HomeMy WebLinkAbout20241036.tiffMariah Higgins
From:
Sent:
To:
Cc:
Subject:
Attachments:
Follow Up Flag:
Flag Status:
Bill Fritz
Friday, June 6, 2025 9:49 AM
CTB
Cathy Hoover
Option Letter for Communication
A 35 OL#3.pdf
Follow up
Flagged
Please include the attached Option Letter#3 for Tobacco A-35 Grant in communication to the board. Thanks Bill
cowry,
Bill Fritz
Finance Manager
Department of Public Health and Environment
Desk: 970-400-2122
1555 North 17th Ave., Greeley, CO 80631
011000
Join Our Team
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CoMMvA;Co.-t-;onS cc:l-SL,ACT(cp/Rw/co)
o6/t1/25 06 /09 /25
20..2m-1036
HL-oo57
Docusige Envelope ID: 76367106-0AB3-42DF-8098-C4B6C6686941
STATE OF COLORADO
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
OPTION LETTER #3
State Agency:
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80246
Original Contract Number:
2024*0171
Contractor:
Option Letter Contract Number:
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
1150 "O" Street
Greeley CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley CO 80631
2024*0171 Option Letter #3
Contract Performance Beginning Date:
Current Contract Expiration Date:
July 1, 2023
June 30, 2026
CONTRACT MAXIMUM AMOUNT TABLE
Document
Type
Contract Number
Federal Funding
Amount
State Funding
Amount
Other Funding
Amount
Term (dates)
Total
Original
Contract
2024*0171
$0.00
$330,134.00
$0.00
07/01/2023-
06/30/2024
$330,134.00
Option Letter
#1
2024*0171
Option Letter #1
$0.00
$330,134.00
$0.00
07/01/2024-
06/30/2025
$330,134.00
Option Letter
#2
2024*0171
Option Letter #2
$0.00
$81,740.00
$0.00
01/01/2025-
06/30/2025
$81,740.00
Option Letter
#3
2024*0171
$0.00
$412,668.00
$0.00
07/01/2025-
$412,668.00
Current Contract Maximum
Cumulative Amount
$1,154,676.00
1.
OPTIONS:
A. Option to extend for an Extension Term
B. Option to change the quantity of Services under the Contract
2. REQUIRED PROVISIONS:
A. In accordance with Section 2C of the Original Main Task Order Contract referenced above, the
State hereby exercises its option for an additional term, beginning July 1, 2025 and ending on the
current contract expiration date shown above, at the rates stated in the Original Task Order Contract,
as amended for the following reason: to extend the contract into Fiscal Year 2026.
B. In accordance with Section 5Bv of the Original Main Task Order Contract referenced above, the State
hereby exercises its option to increase the quantity of the services at the rates stated in the Original
Option Letter Contract Number: 2024*0171 Option Letter #3 Page 1 of 3 Version OSCA12.24/CDPHE A1.25
Docusign Envelope ID: 78367106-0AB3-42DF-8098-C4B6C6686941
Task Order Contract, as amended. Exhibit C - Budget is deleted and replaced in its entirety with
Exhibit C - Budget attached to this Option Letter, for the following reason: to add funds supporting
the renewal term Statement of Work activities and deliverables.
C. The Contract Maximum Amount table on the Contract's Cover Page is hereby deleted and replaced
with the Current Contract Maximum Amount table shown above.
3. OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or July 1, 2025,
whichever is later.
Option Letter Contract Number: 2024*0171 Option Letter #3 Page 2 of 3 Version OSCA12.24/CDPHE A1.25
Docusign Envelope ID: 76367106-0AB3-42DF-8098-C4B6C6686941
STATE OF COLORADO
Jared S. Potts, Governor
Colorado Department of Public Health and Environment
Jill Hunsaker Ryan, MPH, Executive Director
DocuSigned by:
aliuffsto,
In accordance with §24-30-202 C.R.S., this Option is not
valid until signed and dated below by the State Controller or
an authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
DocuSlgned by:
FIC.4 Wt...
73366F4A4A064BC...
2C13012416624B1...
