HomeMy WebLinkAbout20012714.tiff RESOLUTION
RE: APPROVE TASK ORDER FOR YOUTH FITNESS AND NUTRITION 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 Youth Fitness and
Nutrition 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 October 1, 2001, and ending September 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 Youth Fitness and Nutrition 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 26th day of September, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: ia_ DD E I co EXCUSED DATE OF SIGNING (AYE)
�/ fit ;. M. J. Geile, Chai
Weld County Clerk to the oa ,/�'
"�i- Glenn Vaad, P
BY: �r - � r
Deputy Clerk to the Bo _ ' H Gym
" Willia.J. Jerke S
APPRO ED AS TO F M: Z J l
vid E. Long N
County Attorn4y lll
Robert W,—
D. Masden
!a3
Date of signature:
2001-2714
HL0028
•
vtirtie;. Memorandum
TO: M.J. Geile, Chair •
VI
'Deo
Board of County Commissionets
FROM: Mark E. Wallace, MD, MPH, Director
Department of Public Health and
COLORADO Environment '0-
DATE: September 20, 2001
SUBJECT: Youth Fitness and Nutrition Program Task
Order
Enclosed for Board review and approval is a task order between the Colorado Department of
Public Health and Environment (CDPHE) and Weld County Department of Public Health and
Environment (WCDPHE) for the After School Fitness and Nutrition Program.
This task order will allow WCDPHE to partner with the City of Greeley Community Outreach
Program to provide fitness and nutrition classes to low-income adolescents who are considered to
be at a higher risk for developing chronic diseases and less likely to have the opportunity to
engage in health and fitness programs. For these services, Weld County-will be paid a sum not
to exceed $18,035 for the time period October 1, 2001 through September 30, 2002.
I recommend your approval of this task order.
Enclosure
2001-2714
J/%rtYAQ ?
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF
PUBLIC HEALTH AND ENVIRONMENT
DEPARTMENT OR AGENCY NUMBER
FAA
CONTRACT ROUTING NUMBER
02-00637
TASK ORDER
THIS TASK ORDER is made this 1st day of October,2001 by and between:the State of Colorado,for the use and
benefit of the COLORADO 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 Weld County Department of Public Health&Environment(a political subdivision of
the state of Colorado),whose address or principal place of business is 1555 North 17th Avenue,Greeley,
Colorado 80631,hereinafter referred to as"the Contractor."
FACTUAL RECITALS
Section 29-1-201,8 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. All
State contracts with its political subdivisions are exempt from the state of Colorado' State's personnel rules under
section 24-50-101 et seq.,and the State procurement code under section 24-101-101, et seq.,C.R.S.,as amended.
The State has formulated a comprehensive State plan,with associated budgets,relative to the State's programs and
services which allocates funds to local health agencies in order to provide certain purchased services to the people of
the state of Colorado. This funding is to be allocated through task orders with local health agencies. 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(s)ELI Organizational Unit Code(s)0020,Appropriation Code(s)F86,under Master
Contract, contract routing number 02-00637,and Task Order encumbrance number PO FAA OLL0200637.
The State has received Preventive Health and Health Services Block Grant(PHHSBG)funds for federal Fiscal Year
2001-02(October 1,2001 -September 30,2002)from the United States Department of Health and Human Services
(USDHHS). The Contractor is considered by the State to be an appropriate agency to provide those services set
forth in the attached Scope of Work. All required approvals,clearances,and coordination have been accomplished
from and with all appropriate agencies.
NOW THEREFORE,in consideration of their mutual promises to each other, stated below,the parties hereto agree
as follows:
A. PERIOD OF PERFORMANCE AND TERMINATION. The effective date of this Task Order is
October 1,2001 or on the date this Task Order is approved by the State Controller,whichever is later.
The initial term of this Task Order shall commence on October 1,2001,and continue through and
including September 30,2002 unless sooner terminated by the parties pursuant to the terms and
conditions of the Master Contract and this Task Order.
