The URL can be used to link to this page

Browse Search

Home My WebLink About20071797.tiff RESOLUTION RE: APPROVE INTERGOVERNMENT CONTRACT FOR COLORADO EMS PROVIDER GRANT AND AUTHORIZE CHAIR TO SIGN WHEREAS,the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS,the EREAS,the Board has been presented with an I ntergovernment Contract for Colorado EMS Provider Grant 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 Paramedic Services, and Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division, commencing July 1, 2007, and ending June 30, 2008, with further terms and conditions being as stated in said contract, and WHEREAS,after review, the Board deems it advisable to approve said 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(ntergovernment Contract for Colorado EMS Provider Grant 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 Paramedic Services, and Colorado Department of Public Health and Environment, Health Facilities and Emergency Medical Services Division be,and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. 2007-1797 AM0019 INTERGOVERNMENT CONTRACT FOR COLORADO EMS PROVIDER GRANT PAGE 2 The above and foregoing Resolution was,on motion duly made and seconded,adopted by the following vote on the 27th day of June, A.D., 2007. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: EXCUSED JEc r,id E. Long, Chair Weld County Clerk tote ar• 1 ► e '.-Tem BY: Deputy Cler to the Board Mum m Pow � l 9 ,Jf F. G rcia AP D M: tr6V� � obert D. Masden o n ttorney 7 Doug as emacher Date of signature: / 9-O7 2007-1797 AM0019 STATE OF COLORADO Bill Ritter,Jr.,Governor James B. Martin, Executive Director of fop Dedicated to protecting and improving the health and environment of the people of Colorado F� VP-7 4300 Cherry Creek Dr.S. Laboratory Services Division Denver,Colorado 80246-1530 8100 Lowry Blvd. \s7e Phone(303)692-2000 Denver,Colorado 80230-6928 ra 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 21, 2007 Weld County Paramedic Services 1121 M Street Greeley, CO 80631 Dear Dave Bressler: Enclosed please find four copies of your Intergovernment Contract for the fiscal year 2008. Please have all four copies signed by the appropriate persons at your agency and return all four to me. Please note that the first signature is the authorized officer, and the second is an attestation signature that cannot be the same person who signed as the authorized officer. Both signatures are required. We will return one fully signed copy to you once the contract has been approved. Please don't hesitate to contact me at 303-692-2987 or Jeanne.bakehouse@state.co.us ifyou have any questions. Thank you. Sincerely, X111 CU1N� )��VUu� 110(2, Jeanne-Marie Bakehouse EMS Provider Grants Program Manager Health Facilities and Emergency Medical Services Division 2007-1797 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ROUTING NO. 08 FMA 00030 INTERGOVERNMENT CONTRACT STATE: CONTRACTOR: State of Colorado for the use&benefit of the Weld County Paramedic Services Department of Public Health and Environment 1121 M Street HFEMSD Greeley, CO 80631 4300 Cherry Creek Drive South Denver,CO 80246 CONTRACT MADE DATE: CONTRACTOR ENTITY TYPE: 06/18/2007 Colorado Political Subdivision CONTRACTOR FEIN OR SOCIALSECURrY NUNRSER PO/SC ENCUMBRANCE NUMBER: 846000813 PO FMA EMS0800030 BILLI NG STATEMENTS RECEIVED: TERM: Upon delivery and acceptance of performance This contract shall be effective upon approval STATUTORY AUTHORITY: by the State Controller,or designee, or on 25-3.5-604 C.R.S. 07/01/2007,whichever is later. The contract CONTRACT PRICE NOT To EXCEED: shall end on 06/30/2008. $77,120.00 FEDERAL FUNDING DOLLARS $ STATE FUNDING DOLLARS: $77,120.00 MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR PROCUREMENT METHOD: FY 08: $77,120.00 Competitive Negotiation BID/REP/LIST PRICE ACRRE:MI1NT NUMBER: Not Applicable LAW SPECIFIED VENDOR STATMME PRICE STRUCIURE Not Applicable Cost Reimbursement S L/TTE1 RI 2RISENTA'INB: CONTRACTOR REPRESENTATIVE: Jeanne-Marie Bakehouse Dave Bressler HFEMSD-EMTS Section 4300 Cherry Creek Drive South 1121 M Street Denver, CO 80246 Greeley, CO 80631 SCOPE(Or WORK: EMS Provider Grant made in accordance with the vendor's state fiscal year 2008 application, which is incorporated herein by reference as Attachment A-1. CDPHE Version 1.0(4/04) Page 1 of 16 Revised:4/1/04 EXHIBEIS: , The following exhibits are hereby incorporated: Exhibit A - Additional Provisions (and any of its Attachments; e.g.,A-1,A-2, etc.) Exhibit B - Statement of Work (and any of its Attachments; e.g.,B-1,B-2, etc.) Exhibit C - Limited Amendment Template COORDINATION: The State warrants that required approval, clearance and coordination has been accomplished from and with appropriate agencies. Section 29-1-203, C.R.S., as amended, encourages governments to make the most efficient and effective use of their powers and responsibilities by cooperating and contracting with each other to the fullest extent possible to provide any function, service, or facility lawfully authorized to each of the cooperating or contracting entities. APPROVAL In no event shall this contract be deemed valid until it shall have been approved by the State Controller or his/her designee. PROCUREMENT: All State of Colorado contracts with its political subdivisions and other governmental entities are exempt from the State of Colorado's personnel rules and procurement code. PRICE PROVISIONS: Payments pursuant to this contract shall be made as earned, in whole or in part, from available funds, encumbered for the purchase of the described services and/or deliverables. The liability of the State at any time for such payments shall be limited to the encumbered amount remaining of such funds. Authority exists in the laws and funds have been budgeted, appropriated and otherwise made available, and a sufficient unencumbered balance thereof remains available for payment. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted and otherwise made available. CDPI-IE Version 1.0(4/04) Page 2 of 16 Revised:4/1/04 GENERAL PROVISIONS The following clauses apply to this contract. In some instances,these general clauses have been expanded upon in other sections/exhibits of/to this contract. To the extent that other provisions of the contract provide more specificity than these general clauses, the more specific provision shall control. 1. Governmental Immunity. Notwithstanding any other provision to the contrary,no term or condition of this contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights, benefits,protection or other provisions of the Colorado Governmental Immunity Act,Section 24-10-101 et.seq.,CRS,as now or hereafter amended. The parties understand and agree that liability for claims for injuries to persons or property arising out of negligence of the State of Colorado, its departments,institutions, agencies,boards,officials and employees is controlled and limited by the provisions of Section 24-10-101 et.seq.,CRS and the risk management statutes, Section 24-30-1501,et.seq.,CRS as now or hereafter amended. 2. Federal Funds Contingency. Payment pursuant to this contract, if in federal funds, whether in whole or in part, is subject to and contingent upon the continuing availability of federal funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable, as determined by the State, the State may immediately terminate this contract or amend it accordingly without liability including liability for termination costs. 3. Billing Procedures. The State shall establish billing procedures and requirements for payment due the Contractor in providing performance pursuant to this contract.The Contractor shall comply with the established billing procedures and requirements for submission of billing statements. The State shall comply with CRS 24- 30-202(24)when paying vendors upon receipt of a correct notice of the amount due for goods or services provided hereunder. 4. Exhibits-Interpretation. Unless otherwise stated,all referenced exhibits are incorporated herein and made a part of this contract.Unless otherwise stated,the terms of this contract shall control over any conflicting terms in any of its exhibits. In the event of conflicts or inconsistencies between this contract and its exhibits or attachments,such conflicts or inconsistencies shall be resolved by reference to the documents in the following order of priority: I)the Special Provisions of this Contract;2)the Additional Provisions Exhibit A and its attachments if included;3)the Contract(other than the Special Provisions);4)the RFP if applicable and attached;5)the Scope/Statement of Work Exhibit B and its attachments if included;6)the Contractor's proposal if applicable and attached; 7)other exhibits/attachments in their order of appearance. 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 Contract. If the Contractor's Proposal, if attached hereto,or any attachments or exhibits thereto, or the Scope/Statement of Work Exhibit B,establish or create standards of performance greater than those set forth in the RFP,then the Contractor shall also meet those standards of performance under this Contract. 5. Notice and Representatives. For the purposes of this contract,the representative for each party is as designated herein. Any notice required or permitted may be delivered in person or sent by registered or certified mail, return receipt requested,to the party at the address provided,and if sent by mail it is effective when posted in a U.S. Mail Depository with sufficient postage attached thereto.Notice of change of address or change or representative shall be treated as any other notice. 6. Contractor Representations-Qualifications/Licenses/Approvals/Insurance. The Contractor certifies that,at the time of entering into this contract, it and its agents have currently in effect all necessary licenses, certifications, approvals, insurance, etc. required to properly provide the services and/or supplies covered by this contract in the state of Colorado. Proof of such licenses, certifications, approvals, insurance, etc. shall be provided upon the State's request. Any revocation, withdrawal or non-renewal of necessary license, CDPHE Version 1.0(4/04) Page 3 of 16 Revised:4/1/04 certification,approval,insurance, etc.required for the Contractor to properly perform this contract,shall be grounds for termination of this contract by the State. Contractor certifies that it is qualified to perform such services or provide such deliverables as delineated in this contract. 7. Legal Authority. The Contractor warrants that it possesses the legal authority to enter into this contract and that it has taken all actions required by its procedures,by-laws,and/or applicable law to exercise that authority,and to lawfully authorize its undersigned signatory to execute this contract and bind the Contractor to its terms.The person(s)executing this contract on behalf of the Contractor warrant(s)that such person(s)have full authorization to execute this contract. 8. Insurance—Contractor. The Contractor is a"public entity"within the meaning of the Colorado Governmental Immunity Act(CGIA),section 24-10-101, et seq.,C.R.S.,as amended. Therefore,at all times during the initial term of this Contract,and any renewals or extensions hereof,the Contractor shall maintain such liability insurance,by commercial policy or self-insurance, as is necessary to meet its liabilities under the CGIA. If requested by the State,the Contractor shall provide the State with written proof of such insurance coverage. 