HomeMy WebLinkAbout20211729.tiffCorth/aC+I "a
sI AGREEMENT AMENDMENT BETWEEN
THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES
AND RACHEL JASPER AND BRANDON JASPER
This Agreement Amendment, made and entered into 154! ,day of V 2022, 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 Rachel Jasper and Brandon Jasper, hereinafter referred to
as the "Contractor".
WHEREAS the parties entered into an Agreement for Respite Services, (the "Original Agreement")
identified by the Weld County Clerk to the Board of County Commissioners as document Tyler ID No. 2021-1729,
approved on June 30, 2021.
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 June 30, 2022.
• 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:
1. Term
This agreement is being renewed for the second year, for the period of July 1, 2022 through June 30, 2023.
2. Name Change
Reflect name change from Rachel Winterfeld to Rachel Jasper.
3. Name Addition
Brandon Jasper is now added as the "Contractor".
• All other terms and conditions of the Original Agreement remain unchanged.
L'/ i3/z2
ZOZ1-129
0ln/13/ ZZ
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and
year first above written.
ATTEST:
Jerk to the Board_
BY: L-
Deputy
1861
BOARD OF COUNTY COMMISSIONERS
WELI'COUNTY, COLORADO
K. James, Chair
JUN 1 3 2022
Rachel and Brandon Jasper
4907 West 23rd Street Road
Greeley, Colorado 80634
By: Rachei Ja (Jun 1.20221442 MDT;
Rachel Jasper
Jun 1, 2022
Date:
By: Brandon Jasper (Jun 1, 202215:16 MD0'
Brandon Jasper
Jun 1, 2022
Date:
New Contract Request
Entity Information
Entity Name*
JASPER, RACHEL
Contract ID
5946
Contract Name *
JASPER, RACHEL AND BRANDON RESPITE AMENDMENT
Contract Status
CTB REVIEW
Contract Lead
WLUNA
Contract Lead Email
wiuna@weldgov.com, cobbx
xlk@weldgov.com
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Desorption
(CONSENT) JASPER, RACHEL AND BRANDON RESPITE AMENDMENT. TERM: 07/01 /2022 TO 06/30/2023
Contract Description 2
PA ROUTED TO CTB ON 05/ 17/2022
Contract Type *
Department
Requested BOCC Agenda Due Date
AMENDMENT
HUMAN SERVICES
Date* 05/14/2022
05/18/2022
Amount *
Department Email
$0.00
CM-
Will a work session with BOCC be required?*
HumanServicesC@weldgov.co
NO
Renewable
m
NO
Does Contract require Purchasing Dept- to be included?
Department Head Email
Automatic Renewal
CM -Human Services -
De ptH a ad ewe l d gov. con
Grant
County Attorney
GENERAL COUNTY
WA
ATTORNEY EMAIL
County Attorney Email
CM-
COU NTYATTORN EY@WELDG
OV.COM
If this is a renewal enter previous Contract ID
if this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in
OnBase
Contract Dates
Effective Date Review Date * Renewal Date
04/2812023
Termination Notice Period Committed Delivery Date Expiration Date*
06/30/2023
Contact Information
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
CONSENT 06 / 0.31` 2022
Approval Process
Department Head Finance Approver Legal Counsel
JAMIE ULRICH CONSENT CONSENT
DH Approved Date Finance Approved Date Legal Counsel Approved Date
06/03/2022 06/03,2022 06/03/2022
Final Approval
BOCC Tyler Ref #
AG 061322
BOCC Signed Date
BOCC Agenda Date
06/13/2022
Originator
WLUNA
AGREEMENT FOR RESPITE SERVICES BETWEEN WELD COUNTY,
ON BEHALF OF WELD COUNTY DEPARTMENT OF HUMAN SERVICES, AND
-744
THIS AGREEMENT is made and entered into this day of 2021
by and between the Board of County Commissioners of the County of W ld, State of Colorado,
on behalf of the Weld County Department of Human Services, whose address is 1150 "O" Street,
Greeley, Colorado 80631, hereinafter referred to as "County", and Rachel Winterfeld, whose
address is 4907 West 23rd Street Road, Greeley, Colorado 806345 hereinafter referred to as
"Contractor."