By: Signature
Chelsea Gilbertson
By: Signature
Kurt Williams
Name of Executive Director Delegate
Procurement & Contracts Section
Name of State Controller Delegate
Controller
Title of Executive Director Delegate
2025-03-25
Date:
Title of State Controller Delegate
2025-06-06
Option Effective Date:
Option Letter Contract Number: 2024.0171 Option Letter #3 Page 3 of 3 Version OSCA12.24/CDPHE A1.25
Docusign Envelope ID: 78367106-0AB3-42DF-8098-C4B6C6686941
EXHIBIT C BUDGET
COLORADO
Department of Public
Health £t Environment
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing #2024*0171
Contractor Name
Weld County Department of Public Health and
Environment
Program Contact Name, Title,
Phone and Email
Cathy Hoover, Program
Manager, 970-300-2371,
choover@weld.gov
Budget Period
7/1/2025-6/30/2026
Fiscal Contact Name, Title,
Phone and Email
Bill Fritz, Finance Manager, 970 -
400-2122, bfritz@weld.gov
Project Name
Community Tobacco Initiatives
Contract (CT or PO) Number
CT FHLA 2024*0171
Expenditure Categories
Personal Services
Position Title
Description of Work
Gross er
Annual Salary
Fringe
Percent of
Time on
Project
Total Amount
Requested from
CDPHE
Health Education Specialist I
This position is responsible for coordinating
activities related to the Weld Tobacco Education
and Prevention Program (WCTEPP)
implementation plan and contract including
working with municipal governments, schools,
youth, and collaboration with community based
organizations. (0.99 FTE)
73,959.00
28,052.50
99.00%
100,991.39
Health Education Specialist I
This position is responsible for coordinating
activities related to the WCTEPP implementation
plan and contract including working with
municipal governments, schools, youth, and
collaboration with community based
organizations. (0.99 FTE)
70,056.00
26,530.21
99.00%
95,620.35
Public Health Education Manager
This position is responsible for supporting and
overseeing WCTEPP activities related to the
tobacco implementation plan and contract,
supervising personnel on the project, managing
budget development and project expenditures,
and reviewing contract deliverables. (0.47 FTE)
109,775.00
41,571.79
47.00%
71,132.99
Data and Evaluation Specialist
This position gathers and provides relevant data
such as the Community Health Assessment (CHA)
and Colorado Quitline data and provides support
and assistance to WCTEPP staff on work plan
activities and evaluation coordination as needed
including the Community Profile and grant
applications. (0.10 FTE)
97,735.00
37,012.24
10.00%
13,474.72
Personal Services
Position Title
Description of Work
Hourly Wage
Hourly Fringe
Total # of
Hours on
Project
Total Amount
Requested from
CDPHE
Option Letter Contract Number: 2024`0171 Option Letter #3
Page 1 of 3
Docusign Envelope ID: 7B367106-0AB3-42DF-8098-C4B6C6686941
EXHIBIT C BUDGET
Community Health Worker
We utilize our internal Community Health
Workers to provide quitline materials, Baby and
Me Tobacco Free materials, and other resources
at events and during screenings they conduct
each month. They assist on translating and
providing cultural competency on materials we
develop.
25.75
0.39
350.00
9,147.69
Total Personal Services (including fringe benefits)
290,367.14
Supplies & Operating Expenses
Item
Description of Item
Rate
Quantity
Total Amount
Requested from
CDPHE
Printing/copies
Printing and photocopying materials utilized for presentations,
77.92
12.00
935.00
General Office Supplies
General office supplies purchased will be those most commonly
74.04
12.00
888.42
Promotional Materials (participant
support costs excluded from indirect)
Purchase new and replacement promotional items for table
events to improve engagement. Items will be available at public
outreach events to educate individuals on tobacco price, smoke -
2,387.00
1.00
2,387.00
Professional Development- Internal
Registration for WCTEPP staff to attend a professional
1,500.00
3.00
4,500.00
Professional Development- External
(participant support costs excluded
from indirect)
To increase community capacity, WCTEPP will sponsor training
within schools and healthcare providers to provide cessation
service within their networks. (10 school staff to NOT on
10,400.00
1.00
10,400.00
Incentives for Training (participant
support costs excluded from indirect)
WCTEPP will provide community partners attending training
$200 gift cards. (170200=$3,400)
17.00
200.00
3,400.00
Food for Program Participants
(participant support costs excluded
from indirect)
To encourage participation and reduce barriers to attendance:
snacks for participants of youth and adult cessation cohorts (5
cohorts/year x 10 weeks x 5 participants x $2.00/person =
1,100.00
1.00
1,100.00
Software
With assistance from our Data and Evaluation Specialist, the
237.50
12.00
2,850.00
Total Supplies & Operating
26,460.42
Travel
Item
Description of Item
Rate
Quantity
Total Amount
Requested from
CDPHE
Mileage
Project -related mileage for WCTEPP staff for travel to attend
0.70
6,500.00
4,550.00
Hotel
3 nights hotel for 3 people for grantee meeting, location TBD.
200.00
9.00
1,800.00
Per Diem
Per diem for 3 people for grantee meeting, location TBD.
90.00
9.00
810.00
Total Travel
7,160.00
Contractual
Subcontractor Name
Description of Item
Rate
Quantity
Total Amount
Requested from
CDPHE
Mini Grants for Schools
Funding to be awarded to 4 schools in Weld County in the form
4,000.00
4.00
16,000.00
Tobacco Free Schools Designation
Program
Awarding schools for their participation in our TFS Designation
Program. Each tier requires a different level of tobacco
7,500.00
1.00
7,500.00
Option Letter Contract Number: 202,0171 Option Letter #3
Page 2 of 3
Docusign Envelope ID: 76367106-0AB3-42DF-8098-C4B6C6686941
EXHIBIT C BUDGET
Total Contractual
23,500.00
SUB -TOTAL OF DIRECT COSTS
347,487.56
Less: Expenses per OMB 2 CFR 200
Subcontractor in excess of $50,000
$-
Rent
$-
Equipment in excess of $10,000
$-
Other Unallowable expenses
17,287.00
Total Expenses per OMB 2 CFR 200
$17,287.00
Modified Total Direct Costs (MTDC)
$330,200.56
Indirect
Item
Description of Item
Percentage
Total Amount
Requested from
CDPHE
CDPHE-Negotiated Indirect Cost Rate
CDPHE FY25 negotiated indirect rate of 19.74% for Modified total direct costs,
19.74%
65,180.44
Total Indirect
65,180.44
TOTAL
412,668.00
Option Letter Contract Number: 2024*0171 Option Letter #3 Page 3 of 3
Mariah Higgins
From:
Sent:
To:
Subject:
Attachments:
Follow Up Flag:
Flag Status:
Bill Fritz
Tuesday, December 31, 2024 11:33 AM
CTB
Option Letter for Communication
TOB a35 Option Letter.pdf
Follow up
Flagged
Good morning, attached is an option letter for our tobacco cessation grant for teens. A bump f $81K for the program.