B. SCOPE OF WORK. The Contractor,in accordance with the terms and conditions of the Master Contract
and this Task Order,shall perform and complete,in a timely and satisfactory manner,all work items
described in the Statement of Work and Budget,which are incorporated herein by this reference,made a
part hereof and attached hereto as"Attachment A."
Page 1 of 5
C. COMPENSATION.
The Contractor shall be compensated in accordance with the rates set forth in Attachment A
hereto. 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 a sum not to exceed for the
initial term of this Task Order. Of the total financial obligation of the State referenced above,
$18,035.00 are identified as attributable to a funding source of the United States government
and, $0.00 are identified as attributable to a funding source of the state of Colorado.
2. To receive compensation under this Task Order,the State may require the Contractor to submit a
signed quarterly billing statement within thirty(30)calendar days of the end of the billing period
for which services were rendered. A sample"Task Order Reimbursement Statement"is
incorporated herein by reference,made a part hereof,and attached hereto as"Attachment B."
Expenditures shall be in accordance with those items identified in Attachment C. These items
may include,but are not limited to: the Contractor's salaries, fringe benefits,supplies,travel,
operating,and indirect costs which are allowable and allocable expenses related to its performance
under this Task Order.
Billing statements shall reference the related Master Contract and this Task Order by their
respective contract routing numbers. The contract routing numbers are located on page one of
these documents. Billing statement shall also indicate the applicable performance dates,the
names of payees;a brief description of the services performed during the relevant performance
dates;all expenditures incurred;and,the total reimbursement requested. Reimbursement during
the initial,or any renewal,term of this Task Order shall be conditioned upon affirmation by the
State that all services were rendered by the Contractor in accordance with the terms of this Task
Order. Billing statements shall be sent to:
Steve Holloway
EDO-OLL-A3
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South,Denver,CO 80246
3. The State may prospectively increase or decrease the amount payable under this Task Order
through a"Task Order Change Order Letter",a sample of which 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);
B. The type(s)of service(s)or program(s)increased or decreased and the new level of each
service or program;
C. The amount of the increase or decrease in the level of funding for each service or
program and the new total financial obligation;
D. The intended effective date of the funding change;and,
E. A provision stating that the Task Order Change Order 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 Change Order Letter shall become an
amendment to this Task Order. Except for the General and Special Provisions of the Master
Contract,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 task order
Page 2 of 5
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
return 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. If this Task Order is terminated under this clause,then the parties
shall not be relieved of their respective duties and obligations under this Task Order until the
effective date of termination has passed.
Increases or decreases in the level of contractual funding made through this task order change
order letter process during the initial,or renewal,term of this Task Order may only be made under
the following circumstances:
A. If necessary to fully utilize appropriations of the state of Colorado and/or non-
appropriated federal grant awards;
B. Adjustments to reflect current year expenditures;
C. 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;
D. Closure of programs and/or termination of related contracts or task orders;
E. Delay or difficulty in implementing new programs or services;and,
F. Other special circumstances as deemed appropriate by the State.
Page 3 of 5
4. The State may renew this Task Order through a"Task Order Renewal Letter",a sample of which is
incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment E." 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 Task Order by its contract routing number and affected paragraph number(s);
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,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 task order 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.
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. If the Task Order is terminated under this clause,then the
parties shall not be relieved of their respective duties and obligations under this Task Order until the effective
date of termination has passed.
A. PAYMENT MECHANISM. Payments under this Task Order shall be made either through the State's
Electronic Fund Transfer system or,upon the Contractor's quarterly submission of duplicate invoices
requesting reimbursement for those services provided in the previous quarter.
B. ATTACHMENTS. All attachments 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 of this Task Order and those of any
attachment hereto,the terms and conditions of this Task Order shall control.
Page 4 of 5
IN WITNESS WHEREOF,the parties hereto have executed this Task Order on the day first above written.
