HomeMy WebLinkAbout20013465.tiff MINUTES
MEETING BETWEEN WELD COUNTY
COMMISSIONERS,
NCMC BOARD OF TRUSTEES, AND NCMC INC.
BOARD OF DIRECTORS
TUESDAY, DECEMBER 11 , 2001
4:00PM
The meeting between the Board of Weld County Commissioners, NCMC Board of Trustees,
which is appointed by the Commissioners, and the NCMC, Inc. Board of Directors was called to
order by Chairman Mike Geile at 4:00PM on December 11, 2001. Commissioner Geile
indicated that the Commissioners had asked for the meeting as indicated in their December 5,
2001, letter to the other boards to discuss issues facing the NCMC, Inc. Board of Directors. He
explained Weld County's interest as the land owner of the hospital, and the Commissioners'
role in appointing the NCMC Board of Trustees. He indicated that recent events with the NCMC
Inc. Board of Directors had caused debate in the community questioning what was going on at
NCMC, NCMC perception of being a community hospital, the functioning of the Board of
Directors, quality of care, and NCMC's competitiveness in the health industry. The other four
Commissioners echoed Geile's concerns and comments with Commisioner Jerke asking about
the profit strategy of the hospital, and Commissioner Long questioning if we were losing the
concept of a community hospital in Weld County.
Commissioner Geile went through the questions raised by the Commissioners in their
December 5, 2001, letter to the other two boards. Dr. Dan Zenk, Chair of the NCMC, Inc. Board
of Directors, read a prepared statement in response to the questions. The written response is
attached.
Commissioner Geile asked if the NCMC Inc. Board was a functioning board. Dr. Zenk
responded that he felt it was a functioning Board and a very productive board. He cited
examples of how NCMC provided quality care via the Banner agreement.
Geile raised questions about the conflict of interest issue. Dr. Zenk said the Board of Directors
had engaged an attorney, Phil Figa, to investigate the conflict of interest allegations. The scope
is to examine the allegations made against former Board of Director President Frank Cordell,
and a consultant, Jeff Tindle. All members of the Board of Directors and Banner
representatives are cooperating with the investigation. A report is due to the Board of
Directors on December 18, 2001. As advised by the Board of Directors' attorney Dr. Zenk
would make no other comments on the matter.
Commisioner Vaad asked whether NCMC's role as a community hospital and regional health
facility were mutually exclusive. Dr. Zenk responded that they were not, and he feels that the
patients expect more than a community hospital. An institution, such as NCMC, can be and is
both.
( 34J f/SCCC /
t' t 7 2001-3465
Vaad questioned how the nominating committee functioned. Geile asked how people were
recruited for the Board of Directors. Lori Briscoe, Chair of the Nominating Committee, explained
the process. The committee seeks members that will complement the other Board members
skill sets, and individuals that will devote the necessary time to the Board.
Commissioner Jerke suggested that the NCMC Inc. Board of Directors in order to restore
community confidence may want to come up with a system of checks and balances, such as
having the Commissioners confirm Board nominations, like the U.S. Senate does at the federal
level. Also, they may want to look at term limits. Dr. Zenk had no comments until the Board of
Directors has an opportunity to discuss the issues raised.
Commissioner Jerke asked about the issue of profits being taken out of the community. Dr.
Zenk said all of this was part of the new negotiations with Banner and he could not comment.
Jerke ask about the current contract arrangement. Don Mueller, Chair of the Finance
Committee explained the current arrangement. In a simple explanation NCMC Inc. gets 40%
of the profits after all expenses and Banner's 1.4% management fee are subtracted from the
income.
Commissioner Geile inquired about performance indicators or goals in the Banner contract.
Ellen Stewart, the NCMC Inc. Board attorney, explained there were 27-28 performance
warranties in the agreement , as well as, certain performance items in the bond obligation that
Banner must fulfill. Dr. Zenk added that after the new agreement is approved Banner and the
Board were planning a public relations campaign to inform the public of the arrangement and
the commitment to quality medical care.
