HomeMy WebLinkAbout20011342.tiff RESOLUTION
RE: APPROVE TASK ORDER FOR FAMILY PLANNING PROGRAM AND AUTHORIZE
CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a Task Order for the Family Planning
Program between the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Department of Public Health and
Environment, and the Colorado Department of Public Health and Environment, commencing
July 1, 2001, and ending June 30, 2002, with further terms and conditions being as stated in
said task order, and
WHEREAS, after review, the Board deems it advisable to approve said task order, a
copy of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the Task Order for the Family Planning Program between the
County of Weld, State of Colorado, by and through the Board of County Commissioners of
Weld County, on behalf of the Weld County Department of Public Health and Environment, and
the Colorado Department of Public Health and Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said task order.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 21st day of May, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD CO TY, COLORADO
ATTEST: goil �%`� r' 5≥'\�✓ �� �'� ` M. J.J. eile, Chair
Weld County Clerk to - B.'•-
iabi t( =O at EXCUSED
BY: Glenn Vaad, Pro-Tem
•
Deputy Clerk to the
Wi H. Jerke
APPROViD AS TOE Cb�
?,it Long i
my Attorney 17V \
obert D. Masden
2001-1342
b(, re/ZI. HL0028
Memorandum ,,,,EL r,
I r: n5
WilgTO: M.J. Geile, Chair
O Board of County C mGs,sioners -j
• FROM: Mark E. Wallace, MD, MPH, Director
COLORADO Department of Public Health and Vv� ryyll�,
Environment A 1 , GO
DATE: Mary 17, 2001
SUBJECT: Task Order for the Family Planning Program
Enclosed for Board review and approval is a task order for the Family Planning Program. If
approved, this task order will become part of the master contract between the Colorado
Department of Public Health and Environment and the Weld County Department of Public
Health and Environment (WCDPHE).
Under the provisions of this task order, WCDPHE will be reimbursed an amount not to exceed
$97,513 for the time period July 1, 2001 through June 30, 2002 to provide contraceptive services
to both men and women in their reproductive years. These services will include education and
counseling, comprehensive health and social histories, physical examinations, supplies, follow-
up and/or referral services. This funding is an increase of $1,452 over the previous year's
funding for this program.
I recommend your approval of this task order.
Enclosure
2001-1342
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FLA
CONTRACT ROUTING NUMBER
02-00026
TASK ORDER
This TASK ORDER is made this 30T"day of JUNE,2001, by and between:the State of Colorado, for the use and
benefit of the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,whose address or principal place
of business is 4300 Cherry Creek Drive South,Denver,Colorado 80246,hereinafter referred to as"the State";
and,the BOARD OF COUNTY COMMISIONERS OF WELD COUNTY(a political subdivision of the state
of Colorado),whose address or principal place of business is 915 l0T"Street,3'Floor,Greeley,Colorado
80631, for the use and benefit of the Weld County Department of Public Health and Environment,whose
address or principal place of business is 1555 North 171h Avenue,Greeley,Colorado 80631,hereinafter referred to
as"the Contractor".
WHEREAS,the State has received federal funds under Title X of the Public Health Service Act("the Act")and
from the general fund of the state of Colorado to develop and deliver a comprehensive statewide plan directed at
family planning services;
WHEREAS,the State has formulated a comprehensive statewide plan relative to its Family Planning Program
("FPP");
WHEREAS,this comprehensive statewide plan allocates funds to implement the FPP in order to provide these
family planning services to the people of the state of Colorado;
WHEREAS,as of the made date of this Task Order,the State has a currently valid Group II purchasing delegation
agreement with the division of purchasing within the Colorado Department of Personnel;
WHEREAS,this procurement is exempt from the Colorado Procurement Code and Rules because the Contractor is
a political subdivision of the State of Colorado;
WHEREAS,as to the State,authority exists in the Law and Funds have been budgeted,appropriated, and otherwise
made available and a sufficient uncommitted balance thereof remains available for subsequent encumbering and
payment of this Task Order in Fund Number 100,Appropriation Codes 622,624,and 625,under Contract
Encumbrance Number PO FLA FPP02-00026;under master contract routing number 00 FAA 00008;and,
WHEREAS, all required approvals, clearances and coordination have been accomplished from appropriate
agencies.
