HomeMy WebLinkAbout20052767 RESOLUTION
RE: APPROVE AGREEMENT FOR CHILD AND ADULT CARE FOOD PROGRAM AND
CERTIFICATE AND STATEMENT OF AUTHORITY AND TRUTH OF APPLICATION
AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS,the Board has been presented with an Agreement for the Child and Adult Care
Food Program, and Certificate and Statement of Authority and Truth of Application between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld
County, on behalf of the Department of Human Services, Family Educational Network of Weld
County, and the Colorado Department of Public Health and Environment, commencing
October 1,2005,and ending September 30,2010,with furtherterms and conditions being as stated
in said agreement, and
WHEREAS,after review,the Board deems it advisable to approve said agreement, 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 Agreement for the Child and Adult Care Food Program, and Certificate
and Statement of Authority and Truth of Application between the County of Weld,State of Colorado,
by and through the Board of County Commissioners of Weld County, on behalf of the Department
of Human Services, Family Educational Network of Weld County, and the Colorado Department of
Public Health and Environment be, and hereby are, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to
sign said agreement.
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 14th day of September, A.D., 2005.
BOARD OF COUNTY COMMISSIONERS
1;174 WELD COUNTY, COLORADO• i10441 'tn. `1 ti-,, ,--‘
(1861 .x, � William H. rke, Chair
my Clerk to the Board —
f 4% ��/
♦ t► ; I
®UN
eile, Pro-Tem
Dep h Clerk o the Board <
Davis Lo'ran'
A AST •
Robert D. Masde
ounty Attorney
Glenn Vaad
Date of signature: 917316
2005-2767
�l , / �S �� � 0 O7—ac.,- —
a
MEMORANDUM
frDATE: September 8, 2005
TO: Board of County Commissioners n
"lip O FROM: Walt Speckman, Executive Director ' 0)"
•
COLORADO
SUBJECT: Agreement between FENWC and the Child and Adult
Care Food Program
Presented for approval before the Weld County Board of County Commissioners is an
Agreement between FENWC and the Child and Adult Care Food Program hereinafter referred to
as the CACFP Program.
FENWC agrees to provide breakfast, lunch and snack to all children in the Program.
FENWC will seek reimbursement for such meals as deemed by the CACFP Program.
FENWC also agrees to follow all regulations that is required from the CACFP Program including
appropriate documentation, forms, etc.
The CACFP Program will reimburse FENWC for the appropriate meals according to the
Regulations goveming the Child and Adult Care Food Program.
The term of this contract will be from 10/1/05 and end on 9/30/2010.
If you have any questions please contact Janet Flaugher, Director, @ 353-3800, ext. 3340.
2005-2767
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COLORADO DEPARTMENT OF PUBLIC HEALTH &ENVIRONMENT-
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CHILD AND ADULT CARE FOOD PROGRAM
CERTIFICATE AND STATEMENT OF AUTHORITY&TRUTH OF APPLICATION
(' . .41Di \ (4 , t. i�.( 5r s i ,(, IC .. y - ( (-Mitt
Legal Name of the Institution
Trade Name of the Institution(Complete only if doing business as idtaj)
Whose address is:
(Sheet Address)
(City) ( (State) (Zip Code)
((flc ) c/ - 1[5 'el
(Telephone) (Fax)
This Institution is a: Sole Proprietorship ❑ Partnership ❑ Limited Liability Corporation ❑ Public Entity ❑
Religious Institution/Church ❑ Non-Profit Corporation Js( For Profit Corporation ❑
Military Installation ❑
Today's Date:
The Child and Adult Care Food Program (CACFP)rules and regulations 7 CFR 226.6(b)(15)requires that all institutions
certify that all information on the application is true and correct. The regulation also requires the name, mailing address,
and date of birth of the institution's responsible principals and responsible individuals as defined in this document
By entering into an agreement with the CACFP the institution named above, all sites listed on Attachment B-1 of the
CACFP agreement, and all individuals employed by the institution agree to abide by all regulations governing the
CACFP,the CACFP agreement, and all appropriate Federal and State regulations and policies.
When there is a change of responsible principals or responsible individuals, it is the responsibility of the institution to
request within 10 calendar days of the change from the CDPHE-CACFP office, forms to register the change. The
signature on the Claim for Reimbursement must match one of the signatures on this form or the Claim for
Reimbursement cannot be processed and your reimbursement will be delayed.
RESPONSIBLE PRINCIPAL(S):
The CACFP defines a responsible principal(s)as the person(s)who are financially and administratively responsible for
the administration and operation of the institution. Each institution must submit responsible principal information for each
of the following individua
ls by institution type:
INSTITUTION TYPE :', RESPONSIBLE PRINCIPAL
Sole Proprietorship Individual AND Executive/Center Director
Partnerships ALL partners, signed as a general or imited partner AND Executive/Center Director
Limited Liability Corporation ALL managers/members AND Executive/Center Director
School District Superintendent OR Chair, Local Board of Education AND Executive/Center Director
Postsecondary Institution President OR Dean AND Executive/Center Director
Counties Chair, Board of County Commissioners AND Executive/Center Director
Cities and Towns Mayor AND Executive/Center Director
Religious Institution/Church Chair, Board of Directors AND Pastor, Rabbi AND Executive/Center Director
Non-Profit Corporation Chair, Board of Directors AND Executive/Center Director
For-Profit Corporation ALL owners AND Executive/Center Director
Military Installation Based on delegated authority at the Installation
RESPONSIBLE INDIVIDUAL(S):
The CACFP defines responsible individual(s) as the person(s) authorized by the responsible principal(s) as other
individual(s) with responsibility for functions of the CACFP, such as, person(s) in a management position, cook,
individual preparing the claim for reimbursement
J:ICACFPCommonlFORMSRenewah Forms FY06\CSA&TARevision.final.6.30.05.doc Page 1
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Certificate and Statement of Authorit
y and Truth in Application(continued)
THIS PAGE MAY BE COPIED FOR EACH RESPONSIBLE PRINCIPAL AS NECESSARY
As a responsible principal, I understand the following:
• The institution accepts final administrative and financial responsibility for all child and adult centers and family
day care home providers supervised by the institution.
• The institution must operate a nonprofit food service using all of the income received from the CACFP solely for
the operation or improvement of such service.
• A failure to property administer the CACFP could result in termination of the CACFP agreement and the
placement of the above named institution and any responsible principals and responsible individuals on the
National Disqualified List.
• Placement on the National Disqualified List means the institution, and all of its responsible principals and
responsible individuals are prohibited from future participation in the CACFP.
We, as responsible principals, authorize the responsible individual(s), whose name(s) and signature(s) appear on
page 3, to perform key functions of the CACFP. Additionally we, as responsible principals, acknowledge legal and
financial responsibility for all actions taken by the individuals conducting CACFP operations for the institution.
Each individual identified as a RESPONSIBLE PRINCIPAL must individually complete the following information.
RESPONSIBLE PRINCIPAL# ••
As a Responsible Principal, I certify the following:
• All information on the institution's application is true and correct
• The above named institution has not been disqualified from participation in any other publicly funded program in
the past seven years.
■ I have not been a principal in an institution participating in a publicly funded program that has been ruled
ineligible as a result of violating that program's requirements during the past seven years.
• I have not been convicted of a business-related offense during the past seven years.
• I am not on the Child and Adult Care Food Program (CACFP) National Disqualified List.
By signing below, I acknowledge that I have read and agree to all information contained in the CACFP agreement
and understand that submission of false information and certifications will lead to placement on the National
Disqualified List and subject me to any other applicable civil or criminal penalties.