Please add it to communication to the BOCC. Thanks Bill
Bill Fritz
Finance Manager
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley, CO 80631
Direct Phone: 970.400.2122
VISION: Everyone in Weld County has the opportunity to live their healthiest lives.
MISSION: We serve Weld County by cultivating partnerships to promote public health and environmental quality
through the delivery of relevant, innovative, and cost-effective services.
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain
information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and
destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the
named recipient is strictly prohibited.
COMNloeV. GO r 01'15 CC:F4L,Jt1cT(CP/CD)
of/occ/2S ol/06/25
2024-1036
1-ILoo57
Docusign Envelope ID: 84B7881A-D2A3-4166-8FE4-560C13FF9A06
STATE OF COLORADO
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
OPTION LETTER #2
State Agency:
Original Contract Number:
Colorado Department Of Public Health and Environment
2024*0171
4300 Cherry Creek Dr S
Denver, CO 80246
Option Letter Contract Number:
Contractor:
2024*0171 Option Letter #2
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
1150 "O" Street
Greeley CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley CO 80631
Contract Performance Beginning Date:
Current Contract Expiration Date:
July 1, 2023
June 30, 2025
CONTRACT MAXIMUM AMOUNT TABLE
Document
Type
Contract
Number
Federal
Funding
Amount
State Funding
Amount
Other Funding
Amount
Term (dates)
Total
Original
2024*0171
$0.00
$330,134.00
$0.00
07/01/2023-
$330,134.00
Contract
06/30/2024
Option Letter
2024*0171
$0.00
$330,134.00
$0.00
07/01/2024-
$330,134.00
#1
Option
06/30/2025
Letter #1
Option Letter
2024*0171
$0.00
$81,740.00
$0.00
01/01/2025-
$81,740.00
#2
Option
06/30/2025
Letter #2
Current Contract Maximum
$742,008.00
Cumulative Amount
1) OPTIONS
A. Option to change the quantity of services under the Contract.
2) REQUIRED PROVISIONS:
A. In accordance with Section 5Bv of the Original Main Task Order Contract referenced above,
the State hereby exercises its option to increase the quantity of the services at the rates stated
in the Original Task Order Contract, as amended. Exhibit C - Budget is deleted and replaced in
its entirety with Exhibit C - Budget attached to this Option Letter, for the following reason: to
add funds for the current term.
B. The Contract Maximum Amount table on the Contract's Cover Page is hereby deleted and
replaced with the Current Contract Maximum Amount table shown above.
Option Letter Contract Number: 2024*0171 Option Letter #2 Page 1 of 3 Ver.A 27.01.20
Docusign Envelope ID: 84B7881A-D2A3-4166-8FE4-560C13FF9A06
3) OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or January 1,
2025, whichever is later.
Option Letter Contract Number: 2024*0171 Option Letter #2 Page 2 of 3 Ver.A 27.01.20
Docusign Envelope ID: 84B7881A-D2A3-4166-8FE4-560C13FF9A06
SIGNATURE PAGE
STATE OF COLORADO
Jared S. Polls, Governor
Colorado Department of Public Health and Environment
Jill Hunsaker Ryan, MPH, Executive Director
e--DoeuSigned by: ' ', -
aul,st c ALU't CIA.
-2C 1381241652481._
In accordance with §24-30-202 C.R.S., this Option is not
valid until signed and dated below by the State Controller or
� an authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
r-DocuSigned by:
4.4 W+L& o
,-73365G4A4A081BC_.
By: Signature
Chelsea Gilbertson
By: Signature
Kurt Williams
Name of Executive Director Delegate
Procurement & Contracts Section
Name of State Controller Delegate
Controller
Title of Executive Director Delegate
2024-11-18
Date:
Title of State Controller Delegate
2024-12-31
Option Effective Date:
-- Signature Page End --
Option Letter Contract Number: 2024*0171 Option Letter #2 Page 3 of 3 Ver.A 27.01.20
Docusign Envelope ID 8467881A-D2A3-4166-8FE4-560C13FF9A06
EXHIBIT C BUDGET
COLORADO
Department of Public
Health & Environment
PREVENTION SERVICES DIVISION- BUDGET JUSTIFICATION FORM
Original Contract Routing #2024*0171
Contractor Name
WELD COUNTY
Budget Period
07/01,12024 - 06/30/2025
Project Name
Commurity Tobacco Initiatives
Version 6.2024
Program Contact Name, Title, Phone and
Email
Cathy Hoover
Program Manager
970-400-2371
choover@weld.gov
Fiscal Contact Name, Title, Phone and Email
Bill Fritz
Director Administration & Finance
970-400-2122
bfritz@weld.gov
Contract/Encumbrance Number
CT FHLA 2024*0171
Expenditure
Categories
Budget
Totals
Personal
Salaried
Services
Employees
Original
Budget
Modification to
Budget in
Amendment/
Total Amount
Requested
Option Letter
from CDPHE
Position Title
Description of Work and Justification for Revision
This position is responsible for coordinating activities related to the Weld Tobacco Education
and Prevention Program
(WCTEPP)
implementation plan and contract including working with
municipal governments, schools, youth, and collaboration with community based
organizations. (0.99 FTE)
Health Education Specialist I
$94,317.57
$10,610.76
$104,928.33
Justification for Revision: Including 9 months at higher pay grade (94317.57/12=$7859.80.