WITNESSETH:
WHEREAS, required approval, clearance, and coordination have been accomplished
from and with appropriate agencies; and
WHEREAS, the Colorado Department of Human Services has provided funding to the
County for respite care for Weld County certified foster care homes; and
WHEREAS, County has determined that due to the significant challenges often
experienced by certified foster care providers, it is necessary to offer them respite services, as
described in Exhibit A, "Scope of Services", a copy of which is attached hereto and made a part
hereof by this reference, to allow them to continue to provide high quality care for the children in
their charge, and
WHEREAS, Contractor is willing and able to abide by the terms and conditions required
by County, as more fully set forth in this Agreement,
WHEREAS, Contractor is able and available to provide respite services as defined in this
Agreement at the rates set forth in Exhibit B, "Rate Schedule" a copy of which is attached hereto
and made a part hereof by this reference,
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein, the parties hereto agree as follows:
RESPITE CARE PROVIDER'S RIGHTS AND RESPONSIBILITIES:
As used in this Agreement "Respite Care" is defined as those child care services
required by one or more children who are in the care of a certified foster home,
which services are provided by Contractor in order to give foster parents an
opportunity to address matters which cannot be addressed while caring for the
child(ren) in their care. These services are described in Exhibit A. These services
may also include transporting the child to school and other appointments previously
arranged by the foster parent. Transportation services are provided at the sole
risk, responsibility and liability of Contractor.
2021-1729
1 �� Revised 6/2021
2. Contractor may provide up to sixteen (16) hours of Respite Care per child per
month for certified Weld County foster homes seeking respite care, as approved by
the Department. The hours of respite care may be provided in any combination
(schedule) throughout the month so long as the total hours provided does not exceed
sixteen (16) hours per month.
3. 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 OMG
Circular A-133.
4. Contractor agrees to accept payment by either County warrant or ACH direct
deposit.
5. Contractor agrees to obtain a criminal background check and warrants that if any
previous criminal charge filed against Contractor does not appear in the background
check, he/she shall disclose such charges.
6. Contractor assures that it will fully comply with all applicable Federal and State
laws which govern the ability of the County to comply with the relevant funding
requirements.
7. Contractor assures and certifies as follows:
a. He/She is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation with any
program with a Federal or State department or agency; and
b. He/She has not, within a three-year period preceding this Agreement, been
convicted of or had a civil judgment rendered against him/her for
commission of fraud or criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, State or Local)
transaction or contract under public transaction; or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, or receiving stolen property; and
c. He/She is not presently indicted for or otherwise criminally or civilly
charged by a government entity (federal, state or local) with commission of
any of the offenses enumerated in this certification; and
d. He/She has not, within a three-year period preceding this Agreement, had
one or more public transactions (federal, state, or local) terminated for cause
or default.
2 Revised 6/2021
8. Contractor certifies, warrants, and agrees that it does not knowingly employ or
contract with an illegal alien who will perform work under this
contract. Contractor will confirm the employment eligibility of all employees who
are newly hired for employment in the United States to perform work under this
Agreement, through participation in the E -Verify program or the State of Colorado
program established pursuant to C.R.S. §8-17.5-102(5)(c). Contractor shall not
knowingly employ or contract with an illegal alien to perform work under this
Agreement or enter into a contract with a subcontractor that fails to certify with
Contractor that the subcontractor shall not knowingly employ or contract with an
illegal alien to perform work under this Agreement. Contractor shall not use E -
Verify Program or State of Colorado program procedures to undertake pre-
employment screening or job applicants while this Agreement is being
performed. If Contractor obtains actual knowledge that a subcontractor
performing work under the public contract for services knowingly employs or
contracts with an illegal alien, Contractor shall notify the subcontractor and County
within three (3) days that Contractor has actual knowledge that a subcontractor is
employing or contracting with an illegal alien and shall terminate the subcontract
if a subcontractor does not stop employing or contracting with the illegal alien
within three (3) days of receiving notice. Contractor shall not terminate the
contract if within three days the subcontractor provides information to establish that
the subcontractor has not knowingly employed or contracted with an illegal
alien. Contractor shall comply with reasonable requests made in the course of an
investigation, undertaken pursuant to C.R.S. §8-17.5-102(5), by the Colorado
Department of Labor and Employment. If Contractor participates in the State of
Colorado program, Contractor shall, within twenty days after hiring a new
employee to perform work under the contract, affirm that Contractor has examined
the legal work status of such employee, retained file copies of the documents, and
not altered or falsified the identification documents for such
employees. Contractor shall deliver to County, a written notarized affirmation that
it has examined the legal work status of such employee and shall comply with all
of the other requirements of the State of Colorado program. If Contractor fails to
comply with any requirement of this provision or of C.R.S. §8-17.5-101 et seq.,
County, may terminate this Agreement for breach, and if so terminated, Contractor
shall be liable for actual and consequential damages.
