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Home My WebLink About20231438.tiffCon -1 -vacs- (DO ot31 b BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TILE: Amendment #3 to the Professional Services Agreement with Keep Swimming, LLC DEPARTMENT: Human Services PERSON REQUESTING: Jamie Ulrich, Director, Human Services DATE: April 29, 2025 Brief description of the problem/issue: On May 22, 2023, the Department entered into a Professional Services Agreement with Keep Swimming, LLC, known to the Board as Tyler ID 2023- 1438. This is related to Bid# B2300040. On May 20, 2024 thle Board approved Amendment #1 to extend the term date through May 31, 2026. On October 9, 2024 the Board approved Amendment #2 which updated Exhibit A, Scope of Services and Exhibit B, Rate Schedule. The Department is now requesting approval of Amendment #3 which updates Exhibit B, Rate Schedule to add a cancellation fee of $500.00 as of April 1, 2025. What options exist for the Board? Approval of Amendment #3 with Keep Swimming, LLC. Deny approval of Amendment #3 with Keep Swimming, LLC. Consequences: The Department will not enter into an amendment to update rates. Impacts: Provider may not provide needed services to Department of Human Services clients. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): Fees for Services Program Area Rate Unit Type Service Name Life Skills $ 105.00 Hour Inside Out Well Being Program: In -Home or Community AND with Transportation $ 35.00 Each Inside Out Well Being Program: No Show $ 50.00 Hour Inside Out Well Being Program: FTM, TDM, Prof. Staffing I$ 105.00 Hour Keep Swimming Life Skills Coaching: In - Home or Community AND with Transportation $ 35.00 Each Keep Swimming Life Skills Coaching: No Show Pass -Around M morandum; April 29, 2025 - CMS ID 9370 Cal n ,i QC. Oinbc(se (Dq%) 5/1/25 5/1/25 2oz3-iLBS Nt00ct5 Program Area Life Skills Rate $ 50.00 Unit Type Hour Service Name Keep Swimming Life Skills Coaching: FTM, TDM, Professional Staffing $3,400.00 Per episode NTDC Trainer for Kinship and Foster Caregivers: In -Home or Community $ 500.00 Each NTDC Trainer for Kinship and Foster Caregivers: No Show/Cancellation $ 300.00 Per episode Booster Training for Kinship and Foster Caregivers: In -Home or Community $ 0.65 Mile Life Skills: Mileage • Funded through Core/Non-Core Child Welfare funding. Recommendation: • Approval of Amendment #3 and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck Scott K. James Jason S. Maxey Lynette Peppier Kevin D. Ross ‘1,72 sfisv� rssfl«!'t' /7� �•'1�/•2.yLc. Pass -Around Memorandum; April 29, 2025 - CMS ID 9370 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND KEEP SWIMMING, LLC This Agreement Amendment made and entered into 1day of 2025 by and between the Board of Weld County Commissioners, on behalf of th Weld County Department of Human Services, hereinafter referred to as the "Department", and Keep Swimming, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Life Skills, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023-1438, approved on May 22, 2023. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2024. • The Original Agreement was amended on: May 20, 2024 to extend the term date through May 31, 2026. October 9, 2024 to update Exhibit A, Scope of Services and Exhibit B, Rate Schedule. The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2023-1438. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of April 1, 2025: 1. Exhibit A, Scope of Services, is hereby amended as attached. 2. Exhibit B, Rate Schedule, is hereby amended as attached • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ATTEST: Cler to the Board BY: BOARD OF COUNTY COMMISSIONERS COUNTY, COLORADO ry L. ;, uck, Chair ONTRACTOR: MAY 0 7 225 Keep Swimming, LLC 190 Lane Court Fort Lupton, Colorado 80621 Wenoi ,70 Tauthaber By: Wendy Jo Fa aber (May 2, 2025 10:41 MDT) Wendy Faulhaber, Coach Practitioner Date: 05/02/2025 2O7 3-1,-3 ' EXHIBIT A SCOPE OF SERVICES Contractor will provide Life Skills, as referred by the Department. 1. Inside Out Well Being Program a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Inside Out curriculum. ii. International Coaching Federation Practices. iii. Binder with worksheets and lessons. b. Anticipated Frequency of Services: i. One (1) hour, weekly. c. Anticipated Duration of Services: i. Three (3) months. d. Goals of Services: i. The four (4) Core Areas of Wellbeing: 1. Meaningful connection. 2. Environmental connection. 3. Inner connection. 4. Social connection. e. Outcomes of Services: i. For clients to know the meaning in their lives. ii. For clients to gain motivation and dedication. iii. For clients to know their purpose, values, sense of control, and sense of self-worth. f. Target Population: i. Individuals fourteen (14) years of age or older. ii. Groups of four (4) to twelve (12) of similar ages. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than two-thirds (2/3) of the sessions will take place over video conferencing. 2. Keep Swimming Life Skills Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clifton Strengths Assessment. ii. International Coaching Federation Practices. iii. Twelve (12) sessions Keep Swimming curriculum. iv. Coaching Planner. v. Five (5) Protective Factors. vi. Emotional Intelligence. b. Anticipated Frequency of Services: i. One (1) to two (2) hours, weekly. ii. Fourteen (14) hours total. c. Anticipated Duration of Services: i. Twelve (12) to sixteen (16) weeks. d. Goals of Services: i. Client will be able to identify top five (5) values. ii. Client will know and be able to use signature strengths in life situations. iii. Client will be able to identify what they want, what they will have when they get what they want, and action steps for achievement. e. Outcomes of Services: i. Client can use skills learned. ii. Client will have strengthening language that empowers them. iii. Education, motivation, and inspiration to live a successful life with intention based on their values and ability to use their strengths. iv. To be able to identify four (4) of the five (5) Protective Factors and the skills to use them. v. Client will have an understanding of what strengths they do have to offer in their relationships at fun and play and in work/education settings. f. Target Population: i. Fourteen (14) years of age and older. ii. Individuals or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than half (1/2) of the sessions will take place over video conferencing. 3. NTDC Trainer for Kinship and Foster Caregivers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. National Training & Development Curriculum (NTDC) will be utilized for all foster and kinship parent pre -certifications. b. Anticipated Frequency of Services: i. Contractor will offer up to eleven (11) training cohorts per year. ii. Each cohort is required to complete eighteen (18) training modules. iii. A Cohort will be made up of a minimum of six (6) participants. If the minimum number of participants is not met, the cohort may be cancelled by the County two (2) weeks prior to the scheduled cohort start date. A cancellation fee will apply if the cohort is cancelled less than two (2) weeks prior to the scheduled start date. iv. If a kinship family was scheduled to participate in the cancelled cohort, the County may ask the Contractor to provide one-on-one training for that specific kinship family. c. Anticipated Duration of Services: i. Each cohort will complete twenty-four (24) hours of training which includes the eighteen (18) training modules. d. Goals of Services: i. Successful completion of training: being present for all hours and active participation. ii. Evaluation: each participant will receive an evaluation of trainer and curriculum. iii. Foster Parent comprehension of curriculum: successful completion of Pre and Post Test. e. Outcomes of Services: i. Success of this training program will be measured by the number of parents who complete the training cohort and become certified through Weld County DHS. ii. Each participant will comprehend the curriculum, utilize and efficiently care for the children in their care from what they learned through the NTDC training. iii. Increase Foster/Kinship Certifications iv. Decrease turnover in Foster/Kinship Care f. Target Population: i. Uncertified Foster and Kinship Caregivers. g. Language: i. Training classes will be offered in English. If a family is non-English speaking, County contracted interpreter services will be arranged so the family can complete the training, or another training will be provided for them by Weld County. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. 1.10b includes twenty-four (24) hours of training, all pre and post - communication with participants, and county and location arrangements for each training. 4. Booster Training for Kinship and Foster Caregivers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Each booster will be developed based on the surveys the county receives from licensed Kinship and Foster Caregivers that they need. b. Anticipated Frequency of Services: i. Minimum - once per quarter. c. Anticipated Duration of Services: i. Two (2) to three (3) hours per quarter. d. Goals of Services: i. Continuing Education for Kinship Foster Certification. ii. Retention of caregivers. iii. Information and Updates within Human Services that pertain to Kinship and Foster Families. iv. Further Education to support families who are caring for children in Foster and Kinship with specific challenges and/or needs. e. Outcomes of Services: i. Provide support. ii. Provide Encouragement. iii. Empower the community to come together and talk about issues and support one another. f. Target Population: i. Certified Foster and Kinship Caregivers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Virtually and in -person around Weld County to support all families with location and convenience. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team (HS- CWServiceReferralAweld.gov) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(c�weld.gov. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS- CWServiceReferral(aiweld.gov. No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit B, Rate Schedule, then Contractor understands that the Department will not reimburse for "no-shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 - hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(S weld.gov within three (3) days of when the client is placed on a behavioral plan or discharged. 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS- CWServiceReferralCfiweld.gov immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational, or behavioral issues. Areas of concem should be reported to the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral(ttweld.gov immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department 13.On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS-CWServiceReferrak weld.gov of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas: Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 16.Trg. ainin Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department, and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Program Area kill Rate $ 35.00 $" $ 105.00 0i $ 50.00 Unit Type Service Name our' Each Hour Hour Each Hour Per episode Inside Out Well Being' "Peat Community AND with Transpor on Inside Out Well Being Program: No Show Inside Out Well Being Prot Praf.Staffing Keep Swimming Life Skills Coaching: In - Home or Community AND with Transportation Keep Swimming Life Skills Co Show Keep Swimming Life Skills Coaching: FTM, TDM, Professional Staffing NTDC Trainer for Kinship and Fost Caregivers: In -Home or"Com nit Program Area Rate $ 500.00 0.65 Unit Type Each Per e • isode Mile Service Name NTDC Trainer for Kinship and Foster Care. ivers: No Show/Cancellation Booster Training for Kinship and Foster Care. ivers: in -Home or Communi Life Skills: Milea • e 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7th day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7th day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary. b. The Court with jurisdiction over the case has ordered that a non - Medicaid provider or service be used. c. A Medicaid provider is not available to provide the needed service. d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: a. Withhold payment to the Contractor until the necessary services or corrections in 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 the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. SIGNATURE REQUESTED: Weld/Keep Swimming, LLC Amendment #3 (f) 5.1.25 Final Audit Report 2025-05-02 Created: 2025-05-01 By: Sara Adams (sadams@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAsbszoyruLMkOtN4HNu9gtH8UBgJ6YFAk "SIGNATURE REQUESTED: Weld/Keep Swimming, LLC Amen dment #3 (f) 5.1.25" History 5 Document created by Sara Adams (sadams@weld.gov) 2025-05-01 - 5:37:51 PM GMT- IP address: 204.133.39.9 El Document emailed to wendyjo@wendyjocoaching.com for signature 2025-05-01 - 5:38:37 PM GMT 5 Email viewed by wendyjo@wendyjocoaching.com 2025-05-01 - 7:41:53 PM GMT- IP address: 75.71.183.58 da Signer wendyjo@wendyjocoaching.com entered name at signing as Wendy Jo Faulhaber 2025-05-02 - 4:41:33 PM GMT- IP address: 75.71.183.58 2I5 Document e -signed by Wendy Jo Faulhaber (wendyjo@wendyjocoaching.com) Signature Date: 2025-05-02 - 4:41:35 PM GMT - Time Source: server- IP address: 75.71.183.58 • Agreement completed. 