HomeMy WebLinkAbout20002907.tiff RESOLUTION
RE: APPROVE SUBSIDY PAYMENT DISTRIBUTION FORM AND CONTRACT RENEWAL
LETTER#3 FOR STATE EMERGENCY MEDICAL SERVICES COUNTY FUNDS 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 Subsidy Payment Distribution Form
and Contract Renewal Letter#3 for the State Emergency Medical Services County Subsidy
Contract 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 Ambulance Service, and the
Colorado Department of Public Health and Environment, with terms and conditions being as
stated in said form and renewal letter, and
WHEREAS, after review, the Board deems it advisable to approve said form and
renewal letter, copies of which are attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that Subsidy Payment Distribution Form and Contract Renewal Letter
#3 for the State Emergency Medical Services County Subsidy Contract 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 Ambulance Service, 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 form and renewal letter.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 20th day of November, A.D., 2000.
BOARD OF COUNTY COMMISSIONERS
/ WELD COUNTY, COLORADO
ATTEST: Lid) v�'�� �. '4_ k
aBarbara J. rkmey r, Chair
Weld County Clerk to the B. ,rd
I icO
Si �?
1, • .- J. ei e, Pro-Tem
BY: . /ii / . i /� �
Deputy Clerk to the Bo ®
ei K. org- E. Baxter
APPROVED AS TO FORM:
Dale Kn all
County Attorney
Glenn Vaad
2000-2907
AM0013
STATE OF COLORADO
Bill Owens,Governor OF-cO
Jane E.Norton,Executive Director `L,
i5
Dedicated to protecting and improving the health and environment of the people of Colorado
*
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division '9* 4:0 �
Denver,Colorado 80246-1530 8100 Lowry Blvd. ♦1876*
Phone(303)692-2000 Denver CO 80230-6928
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado of Public Health
and Environment
http:gwww.cdphestate.co.us
October 25, 2000
Barb Foster
P.O. Box 69
Greeley,CO 80632-0069
Dear County Plan Coordinator:
As you know the State and your county have a contract in place for disbursement of the
Emergency Medical Services County Subsidy Funds. Enclosed is the third year renewal letter
and the Payment Distribution Form necessary for payment.
This year we are mailing the renewal letters to the County Plan Coordinators in an effort to keep
these letters from on the fast track. Please take this package to your County Commissioner and
get the necessary signatures.
• All three copies of a renewal letter must be signed by the chairperson of your County
Commissioners.
• The Payment Distribution form must also be signed by the chairperson of the board.
• DO NOT remove the copy of the original contract that is attached to one copy of the renewal
letter.
It is important that we have a signed agreement and payment form by December 1, 2000. Please
return the signed documents in the enclosed return envelope.
If you have any questions,please call me at(303)692-2987.
Sincerely,
l �
(1-1.A.' 0cr ;1, ,e I y--
Laurie Borgers
Grants Manager
Pre-Hospital Care Program
Attachments: Third year renewal letter
One copy of the original contract
Payment Distribution Form
2000-2907
COUNTY SUBSIDY PAYMENT DISTRIBUTION FORM
COLORADO EMERGENCY MEDICAL SERVICES SUBSIDY PROGRAM FOR
COUNTIES
In accordance with the provision of CRS 23-3.5-605, the undersigned hereby requests and EMS
county subsidy distribution payment for the improvement and expansion of prehospital EMS. It
is understood that payment is contingent upon approval of the statutory reporting requirement by
the state advisory council on EMS.
Payment to: Board of County Commissioners Weld County
Name of Board of County Commissioners(payee)
P.O. Box 69
Address
Greeley Colorado 80632-0069
(City) (State) (Zip)
Chairperson Board of County Commissio ers
��SIGNATURE:7 f � t, 2ibATE: November 20, 2000
Printed Name: Barbara J. Kirkmeyer, Chair
SIGN AND RETURN THIS FORM ALONG WITH ALL REPORTING DOCUMENTATION
For use only by Department of Public Health and Environment
Amount: $15,092.33
Approved by: Date:
Grants Manager
Date:
Fiscal Officer
Fund Agency 0_r_g Appr Code Func Ob1' GBL
408 FLA 8300 839 FLWT 5120 001S
Original Contract Number: 9807612
Renewal Routing#: 100201
Vendor#: 846000813 U
STATE OF COLORADO
Bill Owens,Governor
bleoto
Jane E.Norton,Executive Director .O
�� � ,
Dedicated to protecting and improving the health and environment of the people of Colorado -a�
4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division "' 4:0
Denver,Colorado 80246-1530 8100 Lowry Blvd. -45876•
Denver
Phone(303)692-2000 Denver CO 80230-6928
TDD Line(303)691-7700 (303)692-3090 Colorado Department
Located in Glendale,Colorado of Public Health
http://www.cdphe.state.co.us and Environment
October 26,2000
State Fiscal Year 2000-2001 Contracting Routing Number
FLA 0100201
Contract Renewal Letter No.3
•
In accordance with Paragraph 10 of the contract with routing number 9807612 and contract number FAA,EMS 9807612
hereinafter referred to as the Original Contract(copy attached and by this reference made a part hereof)between the State of
Colorado,Department of Public Health and Environment EMSP Division and The Board of County Commissioners,Weld
County,the parties hereby agree the Original Contract is hereby renewed for the period of January 1,2001 through December 31,
2001. The parties agree that the maximum amount payable by the State for the eligible services during this renewal period is
FIFTEEN THOUSAND NINETY TWO DOLLARS AND THIRTY THREE CENTS($15,092.33)according to the work plan
. The terms of
conditions of the Original Contract are hereby reaffirmed and shall continue in full force and effect throughout this renewal period
unless otherwise stated.
This amendment to the Original Contract is intended to be effective as of January 1,2001, but in no event shall it 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 three originals of this letter as soon as possible to:
Laurie Borgers,Grants Manager
Colorado Department of Public Health and Environment
EMSP Division
Mail Code:EMSPD-PCP-A5
4300 Cherry Creek Drive South
Denver,Colorado 80246-1530
One original of this letter will be returned to you when fully approved.
Contractor: Board of County Commissioners, State of Colorado:
Weld County
Bill Owens,Governor
By/ad/JUL ✓ //LE[ l '
Signature '�1t
By: I : �►i"N
Print Name: Barbara J. Kirkmeyer (11/20/2000) For the Execuf e 'rector
Colorado Dep rtme t of Public Health
Title: Chairperson,Board of County Commissioners And Environm.
APPROVALS: APPROVALS:
PROG M STATE CONTROLLER
By: b, C'• ,a By:
Arthur Barnhart
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