Commissioner Vaad asked if there was anything the Board of Weld County Commissioners
could do to help. NCMC Director Jeff Beddingfield indicated that the institution was badly
needing to make a $100 million capital investment to maintain and provide future quality of
care. The investment is also needed to address physicians concerns regarding the hospital.
The NCMC Foundation will be doing a capital fund drive. Any assistance the Commissioners
can give to help restore confidence in the community to help the fund drive would be
appreciated.
Dr. Susan Carter, NCMC Trustee, suggested that the information gathered by the Trustees
each month by visiting different units in the hospital should be reported not only to the Trustee
Board, but communicated to the public to keep them informed about the good things happening
at NCMC.
Commissioner Geile asked about the relationship with Banner and NCMC concerning the
outpatient clinic. Ellen Stewart expained that the relationship was a 50%/50%joint venture with
Banner where NCMC was just the landlord. Banner handles all operations.
Commissioner Geile raised questions about the policy on public meetings of the NCMC Inc.
Board of Directors. Dr. Zenk said the regular session of the meetings are open, but at the end
they go into closed session due to the confidential nature of the topics, such as patient issues,
personnel, negotiations, or other proprietary information. The Board has not discussed
changing their policy, so he had no other comments until the Board discusses it.
Commissioners Geile suggested that another meeting be held in the near future. The agenda
would be:
1. Policy on open meetings.
2. Results of the conflict of interest investigation.
3. Philosophy on term limits and Board appointments.
4. Contract negotiations with Banner.
5. Communications with the public.
6. Concept of a community hospital as it relates to the management agreement and how
NCMC is evolving.
NCMC Trustee/ NCMC Director Brian Larson made comments on the Board of Directors and
NCMC. He feels as a new member to the Board of Directors he finds the Board is very
functional and the hospital is operated very well.
Dr. Zenk said in closing the Board wants NCMC to be both a community hospital and a regional
health facility, and as an institution it can be both and be good at being both. He believes the
arrangement with Banner has been beneficial for the community. NCMC is well operated by
Banner. NCMC Inc. Board of Director will meet again with the Commissioners as soon as
practical after December 18, 2001, when the conflict of interest investigation is complete.
The meeting was adjourned at 5:40 PM.
4 OFFICE OF THE COUNTY COMMISSIONERS
915 10th STREET
P.O. BOX 758
GREELEY, COLORADO 80632
1 WEBSITE: www.co.weld.co.us
C. PHONE: (970) 356-4000,
4200
(970)
FAX: 352-0242
COLORADO
December 5, 2001
William Hughes, Executive Director Brian Larson, Chairman
NCMC, Inc. North Colorado Medical Center Board of Trustees
1801 16th Street 510 49th Avenue
Greeley. CO 80631-5199 Greeley, CO 80634
Dr. Daniel Zenk
Chairman NCMC,Inc., Board of Directors
1801 16th Street
Greeley, CO 8063 1-5 199
Dear Sirs:
The Weld County Board of County Commissioners ("Commissioners") is requesting
information regarding the issues currently facing the Board of Directors of North Colorado Medical
Center("Board") and is seeking this information by means of a series of discussions with the Board of
Trustees for the North Colorado Medical Center("Trustees")and the Board of Directors for the North
Colorado Medical Center,Inc. The Commissioners are not responsible for the management of the
Hospital but are looked to by their constituents for answers concerning the management and operation of
what is still viewed as a local community hospital. Additionally, some of the Medical Center real estate
is titled in the Board's name and the Board appoints members of the Board of Trustees. It is a concern
over the public's perception of the Medical Center management which has led the Commissioners to
request these meetings to clear the air and help restore public confidence in this essential community
resource. This meeting would be conducted in accordance with the Colorado Open Meetings Law
public meeting since the Trustees and Commissioners would be attending in their public capacities
The initial meeting is proposed for 4:00 PM,December 11, 2001 in Room 103 of the Health and
Planning Building located at 1555 N. 17th Avenue Greeley CO 80634. The primary purpose of the first
meeting will be for the Commissioners to present issues that need to be addressed for the benefit of the
Board and the public. The Commissioner recognize that responses may not be immediately available and
that follow-up meetings will be necessary. The Commissioners intend to pose questions which, will
include,but not be limited to the following:
♦ The public perception,primarily based upon newspaper accounts, is that the NCMC Inc. Board
has lost some of its effectiveness in dealing with issues such as the renegotiations with Banner due to
internal differences and possible conflicts of interest. The Commissioners would like to hear a response
to the public perception and any steps the Board may be taking to assure the continued productivity of the
Board.