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NOW THEREFORE,in consideration of their mutual promises to each other,stated below,the parties hereto
agree as follows:
A. PERFORMANCE PERIOD. The proposed effective date of this Task Order is July 1,2001. In
accordance with section 24-30-202O)C.R.S.,as amended,the effective date of this Task Order is the date
the State Controller approves this Task Order. The initial term of this Task Order shall commence on the
effective date of this Task Order and continue through and including June 30,2002, unless sooner
terminated by the parties pursuant to the terms and conditions of this Task Order and the Master Contract.
The Contractor is not authorized to,and shall not,commence performance under this Task Order until this
Task Order has been approved by the State Controller. The state shall have no financial obligation to the
Contractor for any work or services or,any costs or expenses, incurred by the Contractor prior to the
effective date of this Task Order. The total term of this Task Order, including any renewals or extensions
hereof,may not exceed five(5)years.
B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR.
The Contractor shall conduct a comprehensive family planning program("the program")in Weld
County. This program shall comply with section 1001 of the Act and all applicable federal
regulations,as amended,contained in Title X,42 C.F.R., Subpart A,Part 59,as well as all
applicable state regulations.
2. The Contractor shall make its program available to men and women in their reproductive years
and shall offer the following services,as appropriate:
A. Outreach services and/or other program efforts designed to improve client recruitment;
B. Nursing and medical services which shall include a comprehensive health and social
history and physical examination administered in accordance with all applicable Title X
regulations and,all applicable nursing-medical policies or procedures which have been,
or may be,established by the State's Women's Health Section("WHS");
C. Contraceptive information,education,and supplies regarding all family planning
methods;
D. Education and counseling services regarding family planning, family planning methods,
child spacing, infertility,sterilization,nutrition,sexually transmitted diseases,HIV/AIDS
and other related health issues;and,
E. Follow-up and/or referral services,as appropriate.
3. The services provided by the Contractor must be deemed acceptable, in good faith,by the WHS.
For a service to be"acceptable" it must comply with all applicable: Title X regulations, WHS
nursing-medical policies and procedures,and fiscal and administrative policies and procedures of
the State. All applicable Title X regulations,WHS nursing-medical policies and procedures,and
fiscal or administrative policies of the State have been provided to the Contractor by the State as
of the effective date of this Task Order.
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4. The Contractor shall provide the State's nursing consultant and administrators with reasonable
access to its operations to perform: periodic site reviews, data reviews,or evaluations of the
Contractor's program. Evaluations of the Contractor's program shall be based on established
standards and policies of the State. The Contractor shall cooperate during all periodic site visits,
data reviews,or evaluations conducted by the State.
5. If necessary,the Contractor shall comply with all recommendations made by the State's nursing
consultant and/or administrators after a periodic site visit,data review,or evaluation which are
necessary to bring its program into compliance with all applicable federal and state laws,policies
and regulations. The Contractor shall be in full compliance with all such recommendations, if
any,within three(3)months of the date a recommendation is made by the State. If the Contractor
cannot obtain full compliance within this three(3)month period,then on or before the expiration
date of that three(3)month period the Contractor shall present sufficient written evidence to the
State:to show that continuing progress is being made towards full compliance; and,the date when
full compliance shall occur. In no event, however,shall full compliance with a recommendation
occur any later than six(6)months after the date that a recommendation was initially made by the
State.
6. On a monthly basis,the Contractor shall collect and provide to the State, by the fifteenth calendar
day of the following month,all pertinent data regarding all services offered,and all clients served,
by its program. This data will be verified on a quarterly basis to help assure accuracy.