Responsible Principal's Tit :
/ /
Printed Name: Lk.) Date of Birth: //2( /1-7
Address other than inntWonisi
address:
Phone number other than institution's phone number: (
Legal Signature: Date Signed:
J:ICACFPCommon\FORMS\Renewal Forms FY061CSA&TARevision.final 6.30.05.doc Page 3
. Certificate and Statement of Authority and Truth in Application(continued)
THIS PAGE MAY BE COPIED FOR RESPONSIBLE INDIVIDUALS AS NECESSARY
Responsible individuals are the persons identified by the responsible principals as individuals with
responsibility/authority for key functions of the CACFP, such as those in a management position, individual
preparing and signing the claim for reimbursement, cook, etc.
Each person identified as a RESPONSIBLE INDIVIDUAL must individually complete the following information.
RESPONSIBLE INDIVIDUAL#
By signing below, I acknowledge that I have read and agree to all information contained in this document.
Responsible Individual's Title: Het 1 E� � c. f,,
Printed Name: � N, c 1c,- `t( 6 t`. Date of Birth: 11 / t_ t #LAT,'
Address if different than institution's address: _
Phone number if different than institution's phone number:
Legal Signature:'. �� ' fir' i t e 1 L . Date Signed:
f
RESPONSIBLE INDIVIDUAL# •
By signing below, I acknowledge that I have read and agree to all information contained in this document.
Responsible Individual's Title: e-7 r ; rF t
Printed Name: ft _ r r.; { 1 _ Date of Birth: CA(
Address if different than institution's address:
Phone number if differentthan institutio ' phone number: _S )
Legal Signature: je , J/.�r•l-T. Date Signed:
RESPONSIBLE INDIVIDUAL# •
By signing below, I acknowledge that I have read and agree to all information contained in this document.
Responsible Individual's
Printed Name: LT_ ii (,A Date of Birth: i ti 3
Address if different than institution's address:
a
Phone number if different than institution's phone number: (
Legal Signature:
.,�' Date Signed: /'- /i ` >
�� ' �L� -
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t ;
J:SCACFPCommonlFGRMS1Renewal Forms FY061CSABJARevision.fina1.6.30.05.doc
Page 4
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
ROUTING NO. 06 FLA 00477
APPROVED PHASE 1 WAIVER #189 INTERGOVERNMENT CONTRACT
STATE: CONTRACTOR:
WELD COUNTY FAMILY EDUCATION
State of Colorado for the use&benefit of the NETWORK OF WELD COUNTY
Department of Public Health and Environment P. O.Box 1805
PSD-CACFP.
Greeley,CO 80632
4300 Cherry Creek Drive South
Denver,CO 80246
CONTRACT MADE DATE: CONTRACTOR ENTITY TYPE:
07/01/2005 Colorado Political Subdivision
CONTRACTOR FEIN OR SI MMI SECURITY NUMBER
PO/SC ENCUMBERANCE NUMBER 846000813
PO FLA CFP0G000001 BILLING STATEMENTS RECEIVED:
TERM: Monthly
This contract shall be effective upon approval STATUTORY AUTHORITY:
by the State Controller,or designee,or on 7 CFR 226
11/01/2005,whichever is later. The contract CONTRACT PRICE NOT TO EXCEED:
shall end on 09/30/2010.
$SEE EXHIBIT A
FEDERAL FUNDING DOLLARS: $See Exhibit A
STATE FUNDING DOLLARS: $
MAXIMUM AMOUNT AVAI ABLE PER FISCAL YEAR
PROCUREMENT METHOD: FY 06:$
Exempt
BID/REP/LIST PRICE AGREEMENT NUMBER
Not Applicable
LAW SPECIFIED VENDORSrATUIE PRICE SIRUCIURE
Not Applicable Cost Reimbursement
STATE REPRESENTATIVE CONTRACIDRREPRESENTATIVE
Laura Jorstad Julie Mallory
PSD-CACFP
4300 Cherry Creek Drive South P. O. Box 1805
Denver, CO 80246 Greeley, CO 80632
SCOPE OF WORK:
The purpose of this Contract is to carry out the objectives of Section 17 of the National School
Lunch Act, as amended, the regulations governing the Child and Adult Care Food Program issued
thereunder (7 CFR 226), and Section 17 of Public Law 105-336, also known as "The Child
Nutrition Reauthorization Act of 1998".
CDPHE Version 1.0(4/04) Pagel of 17 Revised:4/1/04
ExRams:
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.
CDPHE version 1.0(4/04) Page 2 of 17 Revised:4/1/04
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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 hmmunity Act,Section 24-10-101
et.seq.,CRS,as now or hereafter amended. The parties understand and agree that liability for rlaimc 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
etseq.,CRS and the risk management statutes,Section 24-30-1501,etseq.,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 contact 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 contact 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: 1)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 Contact 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-Oualifications/Licenses/Auumvals/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 17 Revised:4/1/04
certification,approval,insurance, etc.required for the Contractor to properly perform this contact, 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 contact on behalf of the Contractor warrant(s)that such person(s)have full
authorization to execute this contact.
8. In rice—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 Untied 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
seo., 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 Contactor,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 17 Revised: 4/1/04
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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
rlmtimdng obligation. Confidential or proprietary information for the purpose of this paragraph is information
relating to Contractor's research,development,trade secrets,business affairs,internal 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(mcluding but not limited to,disclosures required pursuant to the Colorado(Open)Public Records Act,
sections 24-72-201,et.seq,C.RS.,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 shallbe 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 17 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. 84-7301231C]and from all state and local government use taxes[C.RS. 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 orgrnvation which employees, or is about to employ,any of the above,
has a financial or other interest in the finn selected for award. The Contractor's,subcontractor's,or
sub grantee'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 or delivered 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 17 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 contact price pursuant to the application of a clause in this contract chart 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 Contact,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 chill be used only for the following:
I. 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;
H. To revise specifications within the current Scope of Work and/or Budget that
increase/decrease the level of funding during the current tent of the Original Contract;
III. 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"rhanges to the Budget.
Upon proper execution and approval,this Limited Amendment shall become a formal amendment
to this Contract.
b. 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 17 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 breath 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 patty 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 breath of thic 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 contact
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 contact,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 Contractor 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 Verson 1.0(4/04) Page 8 of 17 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 panics 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;
III. 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 17 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,a legally extended,the
State Procurement Officer or deleger. :nall 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 than be in
the City and County of Denver,Colorado.
23. Understandinp 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
CDPHE Version 1.0(4/04) Page 10 of 17 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,delegate/I 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, Contactor 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 chart 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.
Ira 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 than 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 17 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 than 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 Verson 1.0(4/04) • Page 12 of 17 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
ve
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
i. 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 chalk 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 alerting 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 Title 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 to 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 17 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 chall 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(1)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 chap 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-21
(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 17 Revised:4/1/04
These Special Provisions are required by Fiscal Rule 31 to be used in every State contract'
including grants.
STATE OF COLORADO SPECIAL PROVISIONS
(For Use with Inter-Governmental Contracts Only)
1. CONTROLLER'S APPROVAL. CRS 24-30-202 (1)
This contract shall not be deemed valid until it has been approved by the Controller of the State of Colorado or such
assistant as he may designate.
2. FUND AVAILABILITY. CRS 24-30-202(5.5)
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.
3. INDEMNIFICATION.
To the extent authorized by law, the contractor shall indemnify, save, and hold harmless the State against any
and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as a
result of any act or omission by the Contractor, or its employees, agents, subcontractors, or assignees pursuant
to the terms of this contract
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 for the parties, 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 CCR801-2
THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN
EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE OR SHALL BE
DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHAT L PAY WHEN DUE ALL REQUIRED
EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES PAID BY THE STATE PURSUANT TO
THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND TTS EMPLOYEES ARE NOT ENTITLED TO
UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR 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 AGREEMENTS, 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 SEAT T BE SOT ELY RESPONSIBLE FOR THE AL1_S
OF THE CONTRACTOR,II'S EMPLOYEES AND AGENTS.