9. Except where exempted by federal law and except as provided in C.R.S. § 24-76.5-
103(3), if Contractor receives federal or state funds under the contract, Contractor
must confirm that any individual natural person eighteen (18) years of age or older
is lawfully present in the United States pursuant to C.R.S. § 24-76.5-103(4), if such
individual applies for public benefits provided under the contract. If Contractor
3 Revised 6/2021
operates as a sole proprietor, it hereby swears or affirms under penalty of perjury
that it: (a) is a citizen of the United States or is otherwise lawfully present in the
United States pursuant to federal law, (b) shall produce one of the forms of
identification required by C.R.S. § 24-76.5-101, et seq., and (c) shall produce one
of the forms of identification required by C.R.S. § 24-76.5-103 prior to the effective
date of the contract.
10. Contractor certifies that, at the time of entering into this Agreement, he/she has
currently in effect all necessary licenses, approvals, insurance, etc., required to
properly provide the services covered by this Agreement. These requirements
include the following:
a. Current Colorado driver's license indicating Contractor is at least eighteen
(18) years of age; and
b. Completed background check through the Colorado Bureau of Investigation
(CBI) and the Federal Bureau of Investigation (FBI).
c. Current CPR and First Aid certifications. If either certification expires
during the term of this Agreement, Contractor shall renew the certification
ensuring that there is no lapse in certification. County will pay for
certification through select CPR and First Aid trainers identified by the
County.
d. Contractor shall procure at least the minimum amount of automobile
liability insurance required by the State of Colorado. County provides no
automobile liability coverage for Contractor. Proof of said automobile
liability insurance shall be provided to County prior to the performance of
any services under this Agreement.
e. Copies of all documentation relating to the foregoing requirements shall be
provided to the County by Contractor prior to the performance of any
services covered under this Agreement. County shall determine eligibility
for certification based upon the successful completion of all required
training and receipt of current documentation.
11. Contractor shall have attended either fifteen (15) hours of PRIDE training or 27
hours of the National Training and Development Curriculum (NTDC) through the
Weld County Department of Human Services prior to the performance of services
under this Agreement. County shall not compensate Contractor for said training;
including time spent traveling to and from training, time spent in attendance of the
training, or any associated costs paid by Contractor for such training, unless
specifically agreed to in writing in advance by County.
12. Contractor shall indemnify, defend and hold harmless Weld County, the Board of
County Commissioners of Weld County, its employees, volunteers and agents for
any damages caused by his/her actions while performing services pursuant to this
4 Revised 6/2021
Agreement, and shall hold County harmless from any loss occasioned as a result
of the performance of this Agreement.
13. Contractor shall be totally responsible to provide whatever personal liability
and/or other insurances he/she deems necessary to cover his/her personal liability
for any injuries caused by Contractor in the course of providing services under
this Agreement.
14. Contractor shall perform his/her duties hereunder as an independent contractor
and not as an employee of County. Contractor shall be solely responsible for
his/her acts performed pursuant to this Agreement. Under no circumstances shall
Contractor be deemed to be an agent or employee of Weld County. Contractor is
not entitled to unemployment insurance or workers' compensation benefits
through Weld County and Weld County shall not pay for or otherwise
provide such coverage for Contractor. Unemployment insurance benefits will
not be available to Contractor for services provided under this Agreement.
Contractor shall pay when due any/all applicable employment taxes and
income taxes and local head taxes (if applicable) incurred as a result of the
services provided under this Agreement.