♦ There have been concerns aired about the process and the progress regarding the renegotiated
agreement with Banner. The Commissioners wish to understand the role of the consultant,Mr.Tindall,
in the process and be advised as to the status of the renegotiated agreement. The Commissioners also are
interested in the views of the Board as to the effectiveness of Banner as an operator,to date.
♦ The Commissioners would like to be informed regarding the process for selection and
appointment of new Board members and the process and grounds for removal of Board members.
♦ The Commissioners would like to hear further discussion of the plans for the satellite centers and
their relationship to the main Medical Center Campus. They are also interested in who owns and has
financed the satellite facilities. They are also concerned about the effect the satellites will have on the
value of the main Medical Center and the effect on the Medical Center's ability repay the outstanding
bonded indebtedness.
♦ The Commissioners would like to hear discussion regarding the philosophy of the Board
regarding public meetings. The Board is not contesting your legal position that the meetings of the Board
are not subject to the Open Meetings Act, but is interested, as a matter of public policy,in seeing that the
community be kept informed as to the status of the local hospital.
The Commissioners appreciate the time and effort you have dedicated to dealing with this
vital community resource and for the information you will be able to provide.
Sincerely,
BOARD OF COUNTY COMMISSIONERS
Ji
/M. J. Geile, Chair
Glenn Vaa ro William H. Jerke
C7?-(:)\, \
David E. Long Robert D. Masden
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_E Morrison - Commissioners Presentation12 11 01.doc
III
ADDRESS TO THE WELD COUNTY COMMISSION
ERS
December 11 , 2001
By Dr. Daniel Zenk, Chairman, NCMC, Inc. Board of Directors
Good afternoon Mr. Chairman, and members of the Board of
County Commissioners. My name is Daniel Zenk. I am a
physician practicing in Greeley and the newly elected Chair and
President of NCMC, Inc. I am here today to address the five
areas of concern raised by you in your letter to the NCMC, Inc.
Board of Directors dated December 5, 2001 .
As a matter of procedure, I respectfully request I be allowed
to make my presentation to you and then, when completed, I will
attempt to address questions of the Commissioners. I will be
speaking as a representative the entire Board of Directors.
(Pause to see if acceptable to the Commissioners)
The first area raised by the Commissioners is as follows:
The public perception, primarily based upon newspaper
accounts, is that the NCMC Inc. Board has lost some of its
effectiveness in dealing with issues such as the
renegotiations with Banner due to internal differences and
possible conflicts of interest. The Commissioners would like
to hear a response to the public perception and any steps the
Board may be taking to assure the continued productivity of
the Board.
As you are all aware, NCMC, Inc. has had an agreement
with Banner Health System (formerly Lutheran Health System)
since 1995. The agreement, known as the Operating Agreement,
is a complex legal document, which sets forth the relationship
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Morrison - Commissioners Presentation 12.11.0^.doc Pace
between NCMC, Inc. and Banner. The existing agreement is still
in effect, has not been terminated by either party and will run
through June of 2024, or for another 22 and a half years.
However as you know, there is a one year notice for termination
provision which can be activated by either party without cause.
Over the past year, the NCMC Inc. Board and Banner have
been in discussions concerning a revision to the Operating
Agreement to address concerns of both parties. The primary
impetus for the re-negotiations was the significant capital
expansion required for the Medical Center Campus. The
projected expansion of the facilities over the next several years is
estimated to be over $100 Million Dollars. The Board of NCMC,
Inc. does not take this investment responsibility lightly and
therefore the decision to move forward with such a large project
required the Board to carefully consider all of its options related to
the operation of the Medical Center Campus.
In addition, as you are aware, there is generally debate
within an organization concerning significant long-term financial
commitments and the best way for the organization to proceed.
