HomeMy WebLinkAbout20011407.tiff RESOLUTION
RE: APPROVE NOTIFICATION OF FINANCIAL ASSISTANCE AWARD FOR INTENSIVE
FAMILY THERAPY - FAMILY GROUP DECISION MAKING AND AUTHORIZE CHAIR
TO SIGN - LUTHERAN FAMILY SERVICES
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 Notification of Financial Assistance
Award for Intensive Family Therapy- Family Group Decision Making 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 Social Services, and Lutheran Family Services, commencing
June 1, 2001, and ending May 31, 2002, with further terms and conditions being as stated in
said award, and
WHEREAS, after review, the Board deems it advisable to approve said award, 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, ex-officio Board of Social Services, that the Notification of Financial
Assistance Award for Intensive Family Therapy - Family Group Decision Making 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 Social Services, and Lutheran Family Services,
be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said award.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 30th day of May, A.D., 2001.
BOARD OF COUNTY COMMISSIONERS
O
WELD CO TY, COLORADO
ATTEST: gill lilt)
Mwlxicc�f er
Weld County Clerk tBY: �> 4<
Deputy Clerk to the Board
Willi . Jere
AP AS RM:
i 7 avi or kg
oarinttorney , 1 M`FX —
Robert D. Masden
2001-1407
7^C . ' SS SS0028
DEPARTMENT OF SOCIAL SERVICES
PO BOX A
GREELEY,CO 80632
111 i WEBSITE:www.co.weld.co.us
*■ Administration and Public Assistance(970)352-1551
C� Child Support(970)352-6933..
COLORADO
MEMORANDUM
TO: M. J. Geile, Chair Date: May 23, 2001
Board of County Commissioners
FR: Judy Griego, Director 1 Li
Weld County Departme t of Skcial S is s
RE: PY 2001-2002 Notification of Financial Assistance Awards (NOFAA)under Core
Services Funds-Lutheran Family Services
Enclosed for Board approval are the PY 2001-2002 Notifications of Financial Assistance
Awards (NOFAA) for Families, Youth, and Children Commission (FYC) Core Services
Funds, which are for the period of June 1, 2001,through May 31, 2002.
The Families, Youth and Children Commission (FYC) reviewed proposals under a
Request for Proposal process and are recommending approval of these bids.
Lutheran Family Services
A. Option B, Home Based Services.A maximum number of 40 families with children
0-18 years, a maximum of ten families at any given time. Rate is$107/hour.
B. Intensive Family Therapy: Family Group Decision Making: One or two clinicians
will participate in the Family Group Decision Making depending on the needs of
the family. Bicultural-bilingual services are available for a limited number of
conferences. Direct service capacity is estimated at 100 hours per week. Staff
availability is dependent on the combination of all cases in the Foster Care
Services program. Rate per Family Group Conference is$1,800.
MEMORANDUM TO M.J. GEILE, CHAIR
WELD COUNTY BOARD OF COMMISSIONERS
RE: CORE SERVICE NOFAA PY 2001-2002-Lutheran Family Services
C. Foster Parent Consultation. Foster Parent Support groups, birth child support
groups and training groups (parent and/or child). Program capacity is 40
families per year, or 160 clients, average length of service is 12 weeks. Direct
service capacity is 100 hours per week. There is no maximum capacity per month.
Hourly rate is$107.00.
If you have any questions, please telephone me at extension 6510.
of
Page 2 of 2
Weld County Department of Social Services
Notification of Financial Assistance Award
for Families,Youth and Children Commission(Core) Funds
Type of Action Contract Award No.
X Initial Award FY01-CORE-0002
Revision (RFP-FYC-01008)
Contract Award Period Name and Address of Contractor
Beginning 06/01/2001 and Lutheran Family Services
Ending 05/31/2002 Intensive Family Therapy-Family Group Decision Making
3800 Automation Way, Suite 200
Fort Collins, CO 80525
Computation of Awards Description
Unit of Service The issuance of the Notification of Financial Assistance
Services available to any client referred by Award is based upon your Request for Proposal(RFP).