1179+7859.80=9033.77. (9038.77x9)+(7859.80x3)=
$104,928.33. $104,928.33-
94,317.57=$10,610.76
This position is responsible for coordinating
activities related to the WCTEPP implementation
plan and contract including working with municipal governments, schools, youth, and
Health Education Specialist I
collaboration with community based organizations. (0.99 FTE)
$97,147.11
($8,095.58)
$89,051.53
Justification for Revision: Was without a staff member for over a month.
This position is responsible for supporting
and overseeing WCTEPP activities related to the
tobacco implementation plan and contract, supervising personnel on the project, managing
Health Communication
Supervisor
budget development and project expenditures, and reviewing contract deliverables. (0.5
FTE)
$75,021.16
($3,700.00)
$71,321.16
Justification for Revision: Adjusting down to match the new Supervisor salary.
This position will provide overall program administration, budget management, and staff
supervision. (0.01
FTE)
Division Director
$2,007.38
($2,007.38)
$0.00
Justification for Revision: Division Director does not charge his hours to grant time
This position gathers and provides relevant
data such as the Community Health Assessment
(CHA) and Colorado Quitline data and
provides support and assistance to WCTEPP staff on
work plan activities and evaluation coordination as needed including the Community Profile
and grant applications.
(0.01 FTE)
Data and Evaluation Specialist
$1,172.13
$8,204.91
$9,377.04
Justification for Revision: This position provides a bit more data support when reporting,
planning, or developing materials than
the .01 FTW allowed, .08 is more accurate of their
time spent assisting on STEPP items.
2024 Fringe benefits are 44.34%. Included components are: Medicare, unemployment,
worker's compensation, PERA, life insurance, health insurance, vacation, holidays, and sick
Fringe
leave.
$0.00
$0.00
$0.00
Justification for Revision: No change requested
Option Letter Contract Number 2024'0171 Option Letter #2
Page 1 of 4
Docusign Envelope ID: 84B7881A-D2A3-4166-8FE4-560C13FF9A06
EXHIBIT C BUDGET
Bilingual Health Specialist
Justification for
quitline materials,
during screening
hrs/month, for
Revision: We utilize our internal Community Health Workers to
Baby and Me Tobacco Free materials, and other resources at
the conduct each month. They assist on translating materials ($25/hr
9 months)
provide
events and
for 40
$0.00
$9,000.00
$9,000.00
Personal
Hourly
Employees
Services
Original
Budget
Modification to
Budget in
Amendment/
Option Letter
Total Amount
Requested
from CDPHE
Position Title
Description of Work and Justification for Revision
Line not open
$0.00
Total Personal Services
(including fringe benefits)
$269,665.35
$14,012.71
$283,678.06
Supplies
& Operating
Expenses
Original
Budget
Modification to
Budget in
Amendment/
Option Letter
Total Amount
Requested
from CDPHE
Item
Description of Item and Justification for Revision
Printing/Copies
Printing and photocopying
based on historical usage: black
1250 = $75. ($165 + $75 = $250);
$20/month)
Justification for Revision: Adding
completed. Will be for classes
the gap in printing services
distribute to parents at resource
1000x.3= $300, brochures 1700x.35=$593,
$280+300+595+560=$1733).
materials
conducted
provided
Adding
utilized for presentations, trainings, and outreach. Costs
and white $0.02/copy x 8,250 = $165; color $0.06/copy x
may also include allocated costs for printing. (Average
printing costs for new cessation course materials once T4Tc
Q3 and Q4. Also adding additional funds to cover
by CDPHE. Adding printing costs for materials to
fairs and as requested. (rack cards 2000x.14=$280, flyers
training packets 80x7.00=$560
an additional buffer of $302 for an unexpected costs.
$240.00
$2,000.00
$2,240.00
General Office Supplies
General office supplies
general offices supply
and are dependent cn
pack) @ $11.79/pack;
pack) @ $7.89/pack (3
= $38.94); paper clips
pack) @ $2.30/pack=$2.30.
expense = $138.60 for
Justification for Revision:
equipment for new staff
(1,000
purchased will be those most
needs vary throughout the
market prices and availability.
sticky notes (24 pack) @ $18.34/pack(
x $7.89 = $23.67); legal notepads
piece pack) @ $6.70/pack=$6.70;
May also include allocated
12 months; avg. $11.55/month)
Staff members need webcams
member (keyboard and
commonly
year; purchases
Items
(12
office
for
mouse).
utilized by staff.
will vary based
may include: highlighters
3 x $18.34 = 55.02);
pack) @ $12.98/pack(
and staples (10,000
supply costs.Total
virtual meetings, and
However,
upon
estimated
new
needs
(24
pens (60
3 x $12.98
piece
desk
$138.60
$200.00
$338.60
Phone
Monthly cell phone usage
billed at 50% based on
Justification for Revision:
($60.00/month charge)
in tobacco prevention
Manager no longer uses
for Health
work. (12
a county
Communication Supervisor
x $30.00 = $360.00)
phone
$360.00
($360.00)
$0.00
FTE
Promotional Materials
(Participant support cost
excluded from indirect)
WCTEPP branded
("quit kits") either
utilization of cessation
to educate individuals
and/or for tobacco
stickers*, travel
and sunflower seeds.