5. NON-DISCRIMINATION.
The 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 contact 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
CDPHE Version 1.0(4/04) Page 15 of 17 Revised:4/1/04
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 the contact is capable of execution.
At all times during the performance of this contract,the Contractor shall strictly adhere to all applicable federal and
State laws,rules,and regulations that have been or may hereafter be established
7. 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 United States copyright laws or applicable licensing restrictions.
The Contractor hereby certifies that,for the term of this Contract and any extensions, the Contractor has in place
appropriate systems and controls to prevent such improper use of public funds. If the State determines that the
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 the Contract and any remedy consistent with
United States copyright laws or applicable licensing restrictions.
8. EMPLOYEE FINANCIAL INTEREST. CRS 24-18-201 &CRS 24-50-507
The signatories aver that to their knowledge, no employee of the State of Colorado has any personal or beneficial
interest whatsoever in the service or property described herein.
Effective Data:Apil 1,2004
CDPHE Version 1.0(4/04) Page 16 of 17 Revised:4/1/04
•
THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
CONTRACTOR: STATE OF COLORADO:
WELD COUNTY FAMILY EDUCATION BILL OWENS,GOVERNOR
NETWORK OF WELD COUNTY
Legal Name of Contracting Entity 1.By �-
r-( ,C
2
For xecutiv Director
846000813 Department of Public Health and Environment
Social
Security Number or FEIN
42
'7 /�..4 Department Program Approval:
Signature of Authorized Officer
William H. Jerke, Chair By
Print Name&Title of Authorized Officer
9/14/2005
GOVERNMENTAL ENTITIES:
(An attestation and seal are required)
Attest(Seal)By � ,
(Place government seal here)
Board of Weld County Commissioners
LEGAL REVIEW:
COLORADO DEPARTMENT OF LAW
OFFICE OF THE ATTORNEY GENERAL
By /
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
By
Date si J/
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19OO5 - ?747
EXHIBIT A
ADDITIONAL PROVISIONS
To Contract Dated 07/01/2005-Contract Routing Number 06 FLA 00477
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
1. This contract contains federal funds(see Catalog of Federal Domestic Assistance(CFDA)number
10.5580).
2. The United State Department of Agriculture,Food and Nutrition Service("USDA"),has awarded federal
funds under a Federal State Agreement,Form FNS-74,to administer the Child and Adult Care Food
Program("CACFP"),as authorized by Section 17 of the National School Lunch Act,as amended. The
State has formulated a comprehensive State plan,with associated budgets,to disburse these funds
throughout the state of Colorado. Under this comprehensive State plan,the State shall allocate these funds
to qualified entities to provide quality meals to eligible persons of the state of Colorado on behalf of the
State.
The underlying Federal State Agreement"FSA",mentioned above, as further discussed in Title 7,Chapter
II(Food and Nutrition Service,Department of Agriculture), Part 226(Child and Adult Care Food
Program), Section 226.11,authorizes the State to develop a policy that allows centers(contractors)to
"earn"reimbursement for meals served in the month preceding the month in which the contract is executed,
and allows the State to reimburse centers for those meals"after"an agreement has been executed. The
State has developed and implemented such a policy. In this case the"date of contract execution" shall be
the same date as the contract's"effective"date. The effective date of the contract shall be deemed to be the
date stipulated in the contract as the proposed effective date. Based upon the underlying federal grant
authorization as discussed above,the Contractor is authorized to perform work under this contract, if such
work is approved by the State,during the month preceding the Contract's proposed effective date. Once
this Contract is fully approved by the State Controller or designee,the State is then authorized to pay the
Contractor for all work authorized by the State to be performed and actually performed by the Contractor
during the month preceding the Contract's proposed effective date.
3. Payments pursuant to this Contract shall be made as earned, in whole or in part from available funds for the
purchase of meals under the federal Child and Adult Care Food Program. The Contractor expressly
acknowledges that the maximum amount of funds available statewide for each state of Colorado fiscal year
for the purchase of Child and Adult Care food service from all Contractors is the amount,which is
encumbered in the blanket encumbrance.The liability of the State,at any time,for payments to the
Contractor,and all other contractors, shall be limited to the remaining unencumbered balance of these
funds.
4. To receive compensation under this Contract,the Contractor shall submit a signed Claim for
Reimbursement on a monthly basis. A Claim for Reimbursement must be submitted within sixty (60)
calendar days of the end of the month for which services are claimed. Expenditures shall be in accordance
with the Statement of Work attached hereto as Exhibit B and incorporated herein.
Monthly Claims for Reimbursement shall be sent to:
Prevention Services Division
Child and Adult Care Food Program
Colorado Department of Public Health and Environment
PSD-CAC-A4
4300 Cherry Creek Drive South
Denver,CO 80246
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EXHIBIT A
To be considered for payment, Claims for Reimbursement pursuant to this Contract must be received in
accordance with the procedures established by the State.Only original claims received within sixty(60)
calendar days following the last day of the claim month shall be eligible for reimbursement.Revised claims
requiring an upward adjustment to the prior amount paid must be submitted within ninety(90)calendar
days of the last day of the claim month. Revised claims requiring a downward adjustment may be
submitted at anytime.
5. The State has determined that this contract does not constitute a Business Associate relationship under
HIPAA.
6. The purpose of this Contract is to carry out the objectives of Section 17 of the National School Lunch Act,
as amended,the Regulations governing the CHILD AND ADULT CARE FOOD PROGRAM(CACFP)
issued thereunder(7 C.F.R., Part 226),and Section 107 of Public Law 105-336, also known as"The Child
Nutrition Reauthorization Act of 1998".
7. This contract shall include agreements with the following types of institutions.
a. Adult day care centers;
b. Child care centers;
c. Outside-school-hours care centers;
d. At-risk after school programs;
e. Emergency shelters;
f. Sponsoring organizations of any of the above types of Contractors.
8. The Contractor shall comply with the Title VI of the Civil Rights Acts of 1964(Public Law 88-352)and all
requirements imposed by the Regulations of the: Department of Agriculture(7 C.F.R.,Part 15),the
Department of Justice(28 C.F.R., Subparts 42& 50);the directives or regulations of the Federal Food and
Nutrition Service(FNS)issued pursuant to that Act;and those regulations which state that no person in the
United States shall, on the basis of race,color,national origin,sex, age,or disability,be excluded from
participation in,or be denied the benefits of,or be otherwise subject to discrimination under any program
or activity for which the Contractor received Federal financial assistance.
The Contractor shall compile data,maintain records,and submit reports as required to permit the effective
enforcement of Title VI.The Contractor shall permit authorized State personnel, during the Contractor's
normal working hours,to review such records,books, and accounts as may be needed to ascertain the
Contractor's compliance with Title VI. If the Contractor fails to maintain such data and records,then the
State shall have the right to seek judicial enforcement of this provision. This provision is binding upon the
Contractor, its successors,transferees, and assignees so long as it receives assistance or retains possession
of any assistance from the State.
9. The Contractor must be a public organization or a nonprofit organization,which has tax-exempt status
under the Internal Revenue Code.
