
• Outline specific steps to ensure external and internal COHAN in the appropriate All-Hazards Regional
communications are maintained/established folder and subsequent agency folder by July 31,2009.
between public health, environmental health, medical
partners, and emergency management during
incident recovery stages.
• Outline plans and protocols to be initiated during the
incident recovery stages.
1.4 Utilize the most current Public Health Emergency 1.4(1). Posted updated PHEOP,with all minimum
Operations Plan (PHEOP)template to update this plan and requirements using the most current up to date PHEOP
the associated Emergency Support Function(ESF)#8 annex. template,to COHAN in the appropriate All-Hazards
PHEOP must include at a minimum: Regional folder and subsequent agency folder by July
• Disaster Behavioral Health lead identification 31,2009.
• Incident recovery planning
• For each identified Alternate Care Facility(ACF)in 1.4a(1). Included COOP Annex in the PHEOP, and
the county,please include: posted to COHAN in appropriate All-Hazards Regional
o ACF location folder and subsequent agency folder by July 31,2009.
o ACF contact information
o Identify the agency who has the authority for
activation of each ACF in the county
o 24/7 ACF activation protocol procedures and
contact information
1.4a. Maintain, update, and exercise agency Continuity of
Operations(COOP)Annex to the PHEOP by July 31,2009.
• Utilize the Continuity of Operations
(COOP)Annex to the PHEOP
template, as provided by CDPHE,
COOP
Page 6of21
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Local Agency Activity CDPHE Measure
1.5. Work with Regional staff to update local information in 1.5 (I).Updated and maintained SNS contact partners,
the Strategic National Stockpile(SNS)plan, as necessary. providing this information to the Regional Planner,as
requested, by January 15, 2009.
• Plan must be updated according to the Strategic
National Stockpile Emergency Response Plan
Template.
• CDPHE will provide guidance and updates for
integrating the most current Technical Assistance
Review(TAR)criteria.
1.6.Continue to participate in local Healthcare Coalitions in 1.6 (1). Documented meetings with Healthcare
the Region. At a minimum, the meetings should address: Coalitions in the Region.
• Alternate Care Facility(ACF)planning
• How staffing will be initiated and maintained at the Suggested documentation to be kept on file, includes:
ACFs during activation • Sign-in Roster
• Procedures for accessing&activation of local • Agenda
Mobile Medical Caches
1.7. Identify a local ESF#8 lead agency that is approved by 1.7(I). Provided local ESF#8 lead agency contact
the local office of emergency management for: information to the State ESF#8 lead by October 30`",
2008. For each agency contact,please provide: (I)
• Public Health(prevention&control, human illness) main telephone number,and(2)a 24/7 contact number.
• Mortuary(Death certificates, victim family
notification)
• Environmental Health(Air, water,food, risks to
humans& environment)
• Medical(patient care)
1.8. (For Agencies that have been identified and approved by 1.8(I). Documented that the local ESF#8 Lead has
local emergency management). Local ESF#8 Lead must participated in HC Standard trainings&drills, as
participate in Health Care (HC)Standard trainings&drills, as scheduled by CDPHE by August 9,2009.
scheduled by CDPHE by August 9th,2009.
1.9. Participate in local Colorado Volunteer Mobilizer 1.9(1).Identify a CVM Coordinator at the
(CVM)coordination,training, and exercises. local/regional level and provide that person's contact
information to the State CVM Coordinator by
November 6, 2008.
1.9(2). Documented that the local CVM coordinator
has received CVM training by May 8,2009,as
documented in CO.TRAIN.
1.9(3). Document that the local CVM has started to
recruit local volunteers by August 9, 2009. (Keep on
agency file).
1.9 (4). Participated in at least I CDPHE sponsored
CVM drill by August 9,2009.
1.10. Update Local Public Health Agency Point of 1.10. (I). Posted the updated Local Public Health
Distribution(POD)Plan per lessons learned from the Agency POD Plan per lessons teamed from the
November 2007 POD Squad exercise. November 2007 POD Squad exercise to COHAN
under the appropriate All-Hazards folder by April 3`a
2009.
1.11. Maintain key stakeholder information; including,but not 1.11 0). Updated and maintained contact information
limited to jurisdictional medical providers, school districts, on COHAN quarterly, especially for 24x7 emergency
Page 7of21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
emergency management and other jurisdictional partners. contact role. Detect and correct errors.
Information must be updated at least quarterly.