market prices, availability,
$.65/sticker=$130;
$175, 150 grocery
small playdough
$92/month for
justification for
for 6 baskets comprised
for Visa gift cards
Gift cards for healthcare
(12x200=$2400)
promotional
with
-free
size
180
totes
@$.50/container
12 months)
Revision:
to
materials may be
community medical providers
resources and services such
on tobacco price, smoke -free
schools education. Specific
nand sanitizers*, pens*, grocery
Price of specific promotional
and intended event or
hand sanitizer bottles @ $1.80/bottle=$324,
@$1.30/tote = $195, 150
=$80, 200 bags
Provider incentive baskets
of coffee beans, mug, notebook,
arovide to NOT and Demension
providers for participation
used as a community
in relationship
as the Quitline;
policy expansion,
items may
totes*,
items and
audience. (200
chapstick
of sunflower
were not
pens
trainees
in key informant
chapstick*,
@.80/chapstick
(15x200=$3000).
engagement tools
building to promote
at public outreach events
cessation resources;
include but are not limited to
small play dough,
amounts may vary based on
stickers @
500 pens @ $.35/pen =
= $120, 160
seeds at $.40/bag =$80 (avg
budgeted previously. Planning
etc. (6X100). Adding funding
Adding Visa
interviews
$1,104.00
$6,000.00
$7,104.00
Option Letter Contract Number. 20240171 Option Letter #2
Page 2 of 4
Docusign Envelope ID: 84B7881 A-D2A3-4166-8FE4-560C13FF9A06
EXHIBIT C BUDGET
Professional development
Registration
training such
enhance cessation
training is
$1,200.00)
Justification
(10x400=$4000)
sending both
Added second
Weld Staff
development
enrolling. (Choices
offered
*Registration
($1,200).
for
as
for
Weld
RMTTST
training
at least
the Rocky
education
virtually
Revision:
, and
Specialists
one Health Education Specialist
Mountain Tobacco Training Specialist
and prevention services WCTEPP
so no meals or lodging is required.
price based on advertised 2024
Budgeting to send 10 school staff
5 community members to Demensions
to Demensions (2x800=$1600)
trainee but may repurpose for a
Reserving funding for Weld Specialists
of their choice, will receive prior approval
to grant writing, grant management,
to attend
(1
a
Training
is already
person
T4T (5x800=$4000).
and
attend
from
or
professional development
to support and
providing. This
x $1,200.00*=
to NOT on Tobacco T41
Will be
NOT (2x400=$800) T4Ts.
authority, rather than
a professional
Project Officer before
project management)
$1,200.00
$13,600.00
$14,800.00
rates.
members
prescribing
to
similar
Food for program participants
(Participant support cost
excluded from indirect)
To encourage
youth and adult
= $500.00), and
justice trainings
600.00 = $1,100.00)
Justification
session (14x15=$210).
professionals
(15x15=$225)
participation
for
as
cessation
lunch
(2 trainings/year
Revision:
relationships
and reduce barriers to attendance: snacks for participants
cohorts (5 cohorts/year x 10 weeks x 5 participants
and snacks for attendees of day -long trusted adult and
x20 participants x $15.00/person = $600.00)
Adding food costs for one healthcare key informant
Adding funds to purchase coffee for meetings with healthcare
are established and lines of communication are
of
x $2.00/person
restorative
($500.00 +
data gathering
opened
$1,100.00
$435.00
$1,535.00
Software
Justification for Revision: With assistance from our Data and Evaluation Specialist, the
program uses Survey Monkey and Tableau for data -driven decision making, surveillance, and
data dissemination with county partners. These subscriptions are shared with the division so
only allocating 20% of subscription fee (Tableau 4,000x.2=$800) (Survey monkey
10,250x.2=$2,050)
$0.00
$2,850.00
$2,850.00
Total Supplies
& Operating Expenses
$4,142.60
$24,725.00
$28,867.60
Travel
Original
Budget
Modification to
Budget in
Amendment/
Option Letter
Total Amount
Requested
from CDPHE
Item
Description of Item and Justification for Revision
Mileage
Project -related
presentations with
based on historical
Justification for
healthcare outreach.
mileage for WCTEPP
schools and
need and
Revision: Added
community
staff for travel to attend meetings, trainings, and
partners within Weld County. Cost estimates are
County reimbursement rate of $0.65.
mileage for new cessation class offerings and increased
$1,060.15
$500.00
$1,560.15
2024
Total Travel
$1,060.15
$500.00
$1,560.15
Contractual
(payments to
third
parties
or entities)
Original
Budget
Modification to
Budget in
Amendment/
Option Letter
Total Amount
Requested
from CDPHE
Subcontractor Entity Name
Description of Item and Justification for Revision
TBD- School mini -grants
Funding to be awarded
each to support
developed by the
schools checklist,
final stakeholder
meet monthly with
Funding will assist
much of the program
Justification for Revision:
Paso County recommendations,
to 3
their individual
schools in Weld County in the form of mini -grants
program implementation in accordance with the
Program activities will include completion of a tobacco
implementation of tobacco prevention activities,
Each school will be required to sign an MOU with
staff, and submit bi-monthly progress reports to
and retention of youth in each school group
implementation costs. ($1,000.00 x 3 = $3000.00)
the mini grant budget to $4k/per school to
and expanding to reach 6 schools (6x4000=$24000)
up to $1000.00
guidelines
free
and a
$3,000.00
$24,000.00
$27,000.00
WCTEPP.
training
presentation.
