HomeMy WebLinkAbout20242961.tiffCONS
COLORADO
Office of Children,
Youth Et Families
Division of Child Welfare
Coin -I* vacs- (Dii83.33
INDIVIDUAL PROVIDER CONTRACT
FOR PURCHASE OF FOSTER CARE SERVICES IN A FOSTER CARE HOME
1. THIS CONTRACT AND AGREEMENT, made this date N‘0\)-emVQt/t0 12QZ'4, by and between Weld
County Department of Human or Social Services, 315 North 11th Avenue, Greeley, Colorado hereinafter
called "County Department" and hereinafter called "Provider", Allison Sedlacek and Roger Sedlacek at
4428 West 14th Street Drive, Greeley, Colorado 80634.
2. This Contract and Agreement shall be effective from November 17, 2024 and continue in force until
November 16, 2025 or until the facility certificate is revoked or surrendered. This contract and agreement
may be renewed at any time during the term of the valid facility certificate. This contract and agreement
is in lieu of and supersedes all prior purchase contracts between the parties hereto and relating to the
services herein described.
3. The Provider holds a valid certificate as a: ® Foster Care Home or ❑ Therapeutic Foster Care Home or
❑ Kinship Foster Care Home -(check applicable blank). Such certification standards shall be maintained
during the term hereof. The provider has read and is fully familiar with the "Rules Regulating Foster Care
Homes" issued by the Colorado Department of Human Services.
4. The County Department may but shall not be obligated to purchase foster care home services. The County
Department or any duly authorized agent may request such services to be provided to any child or youth
at any time within the limits of the certificate and without prior notice. At such time or as soon as possible
after the acceptance of a child or youth for services, the County Department and the Provider shall verify
foster care placement of each child or youth in writing on the required form, which shall become an
addendum to this contract, subject to all the terms and conditions hereof.
5. The terms of this Agreement are contained in the terms recited in this document and in Exhibit A and
Addendum 1, which form integral parts of this Agreement. Exhibit A and Addendum 1 are specifically
incorporated herein by this reference.
The Provider agrees:
1. To the rates for child placement as set for by the State of Colorado apply to the services contemplated by
this Agreement and that such rates may be negotiated with the Provider individually in cases with
exceptional circumstances as determined by the County Department;
2. To safely provide the 24 -hour physical care and supervision of each child or youth until removed or until
the agreement is renewed;
3. To accept a child or youth, only with the approval of the certifying agency;
4. To cooperate fully with the County Department or its representatives, and participate in the development
of the Family Service Plans for a child or youth in placement, including visits with their parents, siblings,
relatives, or to transition to another foster care facility;
5. To maintain approved standards of care as set by the Colorado Department of Human Services;
6. To maintain the confidentiality of information shared about the child or youth and his/her family;
CWS-7A Revised 08/2022 1
2024-2961
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7. Not to accept money from parents or guardians;
8. Not to make any independent agreement with parents or guardians;
9. Not to release the child or youth to anyone without prior authorization from the County Department ;
10. To allow representatives of the County Department to visit the foster care home and to meet with the
child or youth at any reasonable time, including scheduled and unscheduled visits; and,
11. To give the County Department a 30 -day notice, except in an emergency, to remove a child or youth for
placement elsewhere, and to work with the County Department as requested to prepare the child or youth
for another placement.
12. To provide transportation to the child or youth. Transportation to be provided will be agreed upon at
placement and may be changed upon mutual agreement of the provider and the County Department, as
recorded in the Family Service Plan. Transportation must be provided or arranged:
a. For professional services and/or for school attendance when necessary; and,
b. For youth to participate in age or developmentally appropriate extracurricular, enrichment, cultural,
and social activities.
13. To report promptly to the County Department:
a. Any unplanned absence of the child or youth from provider's care;
b. Any major illness of the child or youth;
c. Any serious injury to the child or youth;
d. Any significant change in the sleeping arrangement for the child or youth;
e. Any contemplated change of address or change of household members;
f. Any conflict the child or youth may have with law enforcement, school/school district staff, or other
persons in authority;
g. Any emergency;
h. Any pertinent discussion with parents or guardians about the child or youth or supervising agency; and,
i. Any information received regarding a change of address of the parents or guardians.