9. Rights in Data, Documents and Computer Software or Other Intellectual Property. All intellectual property including without limitation, databases,software, documents,research,programs and codes,as well as all, reports, studies,data,photographs,negatives or other documents,drawings or materials prepared by the Contractor in the performance of its obligations under this contract shall be the exclusive property of the State. Unless otherwise stated,all such material shall be delivered to the State by the Contractor upon completion,termination,or cancellation of this contract. Contractor shall not use,willingly allow,or cause to have such materials used for any purpose other than the performance of the Contractor's obligations under this contract without the prior written consent of the State. All documentation,accompanying the intellectual property or otherwise,shall comply with the State requirements which include but is not limited to all documentation being in a paper,human readable format which is useable by one who is reasonably proficient in the given subject area. Software documentation shall be delivered by Contractor to the State that clearly identifies the programming language and version used,and when different programming languages are incorporated, identifies the interfaces between code programmed in different programming languages. The documentation shall contain source code which describes the program logic,relationship between any internal functions,and identifies the disk files which contain the various parts of the code. Files containing the source code shall be delivered and their significance to the program described in the documentation. The documentation shall describe error messages and the location in the source code,by page, line number,or other suitable identifier,where the error message is generated. The Contractor warrants that the delivered software will be sufficiently descriptive to enable maintenance and modification of the software. The State's ownership rights described herein shall include,but not be limited to,the right to copy,publish, display,transfer,prepare derivative works, or otherwise use the works. If any material is produced under this Contract and the parties hereto mutually agreed that said material could be copyrighted by Contractor or a third party,then the State, and any applicable federal funding entity, shall, without additional cost,have a paid in full, irrevocable,royalty free,and non-exclusive license to reproduce, publish,or otherwise use,and authorize others to use,the copyrightable material for any purpose authorized by the Copyright Law of the United States as now or hereafter enacted. Upon the written request of the State,the Contractor shall provide the State with three(3)copies of all such copyrightable material. 10. Confidential or Proprietary Information. Subject to the Public(Open)Records Act,section 24-72-101,et - - - ----- - seq.,C.R.S.,as amended, if the Contractor obtains access to any records, files, or other information of the State in connection with,or during the performance of,this Contract,then the Contractor shall keep all such records, files,or other information confidential and shall comply with all laws and regulations concerning the confidentiality of all such records, files,or information to the same extent as such laws and regulations apply to the State. Any breach of confidentiality by the Contractor, or third party agents of the Contractor,shall constitute good cause for the State to cancel this Contract, without liability to the State. CDPHE Version 1.0(4/04) Page 4 of 16 Revised:4/1/04 Any State waiver of an alleged breach of confidentiality by the Contractor,or third party agents of the Contractor,does not constitute a waiver of any subsequent breach by the Contractor,or third party agents of the Contractor. Contractor shall protect the confidentiality of all information used,held,created or received in connection with this Contract and shall insure that any subcontractors or agents of Contractor protect the confidentiality of all information under this Contract. Contractor shall use and disclose confidential information only for purposes of this Contract and for the operation and administration of the Contractor. Contractor shall implement appropriate safeguards as are necessary to prevent the use of disclosure of confidential information and shall maintain a comprehensive written information privacy and security program that includes administrative, technical and physical safeguards for the electronic transmission of confidential information which are appropriate to the size and complexity of the Contractor's operations and the nature and scope of its activities. Contractor shall promptly notify the State if Contractor breaches the confidentiality of any information covered by this Contract. The Contractor must identify to the State the information that it considers confidential or proprietary. This is a continuing obligation. Confidential or proprietary information for the purpose of this paragraph is information relating to Contractor's research,development,trade secrets,business affairs, intemal operations and management procedures and those of its customers,clients or affiliates,but does not include information lawfully obtained by third parties, information which is in the public domain,or information which is or could have been acquired/developed independently by the State or a third party. Notwithstanding the foregoing,the State shall not be in violation of its obligations under this section should it disclose confidential information if such disclosure is, in the sole opinion of the State's legal counsel, required by applicable law and/or legal process(including, but not limited to,disclosures required pursuant to the Colorado(Open)Public Records Act, sections 24-72-201,et. seq, C.R.S.,as now or hereafter amended). The State shall endeavor to provide notice to the Contractor,as promptly as practicable under the circumstances,of any demand,request,subpoena,court order or other action requiring such disclosure, in order to afford Contractor the opportunity to take such lawful action as it deems appropriate to oppose,prevent or limit the disclosure,solely at its own instance and expense; but nothing herein shall be construed to require the State to refuse or delay compliance with any such law,order or demand. 11. Records Maintenance,Performance Monitoring&Audits. The Contractor shall maintain a complete file of all records, documents, communications, and other materials that pertain to the operation of the program/project or the delivery of services under this contract. 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 contract payment was made. These records shall be maintained according to generally accepted accounting principles and shall be easily separable from other Contractor records. The Contractor shall protect the confidentiality of all records and other materials containing personally identifying information that are maintained in accordance with this contract. Except as provided by law, no information in possession of the Contractor about any individual constituent shall be disclosed in a form including identifying information without the prior written consent of the person in interest,a minor's parent,guardian, or the State. The Contractor shall have written policies governing access to,duplication and dissemination of, all such information and advise its agents, if any,that they are subject to these confidentiality requirements. The Contractor shall provide its agents, if any, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. The Contractor authorizes the State, the federal government or their designee, to perform audits and/or inspections of its records, at any reasonable time during the term of this contract and for a period of six (6) years following the termination of this contract,to assure compliance with the state or federal government's terms and/or to evaluate the Contractor's performance. Any amounts the State paid improperly shall be immediately returned to the State or may be recovered in accordance with other remedies. All such records, documents, communications,and other materials shall be the property of the State unless otherwise specified herein and shall be maintained by the Contractor in a central location as custodian for the State on behalf of the State,for a period of six (6)years from the date of final payment or submission of the final federal expenditure report under this contract, unless the State requests that the records be retained for a longer period, or until an audit has been completed with the following qualification. If an audit by or CDPHE Version 1.0(4/04) Page 5 of 16 Revised:4/1/04 on behalf of the federal and/or state government has begun but is not completed at the end of the six(6) year period,or if audit findings have not been resolved after a six(6)year period,the materials shall be retained until the resolution of the audit findings. The Contractor shall permit the State,any other governmental agency authorized by law, or an authorized designee thereof, in its sole discretion,to monitor all activities conducted by the Contractor pursuant to the terms of this contract. Monitoring may consist of internal evaluation procedures, reexamination of program data,special analyses,on-site verification,formal audit examinations,or any other procedures as deemed reasonable and relevant. All such monitoring shall be performed in a manner that will not unduly interfere with contract work. 12. Taxes. The State,as purchaser, is exempt from all federal excise taxes under Chapter 32 of the Internal Revenue Code [No. 84-730123K] and from all state and local government use taxes [C.R.S. 39-26-114(a) and 203,as amended].The Contractor is hereby notified that when materials are purchased for the benefit of the State,such exemptions apply except that in certain political subdivisions the vendor may be required to pay sales or use taxes even though the ultimate product or service is provided to the State. These sales or use taxes will not be reimbursed by the State. 13. Conflict of Interest. During the term of this contract,the Contractor shall not engage in any business or personal activities or practices or maintain any relationships which conflict in any way with the Contractor fully performing his/her obligations under this contract. Additionally,the Contractor acknowledges that, in governmental contracting,even the appearance of a conflict of interest is harmful to the interests of the State. Thus,the Contractor agrees to refrain from any practices, activities or relationships which could reasonably be considered to be in conflict with the Contractor's fully performing his/her obligations to the State under the terms of this contract,without the prior written approval of the State. In the event that the Contractor is uncertain whether the appearance of a conflict of interest may reasonably exist,the Contractor shall submit to the State a full disclosure statement setting forth the relevant details for the State's consideration and direction. Failure to promptly submit a disclosure statement or to follow the State's direction in regard to the apparent conflict shall be grounds for termination of the contract. Further,the Contractor,and its subcontractors or subgrantees,shall maintain a written code of standards governing the performance of its employees engaged in the award and administration of contracts. No employee, officer, or agent of the Contractor, subcontractor,or subgrantee shall participate in the selection, or in the award or administration of a contract or subcontract supported by Federal funds if a conflict of interest,real or apparent, would be involved. Such a conflict would arise when: a. The employee,officer or agent; b. Any member of the employee's immediate family; c. The employee's partner;or d. An organization which employees, or is about to employ,any of the above, has a financial or other interest in the firm selected for award. The Contractor's, subcontractor's, or subgrantee's officers,employees,or agents will neither solicit nor accept gratuities, favors,or anything of monetary value from Contractor's potential contractors, or parties to subagreements. 14. Inspection and Acceptance(Services)and Contractor Warranty. The State reserves the right to inspect services provided under this contract at all reasonable times and places during the term of the contract. "Services"as used in this clause includes services performed or tangible-material-produced ordelivered in the performance of services. If any of the services do not conform with contract requirements,the State may require the contractor to perform the services again in conformity with contract requirements, with no additional payment. When defects in the quality or quantity of service cannot be corrected by re- performance,the State may(1)require the contractor to take necessary action to ensure that the future performance conforms to contract requirements and(2)equitably reduce the payment due the contractor to CDPHE Version 1.0(4/04) Page 6 of 16 Revised:4/1/04 reflect the reduced value of the services performed. These remedies in no way limit the remedies available to the State in the termination provisions of this contract,or remedies otherwise available at law. Contractor warrants that all supplies furnished under this contract shall be free from defects in materials or workmanship,are installed properly and in accordance with manufacturer recommendations or other industry standards, and will function in a failure-free manner for a period of one(1)year from the date of delivery or installation. Contractor shall,at its option,repair or replace any supplies that fail to satisfy this warranty during the warranty period. Additionally, Contractor agrees to assign to the State all written manufacturer warranties relating to the supplies and to deliver such written warranties to the State. 