For profit centers are eligible to participate if the center receives funds under Title XX of the Social
Security Act for at least twenty-five percent(25%)of each institution's enrolled participants or license
capacity, whichever is less,during the month preceding its original application to the CACFP.The center
shall continue to certify such information in each succeeding claim month. The Contractor is not eligible to
claim reimbursement for meals served in any for profit center during which the center receives Title XX
funds for less than twenty-five(25%)of its enrolled participants or license capacity.
For profit centers are also eligible to participate if at least twenty-five percent(25%)of the participants
served in the center are eligible for Free or Reduced price meals.
10. The Contractor certifies that all centers listed in Attachment B-1 shall have a valid license or registration
certificate for providing care.
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EXHIBIT A
11. The Contractor certifies that it provides organized care in nonresidential situations for programs
participating as child care,adult care or after school at-risk programs.If the Contractor is participating as
an Emergency Shelter Serving Homeless Children,the Contractor certifies that it provides a residential
setting for homeless children or is a shelter for children who are residents of any emergency shelter.
12. The Contractor certifies that its institutions and any of its principals are not on the CACFP National
disqualified list The contractor certifies that during the preceding seven years,neither the institution nor
any of its principals has been declared ineligible to participate in any publicly funded program by reason of
violating that program's requirements.The Contractor certifies that neither the institution nor any of its
principals has been convicted of any activity that occurred during the past seven years that indicated a lack
of business integrity. Any institutions or individuals providing false certifications will be placed on the
CACFP National disqualified list and will be subject to any other applicable civil or criminal penalties.
13. The Contractor certifies that is capable of operating in conformance with the following performance
standards:
a. Financial viability and financial management—Program funds must be expended and accounted
for in accordance with the requirements of 7 C.P.A. 226.
b. Administrative capability—Appropriate and effective management practices must be in effect to
ensure that the Program operates in accordance with this part
c. Program accountability—Internal controls and other management systems must be in effect to
ensure that the Program operates in accordance with the requirements of 7 C.F.R. 226.
14. The Contractor certifies that it accepts full and final financial and administrative responsibility for all
CACFP operations for each facility as included in Attachment B-1. Claims must be submitted accurately.
Failure to submit accurate claims may result in over-claims being assessed,and/or suspension,termination
or legal action being taken.
15. The Contractor agrees that if a responsible individual or principal change during the period of time covered
by this agreement,the owner,organization,or it's representatives must submit a new Certificate and
Statement of Authority&Truth of Application within 10 calendar days of the change.
16. The Contractor agrees that if the business structure or ownership of the participating institution changes
during the period of time covered by this agreement,the owner or organization officials must submit a new
Certificate and Statement of Authority&Truth of Application within 10 calendar days of the change.
Examples of business structure or ownership changes include,but are not limited to,the following:
formation or dissolution of a corporate entity; sale of sole proprietorship;creation of a lease/purchase
agreement;and change of corporate officials. Some of these changes in business structure or ownership
may necessitate the termination of this agreement and the submission of a new CACFP application and
agreement with the new owner/s.
17. The Contractor understands that any unpaid over-claim assessed to the participating institution shall be
subject to collection proceedings through any means deemed necessary.The State must assess interest
beginning with the initial demand for remittance of any over-claim.
18. The Contractor certifies that it shall provide services to all program participants and employees in a smoke
free environment In accordance with Public Law 103-227,also known as the Pro-Children Act of 1994,
smoke free shall mean that smoking is not permitted in any portion of any indoor facility owned,leased,or
contracted for if said facility is routinely or regularly used for the provision of child care or health services
to any child under the age of 18 when those services are funded all or in part with Federal funds.
19. The Contractor shall keep full and accurate records pertaining to its participation in the CACFP as a basis
for its claims for reimbursement and,for State and Federal audit and review purposes for a period of three
(3)years and four(4)months following the end of the applicable fiscal year in which this contract is in
effect,canceled,terminated,or expires. If any litigation,claim,or audit is commenced before the
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EXHIBIT A
expiration of the three(3)years and four(4)months period,then the Contractor shall maintain all pertinent
records until litigation,claims,or audit findings have been resolved. This provision shall control over any
conflicting provisions within the Contract's General Provisions.
20. The State shall notify the Contractor of any change in the minimum meal requirements or in the applicable
rates of reimbursement as soon as possible after the State receives such notification from USDA.
21. The State shall annually make available on behalf of the Contractor to the local media serving the area from
which the Contractor draws its attendance,a public release announcing the availability of meals to all
eligible enrolled participants without regard to race, color,national origin, sex,age, or disability.
22. Either party may terminate this Contract by giving thirty(30)days written notice to the other party.The
State may immediately terminate this Contract if it receives evidence that the Contractor has failed to
comply with the terms and conditions of this Contract or the federal regulations governing this Contract.
Any termination of this Contract by the State shall be made in accordance with all applicable laws and
regulations including 7 C.F.R. 226.6(c). No termination or expiration of this Contact,however,shall affect
the obligation of the Contractor to maintain and retain records and to make such records available for audit.
The Contractor may appeal a termination according to the procedures established in 7 C.F.R Part 226.6(k).
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EXHIBIT B
STATEMENT OF WORK
To Contract Dated 07/01/2005-Contract Routing Number 06 FLA 00477
These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above.
1. Definitions.For the purposes of this Contract,the following definitions shall apply:
a. Eligible"participant"means a person who is eligible for CACFP benefits and includes the
following:
i. Children twelve(12)years of age and under;
ii. Children of migrant workers fifteen(15)years of age and under;
iii. Children with mental or physical handicaps,as defined by the State,and enrolled in an
institution serving a majority of persons eighteen(18)years of age and under;
iv. Adults sixty(60)years of age or older and enrolled in an adult day care center;
v. Adults who are functionally impaired(as defined in this section)and enrolled in an adult
day care center;
vi. Children eighteen(18)years of age and under and enrolled in an at-risk after school
program;
vii. Children eighteen(18)years of age and under and residing in an emergency shelter.
b. "Functionally impaired adult"means a chronically impaired disabled person 18 years of age or
older,including,but not limited to,a victim of Alzheimer's disease or other related disorders with
neurological and organic brain dysfunction,who is physically or mentally impaired to the extent
that the person's capacity for independence and ability to carry out activities of daily living is
markedly limited.Activities of daily living include,but are not limited to, adaptive activities such
as cleaning,shopping,cooking,taking public transportation,maintaining a residence, caring
appropriately for one's grooming or hygiene,using telephones and directories,or using a post
office. Marked limitations refer to the severity of impairment,and not the number of limited
activities, and occur when the degree of limitation is such as to seriously interfere with the ability
to function independently,
c. "Institution"means a child care center, outside-school-hours care center,emergency shelter, adult
day care center or sponsoring organization of centers which enters into an agreement with the state
agency to assume final administrative and financial responsibility for Program operations.
d. "Facility"means a center sponsored by an institution(as defined in this section).
e. "Milk"means pasteurized fluid types of unflavored or flavored whole milk,low fat milk, skim
milk,or cultured buttermilk,which meet State and local standards for such milk. All milk should
contain vitamins A and D at levels specified by the Food and Drug Administration and be
consistent with State and local standards for such milk.
2. Attachment B-1 lists those centers that have been approved to participate in the CACFP and,those meals that
may be claimed by the Contractor for reimbursement under this Contract.Requests for facilities or meals to be
added or deleted from Attachment B-1 may be made as the need arises.All such requests shall be sent in
writing and to the State.All references to Attachment B-1 shall be deemed to include that Attachment as
subsequently supplemented or amended.
The State shall only reimburse the Contractor for creditable meals served to eligible participants at those
facilities listed in Attachment B-1 and shall be based on the actual count of meals served by eligibility category
(free,reduced cost,or paid).