14. To comply with the Civil Rights Act of 1964, Section 504, Rehabilitation Act of 1973, and the ADA of 1990,
concerning discrimination on the basis of race, color, sex, age, sexual orientation, expression, or gender
identity, religion, political beliefs, national origin, or handicapping condition.
Pursuant to §19-1-130, C.R.S., a service provider means the state department of human services, a
county department of human or social services, or a child placement agency. This includes a
contractor or subcontractor that provides placement -related services on a service provider's behalf.
A service provider shall provide placement -related services in a manner that is culturally responsive to the
complex social identity of the individual receiving such services. complex social identities include but are
not limited to race, ethnicity, nationality, age, religion, sex, sexual orientation, gender identity, gender
expression, socioeconomic status, physical or cognitive ability, language, beliefs, values, behavior
patterns, and customs.
Subjecting a child or youth in foster care or an individual, family, or other service provider to
discrimination or harassment on the basis of actual or perceived disability, race, creed, religion, color, sex,
sexual orientation, gender identity, gender expression, marital status, national origin, ancestry, or any
communicable disease, including HIV, when providing any placement -related service is prohibited.
15. To complete pre -service training prior to the placement of a child or youth.
16. To annually:
a. Update the Training Development Plan with the County Department;
CWS-7A Revised 08/2022 2
b. Complete ongoing, quality, and relevant training that will build competencies to meet the needs of the
children and youth served in the foster care home as required by the Colorado Department of Human
Services regulations including ongoing training required to use and apply the reasonable and prudent
parent standard for each child or youth served in the foster care home.
17. To attend semi-annual Administrative Reviews for a child or youth in placement.
18. To be knowledgeable of, and comply with the "Rules Regulating Foster Care Homes" and the "General
Rules for Child Care Facilities;
19. Not to enter into any subordinate subcontract hereunder;
20. To keep required and necessary records for audit/review purposes by state and federal personnel. These
records shall document the type of care and dates that care is provided for each child or youth. In
addition, medical, educational, and progress summary records shall be maintained for each child or youth
as required pursuant to the Colorado Department of Human Services' Rules Regulating Foster Care Homes.
21. To complete or schedule a medical examination for the child or youth within 14 days of initial placement
and complete a dental examination within eight weeks of initial placement.
The County Department agrees:
1. To share all available information about the child or youth, including relevant social, medical and
educational history, behavior problems, court involvement, parental, sibling and relative visitation plans,
and other specific characteristics of the child or youth, with the provider before placement and to share
additional information when obtained while the child or youth is in placement.
2. To inform the provider of expectations regarding the care of the child or youth, such as meeting medical
needs, visitation, special psychological needs, trauma and other grief/loss issues, and the child's or youth's
identification with his/her family;
3. To give the provider the written admission record of the child or youth to the foster care home at the time
of placement;
4. To give the provider a written procedure or authorization for obtaining medical care for the child or youth;
5. To involve the provider in family service planning for the child or youth as a member of treatment team;
6. To give the provider a copy of the Family Service Plan, as it pertains to their expectations for meeting the
needs of the child or youth in the foster care home, at the time of placement or when it is completed
following placement;
7. To give at least a 30 -day notice of plans to remove a child or youth from the foster care home. The 30 -day
notice may be waived by mutual consent to allow and permit immediate removal of a child or youth for
placement elsewhere, or without such waiver in the event of an emergency. An emergency is defined as
any situation in which a provider's inability to provide services threatens the health, safety or welfare of a
child or youth.
8. To pay the provider at the rates established by the Colorado Department of Human Services or as
authorized and negotiated between the provider and the County Department:
a. Payment shall be made by electronic banking transfers (EBT) drawn by the duly authorized county
officer; and,
b. Provider shall notify the County Department of any payment or billing dispute within 60 days of the
month when service was provided. Failure to do so will result in forfeiture of the payment. The
Provider understands that, pursuant to the Colorado Department of Human Services' Rules for the
General Reimbursement for Child Welfare Services, when reimbursement is warranted the State
reimburses for retroactive payments not greater than the current and (2) preceding months.