15. Contractor shall not have authorization, express or implied, to bind County to any
agreement, liability or understanding.
16. Contractor agrees that he/she shall not use alcohol, illegal drugs, marijuana,
whether for recreational or medical purposes, or any other drugs which have the
potential of impacting Contractor's ability to supervise the children in his/her care
while providing services under this Agreement or within five (5) hours prior to
the provision of said services.
Contractor shall protect the confidentiality of all records and other materials to
which he/she has access relating to the foster family and child(ren) to whom the
services are provided, which are maintained in accordance with this Agreement
except for purposes directly connected with the administration of Child
Protection.
COUNTY'S RIGHTS AND RESPONSIBILITIES:
Weld County, the Board of County Commissioners of Weld County, its officers
and employees, shall not be held liable for injuries or damages caused by any
negligent acts or omissions of Contractor while performing duties described in this
Agreement.
2. County shall not indemnify Contractor for any loss incurred by Contractor as a
Revised 6/2021
result of services performed under this Agreement.
3. County shall pay Contractor in accordance with the terms set forth in Exhibit B, as
long as services are rendered satisfactorily and in accordance with the Agreement.
4. Payment pursuant to this Agreement is subject to, and contingent upon, the
continuing availability of funds made available for the purposes hereof. No portion
of this Agreement shall be deemed to create an obligation on the part of County to
expend funds not otherwise appropriated. The County may terminate this
Agreement at any time if said source of funding is no longer available to County.
County may withhold payment under this Agreement if Contractor fails to comply
with any part of the Agreement. In the event County withholds payment, Contractor
may appeal such circumstance in writing to the Weld County Director of Human
Services. The decision of the Weld County Director of Human Services shall be
final.
GENERAL PROVISIONS:
1. This Agreement shall become effective on July 1, 2021, upon proper execution of
this Agreement, and shall expire on June 30, 2022 unless sooner terminated as
provided herein. This Agreement is for a period of three years subject to annual
renewal by written mutual agreement of the parties.
2. Either party may terminate this Agreement at any time for any reason by providing
the other party with a 30 -day written notice thereof. Furthermore, this Agreement
may be terminated by County at any time without notice upon a material breach by
Contractor of the terms of the Agreement.
3. Contractor may not assign or transfer this Agreement, any interest therein or claim
hereunder, without the prior written approval of County. 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.
4. No term or condition of this contract 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 of §§24-10-101 et. seq.,
as applicable now or hereafter amended.
6 Revised 6/2021
5. If any section, subsection, paragraph, sentence, clause, or phrase of this Agreement
is for any reason held or decided to be unconstitutional, such decision shall not
affect the validity of the remaining portions. The parties hereto declare that they
would have entered into this Agreement and each and every section, subsection,
paragraph, sentence, clause, and phrase thereof irrespective of the fact that any one
or more sections, subsections, paragraphs, sentences, clauses, or phrases might be
declared to be unconstitutional or invalid.
6. No officer, member or employee of County and no member of their governing
bodies shall have any pecuniary interest, direct or indirect, in the approved
Agreement or the proceeds thereof. The appearance of conflict of interest applies
to the relationship of a Contractor with County when the Contractor also maintains
a relationship with a third party and the two relationships are in opposition. In
order to create the appearance of a conflict of interest, it is not necessary that the
Contractor gain from knowledge of these opposing interests. It is only necessary
that the Contractor knows that the two relationships are in opposition. During the
term of the Agreement, Contractor shall not enter into any third -party relationship
that gives the appearance of creating a conflict of interest. Upon learning of an
existing appearance of a conflict of interest situation, Contractor shall submit to the
Department, a full disclosure statement setting forth the details that create the
appearance of a conflict of interest. Failure to promptly submit a disclosure
statement required by this paragraph shall constitute grounds for the Department's
termination, for cause, of its Agreement with the Contractor. Contractor certifies
that no Federally appropriated funds have been paid or will be paid, by or on behalf
of Contractor, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of an Federal contract, loan, grant, or
cooperative agreement.
7. This Agreement, together with Exhibits A and B, constitutes the entire
understanding between the parties with respect to the subject matter hereof, and
may not be changed or modified, unless by a written amendment executed by both
parties. This Agreement shall be binding upon the parties hereto, their successors,
heirs, legal representatives, and assigns. Neither County nor Contractor may
assign any of its rights or obligations hereunder without the prior consent of the
other party.