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EXHIBIT B
3. The Contractor's governing body is responsible for the administration of the facilities listed in Attachment B-1
or is an agency to which the facilities listed in Attachment B-1 have delegated authority for the operation of the
food service program.
4. In order to qualify for reimbursement under this Contract,the Contractor shall conduct itself in accordance with
the regulations governing the CACFP(7 C.F.R.226)and all appropriate Federal and State regulations and
policies.
5. The Contractor shall operate a nonprofit food service using all of the income received from the CACFP solely
for the operation or improvement of such service. The Contractor shall use cash reimbursement only for the
purchase of food and other food service expenses.
6. The Contractor shall ensure that meals and snacks are provided to all eligible participants in accordance with
those requirements contained in 7 C.F.R. Part 226.20,and specified in Attachment B-2.
7. The Contractor shall serve the same meal at no separate charge to enrolled participants who are in attendance at
meal time(non-pricing institution)and so designate on the Application Form and Nondiscrimination Policy
Statement and abide by the terms of the Nondiscrimination Policy Statement and Program Verification Rules(7
C.F.R. Part 226.23 (h)(1).
8. The Contractor shall collect data on family size and income and record that data on the Income Eligibility Form
(IEF)for participants enrolled at all facilities listed in Attachment B-1 to determine which participants are from
families meeting the income eligibility guidelines for free or reduced cost meals. Participants for whom family
size and income data is not available shall be reported under the Paid(not eligible for free or reduced cost
meals)category only.
An IEF is valid for twelve(12)months. The eligibility term is calculated from the first day of the month in
which the parent or guardian signed the IEF.Free or reduced cost meals may be claimed for reimbursement
beginning with that date. The IEF is never retroactive from this date. Meals claimed after the expiration date of
an IEF can only be claimed in the Paid category.
Residential children served meals in an Emergency Shelter are automatically classified in the Free category. An
IEF is not required.
Children served in At-Risk After School Programs are automatically reimbursed for snacks served in the Free
category.
9. The Contractor must maintain and update annually data on enrolled participants that include name,date of birth,
address,and telephone number.
10. The Contractor shall claim reimbursement only for those meals served to eligible enrolled participants in each
income category within the limits of the Contractor's licensed capacity or registration certificate capacity.No
more than two(2)meals and one(I)snack or two(2)snacks and one(1)meal per participant per day may be
claimed for child and adult care programs. Children served in an At-Risk After School Program may only be
claimed for one snack per child per day. Eligible children served in an Emergency Shelter program may be
claimed for no more than three(3)meals,breakfast, lunch, and supper, two(2)meals and one(1)snack, or two
(2)snacks and one(1)meal per participant per day.
11. If the Contractor provides care for infants,then the contractor must offer the infant a complete,developmentally
appropriate meal that complies the CACFP Infant Meal Pattern requirements for the age of the infant. The
Contractor must supply the choice of at least one iron-fortified infant formula.A parent or guardian may decline
the formula provided by the Contractor and supply a formula of the parents' choice.
12. The Contractor shall store,prepare, and serve food in conformance with all applicable State and local health
laws and regulations.
To be attached to CDPITE Page 2 of 4 Revised:4/1/04
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EXHIBIT B
13. The Contractor shall maintain full and accurate records that pertain to the CACFP,and retain such records for a
period of three(3)years and four(4)months following the end of the applicable fiscal year in which this
contract is in effect, canceled,is terminated,or expires.This documentation must be sufficient to show that all
reimbursement funds are used: (1)solely for the conduct of the CACFP food service, or(2)to improve such
food service operations principally for the benefit of the enrolled participants.These records include,but are not
limited to,the following:
a. Menus and food production records which indicate the quantities of foods prepared,the number of
participants for whom meals were prepared for,the number of particirgpts for whom meals were
served,and the serving sizes of these meals.
b. Daily records of the meals served to participants itemized by:name,type of meal(i.e.,breakfast,
lunch,supper,or snack),and income category(i.e.,free,reduced cost or paid).This information
shall be recorded on the"Records of Meals Served"form.
c. Approved Income Eligibility Forms(IEF)for enrolled participants categorized as free or reduced
cost.
d. Documentation of income to the Contractor from funds to subsidize the food service program,
including: CACFP reimbursement,payments for adult meals,loans,and donations.
e. Specifically itemized invoices or receipts for purchases by the Contractor,including:food costs,
bills from food service management companies,payroll records including fringe benefits,
equipment costs,maintenance and repair fees, office costs,utilities' costs and other administrative
costs.
f. License,registration or certification documentation.
g. Documentation of visits to facilities to monitor compliance.This requirement pertains only to
sponsors that administer more than one facility in accordance with 7 C.F.R. 226.16(d).
h. Documentation of participant enrollment.
i. Documentation of attendance,including times the participants are in the Contractor's facilities.
(Class attendance records or sign-in/sign-out sheets).
j. Documentation of Civil Rights racial/ethnic data
k. Documentation of staff training pertaining to the CACFP.
1. Special Diet Statements documenting variances from the CACFP meal patterns.
m. Any contract(s)with a food service management company.
n. Any Colorado Department of Human Services contract(s)—For-profit Centers only.
o. Copies of any payment and billing records from the Department of Human Services—For-Profit
Centers only.
p. Copies of records of bank account deposits of CACFP reimbursement.
14. The Contractor shall make all accounts and records that pertain to the CACFP available upon request to the
State and USDA for audit or review during the Contractor's normal business hours at all times during the term
of this Contract.This right of access shall not cease upon the cancellation,termination,or expiration of this
Contract.If any litigation,claim,or audit is commenced before expiration of the three(3)year and four(4)
month period stated above,then the contractor shall maintain all pertinent CACFP records until litigation,
claims, or audit findings have been resolved. In addition,the State and/or USDA may make unannounced visits
to any of the Contractor's facilities during normal hours of operation.
15. The Contractor shall provide adequate supervisory and operational personnel for overall monitoring and
management of each food service operation,and promptly take such actions as are necessary to correct
deficiencies found at the time of any on-site visit,review,or audit.
16. If the Contractor is acting as a sponsor,then it shall provide adequate supervisory and operational personnel for
overall monitoring and management of the food service operation of each facility listed on Attachment B-1,
and promptly take such actions as are necessary to correct deficiencies found at the time of any on-site visit,
review, or audit
The Contractor shall also monitor all facilities at least three(3)times each year,two(2)of which are •
unannounced, one(1)unannounced of which includes a meal service,with the first review occurring within the
first four(4)weeks of operation and no more than six(6)months elapsing between reviews.
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EXHIBIT B
17. The Contractor must cease claims for reimbursement from the CACFP if the facility participates in the sununer
food service program(SFSP).
18. Contractors participating as an At-Risk After School Care Snack Program must meet the following
requirements:
a. Operate an after school care program which provides children with regularly scheduled activities
in an organized,structured and supervised environment that must include educational or
enrichment activities.
b. Be located in an area served by a school in which at least fifty percent(50%)of the enrolled
children are certified eligible for Free or Reduced price school meals. If a state or local jurisdiction
does require licensing,then these facilities would need to be licensed.Facilities that are not
required to be licensed must meet state or local health and safety standards.
c. Snacks may not be reimbursed during summer vacation,except in eligibility areas where schools
operate on a year-round basis.At-risk after school care programs may receive reimbursement for
snacks through the whole year.