WCTEPP
with
for/and
WCTEPP,
WCTEPP.
and pay for
align with El
recruitment
and activity
Bumping
Option Letter Contract Number 2024"0171 Option Letter #2
Page 3 of 4
Docusign Envelope ID: 8467881A-D2A3-4166-8FE4-560O13FF9A06
EXHIBIT C BUDGET
I
Tobacco Free Schools
Designation Program
Justification for Revision: Awarding schools for their participation in our TFS Designation
Program. Each tier requires a different level of tobacco education and policy to be
implemented within the schools. Estimating 8x $500 bronze, 2x $750 silver, and lx $1000
gold. Payments will ae made directly to the school and coded internally as "grants and
donations".
$0.00
$6,500.00
$6,500.00
Total
Contractual
$3,000.00
$30,500.00
$33,500.00
SUB -TOTAL BEFORE INDIRECT $277,868.10
$69,737.71
$347,605.81
Indirect
Original
Budget
Modification to
Budget in
Amendment/
Option Letter
Total Amount
Requested
from CDPHE
Item
Description of Item
CDPHE Negotiated Indirect Cost
Rate
CDPHE FY24 negotiated indirect rate of 18.96% for Modified total direct costs,
all salaries and wages, fringe benefits, materials and supplies, services, travel,
and subcontracts up to the first $25,000 of each subgrant or subcontract
period covered by the subgrant or subcontract). Equipment, capital expenditures,
for patient care, tuition remission, rental costs, scholarships, and fellowships,
support costs and the portion of each subgrant and subcontract in excess
excluded from modified total direct costs.
Justification for Revision: Adding additional indirect rates due to increase in
consisting of
and subgrants
(regardless of the
charges
participant
of $25,000 shall be
direct costs.
$52,265.90
$12,002.29
$64,268.19
Total
Indirect
$52,265.90
$12,002.29
$64,268.19
TOTAL
$330,134.00
$81,740.00
$411,874.00
Option Letter Contract Number: 2024*0171 Option Letter #2 Page 4 of 4
DocuSign Envelope ID: 935E1F2A-EC00-483C-A3ED-D146827E14CB
OPTION LETTER #1
State Agency:
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, Colorado 80246
Original Contract Number:
2024*0171
Option Letter Contract Number:
2024*0171 Option Letter #1
Contractor:
Board of County Commissioners of Weld County
(a political subdivision of the state of Colorado)
1150 "O" Street
Greeley CO 80631
for the use and benefit of the
Weld County Department of Public Health and Environment
1555 North 17th Avenue
Greeley CO 80631
Contract Performance Beginning Date:
July 1, 2023
Current Contract Expiration Date:
June 30, 2025
CONTRACT MAXIMUM AMOUNT TABLE
Document
Type
Contract
Number
Federal Funding
Amount
State Funding
Amount
Other Funding
Amount
Term (dates)
Total
Original
Contract
2024*0171
$0.00
$330,134.00
$0.00
07/01/2023-
06/30/2024
$330,134.00
Option Letter
#1
2024*0171
Option
Letter #1
$0.00
$330,134.00
$0.00
07/01/2024-
06/30/2025
$330,134.00
Current Contract Maximum
Cumulative Amount
$660,268.00
1) OPTIONS
A. Option to extend for an Extension Term.
B. Option to change quantity of services under the Contract.
2) REQUIRED PROVISIONS:
A. In accordance with Section 2C of the Original Main Task Order Contract referenced above,
the State hereby exercises its option for an additional term, beginning July 1, 2024 and ending
on the current contract expiration date shown above, at the rates stated in the Original Task
Order Contract, as amended for the following reason: To extend the contract into Fiscal
Year 2025.
B. In accordance with Section 5Bv of the Original Main Task Order Contract referenced above,
the State hereby exercises its option to Increase the quantity of the Services at the rates stated
in the Original Task Order Contract, as amended. Exhibit C, Budget is deleted and replaced in
its entirety with Exhibit C, Budget attached to this Option Letter, for the following reason: To
add funds supporting the renewal term Statement of Work activities and deliverables.
2) OPTION EFFECTIVE DATE:
A. The effective date of this Option Letter is upon approval of the State Controller or July 1,
2024, whichever is later.
Page 1 of 2
Option Letter Contract Number: 2024*0171 Option Letter #1
CoKMv( co.+; an 5 Cc : HL, ftCI (c'ICD)
O5 /01/29
0'4 1214
Ver. 27.01.20
2024-1036
HLOO57
DocuSign Envelope ID: 935E1 F2A-EC00-483C-A3ED-D146827E14CB
Exhibit C Budget
COLORADO
--- Department of Public
TM Health & Environment
Version 6.2023
PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH JUSTIFICATION FORM
Original Contract Routing # 2024*0171
CDPHE
Contractor
Name
WELD
COUNTY
Program
Title,
Phone
Contact
and
Name,
Email
Melanie Cyphers
Substance Abuse Prevention Manager
970-400-2423
mcyphers@weldgov.com
Budget
Period
07/01/2024
- 06/30/2025
Fiscal
Phone
Contact
and
Name,
Title,
Bill Fritz
Director Administration & Finance
970-400-2122
bfritz@weld.gov
Email
Project
Name
Community
Tobacco
Initiatives
Contract
Number
(CT
or PO)
2024*0171
CT FHLA
Expenditure Categories
Personal
Salaried
Services
Employees
Position Title
Description of
Work
Gross
Annual
or
Salary
Fringe
Percent
on
of
Total
Requested
CDPHE
Amount
Time
Project
from
I
Health
Education
Specialist
implementation
This
activities
and
working
youth,
organizations.
position
related
Prevention
with
and
is
collaboration
responsible
municipal
(0.99
to
Program
plan
the
and
FTE)
Weld
governments,
(WCTEPP)
contract
with
for
Tobacco
coordinating
including
Education
schools,
based
$ 66,004.07
$ 29,266.20
99.00%
$ 94,317.57
community
Health
Education
Specialist
This
activities
plan
governments,
with
position
and
community
related
contract
is responsible
schools,
to
based
the
including
youth,
organizations.