9. To provide or arrange through statewide contracted training, a minimum of twelve hours of core pre -
service training for foster care homes and 15 hours of pre -service training directed at the needs of the
child or youth to be served in the foster care home.
CWS-7A Revised 08/2022 3
10. To annually complete the following:
a. Update the Training Development Plan with the provider;
b. Provide or make available quality and relevant training for each foster parent that will build
competencies to meet the needs of the children and youth served in the foster care home;
c. Provide training that prepares each foster parent to use and apply the reasonable and prudent parent
standard; and,
d. Pursuant to the Colorado Department of Human Services' Rules Regulating Family Foster Care Homes,
document that the provider is trained in and can use and apply the reasonable and prudent parent
standard for each child or youth placed in the foster care home.
11. The County Department is responsible for providing information on county specific procedures.
12. To invite the provider to Administrative Reviews for each child or youth in placement.
13. To incorporate provider information in planning for the child or youth placed in the foster care home.
14. To assure that the service described herein has been accomplished and a record made thereof on a case
by case basis.
15. To provide notice of court hearings for each child or youth placed in the foster care home.
WHEREFORE, the parties have herein set their hands and affixed their seals the day and date first written
above.
COUNTY:
Jamie Ulrich
Weld County Department
of Human Services
Jamie Ulrich (Nov 4, 2024 09:28 MST)
Signature
ATTEST: �..1AfrA0) XL; :'R BOARD OF COUNTY COMMISSIONERS
..... Y93R
BY:
Clerk to the Board
Deputy Clerk to the Boa
PROVIDER:
Allison Sedlacek
Provider
Roger Sedlacek
Provider
CWS-7A Revised 08/2022
ELD COUNTY, COLORADO
0
in D. Ross, Chair
Altisom L Sedlacek
Allison L Sedlacek (Nov 4, 2024 08:11 MST)
Date
Date NOV 0 C 2024
Nov 4, 2024
Signature
Re� L Ser%�xce�
Roger Sedlacek (Nov 4, 2024 09:00 MST)
Date
Nov 4, 2024
Signature Date
4
2ozy- 29 kol
EXHIBIT A to the CWS-7A
Additional Provisions for the Agreement to Purchase Foster Care
Services and Foster Care FacilityAgreement CWS-7A
The following additional provisions in this Exhibit A and Addendum 1 apply to the agreement entitled,
"Individual Provider Contract for Purpose of Foster Care Services and Foster Care Facility Agreement," by and
between the Weld County Department of Human Services, hereinafter referred to as, "County," and Allison
Sedlacek and Roger Sedlacek, Provider ID# 1761333, hereinafter referred to as, "Provider."
GENERAL PROVISIONS
1. Each party shall have the right to terminate this Agreement by giving the other party written notice
received at least thirty (30) days prior to the intended date of termination. If notice is so given, this
Agreement shall terminate upon the expiration of thirty (30) days, or until the eligible child(ren) may
be placed elsewhere, whichever occurs first, and the liability of the parties hereunder for further
performance of the terms of this Agreement shall thereupon cease; however, the parties shall not be
released from the duty to perform their obligations up to the date of termination. This provision does
not affect removal of a child in an emergencysituation.
2. Provider agrees that Provider is an independent contractor and that neither Provider nor Provider's
agents or employees are, or shall be deemed to be, agents or employees of the County for any
purpose. Provider shall have no authorization, express or implied, to bind the County to any
agreement, liability, or understanding. The parties agree that Provider will not become an employee of
County. Provider shall be solely and entirely responsible for its acts or of any agent, employee, servants
and sub -Providers during the performance of this Agreement. Provider is not entitled to
unemployment insurance or workers' compensation benefits through Weld County and Weld County
shall not pay for or otherwise provide such coverage for Provider. Unemployment insurance benefits
will not be available to Provider for services provided under this Agreement. Provider shall pay when
due any/all applicable employment taxes and income taxes and local head taxes (if applicable)
incurred as a result of the services provided under this Agreement.