15. Adjustments in Price. Adjustments to contract prices are allowable only so long as they are mutually agreeable by the parties and so long as they are included within a contract amendment made prior to the effective date of the price adjustments and made pursuant to the State of Colorado Fiscal Rules,signed by the parties,and approved by the State Controller or designee. The Contractor shall provide cost or pricing data for any price adjustment subject to the provisions of the Cost or Pricing Data Section of the Colorado State Procurement Rules. Any adjustment in contract price pursuant to the application of a clause in this contract shall be made in one or more of the following ways: a. By agreement on a fixed-price adjustment; b. By unit prices specified in the contract; c. In such other manner as the parties may mutually agree;or d. In the absence of agreement between the parties,by a unilateral determination by the procurement officer of the costs attributable to the event or situation covered by the clause,plus appropriate profit or fee. 16. Contract Renewal, Extension, and Modification. a. Limited Amendment. The State, with the concurrence of the Contractor,may prospectively renew or extend the term of this Contract, or increase or decrease the amount payable under this Contract through a"Limited Amendment"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 The parties understand that this Limited Amendment shall be used only for the following: 1. To increase or decrease the level of funding during the current term of the Original Contract due to an increase or decrease in the amount of goods and/or level of services being provided based upon the existing Scope of Work and/or established pricing and/or established Budget/pricing; II. To revise specifications within the current Scope of Work and/or Budget that increase/decrease the level of funding during the current term of the Original Contract; ❑I. To renew or extend the term of the contract with appropriate changes in the amount of funding that results in a new total financial obligation of the State based upon: (A) the same Scope of Work and pricing,or (B) revised specifications to the previously defined Scope of Work. IV. To make changes to the specifications to the original Scope of Work. project management/manager identification, notice address or notification personnel, or the period of performance, that result in"no cost" changes to the Budget. Upon proper execution and approval,this Limited Amendment shall become a formal amendment to this Contract. h. Other Contract Modifications. 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 CDPHE Version 1.0(4/04) Page 7 of 16 Revised:4/1/04 modification shall automatically be incorporated into and be part of this contract on the effective date of such change as if fully set forth herein. If either the State or the Contractor desires to modify the terms and conditions of this Contract other than as provided for in paragraph 16.a above,then the parties shall execute a standard written amendment to this Contract initiated by the State. The standard written amendment must be executed and approved in accordance with all applicable laws and rules by all necessary parties including the State Controller or delegate. 17. Litigation. The Contractor shall within five(5)calendar days after being served with a summons, complaint,or other pleading which has been filed in any federal or state court or administrative agency notify the State that it is a party defendant in a case which involves services provided under this contract. The Contractor shall deliver copies of such document(s)to the State's Executive Director. The term "litigation" includes an assignment for the benefit of creditors,and filings in bankruptcy,reorganization and/or foreclosure. 18. Notice of Breach and Dispute Resolution: If the State or the Contractor believes in good faith that the other party has failed to timely complete a deliverable,or has otherwise committed a material breach of this Contract,then the non-breaching party shall notify the breaching party in writing of the alleged breach within ten(10)business days of: 1)the date of the alleged breach if the non-breaching party is aware of the breach at the time it occurs; or 2)the date that the non-breaching party becomes aware of the breach. Upon receipt of written notice of an alleged breach of the Contract,the breaching party shall have ten(10) business days,or such additional time as may be agreed to in writing between the parties,within which to cure the alleged breach or to notify the non-breaching party in writing of the breaching party's belief that a material breach of this Contract has not occurred. Failure of the breaching party to cure or respond in writing within the above time period shall result in the non-breaching party being entitled to pursue any and all remedies available at law or in equity. Except as herein specifically provided otherwise,disputes concerning the performance of this contract which cannot be resolved by the designated contract representatives shall be referred in writing to a senior departmental management staff designated by the department and a senior manager designated by the Contractor. Failing resolution at that level, disputes shall be presented in writing to the Executive Director and the Contractor's chief executive officer for resolution. This process is not intended to supersede any other process for the resolution of controversies provided by law. The Contractor and its sureties shall be liable for any damage to the State resulting from the Contractor's breach,whether or not the Contractor's right to proceed with the work is terminated. The State reserves the right, in its sole discretion,to determine whether or not to accept substituted performance tendered by the Contractor or the Contractor's sureties and acceptance is dependent upon completion of all applicable inspection procedures. 19. Remedies: In addition to any other remedies provided for in this contract,and without limiting its remedies otherwise available at law,the State may exercise the following remedial actions if the Contractor substantially fails to satisfy or perform the duties and obligations in this contract. Substantial failure to satisfy the duties and obligations shall be defined to mean significant insufficient, incorrect or improper performance,activities,or inaction by the Contractor. Without limitation,these remedial actions include: a. withhold payment to Contractor until the necessary services or corrections in performance are satisfactorily completed; and/or b. require the vendor to take necessary action to ensure that the future performance conforms to contract requirements;and/or `" c. - request the removal from work on the contract of employees or agents of Contfactor whom the State justifies as being incompetent,careless, insubordinate, unsuitable,or otherwise unacceptable, or whose continued employment on the contract the State deems to be contrary to the public interest or not in the best interest of the State; and/or d. deny payment for those services or obligations which have not been performed and which due to circumstances caused by Contractor cannot be performed,or if performed would be of no value to CDPHE Version 1.0(4/04) Page 8 of 16 Revised:4/1/04 the State; denial of the amount of payment must be reasonably related to the value of work or performance lost to the State; and/or e. suspend Contractor's performance pending necessary corrective action as specified by the State without Contractor's entitlement to adjustment in price/cost or schedule; and/or f. modify or recover payments(from payments under this contract or other contracts between the State and the vendor as a debt due to the State)to correct an error due to omission,error, fraud and/or defalcation; and/or g. terminate the contract. These remedies in no way limit the remedies available to the State in the termination provisions of this contract, or remedies otherwise available at law. 20. Termination. a. Termination for Default. The State may terminate the contract for cause. In the event this contract is terminated for cause, the State will only reimburse the Contractor for accepted work or deliverables received up to the date of termination. In the event this contract is terminated for cause, final payment to the Contractor may be withheld at the discretion of the State until completion of final audit. Notwithstanding the above, the Contractor shall not be relieved of liability to the State for any damages sustained by the State by virtue of any breach of the contract by the Contractor, and the State may withhold any payment to the Contractor for the purposes of mitigating its damages until such time as the exact amount of damages due to the State from the Contractor is determined. If it is determined that the Contractor was not in default then such termination shall be treated as a termination for convenience as described herein. In the event of termination,all finished or unfinished documents, data,studies, surveys,drawings, maps, models, photographs,and reports or other material prepared by the contractor under this contract shall,at the option of the State, become its property,and the Contractor shall be entitled to receive just and equitable compensation for any services and supplies delivered and accepted. The Contractor shall be obligated to return any payment advanced under the provisions of this contract. b. Termination for Convenience. The State shall have the right to terminate this contract at any time • the State determines necessary by giving the Contractor at least twenty(20)calendar days prior written notice. If notice is so given,this contract shall terminate on the expiration of the specified time period, and the liability of the parties hereunder for further performance of the terms of this contract shall thereupon cease, but the parties shall not be released from the duty to perform their obligations up to the date of termination. In the event of termination,all finished or unfinished documents,data, studies, surveys, drawings, maps, models, photographs, and reports or other material prepared by the contractor under this contract shall, at the option of the State,become its property, and the Contractor shall be entitled to receive just and equitable compensation for any satisfactory services and supplies delivered. In the event that the State terminates this contract under the Termination for Convenience provisions, the Contractor is entitled to submit a termination claim within ten(10)days of the effective date of termination. The termination claim shall address and the State shall consider paying the following costs: I. the contract price for performance of work, which is accepted by the State, up to the effective date of the termination; II. reasonable and necessary costs incurred in preparing to perform the terminated portion of the contract; Ill reasonable profit on the completed but undelivered work up to the date of termination; IV. the costs of settling claims arising out of the termination of subcontracts or orders, not to exceed 30 days pay for each subcontractor; V. reasonable accounting, legal, clerical, and other costs arising out of the termination settlement. CDPHE Version 1.0(4/04) Page 9 of 16 Revised:4/1/04 In no event shall reimbursement under this clause exceed the contract amount reduced by amounts previously paid by the State to the Contractor. c. Immediate Termination. This contract is subject to immediate termination by the State in the event that the State determines that the health,safety,or welfare of persons receiving services may be in jeopardy. Additionally,the State may immediately terminate this contract upon verifying that the Contractor has engaged in or is about to participate in fraudulent or other illegal acts. 21. Stop Work Order. Upon written approval by the State Procurement Officer or delegee,the State may,by written order to the Contractor,at any time,and without notice to any surety,require the Contractor to stop all or any part of the work called for by this contract. This order shall be for a specified period after the order is delivered to the Contractor. Any such order shall be identified specifically as a stop work order issued pursuant to this clause. Upon receipt of such an order,the Contractor shall forthwith comply with its terms and take all reasonable steps to minimize the incurring of costs allocable to the work covered by the order during the period of work stoppage. Before the stop work order expires,as legally extended,the State Procurement Officer or delegee shall either: a. Cancel the stop work order;or b. Terminate the work covered by such order;or c. Terminate the contract. If a stop work order issued under this clause is properly canceled,the Contractor shall have the right to resume work. An appropriate adjustment shall be made in the delivery schedule or contract price,or both, and the contract shall be modified accordingly in writing pursuant to the terms of this contract dealing with contract modifications, if: a. The stop work order results in increased time required for,or in the Contractor's cost properly allocable to,the performance of any part of this contract;and b. The Contractor asserts claim for such an adjustment within thirty(30)days after the end of the period of work stoppage. If the work covered by such order is terminated for default or convenience,the reasonable costs resulting from the stop work order shall be allowed by adjustment or otherwise and such adjustment shall be in accordance with the Price Adjustment Clause of this contract. 