7. Within thirty(30)calendar days of receipt of a written request from the State, the Contractor shall
submit nursing-medical chart audits to the State.
8. The Contractor shall use program income generated from client fee collections and donations only
for family planning purposes which further the objectives of the legislation under which this Task
Order is entered into. In accordance with Title X guidelines,the Contractor shall not charge for
any Title X required services provided to clients who are at or below 100%of the official poverty
line as defined by the Office of Management and Budget(OMB). A copy of this guideline has
been provided to the Contractor by the State as of the effective date of this Task Order. If the
State receives new poverty guidelines from the OMB,then the State shall immediately forward
these new poverty guidelines to the Contractor. The Contractor shall utilize these new poverty
guidelines, if any,upon receipt thereof from the State.
The Contractor's charges for services to clients who are above 100%of poverty level shall be
based on a sliding fee scale which takes into account the client's family size and/or individual
income. These charges and the sliding fee scale shall be made available to all clients of the
Contractor,the general public,and the State. Charges shall be based upon the Contractor's actual
costs of providing these services. These costs shall be reviewed annually by the Contractor and
the State. The Contractor shall insure that all clients understand they will not be denied services
because of an inability to pay any of the Contractor's sliding fee charges.
9. All money received by the Contractor from the State under this Contractor shall be used by the
Contractor to provide contraceptive services to approximately 1370 target program clients.
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10. The Contractor shall either use a cytology laboratory chosen by the State or,a laboratory proposed
by the Contractor and approved by the State.
11. During the initial term of this Task Order, and any renewal or extension term thereof,the
Contractor shall provide to the State expenditure/revenue reports. A sample report is incorporated
herein by this reference,made part hereof,and attached hereto as"Attachment A".The report for
the months January through June is due no later than August 7 and the report for the months July
through December is due no later than February 7 after the end of the period for which the report
is submitted. Quarterly reports may be submitted at the option of the Contractor and are due no
later than 5 weeks after the close of the quarter. The report shall contain,but is not limited to,the
following information:the total actual costs incurred by the Contractor to provide program
services during the previous quarter,and the sources and amounts of funding which paid for those
services. The July-December report shall also include the results of a time study which gives the
percentages of time allocated to medical and non-medical cost centers.
12. The Contractor shall protect the confidentiality of all client records and other materials that are
created or maintained under this Task Order. Except for purposes directly related to the
administration of this Task Order,no information about,or obtained from,any client shall be
disclosed by the Contractor in any form which would identify that client without the prior written
consent of that client. The Contractor shall have written policies goveming the access to and,the
duplication and dissemination of, all such information. The Contractor shall advise its directors,
officers,employees,agents, servants,and subcontractors, if any,that they are subject to these
confidentiality requirements.
13. The Contractor shall provide all services to all program participants and employees in a smoke-
free environment. Smoking shall not be permitted in the Contractor's waiting areas or
examination rooms,or in formal sessions where education,therapy, or similar services are
provided. The Contractor may designate smoking areas for staff,program participants, family
members, and visitors. These designated smoking areas shall be well ventilated to insure that the
Contractor's waiting areas,examination rooms,and service delivery environment remain smoke
free.
C. DUTIES AND OBLIGATIONS OF THE STATE.
1. In consideration of those services satisfactorily and timely performed by the Contractor under this
Task Order,the State shall cause to be paid to the Contractor an amount not to exceed NINETY
SEVEN THOUSAND, FIVE HUNDRED AND THIRTEEN DOLLARS,($97,513.00)for the
initial term of this Task Order. Of this total financial obligation of the State to the Contractor
under this Task Order, $56,717.00 is identified as routine family planning funding attributable to
the Title X federal funding source of the United States government, and $40,796.00 are identified
as attributable to a funding source of the state of Colorado. This Task Order involves the
expenditure of federal and state funds. This Task Order is subject to,and contingent upon,the
continuing availability of those funds for the purposes hereof.