1.12. Use statewide technology information systems for 1.12(1). Maintained Health Alert Network(HAN)
communication(such as COHAN, Dialogics, CO.TRAIN, communication protocol and capability.
PRS, Colorado Electronic Data Reporting System(CEDRS), • Posted protocol on COHAN in agency
Outbreak Management System(OMS), Integrated Data specific folder. Ensure appropriate agency
Repository, Situational Awareness Tool, secure messaging, staff is trained on the HAN communication
etc.). protocol.
1.12 (2). Conducted quarterly tests and assessed
1.12a. Ensure redundant communication system response rates of fax and at least one other device
infrastructure. (phone, radio, e-mail). (Keep response rates and
testing information on file).
1.12a. (I). Demonstrated the possession of a back-up
redundant system(s)that doesn't rely on the same
infrastructure as the primary and ability for multiple
methods of contact(phone, fax,radio, and e-mail)
during emergency conditions(e.g. no cell phone).
Page 8 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
(Lo .. . � i
II.
Essential Public Health Service#2: Diagnosis and investigate health problems and health
hazards in the community
Essential Public Health Service #8: Assure a competent public health and personal health care
workforce
CDC Goals 1,3,5, 6
Local Agency Activity CDPHE Measure
5.1. Acquire and maintain relevant laboratory capability and 5.1 (1). Documented laboratory capability through
capacity for response for the identification of biological agents equipment,staff,and other resources to support
in clinical(human and animal), environmental, and food laboratory identification of multi-specimens. (Keep on
specimens. agency file).
5.2. Perform testing and CDPHE-provided proficiency testing 5.2(I). Documented the use of LRN specimen testing
according to the Laboratory Response Network(LRN) methods and report results of LRN tests to LRN. (Keep
protocols(not to be shared for any reason to non-approved on agency file).
agencies).
5.3 Expedite the reporting(within 24 hrs.) of the results of LRN 5.3 (1). Provided specimen testing result documentation
testing activity to CDPHE,the LRN, and the CDC upon and progress reports,as requested by CDPHE and
request, including progress reports as required. CDC.
5.4.Obtain and maintain needed permits, licenses and 5.4(1). Provided documentation of certification,
certification to allow for LRN testing. permits, and licenses.
5.5 Provide a representative to attend the Colorado Laboratory 5.5 (1). Documented staff attendance at the Colorado
Forum meetings,and attend audio conferences as needed. Laboratory Forum meetings, and audio conferences.
(Keep on agency file).
5.6. Conduct testing of environmental specimens classified as 5.6(1). Documented the classification and testing of
non-credible threats by Federal Bureau of Investigation(FBI)or environmental specimens. (Keep on agency file).
other qualified law enforcement authority.
5.7. Participate in exercises and assessment studies and conduct 5.7(I). If no real events occur in the off-hours time
proficiency testing. frame,sentinel laboratories documented participation in
rapid response scenario(s), involving call-down
procedures, communications, and laboratory response
time assembly,testing and reporting.
5.8. Enter progress reports data into the Preparedness Reporting 5.8(1).Entered progress data into PRS.
System(PRS), as requested by CDPHE.
5.9. Establish lines of communications with regional partners I). Documented communication strategies with regional
including CDPHE,public health, environmental health,public health, environmental health, safety, hospital, and other
safety,hospitals and others as needed. (Keep on agency file). rs as needed.
5.10. Maintain LRN membership by successfully participating 5.10(1). Documented participation in LRN proficiency
in LRN proficiency test exercises. exercises.
5.11. Establish lines of communication and/or Public Health 5.11 (I). Documented PHIN-compliant information
Information Network(PHIN)compliant information systems systems and/or communication strategies with regional,
with regional partners including CDPHE,public health, public health, environmental health, public safety,
environmental health,public safety, hospitals and others as hospitals and others as needed.
needed.
Page 9 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Local Agency Activity CDPHE Measure
5.12. Accommodate inspection of Biosafety Level(BSL)-3 5.12(I). Documented the completion of an inspection
laboratory,to be completed by CDPHE staff as requested, of BSL-3 laboratory by CDPHE staff.
annually.