22. Venue. The parties agree that exclusive venue for any action related to performance of this contract shall be in the City and County of Denver,Colorado. 23. Understanding of the Parties. a. Complete Integration. This contract is intended as the complete integration of all understandings between the parties.No prior or contemporaneous addition,deletion, or other amendment hereto shall have any force or effect whatsoever,unless embodied herein in writing.No subsequent novation,renewal,addition,deletion,or other amendment hereto shall have any force or effect unless embodied in a written contract executed and approved pursuant to the State Fiscal Rules. b. Severability. To the extent that this contract may be executed and performance of the obligations of the parties may be accomplished within the intent of the contract,the terms of this contract are severable, and should any term or provision hereof be declared invalid or become inoperative for any reason,such invalidity or failure shall not affect the validity of any other term or provision hereof. . . . . . . _._. _ ._- - _ __ . . . c. Binding Agreement. Except as herein specifically provided otherwise, it is expressly understood and agreed that this contract shall inure to the benefit of and be binding upon the parties hereto and their respective successors and assigns. All rights of action relating to enforcement of the terms and conditions shall be strictly reserved to the State and the named Contractor. Nothing contained CDPlIE Version 1.0(4/04) Page 10 of 16 Revised:4/1/04 in this agreement shall give or allow any claim or right of action whatsoever by any other third person. It is the express intention of the State and the Contractor that any such person or entity, other than the State or the Contractor,receiving services or benefits under this agreement shall be deemed an incidental beneficiary only. d. Waiver. The waiver of any breach of a term hereof shall not be construed as a waiver of any other term, or the same term upon subsequent breach. e. Continuing Obligations. The State and the Contractor's obligations under this contract shall survive following termination or expiration to the extent necessary to give effect to the intent and understanding of the parties. f. Assignment and Change In Ownership,Address, Financial Status. Except as herein specifically provided otherwise, the rights, duties and obligations of the Contractor arising hereunder cannot be assigned, delegated, subgranted or subcontracted except with the express prior written consent of the State, which consent shall not be unreasonably withheld. In the case of assignment or delegation,Contractor and the State shall execute the standard State novation agreement prior to the assignment or delegation being effective against the State.The subgrants and subcontracts permitted by the State shall be subject to the requirements of this contract. The Contractor is responsible for all subcontracting arrangements, delivery of services, and performance of any subgrantor or subcontractor. The Contractor warrants and agrees that any subgrant or subcontract, resulting from its performance under the terms and conditions of this contract,shall include a provision that the said subgrantor or subcontractor shall abide by the terms and conditions hereof Also, the Contractor warrants and agrees that all subgrants or subcontracts shall include a provision that the subgrantor or subcontractor shall indemnify and hold harmless the State. The subgrantors or subcontractors must be certified to work on any equipment for which their services are obtained. This provision shall not be construed to prohibit assignments of the right to payment to the extent permitted by section 4-9-318, CRS, provided that written notice of assignment adequate to identify the rights assigned is received by the controller for the agency,department,or institution executing this contract. Such assignment shall not be deemed valid until receipt by such controller—as distinguished from the State Controller—and the Contractor assumes the risk that such written notice of assignment is received by the controller for the agency, department. or institution involved. The Contractor is required to formally notify the State prior to, or if circumstances do no allow prior notification then immediately following, any of the following: I. change in ownership; II. change of address; III. the filing of bankruptcy. g. Force Majeure. Neither the Contractor nor the State shall be liable to the other for any delay in, or failure of performance of,any covenant or promise contained in this contract, nor shall any delay or failure constitute default or give rise to any liability for damages if, and only to the extent that, such delay or failure is caused by"force majeure." As used in this contract"force majeure" means acts of God; acts of the public enemy; acts of the State and any governmental entity in its sovereign or contractual capacity: fires; floods,epidemics; quarantine restrictions, strikes or other labor disputes; freight embargoes; or unusually severe weather. h. Changes In Law. This contract is subject to such modifications as may be required by changes in applicable federal or State law, or their implementing rules, regulations,or procedures. Any such required modification shall automatically be incorporated into and be part of this contract on the effective date of such change as if fully set forth herein. Except as provided above, no modification of this contract shall be effective unless agreed to in writing by both parties in the CDPHE Version 1.0(4/04) Page 11 of 16 Revised:4/1/04 form of a written amendment to this Contract that has been previously executed and approved in accordance with applicable law. i. Media or Public Announcements. Unless otherwise provided for in this Contract,the Contractor shall not make any news release,publicity statement,or other public announcement,either in written or oral form,that concerns the work provided under this Contract, without the prior written approval of the State. The Contractor shall submit a written request for approval to the State no less than ten(10)business days before the proposed date of publication. The State shall not unreasonably withhold approval of the Contractor's written request to publish. Approval or denial of the Contractor's request by the State,shall be delivered to the Contractor in writing within six (6)business days from the date of the State's receipt of Contractor's request for approval. If required by the terms and conditions of a federal or state grant,the Contractor shall obtain the prior approval of the State and all necessary third parties prior to publishing any materials produced under this Contract. If required by the terms and conditions of a federal or state grant, the Contractor shall also credit the State and all necessary third parties with assisting in the publication of any materials produced under this Contract. It shall be the obligation of the Contractor to inquire of the State as to whether these requirements exist and obtain written notification from the State as Contractor deems appropriate. 24. Intellectual Indemnity. Contractor shall defend,at its sole expense,any claim(s)or suit(s)brought against the State alleging that the use by the State of any product(s),or any part thereof,supplied by Contractor under this agreement constitutes infringement of any patent,copyright,trademark,or other proprietary rights, provided that the State gives Contractor written notice within twenty(20)days of receipt by the State of such notice of such claim or suit,provides assistance and cooperation to Contractor in connection with such action,and Contractor has sole authority to defend or settle the claim. Contractor shall consult the State regarding such defense and the State may,at its discretion and expense,participate in any defense. Should the State not choose to participate, Contractor shall keep the State advised of any settlement or defense. Contractor shall have liability for all such claims or suits,except as expressly provided herein,and shall indemnify the State for all liability incurred by the State as a result of such infringement. Contractor shall pay all reasonable out-of-pocket costs and expenses, and damages finally awarded by a court of competent jurisdiction,awarded or agreed to by Contractor regarding such claims or suits. If the product(s),or any part thereof, become the subject of any claim,suit or proceeding for infringement of any patent,trademark or copyright,or in the event of any adjudication that the product(s),or any part thereof, infringes any patent,trademark or copyright,or if the sub-license or use of the product(s),or any part thereof, is enjoined,Contractor,after consultation with the State,shall do one of the following at Contractor's expense: a. produce for the State the right under such patent,trademark or copyright to use or sub-license,as appropriate,the product or such part thereof;or b. replace the product(s),or part thereof,with other suitable products or parts conforming to the original license and State specifications;or c. suitably modify the products, or part thereof. Except as otherwise expressly provided herein,Contractor shall not be liable for any costs or expenses incurred without its prior written authorization. - — - -- Contractor shall have no obligation to defend against or to pay any costs,damages or attorney's fees with - respect to any claim based upon: a. the use of an altered release if Contractor had not consented to the alteration; or b. the combination,operation or use of the product(s)with programs or data which were not furnished by Contractor, if such infringement would have been avoided if the programs or data CDPHE Version 1.0(4/04) Page 12 of 16 Revised:4/1/04 furnished by persons or entities other than Contractor had not been combined,operated or used with the product(s);or c. the use of product(s)on or in connection with equipment or software not permitted under this contract if such infringement would have been avoided by not using the product(s)on or in connection with such other equipment or software. 25. Conformance with Law. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and its agent(s)shall at all times during the term of this contract strictly adhere to all applicable federal laws, state laws,Executive Orders and implementing regulations as they currently exist and may hereafter be amended. Without limitation,these federal laws and regulations include: a. Office of Management and Budget Circulars A-21, A-87,A-102, A-110,A-122, A-133,and The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments,as applicable; b. the"Hatch Act" (5 U.S.C. 1501-1508)and Public Law 95-454, Section 4728. These federal statutes declare that federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs; c. the"Davis-Bacon Act" (40 U.S.C. 276A-276A-5). This federal Act requires that all laborers and mechanics employed by contractors or subcontractors to work on construction projects financed by federal assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor; d. 42 U.S.C. 6101 et seq.,42 U.S.C. 2000d,29 U.S.C.794. These federal Acts mandate that no person shall, on the grounds of race, color, national origin,age, or disability,be excluded from participation in or be subjected to discrimination in any program or activity funded, in whole or in part, by federal funds; e. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C. 12101, 12102, 12111 - 12117, 12131 - 12134, 12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47 U.S.C. 225 and 47 U.S.C. 611); f. if the Contractor is acquiring an interest in real property and displacing households or businesses in the performance of this Contract,then the Contractor is in compliance with the"Uniform Relocation Assistance and Real Property Acquisition Policies Act", as amended,(Public Law 91- 646, as amended, and Public Law 100-17, 101 Stat. 246-256); g. when applicable,the Contractor shall comply with the provisions of the"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments" (Common Rule); h. Section 2101 of the Federal Acquisition Streamlining Act of 1994, Public Law 103-355, which prohibits the use of federal money to lobby the legislative body of a political subdivision of a State;and If the Contractor is a covered entity under the Health Insurance Portability and Accountability Act of 1996,42 U.S.C. 1320d— 1320d-8, the Contractor shall comply with applicable HIPAA requirements. If Contractor is a business associate under HIPAA,Contractor hereby agrees to,and has an affirmative duty to,execute the State's current HIPAA Business Associate Agreement. In this case,Contractor must contact the State's representative and request a copy of the Business Associate Agreement,complete the agreement, have it signed by an authorized representative of the Contractor,and deliver it to the State. 26. Contractor Affirmation. If this Contract involves federal funds or compliance is otherwise federally mandated, then by signing and submitting this Contract the Contractor affirmatively avers that: a. the Contractor is in compliance with the requirements of the"Drug-Free Workplace Act"(Public Law 100-690`I'itte V;Subtitle D,41 U:S.C. 701 et seq.); b. the Contractor is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; the Contractor shall comply with all applicable regulations pursuant to Executive Order 12549, including. Debarment and Suspension and Participants' Responsibilities.29 C.F.R. 98.510(1990); and, CDPHE Version 1.0(4/04) Page 13 of 16 Revised:4/1/04 c. the Contractor shall comply with all applicable regulations pursuant to Section 319 of Public Law 101-121,Guidance for New Restrictions on Lobbying, including,Certification and Disclosure,29 C.F.R.93.110(1990). 27. Annual Audits. If the Contractor expends federal funds from all sources(direct or from pass-through entities)in an amount of$500,000 or more during its fiscal year,then the Contractor shall have an audit of that fiscal year in accordance with Office of Management and Budget(OMB)Circular A-133 (Audits of States, Local Governments,and Non-Profit Organizations). If the Contractor expends federal funds received from the State in an amount of$500,000 or more during its fiscal year,then the Contractor shall furnish one(I)copy of the audit report(s)to the State's Internal Audit Office within thirty(30)calendar days after the Contractor's receipt of its auditor's report or nine(9)months after the end of the Contractor's audit period,whichever is earlier. If(an)instance(s)of noncompliance with federal laws and regulations occurs,then the Contractor shall take all appropriate corrective action(s)within six(6)months of the issuance of(a)report(s). If the Contractor submits an annual indirect cost proposal to the State for review and approval,then the Contactor's auditor shall audit the proposal in accordance with the requirements of OMB Circulars A-2I (Cost Principles for Educational Institutions),A-87(Cost Principles for State, Local,and Tribal Governments),or A-122(Cost Principles for Non-Profit Organizations),whichever is applicable. 28. Holdover. In the event that the State desires to continue the services provided for in this Contract and a replacement contract has not been fully executed by the expiration date of the Contract,this Contract may be extended unilaterally by the State for a period of up to two(2)months upon written notice to the Contractor under the same terms and conditions of the original Contract including,but not limited to, prices,rates,and service delivery requirements. However,this extension terminates when the replacement contract becomes effective when signed by the State Controller or an authorized delegate. CDPHE Version 1.0(4/04) Page 14 of 16 Revised:4/1/04 SPECIAL PROVISIONS The Special Provisions apply to all contracts except where noted in italics. I. CONTROLLER'S APPROVAL. CRS 24-30-202(1). This contract shall not be deemed valid until it has been approved by the Colorado State Controller or designee. 2. FUND AVAILABILITY. CRS 24-30-202(5.5). 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. 3. INDEMNIFICATION_ Contractor shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees and related costs, incurred as a result of any act or omission by Contractor,or its employees,agents,subcontractors,or assignees pursuant to the terms of this contract. /Applicable Only to Intergovernmental Contracts/No term or condition of this contract shall be construed or interpreted as a waiver, express or implied,of any of the immunities,rights,benefits,protection,or other provisions,of the Colorado Governmental Immunity Act,CRS 24-10-101 et seq., or the Federal Tort Claims Act,28 U.S.C.2671 et seq.,as applicable,as now or hereafter amended. 4. INDEPENDENT CONTRACTOR. 4 CCR 801-2. Contractor shall perform its duties hereunder as an independent contractor and not as an employee. Neither contractor nor any agent or employee of contractor shall be or shall be deemed to be an agent or employee of the state. Contractor shall pay when due all required employment taxes and income taxes and local head taxes on any monies paid by the slate pursuant to this contract. Contractor acknowledges that contractor and its employees are not entitled to unemployment insurance benefits unless contractor or a third party provides such coverage and that the state does not pay for or otherwise provide such coverage. Contractor shall have no authorization, express or implied,to bind the state to any agreement,liability or understanding,except as expressly set forth herein. Contractor shall provide and keep in force workers'compensation(and provide proof of such insurance when requested by the state)and unemployment compensation insurance in the amounts required by law and shall be solely responsible for its acts and those of its employees and agents. 5. NON-DISCRIMINATION. Contractor agrees to comply with the letter and the spirit of all applicable State and federal laws respecting discrimination and unfair employment practices. 6. CHOICE OF LAW. The laws of the State of Colorado,and rules and regulations issued pursuant thereto,shall be applied in the interpretation. execution, and enforcement of this contract. Any provision of this contract, whether or not incorporated herein by reference, which provides for arbitration by any extra judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law,whether by way of complaint,defense,or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract,to the extent that this contract is capable of execution. At all times during the performance of this contract,Contractor shall strictly adhere to all applicable federal and State laws,rules,and regulations that have been or may hereafter be established. 7. [Not Applicable to Intergovernmental Contracts] VENDOR OFFSET. CRS 24-30-202(I)and 24-30-202.4. The State Controller may withhold payment of certain debts owed to State agencies under the vendor offset intercept system for(a)unpaid child support debt or child support arrearages; (b)unpaid balances of tax,accrued interest,or other charges specified in Article 21,Title 39,CRS; (c)unpaid loans due to the Student Loan Division of the Department of Higher Education: (d)amounts required to he paid to the Unemployment Compensation Fund;and(c)other unpaid debts owing to the State or its agencies,as a result of final agency determination or reduced to judgment,as certified by the State Controller. 8. SOFTWARE PIRACY PROHIBITION. Governor's Executive Order D 002 00. No State or other public funds payable under this contract shall be used for the acquisition, operation, or maintenance of computer software in violation of federal copyright laws or applicable licensing restrictions. Contractor hereby certifies that,for the term of this contract and any extensions,Contractor has in place appropriate systems and controls to prevent such improper use of public funds. If the State determines that Contractor is in violation of this paragraph,the State may exercise any remedy available at law or equity or under this contract,including,without limitation,immediate termination of this contract and any remedy consistent with federal copyright laws or applicable licensing restrictions. 9. EMPLOYEE FINANCIAL INTEREST. CRS 24-18-201 and 24-50-507. The signatories aver that to their knowledge,no employee of the State has any personal or beneficial interest whatsoever in the service or property described in this contract. 10. [Not Applicable to Intergovernmental Contracts]. ILLEGAL ALIENS - PUBLIC CONTRACTS FOR SERVICES AND RESTRICTIONS ON PUBLIC BENEFITS. CRS 8-17.5-101 and 24-76.5-101. Contractor certifies that it shall comply with the provisions of CR5 8-17.5-101 et seq. Contractor shall not knowingly employ or contract with an illegal alien to perform work under this contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this contract. Contractor represents, warrants, and agrees that it (i) has verified that it does not employ any illegal aliens, through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security, and (ii) otherwise shall comply with the requirements of CR5 8-17.5-102(2)(b). Contractor shall comply with all reasonable requests made in the course of an investigation under CRS 8-17.5-102 by the Colorado Department of Labor and Employment. Failure to comply with any requirement of this provision or CRS 8-17.5-101 et seq., shall be cause for termination for breach and Contractor shall be liable for actual and consequential damages. Contractor, if a natural person eighteen(18)years of age or older, hereby swears or affirms under penalty ofperjury ____ __ _ that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to federal law, (ii) shall comply with the provisions of CRS 24-76.5-101 et seq., and(iii)shall produce one form of identification required by CRS 24-76.5-103 prior to the effective date of this contract. Revised October 25, 2006 Effective Date of Special Provisions: August 7, 2006 CDPHE Version 1.0(4/04) Page 15 of 16 Revised:4/1/04 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT CONTRACTOR: STATE OF COLORADO: Board of County Commissioners of Weld County BILL RITTER JR. OVERNOR for the use and benefit of Weld County Paramedic Services By _-. Legal Name of Contracting Entity For Executive Director 846000813 Department of Public Health and Environment Social Security Number or FEIN 74L, Department Program Approval: Signature of Authorized Officer 06/27/2007 • William H. Jerke, Chair Pro-Tem_ Print Name&Title of Authorized Officer Board of Weld County Commissioners GOVERNMENTAL ENTITIES: t; I . / N 4 (An attestation seal a r ui e ) = - (gyp ' It61 • :� �1 `/ 1Y1��iilJi�` vies (Seal)By ad r (Town/City/Count Jerk o quiva lent) : v (Fte4 eal here) LEGAL REVIEW: COLORADO DEPARTMENT OF LAW OFFICE OF THE ATTORNEY GENERAL By ,AJP‘ 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: Leslie M.Shenefelt - - - - -- - ---- - --- Date CDPHE Version 1.0(4/04) Page 16 of 16 Revised:4/1/04 , 7oc2-J79% EXHIBIT A ADDITIONAL PROVISIONS To Contract Dated 06/15/2007-Contract Routing Number 08 FMA 00030 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. 1. The contractor shall perform in accordance with it's Colorado EMS Provider Grant Application Fiscal Year 2008,which is incorporated herein by reference as Attachment A-1. The items listed under"Applicant Duties and Obligations Should Funding be Awarded"section are presently reaffirmed. 2. The state will fund 50%of the total cost,not to exceed $77,120.00. Should the vendor realize savings on the grant,it shall be shared equally between the contractor and the state,respectively. 