Each board member of NCMC, Inc. must act in what that person
believes to be the best interest of NCMC, Inc. As the board is
comprised of individuals from diverse backgrounds it is not
uncommon that individual members of the Board will not always
see things in the same way. The key here is that after a healthy
and open debate among the members of the Board a decision
was reached to attempt to negotiate an amended Operating
Agreement with Banner. Some members of the Board have
disagreed with the decision, and that is their right. However, the
rationale was to improve on the existing agreement.
I do not believe that the Board of Directors has a problem
with productivity. During the last 6 years of the Operating
Agreement the Board and Banner have, in a deliberate and
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business like fashion attempted to address the health care needs
of the people of Weld County. There have been expansions in
the services provided by the Medical Center, including the recent
announcement of the new burn center. In addition, NCMC, Inc.
has entered into a joint venture with some of its physicians to
build and operate an Ambulatory Surgery Center in West Greeley.
NCMC and Banner have, thorough a joint venture, North
Colorado Health Ventures, has or will acquire property in Windsor
n
and Johnstown for the building and operation of medical clinics,
and NCMC, Inc. has financed significant building and equipment
for the main Medical Center Campus. Furthermore, NCMC, Inc.
enjoys an excellent financial position due to good returns on its
investment portfolio in addition to monies received from Banner
under the Operating Agreement.
On November 16th, the Board was informed via a newspaper
article of a possible conflict of interest of a member of the Board.
In subsequent newspaper articles the Board learned of possible
additional conflicts of interest regarding the consultant selected by
the Board to assist it in the negotiations of the agreement with
Banner. Upon learning of the possible conflict issue the Board of
Directors called an emergency meeting on November 20th (two
business days after the article was published). At that meeting
the Board determined that its best course of action was to
suspend the
negotiations with Bann
er until the issue of possible
conflicts could be investigated. The Board voted unanimously to
retain a consultant to conduct an investigation of possible conflicts
and report back to the board. At its regular meeting on November
27th the board received proposals from three qualified attorneys
concerning the conflict of interest investigation and the Board
selected Phil Figa, of the law firm of Burns, Figa and Will, in
Denver to conduct the investigation. Mr. Figa has, to date,
conducted over 16 interviews and has reviewed numerous
documents in the preparation of his report. He is scheduled to
report to the Board of Directors on December 18th. At this point
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in time all that the Board of Directors has are allegations. The
Board is taking what it believes to be prudent action to have an
independent, experienced third party conduct an investigation and
report back to the Board. The work of Mr. Figa is confidential and
is being performed under attorney client privilege, therefore we do
not anticipate that Mr. Figa's report will be released to the public
in total, however, the Board may release a summary of his
findings to the public.
As you know, the investigations are very delicate. All of the board
members of NCMC Inc have agreed personally to cooperate with
Mr. Figa and they may be disclosing private, personal information
about their businesses to Mr. Figa so that he may conduct the
investigation with full disclosure. Some of the information
disclosed may be irrelevant to the issue of a conflict of interest in
this case. It would not serve anyone's purpose to have private
information released to the public about the activities of board
members of a private corporation unrelated to the allegations in
the newspaper accounts. To do so may severely hamper the
ability of the NCMC Inc. Board to obtain qualified directors in the
future, if each director serves under the threat that their entire
private financial affairs are open to the public. Members of the
NCMC Inc Board of Directors serve without compensation and
have volunteered countless hours in the service to NCMC, Inc.
and the Weld County community. Volunteer directors are a
precious resource and I believe that we need to protect the
privacy of these volunteers. That being said, if there has been
improper conduct by any member of the NCMC, Inc. Board, the
Board will take appropriate action.
The second issue raised by the Commissioners is:
There have been concerns aired about the process and
the progress regarding the renegotiated agreement with
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Banner. The Commissioners wish to understand the role of
the consultan
t Mr. Tindle in the process and be advised as
,
to the status of the renegotiated agreement. The
Commissioners also are interested in the views of the Board
as to the effectiveness of Banner as an operator, to date.