Page 10 of 21
•
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
For Agencies with Regional Epidemiologist ONLY
• Regional Epidemiologist Year Three Activities=2008-2009 Agency Deliverables to be completed
• Only Essential Services with applicable deliverables will be listed under the Epidemiologist Task List for 2008-2009
I. Essential Public Health Service#1: Monitor health status to identify community health problems
CDC Goals 1, 4, 5, 9
Regional Activity CDPHE Measure
El. Assess the timeliness and completeness of El (I). Submit a report regarding the assessment of timeliness and
communicable disease reporting in the region/ completeness of communicable disease reporting in the
jurisdiction by either reviewing semi-annual CDPHE- region/jurisdiction, problems identified,and how these were
generated tabulations or some other method. addressed.
E2. Participate in the pandemic surveillance and E2(1). Provide a summary of the exercise for your region to CDPHE
reporting exercise to be held in the fall of 2008. by December 12,2008.
II. Essential Public Health Service #2: Diagnosis and investigate health problems and health
hazards in the community
CDC Goals 1, 4, 5, 9
Regional Activity CDPHE Measure
E3. Demonstrate competency in communicable disease Please complete three of the five measures listed below:
outbreak investigation skills. E3 (I). Submit a formal outbreak investigation report(in most cases,
this is different than an"after-action report").
E3 (2). Incorporate National Incident Management System
(NIMS)/incident Command System(ICS) into a multi jurisdictional
or large communicable disease investigation,or other large event.
Document the investigation or event for which NIMS/ICS was used.
E3 (3). Use the(CDPHE)Outbreak Management Systems(OMS) for
a disease/outbreak investigation and submit a report, including
suggestions for enhancing the OMS.
E3 (4). Submit CDC Electronic Foodbome Outbreak Reporting
System(eFORS) forms("Fork and Spoon" forms)to CDPHE within
two months after the first illness onset of the outbreak.
E3 (5). Conduct a presentation on a disease investigation at an
epidemiological or emergency preparedness conference(within
Colorado or nationally).
III. Essential Public Health Service #3: Inform, educate, and empower people about health issues
CDC Goals 1, 4, 6
Regional Activity CDPHE Measure
E4. Distribute disease surveillance data generated by E4(I). Document dates when disease surveillance data was
CDPHE or by a local public health agency to health care distributed to health care providers or local public health agencies,a
providers in the region/jurisdiction, or provide the data summary of content, and the method that was used to distribute the
directly to local public health agencies in the information.
region/jurisdiction so they can distribute to health care
providers.
Page 11 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Activity CDPHE Measure
E5. Prepare at least one article to be included in the E5 (1). Submit one or more articles to CDPHE for inclusion in the
weekly"Hot Topics in Epidemiology" update distributed "Hot Topics in Epidemiology" update.
by CDPHE.
IV. Essential Public Health Service#4: Mobilize community partnerships to identify and solve
health problems
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure
E6. Integrate with local and regional public health E6 (I). Submit a report documenting how the regional
preparedness staff,and with local public health agency epidemiologist has integrated into local and regional public health
communicable disease staff preparedness activities and local communicable disease activities.
E7. Regional epidemiologists(or an epi-trained designee E7(1). Document assistance in a real situation of need/urgency, as
from the regional epidemiologist's office)may be requested by CDPHE.
deployed or asked to assist in a real situation of
need/urgency, including assistance to counties, as
requested by CDPHE.
V. Essential Public Health Service#8: Assure a competent public health and personal health care
workforce
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure
E8. Educate clinical labs,hospital infection control E8 (1). Documented meetings with clinical labs, infection control
practitioners,and local public health agencies in the practitioners, and local public health agencies where education was
region/jurisdiction about the list of reportable diseases, provided on reportable diseases and lab testing capabilities. Note:
reporting requirements, Colorado Electronic Data Denver Metro area epidemiologists(Boulder, Broomfield, Denver,
Reporting System(CEDRS),and CDPHE lab testing Jefferson, Tri-County) are not required to meet with hospital Incident
capabilities. Command Posts (ICPs) and clinical labs as the CDPHE Emerging
Infections Program regularly does this.
E9. Participate in regional epidemiologist conference E9(1). Participated in at least 80%of the twice-monthly conference
calls and regional staff meetings/trainings. calls.
E9(2). Presented or lead a discussion during one of the regional
epidemiologist conference calls.
E9(3). Participated in writing the conference call minutes as assigned.
E9(4). Participated in the regional epidemiologist and regional staff
meetings/trainings, including the one-day public health preparedness
planning conference to be held in the spring of 2009.