3. To receive compensation under this Contract,the Contractor shall submit a signed Payment Request Statement along with copies of paid invoices. A sample Payment Request Statement is attached hereto as Attachment A-2 and incorporated herein by this reference. Expenditures shall be in accordance with the Contractor's application attached hereto as Attachment A-1. Payment during the initial,and any renewal or extension,term of this Contract shall be conditioned upon affirmation by the State that all services were rendered by the Contractor in accordance with the terms of this Contract. Payment Request Statements shall be sent to: Jeanne-Marie Bakehouse HFEMSD Grants Program Colorado Department of Public Health and Environment HFEMSD—A200 4300 Cherry Creek Drive South Denver, CO 80246 To be considered for payment,billings for payments pursuant to this Contract must be received within a reasonable time after the period for which payment is requested;but in no event no later than thirty(30) calendar days after the relevant performance period has passed. 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 Contract. Unless otherwise provided for in this Contract,"Local Match"shall be included on all billing statements, in the column provided therefore, as required by the funding source. 3. The State has determined that this contract does not constitute a Business Associate relationship under HIPAA. To be attached to CDPHE Page 1 of 1 Revised:4/1/04 Version 1.0(4/04)contract template • utu__)I i iui«ppnlaun. _ ragc 1 U1 IL 9: 'ReDim' can only change the rightmost dimension. ATTACHMENT A—f A Colorado EMS Provider Grant Fiscal Year 2008 Application FEB 1 5 2007 Colorado Department of Public Health and Environment Je Jepi of Public Health&E^ HFEMSD A2 HF&EMSD 4300 Cherry Creek Drive South Denver, CO 80246-1530 RETAC Eval # ue- ^ SEMTAC Eval #ti`13 U 4.031 Date Printed: Wednesday, February 14, 2007 3:41 PM Request Categories /� 1 Ambulance, Other Vehicle A3LP �35�4"•� � '.� "W Q. Data Collectionef31 Agency Information 1. Legal Name of Agency Weld County Paramedic Services DBA (Doing Business As - If 2. WCPS Applicable) 3. Federal TaxID Number 84-6000813 4. Grant Contact Person Director Dave Bressler Phone: 970-353-5700 Fax: 970-304-6408 Pager: Email: dbressler@co.weld.co.us 5. Agency Mailing Address 1121 M St, Greeley, CO, 80631 6. Agency Street Address 1121 M St, Greeley, CO, 80631 7. Legal Status of Agency / Organization City/County Government 8. Type of Service ALS: Yes, BLS: No, Fire/Rescue: No, Training: No, Other: No, Describe: 9 This a RETAC or statewide grant No project: 10. This is a multi Agency Application: No- 1 I. List your RETAC: Northeast 12. List the county your agency is licensed weld in: 13. This agency has current grant requests No in to other agencies for the current https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102 PrintApp.aspx 2/14/2007 11,111__,1 VLil_1-1 inuipprnaux t. 7 e rage z or 1G budget year? If yes, describe them here. Request Categories Agency Match: 50% J CATEGORIES Agency Share State Share No More than 2 categories allowed per application Total Category Cost 50% 50% �J I Ambulance, Other Vehicle $70,840.00 $35,420.00 $35,420.00 O II Communications $0.00 $0.00 $0.00 td1 III Data Collection $83,400.00 $41,700.00 $41,700.00 IV Defibrillation/Cardiac Monitor $0.00 $0.00 $0.00 II II V EMS Equipment $0.00 $0.00 $0.00 ❑ VI EMS Training $0.00 $0.00 $0.00 I VII Extrication Equipment $0.00 $0.00 $0.00 VIII Injury Prevention $0.00 $0.00 $0.00 IX Other $0.00 $0.00 $0.00 O X Recruitment/Retention • $0.00 $0.00 $0.00 RR Cash Match= 0% Grant Request Totals: $154,240.00 $77,120.00 $77,120.00 -11)to.'1 Balance Sheet for Entire Agency Enter the date of your most current financials for - 1 your entire agency: For 12 months ending: Note: Use this same accounting period 12/31/2005 throughout the financial information Category 2. Accounting Method: Cash Define accounting method for Depreciation and Straightline 3' Capital 3 Ambulance re-chassis, Medical Gator, and 4. List New Capital Items Purchased: Computer equipment for ambulances. Assets 5. Unreserved Cash Accounts $366,468.00 6. Reserved Cash Accounts $0.00 7. Unreserved Investments $0.00 8.]Reserved Investments $0.00 .. 9. Held in trust for Pension Benefits $0.00 10. Real Estate and Buildings $704,801.00 11. Equipment $104,841.00 Market Value: No https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5IO2_PrintApp.aspx 2/14/2007 .irm_J t uza_rrintApprs ianx ragc , , II Depreciated Value: Yes ► 12. Accounts Receivable $2,159,037.00 I7 Prepaid Expenses $0.00 PI-Inventory $0.00 15. Other Assets $0.00 Total Assets $3,335,147.00 Liabilities [-7 Acconts Payable $48,110.00 17. Short Term Notes and Loans $885,000.00 18]Long Term Notes and Loans $0.00 19. Taxes Payable $15,476.00 20. Payable Payroll Expenses $250,775.00 nPrepaid and Deferred Revenue $9,897.00 1 Total Liabilities $1,209,258.00 NetWorth $2,125,889.00 Profit and Loss 1 Enter the date of your most current financials For 12 months ending: for your(agency) 12/31/2005 Income/Revenues For this agency: The EMS Portion of our 2. budget is different from the Entire Agency No (budget) Entire Agency EMS Portion 3. Government $0.00: $0.00 Mil Levy = 0% 4' $0.00 $0.00 enter dollar revenues --> 5. Donations, Contributions, Bequests $2,100.00 $0.00 6. EMS Fee for Service $7,723,410.00 $0.00 7. Fund Raising $0.00 $0.00 8. Interest and Dividends $0.00 $0.00 Grants - List Sources: State Provider and g' $85,576.00 $0,00 RETAC - • 1-0.I Subseripttion Program $0.00. $0.0() 11 Other Income, Define: Contracted billing for North Park ambulance district $2'984'00 $0.00 Total Income $7,814,070.00' $0.00 Expenses I-II II 11 https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 11 L11_J1VL4 1-1111L/1ppDlali1S. _ rage 4 or !L. 12.j Operational Expense $3,110,452.00 $0.00 13. Personnel Costs $3,154,140.00 $0.00 Salaries, benefits, etc. . 14. Depreciation Expense $182,419.00 $0.00 15. Debt Service $0.00 $0.00 16. Capital Expenditures $108,233.00 .$0.00 17. Other Expenses, Define: $0.00 $0.00 Total Expenditures $6,555,244.00 $0.00 Profit (or Loss) $1,258,826.00 $0.00 Rates and Collection 1. This agency charges for EMS services Yes Who processes this agency's billing and Agency: Yes • 2. accounting? Contract Service: No No Billing/Accounting: No Service Base Rate Medicare Allowable 3. BLS (Basic Life Support)non-emergent $1,220.00 $199.56 4. BLS—Emergent $1,220.00 $319.30 5 ALS1 (Advanced Life Support-Level 1) $1,220.00 $239.48 Non-emergent 6. ALS1 —Emergent $1,220.00 $548.00 7. ALS2 - non-emergent $0.00 $0.00 8. SCT (Specialty Care Transport) $0.00 $0.00 non-emergent 9 SCT(Specialty Care Transport) $0.00 $0.00 emergent 10. PI (Paramedic ALS Intercept) $0.00 $0.00 non-emergent 11. FW(fixed Wing)—non-emergent $0.00 $0.00 12. FW (fixed Wing)—emergent $0.00 $0.00 13. RW (Rotary Wing)—non-emergent $0.00 $0.00 14. RW(Rotary Wing—emergent $0.00 $0.00 15: Treat and Release $150.00 16. Mileage Rate—Urban $18.00 17. Mileage Rate—Rural I to 1-7 miles-- - - --- - $18.00 18. Mileage Rate - Rural 18 to 50 miles $18.00 19. Overall collection rate(Percentage): 33 % Financial Narrative (REQUIRED) hops://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 • ran J1uza rrrnuAppnrantc, rage or 12. 1. Please explain below Any information about your agency financials that will help evaluators understand your financial situation, such as reserves or balances. If your board requires a specific balance or reserve for example, use this space to explain that. - Explanations of unreserved cash accounts and investments, as well as reserved cash accounts or investments. - Your cash match source. If applicable, the issues which have dictated your choice for filing a financial waiver. Your comments should include explanations of extenuating circumstances that have rendered financial hardship or other reasons for requesting a financial waiver (The numbers provided throughout section I are based on the fiscal year 2005. These facts have been audited and are accurate. The 2006 financial records have been completed but have not been audited.) Weld County Paramedic Services (WCPS) is owned and operated by the Board of County Commissioners of Weld County. The agency being an enterprise fund is solely responsible for its budget and financial well being within the county. The agency serves over 4,000 square mile of North /Northeastern Colorado. Operating as and enterprise of Weld County Government since 1989, WCPS is required to bill and collect all of their operational costs of providing advanced life support treatment and transportation. The service area and customer base include a population that is over 50% Medicare, Medicaid and medically indigent. With the required changes placed on ambulance services in the Medicare / Medicaid fee schedules and forced acceptance of assignment, coupled with eh changes in the Colorado No Fault automobile insurance on collections rates, WCPS has experienced an average collection rate of 33% over the last year. This year has been a transition year for WCPS; the service has had to fill 4 FTE's due to increasing call volume and the need for better system coverage. WCPS has continued to strictly monitor the budget along with decreasing certain items, and continuing to electronically bill patients to address the revenue shortfall created by these changes. The result being a negative impact on our scheduled replacement of ambulances, along with the inability to purchase needed data collection laptops. WCPS has had to lengthen the service life of our ambulances and continue to employ a re-chassis program for maximum cost savings and timely replacement of vehicles. Uncollected debt still continues to be a burden on WCPS; it is recorded as bad debt and reflects negatively on our budget numbers. The fact is that this portion of uncollected money affects the operation and administrative functions of WCPS. When providing services to the citizens and visitors of Weld County, WCPS maintains 100% compliance. Bad debt reflects that portion of services that will never pay for themselves. Collection rates of 33% explain that with 100% services provided we are losing 67% of our budget to bad debt or write offs. This trend has continued be consistent over the last few years and will continue to be in our future. This uncollected debt obviously affects our ability to maintain equipment, purchase new equipment, and provide data collections to the state as requested. WCPS has maintained a solid budget but with increasing bad dept and mandatory write-offs they will continue to the strain the budgets for replacement of vehicles and the purchase of new equipment. Narrative Describing Your Agency's Structure and Service Area Please use this area to describe your agency to someone from outside your area. Include a description of your district proper. response area and the number of residents. Assume that the reader does not know the structure and staffing of your agency, the ten-ain and roads of your area, and any special circumstances your agency contends with. https://www.hfemsd2.dphe.state.co.us/CEMSISWeb Grants/frin 5102 PrintApp.aspx 2/14/2007 Wm)1Uza_YnntApplilank1 Page 6 of 12 Weld County Paramedic Services (WCPS)provides advanced life support response, evaluation, treatment and transport to the 300,000 citizens and numerous visitors throughout the 4,000 square miles of Weld County Colorado. This service is provided in cooperation with surrounding ALS providers via mutual aid agreements along with the tiered response of first responders from the fire departments operating throughout Weld County. Of the near 13,000 calls for service, over 60% of the calls for service fall into the rural/frontier areas, county roads and highways of Weld County. The other 40% of calls occur within the city of Greeley. Advanced Life Support coverage is provided through the fluid deployment of five ambulances during the day and four ambulances from 2200 to 0600, via fixed stations and system status placement of resources throughout Weld County. Operating with 38 full time field staff and an office and administrative staff of 8 Weld County operates as and enterprise of Weld County Government, billing and collecting all costs of operation. Grant Request Categories Category I - Ambulance, Other Vehicle (Request Details) 1. Qty 1 2. Type Code III 3. Two or Four Wheel Drive 2 wd 4. Description Braun remount of exsisting ambulance 5. Price Each $70,840.00 6. Total Request $70,840.00 7. Agency Share $35,420.00 8. State Share • $35,420.00 9. Is this a new vehicle or a replacement? Replacement 8a. Which unit does it replace? 1 Vehicle Requests. Total $70,840.00 Category I - Ambulance, Other Vehicle (Equipment Request Details) 1. Qty 2. Description 3. Price Each $ 4. Total Request $ 5. Agency Share $ 6. State Share $ https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 trmatuza_rrinukpputanx, -. rage / ur iz 0 Vehicle Equipment Requests Category I - Ambulance, Other Vehicle (Additional Questions) If the requested vehicle(s) is(are) replacement(s): What was the number of calls your agency was unable to respond to due to mechanical 1' 0 unavailablility of the emergency vehicle to be replaced 2. What will be done with the unit that is replaced? This unit will be remounted and placed back into service. 