2025-05-02 - 4:41:35 PM GMT Powered by Adobe Acrobat Sign tract"o..# Entity Information Entity Name * KEEP SWIMMING LLC Entity ID* @00047073 Contract Name" Contract ID KEEP SWIMMING, LLC (PROFESSIONAL SERVICES 9370 AGREEMENT AMENDMENT #3) (RELATED TO BID# Contract Lead* B2300040) SADAMS Contract Status CTB REVIEW O New Entity? Parent Contract ID 20231438 Requires Board Approval YES Contract Lead Email Department Project # sadams@weld.gov;cobbx xlk@weld.gov Contract Description* (CONSENT) KEEP SWIMMING, LLC - PROFESSIONAL SERVICES AGREEMENT AMENDMENT #3. RELATED TO BID# B2300040. UPDATE EXHIBIT A, SCOPE AND EXHIBIT B, RATE SCHEDULE. Contract Description 2 PA ROUTING THROUGH THE NORMAL PROCESS. ETA TO CTB IS 04/29/2025 Contract Type* Department Requested BOCC Agenda Due Date AMENDMENT HUMAN SERVICES Date* 05/03/2025 05/07/2025 Department Email CM- Will a work session with BOCC be required?* HumanServices@weld.gov NO Amount* $0.00 Renewable * NO Automatic Renewal Grant IGA Department Head Email CM-HumanServices- DeptHead@weld.gov County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL D.GOV If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Does Contract require Purchasing Dept. to be included? 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 Termination Notice Period Contact Information Review Date* 03/31/2026 Committed Delivery Date Renewal Date Expiration Date* 05/31/2026 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/02/2025 Approval Process Department Head JAMIE ULRICH DH Approved Date 05/02/2025 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 05/07/2025 Finance Approver CONSENT Legal Counsel CONSENT Finance Approved Date Legal Counsel Approved Date 05/02/2025 05/02/2025 Tyler Ref # AG 050725 Originator SADAMS hn va d iDw15D BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Professional Service Agreement Amendment #2 with Keep Swimming, LLC DEPARTMENT: Human Services DATE: October 1, 2024 PERSON REQUESTING: Jamie Ulrich, Director, Human Services Brief description of the problem/issue: The Department entered into a Professional Service Agreement (PSA) with Keep Swimming, LLC on May 22, 2023, known to the Board as Tyler ID# 2023-1438, for Life Skills Services. This is related to Bid #B2300040. The Department is now requesting approval for Amendment #2 to add Foster Parent Training services. These services will add the National Training & Development Curriculum (NTDC) that will be utilized for all foster and kinship parent pre -certifications to prepare them for the successful certification completion to become foster parents. What options exist for the Board? • Approval of the Amendment #2 with Keep Swimming, LLC. • Deny approval of Amendment #2 with Keep Swimming, LLC. Consequences: The Department will not have a revised agreement with Keep Swimming, LLC, Impacts: The Department will not be able to offer NTDC Training services to potential foster parents. Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years): • Term: October 1, 2024 through May 31, 2026. • Funded through: Child Welfare Core and Non -Core funding. Fees for Services: Inside Out Well Being Program: In -Home or Life Skills $ 105.00 Hour Community AND with Transportation $ 35.00 Each Inside Out Well Being Program: No Show $ 50.00 Hour Inside Out Well Being Program: FTM, TDM, Prof.Staffing Keep Swimming Life Skills Coaching: In -Home or $ 105.00 Hour Community AND with Transportation $ 35.00 Each Keep Swimming Life Skills Coaching: No Show $ 50.00 Hour Keep Swimming Life Skills Coaching: FTM, TDM, Professional Staffing Pass -Around Memorandum; October 1, 2024 - CMS ID 8750 canes Ntri 0/9/744 cc 0 ribaqk c tS C-ivou.p) 10/9 /24 ZnZ3r lL§s W-009 Life Skills $3,400.00 Per episode NTDC Trainer for Kinship and Foster Caregivers: In -Home or Community $ 500.00 Each NTDC Trainer for Kinship and Foster Caregivers: No Show $ 300.00 Per episode Booster Training for Kinship and Foster Caregivers: In -Home or Community $ 0.65 Mile Life Skills: Mileage Recommendation: • Approval of the Amendment #2 and authorize the Chair to sign. Support Recommendation Schedule Place on BOCC Agenda Work Session Other/Comments: Perry L. Buck, Pro-Tem Mike Freeman Scott K. James Kevin D. Ross, Chair Lori Saine MCA ICR- Pass-Around Memorandum; October 1, 2024 — CMS ID 8750 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND KEEP SWIMMING, LLC This Agreement Amendment made and entered into CI'day of Ukt , 2024 by and between the Board of Weld County Commissioners, on behalf of the Weld County Department of Human Services, hereinafter referred to as the "Department", and Keep Swimming, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Life Skills, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023-1438, approved on May 22, 2023. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement was set to end on May 31, 2024. • The Original Agreement was amended on: • May 20, 2024 to extend the term date through May 31, 2026. • The Amendments are identified by the Weld County Clerk to the Board of County Commissioners as document number 2023-1438. • These Amendments, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of October 1, 2024: 1. Exhibit A, Scope of Services, is hereby amended as attached. 2. Exhibit B, Rate Schedule, is hereby amended as attached. • All other terms and conditions of the Original Agreement remain unchanged. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ddfrAvV J6L;d2' ATTEST: BY: Deputy Clerk to the COUNTY: BOARD OF COUNTY COMMISSIONERS ELD COUN •LOR n D. Ross, Chair OCT 0 9 2024 CONTRACTOR: Keep Swimming, LLC 190 Lane Court Fort Lupton, Colorado 80621 By: Wendy Jo PaiaL1er (Oct 2, 2024 21:45 MDT) Wendy Faulhaber, Coach Practitioner Date: 10/02/2024 Lo -L3- 43% EXHIBIT A SCOPE OF SERVICES Contractor will provide Life Skills, as referred by the Department. 1. Inside Out Well Being Program a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Inside Out curriculum. ii. International Coaching Federation Practices. iii. Binder with worksheets and lessons. b. Anticipated Frequency of Services: i. One (1) hour, weekly. c. Anticipated Duration of Services: i. Three (3) months. d. Goals of Services: i. The four (4) Core Areas of Wellbeing: 1. Meaningful connection. 2. Environmental connection. 3. Inner connection. 4. Social connection. e. Outcomes of Services: i. For clients to know the meaning in their lives. ii. For clients to gain motivation and dedication. iii. For clients to know their purpose, values, sense of control, and sense of self-worth. f. Target Population: i. Individuals fourteen (14) years of age or older. ii. Groups of four (4) to twelve (12) of similar ages. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than two-thirds (2/3) of the sessions will take place over video conferencing. 2. Keep Swimming Life Skills Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clifton Strengths Assessment. ii. International Coaching Federation Practices. iii. Twelve (12) sessions Keep Swimming curriculum. iv. Coaching Planner. v. Five (5) Protective Factors. vi. Emotional Intelligence. b. Anticipated Frequency of Services: i. One (1) to two (2) hours, weekly. ii. Fourteen (14) hours total. c. Anticipated Duration of Services: i. Twelve (12) to sixteen (16) weeks. d. Goals of Services: i. Client will be able to identify top five (5) values. ii. Client will know and be able to use signature strengths in life situations. iii. Client will be able to identify what they want, what they will have when they get what they want, and action steps for achievement. e. Outcomes of Services: i. Client can use skills learned. ii. Client will have strengthening language that empowers them. iii. Education, motivation, and inspiration to live a successful life with intention based on their values and ability to use their strengths. iv. To be able to identify four (4) of the five (5) Protective Factors and the skills to use them. v. Client will have an understanding of what strengths they do have to offer in their relationships at fun and play and in work/education settings. f. Target Population: i. Fourteen (14) years of age and older. ii. Individuals or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than half (1/2) of the sessions will take place over video conferencing. 3. NTDC Trainer for Kinship and Foster Caregivers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. National Training & Development Curriculum (NTDC) will be utilized for all foster and kinship parent pre -certifications. b. Anticipated Frequency of Services: i. Contractor will offer at least eleven (11) training cohorts per year. ii. Each cohort is required to complete eighteen (18) training modules. iii. A Cohort will be made up of a minimum of six (6) participants. If the minimum number of participants is not met, the cohort may be cancelled by the County two (2) weeks prior to the scheduled cohort start date. iv. If a kinship family was scheduled to participate in the cancelled cohort, the County may ask the Contractor to provide one-on-one training for that specific kinship family. c. Anticipated Duration of Services: i. Each cohort will complete twenty-four (24) hours of training which includes the eighteen (18) training modules. d. Goals of Services: i. Successful completion of training: being present for all hours and active participation. ii. Evaluation: each participant will receive an evaluation of trainer and curriculum. iii. Foster Parent comprehension of curriculum: successful completion of Pre and Post Test. e. Outcomes of Services: i. Success of this training program will be measured by the number of parents who complete the training cohort and become certified through Weld County DHS. ii. Each participant will comprehend the curriculum, utilize and efficiently care for the children in their care from what they learned through the NTDC training. iii. Increase Foster/Kinship Certifications iv. Decrease turnover in Foster/Kinship Care f. Target Population: i. Uncertified Foster and Kinship Caregivers. g. Language: i. Training classes will be offered in English. If a family is non-English speaking, County contracted interpreter services will be arranged so the family can complete the training, or another training will be provided for them by Weld County. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. 1.10b includes twenty-four (24) hours of training, all pre and post - communication with participants, and county and location arrangements for each training. 4. Booster Training for Kinship and Foster Caregivers a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Each booster will be developed based on the surveys the county receives from licensed Kinship and Foster Caregivers that they need. b. Anticipated Frequency of Services: i. Minimum - once per quarter. c. Anticipated Duration of Services: i. Two (2) to three (3) hours per quarter. d. Goals of Services: i. Continuing Education for Kinship Foster Certification. ii. Retention of caregivers. iii. Information and Updates within Human Services that pertain to Kinship and Foster Families. iv. Further Education to support families who are caring for children in Foster and Kinship with specific challenges and/or needs. e. Outcomes of Services: i. Provide support. ii. Provide Encouragement. iii. Empower the community to come together and talk about issues and support one another. f. Target Population: i. Certified Foster and Kinship Caregivers. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Virtually and in -person around Weld County to support all families with location and convenience. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team (HS- CWServiceReferral@weld.gov) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov. No other Department staffor other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit B, Rate Schedule, then Contractor understands that the Department will not reimburse for "no-shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 -hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral@weld.gov within three (3) days of when the client is placed on a behavioral plan or discharged. 