EI0.New Regional Epidemiologists will successfully El0(I). Completed the Public and Environmental Health Radiological
complete the Public and Environmental Health CD.online Training(PEHRT), by August 9, 2009,as documented on
Radiological CD.online Training(PEHRT),by August 9, CO.TRAIN.
2009.
El I. Attend the Modular Emergency Response El I (I). Documented successful completion of the Modular
Radiological Transportation Training(MERRTT) Emergency Response Radiological Transportation Training
course. (MERRTT)course by August 9, 2009.
Page 12 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Epidemiologist Coordinator Meeting and Conference Call Calendar
2008 - 2009
Date Type Location/Time
August 20, 2008 Regional Epi Conference Call 9:30- 10:30 am
September 3, 2008 Regional Epi Conference Call 9:30- 10:30 am
September 17, 2008 Regional Epi Conference Call 9:30 - 10:30 am
October 1, 2008 Regional Epi Conference Call 9:30- 10:30 am
October 15, 2008 Regional Epi Conference Call 9:30- 10:30 am
October 22-23, 2008 Regional Staff Meeting CDPHE Denver Office
November 5, 2008 Regional Epi Conference Call 9:30- 10:30 am
November 19, 2008 Regional Epi Conference Call 9:30- 10:30 am
December 3, 2008 Regional Epi Conference Call 9:30- 10:30 am
December 17, 2008 Regional Epi Conference Call 9:30- 10:30 am
January 7, 2009 Regional Epi Conference Call 9:30- 10:30 am
January 21, 2009 Regional Epi Conference Call 9:30 - 10:30 am
February 4, 2009 Regional Epi Conference Call 9:30- 10:30 am
February 18, 2009 Regional Epi Conference Call 9:30 - 10:30 am
March 4, 2009 Regional Epi Conference Call 9:30- 10:30 am
March 18, 2009 Regional Epi Conference Call 9:30 - 10:30 am
April 1, 2009 Regional Epi Conference Call 9:30- 10:30 am
April 15, 2009 Regional Epi Conference Call 9:30 - 10:30 am
May (Date To be Determined) Regional Staff Meeting and To be Determined
Planning Conference (TBD)
May 6, 2009 Regional Epi Conference Call 9:30 - 10:30 am
May 20, 2009 Regional Epi Conference Call 9:30- 10:30 am
June 3, 2009 Regional Epi Conference Call 9:30- 10:30 am
June 17, 2009 Regional Epi Conference Call 9:30- 10:30 am
July 1, 2009 Regional Epi Conference Call 9:30- 10:30 am
July 15, 2009 Regional Epi Conference Call 9:30- 10:30 am
August 5, 2009 Regional Epi Conference Call 9:30 - 10:30 am
Page 13 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
For Agencies with Regional Planners ONLY
Regional Planner Year Three Activities=2008-2009 Agency Deliverables to be completed
C. Only Essential Services with applicable deliverables will be listed under the Planner Task List for 2008-2009
I. Essential Public Health Service#4: Mobilize community partnerships to identify and solve
health problems
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure _
PI Update the Regional Strategic National Stockpile(SNS)plan P 1 (1). Posted SNS plan to the appropriate All-Hazards
and post to COHAN under appropriate All-Hazards COHAN COHAN folder by March 31, 2009.
folder.
• Plan must be updated according to the Strategic National *Please note: deadline for completion of SNS plans is
Stockpile Emergency Response Plan Template. contingent upon date of the CDC/Division of the
Strategic National Stockpile(DSNS)annual
• CDPHE will provide guidance and updates for assessment. SNS plans must be completed prior to
integrating the most current Technical Assistance Review assessment.
(TAR)criteria.
P2 Assist Local Public Health Agencies with updating local Point P2(1). Posted the updated Local Public Health
of Distribution(POD)Plans per lessons learned from the Agencies POD Plans to COHAN under the appropriate
November 2007 POD Squad exercise. If no POD site was All-Hazards folder by April 3,2009.
activated during POD Squad, update local POD plans per gaps
identified during a local POD event(real event or simulated
exercise event).
P3. Participate in Planner Meetings,The Annual Public Health P3 (1). Participated in at least 80%of the conference
Emergency Preparedness Planning Conference, and Planner calls and meetings, as scheduled by CDPHE.
Conference calls(including SNS),as scheduled by CDPHE.