CONTRACTOR: STATE OF COLORADO
Bill Go or
Weld County oard of Commissioners
Legal Name and L I Type of Entity
By:
By: For the Exec ve Director
g atu e DEPARTMENT PURL C ALTH
AND ENVIRO ENT
M. J. Geile (09/26/2001)
Print Name
Chair
Title
84-6000-813
Federal Employer Identification Number
If Corporation,Town/City/County,or Equivalent: PROGRAM APPROVAL:
Jeff Stoll
B :, > 2 .
Y 7/
ATTEST
(Affix
Seal)
'0
Lei WELD COUNTY DEPARTMENT OF
By: Q4.4.4s1x PUB C HEALTH AD E VIRO NT
XITAXACIIRMIKQUarJOK Deputy Clerk to the ° CR, BY
Z, � � Mark E. Wallace, MD, MPH'Director
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:
Page 5 of 5
ATTACHMENT A
• PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT
Fiscal Year 2001-2002
After School Fitness and Nutrition Program (Nu-Fit Club)
Submitted by: Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley, CO 80631
Contact: Gaye Alcin, Supervisor(ext. 2380)
Kathy Schlepp, Health Educator (ext. 2325)
(970) 304-6420
*Weld County Department of Public Health and Environment will be contracting with graduate
students from the University of Northern Colorado for the fulfillment of the activities outlined in
this grant application.
Program Strategy
The proposed use of this grant will be to partner with the City of GreeleyCommunity Outreach
Program to provide quality physical activity and nutrition education opportunities to the
participants in their after-school programs. The City of Greeley Community Outreach Program
has been established since 1995. During this time, there have been seven sites throughout the
city of Greeley which have provided after school activities for youth age 5-15. This program has
been very successful in keeping kids involved in activities during the after school hours.
Through funding sources in the previous fiscal year, the Nu-Fit Club joined with the outreach
program to pilot the program last year. It was a success, and found to be an asset to the
community. With this proposed grant money, the Nu-Fit Club will continue, and will be
expanded to involve more youth in physical activity and nutrition education.
The Nu-Fit Club would consist of two nights per week to compose a 15-week semester. The
program would encompass boys and girls between the ages of ten and thirteen. The youth would
be involved in a physical activity session both nights of the week, and will also be involved in an
educational session regarding the importance of nutrition one night a week. This will include a
demonstration of how to prepare a healthy snack or meal. Psycho-social issues such as body
image, self-esteem, and the benefits of exercise and nutrition will also be discussed. This
program would also include a parent education component, consisting of a 4-week course each
semester on involving children in physical activity and a nutrition/food safety demonstration of
how to prepare healthy meals. Daycare will be provided for these classes.
The physical fitness educator from the University of Northern Colorado will conduct evaluation
of the program. Pre and post step tests, heart rate tests and body mass index will be performed
on each participant to determine fitness improvement, and.a pre and post nutrition test will also
be given to assess an increase in nutrition knowledge. The participants will keep a journal every
session which will be analyzed to assess the participants' ability to take responsibility for their
own nutrition and fitness status. Several pieces of this evaluation were done in the initial pilot
program, and were found to be quite effective in assessing the benefits of the program.
In addition to the preceding activities, a local media campaign will be used to support the efforts
of this program. Included in this campaign will be public service announcements, brochures
created by the program participants, and marketing for the parent classes.
The curriculum for the Nu-Fit Club addresses many crucial issues facing our youth today. It is
hoped that continuation of this project will be a model to be utilized and expanded upon by other
cities of similar size addressing the urgent need for youth fitness and nutrition programs.
National Health Objective
Healthy People 2010 Objectives for Physical Activity and Fitness, specifically objective 22-7,
will be the main focus of this program. This objective states: Increase the proportion of
adolescents who engage in vigorous physical activity that promotes cardiorespiratory fitness 3 or
more days per week for 20 or more minutes per occasion. The 1999 baseline for this behavior
was 65 percent of students in grades 9 through 12. The 2010 target is to increase this number to
85 percent.