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral@weld.gov immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational, or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral@weld.gov immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Staffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Staffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS-CWServiceReferral@weld.govofnewstaffwhowill manageand/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CFSR) examines child welfare service outcomes in three areas: Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 16. Tr.lirig Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department, and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. EXHIBIT B RATE SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Program Area Life Skills . Rate $ 105.00 Unit Type Hour Service Name Inside Out Well Being Program: In -Home or Community AND with Transportation $ 35.00 Each Inside Out Well Being Program: No Show $ 50.00 Hour inside Out Well Being Program: FTM, TDM,. Prof.Staffing $ 105.00 Hour Keep Swimming Life Skills Coaching: In -Home or Community AND with Transportation $ 35.00 Each Keep Swimming Life Skills Coaching: No Show $ 50.00 Hour Keep Swimming Life Skills Coaching: FTM, TDM, Professional Staffing $3,400'.00 Per episode NTDC Trainer for Kinship and Foster Caregivers: In- Home or Community Program Area Rate $ 500.00 Unit Type Each Service Name NTDC Trainer for Kinship and Foster Caregivers: No Show $ 300.00 Per episode Booster Training for Kinship and Foster Caregivers: In- Home or Community $ 0.65 Mile Life Skills: Mileage 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 75" day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service: a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 75" day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: a. Withhold payment to the Contractor until the necessary services or corrections in 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 the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A- 133. ACORO® CERTIFICATE OF LIABILITY INSURANCE °Aos/1s rzo°za l THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PROWLER Canopy Program Support Insurance Canopy o F,,,,. 844-520-6993 Fe -7801-763-1374 P.O. Box 34833 Chesterfield VA 23234 E-MAIL info@insurancecanopy.com ADDREss: @insurancecenoPY com INSURERS) AFFORDING COVERAGE NAIL M wsuRERA: Great American Alliance Insurance Company 26832 INSURED -- - _.—J INSURER B Keep Swimming LLC INsuRERc: 190 Lane Court _ INSURER D Fort Lupton CO 80621 INSURER S: INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 110DL$UBR! ---_--- �--POIJCY EFF POLICY EXP LTR TYPEOFINSURANCE D{SRWYD' PoUCYNUMBER (MMIDD/YYYYt'(MMIDD/YYYYI' la:urs GENERAL LIABILITY X r CORAL LIA3SITV fi r MMERCIAL GENE I! CLAIMSMADE �! OCCUR' ,r-,,,F,I _ ' i PLF197552-LET170229 A 09/18/2024 09/18/2025, __ _ _ GEN'L AGGREGATE LIMIT APPLIES PER: - ! X POLICY JECT '': LOC EACH OCCURRENCE f 2,000,000 PREMISES .....T $ 300 DQQ MED ExP (A y parson) : E 5,000 PERSON, & ADV INJURY '$L INCLUDED GENERAL AGGREGATE $ 3,000,000 PRODUCTS-COMP/OP A. '.$ 3,000,000 ! ANIMAL BAILEE AUTOMOBILE LUIBILnY ! FIT! ANY AUTO I ALL OWNED , SCHEDULED _; AUTOS '. AUTOS HIRED AUTOS -�, AUTOSWNED .., COMBINED SINGLE LIMIT �.SEa acdtleml i BODILY INJURY (Per parson) E -_-- -- - BODILY INJURY (Peraabmll $ pRe="TY DAMAGE �— -- -- - Z ,-. '. $ $ UMBRELLA LWB OCCUR I r— ,, EXCESS U. CLAIMS -MADE EACH OCCURRENCE E AGGREGATE WORKERS COMPENSATON'. AND EMPLOYERS' LUIBNTY Y! NTORY ANY PROPRIETOR/PARTNErECUTNE OFFICEMIEMBER E%CLUDED? ❑.NIA �;, (MarMatory In NN) Kyea. deeenbe'near DESCRIPTION OF OPERATIONS be I ''. W C STAN- OTH-: LIMITS '. ER E. L. EACH ACCIDENT E -_--- - '— --------- ---- E.L. DISEASE - EA EMPLOYEE E . _... : EL DISEASE - POLICY LIMn E A Professional Liability Irx r—'', PLF197552-LET170229 09/18/2024 09/18/2025'INCLUDED DESCRIPTION OF OPERATIONS / LOCATIONS I VEHlCLE5 (Attach ACORD 101, Atltlitional RemarNs Sehetlule, R more spate is nequlretl) It is understood and agreed that the Certificate Holder is named as Additional Insured per attached CG 20 26 (Ed. 04 13) - Additional Insured - Designated Person or Organization subject to all policy terms, conditions, and exGusions. CERTIFICATE HOLDER CANCELLATION Board of County Commissioners of Weld County and its SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Officers/Employees THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Weld County, 315 N. 11th Avenue Bldg A Greeley, CO80631 AUTHORIZED REPRESENTATIVE .ye ACORD 25 (2014/01) INS025 Rau. © 1998-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PLF197552-LET170229 CG 20 26 (Ed. 04 13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s) or Organization(s): Board of County Commissioners of Weld County and its Officers/Employees Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II - WHO IS AN INSURED is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. in the performance of your ongoing operations; or 2. in connection with your premises owned by or rented to you. However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contractor agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contract or agreement; or 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Copyright, ISO Properties, Inc., 2012 CG 20 26 (Ed. 04/13) PRO (Page 1 of 1) Keep Swimming LLC, Amendment #2 (full) (f) Final Audit Report 2024-10-03 Created: 2024-09-25 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAXNQLp36aSvY2nJgCcMtSz6QtlgjhOjBt "_Keep Swimming LLC, Amendment #2 (full) (f)" History t Document created by Windy Luna (wluna@weld.gov) 2024-09-25 - 4:38:34 PM GMT- IP address: 204.133.39.9 El Document emailed to wendyjo@wendyjocoaching.com for signature 2024-09-25 - 4:40:44 PM GMT t Email viewed by wendyjo@wendyjocoaching.com 2024-09-25 - 5:18:37 PM GMT- IP address: 73.217.10.69 5 Email viewed by wendyjo@wendyjocoaching.com 2024-10-03 - 3:41:59 AM GMT- IP address: 73.217.10.69 ere Signerwendyjo@wendyjocoaching.com entered name at signing as Wendy Jo Faulhaber 2024-10-03 - 3:45:54 AM GMT- IP address: 73.217.10.69 0f Document e -signed by Wendy Jo Faulhaber (wendyjo@wendyjocoaching.com) Signature Date: 2024-10-03 - 3:45:56 AM GMT - Time Source: server- IP address: 73.217.10.69 Q Agreement completed. 2024-10-03 - 3:45:56 AM GMT Powered by Adobe Acrobat Sign Contract F�+ Entity Information Entity Name KEEP SWIMMING LLC Entity ID* @00047073 Contract Name* Contract ID KEEP SWIMMING,LLC (PROFESSIONAL SERVICES 8750 AGREEMENT AMENDMENT #2) (RELATED TO BID# B2300040) Contract Status CTB REVIEW Contract Lead WLUNA Q New Entity? Parent Contract ID 20231438 Requires Board Approval YES Contract Lead Email Department Project # wluna@weld.gov;cobbxxl k@weld.gov Contract Description KEEP SWIMMING,LLC-PROFESSIONAL SERVICES AGREEMENT AMENDMENT #2. RELATED TO BID# B2300040. TERM: OCTOBER 1, 2024 THROUGH MAY 31, 2026. Contract Description 2 PA ROUTING WITH THIS Contract Type* AMENDMENT Amount* $0.00 Renewable" YES Automatic Renewal Grant IGA ENTRY. Department HUMAN SERVICES 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 If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Requested BOCC Agenda Due Date Date* 10/05/2024 10/09/2024 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? 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 Termination Notice Period Contact Information Contact Info Review Date* 03/31/2025 Renewal Date* 06/01/2025 Committed Delivery Date Expiration Date Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head JAMIE ULRICH DH Approved Date 10/03/2024 Final Approval BOCC Approved BOCC Signed Date BOCC Agenda Date 10/09/2024 Finance Approver CHERYL PATTELLI Legal Counsel MATTHEW CONROY Finance Approved Date Legal Counsel Approved Date 10/04/2024 10/07/2024 Tyler Ref # AG 100924 Originator WLUNA Con aci t 'l0'0 AGREEMENT AMENDMENT BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND KEEP SWIMMING, LLC This Agreement Amendment made and entered into Z 041 day of MQIt , 2024 by and between the Board of Weld County Commissioners, on behalf of the Weld Count} epartment of Human Services, hereinafter referred to as the "Department", and Keep Swimming, LLC, hereinafter referred to as the "Contractor". WHEREAS the parties entered into an Agreement for Life Skills, (the "Original Agreement") identified by the Weld County Clerk to the Board of County Commissioners as document No. 2023- 1438, approved on May 22, 2023. WHEREAS the parties hereby agree to amend the term of the Original Agreement in accordance with the terms of the Original Agreement and any previously adopted amendment, which is incorporated by reference herein, as well as the terms provided herein. NOW THEREFORE, in consideration of the premises, the parties hereto covenant and agree as follows: • The Original Agreement will end on May 31, 2024. • This Amendment, together with the Original Agreement, constitutes the entire understanding between the parties. The following additional changes are hereby made to the current Agreement as of June 1, 2024: 1. Paragraph 3. — Term. The term of this Agreement shall be from June 1, 2024, through May 31, 2026, unless sooner terminated as provided herein, and is subject to continued budget appropriations. • All other terms and conditions of the Original Agreement remain unchanged. coh5d14- Pic)/eiduL 5/2 c1/21-1 ek6--01-5-9 *2P/a 0UIS 2.623- I q3Z' IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ' ATTEST: Clerk to the Board Deputy Clerk to the B r COUNTY: BOARD OF COUNTY COMMISSIONERS WELD CO Kevin D. Ross, Chair MAY 2 0 2024 Fat orl p Keep Swimming, LLC 190 Lane Court Fort Lupton, Colorado (303) 913-3475 GVeholidhabe` Y: Wendy Faulha er (May 6, 202411:33 MDT) Wendy Faulhaber, Coach Practitioner Date: May 6, 2024 ;40,23 - 401 SIGNATURE REQUESTED: Weld/Keep Swimming, LLC Amendment #1 Final Audit Report 2024-05-06 Created: 2024-05-01 By: Windy Luna (wluna@weld.gov) Status: Signed Transaction ID: CBJCHBCAABAAI6c60zMUQrDSwtNvTNpuvong12U0ZE9A "SIGNATURE REQUESTED: Weld/Keep Swimming, LLC Amen dment #1" History tt Document created by Windy Luna (wluna@weld.gov) 2024-05-01 - 5:07:52 PM GMT- IP address: 204.133.39.9 C'y Document emailed to wendyjo@wendyjocoaching.com for signature 2024-05-01 - 5:08:29 PM GMT t Email viewed by wendyjo@wendyjocoaching.com 2024-05-01 - 7:12:01 PM GMT- IP address: 174.218.163.71 t Email viewed by wendyjo@wendyjocoaching.com 2024-05-06 - 5:31:41 PM GMT- IP address: 73.217.10.69 u75 Signer wendyjo@wendyjocoaching.com entered name at signing as Wendy Faulhaber 2024-05-06 - 5:33:24 PM GMT- IP address: 73.217.10.69 f Document e -signed by Wendy Faulhaber (wendyjo@wendyjocoaching.com) Signature Date: 2024-05-06 - 5:33:26 PM GMT - Time Source: server- IP address: 73.217.10.69 0 Agreement completed. 2024-05-06 - 5:33:26 PM GMT Powered by Adobe Acrobat Sign trctF Entity Information Entity Name* KEEP SWIMMING LLC Entity ID* @00047073 Contract Name* KEEP SWIMMING, LLC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #1. RELATED TO BID #B2300040) Contract Status CTB REVIEW Contract ID 8180 Contract Lead * WLUNA Q New Entity? Parent Contract ID 20231438 Requires Board Approval YES Contract Lead Email Department Project # wluna@weldgov.com;cob bxxlk@weldgov.com Contract Description * (CONSENT) KEEP SWIMMING, LLC PROFESSIONAL SERVICES AGREEMENT AMENDMENT #1. RELATED TO BID #B2300040. TERM: 06/01 /2024 THROUGH 05/31 /2026. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR LIST PRESENTED TO THE BOCC ON 04/5/23. Contract Type* Department AMENDMENT HUMAN SERVICES Amount* $0.00 Renewable* YES Automatic Renewal Grant IGA Department Email CM- HumanServices@weldgov. com Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM Requested BOCC Agenda Date* 05/22/2024 Due Date 05/18/2024 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 Termination Notice Period Contact Information Review Date * 03/31/2025 Renewal Date" 06/01/2025 Committed Delivery Date Expiration Date Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date CONSENT 05/13/2024 Approval Process Department Head Finance Approver Legal Counsel JAMIE ULRICH CONSENT CONSENT DH Approved Date Finance Approved Date Legal Counsel Approved Date 05/13/2024 05/13/2024 05/13/2024 Final Approval BOCC Approved Tyler Ref # AG 052024 BOCC Signed Date Originator WLUNA BOCC Agenda Date 05/20/2024 Co►ihack tp 1oDZ PROFESSIONAL SERVICE AGREEMENT BETWEEN WELD COUNTY AND KEEP SWIMMING, LLC THIS AGREEMENT is made and entered into this ZZ' day of , 2023, by and between the Board of Weld County Commissioners, on behalf of the Weld Co Department of Human Services, hereinafter referred to as "County," and Keep Swimming, LLC, hereinafter referred to as "Contractor". WHEREAS, County desires to retain Contractor to perform services as required by County and set forth in the attached Exhibits; and WHEREAS, Contractor is willing and has the specific ability, qualifications, and time to perform the required services according to the terms of this Agreement; and WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the services as set forth below; and WHEREAS, the Colorado Department of Human Services has provided Core and Non - Core or other funding to the Department for Life Skills. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, the parties hereto agree as follows: 1. Introduction. The terms of this Agreement are contained in the terms recited in this document and in the attached Exhibits, each of which forms an integral part of this Agreement and are incorporated herein. The parties each acknowledge and agree that this Agreement, including the attached Exhibits, define the performance obligations of Contractor and Contractor's willingness and ability to meet those requirements (the "Work"). If a conflict occurs between this Agreement and any Exhibit or other attached document, the terms of this Agreement shall control, and the remaining order of precedence shall based upon order of attachment. Exhibit A consists of the Scope of Services. Exhibit B consist of the Rate Schedule. Exhibit C consists of County's Request for Proposal (RFP) as set forth in Bid Package No. B2300040 which is incorporated into this agreement by reference and will be provided upon request to the Department. Exhibit D consists of Contractor's Response to County's Request. 2. Service or Work. Contractor agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the Work described in the attached Exhibits. Services shall be provided by the Contractor to any person(s) eligible for services in compliance with Exhibits A, Scope of Services, and Exhibit D, Contractor's Response to Request for Proposal. Contractor shall further be responsible for the timely completion and acknowledges that a failure WW1+ 1Ciefldk)- °22,23 01,&.e-6-110) ,5/a02/a3 2023-1438 01300(5 to comply with the standards and requirements of Work within the time limits prescribed by County may result in County's decision to withhold payment or to terminate this Agreement. 3. Term. The term of this Agreement shall be from June 1, 2023, through May 31, 2024, unless sooner terminated as provided herein. Both of the parties to this Agreement understand and agree that the laws of the State of Colorado prohibit County from entering into Agreements which bind County for periods longer than one year. This Agreement may be renewed for 2 (two) additional one-year terms upon mutual written agreement of the Parties. 4. Termination; Breach; Cure. County may terminate this Agreement for its own convenience upon thirty (30) days written notice to Contractor. Either Party may immediately terminate this Agreement upon material breach of the other party, however the breaching party shall have fifteen (15) days after receiving such notice to cure such breach. If this Agreement is terminated by County, Contractor shall be compensated for, and such compensation shall be limited to, (1) the sum of the amounts contained in invoices which it has submitted and which have been approved by the County; (2) the reasonable value to County of the services which Contractor provided prior to the date of the termination notice, but which had not yet been approved for payment; and (3) the cost of any work which the County approves in writing which it determines is needed to accomplish an orderly termination of the work. County shall be entitled to the use of all material generated pursuant to this Agreement upon termination. Upon termination of this Agreement by County, Contractor shall have no claim of any kind whatsoever against the County by reason of such termination or by reason of any act incidental thereto, except for compensation for work satisfactorily performed and/or materials described herein properly delivered. 5. Extension or Amendment. Any amendments or modifications to this agreement shall be in writing signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services. Accordingly, no claim that the County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by the County for such additional services is not timely executed and issued in strict accordance with this Agreement, Contractor's rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. Any claims by the Contractor for adjustment hereunder must be made in writing prior to performance of any work covered in the anticipated Amendment, unless approved and documented otherwise by the County Representative. Any change in work made without such prior Amendment shall be deemed covered in the compensation and time provisions of this Agreement, unless approved and documented otherwise by the County Representative. 6. Compensation. County agrees to pay Contractor through an invoice process during the course of this Agreement in accordance with the Rate Schedule as described as Exhibit B. Contractor agrees to submit invoices which detail the work completed by Contractor. The County will review each invoice and if it agrees Contractor has completed the invoiced items to the County's satisfaction, it will remit payment to the Contractor. No payment in excess of that set forth in the Exhibits will be made by County unless an Amendment authorizing such additional 2 payment has been specifically approved by Weld County as required pursuant to the Weld County Code. If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor was improper because the service for which payment was made did not perform as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. Unless expressly enumerated in the attached Exhibits, Contractor shall not be entitled to be paid for any other expenses (e.g. mileage). Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after December 31 of any year, without an appropriation therefore by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, Title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 7. Independent Contractor. Contractor agrees that it is an independent contractor and that Contractor's officers, agents or employees will not become employees of County, nor entitled to any employee benefits (including unemployment insurance or workers' compensation benefits) from County as a result of the execution of this Agreement. Contractor shall be solely responsible for its acts and those of its agents and employees for all acts performed pursuant to this Agreement. Contractor, its employees and agents are not entitled to unemployment insurance or workers' compensation benefits through County and County shall not pay for or otherwise provide such coverage for Contractor or any of its agents or employees. Unemployment insurance benefits will be available to Contractor and its employees and agents only if such coverage is made available by Contractor or a third party. Contractor shall pay when due all applicable employment taxes and income taxes and local head taxes (if applicable) incurred pursuant to this Agreement. 8. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for the completion of the Work without County's prior written consent, which may be withheld in County's sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the Work during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Work. Contractor shall require each subcontractor, as approved by County and to the extent of the Work to be performed by the subcontractor, to be bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any subcontractor hired by Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and subcontractors. 9. Ownership. All work and information obtained by Contractor under this Agreement or 3 individual work order shall become or remain (as applicable), the property of County. In addition, all reports, documents, data, plans, drawings, records and computer files generated by Contractor in relation to this Agreement and all reports, test results and all other tangible materials obtained and/or produced in connection with the performance of this Agreement, whether or not such materials are in completed form, shall at all times be considered the property of the County. Contractor shall not make use of such material for purposes other than in connection with this Agreement without prior written approval of County. 10. Confidentiality. Confidential information of the Contractor should be transmitted separately from non -confidential information, clearly denoting in red on the relevant document at the top the word, "CONFIDENTIAL." However, Contractor is advised that as a public entity, Weld County must comply with the provisions of the Colorado Open Records Act (CORA), C.R.S. 24-72-201, et seq., with regard to public records, and cannot guarantee the confidentiality of all documents. Contractor agrees to keep confidential all of County's confidential information. Contractor agrees not to sell, assign, distribute, or disclose any such confidential information to any other person or entity without seeking written permission from the County. Contractor agrees to advise its employees, agents, and consultants, of the confidential and proprietary nature of this confidential information and of the restrictions imposed by this Agreement. 11. Warranty. Contractor warrants that the Work performed under this Agreement will be performed in a manner consistent with the standards governing such services and the provisions of this Agreement. Contractor further represents and warrants that all Work shall be performed by qualified personnel in a professional manner, consistent with industry standards, and that all services will conform to applicable specifications. 12. Acceptance of Services Not a Waiver. Upon completion of the Work, Contractor shall submit to County originals of all test results, reports, etc., generated during completion of this work. Acceptance by County of reports and incidental material(s) furnished under this Agreement shall not in any way relieve Contractor of responsibility for the quality and accuracy of the project. In no event shall any action by County hereunder constitute or be construed to be a waiver by County of any breach of this Agreement or default which may then exist on the part of Contractor, and County's action or inaction when any such breach or default exists shall not impair or prejudice any right or remedy available to County with respect to such breach or default. No assent, expressed or implied, to any breach of any one or more covenants, provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach. Acceptance by the County of, or payment for, the Work completed under this Agreement shall not be construed as a waiver of any of the County's rights under this Agreement or under the law generally. 13. Insurance. Contractor must secure, before the commencement of the Work, the following insurance covering all operations, goods, and services provided pursuant to this Agreement, and shall keep the required insurance coverage in force at all times during the term of the Agreement, or any extension thereof, and during any warranty period. For all coverages, Contractor's insurer shall waive subrogation rights against County. a. Types of Insurance. 4 Workers' Compensation / Employer's Liability Insurance as required by state statute, covering all of the Contractor's employees acting within the course and scope of their employment. The policy shall contain a waiver of subrogation against the County. This requirement shall not apply when a Contractor or subcontractor is exempt under Colorado Workers' Compensation Act., AND when such Contractor or subcontractor executes the appropriate sole proprietor waiver form. Commercial General Liability Insurance including public liability and property damage, covering all operations required by the Work. Such policy shall include minimum limits as follows: $1,000,000 each occurrence; $1,000,000 general aggregate; $1,000,000 Personal injury; $5,000 Medical payment per person. Automobile Liability Insurance: Contractor shall maintain limits of $1,000,000 for bodily injury per person, $1,000,000 for bodily injury for each accident, and $1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere, for vehicles owned, hired, and non -owned vehicles used in the performance of this Contract. Professional Liability (Errors and Omissions Liability). The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Services of this contract. Contractor shall maintain limits for all claims covering wrongful acts, errors and/or omissions, including design errors, if applicable, for damage sustained by reason of or in the course of operations under this Contract resulting from professional services. In the event that the professional liability insurance required by this Contract is written on a claims -made basis, Contractor warrants that any retroactive date under the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed. Minimum Limits: $1,000,000 Per Loss; $2,000,000 Aggregate. b. Proof of Insurance. Upon County's request, Contractor shall provide to County a certificate of insurance, a policy, or other proof of insurance as determined in County's sole discretion. County may require Contractor to provide a certificate of insurance naming Weld County, Colorado, its elected officials, and its employees as an additional named insured. c. Subcontractor Insurance. Contractor hereby warrants that all subcontractors providing services under this Agreement have or will have the above described insurance prior to their commencement of the Work, or otherwise that they are covered by the Contractor's policies to the minimum limits as required herein. Contractor agrees to provide proof of insurance for all such subcontractors upon request by the County. d. No limitation of Liability. The insurance coverages specified in this Agreement are the minimum requirements, and these requirements do not decrease or limit the liability of Contractor. The County in no way warrants that the minimum limits contained herein are sufficient to protect the Contractor from liabilities that might arise out of the performance 5 of the Work under by the Contractor, its agents, representatives, employees, or subcontractors. The Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverages. The Contractor is not relieved of any liability or other obligations assumed or pursuant to the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration, or types. The Contractor shall maintain, at its own expense, any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. e. Certification of Compliance with Insurance Requirements. The Contractor stipulates that it has met the insurance requirements identified herein. The Contractor shall be responsible for the professional quality, technical accuracy, and quantity of all services provided, the timely delivery of said services, and the coordination of all services rendered by the Contractor and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. 