3 What is the average length of service, in miles and or years, 15000 Miles of vehicles operated by your agency? Category I - Ambulance, Other Vehicle (Narratives) Weld County Paramedic Services (WCPS) has initiated a re-chassis program in which chassis would be replaced and patient modules would be remounted. The first re-chassis occurred in 2004 and was a great success at an average savings of over$68,000 over the purchase of a new ambulance. Please describe your This project will continue until each of the 9 type III ambulances have been agency's vehicle remounted 3 times each. The vehicles with one remount are as follows in 2004 vehicles 16 and 18 were remounted and in 2005 vehicles 17, 19, 20 replacement program. were remounted. At the present time we had two vehicles being remounted for 2006 and it was vehicles 21 and 22. We will need to remount vehicles 23and 24 to complete the first cycle of the three remounts. We will need to complete these last two vehicles in 2007 due to mileage and increased cost of operation due maintenance issues. Weld County Paramedic Services (WCPS) is an agency of Weld County government that operates as and enterprise fund. Funding is provided through fees for service only. The economy, Medicare, and Medicaid cuts, tort law auto insurance and increasing costs are some of the major factors that have negatively affected WCPS. Significant mandatory budget cuts Vehicle request have been met. The management of WCPS continues to search for methods narrative- Please to operate more efficiently and effectively. In 1998 a decision was made to explain if this vehicle establish a program that would save and estimated $2.5 million over the - wilt-be replacing any next 12 years. A re-chassis program was undertaken in which ambulances • previously owned chassis would be replaced and patient modules would be remounted. The vehicles and how the first re-chassis occurred in 2004 at a savings of approximately $68,000 over cost was determined, as the purchase of a new ambulance. This project will continue until each of well as any other the 9 type III ambulances have been remounted 3 times. This project will information that would require the remounting of 1 unit this fiscal year. With considerations for help an outside person inflation and variations in the requirements of each specific unit it is https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 rrm_Dtuza rrmtApptsianx, Page 8 of 12 understand the needs of estimated that the cost of remounting 1 chassis this year will be $70,840.00. your vehicle request. WCPS respectfully requests matching funds from the state for our re- chassis project. This program of remounting ambulances is a responsible and effective utilization of funds that are increasingly difficult too obtain. It is but one of many methods by which WCPS strive to maintain the highest quality emergency service with less financial resources. Category III - Data Collection (Request Details) Total Agenc Qty Description Price Each Request Share State Share 10 Panasonic Tough Book Item $4,536.00 $45,360.00 $22,680.00 $22,680.00 number Cf-19CDBABVM 10 512 Memory upgrade $79.00 $790.00 $395.00 $395.00 10 Battery Charger $167.00 $1,670.00 $835.00 $835.00 10 Batter for CF18B-D-F-K $149.00 $1,490.00 $745.00 $745.00 10 Protection Plus $840.00 $8,400.00 $4,200.00 $4,200.00 10 Two Year Extended Warranty $420.00 $4,200.00 $2,100.00 $2,100.00 Extension 10 Desktop port replicator $302.00 $3,020.00 $1,510.00 $1,510.00 10 Pentax pocketjet III printer engine $298.00 $2,980.00 $1,490.00 $1,490.00 10 Gamber CF-18 Dock with $589.00 ' $5,890.00 $2,945.00 $2,945.00 wireless pass 10 Mounting Kit $545.00 $5,450.00 $2,725.00 $2,725.00 10 Wireless antenna $40.00 $400.00 $200.00 $200.00 10 Service work- Install $375.00 $3,750.00 $1,875.00 $1,875.00 12 Requests in Category. Total $83,400.00 Category III - Data Collection (Narrative) Weld County Paramedic Services (WCPS) is an agency of Weld County government that operates as and enterprise fund. Funding is provided through fees for service only. The economy, Medicare, and Medicaid cuts, tort law auto insurance and increasing costs are some of the major factors that have negatively affected WCPS. Significant mandatory budget cuts have been met. The management of WCPS continues to search for methods to operate more efficiently and effectively. WCPS initiated a data collection project approximately 2 years ago with the purchase of the Motorola 900 laptop computers.The computers were installed wilhffealthware solutions and electronic data collection was begun.WCPS eventually migrated to the use of Tiburon for its dispatch information. The goal of installing Tiburon and Healthware on the same machine was to someday migrate the Tiburon information into Healthware and decrease the need for repetitive data entry. The problem became clear very shortly after both systems were installed on the ML 900. We began having data corruption issues on Healthware and Tiburon rarely was reliable for crew utilization. The unfortunate result was that Healthware and Tiburon would not run together on the same machine without causing conflicts https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 -11 VLa1. 11111.1-11JI Jlalllt 1 µsV l Vl LL with each other. WCPS has spent countless hours and dollars on finding a solution to the problem. The last effort was utilizing VM software which failed to produce reliable results. The end decision was to use the ML 900 for Tiburon and purchase a separate laptop for data collection. WCPS is requesting funding for the purchase of 10 Panasonic tough books (item number CF-19CDBABVM and required options). WCPS has always maintained its need and want to provide the highest quality data to the State of Colorado. This move to separate computers will allow WCPS to provide this data in a timely and consistent manner without fear of corrupted data due to software incompatibility. This move will also provide a positive work environment for the crews of WCPS by providing them a portable workstation to better fit their active jobs. Maintenance will also decrease due to the separation of the conflicting software and keeping the machines up and running without taking them down for one issue. These computers will keep the data collection stream clean and efficient by allowing the employees to complete their trip sheets in a timely manner after the call with minimal delays due to computer issues. With running nearly 13,000 calls in 2006 WCPS feels it has valuable data to provide to the State of Colorado and maintains its dedication to provide this information. Attestation Special note for multi-agency applicants: ALL agencies involved in a multi-agency grant application are required to complete, sign and submit this attest form, in addition to providing financial information for each agency. 1. Legal Name of Agency: Weld County Paramedic Services DBA (Doing Business As- If 2' Applicable: WCPS 3. Federal Tax ID Number: 84-6000813 4. Grant Contact Person: 4a. Title: Director 46. First Name: Dave 4c. Last Name: Bressler Authorized Agent The individual whose name and signature appear below, has been designated by the agency/organization listed above as the Authorized Agent to complete and submit this grant application on its behalf. The agency/organization agrees to comply with the rules and regulations governing the State of Colorado EMS Grants Program concerning grant requests. Financial Information The Authorized Agent attests to the agency or organization's ability to provide the matching funds 5. (50%, 40%, 30%, 20% or 10%) to complete the purchase of the grant award, should the agency be awarded state funds. The Authorized Agent is aware that EMS vehicles and equipment purchased must be without any 6. financial liens and without the item being used as collateral to secure a loan of any kind The Authorized Agent attests that, to the best of his/her knowledge, the information contained 7. herein, with regard to the Agency's financial condition, is true, accurate and correctly reflects the financial condition of the agency/organization. Notification of Affected Entities By signing below, the Authorized Agent also attests to the fact that: https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 11111._.) rumnpyrnanict.. rage iU oI 1Z The agency(ies)/organization(s) affected by the possible outcome of this grant request, including 8. but not limited to agencies/organizations listed in this application if it is a multi-agency application, has(have)been notified and has(have) agreed to its submission. Applicant Duties and Obligations Should Funding be Awarded Should the agency/organization listed in this application receive funding under this grant application, the agency/organization (hereinafter referred to as 'grantee') shall, and affirmatively promises to, comply with all of the provisions set forth below. 9 The grantee shall use grant funds received under this grant to complete all aspects of its grant application, and shall not use such funds for purposes other than this. 10. The grantee shall submit quarterly progress reports to the Colorado Department of Public Health and Environment, EMS Category(hereinafter referred to as 'the State') 11. Requirements for Training and Education Grants For any training or education requests funded from this application the grantee shall comply with the following terms and conditions: Reimbursement for all travel expenses associated with the training or education program shall A. be made in accordance with the then current state of Colorado reimbursement rates for travel as specified in the Fiscal Rules of the state of Colorado. Written proof of the successful completion of any training or educational program shall be B. submitted at the same time as the invoice requesting reimbursement for that training or educational program. If the grantee provides a training or educational program, then the grantee shall acknowledge C the use of emergency medical and trauma services account grant funds in all public service • announcements, program announcements, or any other printed material used for the purpose of _ promoting or advertising the training or educational program. If the grantee provides a training or educational program, then the grantee shall develop and D utilize a course evaluation tool to measure the effectiveness of that training or educational program. The grantee shall submit a copy of all evaluation reports to the State upon completion of the training or educational program. 12. Requirements for Equipment Grants For any equipment purchases funded from this application, the grantee shall comply with the following requirements. A The grantee shall provide the state with written documentation of the purchase of the specified equipment. All communications equipment shall be purchased from the State award for communications equipment, or from another vendor for a comparable price and quality. If the grantee desires to purchase communications equipment which is not listed on the State award then the grantee B. must complete, with the State's assistance if needed, an informal competitive solicitation process before purchasing that equipment. If a competitive solicitation process is used, then the grantee shall purchase the communications equipment from the lowest bidder whose bid meets the bid specifications. If the grantee desires to purchase emergency vehicles other than ambulances, then the grantee must complete, with the State's assistance if needed, an informal competitive solicitation C. process before purchasing that equipment. The proposed specifications for these emergency vehicles must be approved by the State prior to the initiation of the informal competitive solicitation process. If a competitive solicitation process is used, then the grantee shall purchase the emergency vehicles from the lowest bidder whose bid meets the bid https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 --•-• __.,_.. - .