Weld County DSS. Services will not be limited The RFP specifies the scope of services and conditions
by proximity(e.g. South Weld County). One or of award. Except where it is in conflict with this
two clinicians per FGDM conference,depending NOFAA in which case the NOFAA governs, the RFP
on needs of the family. Bicultural-bilingual upon which this award is based is an integral part of the
services available for a limited number of action.
conferences.Direct program capacity is
estimated at 100 hours per week.This is a Special conditions
component of Foster Parent Consultation
program. Staff availability is dependent on the 1) Reimbursement for the Unit of Services will be based
combination of all cases in the Foster Care on rate per conference.
Services program. 2) The rate will be paid for only direct face to face contact
with the child and/or family, as evidenced by client-
signed verification form,and as specified in the unit of
cost Per Unit of Service cost computation.
3) Unit of service costs cannot exceed the hourly and
Rate per Family Group Conference $1,800.00 yearly cost per child and/or family.
Unit of Service Based on Approved Plan 4) Payment will only be remitted on cases open with, and
referrals made by the Weld County Department of
Enclosures: Social Services.
X Signed RFP:Exhibit A 5) Requests for payment must be an original submitted to
Supplemental Narrative to RFP: Exhibit B the Weld County Department of Social Services by the
Recommendation(s) end of the 25i° calendar day following the end of the
month of service. The provider must submit requests
Conditions of Approval
for payment on forms approved by Weld County
Department of Social Services.
Approvals: Program Official:
By By
M.J. eile, Chair Jut ego,Director
Board of Weld County Commissioners Weld County Department of Social Services
Date: 05/3072001 - Date:_5/Z3/0 1
/ , 2001-1407
Signed RFP: Exhibit A
Lutheran Family Services
RFP: 01008-Intensive Family Therapy
INVITATION TO BID
DATE:April 18, 2001 BID NO: RFP-FYC-01008
RETURN BID TO: Pat Persichino, Director of General Services
915 10th Street, P.O. Box 758, Greeley, CO 80632
SUMMARY
Request for Proposal (RFP-FYC-01008) for:Family Preservation Program--Intensive Family Therapy
Program Family Issue's Cash Fund or Family
Preservation Program Funds
Deadline: May 11, 2001, Friday, 10:00 a.m.
The Placement Alternatives Commission, an advisory commission to the Weld County Department of Social
Services, announces that competing applications will be accepted for approved vendors pursuant to the Board
of Weld County Commissioners authority under the Statewide Family Preservation Program (C.R.S. 26-5.5-
101)and Emergency Assistance for Families with Children at Imminent Risk of Out-of-Home Placement
(C.R.S.26-5.3-101). The Placement Alternatives Commission wishes to approve services targeted to run
from June 1, 2001, through May 31, 2002, at specific rates for different types of service, the County will
authorize approved vendors and rates for services only. The Intensive Family Therapy Program must provide
for therapeutic intervention through one or more qualified family therapists, typically with all family
members, to improve family communication, function, and relationships. This program announcement
consists of five parts, as follows:
PART A...Administrative Information PART D...Bidder Response Format
PART B...Background, Overview and Goals PART E...Bid Evaluation Process
PART C...Statement of Work
Delivery Date ataAt'�'�` `twe. '7/-'sz
(After receipt of order) BID MUST BE SIGNED IN INK
Sharon K. Thomas, LCSW
TYPED R PRINTED SIGN TURE
VENDOR James D. Barclay
(Name) Handwritten gnature y Authorized
O cer o gent of ender
ADDRESS 363 S. Harlan, #200 TITLE P esident/CEO
Denver, CO 80226 DATE �9/U/
PHONE# (303)922-3433
The above bid is subject to Terms and Conditions as attached hereto and incorporated.