14. Indemnity. The Contractor shall defend, indemnify and hold harmless County, its officers, agents, and employees, from and against any and all injury, loss, damage, liability, suits, actions, claims, or willful acts or omissions of any type or character arising out of the Work done in fulfillment of the terms of this Agreement or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, judicial decision, or other law or court decree. The Contractor shall be fully responsible and liable for any and all injuries or damage received or sustained by any person, persons, or property on account of its performance under this Agreement or its failure to comply with the provisions of the Agreement. It is agreed that the Contractor will be responsible for primary loss investigation, defense and judgment costs where this contract of indemnity applies. In consideration of the award of this contract, the Contractor agrees to waive all rights of subrogation against the County its associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers for losses arising from the work performed by the Contractor for the County. A failure to comply with this provision shall result in County's right to immediately terminate this Agreement. 15. Non -Assignment. Contractor may not assign or transfer this Agreement or any interest therein or claim thereunder, without the prior written approval of County. Any attempts by Contractor to assign or transfer its rights hereunder without such prior approval by County shall, at the option of County, automatically terminate this Agreement and all rights of Contractor hereunder. Such consent may be granted or denied at the sole and absolute discretion of County. 16. Examination of Records. To the extent required by law, the Contractor agrees that an duly authorized representative of County, including the County Auditor, shall have access to and the right to examine and audit any books, documents, papers and records of Contractor, involving all matters and/or transactions related to this Agreement. Contractor agrees to maintain these documents for three years from the date of the last payment received. 17. Interruptions. Neither party to this Agreement shall be liable to the other for delays in delivery or failure to 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 6 God, fires, strikes, war, flood, earthquakes or Governmental actions. 18. Notices. County may designate, prior to commencement of Work, its project representative ("County Representative") who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to County Representative. All notices or other communications made by one party to the other concerning the terms and conditions of this contract shall be deemed delivered under the following circumstances: (a) personal service by a reputable courier service requiring signature for receipt; or (b) five (5) days following delivery to the United States Postal Service, postage prepaid addressed to a party at the address set forth in this contract; or (c) electronic transmission via email at the address set forth below, where a receipt or acknowledgment is required and received by the sending party; or Either party may change its notice address(es) by written notice to the other. Notice may be sent to: TO CONTRACTOR: Name: Wendy Faulhaber Position: Coach Practitioner Address: 190 Lane Court Address: Fort Lupton, Colorado 80621 E-mail: wendyjo@wendyjocoaching.com Phone: (303) 913-3475 TO COUNTY: Name: Jamie Ulrich Position: Director Address: P.O. Box A Address: Greeley, Colorado 80632 E-mail: julrich(ayweld.gov Phone: (970) 400-6510 19. Compliance with Law. Contractor shall strictly comply with all applicable federal and State laws, rules and regulations in effect or hereafter established, including without limitation, laws applicable to discrimination and unfair employment practices. 20. Non -Exclusive Agreement. This Agreement is nonexclusive and County may engage or use other Contractors or persons to perform services of the same or similar nature. 21. Entire Agreement/Modifications. This Agreement including the Exhibits attached hereto and incorporated herein, contains the entire agreement between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all prior negotiations, representations, and understandings or agreements with respect to the subject matter contained in 7 this Agreement. This Agreement may be changed or supplemented only by a written instrument signed by both parties. 22. Fund Availability. 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 succeeding year. 23. Employee Financial Interest/Conflict of Interest — C.R.S. §§24-18-201 et seq. and §24- 50-507. The signatories to this Agreement state that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement. 24. Survival of Termination. The obligations of the parties under this Agreement that by their nature would continue beyond expiration or termination of this Agreement (including, without limitation, the warranties, indemnification obligations, confidentiality and record keeping requirements) shall survive any such expiration or termination. 25. Severability. If any term or condition of this Agreement shall be held to be invalid, illegal, or unenforceable by a court of competent jurisdiction, this Agreement shall be construed and enforced without such provision, to the extent that this Agreement is then capable of execution within the original intent of the parties. 26. Governmental Immunity. No term or condition of this Agreement shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protections or other provisions, of the Colorado Governmental Immunity Act §§24-10-101 et seq., as applicable now or hereafter amended. 27. No Third Party Beneficiary. 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 and nothing 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 receiving services or benefits under this Agreement shall be an incidental beneficiary only. 28. Board of County Commissioners of Weld County Approval. This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County, Colorado or its designee. 29. Choice of Law/Jurisdiction. Colorado law, and rules and regulations established pursuant thereto, shall be applied in the interpretation, execution, and enforcement of this Agreement. Any provision included or incorporated herein by reference which conflicts with said laws, rules and/or regulations shall be null and void. In the event of a legal dispute between the parties, Contractor agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 8 30. Attorney's Fees/Legal Costs. In the event of a dispute between County and Contractor concerning this Agreement, the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. 31. Binding Arbitration Prohibited. Weld County does not agree to binding arbitration by any extra judicial body or person. Any provision to the contrary in this Agreement or incorporated herein by reference shall be null and void. 32. Acknowledgment. County and Contractor acknowledge that each has read this Agreement, understands it and agrees to be bound by its terms. Both parties further agree that this Agreement, with the attached Exhibits, is the complete and exclusive statement of agreement between the parties and supersedes all proposals or prior agreements, oral or written, and any other communications between the parties relating to the subject matter of this Agreement. IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. COUNTY: ` , ,�,/ ");‘k WELD COUNTY, COLORADO BOARD OF COUNTY COMMISSIONERS ATTEST: !/,c� rk to the Board BY: 9 75isi14. Mike Freeman, Chair MAY 2 2 2323 Keep Swimming, LLC 190 Lane Court Fort Lupton, Colorado 80621 By: Wendy J.G ul abet (May 12, 2023 14:40 MOT) Wendy Faulhaber, Coach Practitioner Date: May 12, 2023 EXHIBIT A SCOPE OF SERVICES Contractor will provide Life Skills, as referred by the Department. 1. Inside Out Well Being Program Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Inside Out curriculum. ii. International Coaching Federation Practices. iii. Binder with worksheets and lessons. b. Anticipated Frequency of Services: i. One (1) hour, weekly. c. Anticipated Duration of Services: i. Three (3) months. d. Goals of Services: i. The four (4) Core Areas of Wellbeing: 1. Meaningful connection. 2. Environmental connection. 3. Inner connection. 4. Social connection. e. Outcomes of Services: i. For clients to know the meaning in their lives. ii. For clients to gain motivation and dedication. iii. For clients to know their purpose, values, sense of control, and sense of self-worth. f. Target Population: i. Individuals fourteen (14) years of age or older. ii. Groups of four (4) to twelve (12) of similar ages. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than two-thirds (2/3) of the sessions will take place over video conferencing. 2. Keep Swimming Life Skills Coaching a. Contractor will utilize the following modalities, curriculum, and tools in the delivery of services under this agreement: i. Clifton Strengths Assessment. ii. International Coaching Federation Practices. iii. Twelve (12) sessions Keep Swimming curriculum. iv. Coaching Planner. v. Five (5) Protective Factors vi. Emotional Intelligence. • b. Anticipated Frequency of Services: i. One (1) to two (2) hours, weekly. ii. Fourteen (14) hours total. c. Anticipated Duration of Services: i. Twelve (12) to sixteen (16) weeks. d. Goals of Services: i. Client will be able to identify top five (5) values. ii. Client will know and be able to use signature strengths in life situations. iii. Client will be able to identify what they want, what they will have when they get what they want, and action steps for achievement. e. Outcomes of Services: i. Client can use skills learned. ii. Client will have strengthening language that empowers them. iii. Education, motivation, and inspiration to live a successful life with intention based on their values and ability to use their strengths. iv. To be able to identify four (4) of the five (5) Protective Factors and the skills to use them. v. Client will have an understanding of what strengths they do have to offer in their relationships at fun and play and in work/education settings. f. Target Population: i. Fourteen (14) years of age and older. ii. Individuals or families. g. Language: i. English. h. Medicaid Eligibility: i. This service is not Medicaid eligible. i. Service Access and Transportation: i. Video conferencing. ii. Other local locations in Weld County. iii. No more than half (1/2) of the sessions will take place over video conferencing. Terms 1. Contractor understands and will comply with all aspects of the referral authorization, billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. 2. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. 3. Contractor will respond to the Mental Health and Support Services Team CWServiceReferral(a,weldeov.com) within three (3) business days regarding the ability to accept the received referral. 