3. Payment pursuant to this Agreement, if in State of Colorado, county, or federal funds, whether in
whole or in part, is subject to and contingent upon the continuing availability of State of Colorado,
county, and federal funds for the purposethereof.
4. This Exhibit A is intended to be applied in conjunction with the attached Agreement as the complete
integration of all understandings between the parties. No prior or contemporaneous addition, deletion
or other amendment hereto shall have any force or affect whatsoever, unless embodied herein in
writing. No subsequent notation, renewal, addition, deletion, or other amendment hereto shall have
any force or effect unless embodied as a part of this written Agreement. This section shall not be
construed as prohibiting the periodic amending of this Agreement in writing, if agreed to by both
parties. The Agreement, this Exhibit A and the rate Addendums are intended to be in lieu of and
supersede all prior agreements between the parties hereto and relating to the care and services herein
described.
5. The State of Colorado Department of Human Services and the County shall be and hereby is permitted
to monitor the service program, fiscal and other records sufficiently to assure the purchase of services
in this Agreement are carried out for the benefit of the aforementioned child or youth. Monitoring
may occur through review of program reports, on -site visits where applicable and other Agreements as
Exhibit A to the CWS-7A 5 Revised 11/2022
deemed necessary. Provider understands that the State Department and the County may provide
consultation to Provider to assure satisfactory performance in the provision of purchased services
under this Agreement.
6. County shall have access to Provider's service program, financial and other records, which will
sufficiently and properly reflect all direct and indirect costs of any nature incurred in the performance
of this Agreement for purposes of audit. Such records shall be complete and available for audit 90 days
after final payment hereunder and shall be retained and available for audit purposes for at least five
years after final paymenthereunder.
7. Time is of the essence in each and all of the provisions of this Agreement.
8. Neither party to this Agreement shall be liable to the other for delays in delivery or failureto deliver or
otherwise to perform any obligation under this Agreement, where such failure is due to any cause
beyond its reasonable control, including but not limited to Acts of God, fires, strikes, war, flood,
earthquakes or Governmental actions.
9. Any notice required to be given under this Agreement shall be in writing and shall be mailed or
delivered to the other party at that party's address as stated in thisAgreement.
10. This Agreement is nonexclusive, and County may engage or use other Providers or personsto perform
services of the same or similar nature.
11. Provider assures and certifies that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or
voluntarily excluded from covered transactions by a federal department or agency.
b. Have not, within a three-year period of preceding this Agreement, been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminaloffense in connection with
obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or
contract under a public transaction; violation of federal or state antitrust statutes or commission
of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by agovernment entity
(federal, state, or local) with commission of any of the offenses enumerated in paragraph (B)
above.
d. Have not within a three-year period preceding this Agreement, had one or more public
transactions (federal, state, and local) terminated for cause ordefault.
12. In addition to terminating this Agreement in accordance with the provisions herein, County may
exercise the following remedial actions if the County finds and determines that the Provider has
substantially failed to satisfy the duties found in this Agreement and Exhibit A Substantial failure to
satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the
Provider. These remedial actions include, but are not limited to, any one or more of the following:
Exhibit A to the CWS-7A
6 Revised 11/2022
a. Withhold payment to Provider until the necessary services or correctionsin performance are
satisfactorily completed.
b. Deny payment or recover reimbursement for those services or deliverables which have not been
performed and which due to circumstances caused by Provider cannot be performed or if
performed would be of no value to County. Denial of the amount of payment shall be reasonably
related to the amount of work or deliverables lost to County.
c. Recover from Provider any incorrect payment to Provider due to omission, error, fraud, and/or
defalcation by deducting from subsequent payments under thisAgreement, or other agreements
between County and Provider, or as a debt to County, or otherwise as provided bylaw.
13. It is expressly understood and agreed that the enforcement of the terms and conditions of this
Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to the
undersigned parties or their assignees, and nothing contained in this Agreement shall give or allow any
claim or right of action whatsoever by any other person not included in this Agreement. It is the express
intention of the undersigned parties that any entity other than the undersigned parties or their
assignees receiving services or benefits under this Agreement shall be an incidental beneficiaryonly.