Page 1 of 32
RFP-FYC-01008 Attached A
INTENSIVE FAMILY THERAPY PROGRAM BID PROPOSAL
FAMILY PRESERVATION PROGRAM
2001-2002 BID PROPOSAL APPLICATION
PROGRAM FUNDS YEAR 2001-2002
BID #RFP-FYC-01008
NAME OF AGENCY: Lutheran Family Services of Colorado
_ADDRESS: 3800 Automation Way, #200, Fort Collins, CO 80525
PHONE: ( 970) 266-1788
CONTACT PERSON: Sharon K. Thomas TITLE: Program Director
DESCRIPTION OF FAMILY PRESERVATION PROGRAM CATEGORY: The Intensive Family Therapy Program must
provide for therapeutic intervention through one or more qualified family therapists,typically with all family members, to
improve family communication, functioning and relationships.
12-Month approximate Project Dates: 12-month contract with actual time lines of:
Start June 1, 2001 Start
End May 31. 2002 End
TITLE OF PROJECT: Family Group Decision Making
(5}110-2A.CA1/21(1,711rt V,6,nm K. 1.4",-5 5/22A
Name and Signature of Person Preparing Docu - Date NATI Name and Si a e Chief dmmis ive O flee Apphca�en ate
MANDATOAYYROP AL RE MEN S
For both new bids and renewal bids,please initial to indicate that the following required sections are included in this
Proposal for Bid. For renewal bids,please indicate which of the required sections have not changed from Program Fund
Year 2000-2001 to Program Fund Year 2001-2002.
Indicate No Change from FY 2000-2001 to 2001-2002
Project Description X
Target/Eligibility Populations X
Types of services Provided X
Measurable Outcomes X
Service Objectives X
Workload Standards X
Staff Qualifications X
X Unit of Service Rate Computation
Program Capacity per Month X
X Certificate of Insurance
Page 26 of 32
May 9, 2001
Core Services Proposal
Intensive Family Therapy Program
Lutheran Family Services of Colorado
Family Group Decision Making Services
I. PROJECT DESCRIPTION
Lutheran Family Services of Colorado (LFS) is a community-based agency with an experienced
staff that offers a wide range of services to children, families and adults. It is a non-profit
agency, which has provided human services to Colorado since 1948. Although the agency was
established as an affiliate of the Lutheran Church, it is an equal opportunity agency that provides
services to all individuals without consideration of religious beliefs, race, ethnicity, sex or
economic status.
Lutheran Family Services' Family Group Decision Making Services (FGDMS) is a component of
the LFS Foster Care Program. This program has been providing out of home care services to
this region since 1993 and specializes in establishing permanency for children experiencing
significant emotional and behavioral impairments. Additionally, LFS has offered Family
Preservation Services since 1998. The Family Preservation Services program provides in-
home therapeutic services that promote the health and well being of families. The goals include
maintaining children in their homes or aiding in a safe transition home after being removed.
The Lutheran Family Services FGDMS program can be an excellent accompaniment to family
treatment as well as a central intervention in Expedited Permanency Planning cases. In some
cases the LFS Clinician may be involved soon after the County has contact with the family to
help facilitate permanency discussions. Expedited Permanency Planning cases involve
establishing permanency within one year for children up to 7 years of age and their siblings.
Often, the sooner the family is engaged and involved in the permanency planning process the
more positively they respond. FGDM can significantly aid in this process. FGDM involves
bringing immediate and extended family members together as well as other significant people in
the family's life (i.e. teacher, pastor, friends) to generate options that can aid in keeping children
safe at home or establishing permanency. The professionals involved with the families are also
invited to provide input. The central philosophy behind this approach is that there is a rich pool
of resources within the family's social network that can create options and possibilities that
professional service providers may never access. The family also can feel empowered and
more invested by producing their own solutions. This intervention can be effective in addressing
situations involving the full range of factors that compromise a child's safety and permanency
including physical, sexual and substance abuse, neglect, parent-child conflict, legal issues,
school issues, and financial problems..