This program will also address the Healthy People 2010 Objectives for Nutrition and
Overweight, specifically objectives 19-5 through 19-9. These objectives focus on increasing
daily intakes of fruit, vegetables, and grain products, while also decreasing the intake of saturated
and total fat.
The Centers for Disease Control also list Strategy 5 to "enable more after-school care programs
to provide regular opportunities for active,physical play", which would be included in our
program.
State Health Objective
Governor Bill Owens proposed a four-year strategic plan for Coloradans when he took office in
1999. The core strategies for protecting and improving the health of the citizens of Colorado
include both a prevention and an education component. The plan states that the "key to
addressing this problem [of preventable death and disability] is the public health system's
emphasis on educating Coloradans about adopting more healthy lifestyles and avoiding the risk
factors that contribute to premature death and disability rates." The Nu-Fit Club focuses on
prevention and education within its curriculum.
Health Problem
Physical activity among youth is on the decline. The Healthy People 2010 report states that the
number of overweight children, adolescents, and adults has risen over the past four decades.
This report also states that regular physical activity: increases muscle and bone strength,
increases lean muscle and helps decrease body fat, aids in weight control and is a key part of any
weight loss effort. The 1995 Youth Risk Behavior Survey data reports that twenty-six percent of
students in Colorado high schools describe themselves as "slightly" or "very" overweight.
Thirty-nine percent of these surveyed students were trying to lose weight. Healthy People 2010
assert that "efforts to maintain a healthy weight should start early in childhood and continue
throughout adulthood, as this is likely to be more successful than efforts to lose substantial
amounts of weight and maintain weight loss once obesity is established." It is the intention of
this program to address this issue, and involve youth in fun activities where they will be active
for an extended period of time. Proper nutrition for youth will also be discussed and
demonstrated.
Target Population
This program will focus on 10 to 13 year olds who are enrolled in the City of Greeley
Community Outreach Program. It will also include a 4-week session for parents each semester
on preparing meals and food safety. According to 2000 data, Greeley's population is 76,930
(66.8%white, 29.5% Hispanic and 3.7% African American and other). Of this population,
33.1% are under the age of 21.
Disparate Population
The Nu-Fit Club is targeted toward high-risk, low-income, Hispanic adolescents. The
proportion of this population who are at risk for developing Type II Diabetes has been shown to
be much higher than that of the general population. Healthy People 2010 also state "the
proportion of adolescents from poor households who are overweight or obese is twice that of
adolescents from middle- and high-income households."
Essential Service Areas
Essential Service Area#3 - Inform and Educate
Impact Objective - By October 2005, incorporate all seven of the Greeley Community
Outreach Program sites in the Fitness and Nutrition Program.
Annual Objective - By December 2002, work with the City of Greeley Community
Outreach Program and Colorado State University Cooperative Extension to
increase physical activity and healthy nutrition among the youth in the after-
school program.
Essential Service Area#4 - Mobilize Partnerships
Impact Objective - By October 2005, develop a permanent funding source for the Nu-Fit
Club through the University of Northern Colorado, Colorado State University
Cooperative Extension, the City of Greeley, Weld County Department of Public
Health and Environment, and other community organizations.
Annual Objective - By October 2002, demonstrate a measurable increase in the fitness
level and nutrition knowledge of participants in the program.
Local Support
The Nu-Fit Club is supported through many in-kind contributions. The University of Northern
Colorado provides support time for program evaluation. The City of Greeley provides staff time
to transport and supervise the youth during the program, rooms for the exercise and nutrition
classes at the city recreation facility, and transportation for the youth to the program from several
different sites in the Greeley area. The CSU Extension office provides instructors, food and
supplies for fifteen nutrition classes for the youth, and eight nutrition classes for their parents for
the year. In kind time will also be provided by the Greeley Tribune and AT&T cable and several
radio stations for public service announcements and media coverage for the program.