2. To receive payments under this Task Order,the Contractor shall submit a monthly
"Reimbursement Statement"to the State requesting payment for those program services rendered
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in the previous month. A sample statement is incorporated herein by this reference,made a part
hereof and attached hereto as"Attachment B". Payment by the State is contingent upon the
Contractor's compliance with all terms and conditions of this Task Order. Upon affirmation by
the State that the Contractor has satisfactorily and timely provided the services described in this
Task Order,the State shall pay the Contractor 1/6" of$56,717 or$9,452.83 a month for the
months July through December,and 1/6th of$38,846.00 or$6.474.33 a month for the months
January through June, inclusive. The cryotherapy services at$75.00 per client and/or pap
smear screenings may be billed monthly as expended up to$1,950.00 and will be reimbursed
from state general funds.
3. The State may prospectively increase or decrease the amount payable under this Task Order
through a"Task Order Change Order Letter". A sample letter is incorporated herein by this
reference, made a part hereof,and attached hereto as"Attachment C". To be effective,the Task
Order Change Order Letter must be: signed by the State and the Contractor,and,approved by the
State Controller or an authorized designee thereof. Additionally,the Task Order Change Order
Letter shall include the following information:
A. Identification of the related Master Contract and this Task Order by their respective
contract routing numbers and affected paragraph number(s)of this Task Order;
B. The type(s)of service(s)increased or decreased and the new level of each service;
C. The amount of the increase or decrease in the level of funding for each service and the
new total financial obligation;
D. The intended effective date of the funding change;
E. A provision stating that the Task Order Change Order Letter shall not be valid until
approved the State Controller or such assistant as he may designate.
Upon proper execution and approval,the Task Order Change Order Letter shall become an
amendment to this Task Order. Except for the General and Special Provisions of this Master
Contract, and the Additional provisions, if any, of this Task Order,the Task Order Change Order
Letter shall supersede this Task Order in the event of a conflict between the two. It is expressly
understood and agreed to by the parties that the change order letter process may be used only for
increased or decreased levels of funding,corresponding adjustments to service or program levels,
and any related budget line items. Any other changes to this Task Order,other than those
authorized by the Task Order renewal letter process described below,shall be made by a formal
amendment to this Task Order executed in accordance with the Fiscal Rules of the State of
Colorado.
If the Contractor agrees to and accepts the proposed change,then the Contractor shall execute and
retum the Task Order Change Order Letter to the State by the date indicated in the Task Order
Change Order Letter. If the Contractor does not agree to and accept the proposed change,or fails
to timely return the partially executed Task Order Change Order Letter by the date indicated in the
Task Order Change Order Letter,then the State may, upon written notice to the Contractor,
terminate this Task Order twenty(20)calendar days after the return date indicated in the Task
Order Change Order Letter has passed. This written notice shall specify the effective date of
termination of this Task Order. In the event of termination under this clause,the parties shall not
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be relieved of their respective duties and obligations under this Task Order until the effective date
of termination has occurred.
Increases or decreases in the level of contractual funding made through this task order change
order letter process during the initial or renewal terms of this Task Order may be made under the
following circumstances:
G. If necessary to fully utilize appropriations of the State of Colorado and/or non-appropriated
federal grant awards;
El. Adjustments to reflect current year expenditures;
I. Supplemental appropriations,or non-appropriated federal funding changes resulting in an
increase or decrease in the amounts originally budgeted and available for the purposes of
this Task Order;
J. Closure of programs and/or termination of related contracts;
K. Delay or difficulty in implementing new programs or services;and,
L. Other special circumstances as deemed appropriate by the State
4. The State may renew this Task Order through a"Task Order Renewal Letter". A sample letter is
incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment D". To be
effective,the Task Order Renewal Letter must be: signed by the State and the Contractor;and, approved by
the State Controller or an authorized designee thereof. Additionally,the Task Order Renewal Letter shall
include the following information:
A. Identification of this related Master Contract and this Task Order by their respective contract
numbers and affected paragraph number(s)of the Task Order;
B. The type(s)of service(s)or program(s), if any, increased or decreased and the new level of each
service or program for the renewal term;
C. The amount of the increase or decrease, if any, in the level of funding for each service or program
and the new total financial obligation;
D. The intended effective date of the renewal; and,
E. A provision stating that the Task Order Renewal Letter shall not be valid until approved by the
State Controller or such assistant as he may designate.