II. TARGET/ELIGIBILITY POPULATIONS:
Families considered appropriate for these services are those in which the parental rights are to
be or have been relinquished or terminated, families where the children are at imminent risk of
being removed from the home, or families where children are transitioning back home after
being removed. Families referred by the courts will be considered for the FGDMS program
contingent upon the families'willingness to participate in and ability to profit by participation in
such services. Eligible families will be screened by the referring DSS worker to insure that the
above criteria are met.
Lutheran Family Services Family Group Decision Making Services
The LFS program currently employs five full time Clinicians. All of our Clinicians are cross-
trained so that they can carry FGDM, Foster Care, Home Based Option B, or Foster Parent
Consultation cases. We determine and assign caseloads on a direct/indirect ratio formula (50%
direct client time and 50% indirect time). Each full-time Clinician can provide 20 hours of direct
service per week. Determining porgam regarding capacity is dependent on the number of direct
contact hours needed for each family/case within the agency. This number varies considerably
based on the complexion of our current clients. The amount of time needed to complete the
FGDM process will vary depending on the number of family members and professionals
involved, their availability and the goals agreed upon with the caseworker and family. If we
assume that a Clinician spends an average of 3 hours of direct service per week on one FGDM
case, then the following numbers would apply: an LFS Clinician has the ability to serve 7
families at any given time. If each family is served an average of 6 weeks, we would be able to
serve 56 families each year. (50 weeks (annual minus 2 weeks vacation) divided by 6 = 8. 8 * 7
= 56). If we assume that half the families are 2 parent families and each family has 2.5 children
we would serve 224 clients.
As noted above we have five Clinicians available to provide these services, their availability may
vary depending on caseload. We have expanded, and continue to be willing to expand, our
capacity if the county referrals demonstrate a sustained need for that expansion. During the
current fiscal year we have not turned down a referral.
The FGDMS program can serve children and their families where children are ages 0-18. We
currently contract with a bilingual/bicultural social worker who is available to complete a limited
number FGDM cases. We currently service families in South Weld County. LFS has access to
churches and other meeting spaces in Weld County that will be pursued as necessary in addition
to utilizing the community resources of the family.
III. TYPES OF SERVICES TO BE PROVIDED
Intake Assessment
The FGDMS program staff will be responsible for screening referrals to the program. There will
be an acknowledgment of the referral within 24 hours (one business day). A clinician will be
assigned to contact the DSS worker and the family to collect initial information to assess the
family's needs regarding FGDM. This assessment should be completed within 3-5 working days
of the referral, depending on the availability of the parties involved.
Initial Planning Stage
The Clinician will meet with the caseworker and the family together to clearly establish the goals
of the FGDM and the role of the family members. The Family Risk Scales will be administered
to help in this process if the child is to remain in the family's home. The Clinician will obtain a list
of potential participants from the family and address any objections to involving all available
family members. The initial planning should be completed within 10 working days of the referral.
Planning for The FGDM and Participant Preparation
This phase of treatment is critical to the success of the FGDM. It involves thoroughly preparing
family members, significant others and professionals. Activities may include education regarding
the FGDM concept and model, clearly defining and communicating participants' roles, arranging
for offenders, survivors and children to appropriately and safely attend, managing unresolved
family issues, helping with the preparation of statements in advance, arranging for participation
of people who cannot attend, coordinating logistics and recontacting meeting participants.
Preparation will be done in person whenever possible. An important part of this phase will be
negotiating with the family about including unwanted family members in the FGDM, especially if
they are seen as key people in producing solutions of safety and well being for the children
IFT RFP
2
Weld County
Bid No.: FYC 01008
Lutheran Family Services Family Group Decision Making Services
involved. Often parents may be embarrassed about their situation or have prior conflict with an
extended family member and may not want to include certain people. However, the children's
needs are the focus of the meetings so the parents are strongly encouraged to include all
appropriate family members. if the family continues to refuse to include key people, then the
utility of the meeting will be reassessed with the caseworker and the FGDM process may be
abandoned. This phase should be completed within 3—5 weeks of the referral, depending on
the number and availability of participants.