The firm of Baird Kurtz and Dobson was retained to assist
NCMC, Inc. in its negotiations with Banner. Mr. Tind
le is the
principal of that firm who was designated to conduct the
negotiations. As you are aware, NCMC, Inc. does not have any
employees, and as the board is an all-volunteer organization it
made sense to hire an individual who could devote significant
time and energy to the detailed negotiations. Mr. Tindle was
given specific parameters by the NCMC Board under which he
was to attempt to renegotiate the agreement with Banner. The
Board was scheduled to hear a progress report from Mr. Tindle on
November 27th, but the allegations of conflicts of interest were
brought to our attention in the days preceding the update. As a
result, the Board of Directors took the action to suspend the
negotiations with Banner until the investigation can be completed.
Banner has been informed of the suspension and has indicated
that it will fully cooperate in the investigation regarding the
possible conflicts of interest.
At this point, the specific details of the final negotiation points
with Banner are not available. I am aware of a significant number
of the negotiation points however I cannot share them publicly as
to do so could jeopardize NCMC's position in the negotiations. I
also cannot speculate on the actions the Board of Directors will
take concerning the new agreement, as that will depend on the
findings of Mr. Figa. Please be assured that prior to any
renegotiated agreement with Banner the NCMC Inc Board will
review the revised terms and conditions, in detail, before making
a decision to proceed.
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_EE Morrison - Commissioners Presentation12.11.J1.doe
As to the effectiveness of Banner, I would like to say that to
date, Banner is in full compliance with its obligations to pay
NCMC, Inc. rent under the existing agreement. Accordingly
NCMC, Inc. is also able to be in full compliance with its
obligations under its Bond Indentures. Banner is meeting its
financial responsibilities under the agreement.
As a member of the medical staff, I think that it is important
that the Medical Center has the network, referral base and
leadership that Banner brings to the table. The Medical Center is
no longer just a community hospital, but is continuing to develop
as a regional tertiary referral center. I believe that Banner is key
to the future success of building the regional referral center and
developing the tertiary services at the Medical Center. The
P phy
sicians and h sicians of this community want this to be
superior, technologically advanced tertiary care center. In order
to attract the well-trained specialty physicians to support these
services, we must attract patients from the surrounding areas.
recruited burn surgeon and competencies Our recently ec cited on a g
recent unannounced JCAHO survey are more examples that the
care at our local hospital is something that our community can
and should be proud of. I have great respect for the quality of
care provided by the medical staff and employees of this Medical
Center. This medical center has some of the best nurses and
techs anywhere. I personally would not hesitate to obtain or have
a member of my family obtain medical care from the physicians
and employees of North Colorado Medical Center.
The third issue raised is:
The Commissioners would like to be informed regarding
the process for selection and appointment of new Board
members and the process and grounds for removal of Board
members.
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_E Morrison resentation12 11 01.doc a._,.__.`__
nson - Commissioners P
According to the Bylaws of NCMC, Inc the board members
consist of 10 individuals, 3 are representatives from the Board of
Trustees. Of the 3 representatives from the Board of Trustees,
one mu
st serve on the Finance Committee of the NCMC, Inc.
Board. The remaining seven members are individuals from the
community. The board members have staggered 3 yr terms, so
that the entire board of directors does not turn over all at one and
there is continuity on the board.
The Board of Directors elects a Nominating Committee from
existing Board members each year to bring to the Board a slate of
new directors and officers for the coming year. At the annual
meeting in January, the Board considers nominations from the
Nominating Committee and also the Directors can nominate
persons from the floor to serve as a director or officer.
The Nominating Committee is currently considering nominees for
the vacant positions that arise in 2002. Qualified and interested
persons are encouraged to contact Lori Briscoe, Dr. Michael
Schwartz, or Don Cummins if they desire to serve. As I
mentioned before this is an entirely volunteer board an
d board
members do not receive any compensation for their service. In
addition, board members are expected to attend all regular and
special board meetings and attend committee meetings for those
committees to which they are appointed.
Another issue you raise is the ability to remove a director.
Based upon the recent circumstances we have had the
opportunity to review our Bylaws for provisions concerning the
removal of a director. The NCMC, Inc. Bylaws provide that the
board can remove an officer but there is not provision for removal
as a director, and therefore the Colorado Non-Profit Corporation
statute applies. Under the statute, a Board of Directors can
remove a director with or without cause upon the vote of a
majority of the directors entitled to vote.