19. If applicable,the Contractor shall properly account for,store,and use all USDA commodity foods provided to it
under this Contract.The Contractor shall only use all USDA commodity foods provided to it under this
Contract solely for the benefit of those persons served or assisted by the Contractor under this Contract The
Contractor shall not dispose of any USDA commodity foods without the prior express,written consent of the
State. The Contractor shall promptly provide a written response to all claimc related to the alleged mishandling,
diversion, and/or loss of these commodity foods,which allegedly resulted from the improper accounting,
storage,or use of these commodity foods. If the Contractor,or third party agents of the Contractor,is
responsible for any theft or other loss of any USDA commodity foods,then the State may immediately
terminate this Contract for cause without any further liability to the State of any kind,including termination
costs.
20. The Contractor may contract with a local school food authority or with a food service management company for
the preparation and delivery of meals or meal components.The Contractor shall remain responsible for the
fulfillment of the terms and conditions of this Contract The Contractor shall submit a copy of each such
contract to the State.
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SITE INFORMATION FORM FOR PARTICIPATING CENTERS/SITES Attachment B-1
Listing of all centers/sites participating in the CACFP
Agreement#: 65103-05
Sponsor Name: WELD COUNTY
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning& Ending Times)
BILLIE MARTINEZ License#: 81834 Bkfst AM Snk Lunch PM Snk Supper Late Snk
1050 37TH ST
LicenseCap : 100 Times Times Times Times Times Times
EVANS, CO 80620 LicenseExp Date : 2/28/2006 0730-0830 1100-1200 0230-0245 0430-0500
Phone: (970)5064797 Meals are Prepared:On-site
Send Nutrition Education Mid To: p Off-site ,,:�
❑ Main Office ontact Person:DOROTHY PEREZ
El Above Address Age Range of Children: 0 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning`& Ending Times)
CENTENNIAL License# : 81833
Bkfst AM Snk Lunch PM Snk Supper Late Snk
1400 37TH ST LicenseCap : 50 Times Times Times Times Times Times
EVANS, CO 80620 LicenseExp Date : 12/31/2005 0730-0830 1130-0100 0230-0330 0430-0500
Phone: (970)339-3085 Meals are Prepared:On-site A Off-site
Send Nutrition Education Mtrl To. ❑ Main Office Contact Person:CLAUDIA TAPIA
rii Above Address Age Range of Children: 0 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
DOS RIGS License# : 81829 (Must put Beginning&Ending Times)
RI SST Bkfst AM Snk Lunch PM Snk Supper Late Snk
LicenseCap : 50 Times Times Times Times Times Times
EVANS, CO 80620 LicenseExp Date : 5/31/2006 0730-0845 1100-1230 0230-0245 0430-0500
Phone: (970)330-3220 Meals are Prepared:On-site ;_j Off-site _j
Send Nutrition Education Mtrl To: n Main Office Contact Person:MARIE GUTIERREZ
fri Above Address Age Range of Children: 0 - 5
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning& Ending Times)
EAST MEMORIAL License# : 81830 Bkfst AM Snk Lunch PM Snk Supper Late Snk
614 E 20TH ST
LicenseCap : 50 Times Times Times Times Times Times
GREELEY, CO 80631 LicenseExp Date : 5/31/2006 0730-0830 1100-1200 0230-0245 0430-0500
Phone: (970)352-9478 Meals are Prepared:On-site J Off-site
1
Send Nutrition Education Mtrl To:0 Main Office Contact Person:KAREN WAGGONER
0 Above Address Age Range of Children: 0 - 5
SITE INFORMATION FORM FOR PARTICIPATING CENTERS/SITES Attachment B-1
Listing of all centers/sites participating in the CACFP
Agreement#: 65103-05
Sponsor Name: WELD COUNTY
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
FREDERICK License# : 66816 (Must put Beginning &:Ending Times)
Bkfst AM Snk Lunch PM Snk Supper Late Snk
340 MAPLE LicenseCap : 54 Times Times Times Times Times Times
FREDERICK, CO 80530 LicenseExp Date : 8/31/2005 0730-0830 1100-1230 0230-0245 0430-0500
Phone: (970)833-2230 Meals are Prepared:On-site Li Off-site _j
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:ANGELA LEWELLEN
El Above Address Age Range of Children: 0 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
GILCREST License# : 85080 (Must put Begtnnmg&:Ending Times)
Bkfst AM Snk Lunch PM Snk Supper Late Snk
1175 BIRCH LicenseCap : 15 Times Times Times Times Times Times
GILCREST, CO 80623 LicenseExp Date : 5/31/2006 0730-0830 1100-1230 0230-0245 0430-0500
Phone: (970)737-6767 Meals are Prepared:On-site L. Off-site . _I
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:KAYE WRIGHT
El Above Address Age Range of Children: 3 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
GRAND JUNCTION License#: 04252 (Must put Beginning&:Ending Tknes)
Bkfst AM Snk Lunch PM Snk Supper Late Snk
GRAND JUNCTION, CO LicenseCap : 99 Times Times Times Times Times Times
LicenseExp Date : 7/31/2005 0730-0800 1130-1200 0230-0245
Phone: (970)4347112 Meals are Pre ared:On-site
P Off-site iij
Send Nutrition Education Mtrl To:❑ Main Office Contact Person:KAREN MELOTT
❑ Above Address Age Range of Children: 0 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
HUDSON License# : 81828 (Must put Beginning&Ending Times)
Bkfst AM Snk Lunch PM Snk Supper Late Snk
300 W BEECH LicenseCap : 50 Times Times Times Times Times Times
HUDSON, CO 80642 LicenseExp Date : 5/31/2006 0730-0930 1130-1245 0230-0330 0430-0500
Phone: (970)536-0440 Meals are Prepared:On-site h Off-site LI
❑ Main Office
C Send Nutrition Education Mtrl To: Contact Person:GWEN CERRETTO
ElAbove Address Age Range of Children: 0 - 5
SITE INFORMATION FORM FOR PARTICIPATING CENTERS/SITES Attachment B-1
Listing of all centers/sites participating in the CACFP
•
Agreement#: 65103-05
Sponsor Name: WELD COUNTY
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
ISLAND GROVE VILLAGE License# : 85077 (Must put Beginning s& Ending Times)
119 14TH AVE Bkfst AM Snk Lunch PM Snk Supper Late Snk
LicenseCap : 20 Times Times Times Times Times Times
GREELEY, CO 80631 LicenseExp Date : 3/31/2006 0730-0930 1130-1230 0230-0330 0430-0500
Phone: (970)352-2627 Meals are Prepared:On-site _J Off-site ___I
Send Nutrition Education Mtrl To:❑ Main Office Contact Person:MARIE GUTIERREZ
El Above Address Age Range of Children: 3 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
JEFFERSON License# : 81831 Bkfst AM Snk Lunch SnkPM(Must put
uBeginning
& Sup
Ending per Times)peer Snk
1315 4TH AVETi
mes
: 30 Times Times Times Times Times
GREELEY, CO 80631 LicenseExp Date : 10/31/2005 0730-0930 1130-1245 0230-0330 0430-0500
Phone: (970)356-7408 Meals are Pre ared:On-site
Send Nutrition Education Mtrl To:El Main Office P Off-Site ,
El Above Address Contact Person:MELINDA CASTILLO Age Range of Children: 2 - 5
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning&Ending Times)
MADISON License# : 81832 Bkfst AM Snk Lunch PM Snk Supper Late Snk
500 24TH AVE LicenseCap : 50 Times Times Times Times Times Times
GREELEY, CO 80631 LicenseExp Date : 6/30/2005 0730-0900 1130-1230 0230-0245 0430-0500
Phone: (970)353-2796 Meals are Prepared:On-site LI Off-site j
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:LARA WILEY