Conducting The FGDM
The steps involved in the meeting include introductions, professionals sharing pertinent
information, the family having a private meeting and producing a plan addressing the established
goals, making adjustments in the plan to fit with county concerns, scheduling a follow up meeting
and closure. The facilitator assists the family in producing specific written recommendations
addressing the support, safety and permanency needs of the children/family. Central goals of the
process will be to wrap support around the family in order to prevent out of home placements
and establish permanency as quickly as possible. One or two Clinicians will participate in the
FGDM depending on the needs of the family. A Clinician other than a Clinician involved in
family therapy facilitates the FGDM with the family. The time needed for the FGDM is an
average of 3-5 hours.
The family's recommendations are then communicated to the caseworker and other involved
parties. The Clinician will help incorporate the county worker's goals with the family's
recommendations to create a comprehensive plan for the family.
Follow Up Meeting
LFS will provide a follow up meeting for the FGDM participants to assess progress on the family
plan generated in the FGDM. The timing of the meeting will depend on the specific goals and
responsibilities outlined in the family plan. The meeting will be held approximately 3-5 weeks
after the FGDM session, depending on the needs of the family and the tasks that have been
assigned. If the children have stayed in the family's home, then the Family Risk Scales will be
administered at this time to assess the risk for placement. Results of the meeting will be
communicated to the caseworker.
IV MEASURABLE OUTCOMES
For children that have remained in the family's home, the Family Risk Scales will be
administered initially and at the follow up meeting in measuring the efficacy of the program.
Additionally, the criteria of whether the children have been moved and if there have been
incidents of substantiated abuse or neglect will be assessed at the follow up meeting and at 6
and 12 months. The Family Risk Scales were designed as a standardized measure of a child's
risk of entering foster care. The risk variables measured by the scales are those believed to
contribute to or precipitate the need for out of home placement. Changes in a family's risk status
may be determined by rating the scales two or more times (pre and post tests). There are 26 risk
factors included in the Family Risk Scales, the scales are:
1. Habitability of Family Residence
2. Suitability of Living Conditions
3. Financial Problems
4. Adult Relationships in Household
5. Family's Social Support
6. Parent's Physical Health
7. Parent's Mental Health
8. Knowledge of Child Care and Development
9. Parent's Substance Abuse
IFTRFP
Weld County 3
Bid No.: FYC 01008
Lutheran Family Services Family Group Decision Making Services
10. Parent's Motivation for Problem Solving
11. Parent's Attitude to Preventing Placement
12. Client's Cooperation with Agency
13. Preparation for Parenthood
14. Supervision of Child Under Age 10
15. Parenting of Child Age 10 and Over
16. Physical Punishment of Child
17. Verbal Discipline of Child
18. Emotional Care and Stimulation of Infant (Under 2 Years)
19. Emotional Care and Stimulation of child Age 2 and Older
20. Physical Needs of Child
21. Sexual Abuse of Child
22. Child's Physical Health and Disabilities
23. Child's Mental Health
24. Child's School Adjustment
25. Child's Delinquent Behavior
26. Child's Home-Related Behavior.
V. SERVICE OBJECTIVES
A plan regarding specific goals of the FGDM will be developed early in the FGDM process. The
goals will address the high-risk areas that are contributing to the need for the FGDM. The
central objectives of the FGDM are to promote the safety, well-being and permanency of
children in the family. The three minimum service objectives that the department would like to
have assessed (Improve Family Conflict Management, Improve Parental Competency, Improve
Ability to Access Resources) are inherent in the Family Risk Scales, which will be used for
families where the children will be staying with the family. The Family Risk Scales provide a
detailed assessment of the family's risk areas and will satisfy these criteria. The risk factors are
listed in the section immediately prior to this one. This assessment will be done during initial
contact with the family as well as at the follow up meeting.