•_....rr�....... rage !! ur 1L specifications. If the grantee desires to purchase medical equipment, then the grantee must complete, with the D State's assistance if needed, an informal competitive solicitation process before purchasing that equipment. If a competitive solicitation process is used, then the grantee shall purchase the medical equipment from the lowest bidder whose bid meets the bid specifications. During the initial term and any renewal or extension term of the contract or purchase order issued to convey funding to the grantee, and after the cancellation, termination, or expiration E. date of said contract or purchase order, the grantee shall acquire and maintain personal property casualty insurance for the replacement value of all equipment it purchases under this grant for the useful life of that purchased equipment. The grantee shall keep inventory control records for all equipment it purchases. The grantee F. shall obtain the prior, express, written consent of the State before relocating or reallocating any equipment it purchases. The grantee shall provide the State with a picture of each piece of equipment it purchases. The G. grantee may submit a picture of a piece of purchased equipment at any time, but in no event no later than the date the grantee's final progress report is due to the State. The grantee shall maintain all equipment it purchases in good working order, normal wear and tear excepted. The grantee shall perform all necessary maintenance services for all equipment H. it purchases in a timely manner and in accordance with all manufacturer's specifications and all manufacturer's warranty requirements. The grantee shall keep detailed and accurate records of all maintenance services it performs on all equipment it purchases. The grantee shall repair or replace all purchased equipment which is damaged, destroyed, lost, stolen, or involved in any other form of casualty. If the grantee ceases to provide emergency medical and trauma services in the state of Colorado, then all equipment purchased under this grant shall either be placed with another operating emergency medical services provider in the state of Colorado, or be sold at public J. auction for its then fair market value. That portion of the sale proceeds which equals the State's initial financial contribution towards the purchase of that equipment shall be refunded to the State by the grantee. The grantee shall obtain the prior, express written consent of the State prior to any relocation or sale of any purchased equipment. Authorized Agent 13. First Name David E. 14. Last Name Long 15. Title Chairman, Board of County Commissioners 16. Daytime Phone Number '1970-336-7204 17. Daytime Phone Number Extension X4200 18. Date I2/1 7 19. Signature of Authorized Agent L cam/` C FEB 1 5 2007 - _ \J 1 Once you have all of the answers you need, use this worksheet t ill out your application online. https://www.hfemsd2.dphe.state.co.us/CEMSISWeb_Grants/frm_5102_PrintApp.aspx 2/14/2007 pF CO4p e� Attachment A-2 o * *Ian• Payment Request Statement Colorado Department of Public Health Date: and Environment Contract or Purchase Order#: OE FMA EMS Federal Tax ID#: Agency: To: The Colorado Department of Public Health and Environment From: Health Facilities and Emergency Medical Services Division Name EMS Provider Grants Program 4300 Cherry Creek Drive South Address Denver, Colorado 80246-1530 (303) 692-2980 office (303) 691-7720 fax City,State,&Zip Code Note:A separate line for each invoice submitted should be filled out and back up documentation should be attached in concurrent order. Description of ActivitieslExpenses Invoice ft Invoice Total Agency Cash Match Total EMS Funds Requested TOTALS $ $ $ This is to certify that the above expenses were incurred per contract/purchase order number with the State and we, the contractor, are requesting reimbursement for the same. • Is this the final payment reimbursement request for this coniract/purchase order? YES NO (If yes,Final Report with pictures must be attached for payment.) Contractor Signature Date Phone For State Use Only: Grant Manager Approval Date Fiscal Officer Approval Date EXHIBIT B STATEMENT OF WORK To Contract Dated 06/15/2007-Contract Routing Number 08 FMA 00030 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. The Contractor shall complete the approved items in it's Colorado EMS Provider Grant Application Fiscal Year 2008 which has been incorporated herein by reference as an attachment to Exhibit A. To be attached to CDPHE Page 1 of I Revised:4/1/04 Version 1.0(4/04)contract template EXHIBIT C DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT (ADD PROGRAM NAME HERE) DEPARTMENT OR AGENCY NUMBER *** CONTRACT ROUTING NUMBER LIMITED AMENDMENT#* 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 contract dated ******** ** ****,with contract encumbrance number PO*** ********** and contract routing number** *** *****, whereby the Contractor was to provide to the State the following: [briefly describe what the Contractor was to do under the original contract—indent this paragraph[ [Please choose one of the following four options and then delete this heading and the other three options not selected:) • The State promises to [choose one and delete the otherlincrease/decrease the amount of funds to be paid to the Contractor by ********** Dollars,(5*.**)during the current term of the Original Contract in exchange for the promise of the Contractor to perform the [choose one and delete the otherlincreased/decreased work under the Original Contract. The State promises to pay the Contractor the sum of********** Dollars, ($*.**) in exchange for the promise of the Contractor to continue to perform the work identified in the Original Contract for the renewal term of**** years/months, ending on ******** **, ****. The State promises to [choose one and delete the other)increase/decrease the amount of funds to be paid to the Contractor by********** Dollars,($*.**)for the renewal term of**** [choose one and delete the otherjyears/months,ending on ******** **,****, in exchange for the promise of the Contractor to perform the [choose one and delete the otherlincreased/decreased specifications to the Scope of Work described herein. The State hereby exercises a"no cost"change to the [insert those that apply and delete those that don't)budget, specifications within the Scope 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 Contract or renewal term of the Original Contract. NOW THEREFORE, in consideration of their mutual promises to each other, stated below,the parties hereto ee as follows: - - - agree I. Consideration for this Limited Amendment to the Original 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 Page I of 4 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 here if previous amendment(s),change order(s),renewal(s)have been processed]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 Contract is and shall be modified,altered,and changed in the following respects only: A. [Use this paragraph when changes to the funding level of the Original Contract occur during the current term of the Original Contract]This Limited Amendment is issued pursuant to paragraph*_*.of the Original 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 any portion of this sentence that is not applicable]The revised specifications to the original Scope of Work and the revised Budget, if any, are incorporated herein by this reference and identified as"Attachment*"and "Attachment*". The first sentence in paragraph*_*. of the Original Contract is modified accordingly. All other terms and conditions of the Original Contract are reaffirmed. A. [Use this paragraph when the Original Contract will be renewed for another term]This Limited Amendment is issued pursuant to paragraph*_*.of the Original 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,($*.**)for an amended total financial obligation of the State of********** DOLLARS,($*,**). This is an [choose one and delete the otherlincrease/decrease of ********** Dollars,($*.**)of the amount payable from the previous term. [delete any portion of this sentence that is not applicable]The revised specifications to the original Scope of Work and revised Budget, if any, for this renewal term are incorporated herein by this reference and identified as"Attachment*"and"Attachment*". The first sentence in paragraph *_*.of the Original Contract is modified accordingly. All other terms and conditions of the Original Contract are reaffirmed. A. [Use this paragraph when there are"no cost changes" to the Budget,the specifications within the original Scope of Work,allowable contract provisions as noted,or performance period.]This Limited Amendment is issued pursuant to paragraph_*.of the Original 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 specifications to the Scope 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 Contract. The revised [choose those that apply and delete those that don't]Budget,specifications to the original Scope of Work,project management/manager identification,notice address or notification personnel,or period of performance is incorporated herein by this reference and identified as ` "Attachment*". All other terms and conditions of the Original Contract are reaffirmed. 4" The effective date of this Amendment is date, or upon approval of the State Controller,or an authorized delegate thereof, whichever is later. 5. Except for the General Provisions and Special Provisions of the Original Contract, in the event of any Page 2 of 4 EXHIBIT C conflict, inconsistency, variance, or contradiction between the terms and provisions of this Amendment and any of the terms and provisions of the Original Contract,the terms and provisions of this Amendment shall in all respects supersede,govern,and control. The Special Provisions shall always control over other provisions of the Original Contract or any subsequent amendments thereto. The representations in the Special Provisions to the Original Contract concerning the absence of personal interest of state of Colorado employees is 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 Form Amendment on the day first above written. CONTRACTOR: STATE: [LEGAL NAME OF CONTRACTOR] STATE OF COLORADO (legal type of entity) Bill Ritter,Jr. Governor By: By: Name: For the Executive Director Title: DEPARTMENT OF PUBLIC HEALTH FEIN: AND ENVIRONMENT ATTEST: PROGRAM APPROVAL: If the Contractor is a corporation or governmental entity,then an attestation By: is required. (Seal,if available.) By: City,City and County,County, Special District,or Town Clerk or Equivalent Corporate Secretary or Equivalent [Delete inapplicable language.] ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER CRS 24-30-202 requires that the State Controller approve all state contracts. This limited amendment is not valid until the State Controller,or such assistant as he may delegate,has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below,the State of Colorado may not be obligated to pay for goods and/or services provided. STATE CONTROLLER Leslie M. Shenefelt By: Date: Form:LAT 7-I-046N Page 4 of 4 STATE OF COLORADO Bill Ritter,Jr.,Governor James B.Martin, Executive Director �pF.cotofe Dedicated to protecting and improving the health and environment of the people of Colorado c' ro 4300 Cherry Creek Dr. S. Laboratory Services Division `� t* Denver,Colorado 80246-1530 8100 Lowry Blvd. • Phone(303)692-2000 Denver,Colorado 80230-6928 raga 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 7, 2007 Dear Provider Grantee: Congratulations on your funded FY08 EMS provider grant! Enclosed is your copy of the grant contract. • All contracts expire on June 30, 2008. However, this does not mean that you need to wait until June 30 to turn in your final paperwork. Please ensure that your grant project is complete and that all paperwork is received (not postmarked) at the department by June 30, 2008 at the latest. • The EMS Provider Grants Program is a reimbursement program. When you purchase items for your grant project, you need to pay in full. Then, submit the Payment Request Statement along with copies of the paid invoices and pictures. Please note the award amount on your contract. This amount cannot be exceeded. • When completing the Payment Request Statement, you'll need the contract or the contract routing number that can be found in the first page of your contract. • Tracking reversion dollars is important! If you determine that you will spend less than you were awarded, please notify us right away. This allows us to re-award the reversion dollars to other agencies that can use the grant funds to better their emergency medical and trauma services system. If you have any questions on this process or your grant award, please call me at (303) 692-2987 or Rio Chowdhury at (303) 692-2991. You can also visit www.coems.info. All forms needed for this program, including the Payment Request Statement, are located at this Internet site. Thank you. Sincerely, own — _ — Jeanne-Marie Bakehouse EMS Provider Grants Program Manager Emergency Medical and Trauma Services Section Hello