4. Upon acceptance of a referral, Contractor will offer an initial appointment within seven (7) days of receiving the referral. The first attempt to contact the client will occur within 24 hours of receiving the referral (excluding weekends and holidays). Contractor will document efforts to engage client in referred services. If the client does not respond after three (3) attempts in the first seven (7) days of the referral period, the Contractor will notify the caseworker and the Mental Health and Support Services Team HS - C W ServiceReferral(a,weldgov.com. 5. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Mental Health and Support Services Team HS-CWServiceReferral(&,weldgov.com. No other Department staff or other party to the case may authorize services or modifications to services. 6. Contractor understands that "no shows" are defined as unexcused and unplanned/uncommunicated absences for services. If a rate for "no shows" is not specifically stated in Exhibit B, Rate Schedule, then Contractor understands that the Department will not reimburse for "no-shows". Contractor understands that the Department will only reimburse Contractor for up to two (2) "no-shows", or up to two (2) hours, on the part of case participants who cancel without 24 -hour notice. After three (3) "no-shows", Contractor will place client on a behavioral plan requiring attendance or discharge the client from services. Contractor must inform the caseworker and the Mental Health and Support Services Team HS- CWServiceReferral(),weldgov.com within three (3) days of when the client is placed on a behavioral plan or discharged 7. Contractor understands that the Department will not reimburse Contractor for cancelled appointments either on the part of the client or the Contractor. If the cancellation is generated from the Contractor, a "makeup" session/episode, to occur within 30 days of the cancellation, will be offered to the client (excluding session/episodes that fall on holidays). If the cancellation is generated from the client, the Contractor must request a makeup session from the Department prior to the makeup session occurring (excluding session/episodes that fall on holidays). After three (3) cancellations, Contractor will inform the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(&,weldgov.com immediately via email, to discuss service continuation. 8. Contractor will identify, in detail, areas of continued concern and make recommendations to the caseworker in a monthly report regarding continuation of services and/or the need for additional services. 9. Contractor will submit reports on a monthly basis for each active referral for ongoing services. Reports will be submitted per the online format required by the Department, unless otherwise directed by the Department. 10. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under an active referral. Areas of concern may include, but are not limited to, any physical, emotional, educational, or behavioral issues. Areas of concern should be reported to the caseworker and the Mental Health and Support Services Team HS-CWServiceReferral(a,weldgov.com immediately AND on the required monthly report. 11. Contractor agrees any change to an existing referral must be pre -approved through the Child Welfare Core Service Coordinator or any member of the Mental Health and Support Services Team. Any changes to visitation referrals will be approved by a new referral signed by the Child Welfare Supervisor. A change is defined as anything outside of the approved documented service on the initial authorized referral form. This may include an increase or decrease in services hours, change in frequency, change in location of services, transportation needs, or any change to the initial referral or subsequent authorizations. 12. Contractor agrees to attend meetings when available and as requested by the Department. Such meetings include Court Facilitations, Bid Meetings, Professional Stuffings, Family Team Meetings and/or Team Decision Making meetings. The Department will reimburse for actual participation in the meeting only so long as there is written authorization from the Mental Health and Support Services Team, and the facilitator documents in the meeting notes the timeframe that the provider attended and when participation in the meeting is deemed appropriate and necessary by the Department. The Facilitator will be responsible for filling out the time attended on the meeting notes. Stuffings and/or meetings other than those listed above are not considered reimbursable unless otherwise approved by the Child Welfare Contract and Services Coordinator. Contractor may participate by phone or virtually, if approved by the Department. 13. On a monthly basis, the Contractor will notify the Mental Health and Support Services Team HS- CWServiceReferral(lfweldgov.com of new staff who will manage and/or administer the services with the following information: a. Staff member name and contact information b. Education level/degree (if applicable) c. Licensure/credentials (if applicable) d. Department of Regulatory Authority (DORA) number (if applicable) e. Supervisor name and contact information The Department reserves the right to decline the new staff members managing and/or administering services to Department clients. 14. Compliance with Child and Family Services Review The Child and Family Services Review (CF SR) examines child welfare service outcomes in three areas: Safety, Permanency and Well Being of families. For each outcome, data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review, a Program Improvement Plan (PIP) will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review (CFSR) and will address the aforementioned three areas when completing monthly reports as required by Paragraph 9 of this Exhibit. 15. Certification Contractor certifies that, at the time of entering into this Agreement, it has currently in effect all necessary licenses, approvals, insurance, etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 16. Training Contractor may be required to attend training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees, time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 17. Subpoenas Contractor will, on behalf of its employees and/or officers, accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose, Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service, the Contractor will contact the Weld County Attorney's Office immediately at (970) 336-7235 and advise that the subpoena must be personally served. 18. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners, the Department, and the Contractor. Contractor will collaborate in a timely manner with the Department to resolve issues pertaining to service delivery, service quality, documentation, and invoicing during referral period and after services have concluded. The Contractor will require clients to sign releases of information. Contractor understands that the Department will not reimburse for services rendered to Department clients until releases of information are obtained. Contractor shall permit the Department, and any other duly authorized agent or governmental agency, to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. The monitoring agency may, if in its sole discretion deems necessary or appropriate, have access to any program data, special analyses, on -site checking, formal audit examinations, or any other reasonable procedures for purposes of monitoring. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. EXHIBIT B RATE SCHEDULE Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate(s) specified below in Paragraph 2, Fees for Services. Expenses incurred by the Contractor prior to the term of this Agreement are not eligible Department expenditures and shall not be reimbursed by the Department. For services funded through Core Services, Contractor agrees to accept reimbursement through ACH direct deposit one time per month. If Contractor is not currently set up with the State of Colorado to accept direct deposit, Contractor agrees to complete and submit a State of Colorado direct deposit enrollment form, which will be provided by the Department, with a voided check, deposit slip or bank letter. Failure to complete and submit this form and voided check in a timely and accurate manner may result in a delay of payment. For services not funded through Core Services; Contractor agrees to accept payment through County Warrant when funding source does not allow for direct deposit. Payment pursuant to this Agreement, whether in whole or in part, is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds, or any part thereof, become unavailable as determined by the Department, the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services Program Area life skills Rate 00 Unit Type I ac Service Name No Sham (Max of 2 n hoursr o h/client) 50.00 Hour Team Meeting (FTM), "Team Decision Making (TDM) Meeting, Professional Staffing 105.00 Moor Inside Out 'Nell Being Program 105.00 Hour Keep Swimming Life Skills Coaching 0.65 Mile Mileage 3. Request for Reimbursement and Supporting Documentation Contractor shall submit all Requests for Reimbursement and supporting documentation to the Department by the 7. day of the month following the month of service, but no later than 45 days from the date of service for each client receiving ongoing services. Contractor shall prepare and submit monthly a Request for Reimbursement and monthly report including other supporting documentation, if applicable, certifying that services authorized were provided on the date(s) indicated and the charges were made pursuant to the terms and conditions of Paragraph 3 of this Agreement. Monthly reports will be submitted through the Department's online reporting system, unless otherwise directed or agreed to by the Department. Monthly reports for ongoing services must include the following information, entered in the "Narrative" box for each date of service, a. Time(s) of service (i.e. 2-4pm) b. Location of where the service took place (i.e. clinician's office, client's home, in the community.) c. Clinician/therapist name d. What interventions were used, recommendations and/or goals discussed, progressions towards goals, and client engagement. e. For mileage reimbursement, if applicable, the mileage accumulated minus roundtrip mileage that is included in the rate, starting location, and ending location. f. Any and all safety concerns. When submitting a Request for Reimbursement for a one-time service, the contractor shall submit the first and last page of the evaluation/report to confirm proof of services rendered. The full evaluation/report should be submitted by the contractor to the caseworker. For Monitored Sobriety services, proof of services rendered shall be the test result. Requests for Reimbursement and/or supporting documentation received after the 7`.' day of the month may delay payment. Requests for Reimbursement and/or supporting documentation received after 45 days from the date of service may result in delay or forfeiture of payment. Consistent failure to meet the 45 -day deadline may result in termination of the Agreement. 4. Payment The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid (if Contractor is a Medicaid eligible provider) or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. Exceptions to this Paragraph may include, if approved by the Department, the following: The service being provided by the contractor is not a Medicaid eligible service; a. The service is not deemed medically necessary; b. The Court with jurisdiction over the case has ordered that a non -Medicaid provider or service be used; c. A Medicaid provider is not available to provide the needed service; d. Medicaid is exhausted for the needed service; or e. Medicaid denied service. f. The client is not eligible for Medicaid. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement, including the Financial Management requirements, program objectives, contractual terms, or reporting requirements. In the event of forfeiture of reimbursement, Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he fmd the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: Withhold payment to the Contractor until the necessary services or corrections in performance me 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 the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. Incorrect payment to the Contractor due to omission, error, fraud, and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor, or by the Department as a debt due to the Department or otherwise as provided by law. 6. Financial Management At all times from the effective date of the Agreement until completion of the Agreement, Contractor shall comply with the administrative requirements, cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and OMB Circular A-133. Exhibit C WELD COUNTY'S REQUEST FOR PROPOSAL (Weld County's Request for Proposal is incorporated into this agreement by reference and will be provided upon request to the Department.) This page is intentionally left blank Exhibit D Contractor's response to the Request for Proposal Exhibit D contains the following documents: • Attachment B — Provider Information Form (PIF) • Attachment C — Proposal • Attachment D — Staff Data Sheet • Certificate of Insurance (COI) ATTACHMENT B WELD COUNTY DEPARTMENT OF HUMAN SERVICES - PROVIDER INFORMATION FORM (PIF) AGENCY INFORMATION Agency Name: Keep Swimming, LLC Trails Provider ID (if known): Provider Contact Full Name: Wendy Faulhaber Title: Coach Practitioner Primary Phone Number (10 -digit): 303.913.3475 Ext.: Fax Number (10 -digit): Primary Contact Email: wendyjo@wendyjocoaching.com Web Address: wendyjocoaching.com Agency Location Address (street, city, state, zip): Remote Agency Mailing Address (street, city, state, zip): 190 Lane Court, Fort Lupton, CO 90621 Agency Type (pick one): Public Company D Private Non -Profit ® Private for Profit Send Referrals for Service to: Referral Contact Name: Wendy Faulhaber Title: Coach Practitioner 303 913.3475 wendyjo@wendyjocoaching.com Referral Phone Number (10 -digit): Ext.: Email: ^/� I' Billing Contact Billing Contact Name: Mike Faulhaber Billing Phone Number (lo -digit): 303.472.7453 Ext.: Title: CFP Email: keepswimming2t17@gmail.com ' I certify that the services proposed for intended use by the Weld County Department of Human Services will meet all the specifications it I has so indicated in this bid form. I further affirm intention to enter into an agreement with Weld County, on behalf of the Weld County I iDepartment of Human Services, and comply with all requirements of the contract, if awarded. The Board of Weld County Commissioners reserve the right to reject any or all bids, to waive any informality in the bids, and to accept Ithe bid, or part of a bid, that, in the opinion of the Board, is in the best interests of the Board and of the County of Weld, State of I Colorado. The Board of Weld County Commissioners shall give preference to resident Weld County bidders in all cases where the bids are ; competitive in price and quality. i WELD COUNTY IS EXEMPT FROM COLORADO SALES TAXES. THE CERTIFICATE OF EXEMPTION NUMBER IS #9g-03551-0000. Authorized Rep. Full Name: Wendy Faulhaber Title: Coach Practitioner I I Authorized Rep. Email: wendyjo@wendyjocoaching.com Phone (lo digit,: 303 913 3475 Ext.: Authorized Rep. Address (street, city, state, zip): 190 Lane Cout, t, Fort Lupton, CO 80621 Signature of Authorized Rep.: Wendy G ul aber (May 12, 202314:40 MDT) Date: 1 J REV. DECEMBER 2021 ATTACHMENT C - PROPOSAL Please type your answers in the boxes below or check the appropriate box. SECTION 1— Provider and Program Area Information Bidder's Legal Name: Program Area: Wendy Faulhaber Day Treatment Program Areas are listed in column 1 of the table located in Item XI of the Request for Proposal starting on page 13. Number of services offered on this Attachment C (max 5): You may complete another Attachment Cif you have more than 5. 2 SECTION 2 — Service Name(s) and Information If the service is a monthly package, please offer different levels. All monthly packages must state a specific minimum number of direct service hours. Service #1 Name: Keep Swimming Life Coaching 2.1a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Clifton strengths Assessment, International Coaching Federation Practices, 12 session Keep Swimming curriculum, Coaching Planner, 5 Protective Factors, Emotional Intelligence 2.1b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1 to 2 hours per week (14 hours in total) 2.1c Anticipated duration of service (i.e. 3-4 months): 12 to 16 weeks 2.1d Three (3), or more, specific goals of the service (DO use bullet points): 2.1e • Identification of top 5 values • To know and be able to use signature strengths in life situations • Identify what they want, what they will have when they get what they want and action steps to achieve Three (3), or more, specific outcomes of service: • Client can use the skills learned • Client will have strengthening language that empowers them • Education, Motivation, and Inspiration to live a successful life with intention based on their values and ability to use their strengths. • To be able to identify 4 of the 5 Protective Factors and the skills to use them • Have an understanding of what strengths they do have to offer in their relationships at fund & play and in work/education settings. 2.1f Target population of the service, including age and gender: 14 years of age and older, individual or families 2.1g Languages service is available in (please list proficiency and if interpreter_ services are available):_ English 2.1h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No 2.11 Service location — list where the service will take place (i.e. client's home, in -office, other) Services will be offered over video conferencing and other local locations in Weld County, with no more than % of the sessions being over video conferencing. Service #2 Name: Inside Out Well Being Program 2.2a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): Inside Out Curriculum, International Coaching Federation Practices, Binder with worksheets on the lessons 2.2b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 1 hour 2.2c Anticipated duration of service (i.e. 3-4 months): 3 months 2.2d Three (3), or more, specific goals of the service (DO use bullet points): The 4 Core Areas of Wellbeing REV. OCT 2021 1 ATTACHMENT C - PROPOSAL o Meaningful Connection o Environmental Connection o Inner Connection o Social Connection 2.2e Three (3), or more, specific outcomes of service: We are designed to live meaningful lives. When we lack meaning it directly impacts our health and wellbeing. • To know our meaning. • Gain motivation and dedication. • Know their purpose, values, sense of control, and sense of self-worth. 2.2f Target population of the service: Individuals 14 years of age and older or groups (4-12) of individuals of similar ages. 2.2g 2.2h Languages service is available in (please list proficiency and if interpreter services are available): English Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: No 2.2i Service location — list where the service will take place (i.e. client's home, in -office, other) Services will be offered over video conferencing and other local locations in Weld County, with no more than 2/3 of the sessions being over video conferencing. Service #3 Name: 2.3a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.3b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.3c Anticipated duration of service (i.e. 3-4 months): 2.3d Three (3), or more, specific goals of the service (DO use bullet points): 2.3e Three (3), or more, specific outcomes of service: 2.3f Target population of the service: 2.3g Languages service is available in (please list proficiency and if interpreter services are available): 2.3h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.3i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #4 Name: 2.4a Modalities, curriculum, tools used in delivery of service (DO NOT list company history; DO use bullet points): 2.4b Anticipated frequency of direct service time with the client/family per week, not including professional staffing time, administrative time, overhead, or travel time (i.e. 4 hours/week). If the service has levels, be specific for each level: 2.4c Anticipated duration of service (i.e. 3-4 months): 2.4d Three (3), or more, specific goals of the service (DO use bullet points): 2.4e Three (3), or more, specific outcomes of service: 2.4f Target population of the service: 2.4g Languages service is available in (please list proficiency and if interpreter services are available): REV. OCT 2021 2 ATTACHMENT C - PROPOSAL 2.4h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part: 2.4i Service location — list where the service will take place (i.e. client's home, in -office, other) Service #5 Name: history; bullet 2.5a Modalities, curriculum, tools used in delivery of service (DO NOT list company DO use points): 2.5b Anticipated administrative frequency of direct time, overhead, service time or travel with time (i.e. the 4 client/family hours/week). If per the week, service not including has levels, professional be specific for staffing each time, level: 2.5c Anticipated duration of service (i.e. 3-4 months): 2.5d Three (3), or more, specific goals of the service (DO use bullet points): 2.5e Three (3), or more, specific outcomes of service: 2.5f Target population of the service: 2.5g Languages service is available in (please list proficiency and if interpreter services are available): 7 2.5h Medicaid eligibility — list whether the service is eligible for Medicaid in whole or in part 2.6i Service location — list where the service will take place (i.e. client's home, in -office, other) Section 3 — Service Access Transportation and 3.1 Will you charge Weld County for transporting clients or mileage? Check one: YES ❑ NO 3.2 Will you conduct services in a client's home or in the community? Check one: YES ❑ NO 3.3 Will you transport clients to and/or from services? Check one: ❑ YES NO 3.4 How many miles are you willing to travel round trip? List a specific number of miles. 100 Miles 3.5 When you calculate mileage, what is your starting point address? 190 Lane Court, Fort Lupton, CO 80621 SECTION 4 - SERVICE RATES All rates need to include administrative work (i.e. scheduling or report writing) and overhead. Rates cannot be per episode, except for home studies and monitored sobriety testing. Only hourly or monthly rates will be accepted for services, except for those listed above. • For hourly rates complete section(s) 4.1-4.5. • For monthly rates complete section 4.6. • For Home study providers complete section 4.7. • For monitored sobriety testing providers complete section 4.8. 4.1 Hourly Service #1 Name: Keep Swimming Life Skills Coaching 4.1a In-Office/Video: 4.1b In -Home or Community: $ Amount Unit Type Select Unit Type. Select Unit Type. No. of roundtrip miles included in rate: 0 miles REV. OCT 2021 3 ATTACHMENT C - PROPOSAL 4.1c In-Office/Video, In -Home, or Community with Transportation: 4.1d FTM, TDM, Prof. Staffing: 4.1e No show: 4.1f Mileage rate: 1529.50 50.00 0.65 flat fee per Hour per No Show per Mile No. of roundtrip miles included in rate: 0 This is paid after the miles listed above. miles 4.2 Hourly Service #2 Name: 4.2a Inside Out Well Being Program In-Office/Video: 4.2b In -Home or Community: 4.2c In-Office/Video, In -Home, or Community with Transportation: 4.2d FTM, TDM, Prof. Staffing: 4.2e No show: 4.2f Mileage rate: $ Amount 1200.00 50.00 0.65 U nit Type Select Unit Type. Select Unit Type. flat fee per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: 0 0 miles miles This is paid after the miles listed above. 4.3 Hourly Service #3 Name: 4.3a In-Office/Video: 4.3b In -Home or Community: 4.3c In-Office/Video, In -Home, or Community with Transportation: 4.3d FTM, TDM, Prof. Staffing: 4.3e No show: 4.3f Mileage rate: $ Amount U nit Type Select Unit Type. Select Unit Type. Select Unit Type. per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles This is paid after the miles listed above. 4.4 Hourly Service #4 Name: 4.4a In-Office/Video: 4.4b In -Home or Community: 4.4c In-Office/Video, In -Home, or Community with Transportation: 4.4d FTM, TDM, Prof. Staffing: 4.4e No show: 4.4f Mileage rate: $ Amount U nit Type Select Unit Type. Select Unit Type. Select Unit Type. per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: miles miles This is paid after the miles listed above. 