The central objectives of maintaining permanency and safety of the children in the family will be
evaluated and monitored by collecting follow up information from Weld County Department of
Social Services and the family regarding: 1) Have the children been moved? 2) Have there
been any substantiated reports of abuse or neglect. This information will be collected at the
Follow Up Meeting and at 6 and 12 months after the FGDM meeting.
VI. WORKLOAD STANDARDS
Please see the previous section "Target/Eligibility Populations" for a detailed explanation of our
workload standards. Our supervision standard is one FTE supervisor for every seven FTE
professional staff members. The requested minimum standards for insurance have been met
and documentation provided.
VII. STAFF QUALIFICATIONS
Direct service providers assigned to this program are qualified by one of the following:
• a master's degree in social work or a master's degree in another human service field and at
least two years of pre- or post-master's experience in family and children's services; and/or
• a bachelor's degree in social work or a bachelor's degree in another human service field and
at least six years' post-degree experience in family and children's services.
IFT RFP 4
Weld County
Bid No.: FYC 01008
Lutheran Family Services Family Group Decision Making Services
All staff has expertise in family therapy as demonstrated by specialized training and/or
experience. All staff in this program will be required to secure a minimum of eight hours per
year of continuing education training. All staff will receive weekly supervision from a supervisor
experienced in Intensive Family Therapy and FGDM. The clinical supervisor will be required to
secure a minimum of ten hours per year of continuing education training.
We currently have the following staff available to provide direct services in this program:
Joe Madrid, LCSW Shawna Boatman, MA
Amy Hatcher, MSW Craig McFadden, LPC
Julie Box, MSW
VIII. COMPUTATION OF DIRECT SERVICE RATE
Total Hours of Direct Service Per Client 18 Hours (A)
Total Clients to be Served 58 Clients (B)
Total Hours of Direct Service for Year 1040 Hours (C)
(Line [A] Multiplied by Line [B])
Cost Per hour of Direct Services 24 Per Hour(D)
(salary, benefits, travel)
Total Direct Service Costs $24.877 (E)
(Line [C] Multiplied by Line [D))
Administrative Cost Allocable to Program $49,532 (F)
Overhead Costs Allocable to Program $37,354 (G)
Total Cost, Direct and Allocated, of Program $111,763 (H)
Line [E] plus Line [F] plus Line [G]
Anticipated Profits Contributed by this Program $0 (I)
Total Costs and profits to be covered by this Program $111,763 (J)
Line [H] plus Line [I]
Total Hours of Direct Service for Year 1040 (K)
Rate Per Hour of Direct, face-to-face Service to be Charged $107 (L)
to Weld County Department of Social Services
Although we have completed this rate computation which renders and hourly rate for direct
service, we charge a flat fee for a completed FGDM of$1,800. This case specific rate was
established because a significant portion of the work is done with collateral contact (non-client,
like extended family, friends, support network, etc.).
IFT RFP 5
Weld County
Bid No.: FYC 01008
Lutheran Family Services Family Group Decision Making Services
IX. PROGRAM CAPACITY BY MONTH
This program is a component of our Foster Care Services Program, which includes foster care,
and family preservation services. As outlined in this proposal, our capacity is based on the
number of staff we have and a direct/indirect service ratio. We currently have five FTE's and a
direct service capacity of 100 hours per week. These FTE's are trained to provide services in
any of the program components, so there is not a minimum client capacity necessary to support
this program. Staff availability will be dependant upon the combination of all cases in the Foster
Care Services Program.