WCTEPP
for
working
and
coordinating
implementation
collaboration
with
(0.99
municipal
$ 67,984.20
$ 30,144.19
99.00%
$ 97,147.11
FTE)
Health
Supervisor
Communication
tobacco
supervising
This
overseeing
budget
and
reviewing
position
development
implementation
WCTEPP
personnel
is
contract
responsible
activities
on
and
deliverables.
plan
the
project
for
related
and
project,
supporting
contract,
expenditures,
to
managing
(0.5
the
and
$ 103,950.61
$ 46,091.70
50.00%
$ 75,021.16
FTE)
Division
Director
supervision.
This
administration,
position will
(0.01
budget
provide
overall
management,
program
and
staff
$ 139,073.05
$ 61,664.99
1.00%
$ 2,007.38
FTE)
Option Letter Contract Number: 2024*0171 Option Letter #1 Page 1 of 4
DocuSign Envelope ID: 935E1 F2A-EC00-483C-A3ED-D146827E14CB
Exhibit C Budget
Data and
Specialist
Evaluation
This
such
and
and
activities
including
applications.
position
Colorado
assistance
as
the
and
the
Community
gathers
Quitline
to
evaluation
Community
(0.01
WCTEPP
FTE)
and
data
Health
provides
staff
coordination
Profile
and
Assessment
relevant
provides
on work
and
grant
as
support
plan
needed
(CHA)
data
$ 81,206.04
$ 36,006.76
1.00%
$ 1,172.13
Fringe
2024
components
worker's
health
Fringe
compensation,
insurance,
benefits
are:
Medicare,
vacation,
are
44.34%.
PERA,
unemployment,
holidays,
life
Included
insurance,
and
sick
leave.
Personal
Hourly
Employees
Services
Position Title
Description of
Work
Hourly
Wage
Hourly
Fringe
Total
Hours
Project
# of
on
Requested
Total
CDPHE
Amount
from
Line not open
$ -
Total
Personal
Services (including
fringe
benefits)
$ 269,665.35
Supplies
& Operating
Expenses
Item
Description
of
Item
Rate
Quantity
Total
Requested
CDPHE
Amount
from
Printing/Copies
Printing
trainings,
white
($165
(Average
and
and
$0.02/copy
+ $75
$20/month)
=
photocopying
outreach.
x
$250);
8,250
may
Costs
=
also
materials
$165;
based
include
color
utilized
on
allocated
$0.06/
historical
for
copy
costs
presentations,
usage:
x
1250
for
black
printing.
= $75.
and
$ 20.00
12.00
$ 240.00
General
Office
Supplies
General
utilized
throughout
are
include:
pack)
$7.89/pack
$12.98/pack(
@
$2.30/pack=$2.30.
Total
$11.55/month)
dependent
$6.70/pack=$6.70;
estimated
@
by
office
highlighters
$18.34/pack(
staff.
the
(3
3
supplies
year;
on
x $7.89
x
expense
However,
$12.98
market
May
purchases
(24
=
and
3
purchased
pack)
x
$23.67);
=
also
=
general
prices
$18.34
$38.94);
staples
$138.60
include
@
will
and
legal
$11.79/pack;
=
(10,000
will
offices
55.02);
paper
for
vary
availabil
allocated
notepads
be
12
those
supply
based
clips
pens
piece
months;
ty.
(1,000
office
upon
sticky
(60
(12
pack)
most
needs
Items
avg.
pack)
pack)
supply
commonly
needs
notes
piece
@
vary
may
@
@
and
(24
pack)
costs.
$ 11.55
12.00
$ 138.60
Phone
Monthly
Communication
prevention
cell
work.
phone
Supervisor
(12
usage ($60.00/month
x $30.00
billed
=
at 50%
$360.00)
charge)
based
for
on FTE
Health
in
tobacco
$ 30.00
12.00
$ 360.00
Option Letter Contract Number: 2024*0171 Option Letter #1 Page 2 of 4
DocuSign Envelope ID: 935E1 F2A-EC00-483C-A3ED-D 146827E 14CB
Exhibit C Budget
Promotional
(Participant
excluded
from
Materials
support
cost
WCTEPP
community
medical
cessation
outreach
free
schools
to
chap
specific
market
stickers
$1.80/bottle=$324,
totes
160
seeds
policy
stick*,
@$1.30/tote
at
education.