Upon proper execution and approval,the Task Order Renewal Letter shall become an amendment to this
Task Order. Except for the General and Special Provisions of the Master Contract, and the Additional
Provisions, if any,of this Task Order,the Task Order Renewal Letter shall supersede this Task Order in the
event of a conflict between the two. It is expressly understood and agreed to by the parties that the Task
Order renewal letter process may be used only to: renew this Task Order; increase or decrease levels of
funding related to that renewal; make corresponding adjustments to service or program levels,and,adjust
any related budget line items. Any other changes to this Task Order, other than those authorized by the
change order letter process described above,shall be made by a formal amendment to this Task Order
executed in accordance with the Fiscal Rules of the State of Colorado.
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If the Contractor agrees to and accepts the proposed renewal term,then the Contractor shall execute and
return the Task Order Renewal Letter to the State by the date indicated in the Task Order Renewal Letter.
If the Contractor does not agree to and accept the proposed renewal term,or fails to timely return the
partially executed Task Order Renewal Letter by the date indicated in the Task Order Renewal Letter,then
the State may, upon written notice to the Contractor,terminate this Task Order twenty(20)calendar days
after the return date indicated in the Task Order Renewal Letter has passed. This written notice shall
specify the effective date of termination of this Task Order. In the event of termination under this clause,
the parties shall not be relieved of their respective duties and obligations under this Task Order until the
effective date of termination has occurred.
D. ATTACHMENTS. All attachments to this Task Order are incorporated herein by this reference and made
a part hereof as if fully set forth herein. In the event of any conflict or inconsistency between the terms and
conditions of this Task Order and those of any attachment hereto,the terms and conditions of this Task
Order shall control.
IN WITNESS WHEREOF,the parties hereto have executed this Task Order on the day first above written.
CONTRACTOR: STATE:
BOARD OF COUNTY COMMISSIONERS STATE OF COLORADO
OF WELD COUNTY Bill Owens,Governor
(a political subdivision of the state of Colorado)
for the use and benefit of the
WELD COUNTY DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT
By: By:
Name: M. . Celle or the Executiverrrec :r
Title: Chair (05/21/2001)
FEIN: 846000813 B DEPARTMENT OF11PU:LIC
HEALTH AND ENV1RI MENT
If Corporation,Town/City/County,or Equivalent:
PROGRAM APPROVAL:
lata#g 1/44-0,14-#67
ATTEST(Aff� ea ; By:
1861 riv:,
By:
WELD COUNTY DEPARTMENT OF
Deputy Clerk to the _ HEALTH AN NVIRON EN
Page 7 of 8 BY: �AgAX
1:\contracts\FP FY02\TO Weld.DOC Mark E. Wallace, MD, MPH•Director
Created by C Grosz 4/26/01
APPROVALS:
COLORADO DEPARTMENT OF LAW COLORADO DEPARTMENT OF PERSONNEL
OFFICE OF THE ATTORNEY GENERAL OFFICE OF THE STATE CONTROLLER
Ken Salazar,Attorney General Arthur L. Barnhart,State Controller
By: NOT REQUIRED By: ,
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DELEGATE AGENCY EXPENDITURE/REVENUE REPORT
FAMILY PLANNING PROGRAM-WHS-CDPHE ATTACHMENT A
AGENCY NAME:
-
PERIOD:
COMPLETED BY:
DATE:
EXPENDITURES li
Personnel Services i
Salary - - - _"-- 0.00
Fringe
0
g @ /o 0.00
Subtotal Personnel Services 0.00
Contractual Services
Clinician
- I
Lab&X-ray
0.00 ' —
Other
_ Subtotal Contractual Services 0.00
Operating Expenses - r --r
—
Supplies —___.— -- 0.00
Training
__—_ 0.00
Other 0.00
Subtotal Operating Expenses - 0.00
Travel — - -- --
--- -- --- 0.00
Equipment
Subtotal Direct Costs _-- _--ti "" - 0.00
Indirect Costs @% 0.00
TOTAL EXPENDITURES _ 0.00
Inkind 0.00
TOTAL COSTS -
��ppp S0.00
i i I 1. i 1 J I ills 1 1 NIIl
REVENUES �1
CDPHE-Women's Health _ __ _ _ S0.00�
11'�lil i 1,.' it li 1 li I .1'. u11 HI r',i ii Jil°iiiu
Patient Fees t 0.00
Patient Donations 0.00
""-
Medicaid
0.00
Local Support-PCCHD
0.00
Inkind(Other Donations)
Other-Private Insurance - _ - - - ----_
-- _.— 0.00
TOTAL
---- ---- - --.___ - - S0.00
Unspent Funds-This Quarter — _ - ---_ —I
Unspent Funds-Prior Quarter
Balance Unspent Funds
C Grosz
4/27/01 J:/contracts/FP FY02
OER TEMPLATE
Colorado Department of Public Health and Environment
Contract Reimbursement Statement—Family Planning Program
ATTACHMENT B
To: Family Planning Program
HPDPD-Women's Health Section-A5
4300 Cherry Creek Drive South
Denver, CO 80246-1530
FPP
Agency Tax ID# Contract Month
Please submit within 10 days of end of month
Amount requested for:
$ Title X Contraceptive Services Dollars
$ State Contraceptive Services Dollars
$ Cryotherapies (_@ $75.00 each; attach copy of cervical cancer F/U form)
$ Pap Smear Screening for New Patients
$ Expansion Project
Total amount requested:$
This is to certify that these services were provided per above referenced contract and reimbursement is requested for same.
Signature Date
Contractor
Print name Phone with area code
I hereby certify that all contract requirements have been met and the amounts billed are correct. Payment is authorized.
(CDPHE Authorized Designee)
J:\contracts\FP FY02\Contract Reimbursement form.DOC
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STATE OF COLORADO
Bill Owens,Governor
Jane E.Norton,Executive Director ,of•cpzo
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division * . Goy *
Denver,Colorado 80246-1530 8100 Lowry Blvd. • •:..
Phone(303)692-2000 Denver,Colorado 80230-6928 *1876 r`
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado of Public Health
httpz/www.cdphe.stare.co.us and Environment
Task Order Change Order Letter Attachment C
State Fiscal Year 2001 -2002, Task Order Change Order Letter Number , Contract Routing Number
Pursuant to paragraph_of the Task Order with contract routing number and contract encumbrance number ,(as
amended by Task Order Renewal Letter_ contract routing number , and/or Task Order Change Order Letter contract
routing number , if any),hereinafter referred to as the"Original Task Order"(a copy of which is attached hereto and by this
reference incorporated herein and made a part hereof)between the State of Colorado, Department of Public Health and Environment
and ,for the term from ,through the parties agree that the maximum amount payable by the State for
the eligible services referenced in paragraph of the Original Task Order is increased/decreased by****** Dollars,(S . )for a new
total financial obligation of the State of***** DOLLARS,(S . ). The number of patients to be served by the Contractor is
increased/decreased by_patients to a new total of_patients.