P4. Continue to participate in local Healthcare Coalitions in the P4(1). Update Public Health Emergency Operations
Region. At a minimum,the meetings should address: Plan(PHEOP)with procedures, protocols or planning
• Alternate Care Facility(ACF)planning that are outcomes of Healthcare Coalition meetings and
• Address how staffing will be initiated and maintained at
the ACFs during activation P4(2). Documented meetings with Healthcare
• Determine procedures for accessing&activation of local Coalitions in the Region.
Assistant Secretary for Preparedness and Response
(ASPR)Mobile Medical Caches. Suggested documentation to be kept on file, includes:
• Sign-in roster
• Agenda
• Meeting minutes
II. Essential Public Health Service #5: Develop policies that support individual and community,
health efforts
CDC Goals 1, 4, 6,
Regional Activity CDPHE Measure
P5.Assist local public health agencies through resources and P5 (I). Posted local PHEOP,with all minimum
technical assistance, in the development and or updates of the requirements using the most current up to date PHEOP
Public Health Emergency Operations Plan(PHEOP). Planners
Page 14 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Activity CDPHE Measure
must utilize the most current version of the PHEOP template template,to COHAN in the appropriate All-Hazards
posted onto COHAN. PHEOP must reference at a minimum the Regional folder and subsequent agency folder by July 31,
following topics: 2009.
• Disaster Behavioral health lead identification
• Incident recovery planning
• For each identified Alternate Care Facility(ACF) in
the county,please include:
o ACF location
o ACF contact information
o Identify the agency who has the authority for
activation of each ACF in the county
o 24/7 ACF activation protocol procedures and
contact information
• Update the incident-specific annex entitled `Pandemic
Influenza'
P5a. l.4a. Assist local public health agencies to maintain,
update,and exercise agency Continuity of Operations(COOP)
Annex to the PHEOP by July 31,2009.
• Utilize the Continuity of Operations (COOP)Annex to
the PHEOP template, as provided by CDPHE, COOP
P6. Continue to coordinate and integrate All-Hazards partners P6(I). Documented meetings with All-Hazards partners in
that lead or support Emergency Support Function#8 activities the community who can respond to health and
(public health, environmental health, medical, mortuary and environmental health hazards.
behavioral health).
P6(2). Utilized outcomes of All-Hazards partner meetings
Partners should include but aren't limited to: public health, to update plans, protocols, and procedures.
hospitals, outpatient clinics, community/rural health, physician's
offices, long-term care, nursing homes,behavioral health,
emergency management, military, education, corrections, law
enforcement, fire, Emergency Medical Services(EMS),
governmental officials, Tribal Nations, non-profit,community
and faith-based organizations.
III. Essential Public Health Service #8: Assure a competent public health and personal health
care workforce
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure
P7. New Regional Planners will successfully complete the P7 (1). Completed the Public and Environmental Health
Public and Environmental Health Radiological CD/online Radiological CD/online Training(PEHRT)for new staff
Training(PEHRT),by August 9,2009. by August 9, 2009,as documented on CO.TRAIN.
P8. Attend a state and/or national emergency preparedness P8. (1)Attended at least one emergency preparedness
conference(s)of Regional Planner's choice as approved by conference for the 2008-2009 contract year. (Attendance
CDPHE. documentation to be kept in agency file).
Page 15 of 21
•
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Activity CDPHE Measure
P9.Assist CDPHE with the coordination of local agency site P9(1). Assisted CDPHE with site visit coordination,as
visits,as requested. requested. (Assistance documentation to be kept in agency
• Serve as the CDPHE contact person for the site visits fle)'
in your region.
• Support the CDPHE site visit process by coordinating
local agency, regional staff, dates,and times,as
needed.
• Regional Planner will attend site visit meetings in the
region, as needed.
P I0. Participate in at least one Local or Regional tabletop p 10(I). Participated in at least one local medical surge
exercise by June 1,2009 where Medical Surge was a specific tabletop exercise by June 1,2009, as documented in
Target Capability tested. CO.TRAIN.
• Utilize objectives provided by CDPHE, and integrate
with objectives developed by the region, based on areas
for improvement from past exercises;the medical surge
target capability;and results from the 2008 Emergency
Preparedness and Response(EPR)training and
exercise needs assessment.
• At minimum, invite public health, hospitals, EMS,
outpatient clinics,rural and community health, long-
term care, nursing homes, mental health, tribal nations
and emergency management.