promotional
prices,
branded
providers
events
@
$.40/bag
resources
expansion,
$.65/sticker=$130;
playdough
engagement
travel
small
availability,
to
promotional
in
play
=$80
educate
Specific
size
=
relationship
and
items
500
$195,
@$.50/container
cessation
dough,
hand
(average
tools
services
pens
items
and
and
150
individuals
sanitizers*,
("quit
and
intended
180
@
chap
materials
such
resources;
amounts
$.35/pen
$92/month
building
may
sunflower
hand
kits")
as
include
stick
=$80,
on
event
sanitizer
may
the
pens*,
may
either
to
=
@.80/chap
tobacco
and/or
$175,
promote
Quitline;
seeds.
vary
200
for
be
but
grocery
or
used
with
are
audience.
bottles
150
bags
12
for
based
price,
Price
months)
as
community
utilization
at
tobacco
not
grocery
stick
of
a
public
limited
totes*,
on
@
sunflower
smoke
of
=
(200
$120,
-free
of
-
$ 92.00
12.00
$ 1,104.00
stickers*,
small
indirect)
Professional
development
Registration
professional
Tobacco
cessation
providing.
required.
based
on
Training
education
(1
advertised
This
for
development
person
at
training
least
Specialist
and
x $1,200.00*=
2024
is
one
training
Training
prevention
offered
rates.
Health
Education
such
to
services
virtually
$1,200.00)
support
as
the
so
Specialist
Rocky
WCTEPP
no
*Registration
and
meals
enhance
Mountain
is
to
already
or
attend
lodging
price
a
is
$ 1,200.00
1.00
$ 1,200.00
indirect)
Food
participants
support
for
cost
program
(Participant
excluded
from
snacks
To
cohorts/year
$500.00),
adult
participants
$1,100.00)
encourage
and
for
participants
and
restorative
x
x
lunch
$15.00/person
participation
10
weeks
and
justice
of
and
youth
x 5
snacks
participants
trainings
=
$600.00)
reduce
and
for
adult
attendees
(2
barriers
x
trainings/year
($500.00
to
cessation
$2.00/person
of day
attendance:
cohorts
-long
+ 600.00
x20
(5
=
trusted
=
$ 1,100.00
1.00
$ 1,100.00
Total
Supplies
& Operating
$ 4,142.60
Option Letter Contract Number: 2024*0171 Option Letter #1 Page 3 of 4
DocuSign Envelope ID: 935E1 F2A-EO00-483C-A3ED-D146827E14CB
Exhibit C Budget
Travel
Item
Description of
Item
Rate
Quantity
T Vldl
HTIIVUTTt
manProject-related
Mileage
meetings,
community
on
historical
trainings,
partners
need
mileage
and
and
within
2024
for WCTEPP
presentations
Weld
County
staff for
with
County.
reimbursement
travel
schools
Cost
estimates
to attend
and
rate
are
of $0.65.
based
$ 0.65
1631.00
$ 1,060.15
Total
Travel
$ 1,060.15
Contractual
Subcontractor
Name
Description of
Item
Rate
Quantity
T Vld1
HIITVUIIL
£_A�
oa..�...eAA
TBD- School
mini -grants
implementation
($1,000.00
Funding
mini
program
developed
completion
stakeholder
MOU
bi-monthly
recruitment
for
-grants
muci
with
to
implementation
of
be
by
WCTEPP,
progress
x
up
of
presentation.
and
the
3
awarded
the
to
a
$1000.00
tobacco
of
retention
program
$3000.00)
WCTEPP.
tobacco
meet
reports
to
3
in
free
Each
monthly
of
and
schools
each
accordance
Program
schools
prevention
to
youth
activity
school
WCTEPP.
to
in
support
activities
with
checklist,
each
Weld
with
activities,
will
WCTEPP
Funding
County
their
be
school
the
required
will
training
individual
guidelines
include
and
staff,
will
group
in
the
a
assist
costs.
for/and
final
to sign
and
and
form
submit
with
an
pay
of
$ 1,000.00
3.00
$ 3,000.00
=
in
implementation
Total
Contractual
$ 3,000.00
SUB
-TOTAL
OF
DIRECT
COSTS
$ 277,868.10
Indirect
Item
Description of Item
Total
Amount
CDPHE-Negotiated
Cost
Rate
Indirect
CDPHE
FY24 negotiated
indirect
rate of
18.96%
for modified
total
direct
costs
$ 52,265.90
Total
Indirect
$ 52,265.90
TOTAL
I $ 330,134.00
Option Letter Contract Number: 2024*3171 Option Letter #1 Page 4 of 4
DocuSign Envelope ID: 935E1F2A-EC00-483C-A3ED-D146827E14CB
SIGNATURE PAGE
STATE OF COLORADO
Jared S. Potts, Governor
Colorado Department of Public Health and Environment
Jill Hunsaker Ryan, MPH, Executive Director
FaaDocuSigned by:
aiftrtSbt,
``
In accordance with §24-30-202 C.R.S., this Option is not
valid until signed and dated below by the State Controller or
an authorized delegate.
STATE CONTROLLER
Robert Jaros, CPA, MBA, JD
Do�eu��Sig��nedyby:
Eixa/l.Vl.(l1(i S.wraith
2C13012116621B1...
By: Signature nature
Chelsea Gilbertson
8CA04B14546748A By. Signature
Jannette Scarpin°
Name of Executive Director Delegate
Director of Procurement and Contracts
Name of State Controller Delegate
chief Financial Officer
Title of Executive Director Delegate
2024-04-18
Date:
Title of State Controller Delegate
2024-04-19
Option Effective Date:
-- Signature Page End --
Page 2 of 2
Option Letter Contract Number: 2024*0171 Option Letter #1 Ver. 27.01.20
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