The first sentence in paragraph_of the Original Task Order is hereby modified accordingly. All other terms and conditions of the
Original Task Order are hereby reaffirmed. The proposed effective date is . In accordance with section 24-30-
202(1),C.R.S.,as amended,the effective date of this amendment to the original Task Order is the date the State Controller approves this
contract. In no event shall this amendment be deemed valid until it shall have been approved by the State Controller or such assistant as
he may designate.
Please sign,date,and return all 4 originals of this Task Order Change Order Letter as soon as possible to: Candace Grosz, Fiscal
Officer, Women's Health Section,Colorado Department of Public Health and Environment,4300 Cherry Creek Drive South, 5i°Floor,
Denver, Colorado 80246-1530.
One original of this Task Order Change Order Letter will be retumed to you when fully approved.
Contractor: STATE OF COLORADO
Full contractor name Bill Owens,Governor
By: By:
Signature For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Title:
FEIN:
APPROVALS:
COLORADO DEPARTMET OF PERSONNEL: PROGRAM:
OFFICE OF STATE CONTROLLER
Arthur L. Barnhart, State Controller
By: By:
1:\contracts\FP FY02\task order change order letter.doc
Created by C Grosz,4/27/01
STATE OF COLORADO
Bill Owens,Governor
Jane E.Norton,Executive Director JO*cozo
Dedicated to protecting and improving the health and environment of the people of Colorado he
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division * ci,,
Denver,Colorado 80246-1530 8100 Lowry Blvd. ♦ • r
Phone(303)692-2000 Denver,Colorado 80230-6928 •`t876
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado
httpl/www.cdphe.state.co.us of Public Health
and Environment
Task Order Renewal Letter Attachment D
State Fiscal Year 2001 -2002, Task Order Renewal Letter Number , Contract Routing Number
Pursuant to paragraph_of the Task Order with contract routing number and contract encumbrance number ,(as
amended by Task Order Change Order Letter contract routing number ,and/or Task Order Renewal Letter_,contract routing
number if any),hereinafter referred to as the"Original Task Order"(a copy of which is attached hereto and by this reference
incorporated herein and made a part hereof)between the State of Colorado,Department of Public Health and Environment and
,for the renewal term from , through , ,the parties agree that the maximum amount payable by the State for the
eligible services referenced in paragraph_of the Original Task Order is increased/decreased by***** Dollars,($ . )for a new total
financial obligation of the State of***** DOLLARS,(S. )to provide family planning services to clients and for cryosurgery and/or
pap smears screening services for_clients.
The first sentence in paragraph_of the Original Task Order is hereby modified accordingly. All other terms and conditions of the
Original Task Order are hereby reaffirmed. The proposed effective date is , . In accordance with section 24-30-202O),
C.R.S.,as amended,the effective date of this amendment to the original Task Order is the date the State Controller approves this
contract. In no event shall this amendment be deemed valid until it shall have been approved by the State Controller or such assistant as
he may designate.
For the months of July through December inclusive,the Contractor shall bill for 1/6th of the$ Title X contraceptive service
amount($ /month). For the months of January through June inclusive,the Contractor shall bill 1/6th of the$ State
general fund contraceptive service amount($ /month).
Please sign,date,and return all 4 originals of this Task Order Renewal Letter as soon as possible to the attention of: Candace Grosz,
Fiscal Officer, Women's Health Section,Colorado Department of Public Health and Environment,4300 Cherry Creek Drive South,51h
Floor,Denver,Colorado 80246-1530.
One original of this Task Order Renewal Letter will be returned to you when fully approved.
Contractor: STATE OF COLORADO
(full contractor name) Bill Owens,Governor
By: By:
Signature For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Title:
FEIN:
APPROVALS:
COLORADO DEPARTMENT OF PERSONNEL PROGRAM:
OFFICE OF STATE CONTROLLER
Arthur L. Barnhart, State Controller
By: By:
J:kontracts\FP FY02\task order renewal letter.DOC
Created by C Grosz,4/27/01
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