IFT RFP
6
Weld County
Bid No.: FYC 01008
Apr-2O-01 09 : 27A Lutheran Family Services 9702661799 P . 02
RFP-FYC-01DOS Attached A
Date of Meetings)with Social Services 'vision Supervisor: f7
Comments by SSD Supervisory i f S ----/
�-g _i fL Ce iksF-
j
4-r 3 -O/
Name and Signature of SSD St pervisor Date
Page 27 of 32
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PRODUCER Serial# A2757 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MARSH ADVANTAGE AMERICA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
160 SPEAR STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
SAN FRANCISCO, CA 94105 COMPANIES AFFORDING COVERAGE
y COMPANY Epl;1L>`AAUTUAL INSURANCE COMPANY
INSURED °, ? L
COMPANY --- _
LUTHERAN FAMILY SERVICES OF COLORADO B
363 SOUTH HARLAN !COMPANY
DENVER, CO 80226 C
COMPANY
D
. .sN UR A, D OR H T aLI Y PERIOD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Co TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION f
LTR POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD!YY) LIMITS
GENERAL LIABILITY 9618-911 7/1/00 7/1/01 I GENERAL AGGREGATE I$ 3,000,000
A X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 3,000,000
CLAIMS MADE I X I OCCUR PERSONAL I ADV INJURY $ 1,000,000
OWNERS 8 CONTRACTOR'S PROT
X PROFESSIONAL EACH OCCURRENCE $ 1,000,000
.. _. - FIRE DAMAGE (Any one fire) $ 1,000,000
MED EXP (Any one Person) $ 5,000
AUTOMOBILE LIABILITY 1714-122-ARC 4/22/00 I 4/22/01
A X ANY AUTO COMBINED SINGLE LIMIT $ 1,000,000
ALL OWNED AUTOS -
SCHEDULED AUTOS (P(PeDI Paeon)URV $
X HIRED AUTOS
RY
X NON-OWNED AUTOS BODILY accident)
(Per aocitleN) $
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO AUTO ONLY-EA ACCIDENT $
OTHER THAN AUTO ONLY:
--- ------ ----- EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY
EACH OCCURRENCE $
I UMBRELLA FORM
-- AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKER'S COMPENSATION AND J TORSYLIM S ER EMPLOYERS'LIABILITY
EL EACH ACCIDENT $
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE _ EL DISEASE-POLICY LIMIT $
OFFICERS ARE EXCL EL DISEASE-EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERAGONS/LOCATIONSNEHICLESISPECIAL ITEMS
WELD COUNTY, COLORADO, BY AND THROUGH THE BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY, ITS EMPLOYEES
AND AGENTS,ARE NAMED ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY ONLY.
RE: FAMILY PRESERVATION CONTRACT.
•, - ,-
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
WELD COUNTY SOCIAL SERVICES EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ATTN:JUDY A GRIEGO, DIRECTOR 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
P.O. BOX A BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABILITY
GREELEY, CO 80632 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTJ]DW2EORENTATIVE
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MAY-7g-1923 12 -'CM LU.HER:,N FAMILY _E') Cr:LC 7C 1c-- 71PP F.r2
INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY
District Director II00 Commerce St. , Dallas, TX 7$Z42
Person to Contact:
EP/ED Correspondence Examiner
Telephone Number:
Lutheren Social Service of (214 )767-1SSI
Colorado
` ' 3S3 S. Harlan Refer Reply ₹o:
Denver, CO. SOZ2S-3-=52 EF/EC:MC:i5A0 CAL
Date:
April 21 , 1993
SIN:
• 84-0775550
Dear Sir or Madam: •
Our records show that tuthera_n Sgeial Service of Colorado
is exempt from Federel Income Tax under section 501 (c )(3) of the Internal
Revenue Code. This exemption was granted February 1111 and
remains in full force and effect . Contribu₹ions to your organization 'are
deductible in the manner and to the extent provided by section 170 of the
Code.
We have classified your organization as one that is not a private founda-
tion within the meaning of section S09(a) of the internal Revenue Code
because you are an organization described in section 170(6)( 1 )(A)< i )
If we may 'be of further assistance, please contact the person whose name and
telephone number are shown above.
Sincerely Yours ,
Lerkatrg. C121,1O
Mary A. Smith
EP/ED Correspondence Examiner
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