8. This Agreement shall not be valid until it has been approved by the Board of County
Commissioners of Weld County, Colorado.
7 Revised 6/2021
9. 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.
10. 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.
11. 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 God, fires, strikes, war, flood, earthquakes or Governmental
actions.
12. All work and information obtained by Contractor under this Agreement or
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.
13. 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 this project without
County's prior written consent, which may be withheld in County's sole discretion.
14. Upon completion of the work, the Contractor shall submit to Department originals
of all tests and results, reports, etc., generated during completion of this work.
Acceptance by Department of reports and incidental material(s) furnished under
this Agreement shall not in any way relieve the Contractor of responsibility for the
quality and accuracy of the services. In no event shall any action by the Department
hereunder constitute or be construed to be a waiver by the Department of any breach
of covenant or default which may then exist on the part of the Contractor, and the
Department's action or inaction when any such breach or default shall exist shall
not impair or prejudice any right or remedy available to the Department with respect
to such breach or default; and 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 Department of, or
payment for, any services performed under this Agreement shall not be construed
as a waiver of any of the Department's rights under this Agreement or under the
law generally.
8 Revised 6/2021
15. The Contractor warrants that services performed under this Agreement will be
performed in a manner consistent with the professional standards governing such
services and the provisions of this Agreement. The Contractor shall faithfully
perform the work in accordance with the standards of care, skill, training, diligence
and judgment provided by highly competent individuals and entities that perform
services of a similar nature.
16. This Agreement does not guarantee any work nor does it create an exclusive
agreement for services.
17. Contractor agrees that authorized local, Federal, and State auditors and
representatives shall, during business hours, have access to inspect and copy
records, and shall be allowed to monitor and review through on -site visits, all
activities related to this Agreement, supported with funds under this Agreement, to
ensure compliance with the terms of this Agreement. Contracting parties agree
that monitoring and evaluation of the performance of the Agreement shall be
conducted by appropriate funding sources. The results of the monitoring and
evaluation activities shall be provided to the appropriate and interested parties.
9 Revised 6/2021
IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the
day, month, and year first above written.
COUNTY:
1861
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
Moreno, Chair
JUN 3 0 2021
Rachel Winterfeld
4907 West 23`d Street Road
Greeley, Colorado 80634
,& he1 teW�4(
By: Rachel Winterfeld (Jun 24, 20110:01 MDT)
Rachel Winterfeld
Jun 24, 2021
Date:
10
i-/7c,29
Revised 6/2021
EXHIBIT A
SCOPE OF SERVICES
1. Contractor will provide up to sixteen (16) hours of Respite care services per month per
child for foster children residing in Weld County certified foster homes.
2. Contractor will, at the time of entering into this Agreement, ensure he/she has completed
all the necessary paperwork and has in effect all necessary licenses, approvals, insurance,
etc., required to provide the Respite care services covered by this Agreement.
Contractor will have:
f. Completed and submitted the Colorado Department of Human Services
Application and signed as "Foster Parent/Home" PRIOR to completing the
PRIDE or NTDC training.
g. Successfully completed either fifteen (15) hours of PRIDE training or 27
hours of NTDC training through the County prior to the performance of
services under this Agreement.
h. Provided a copy of their current Colorado driver's license indicating
Contractor is at least eighteen (18) years of age; and
i. Completed a background check through the Colorado Bureau of
Investigation (CBI) and the Federal Bureau of Investigation (FBI).
j. Provided three (3) reference forms completed by non -relatives.
k. Provided proof of current CPR and First Aid certifications.
1. Completed and signed Confidentiality, Discipline and Mandated Reporter
Policies.
m. Provided proof that Contractor has procured at least the minimum amount
of automobile liability insurance required by the State of Colorado. County
provides no automobile liability coverage for Contractor.
Copies of all documentation relating to the foregoing requirements shall be provided to the
County by Contractor prior to the performance of any services covered under this
Agreement. County shall determine eligibility for certification based upon the successful
completion of all required training and receipt of current documentation.