14. No portion of this Agreement shall be deemed to constitute a waiver of any immunity the parties or
their officers or employees may possess, nor shall any portion of this Agreement be deemedto have
created a duty of care that did not previously exist with respect to any person not a party to this
Agreement. The parties hereto acknowledge and agree that no part of this Agreement is intended to
circumvent or replace such immunities.
15. Provider shall promptly notify County in the event in which it is a party defendant or respondent in a
case, which involves services provided under the agreement. The Provider, within five (5) calendar days
after being served with a summons, complaint, or other pleading which has been filed in any federal or
state court or administrative agency, shall deliver copies of such document(s) to the County Director.
The term "litigation" includes an assignment for the benefit of creditors, and filings in bankruptcy,
reorganizations and/or foreclosure.
16. This Agreement and the provision of services hereunder shall be subject to the laws ofColorado and be
in accordance with the policies, procedures, and practices of County. Provider shall strictly comply with
all applicable federal and State laws, rules and regulations in effect or hereafter established.
17. Financial obligations of the County payable after the current fiscal year are contingent upon funds for
that purpose being appropriated, budgeted and otherwise made available. Execution of this
Agreement by County does not create an obligation on the part of County to expend funds not
otherwise appropriated in each succeedingyear.
18. County agrees to purchase, and Provider agrees to provide the care and services, which are listed in
this Agreement. The State approved rate for Child Maintenance/Respite will be paid for any child
placed with the Provider unless the Medically Fragile Tool has been completed due to intensive
medical/physical needs, or limitations that interfere with daily life functioning. The Medically Fragile
Tool will be completed every six months as long as the child remains in care with the Provider. The
rate will be adjusted if the Medically Fragile Tool indicates a change in the level of care. The Medically
Exhibit A to the CWS-7A
7 Revised 11/2022
Fragile Tool will determine the reimbursement rate as specified in Addendum 1.
19. All bed hold authorizations and payments are subject to a 7 -day maximum for a child'stemporary
absence from a facility; however, if the absence is a result of hospitalization the maximum bed hold
authorization may be up to 14 days. Bed hold requests must have prior written authorization from the
Department Administrator or Designee before payment will be release to Provider.
20. Any additional costs for specialized services, which may include but are not limited to; Co -pays,
deductibles, or services not covered by Medicaid, will need to be authorized, in writing by the
Department Administrator, prior to the service being performed. Any payment for specialized services
not authorized in writing may be denied.
21. All reimbursement requests shall:
a. Be submitted in a format approved by the County. If submitted in an unapproved format or
inadequate documentation is provided, the County reserves the right to deny payment.
b. Be submitted by the 4th of each month following the month of service. If the reimbursement
request is not submitted within twenty-five (25) calendar days ofthe month following service, it
may result in forfeiture ofpayment.
c. Placement service reimbursement shall be paid from the date of placement up to, but not
including the day of discharge.
d. Transportation reimbursement shall be for visitation purposes or transportation to school if out of
county and with prior approval only If medical transportation is needed, Provider will arrange
reimbursement through Medicaid. Any other special requests for transportation reimbursement
shall require prior approval by the Resource Manager or the DepartmentAdministrator.
e. Clothing allowance reimbursement shall be approved and reimbursed as indicated on the clothing
allowance form provided by the Foster Care Coordinator.
22. It is agreed that if, after investigation, it is shown that reasonable care was given to guard and protect
personal items brought to Provider by the children, Provider shall be released from responsibility for
loss or damage to such personal items.
PROVIDER SHALL:
1. Conform with and abide by all rules and regulations of the Colorado Department of Human Services,
the Colorado Department of Health Care Policy and Financing (if appropriate), the State of Colorado
and any applicable federal laws and regulations, as such, which may be amended from time to time,
and shall be binding on Provider and control any disputes in thisAgreement.
2. Not charge any fees to children or families of children referred by County for anyservices provided
under this Agreement.
3. Not assign the obligations under this Agreement nor enter into any sub -Agreement without the
express written approval of the Director of the County Department or his/her appointed designee.
Exhibit A to the CWS-7A
8 Revised 11/2022
4. Maintain at all times during the term of this Agreement a liability insurance policy of at least $25,000
for property damage liability, $150,000 for injury and/or damage to any one person, and $500,000 for
total injuries arising from any one accident. Provider shall provide a certificate of insurance provided
by its insurer upon request by County.