❑ Above Address Age Range of Children: 0 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning& Ending Times)
MILLIKEN License# : 85079
BROAD Bkfst AM Snk Lunch PM Snk Supper Late Snk
300LicenseCap : 30 Times Times Times Times Times Times
MILLIKEN, CO 80543 LicenseExp Date : 1/31/2006 0730-0900 1130-1230 0230-0300 0430-0500
Phone: (970)587-2888 Meals are Prepared:On=site ) Off-site _I
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:MABEL TAPIA
El Above Address Age Range of Children: 2 - 6
SITE INFORMATION FORM FOR PARTICIPATING CENTERS/SITES Attachment B-1
Listing of all centers/sites participating in the CACFP
Agreement#: 65103-05
Sponsor Name: WELD COUNTY
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
OLATHE License# : 03811 (Must put Beginning&:Ending Times
HAP COURT Bkfst AM Snk Lunch PM Snk Supper Late Snk
LicenseCap : 46 Times Times Times Times Times Times
OLATHE, CO 81425 LicenseExp Date : 9/30/2005 0730-0800 1130-1200 0230-0245
Phone: (970)323-5301 Meals are Prepared:On-site J Off-site _f
Send Nutrition Education Mal To: ❑ Main Office Contact Person:SUSIE WHITESIDE
❑ Above Address Age Range of Children: 0 - 5
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
PLATTEVILLE (Must put Beginning&:Ending Tunes)
ELEMENTARY License#: 05994
Bkfst AM Snk Lunch PM Snk Supper Late Snk
1202 MAIN LicenseCap : 15 Times Times Times Times Times Times
PLATTEVILLE, CO 80632 LicenseExp Date : 10/31/2005 0730-0803 1100-1200 1130-1200 0230-0245 0430-0500
Phone: (970)785-2271 Meals are are Prepd:On-site \\II
Off-site
Send Nutrition Education Mtrl To: ❑ Main Office J
❑ Above Address Contact Person:KAYE WRIGHT Age Range of Children: 3 - 6
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
(Must put Beginning&:Ending Tunes)
ST. PETERS License#: 1509085 Bkfst AM Snk Lunch PM Snk Supper Late Snk
1112 9TH AVE LicenseCap : 14 Times Times Times Times Times Times
GREELEY, CO LicenseExp Date : 1/31/2006 0800-0830 1000-1030 1200-1230 0330-0400
i
Phone: (970)356-2110 Meals are Prepared:On-site n Off-site J
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:MELINDA CASTILLO
❑ Above Address Age Range of Children: 3 - 7
MEAL SERVICE SCHEDULE OR MEAL TIME RANGES
LUPTON License#: 1521599 (Most put Beginning &:Ending Times)
FT.
FT. 9TH ST Bkfst AM Snk Lunch PM Snk Supper Late Snk
LicenseCap : 15 Times Times Times Times Times Times
FT. LUPTON, CO 80621 LicenseExp Date : 4/30/2005 0800-0830 1045-1230 0230-0245
Phone: (303)857-7463 Meals are Prepared:On-site j Off-site J
Send Nutrition Education Mtrl To: ❑ Main Office Contact Person:ANGIE LEWELLEN
0 Above Address Age Range of Children: 3 - 6
ATTACHMENT B-2
CACFP Requirements for Meals
Each facility participating in the CACFP shall serve one or more of the following types of meals,as approved and
listed on Attachment B-1:
1. Except as otherwise provided in this section each meal shall contain,at a minimum,the food components as
follows:
A BREAKFAST SHALL CONTAIN:
• A serving of fluid milk as a beverage or on cereal;or used in part for each purpose.
• A serving of vegetable(s)or fruit(s);or full-strength vegetable or fruit juice; or an equivalent quantity of
any combination of these foods.
• A serving of whole-grain or enriched bread;or an equivalent serving of cornbread,biscuits,rolls, muffins,
etc., made with whole-grain or enriched meal or flour;or a serving of whole-grain or enriched or fortified
cereal;or a serving of cooked whole-grain or enriched pasta or noodle products such as macaroni; or cereal
grains such as rice,bulgur,or corn grits; or an equivalent quantity of any combination of any of these
foods.
BOTH LUNCH AND SUPPER SHALL CONTAIN:
• A serving of fluid milk as a beverage.
• A serving of lean meat,poultry or fish;or cheese; or an egg;or cooked dry beans or peas;or nuts or nut
butters;or yogurt or an equivalent quantity of any combination of these foods. These foods must be sewed
in a main dish or in a main dish and one other menu item to meet this requirement. Cooked dry beans or dry
peas may be used as the meat alternate or as part of the vegetable/fruit component,but not as both food
components in the same meal.
• A serving of two or more vegetables or fruits;or a combination of both. Full-strength vegetable or fruit
juice may be counted to meet not more than one-half of this requirement.
• A serving of whole-grain or enriched bread;or an equivalent serving of cornbread,biscuits,rolls, muffins,
etc.,made of whole-grain or enriched meal or flour, or a serving of cooked whole-grain or enriched pasta
or noodle products such as macaroni; or cereal grains such as rice,bulgur,or corn grits;or an equivalent
quantity of any combination of these foods.
SNACK SHALL BE SERVED BETWEEN OTHER MEAL TYPES AND CONTAIN TWO OF THE
FOLLOWING FOUR COMPONENTS:
• A serving of fluid milk as a beverage or on cereal;or used in part for each purpose.
• A serving of meat or meat alternate.
• A sewing of vegetable(s)or fruit(s);or full-strength vegetable or fruit juice; or an equivalent quantity of
any combination of these foods. Juice may not be sewed when milk is served as the only other component
Vegetables and fruits are considered one meal component at snack.
• A serving of whole-grain or enriched bread;or an equivalent serving of cornbread,biscuits,rolls, muffins,
etc.,made with whole-grain or enriched meal or flour;or a serving of whole-grain or enriched or fortified
cereal;or a serving of cooked whole-grain or enriched pasta or noodle products such as macaroni; or cereal
grains such as rice,bulgur,or corn grits; or an equivalent quantity of any combination of any of these
foods.
2. Except as otherwise provided in this section,the minimum amounts of component foods to serve at meals as set
forth above are as follows:
AGE 0 MONTHS THROUGH 3 MONTHS:
• Breakfast—Breast milk or 4-6 fluid ounces of iron-fortified infant formula.
• Lunch or supper—Breast milk or 4-6 fluid ounces of iron-fortified infant formula.
• Snack—Breast milk or 4-6 fluid ounces of iron-fortified infant formula
Page 1 of 3
ATTACHMENT B-2
AGE 4 MONTHS THROUGH 7 MONTHS:
• Breakfast—Breast milk or 4-8 fluid ounces of iron-fortified infant formula; 0-3 tablespoons of iron-
fortified dry infant cereal(optional).
• Lunch or supper—Breast milk or 4-8 fluid ounces of iron-fortified infant formula; 0-3 tablespoons of iron-
fortified dry infant cereal(optional);0-3 tablespoons of fruit or vegetable of appropriate consistency or a
combination of both.
• Snack—Breast milk or 4-6 fluid ounces of iron-fortified infant formula
AGE 8 MONTHS UP TO 1 YEAR:
• Breakfast—Breast milk or 6-8 fluid ounces of iron-fortified infant formula; 2-4 tablespoons of iron-
fortified dry infant cereal; 1-4 tablespoons of fruit or vegetable of appropriate consistency or a combination
of both.
• Lunch or supper—Breast milk or 6-8 fluid ounces of iron-fortified infant formula; 2-4 tablespoons of iron-
fortified thy infant cereal and/or 1-4 tablespoons of meat,fish,poultry,egg yolk or cooked dry beans or
peas, or'/z-2 ounces(weight)of cheese,or 1-4 ounces(weight or volume) of cottage cheese or cheese food
or cheese spread of appropriate consistency; and 1-4 tablespoons of fruit or vegetable of appropriate
consistency or a combination of both.