FTE Request
We will contract with two graduate fitness instructors from UNC for a total of 32 weeks, to
provide 8 hours a week contact and preparation time to provide fitness classes and instruction
during the school year. A .05 FTE Health Educator will teach 15 nutrition classes for the
program.
Block Grant Role
This is supplemental funding for activities that are supported by several agencies, including
University of Northern Colorado, CSU Extension and the City of Greeley Community Outreach
Program and Recreation Department.
Percent of PHHS Funds
The amount requested, 50 - 74%, is a significant source of funding with resources from the
agencies listed above to improve the physical fitness and nutrition behaviors of high risk
adolescent youth in Weld County.
Other Funding Sources
All available funding sources have been listed under Local Support.
ATTACHMENT B
INVOICE NUMBER
CONTRACT REIMBURSEMENT STATEMENT
TO: FROM:
•
FAX: ( ) DATE OF EXPENDITURE;
TYPE OF FROM: Final
PROGRAM: Bill?
O Nos
FEDERAL ID TO:
O No
NUMBER:
Reimbursement
Description of Expenditure Local Agency Match Total
Amount Requested
p--
GRAND TOTAL
This is to certify that the above expenses were incurred per Contract # and we are requesting reimbursement for same.
SIGNATURE (CONTRACTOR): _ DATE:
I hereby certify that all contract requirements have been met and the amounts arc correct, Payment is authorized.
AUTHORIZED DESIGNEE (STATE): DATE:
•
fcuhmii in rinnliraiel i Contuaor Notified of Rdmbianrmau Amount Omit? 1
ATTACHMENT C
After School Fitness and Nutrition Program Budget
Total Budget Less In-Kind Requested
PERSONNEL
Fitness Instructors (UNC) $7040 $7040
Health Educator (.065 FTE) 2574 858 WCDPHE 1718
Fringe Benefits 773 258 515
Nutrition Instructor
(salary/fringe for 38 classes) 9682 9682 CSU
Office Technician (.015 FTE) 486 486 WCDPHE
Fringe Benefits 146 146
Recreation staff(.12 FTE) 2560 2560 Greeley
OPERATING EXPENSES
Educational materials $1600 200 CSU $1400
Supplies and Incentives 3600 850 CSU 2750
Day Care for parents 160 160 WCDPHE
Facility Rental 3120 3120 Greeley
Evaluation of Program $2600 1300 UNC $1300
Sub Total: $34343 19620 $14723
Indirect: 7727 4414 3313
TOTAL: $42070 $24034 $18035
Narrative:
Personnel: We will contract with University of Northern Colorado School of Physical Education
for 2 graduate fitness instructors to teach 4 classes per week for 32 weeks. CSU Extension
Services will provide nutrition education for 30 youth nutrition classes and 8 adult nutrition
classes. A .055 FTE Health Educator hours will be added to existing WCDPHE staff to teach 30
nutrition and psycho/social classes to the youth and the .015 in-kind Office Technician will
provide technical support for 1 hour per week for 30 weeks of the program. The City of Greeley
will provide a staff member from each After School program to accompany the youth twice a
week for 30 weeks.
Operating Expenses:
Educational materials for both youth fitness and nutrition classes; brochures and posters to
market the program; videos on fitness for each of the seven After School Programs.
Supplies and Incentives: Food and supplies for nutrition classes and program sponsored
community walk; water bottles, resilience bands for incentives for youth attending the classes at
mid point and end; 5 heart rate monitors for the fitness classes; gift certificates to the Greeley
Recreation Center for recreation programs for those who attend all of the classes; gift certificates
for parents to a local grocery for 100% attendance at the nutrition programs.
The City of Greeley will provide rooms for the youth fitness and nutrition classes.
Evaluation: Contract time and matching time for a graduate students form UNC to evaluate the
program using fitness testing, pre/post tests,journal analysis.