4.5 Hourly Service #5 Name: 4.5a In-Office/Video: 4.5b In -Home or Community: 4.5c In-Office/Video, In -Home, or Community with Transportation: 4.5d FTM, TDM, Prof. Staffing: 4.5e No show: 4.5f Mileage rate: $ Amount U nit Type Select Unit Type. Select Unit Type. Select Unit Type. per Hour per No Show per Mile No. of roundtrip miles included in rate: No. of roundtrip miles included in rate: This is paid after the miles listed above. miles miles REV. OCT 2021 4 ATTACHMENT C - PROPOSAL 4.6 Monthly Service Rates (each level must be listed): Service Name with Level Rate Month per Minimum Service: Hours of 4.6a 4.6b 4.6c 4.6d 4.6e 4.6f 4.6g 4.6h 4.6i 4.6j 4.7 Home Study Providers — List your rates in the box below. Minimum 4.8 Monitored Sobriety Providers — List your rates in the box below. Provider special notes: Service 1 is 12 weeks (14 hours, package total 1529.50) including a coaching planner, materials, and supplies. Service 2 12 weeks (12 hours, package total 1200.00) includes 12 -week curriculum binder, materials, and supplies. REV. OCT 2021 5 ATTACHMENT D - STAFF DATA SHEET Bidder Must List All Staff Who Will Administer the Proposed Service(s) BIDDER'S LEGAL NAME (As it appears on the W-9) AGENCY CONTACT. Wendy Faulhaber Wendy Faulhaber PHONE NUMBER 303 913 3475 EMAIL WendyJo@WendyJocoaching corn PROPOSED SERVICE(S) Strengths Based Life Coaching Programs fYj �, Legal Last Name ; - Meddle . Initial . - Previous Legai Last Name (If applicable) �^ _ Legal First Name v �Y , , a Service Type , q`1, P f Licens _ , Credentials - t y��.ff ',1 „ t DORA # (If applicable) j Faulhaber J Sarazen Wendy Day Treatment ICF-ACC CHILD WELFARE REQUEST FOR PROPOSAL 2023-24 - VARIOUS SERVICES AMERICAN FAMILY PO Box 5316 Binghamton,NY13902 Keep Swimming LLC 190 Lane Ct Fort Lupton,CO 80621 Dear Keep Swimming LLC, American Family Insurance - Business Insurance Underwritten by: Midvale Indemnity Company A Wisconsin Stock Company Tel: (866) 908-0626 Policy Number: CP00009684 Date: 04/10/2023 American Family Insurance - Business Insurance is pleased to be of service to you. Our objective is to provide you with comprehensive and professional products for all of your insurance needs. Please find the enclosed policy documents. If you have any questions, please contact your agent or our Service Center at (866) 908-0626 Sincerely, Customer Care Department Policies are underwritten and issued by member companies and affiliates of Homesite Group Incorporated. Policies are underwritten by Midvale Indemnity Company (California Certificate of Authority Number 2224-4) BID COVL 0001 12 17 AMERICAN FAMILY PO Box 5316 Binghamton, NY 13902 (866) 908-0626 American Family Insurance - Business Insurance Underwritten by: Midvale Indemnity Company A Wisconsin Stock Company Date: 04/10/2023 NOTICE OF POLICY CHANGE Important Notice for: Keep Swimming LLC Email contact: keepswimming137@gmail.com Policy Number CP00009684 Policy Type Commercial General Liability Policy Period 02/02/2023 to 02/02/2024 Effective Date of Endorsement 04/10/2023 We have made change(s) to your insurance policy. - Add Al through MEA This results in a $ 33 change to your premium. Insurance Carrier Midvale Indemnity Company Please login to 'Manage My Account' in order to access your policy information. We encourage you to read through the endorsement to make sure that we captured your request correctly. If you need personal assistance, please call (866) 908-0626 or email us at service@amfambusinessinsurance.com Thank you and we appreciate your business. BID 0009 12 17 AMERICAN FAMILY MIDMIIZEICEIN Send policy correspondence to: PO Box 5316 Binghamton,NY 13902 (866) 908-0626 American Family Insurance - Business Insurance Underwritten by: Midvale Indemnity Company A Wisconsin Stock Company Geoffrey Torres 13659 E 104TH AVE UNIT 550 COMMERCE CITY, CO 80022 (303) 429-7024 POLICY DECLARATIONS Information as of 04/10/2023 This document and your policy contract define our insuring agreement. In return for payment of premium and subject to all the terms of this policy, we agree to provide you insurance as stated in the policy. Policy Information Named Insured: Keep Swimming LLC E-mail Address: keepswimming137@gmail.com Phone: 3039133475 Location Information Location #1 (Primary location) Address: 190 Lane Ct Fort Lupton, CO 80621 Policy Number: CP00009684 Policy Type: Commercial General Liability Policy Period: 02/02/2023 to 02/02/2024 12:01AM Standard Time at Primary Location Policy Level Coverage (limits & deductibles shown are non-stackable across locations) General Liability Per Occurrence Limit General Aggregate Limit (other than products/completed operations) Products/Completed Operations Aggregate limit Personal and Advertising Injury limit Damage to Premises Rented to You (limit per premises) Medical Payments (limit per person) Liability Property Damage Deductible BID CMP 1001 01 18 Limit $1,000,000 $2,000,000 $2,000,000 $1,000,000 $100,000 $5,000 Deductible $500 Page 1 of 3 Other Liability Coveraue Employee Benefits Liability Limit Deductible $1,000,000 $1,000 General Liability Premium $632 Classification Information Location Class Code Class Description Exposure Basis Exposure Amount 41677 Consultants Payroll $31,500 92100 Employee Benefits Liability Coverage Number of 0 Employees Policy Premium $632 Discounts Applied to This Policy Loss -Free Marketing Source Policy Forms and Endorsements CG 00 01 04 13 CG 03 00 01 96 CG 04 35 12 07 CG 20 15 04 13 CG21011185 CG 21 06 05 14 CG 21 47 12 07 CG 21 50 04 13 CG 21 70 01 15 CG 24 26 04 13 CG 74 10 03 21 CG 77 48 03 21 IL 00 21 09 08 IL 01 25 11 13 IL 02 28 09 07 IL 09 85 01 15 IL N 020 09 03 COMMERCIAL GENERAL LIABILITY COVERAGE FORM DEDUCTIBLE LIABILITY INSURANCE EMPLOYEE BENEFITS LIABILITY COVERAGE ADDITIONAL INSURED - VENDORS EXCLUSION - ATHLETIC OR SPORTS PARTICIPANTS EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY INJURY EXCEPTION EMPLOYMENT -RELATED PRACTICES EXCLUSION AMENDMENT OF LIQUOR LIABILITY EXCLUSION CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM AMENDMENT OF INSURED CONTRACT DEFINITION ADDITIONAL INSURED -BLANKET PUNITIVE DAMAGES EXCLUSION NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) COLORADO CHANGES - CIVIL UNION COLORADO CHANGES - CANCELLATION AND NONRENEWAL DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT COLORADO FRAUD STATEMENT In witness whereof, we have caused this policy to be signed by our authorized officers. BID CMP 1001 01 18 Page 2 of 3 Home Office MIDVALE INDEMNITY COMPANY 6000 American Parkway Madison, WI 53783 Tony Desantis, Jr. President David Holman Secretary BID CMP 1001 01 18 Page 3 of 3 ACS R Lf CERTIFICATE OF LIABILITY INSURANCE DATE (MM1OWYYW) 04/10/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement,$). PRODUCER Geoffrey Torres 13659 E 104TH AVE UNIT 550 COMMERCE CITY CO 80022 CONTACT NAME: Geoffrey Torres PHaNE FAX WC, No. Et.: (303) 429-7024 I (LAIC. Not: E-MAIL ADDRESS: gtommt)gamfam.Com INSURER,. AFFORDING COVERAGE NAIL 8 INSURER A: Midvale Indemnity Company 27138 INSURED Keep Swimming LLC 190 Lane Ct Fort Lupton CO 80621 INSURER B : INSURER C INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 00002704389721 REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED LISTED BY THE BY BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF PAID CLAIMS. 1NSR - TYPE OF INSURANCE AOsi MOOR INN. VVVO POLICY NUMBER POLICY EFF (MMAJDIYYYYI " POLICY EXP WINODIyyYY) LIMITS A COMMERCIAL GENERAL UABILITY 1,VA24.- IX I OCCUR Y 0 �SP00008884 0210212023 0210212024 CHIT OCCURRENCE 51,000,000 DAMAGE TO RENTED PREMISES (Ea Occurrence) 5100,000 MED EXP (Any one person) $5,000 PERSONAL 8 ADV INJURY 51,000,000 GEM. AGGREGATE LIMIT APPLIES PER: X POLICY El O- I�,.,.`^' OTHER: � GENERAL AGGREGATE §2 000 000 PRODUCTS - COMP/OP AGG 32,000,000 WTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED ALTOS ^ NON -OWNED ONLY AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE ,Per accident) UMBRELLA UAB OCCUR EXCESS LIAR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I RETENTION $ NORKERSCOMPENSATION AND EMPLOYERS` LIABILITY YIN ANV PROPRIETORIPARTNER/EXECU -TIVE OFFICERIMEM�R atEnED7 El (Mandatory In NH) V yes, describe under DESCRIPTION OF OPERATIONS_below N/A 'STATUTE IOER E.L. EACH ACCIDENT E.L. DISEASE - EA E.L. DISEASE - POLICY LIMIT PROFESSIONAL LIABILITY OCCURRENCE AGGREGATE DESCRIPTION OF OPERAOl005 /LOCATIONS /VEHICLES ("CORD 101, AdditionalRemarks Schedule, nay be *ached N more space is reguired) AEA" CERTIFICATE HOLDER CANCELLATION BOARD OF COUNTY COMMISSIONERS OF WELD COUNTY AND ITS OFFICERSIEMPLOYEES 1180 0 5T GREELEY CO 80871 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CP00009684' COMMERCIAL GENERAL LIABILITY CG 20 15 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - VENDORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) (Vendor) Your Products Hoard of County Commissioners of Weld County and its Officers/Employees Organization Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business. However: 1. The insurance afforded to such vendor only applies to the extent permitted by law; and 2. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. CG 20 15 04 13 B. With respect to the insurance afforded to these vendors, the following additional exclusions apply: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; © Insurance Services Office, Inc., 2012 Page 1 of 2 e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in Sub- paragraphs d. or f.; or Page 2 of 2 (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. C. With respect to the insurance afforded to these vendors, the following is added to Section III — Limits Of Insurance: If coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CG 20 15 0413 SIGNATURE REQUESTED: Weld/Keep Swimming, LLC PSA Final Audit Report 2023-05-12 Created 2023-05-10 By: Windy Luna (wluna@co.weld.co.us) Status: Signed Transaction ID: CBJCHBCAABAA1_ZgBOiyTNiO-jF8Y-W5FglBeZr32V7 "SIGNATURE REQUESTED: Weld/Keep Swimming, LLC PSA" History t Document created by Windy Luna (wluna@co.weld.co.us) 2023-05-10 - 7:56:39 PM GMT -► Document emailed to wendyjo@wendyjocoaching.com for signature 2023-05-10 - 7:57:33 PM GMT In Email viewed by wendyjo@wendyjocoaching.com 2023-05-11 - 5:54:26 AM GMT t Email viewed by wendyjo@wendyjocoaching.com 2023-05-12 - 8:38:54 PM GMT O1j Signer wendyjo@wendyjocoaching.com entered name at signing as Wendy Jo Faulhaber 2023-05-12 - 8:40:01 PM GMT 4 Document e -signed by Wendy Jo Faulhaber (wendyjo@wendyjocoaching.com) Signature Date: 2023-05-12 - 8:40:03 PM GMT - Time Source: server Agreement completed. 2023-05-12 - 8:40:03 PM GMT Powered by Adobe Acrobat Sign Contract Form Entity Name' KEEP SWIMMING LLC Entity ID' @00047073 Contract Name' KEEP SWIMMING, LLC (RELATED TO BID #62300040) PROFESSIONAL SERVICES AGREEMENT Contract Status CTB REVIEW ❑ New Entity? Contract ID 7002 Contract Lead' WLUNA Contract Lead Email w!una #weldgov.com;cobbx xlk@weldgov.com Parent Contract ID Requires Board Approval YES Department Project Contract Description' (CONSENT) KEEP SWIMMING, LLC (NEW BID #62.300040) PROFESSIONAL SERVICES AGREEMENT. TERM 06,101/2023 THROUGH 05131/2024. Contract Description 2 PROVIDER WAS LISTED ON APPROVED VENDOR UST PRESENTED TO BOCC ON 03/29/2023 AND AS A COMMUNICATION ITEM/PA SENT TO CTB ON 03/20/2023. Contract Type' AGREEMENT Amount' $0.00 Renewable' YES Automatic Renewal If this is a renewal enter Department HUMAN SERVICES Department Email CM- HumanServices@weldgov.co m Department Head Email CM-HumanServices- DeptHead@weldgov.com County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY LDG OV.COM Contract ID If this is part of a MA enter NSA Contract ID Requested BOCC Agenda Date' 05/24/2023 Due Date 05/20/2023 MI! a work session with BOCC be required?' NO Does Contract require Purchasing Dept_ to be included? Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Review Date* 03/29/2024 Renewal Date* 05/31/2024 Termination Notice Period Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Department Head JAMIE ULRICH DH Approved Date 05/15/2023 BUCC Signed Date BOCC Agenda Date 05/22/2023 Originator WLUNA Committed Delivery Date Finance Approver CHERYL PATTELLI Expiration Date Purchasing Approved Date Finance Approved Date 05/17/2023 Tyler Ref # AG 052223 Legal Counsel BYRON HOWELL Legal Counsel Approved Date 05/18/2023 Houstan Aragon From: Sent: To: Subject: noreply@weldgov.com Friday, April 4, 2025 1:36 PM CM-ClerktoBoard; Windy Luna; Lesley Cobb; CM-HumanServices-DeptHead Fast Tracked Contract ID (9302) Contract # 9302 has been Fast Tracked to CM -Contract Maintenance. You will be notified in the future based on the Contract information below: Entity Name: KEEP SWIMMING LLC Contract Name: KEEP SWIMMING,LLC (PROFESSIONAL SERVICES AGREEMENT AMENDMENT #1 &2) (RELATED TO BID# B2300040) Contract Amount: $0.00 Contract ID: 9302 Contract Lead: WLUNA Department: HUMAN SERVICES Review Date: 3/31/2026 Renewable Contract: NO Renew Date: Expiration Date:5/31/2026 Tyler Ref #: Thank -you �o�vaC� 1Dta3p2 t2k\A-ewed 1673 -i(43 ASPEN COUNSELING, LLC Houstan Aragon From: Sent: To: Cc: Subject: Sara Adams Friday, April 4, 2025 1:15 PM CTB HS -Contract Management FAST TRACK - Various Core Agreements (Tyler# Various) Good afternoon CTB, FAST TRACK ITEM: The below list will be Fast Track items in CMS for tracking purposes only to correct the expiration date. 8150 8141 2023-1393 9291 8165 CASA OF LARIMER COUNTY 8176 2024-1270 9293 28 CREATIVE NURSING, LLC 8151 2024-1221 9297 171 CRUX COUNSELING, LLC 8132 2023-1396 9300 7, KEEP SWIMMING, LLC 8750 8167 r, 2023-1438 9302 MAISHA BORA LLC 8163 2024-1265 9304 8383 NOCO SPEECH & DIAGNOSTICS 8156 8187 2023-1439 9306 POLARIS PARTNERS LLC REACHING HOPE RHEGNUMI CONSULTING, LLC 8148 2023-1401 9308 8190 2024-1321 9310 8168 2024-1267 9312 SENSITIVE SOLUTIONS BEHAVIORAL HEALTH, LLC 8182 2024-1271 9314 SIMPLE ASSENT, LLC 8215 2024-1416 9323 SPECIALTY COUNSELING & CONSULTING LLC 8263 2024-1474 9317 UNIVERSITY OF NORTHERN COLORADO 8219 2024-1327 9319 WILLOW COLLECTIVE PLLC Mt YUIMOS PRA►Yg. t 8192 2024-1323 9015 : 2023-1397 9321 Thank you, Sara COUNTY, CO Sara Adams Contract Administrative Coordinator Department of Human Services Desk: 970-400-6603 P.O. Box A, 315 N. 11th Ave., Greeley, CO 80632 0.000 Join Our Team Important: 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. 2 Hello