• Snack—Breast milk or 2-4 fluid ounces of iron-fortified infant formula or full-strength fruit juice;0-1/2
slice of crusty enriched or whole-grain bread(optional),or 0-2 cracker-type products(optional)made from
whole-grain or enriched meal or flour that are suitable for an infant for use as a finger food.
AGE 1UPTO3:
• Breakfast—''A cup of milk 1/4 cup of juice or fruit or vegetable; 'A slice of bread or bread alternate,or'/.cup
(volume)or 1/3 ounce(weight),whichever is less, of cereal;or an equivalent quantity of both bread and
cereal.
• Lunch or supper—''A cup of milk; 1 ounce(edible portion as served)of lean meat,poultry or fish,or 1
ounce of cheese, or''egg,or'/ cup of cooked dry beans or peas, or 2 tablespoons of peanut butter, or 4
ounces or''/z cup of yogurt; %cup of vegetable(s)or fruit(s)or both consisting of two or more kinds; 'A
slice of bread or bread alternate,or 1/4 cup of cooked enriched or whole-grain rice,macaroni,noodles or
other pasta products.
• Snack—select two of the following four components—''A cup of milk; 'A ounce of meat or meat alternate
(which includes 2 ounces or'/,cup of yogurt); % cup of juice or equivalent quantity of fruit(s)or
vegetable(s); 'A slice of bread or bread alternate,or''%cup(volume) or 1/3 ounces(weight),whichever is
less, of cereal,or'/.cup of cooked enriched or whole-grain rice,macaroni,noodles or other pasta products.
AGE 3 UP TO 6:
• Breakfast—' cup of milk;'A cup of juice or fruit or vegetable; ''Aslice of bread or bread alternate,or 1/3
cup(volume)or'A ounce(weight),whichever is less, of cereal, or an equivalent quantity of both bread and
cereal.
• Lunch or supper—%cup of milk; 1 %ounces(edible portion as served)of lean meat,poultry or fish,or 1 'h
ounces of cheese,or' egg, or 3/8 cup of cooked dry beans or peas,or 3 tablespoons of peanut butter,or 6
ounces or 3/4 cup of yogurt;'/z cup of vegetable(s)or fruit(s)or both consisting of two or more kinds; %s
slice of bread or bread alternate,or'%cup of cooked enriched or whole-grain rice,macaroni,noodles or
other pasta products.
• Snack—select two of the following components—'/z cup of milk; 'A ounce of meat or meat alternate(which
includes 2 ounces or'A cup of yogurt); %cup of juice,or an equivalent quantity of fruit or vegetables; 'A
slice of bread or bread alternate,or 1/3 cup(volume)or'A ounce(weight),whichever is less, of cereal, or
1/3 cup of cooked enriched or whole-grain rice,macaroni,noodles, or other pasta products.
AGES 6 THROUGH 12:
• Breakfast—1 cup of milk; 'A cup of juice or fruit or vegetables; 1 slice of bread or bread alternate,or%cup
(volume)or 1 ounce(weight),whichever is less, of cereal,or an equivalent quantity of both bread and
cereal.
• Lunch or supper— 1 cup of milk;2 ounces(edible portion as served)of lean meat,poultry or fish,or 2
ounces of cheese, or 1 egg,or'A cup of cooked dry beans or peas, or 4 tablespoons of peanut butter,or 8
Page 2 of 3
ATTACHMENT B-2
ounces or 1 cup of yogurt;%cup of vegetable(s)or fruit(s)or both consisting of two or more kinds; 1 slice
of bread or bread alternate,or 1/2 cup of cooked enriched or whole-grain rice,macaroni,noodles or other
pasta products.
• Snack—select two of the following components— 1 cup of milk; 1 ounce of meat or meat alternate(which
includes 4 ounces or''cup of yogurt);%cup of juice or an equivalent quantity of fruits)or vegetable(s); 1
slice of bread or bread alternate, or%cup(volume)or I ounce(weight),whichever is less, of cereal,or'/s
cup of cooked enriched or whole-grain rice,macaroni,noodles,or other pasta products.
AGE 12 AND OVER INCLUDING ADULT PARTICIPANTS IN ADULT CARE:
• Breakfast— 1 cup of milk; 9 cup of juice or fruit or vegetables;2 slices(servings)of bread or bread
alternate,or I % cups(volume)or 2 ounces(weight), whichever is less,of cereal,or an equivalent quantity
of both bread and cereal.
• Lunch or supper— 1 cup of milk(Milk is not a required component for supper); 2 ounces(edible portion as
served)of lean meat,poultry or fish, or 2 ounces of cheese,or I egg, or 1/2 cup of cooked dry beans or peas,
or 4 tablespoons of peanut butter,or 8 ounces or 1 cup of yogurt; 1 cup(total)of vegetable(s)or fruit(s)or
both consisting of two or more kinds;2 slices(servings)of bread or bread alternate,or 1 cup of cooked
enriched or whole-grain rice,macaroni,noodles or other pasta products, or an equivalent quantity of both
bread and pasta products.
• Snack—select two of the following components—1 cup of milk; 1 ounce of meat or meat alternate,or 1
ounce of cheese, or 1 egg,or 1/2 cup cooked dry beans or peas, or 2 tablespoons of peanut butter, or 4
ounces('/z cup)of yogurt; 1 cup of juice or an equivalent quantity of fruits)or vegetable(s); I slice
(serving)of bread or bread alternate, or'/,cup(volume)or 1 ounce(weight),whichever is less,of cereal, or
'A cup of cooked enriched or whole-grain rice,macaroni,noodles,or other pasta products.
3. For the purpose of this section,a cup means a standard measuring cup.
4. To improve the nutrition of participants additional foods may be served with each meal.
5. If emergency conditions prevent a facility normally having a supply of milk from temporarily obtaining
delivery thereof,the State Agency,may approve the service of breakfasts,lunches, or suppers without milk
during the emergency period.
6. Substitutions may be made in food listed above in this section if individual participants are unable,because of
medical or other special dietary needs,to consume such foods. Such substitutions shall be made only when
supported by a statement from a recognized medical authority,which includes recommended alternate foods.
7. Adult day care centers may provide meals as offer versus serve:
• Each adult care center shall offer its adult participants all of the required food servings as set forth below.
However,at the discretion of the adult care center,adult participants may be permitted to decline:
• One of the four food items(one serving of milk,one serving of vegetable and/or fruit,or two servings
of bread or bread alternate)required at breakfast.
• Two of the six food items(one serving of milk,or two servings of vegetable and/or fruit,or two
servings of bread or bread alternate,and/or one serving of meat or meat alternate)required at lunch
• Two of the five food items(two servings of vegetables and/or fruit, or two servings of bread or bread
alternate,and/or one serving of meat or meat alternate)required at supper.
• The reimbursement of the meal shall not be affected if an adult participant declines a food item.
Page 3 of 3
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 Chem 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 other]increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, (S*.**)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,(S*.**)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****"t***Dollars (S*.**)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 othericurrent 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 agree
as follows:
1. 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 1 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
R******** RR "*. 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 (5*.**)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
R******** RR **** through and including R******RR RR **RR The maximum amount payable
by the State for the work to be performed by the Contractor during this renewal term is
********** Dollars (5*.**)for an amended total financial obligation of the State of**********
DOLLARS,(S*.**]. This is an[choose one and delete the other]increase/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 Ali I bR 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 Owens,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 7-1-04GN
Page 4 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,(5*.**1. This is an[choose one and delete the other]increase/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 tenns 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
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