Contractor further acknowledges that he/she will remain current with all documentation or
certifications for the term of this Agreement. Should an item expire or otherwise become
invalid, Contractor will submit current documentation to the County to avoid a lapse in
documentation and/or certification.
11 Revised 6/2021
3. Contractor acknowledges that the County shall not compensate Contractor for said
training; including time spent traveling to and from training, time spent in attendance at
the training, or any associated costs paid by Contractor for such training, unless
specifically agreed to in writing in advance by County.
4. Contractor acknowledges that arrangements to provide Respite care services must be
communicated to the child's Caseworker and the Foster Care Coordinator prior to Respite
taking place in order to discuss arrangements and ensure all the child's needs are met.
5. Contractor will become familiar with and follow all the State and Federal rules and
regulations as applicable to the services provided under this Agreement.
6. Contractor will complete and submit the Respite Care Payment Form each month by the
2°d of the month following the month of service. The Respite Care Payment Form will be
provided by the Foster Care Coordinator.
12 Revised 6/2021
EXHIBIT B
RATE SCHEDULE
1. Funding and Method of Payment
The County agrees to reimburse the Contractor in consideration of the work and services
performed under this Agreement at the rate specified in Paragraph 2, below. The total
amount to be paid to the Contractor during the term of this Agreement shall be reported by
the County after June 30, 2022.
Expenses incurred by the Contractor prior to the term of this agreement are not eligible
County expenditures and shall not be reimbursed by the County.
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 County,
the County may immediately terminate the Agreement or amend it accordingly.
2. Fees for Services
Respite care is limited to four (4) hours per week per child. The hours of care may be
provided in any combination throughout a month but may not exceed 16 hours per month.
Payment will be $16.75 per each four-hour period but may not exceed $67.00 per month for
16 hours.
Human Services referrals will not be sent to collections by Contractor for default of co-
pay/fees. Services will be performed regardless of client's refusal or inability to pay co -pay.
Contractor will collect any applicable sliding scale co -pays and credit Human Services for
any payments received on the monthly billing statements.
3. Submittal of Vouchers
Contractor shall prepare and submit a Respite Care Payment Form each month to certify that
the services authorized were provided on the date(s) indicated and the charges made were
pursuant to the terms and conditions of Exhibit A. The Respite Care Payment Form will be
provided by the Foster Care Coordinator.
13 Revised 6/2021
New Contract Request
Entity Information
Entity Name* Entity ID
WINTERFELD, RACHEL X00039311
Contract Name *
WINTERFELD, RACHEL RESPITE AGREEMENT
Contract Status
CTB REVIEW
Contract Description *
CONSENT RESPITE AGREEMENT. TERM: 7/1/21 -6/30/22.
Contract Description 2
PA WAS SENT TO CTB ON 6 x'
16 ? 21.
Contract Type *
Department
AGREEMENT
HUMAN SERVICES
Amount*
Department Email
$0.00
CM-
HumanServices@weldgov.co
Renewable *
m
NO
Department Head Email
Automatic Renewal
CM-HumanServices-
DeptHead`veldgov.com
Grant
County Attorney
GENERAL COUNTY
IGA
ATTORNEY EMAIL
County Attorney Email
CM-
COU NTYATTORN EYWELDG
OV.COM
if this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
❑ New Entity?
Contract ID
4895
Contract Lead *
APEGG
Contract lead Email
apegg aweldgov. com , co bbx
xlkweldgov.com
Parent Contract ID
20211643
Requires Board Approval
YES
Department Project #
Requested BOCC Agenda Due Date
Date* 06,262021
06x302021
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be in luded?
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
Contact Name
Purchasing
Purchasing Approver
CONSENT
Approval Process
Department Head
JAMIE ULRICH
DH Approved Date
06?2512021
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
06;'.30;2021
Originator
APEGG
Contact Type
Review Date
05(02/2022
Committed Delivery Date
Renewal Date
Expiration Date
06,30 2022
Contact Phone I Contact Phone 2
Purchasing Approved Date
0625:2021
Finance Approver
CONSENT
Finance Approved Date
0625/2021
Tyler Ref #
AG 063021
Legal Counsel
CONSENT
Legal Counsel Approved Date
06252021
Hello