P11.Attend the Modular Emergency Response Radiological P I I (I). Documented successful completion of the Modular
Transportation Training(MERRTT)course. Emergency Response Radiological Transportation Training
(MERRTT)course by August 9, 2009.
P12.All Regional Staff must participate in the Public Health P12(I). Documented successful completion of the Public
101 course developed by the regional Training Coordinators by Health 101 course developed by the regional Training
August 9,2009. Coordinators by August 9, 2009.
Page 16 of 21
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Epidemiologist Coordinator Meeting and Conference Call Calendar
2008 - 2009
Date Type Location/Time
August 19, 2008 Planner Conference Call 1:00-2:15
October 22—23,2008 Regional Staff Meeting To be Determined
(TBD)
December 2,2008 Planner Conference Call 1:00—2:15
January 2009 Planner Meeting(tentative) TBD
February 10, 2009 Planner Conference Call 1:00-2:15
April 14, 2009 Planner Conference Call 1:00-2:15
May 2009(TBD) Regional Staff Meeting(2 days) TBD
June 16,2009 Planner Conference Call 1:00-2:15
Page 17 of 21
•
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
For Agencies with Regional Trainers ONLY
Regional Trainer Year Three Activities=2008-2009 Agency Deliverables to be completed
Only Essential Services with applicable deliverables will be listed under the Trainer Task List for 2008-2009
I. Essential Public Health Service#4: Mobilize community partnerships to identify and solve health
problems
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure
TI. Work with the regional planner to provide each agency,nursing TI (1). Trained appropriate public health staff in
service, and relevant response partners in the region, with training, each agency and nursing service in your region in
information and technical assistance related to the Regional Strategic the use of the Regional SNS plan by July 30,2009.
National Stockpile(SNS)plan.
T1 (2). Posted training to CO.TRAIN. All
participants who complete a training must be
verified in CO.TRAIN no more than 30 days after
the event.
T2. Assist local Medical Reserve Corps(MRC)Coordinators and/or T2(I). Documented assistance to the local MRC
county/regional Colorado Volunteer Mobilizer(CVM)coordinator in Coordinators and/or county/regional CVM
providing at least one training for volunteers registered in the Colorado coordinator in providing at least one training for
Volunteer Mobilizer System. volunteers registered in the Colorado Volunteer
Mobilizer.
T2(2). Posted training to CO.TRAIN.All
participants who complete a training must be
verified in CO.TRAIN no more than 30 days after
the event.
II. Essential Public Health Service#5: Develop policies that support individual and community
health efforts
CDC Goals 1, 4, 6
Regional Activity CDPHE Measure
T3 (1). Trained appropriate public health staff in each T3 (1). Trained appropriate public health staff in each agency
agency and nursing service in your region on the Public and nursing service in your region on the changes/updates
Health Emergency Operations Plans(PHEOP)and made to PHEOP at least once during fiscal year 08-09.
associated Emergency Support Function #8 annex,the
PHEOP at least once during FY08-09. T3 (2). Posted training to CO.TRAIN. All participants who
Work with the regional planner to meet state complete a training must be verified in CO.TRAIN no more
• requirements and complete necessary planning and than 30 days after the event.
training activities as related to PHEOP annexes:
Pandemic Influenza, Community Containment,
Mass Fatality,and Continuity of Operations Plan
(COOP).
Page 18 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
T4. Assist Local Public Health Agencies with updating T4(1).Trained appropriate public health staff in each agency
local Point of Distribution(POD) Plans per lessons learned and nursing service in your region on POD Plan updates by
from the November 2007 POD Squad exercise. May 29,2009
T4(2). Posted training to CO.TRAIN. All participants who
complete a training must be verified in CO.TRAIN no more
than 30 days after the event.
III. Essential Public Health Service #8: Assure a competent public health and personal health care
workforce
CDC Goals 1, 6, 9
Regional Activity CDPHE Measure
15.Update distance learning contact information for T5(1)Distance learning technology location information was
updated and posted on COHAN biannually—updates to be
satellite downlink, computer lab and video conferencing
made in September 2008 and March 2009.
sites.
T6(I). Documented participation in RTC meetings,Annual
T6. Participate in Regional Training Coordinator(RTC) Planning Conference, and at least 80%of the monthly trainer
Meetings and conference calls in the 2008-2009 grant year. conference calls.
(See tentative schedule provided by the state).
T7. Attend at least one state and/or national emergency T7(1). Attended at least one emergency preparedness
preparedness conference of the Regional Training conference for the 2008-2009 grant year. (Keep in agency
Coordinator's choice. file).