ATTACHMENT D
STATE OF COLORADO
Roy Romer,Governor
Pam Shwayder,Executive Director `e-cc
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Or.S. - Laboratory Radiation Services Division "" G s s
Denver,Colorado 80246-1530 8100 LowryBlvd.
Phone(303)692-2000 Denver CO 80220-6928
Located in Glendale,Colorado (303)692-3090 - Colorado Department
http://www.cdphestate.co.us of Public Health
and Environment
Date] Sample Contract Change Order Letter Attachment t
State Fiscal Year 19" - "", Contract Change Order Letter Number"", Contract Routing Number""-"""""
Pursuant to paragraph""of the contract with contract routing number""-""""" and contract encumbrance number
(as amended by Contract Renewal Letter"".contract routing number""-Rat""" and/or Contract
Change Order Letter"",contract routing number""-""""• if any),hereinafter referred to as the"Original Contract"
(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 Contractor's Legal Name 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 Contract is increased/decreased by dollar
amount DOLLARS,($"."")for a new total financial obligation of the State of dollar amount DOLLARS ($"."").
The revised work plan,which is attached hereto as"Attachment 1",and the revised budget,which is attached hereto
as"Attachment 2",are incorporated herein by this reference and made a part hereof. The first sentence in paragraph
_" of the Original Contract is hereby modified accordingly. All other terms and conditions of the Original Contract
are hereby reaffirmed. This amendment to the Original Contract is intended to be effective as of "",
"""". However,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 "originals of this Contract Renewal Letter by "","""" to the attention
of: ,Colorado Department of Public Health and Environment,4300 Cherry
Creek Drive South,Denver,Colorado 80246,Mail Code: """""-"" One original of this Contract Renewal
Letter will be returned to you when filly approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Roy Romer,Governor
By: By:
For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Tide:
FEIN:
APPROVALS:
CONTROLLER PROGRAM:
By: By:
Clifford W. Hall
ATTACHMENT E
STATE OF COLORADO
Roy Romer,Governor
Patti Shwayder,Executive Director ofT•
ate..'�\
Dedicated to protecting and improving the health and environment of the people of Colorado «
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division "• G:4)i *
Denver,Colorado 80246-1530 8100 Lowry Blvd. "re'6"
Phone(303)692-2000 Denver CO 80220-6928
Located in Glendale,Colorado (303)692-3090 Colorado Deparnrtent
http://www.cdphestate.co.us of Public l lth
and Environment
[Date] Sample Contract Renewal Letter Attachment
State Fiscal Year 19"" - •" Contract Renewal Letter Number"' Contract Routing Number""-""""" '
Pursuant to paragraph"' of the contract with contract routing number ""- and contract encumbrance number
(as amended by Contract Change Order Letter •"-contract routing number""-""""" and/or Contract
Renewal Letter"",contract routing number""-""""" if any),hereinafter referred to as the"Original Contract"(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 Contractor's Legal Name 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 Contract is increased/decreased by dollar
amount DOLLARS (S"."")for a new total financial obligation of the State of dollar amount DOLLARS ($"."").
The revised work plan,which is attached hereto as"Attachment 1",and the revised budget,which is attached hereto
as"Attachment 2",are incorporated herein by this reference and made a part hereof. The first sentence in paragraph
"" of the Original Contract is hereby modified accordingly. All other terms and conditions of the Original Contract
are hereby reaffirmed. This amendment to the Original Contract is intended to be effective as of
"""". However,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 "" originals of this Contract Renewal Letter by ""• """" to the attention
of: """""""""""" ,Colorado Department of Public Health and Environment,4300 Cherry
Creek Drive South,Denver,Colorado 80246,Mail Code: !". One original of this Contract Renewal
Letter will be returned to you when fully approved.
Contractor's Legal Name STATE OF COLORADO
(legal type of entity) Roy Romer,Governor
By: By:
For the Executive Director
Print Name: DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
Title:
FEIN:
APPROVALS: - •
CONTROLLER: PROGRAM:
By: By:
Clifford W. Hall
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