5. Indemnify the County against any and loss against all claims and actions based upon or arising out of
damage or injury, including death, to persons or property caused or sustained in connection with the
performance of this Agreement or by conditions created thereby, or based upon any violations of any
statute, ordinance, or regulation and the defense of any such claims or actions.
6. Attend or participate in Ice Breaker, Family Engagement or Team Decision making meetings,if
requested by the Department. County staff shall notify the Provider of the dates and times attendance
is requested.
7. Request a staffing if considering giving notice to remove a child, except in emergency situations. These
requests shall be made through the child's caseworker and/or the Provider's Foster Care Coordinator.
8. Actively participate in achieving the child's permanency goal, cooperate with any contractors hired by
the Weld County Department of Human Services to preserve placement in the least restrictive
placement appropriate, comply with the treatment plan of the child, and attendcourt hearings as
requested.
9. Have physical examinations completed within 14 days and dental examinations completedwithin 8
weeks of the child being placed with Provider. All documentation of these examinations will be placed
in the foster child's placement binder.
10. Attend all necessary school meetings and support any plan that is developed regarding thechild in
order to promote educational success.
11. Immediately report to the County Department and/or local law enforcement any known or suspected
child abuse or neglect as set forth in Section 19-3-304,C.R.S.
12. Maintain, access and review information monthly on Binti.
13. Maintain/update information in the foster child's binder, either hard copy or in Binti. The binder will be
reviewed on a monthly basis and signed off by child's caseworker and/or the Provider's Foster Care
Coordinator.
14. Maintain/update medication logs on a daily basis, if child is taking medications.
15. Comply with all County and State certification requirements as set forth in the State Department rules,
Staff Manual Volume VII and the Weld County Department of Human Services Policy and Procedure
manual.
Exhibit A to the CWS-7A
9 Revised 11/2022
ADDENDUM 1
Medically Fragile Tool Rates
Child Maintenance
Daily Rate
Medically Fragile
Level 1
$57.73
Level 2
$115.82
Level 3
$174.17
Level 4
Negotiate up to $210
Addendum 1 to Exhibit A CWS-7A 10 Revised 07/2023
N Ct
Entity Information
Entity Name
SEDLACEK, ALLISON
Entity ID*
@00021505
O New Entity?
Contract Name" Contract ID
SEDLACEK, ALLISON AND ROGER (INDIVIDUAL 8838
PROVIDER CONTRACT CWS-7A)
Contract Status
CTB REVIEW
Contract Lead *
SADAMS
Contract Lead Email
sadams@weld.gov;cobbx
xlk@weld.gov
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description
(CONSENT) NOVEMBER RECERT - SEDLACEK, ALLISON AND ROGER (INDIVIDUAL PROVIDER CONTRACT CWS-7A)
TERM: 11/17/2024 - 11/16/25
Contract Description 2
PROVIDER IS ON CONSENT LIST APPROVED BY THE BOCC ON 6/5/2024 AND KNOWN TO THE BOARD AS TYLER
ID# 2024-1386
Contract Type *
CONTRACT
Amount*
$0.00
Renewable *
NO
Automatic Renewal
Grant
IGA
Department Requested BOCC Agenda Due Date
HUMAN SERVICES Date* 11/09/2024
11/13/2024
Department Email
CM-
HumanServices@weld.gov
Department Head Email
CM-HumanServices-
DeptHead@weld.gov
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WEL
D.GOV
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date Review Date * Renewal Date
09/16/2025
Termination Notice Period Committed Delivery Date
Contact Information
Contact Info
Expiration Date*
11/16/2025
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver
CONSENT
Approval Process
Department Head
JAMIE ULRICH
DH Approved Date
11/04/2024
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
11/06/2024
Finance Approver
CONSENT
Purchasing Approved Date
11/04/2024
Legal Counsel
CONSENT
Finance Approved Date Legal Counsel Approved Date
11/04/2024 11/04/2024
Tyler Ref #
AG 110624
Originator
SADAMS
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