TS. Participate in at least one local medical surge tabletop T8(1). Participated in at least one local medical surge
exercise by June I, 2009. tabletop exercise by June 1, 2009,as documented in
CO.TRAIN.
m Utilize objectives provided by CDPHE,and
integrate with objectives developed by the region,
based on areas for improvement from past
exercises;the medical surge target capability;and
results from the 2008 EPR training and exercise
needs assessment.
• At minimum, invite public health, hospitals, EMS,
outpatient clinics, rural and community health,
long-term care, nursing homes, mental health,
tribal nations and emergency management.
T9.New Regional Trainer(s)successfully complete the T9(1). Completed the Public and Environmental Health
Public and Environmental Health Radiological CD/online Radiological CD/online Training(PEHRT),by August 9,
Training. 2009,as documented in CO.TRAIN.
TI 0. Encourage new environmental health staff to complete TI 0(1). Encouraged new environmental health staff to
the Public and Environmental Health Radiological complete the Public and Environmental Health Radiological
CD/online Training(PEHRT),by August 7,2009. CD/online Training(PEHRT), by August 7,2009.
TI1. Attend the Modular Emergency Response TI I (I). Documented successful completion of the Modular
Radiological Transportation Training(MERRTT)course. Emergency Response Radiological Transportation Training
• Promote MERRTT course to local public health (MERRTT)course by August 9,2009.
and environmental agencies in the regional
community.
T12. Work with each local agency and nursing service in T12(1). Using the Three-Year Training and Exercise template
Page 19 of 21
Attachment B-1
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Activity CDPHE Measure
the region to develop an emergency preparedness training provided by CDPHE, posted all completed Training and
calendar and matrix by October 15,2008. At a minimum, Exercise Plans on COHAN under appropriate All-Hazards
each agency should participate in the following courses: folder by October 30, 2008. All training plan documents must
• Medical Surge exercise be linked to the "Training Plan"category in COHAN.
• NIMS required courses as appropriate for agency
positions T12 (2)Using the format provided by CDPHE, included an
• PHEOP Update/Orientation appendix to the Training and Exercise Plan that contains the
• Emergency communications (800 MHz radios, results of the region's training needs assessment.
COHAN, and/or other devices used by the agency)
• EPR 101 (Emergency Preparedness 101 online T12 (3). All emergency preparedness training provided to
course) agency staff was made available for registration on
• SNS 101 (Strategic National Stockpile 101 online CO.TRAIN prior to the event. All participants who complete
course) a training must be verified in CO.TRAIN no more than 30
• Basic Principles in Personal Protective Equipment days after the event.
(online course)
• Public Health 101 (online course when it is made T12 (4). Posted all public health emergency preparedness and
available) response training and presentation materials in COHAN under
the All-Hazards Resources: Training and Presentation
The calendar should include the tentative courses for each Materials folder by September 30,2008 and ongoing
agency/region that will be provided during the 2008-09 thereafter.
grant year as well as the following for each course listed:
• Course Name/Topic T12 (5). Removed out-of-date training and presentation
• Tentative course dates, times and locations materials from the All-Hazards Resources: Training and
Presentation Materials folder by November 30, 2008 and
The agency/region training calendar and training matrix ongoing thereafter.
should be included in the Three-Year Regional Training
Plan.
T13. Continue to integrate the National Incident T13 (1). Worked with the local agencies to ensure that each
Management System(NIMS)compliance, including agency documents staff trained in Incident Command System
assessment and training, according to the NIMS National (ICS)and NIMS using the spreadsheet provided by CDPHE.
Integration Center guidelines. Only the Federal Emergency Management Agency(FEMA)
certificate or paperwork verifying the completion of an
• All agency staff must be trained in ICS-100 and equivalent ICS-100 or ICS-200 course can be used to confirm
Information System-700(IS-700). that an employee has been trained in ICS and NIMS.
• All supervisory staff must be trained in ICS-100,
ICS-200,and IS-700. T13 (2). Ensured that each agency provides the updated
• All program managers and employees who will be NIMS and ICS training data using the provided spreadsheet to
expected to work in the agency's emergency you quarterly(September, December, March and June)
operations center, and/or all personnel with a
direct role in emergency preparedness must be T13 (3). Ensured that all ICS and NIMS training data is
trained in ICS-100, ICS-200, ICS-300, IS-700 and entered into CO.TRAIN and verified quarterly(October,
IS-800. January, April, and July).