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The fourth issue raised by you is:
The Commissioners would like to hear further discussion of
the plans for the satellite centers and their relationship to the
main Medical Center Campus. They are also interested in
who owns and has financed the satellite facilities. They are
also concerned about the effect the satellites will have on the
value of the main Medical Center and the effect on the
Medical Center's ability to repay the outstanding bond
indebtedness.
As previously discussed, the current Operating Agreement
provides that all of the health care facilities in the City of Greeley
are to be solely owned by NCMC, Inc. Therefore the Ambulatory
Surgery Center in West Greeley is not owned by Banner, but is
owned solely by NCMC Inc. and leased to a joint venture between
NCMC, Inc., certain physicians and a management company
based in Texas.
The Operating Agreement also provides that NCMC, Inc.
and Banner will jointly own facilities outside of Greeley but within
Weld County. Therefore the plan is for the clinic facility in
Windsor and the land and new clinic facility in Johnstown to be
owned 50/50 by Banner and NCMC, Inc.
I would like to assure the Commissioners that when a new
facility or business is brought in service under either the NCMC,
Inc. or the North Colorado Health Ventures umbrella, the issues
regarding referrals to the Medical Center campus as well as the
services needed by the community and the concomitant cost of
those services is fully evaluated by both NCMC, Inc. and Banner.
Based on the concept that the Medical Center Campus will serve
as the "hub" for the network, I believe that adding the satellites
only serves to enhance the operations and financial position of
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the Medical Center campus. There is a mechanism in place for
the divestiture of these satellite facilities in the event that NCMC
and Banner are no longer operating under their Operating
Agreement.
The Commissioners can be assured that the NCMC, Inc.
Board and Finance Committee carefully considers the financial
impact of each of the Greeley and Weld County operations to
ensure that the satellite operations do not have a negative impac
t
on the ability of NCMC, Inc. to meet its obligations under the
terms of its bonded indebtedness.
And finally the last issue raised by the Commissioners is:
The Commissioners would like to hear discussion
regarding the philosophy of the Board regarding public
meetings. The Board is not contesting your legal position
that the meetings of the board are not subject to the Open
Meetings Act, but is interested, as a matter of public policy,
in seeing that the community be kept informed as to the
status of the local hospital.
This request for information has placed the NCMC Board in
a very difficult position. The Greeley Tribune attorneys have
threaten litigation over this issue and last Friday our attorneys
received correspondence from the attorneys for the Tribune
requesting that NCMC, Inc. be required to justify its position
publicly at this meeting regarding the Open Meetings Act. The
advice from our attorneys is that since the Tribune has threatened
in
cluding
comment on our position, any
litigation we should not
comments related to public policy
Generally NCMC, Inc. and Banner have a philosophy of
informing the community regarding the services provided by the
countless press
Medical Center and over the years have issued
releases regarding the activities of the Medical Center. The
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_EE Morrison - Commissioners Presentation12.11.01.dec 3C E:
regular sessions of our meetings have been open to the public in
the past and I have no reason to anticipate a change in that
policy. We have executive sessions at the end of each meeting to
discuss items that would not be prudent for public disclosure at
that time. We do not vote or perform official business in executive
session. I would like to assure the commissioners that we do not
wish to be a secretive entity and will do our best to keep the
public informed.
Thank for your consideration in receiving my comments regarding
these very difficult issues and ones we know are of interest to the
public. We as a Board will now entertain questions. Please
understand that since we have not discussed the answers
provided, any response will reflect that Board member's opinion.
Thank you.
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ATTENDANCE RECORD
DECEMBER 11, 2001
NCMC Boards of Directors and Trustees and
Board of County Commissioners, Weld County, Colorado
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ATTENDANCE RECORD
DECEMBER 11, 2001
NCMC Boards of Directors and Trustees and
Board of County Commissioners, Weld County, Colorado
PLEASE legibly write or print your name and complete address.
NAME AND ADDRESS (Please
include City and Zip Code)
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