• Agency directors,executive level staff and all staff
pre-identified to perform duties as a Unified TI3 (4). Documented assistance to regional coalition
Commander, Incident Commander, Command healthcare partners regarding ICS and NIMS training. (Utilize
Staff or Section Chief staff member according to the PRS comment field to describe assistance provided).
the agency's ICS structure must be trained in ICS-
100, ICS-200,ICS-300, ICS-400, IS-700 and IS-
800.
• Encourage regional healthcare coalition partners to
take ICS and NIMS courses, by providing
Page 20 of 21
Attachment B-I
Weld County Department of Public Health and Environment
Public Health Emergency Preparedness and Response
2008-2009 Scope Of Work
Regional Activity CDPHE Measure
resources and availability of training(s) in the
community.
T14. Conduct at least one session on respiratory training T14(I)Documented all train the trainer and/or fit testing
(Train-the-trainer)and/or fit-testing for public health, rural sessions you conducted or coordinated for public health rural
and community health clinics, local physicians, public and/or community health clinics, local physicians, public
safety and/or other partners as requested in your region safety and/or other partners as requested in your region.
before July 31,2009.
T14(2). Posted training to CO.TRAIN. All participants who
complete a training must be verified in CO.TRAIN no more
than 30 days after the event.
T15. Assist in the Development of the Public Health 101 T15 (1). Assisted in the development of the Public Health 101
course for all regional staff by June 1,2009. course by June 1,2009
Regional Training Coordinator Meeting and Conference Call Calendar
2008-2009
Date Type Location/Time
August 20, 2008 Trainer Conference Call 8:30-9:30
September 10, 2008 Trainer Conference Call 8:30-9:30
October 22—23,2008 Regional Staff Meeting Denver(CDPHE)
November 12, 2008 Trainer Conference Call 8:30-9:30
December 10, 2008 Trainer Conference Call 8:30-9:30
January 28 and 29, To be Determined(TBD)
Regional Trainer Meeting
2009 (CDPHE)
February 11,2009 Trainer Conference Call 8:30-9:30
March 11, 2009 Trainer Conference Call 8:30-9:30
April 8,2009 Trainer Conference Call 8:30-9:30
May 2009(TBD) Regional Staff Meeting and TBD
Annual Planning Conference
June 10, 2009 Trainer Conference Call 8:30-9:30
July 8,2009 Trainer Conference Call 8:30-9:30
Page 21 of 21
EXHIBIT 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 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 [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, ($*.**) in exchange for the
promise of the Contractor to continue to perform the work identified in the Original Task Order Contract
for the renewal term of**** years/months, ending on ******** **, ****.
The State promises to [choose one and delete the other] increase/decrease the amount of funds to be
Page 1 of 4
r"
1
paid to the Contractor by ********** Dollars,($*.**) 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), renewal(s) 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********* **, ****, 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. lUse 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
Page 2 of 4
,•• EXHIBIT C
4
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.
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
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 and
accept personal responsibility for any and all damages the State may incur for any errors in such
representation.
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 AND ENVIRONMENT
PROGRAM APPROVAL:
By:
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
David J. McDermott,CPA
By:
Date:
Page 4 of 4
STATE OF COLORADO
Bill Ritter,Jr.,Governor
James B.Martin, Executive Director 0,040
Dedicated Dedicated to protecting and improving the health and environment of the people of Colorado ye 7 ''o
4300 Cherry Creek Dr.S. Laboratory Services Division
Denver,Colorado 80246-1530 8100 Lowry Blvd. `.876•
Phone(303)692-2000 Denver,Colorado 80230-6928
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
August 1, 2008
Mark Wallace
Executive Director
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley, CO 80631
Dear Mr. Wallace,
Enclosed please find your fully approved Task Order Contract, contract routing number 09 FHA 00056
for encumbrance number PO FHA EPI0900056 with the Colorado Department of Public Health and
Environment, Emergency Preparedness and Response Division. Please keep these original documents
for your records.
If you have any questions or require further information, please feel free to contact me.
Sincerely,
C))11/41C;(1-r-Cj
Judy Yockeyv
Contact Administrator
Emergency Preparedness and Response Division
Phone: (303) 692-2645
Fax: (303) 691-7811
E-mail:judy.yockey@state.co.us
Attachments
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